Coma

37

Thursday, February 26, 8:47 P.M.

Susan dashed from the cab without paying and made a bee-line for the Memorial entrance. She had no money and did not intend to get into an argument. The driver jumped out of the cab, too, shouting angrily. He caught the attention of one of the guards, but Susan was already through the entrance.

Susan had to slow to a walk in the main hall. Ahead of her she was dismayed to see Bellows, headed in the same direction. Susan worked her way up to a position directly behind him and debated with herself about catching his attention. She thought again about how he had caused her to disregard the tissue typing done on the coma patients. There was a chance that Bellows was involved. Besides, she remembered Stark’s admonition to speak to no one. So when they reached the corner of the corridor, Susan let Bellows continue down toward the ER. She turned toward the Beard elevators. One was waiting, and she got on and pushed 10.

Susan’s view of the hall became progressively occluded by the closing door. But at the very last minute a hand wrapped around the edge of the door, halting it. Susan stared blankly at it before the face of a guard came into view.

“I would like to have a word with you, Miss,” he said, still holding the door open despite its continued attempts to close, as Susan pressed on the “door close” button.

“Please come off the elevator.”

“But I’m in a terrible hurry. It’s an emergency.”

“The emergency room is on this floor, Miss.”

Susan reluctantly complied with the guard’s demands and got off the elevator. The doors closed behind her, and the car began its ascent to the tenth floor without any occupants.

“It’s not that kind of emergency,” pleaded Susan.

“So much of an emergency you couldn’t pay your cab?” The guard’s voice was a mixture of admonition and concern. Susan’s appearance lent a definite credence to her plea that it was an emergency.

“Take his name and company, and I’ll settle it later. Look, I’m a third-year medical student. My name is Susan Wheeler. I have no time at this moment.”

“Where are you going at this hour?” The guard’s tone had become almost solicitous.

“Beard 10. I’m meeting one of the doctors there. I’ve got to go.” Susan depressed the up button.

“Who?”

“Howard Stark. You can call him.”

The guard was confused, dubious. “All right. But stop by the security office on your way down.”

“Of course,” agreed Susan as the guard turned to go.

Just then the next elevator arrived and Susan boarded it, pushing past a few departing passengers, who looked at her disheveled appearance curiously. On the slow ride up to 10 she leaned against the car’s wall gratefully.

The corridor presented a totally different environment from the one she remembered from her previous daytime visit. The typewriters were quiet The patients gone. The floor was as still as a morgue. The thick carpet absorbed the sound of her own hesitant footsteps as she moved toward her goal and safety. The only light came from a lonely table lamp in the middle of the hall. The New Yorker magazine stacks which could be seen were carefully straightened. The faces on the portraits of the former Memorial surgeons were smudges of violet shadow.

Susan approached Stork’s office and hesitated for a moment, composing herself. She was about to knock, but tried the door. It opened. The anteroom of Stark’s secretary was dark, but the door to his private office was slightly ajar, light slanting through it. Susan pushed open the door and stepped in.

The door shut behind her that instant Susan’s overwrought psyche caused a tremendous panic reaction as she whirled to face an assailant. She had to fight to keep from screaming.

Stark was locking the door. He must have been behind her.

“Sorry for the dramatics, but I don’t think we want anyone interrupting this conversation.” He smiled suddenly. “Susan, you’ll never know how glad I am to see you. After these experiences you told me about, I should have insisted on picking you up from when you called. But no matter, you got here safely. Do you think you were followed?”

Susan’s fight reaction tapered, her heart rate reached an apogee and began to slow. She swallowed. “I don’t think so, but I can’t be sure.”

“Come and sit down. You look like you’ve been through World War I.” Stark touched Susan’s arm, guiding her to a chair in front of his desk. “Looks like you could use a little Scotch, at the very least.”

Susan felt a terrible exhaustion; mental, physical, and emotional, descend over her. She didn’t respond audibly. She simply followed, her chest heaving. She sank into the chair, barely comprehending what she had been through.

“You’re an amazing girl,” said Stark, walking over to the small bar cabinet across the room.

“I don’t think so,” returned Susan, her voice reflecting her exhaustion. “I just happened to walk blindly into an amazing horror.”

Stark got a bottle of Chivas Regal. He carefully poured out two drinks and brought them over to the desk. He handed one to Susan. “I think you’re being too modest.” Stark rounded his desk and sat down, his gaze fixed on Susan. “You’re not hurt, are you?”

Susan shook her head, her hand inadvertently shaking her drink so that the ice clinked against the side of the glass. She tried to steady herself by using both hands. She took a mouthful of the comforting, fiery liquid, letting it slide down her throat between deep breaths.

“Now then, Susan. I want to make sure where we stand. Have you spoken to anyone since we talked?”

“No,” said Susan taking another drink.

“Good, that’s very good.” Stark paused, watching Susan sip her drink. “Does anyone besides yourself have any idea about all this?”

“No. No one.” The Scotch felt delightfully warm inside Susan, and she began to feel a calmness settle over her. Her breathing began to slow to normal She looked at Stark over her glass.

“OK, Susan, now why do you think the Jefferson Institute is a clearing house for transplant organs?”

“I heard them talking. I even saw the shipping cartons for the organs myself.”

“But Susan, it isn’t surprising to me mat a hospital Med with chronic-care, comatose patients would be a source of transplant organs as the patients succumb to their disease processes.”

“That might be true. But the problem is that the people behind this were the ones making at least some of those patients comatose in the first place. Besides, they were getting paid for these organs. Paid a lot of money.” Susan felt her upper eyelids droop, and she raised them forcefully. She felt a torpor stealing over her. She knew she was exhausted but dragged herself straighter in the chair. She took another mouthful of the Scotch and tried not to think about D’Ambrosio. At least she felt warm.

“Susan, you are amazing. I mean, you were only in the place for a short time. How did you learn so much so quickly?”

“I had floor plans from City Hall. They showed operating rooms, and the girl who was showing me around said there were no operating rooms. So I checked them out myself. Then it was clear. Frightfully clear.”

“I see. Very clever.” Stark nodded his head, marveling at Susan. “And they let you leave. I would have imagined that they would have preferred that you stay.” He smiled again. “I was lucky. Extremely lucky. I left with a heart and a kidney on their way to Logan.” Susan suppressed a yawn, trying to hide it from Stark. She felt tired, very tired.

“That’s all very interesting, Susan, and that’s probably all the information I really need. But… you are to be commended. Your activities over the last few days are a study in clairvoyance and perseverance. But let me ask you a few more questions. Tell me…” Stark put his hands together and rotated in his chair so that he could see out over the black waters of the harbor. “Tell me if you can think of any other reasons for this fantastic operation you have so cleverly exposed.”

“You mean, other than money?”

“Yes, other than money.”

“Well, it is a good way to get rid. of someone you don’t want around.”

Stark laughed inappropriately, or so it seemed to Susan.

“No, I mean a real benefit. Can you think of any benefits other than financial?”

“I guess the recipients of the organs get a certain benefit, if they don’t have to know how the donor organ was obtained.”

“I mean a more general benefit. A benefit for society.”

Susan again tried to think, but her eyes wanted to close. She straightened up again. Benefit? She looked at Stark. The meaning of the conversation was becoming diffuse, strange.

“Dr. Stark, I hardly think this is the time…”

“Come on, Susan. Try. You’ve done such a remarkable job at uncovering this thing. Try to think. It’s important.”

“I can’t. It’s such a horror that I have difficulty even considering the word benefit.” Susan’s arms began to feel heavy. She shook her head. For a second she thought she had actually fallen asleep.

“Well, then I’m surprised at you, Susan. From the intelligence that you have so amply displayed over the last couple of days, I thought that you would have been one of the few to see the other side.”

“Other side?” Susan closed her eyes tightly, then opened them, hoping they would stay open.

“Exactly,” Stark rotated back toward Susan, leaning forward, arms on the desk. “Sometimes there are situations where… what should I say… the common folk, if you will, cannot be depended upon to make decisions which win provide long-term benefits. The common man thinks only of his short-run needs and selfish requirements.”

Stark got up and wandered over to the corner where the expansive walls of glass joined. He looked out over the great medical complex he had helped to build. Susan felt herself unable to move. She even had difficulty turning her head. She knew she was tired but she never felt so heavy, so languorous. Besides, Stark kept going in and out of focus.

“Susan,” Stark said suddenly, turning around to face her again, “you must realize that medicine is on the brink of probably the biggest breakthrough in all of its long history. The discovery of anesthesia, the discovery of antibiotics… any of those epochal achievements will pale before the next giant step. We are about to crack the mystery of the immunological mechanisms. Soon we’ll be able to transplant all human organs at will. The fear of most cancer will become a thing of the past. Degenerative disease, trauma… the scope is infinite.

“But such breakthroughs do not come easy, not without hard work and sacrifice. Not without a price. We need first-rate institutions, like the Memorial and its facilities. Next we need people like myself, indeed like Leonardo Da Vinci, willing to step beyond restrictive laws in order to insure progress. What if Leonardo Da Vinci had not dug up his bodies for dissection? What if Copernicus had knuckled under to the laws and dogma of the church? Where would we be today? What we need for the breakthrough to actually happen is data, hard data. Susan, you have the mind to appreciate that.”

Despite the darkening cloud she felt settling over her brain, Susan began to realize what Stark was saying. She tried to get up, but she found she could not lift her arms. She strained but only succeeded in knocking the remains of her drink to the floor. The ice cubes scattered.

“You do understand what I am saying, Susan? I think you do. Our legal system is not geared to handle our needs. My God, they cannot make a decision to terminate a patient even after it is certain that his brain has turned to lifeless Jell-O. How can science proceed under a public policy handicap of that proportion?

“Now, Susan, I want you to think carefully. I know it is a little hard for you to think at this moment, but try. I want to say something to you and I want your response. You are a bright, very bright, girl. You’re obviously one of the… what should I say?… elite sounds too much like a cliché, but you know what I mean. We need you, people like you. What I want to say is that the people who run the Jefferson Institute are on our side. Do you understand, our side?”

Stark paused, looking at Susan. She struggled to keep her eyelids above her pupils. It took all her strength.

“What do you say to that, Susan? Are you willing to dedicate that brain of yours to the good of society, science, and medicine?”

Susan’s mouth formed words but they came out in a whisper. Her face was expressionless. Stark leaned forward to hear. He had to bring his head up to within inches of Susan’s lips.

“Say it again, Susan. I’ll be able to hear if you say it again.”

Susan’s mouth struggled to bring her lower lip against her upper teeth to form the first consonant. It spilled out in a whisper.

“Fuck you, you cra—” Susan’s head slumped back, her mouth gaping and her respirations coming in regular deep-sounding breaths.

Stark looked at Susan’s drugged body for a few moments. Susan’s defiance angered him. But after a few moments of silence his emotion faded into disappointment. “Susan, we could have used that brain of yours.” Stark shook his head slowly. “Well, maybe you can still be useful.”

Stark turned to his phone and called the emergency room. He asked for the admitting resident.