Cannabis
Pentachlorophenol
Carbon disulfide
Phenol
Carbon monoxide
Salicylates
Carbon tetrachloride Sulfanilamide
Chloral hydrate
Sulfides
Cyanide
Tetrahydrozaline
Glutethimide Vitamin
D
Herbicides
Hypnotic
agents
Hydrocarbons
Susan knew that the list was not complete but nonetheless it gave her something to go on, something to keep in mind during her subsequent investigations, and it could be enlarged at any time.
Turning next to the general internal medicine textbooks, Susan opened the ponderous Principles of Internal Medicine and read the appropriate sections dealing with coma. The articles in Cecil and Loeb were about the same. Both books provided a rather good overview, although no new concepts were added. Several references were cited which Susan duly copied down in an ever-expanding list of necessary reading.
It felt good to get up and stretch. Susan allowed a deep comforting yawn. She wiggled her toes to try to encourage the blood to go there.
The cold draft along the floor had made her stir sooner than she might have otherwise. But once up she turned to the Index Medicus, the exhaustive listing of all articles published in all the medical journals.
Starting with the “most recent volumes and working backward, Susan searched for and extracted every article concerning acute coma and every article under the heading “Anesthetic complications: delayed return to consciousness.” By the time she had worked herself back to 1972, Susan had a list of thirty-seven prospective papers worth reading.
One title especially caught Susan’s attention: “Acute Coma at the Boston City Hospital: A Retrospective Statistical Study of Causes,”
Journal of the American Association of Emergency Room Physicians, volume 21, August 1974, pp. 401-3. She found the bound volume containing the article and was soon immersed in it, taking notes as she read.
Bellows had to call her by name before she looked up at him. He had come into the library, located her, and had taken the seat directly across from her. But she did not look up from her reading. Bellows had tried clearing his throat with absolutely no effect. It was as if Susan were in a trance.
“Dr. Susan Wheeler, I believe,” said Bellows, leaning over the table, his shadow falling across the journal in front of her.
Susan finally responded and looked up. “Dr. Bellows, I presume.” Susan smiled.
“Dr. Bellows is right. God, what a relief. I thought for a moment you were in a coma.” Bellows shook his head up and down, as if he were agreeing with himself.
Neither one of them spoke for a few moments. Bellows had prepared a short speech during which he was going to correct any impression he might have given Susan that she was free to cut lectures. He had decided to tell her in plain language that she had to get her ass in gear.
But once confronting her, sense of purpose failed, leaving him as directionless as a sailboat becalmed. Susan remained silent because her intuition had informed her that Bellows had something to say. The silence soon became mildly awkward.
Susan broke it.
“Mark, I’ve been doing a bit of interesting reading here. Look at these figures.”
She stood up and leaned across the table, holding out the journal so that Bellows could see the page. As she did so, her blouse fell away from her chest. Bellows found himself staring down at her splendid breasts, barely contained by a sheer flimsy bra, their skin of a smoothness Bellows imagined to be like velvet. He tried to concentrate on the page Susan was showing him, but his peripheral vision continued to record the insistent image of Susan’s lovely torso. Self-consciously Bellows scanned the library, certain that his preoccupation would be transparent to anyone in the room.
Susan was oblivious to the mental havoc she was inadvertently causing.
“This chart here shows the order of incidence of the various types of acute fatal coma appearing at the emergency room at the Boston City Hospital,” said Susan, running her fingers along the lines. “One of the most amazing facts is that only fifty percent of the cases are ever diagnosed. I find that amazing; wouldn’t you agree? That means that fifty percent of the cases are never diagnosed. They just come in to the ER in coma and die. Just like that.”
“Yeah, it’s amazing,” said Bellows, putting his left hand up to his temple to try to keep from seeing what he was seeing.
“And look here, Mark, at the causes of the cases which they do diagnose: sixty percent are due to alcohol, thirteen percent due to trauma, ten percent to strokes, three percent to drugs or poisons, and the rest divided up among epilepsy, diabetes, meningitis, and pneumonia.
Now obviously ...,” said Susan, sitting back down and relieving the stress on Bellows’s hypothalamus.
Bellows glanced around once more to make sure that no one had noticed the episode.
“... we can dismiss alcohol and trauma as far as causing acute coma in the OR is concerned. So ... that leaves us with strokes, then drugs or poisons, and the others in decreasing probability as possible culprits.”
“Wait a second, Susan,” said Bellows pulling himself together. He put his elbows on the table with his forearms up in the air, his hands drooped but engaged. His head was down at first, then he picked it up and looked at Susan. “That’s all very interesting. A little farfetched, but interesting.”
“Farfetched?”
“Yeah. You cannot possibly extrapolate data from the ER to the OR. But anyway, I didn’t come in here looking for you to argue about that. I came in here because you haven’t been answering your pages. I know, because it was me who was paging you. Look, I’m going to have trouble if you don’t show up for conferences. You’re going to make trouble for yourself, and the fact of the matter is that, while you’re on my service, your trouble is my trouble. I can only make excuses for you for so long. I mean, you can be drawing blood or scrubbing just so often. Stark will be asking questions before you know it. He’s phenomenal. He knows everything that’s going on around here. Besides, you’ll get the reputation of being a phantom among your own section students. Susan, I’m afraid you’re going to have to restrict your research proclivities to after-hours.”
“Are you finished?” asked Susan, rising to the defense.
“I’m finished.”
“Well, answer me this one question. Has Berman or Greenly awakened yet?”
“Of course not ...”
“Then frankly, I believe that my current activities eclipse the importance of a few boring surgical conferences.”
“Oh my aching back! Susan, be reasonable. You’re not going to save the world during your first week on surgery. I’m going out on a limb for you as it is.”
“I appreciate it, Mark. Really I do. But listen. My few hours here in the library have already provided some
