converting her emotionalism to defiance.
“How many such cases have there been in the last year?” asked Susan.
Harris’s eyes scanned Susan’s face for several seconds before he responded. “I suddenly find this conversation somewhat akin to being cross-examined, and in that sense intolerable and unnecessary.” Without waiting for a response, Harris walked past Susan toward the recovery room door.
Susan turned to face him. Bellows reached for her right arm to try and shut her up. Susan fended him off. She called after Harris, “Without wishing to sound impertinent, it does seem to me that some questions need to be asked by someone, and something done.”
Harris stopped abruptly about ten feet from Susan and turned very slowly. Bellows shut his eyes tightly, as if he expected to receive a blow to the head.
“And I suppose that someone should be a medical student! For your information, in case you are planning to be our Socratic gadfly, there have been six cases prior to this present problem in the last few years.
Now if I may have your permission, I will get back to work.”
Harris turned again and started for the door.
“I suppose your emotionalism serves constructive purposes,” called Susan. Bellows supported himself by leaning onto the bed. Harris stopped for the second time, but he did not turn around. Then he continued, and he too blasted open the door to the hall.
Bellows put his left hand up to his forehead. “Holy fuck, Susan, what are you trying to do, commit medical suicide?” Bellows reached out and turned Susan around to face him. “That was Robert Harris, Chief of Anesthesia. Christ!”
Bellows commenced the prep for the third time, rapidly, nervously. “You know, just being here with you when you act like that makes me look bad.
Shit, Susan, why did you want to get him pissed?” Bellows palpated the radial artery and then jammed the needle of the heparinized syringe into the skin on the thumb side of Berman’s wrist. “I’m going to have to say something to Stark before he hears about it through the grapevine.
Susan, I mean, what’s the point of getting him mad? You obviously don’t have any idea what hospital politics are like.”
Susan watched Bellows performing the arterial stick. She consciously avoided looking at Berman’s sickly face. The syringe began to fill with blood spontaneously. The blood was a very bright crimson.
“He got mad because he wanted to get mad. I don’t think I was impertinent until that last question, and he deserved that.”
Bellows didn’t answer.
“Anyway I really didn’t want to make him angry ... well, maybe I did in a way.” Susan thought for a few moments. “You see, I talked with this patient only an hour or so ago. He was the patient I had to leave the ICU
for. It’s just so unbelievable; he was a functioning, normal human being.
And ... I ... we had a conversation and I felt like I knew something about him. I even took a liking to him in a way. That’s what makes me mad or sad or both. And Harris, his attitude made it worse.”
Bellows didn’t respond immediately. He searched in the tray for a syringe cap. “Don’t tell me anymore,” he said at length. “I don’t want to hear about it. Here, hold the syringe for me.” Bellows gave Susan the syringe while he prepared the ice bed. “Susan, I’m afraid you’re going to be poison for me around here. You have no idea how miserable someone like Harris can make it. Here, put pressure on the puncture site.”
“Mark?” said Susan pressing on Berman’s wrist but looking at Bellows directly. “You don’t mind if I call you Mark, do you?”
Bellows took the syringe and placed it into the ice bath. “I’m not sure, to be perfectly honest.”
“Well, anyway, Mark, you have to admit that six, and maybe seven, cases, if Berman proves to be like Greenly, represents a lot of cases of brain death, or vegetables, as you call them.”
“But a lot of surgery goes on here, Susan. It’s often more than a hundred cases a day, some twenty-five thousand per year. That drops the six cases below some two hundredths of one percent in incidence.
That’s still within the surgical anesthesia risk.”
“That may be true, but these six cases represent only one type of possible complication, not surgical- anesthesia risk in general. Mark, it’s got to be too high. In fact, down in the ICU this morning you said that the particular complication Nancy Greenly represented occurred only about one in a hundred thousand. Now you’re trying to tell me that six in twenty-five thousand is OK. Bullshit. It’s too high whether you or Harris or anybody in the hospital accept it. I mean would you want to have some minor surgery tomorrow with that kind of risk? You know this whole thing really bothers me, the more I think about it.”
“Well then, don’t think about it. Come on, we’ve got to get moving.”
“Wait a minute. You know what I’m going to do?”
“I can’t guess and I’m not sure I want to know.”
“I’m going to look into this particular problem. Six cases. That should be enough for some reasonable conclusions. I do have a third-year paper to do and I think I owe that much to Sean here.”
“Oh for Christ sake, Susan, let’s not be melodramatic.”
“I’m not being melodramatic. I think I’m responding to a challenge. Sean challenged me earlier with my image of myself as a doctor. I failed. I wasn’t detached or professional. You might even say I acted like a schoolgirl. Now I’m challenged again. But this time intellectually with a problem, a serious problem. Maybe I can respond to this challenge in a more commendable fashion. Maybe these cases represent a new symptom complex or disease process. Maybe they represent a new complication of anesthesia because of some peculiar susceptibility these people had from some previous insult which they suffered in the past.”
“All the more power to you,” said Bellows getting the remains from the arterial stick together. “Frankly though, it sounds like a hell of a hard way to work out some emotional or psychological adjustment problem of your own. Besides, I think you’ll be wasting your time. I told you before that Dr. Billing, the anesthesiology resident on Greenly’s case, went over it with a fine-toothed comb. And believe me, he’s bright. He said that there was absolutely no explanation for what happened.”
“Your support is appreciated,” said Susan. “I’ll start with your patient in the ICU.”
“Just a minute, Susan dear. I want to make one point crystal clear.”
Bellows held up his index and middle finger like Nixon’s victory sign.
“With Harris on the rag, I don’t want to be involved, no how.
Understood? If you’re crazy enough to want to get involved, it’s your bag from A to Z.”
“Mark, you sound like an invertebrate.”
“I just happen to be aware of hospital realities and I want to be a surgeon.”
Susan looked Mark directly in the eye. “That, Mark, in a nutshell, is probably your tragic flaw.”
Monday, February 23, 1:53 P.M.
The cafeteria at the Memorial could have been in any one of a thousand hospitals. The walls were a drab yellow that tended toward mustard. The ceiling was constructed of a low-grade acoustical tile. The steam table was a long L-shaped affair with brown, stained trays stacked at the beginning.
The excellence of the Memorial’s clinical services did not extend into the food service. The first food seen by an unlucky customer coming into the cafeteria was the salad, the lettuce invariably as crisp as wet Kleenex. To heighten the disagreeable effect, the salads were stacked one on top of the other.
The steam table itself presented the hot selections, which posed a baffling mystery. So many things tasted alike that they were indistinguishable. Only carrots and corn stood aside. The carrots had their own disagreeable taste; the corn had absolutely no taste at all.
By quarter to two in the afternoon, the cafeteria was almost empty.
The few people who were sitting around were mostly kitchen employees, resting after the mad lunchtime rush. As bad as the food was, the cafeteria was still heavily patronized because it enjoyed a monopoly. Few people in the hospital complex took more than thirty minutes for lunch, and there simply was not enough time to go
