“Why don’t I go ahead and do this one, and you do the next one,” said Bellows. Susan nodded in agreement as they approached the bed. They could not see the patient because of the people standing in the way.
There were several nurses on the left, two doctors in scrub suits at the foot, and a tall black doctor in a long white coat on the right. As Bellows and Susan drew near, it was obvious that the latter individual had been talking although at that moment he was adjusting the pressure setting on the respirator. Susan sensed the emotional climate instantly. Both of the doctors in scrub suits were obviously intensely concerned. The smaller individual, Dr. Goodman, was visibly shaking. The other, Dr. Spallek, had his mouth angrily set with clenched teeth, audibly breathing through his nostrils as if he were about to attack the next person in his path.
“There’s got to be some sort of an explanation,” snarled the infuriated Spallek. He took hold of his face mask still tied around his neck and yanked it free, snapping the cord. He flung it to the floor. “That doesn’t seem too much to ask,” he hissed before abruptly turning away and leaving. He collided with Bellows, who miraculously managed to juggle the small tray he was carrying without dropping any of its contents. There were no words of apology from Dr. Spallek. He crossed the recovery room and blasted open the doors to the hall.
Bellows went directly to the left of the bed and put down the tray.
Susan advanced warily, watching the expressions of the remaining people.
The black doctor straightened up and his dark eyes followed the exit of the irate Dr. Spallek. Susan was immediately taken by the imposing image of the man. His tag gave his name: Dr. Robert Harris. He was tall, well over six feet, his dark hair textured into a restrained Afro. His blemishless tawny skin shone, and his face reflected a curious combination of culture and restrained violence. His movements were calm, almost to the point of deliberate slowness. As his eyes returned from watching Spallek’s exit they passed over Susan’s face before returning to the respirator at the side of the bed. If he had noticed Susan, he gave no hint whatsoever.
“What did you use for the pre-op, Norman?” asked Harris, pronouncing each word carefully. He had a cultured Texas accent—if that were possible.
“Innovar,” said Goodman. The pitch of his voice was abnormally high and cracking under the strain.
Susan moved up to the foot of the bed where Spallek had been standing. She studied the crumpled man next to her, Dr. Goodman. He looked pale and his hair was matted with perspiration to his forehead. He had a prominent nose, which Susan saw in perfect profile. His deep-set eyes were riveted to the patient. He did not blink.
Susan looked down at the patient, her eyes wandering to the wrist which Bellows was prepping for the arterial stick. With an exaggerated double-take, her eyes shot back to the face of the patient as recognition occurred. It was Berman!
In contrast to the tanned visage Susan recalled from their meeting in room 503 only ninety minutes ago, Berman’s face was a dusky gray color.
The skin was pulled taut over his cheekbones. An endotracheal tube protruded from the left side of his mouth and some dried secretion was crusted along his lower lip. His eyes were closed but not completely. His right leg was in a huge plaster cast.
“Is he all right?” blurted Susan looking from Harris to Goodman. “What happened?” Susan spoke from emotion, without thinking; she sensed something was wrong and she reacted impulsively. Bellows was surprised at her sudden questions and looked up from his work, holding the syringe in his right hand. Harris straightened up slowly and turned toward Susan.
Goodman’s eyes did not stray.
“Everything is absolutely perfect,” said Harris with a pronunciation suggesting an Oxford sojourn some time in his past. “Blood pressure, pulse, temperature all perfectly normal. However, he has apparently enjoyed his anesthetic slumber so much that he has decided not to wake up.”
“Not another one,” said Bellows, switching his attention to Harris and concerned that he was going to be saddled with another problem like Greenly. “What does the EEG look like?”
“You’ll be the first to know,” said Harris with a trace of sarcasm. “It’s been ordered.”
Comprehension for Susan was delayed by emotion, for hope was momentarily stronger than reason. But eventually it flooded over her.
“EEG?” asked Susan apprehensively. “You mean he’s like the patient down in the ICU?” Her eyes darted back and forth between Berman and Harris, then to Bellows.
“Which patient is that?” asked Harris, picking up the anesthesia record.
“The D&C mishap,” said Bellows. “You remember, about eight days ago, the twenty-three-year-old girl.”
“Well I hope not,” said Harris, “but it’s beginning to look that way.”
“What was the anesthesia?” asked Bellows lifting Berman’s right eyelid and glancing down into the widely dilated pupil.
“Neurolept anesthesia with nitrous,” said Harris. “The girl’s was halothane. If the problem is the same clinically, it wasn’t the anesthetic agent.” Harris looked up from the anesthesia record toward Goodman.
“Why did you give this extra cc of Innovar toward the end of the case, Norman?”
Dr. Goodman did not respond immediately. Dr. Harris called his name again.
“The patient seemed to be getting too light,” said Goodman, suddenly breaking his trance.
“But why Innovar so late in the case? Wouldn’t fentanyl alone have been more prudent?”
“Probably. I should have used the fentanyl alone. The Innovar was just handy and I knew that I’d only use an additional cc.”
“Can’t something be done?” asked Susan with a hint of desperation.
Images of Nancy Greenly streamed back with bits and pieces of the recent conversation with Berman. She could distinctly remember his vitality, which was in sharp contrast to the waxy, lifeless-appearing figure before her.
“It’s been done, whatever it was,” said Harris with finality, returning the anesthesia record to Goodman. “All we can do now is watch and see what kind of cerebral function returns, if any. The pupils are widely dilated and they do not react to light. That is not a good sign, to say the least. It probably means that there was extensive brain death.”
Susan experienced a sickening feeling rise up within herself. She shuddered and the feeling passed but she felt lightheaded. Above all, she felt helplessly desperate.
“This is too much,” said Susan suddenly and with obvious emotion. Her voice quivered. “A normal healthy man with a minor peripheral problem ends up like a ... like a vegetable. My God, this can’t go on. Two young people within just a couple of weeks. I mean, it’s an unacceptable risk.
Why doesn’t the Chief of Anesthesia close the department? Something’s got to be wrong. It’s absurd to allow ...”
Robert Harris’s eyes began to narrow as Susan began her tirade. Then he interrupted her with an obvious edge to his. voice. Bellows’s mouth had dropped open in total dismay.
“I happen to be the Chief of Anesthesia, young lady. And who, may I ask, are you?”
Susan started to speak, but Bellows cut in nervously. “This is Susan Wheeler, Dr. Harris, a third-year medical student who is rotating on surgery, and, ah ... we just wanted to get this blood drawn here, then we’ll be off.” Bellows recommenced his prep on Berman’s right wrist, stroking rapidly with the Betadine sponge.
“Miss Wheeler,” continued Harris in a condescending tone, “your emotionalism is out of place and frankly will not serve constructive purposes. What one needs in those cases is to establish a causal factor.
I’ve just mentioned to Dr. Bellows that the anesthetic agent was different in these two cases. The anesthetic care was unimpeachable save for a few minor debatable points. In short, both these cases were obviously unavoidable idiosyncratic reactions to the combination of anesthesia and surgery. One needs to try to determine from these people if there is a way in order to forecast this kind of disastrous sequelae. To condemn anesthesia across the board and deprive the populace of needed surgery would be far worse than to accept a certain minimal risk involved in anesthesia. What ...”
“Two cases in eight days is hardly a minimal risk,” interrupted Susan contentiously.
Bellows tried to catch Susan’s eye to get her to break off with Harris, but Susan was staring directly at Harris,
