elsewhere.
Susan took a salad but after one look at the limp lettuce, she replaced it. Bellows went directly to the sandwich area and took one.
“There’s not much they can do to a tuna sandwich,” he called back to Susan.
Susan eyed the hot entrees and moved on. Following Bellows’s lead, she selected a tuna sandwich.
The woman who was supposed to be at the cash register was nowhere to be seen.
“Come on,” motioned Bellows, “we ain’t got much time.”
Feeling a bit like a shoplifter by not paying, Susan followed Bellows to a table and sat down. The sandwich was repellent. Somehow too much water had gotten into the tunafish and the tasteless white bread was soggy. But it was food and Susan was famished.
“We’ve got a lecture at two,” garbled Bellows through a huge bite of sandwich. “So eat hearty.”
“Mark?”
“Yeah?” said Bellows as he gulped half his milk in one swig. It was apparent that Bellows was a speed eater of Olympic caliber.
“Mark, you wouldn’t be hurt if I cut your first surgery lecture, would you?” Susan had a twinkle in her eye.
Bellows stopped the second half of his tuna sandwich midway to his mouth and regarded Susan. He had an idea that she was flirting with him, but he dismissed it.
“Hurt? No, why do you ask?” Bellows had a helpless feeling that he was being manipulated.
“Well I just don’t think I could sit through a lecture at this moment in time,” said Susan, opening her milk carton. “I’m a little spaced from this affair with Berman. ... Affair is not the right word. Anyway I’m really uptight; I couldn’t handle a lecture. If I do something active I’ll be much better off. I was thinking that I’d go to the library and look up something about anesthesia complications. It will give me a chance to start my ‘little’ investigation as well as sort out this morning in my mind.”
“Would you like to talk about it?” asked Bellows.
“No, I’ll be OK, really.” Susan was surprised and touched by his sudden warmth.
“The lecture isn’t critical. It’s an introductory kind of thing by one of the emeritus professors. Afterwards I planned for you students to come on the ward to meet your patients.”
“Mark?”
“What?”
“Thanks.”
Susan stood up, smiled at Bellows, and left.
Bellows put the second half of his tuna sandwich into his mouth and chewed it on the right side, then he moved it over to the left cheek. He wasn’t even sure what Susan had thanked him for. He watched her cross the cafeteria and deposit her tray in the rack. She rescued her unfinished milk and sandwich before leaving. At the door she turned and waved. Bellows waved in return but by the time he got his hand up, she had already disappeared.
Bellows looked around self-consciously, wondering if anyone had noticed him with his hand in the air. Replacing his hand on the table, he thought about Susan. He had to admit that she attracted him in a refreshing, basic way, reminding him of the way he felt early in his social career: an excitement, an unsettling impatience. His imagination conjured up sudden romantic pursuits with Susan as the object. But as soon as he did so, he reprimanded himself for being juvenile.
Bellows polished off his milk with another gigantic gulp while carrying his tray to the dirty-dish cart. En route he wondered if he dared to ask Susan out. There were two problems. One was the residency and Stark.
Bellows had no idea how the chief would react to one of his residents dating a student assigned to him. Bellows was not sure if such a worry was rational or not. He did know that Stark tended to favor married residents. The idea was that the married ones would be more dependable, which, as far as Bellows was concerned, was pure bunk. But there was little hope of keeping a relationship between himself and one of the students a secret. Stark would find out and it could be bad. The second problem was Susan herself. She was sharp; there was no question about that. But could she be warm? Bellows had no idea. Maybe she was just too busy, or too intellectualized, or too ambitious. The last thing that Bellows wanted to do was to squander his limited free time on some cold, castrating bitch.
And what about himself? Could Bellows handle a sharp girl who was in his own field even if she were warm and lovable? He had dated a few nurses, but that was different because nurses were allied with but distinct from doctors. Bellows had never dated another doctor or even doctor-to-be. Somehow the idea was a bit disturbing.
Leaving the cafeteria, Susan enjoyed a greater sense of direction than she had felt all day. Although she had no idea how she was actually going to investigate the problem of prolonged coma after anesthesia, she felt that it represented an intellectual challenge which could be met by applying scientific methods and reasoning. For the first time all day she had a feeling that the first two years of medical school had meant something. Her sources were to be the literature in the library and the charts of the patients, particularly Greenly’s and Berman’s.
Near to the cafeteria was the hospital gift shop. It was a pleasant place, populated and run by an assortment of gracefully aging’
suburbanite women dressed in cute pink smocks. The windows of the shop faced the main hospital corridor and were mullioned, giving the shop an appearance of a cottage smack dab in the middle of the busy hospital.
Susan entered the gift shop and quickly found what she was after: a small black loose-leaf notebook. She slipped the purchase into her pocket of her white coat and left for the ICU. Her jumping-off point would be the case of Nancy Greenly.
The ICU was back to its pre-arrest hush. The harsh illumination had been dampened to the level Susan recalled from her first visit. The instant the heavy door closed behind her, Susan tasted the same anxiety she had noted before, the same feeling of incompetence. Again she wanted to leave before something happened and she was asked the simplest of questions to which she would undoubtedly have to answer a demoralizing “I don’t know.” But she did not bolt. Now she at least had something to do which gave her a modicum of confidence. She wanted the chart of Nancy Greenly.
Looking to the left, Susan noticed that no one was standing by Nancy Greenly’s bed. The potassium level had apparently been rectified and the heart was beating normally once again. The crisis over, Nancy Greenly was forgotten and allowed to return to her own infinity. Willing machines resumed the vigil over her vegetablelike functions.
Drawn by an irresistible curiosity, Susan walked over to Nancy Greenly’s side. She had to struggle to keep her emotions in check and to keep the identification transference to a minimum. Looking down at Nancy Greenly, it was difficult for Susan to comprehend that she was looking at a brainless shell rather than a sleeping human being. She wanted to reach out and gently shake Nancy’s shoulder so that she would awaken so that they could talk.
Instead, Susan reached out and picked up Nancy’s wrist. Susan noted the delicate pallor of the hand as it drooped, lifelessly. Nancy was totally paralyzed, completely limp. Susan began to think about paralysis from destruction of the brain. The reflex circuits from the periphery would still be intact, at least to some degree.
Susan grasped Nancy’s hand as if she were shaking it and slowly flexed and extended the wrist. There was no resistance. Then Susan flexed the wrist forcefully to its limit, the fingers almost touching the forearm.
Unmistakenly Susan felt resistance, only for an instant but nonetheless definite. Susan tried it with the other wrist; it was the same. So Nancy Greenly was not totally flaccid. Susan felt a certain sense of academic pleasure; the irrational joy of the positive finding.
Susan found a percussion hammer for tendon reflexes. It was made of hard red rubber with a stainless steel handle. She had had one used on herself and had tried one on fellow students in physical diagnosis classes, but never used one on a patient. Clumsily Susan tried to elicit a reflex by tapping Nancy Greenly’s right wrist. Nothing. But Susan was not exactly sure where to tap. Instead she pulled up the sheet on the right side and tapped under the knee. Nothing. She flexed the knee with her left hand and tapped again. Still nothing. From neuroanatomy class Susan remembered that the reflex she was searching for came from a sudden stretch of the tendon. So she stretched Nancy Greenly’s knee more, then tapped. The thigh muscle contracted almost imperceptibly. Susan tried it again, eliciting a reflex that was no more than a slight tightening of the flaccid muscle. Susan tried it on the left
