Susan was still clutching her notebook and a ballpoint pen. Gritting her teeth, and swearing loudly enough to hear an echo, she threw the notebook and the pen down the course of stairs to the landing below. The notebook bounced on the edge of a stair, then fell flat, cover down, onto the floor. It skidded across the landing and struck the wall, coming to a rest unhurt and open. The pen flipped over the edge of the stairs and a few telltale sounds suggested that it had descended to the bowels of the hospital.
Uninviting as it was, Susan sat down on the top stair, her feet on the very next step, bringing her knees up at acute angles. Her elbows rested on the tops of her knees. She closed her eyes tightly. So much of her experience in medicine with relationships had been reemphasized in the short time she had been at the Memorial. Professional superiors, instructors to professors, reacted to her in a manner that unpredictably varied from warm acceptance to overt hostility. Usually the hostility was more passive-aggressive than Harris’s had been; Nelson’s reaction was more typical. Nelson had been friendly at first, then later had slipped into an obstructive stance. Susan felt an old familiar feeling, a feeling which had developed ever since she had chosen medicine as a career: it was a paradoxical loneliness. Although constantly surrounded by people who reacted to her, she felt apart. The day and a half at the Memorial had not been an auspicious beginning for her clinical years. Even more than during her first days at medical school, she felt that she was entering a male club; she was an outsider forced to adapt, to compromise.
Susan opened her eyes and looked down at her notebook sprawled on the landing below. Throwing the book had given some vent to her frustrations, and she felt a degree more relaxed. Control was returning.
At the same time the childish aspect of the gesture surprised her. It was not like her to do such a thing. Perhaps Nelson and Harris were, in the final analysis, right. Perhaps being a medical student so early in training, she was not the right person to investigate such a serious clinical problem. And perhaps her emotionalism was a built-in handicap.
Would a male have responded in the same way to Harris’s reaction? Was she more emotional than her male counterparts? Susan thought about Bellows and his cool detached manner, how he could concentrate on the sodium ions while confronting a tragedy. Susan had found fault with his behavior the day before, but now, daydreaming in the stairwell, she was no longer so sure. She wondered if she could achieve that type of detachment if it were necessary.
A door opening somewhere far above brought Susan to her feet. There were some hushed and hurried footsteps on the metal stairs, then the sound of another door, then silence returned. The crude cement walls of the stairwell combined with the curious longitudinal rust-colored stains enhanced Susan’s sense of isolation. In slow motion she descended to where her notebook lay. By chance it had opened to the page copied from Nancy Greenly’s chart. Reaching for the book, Susan read her own handwriting. “Age 23, Caucasian, previous medical history negative except for mononucleosis at age 18.” Quickly Susan’s mind conjured up the image of Nancy Greenly, her ghostly pallor, lying in the ICU. “Age twenty-three,” Susan said aloud. In a rush she re-experienced the intensity of her feelings of transference. Susan felt a rekindling of her commitment to investigating the coma problem to the limit of her abilities despite Harris, despite Nelson. Without questioning why, she felt a strong urge to find Bellows. Within a single day her feeling toward Bellows had taken a one-hundred-and-eighty-degree turn.
“Susan, for Christ’s sake, haven’t you had enough yet?” With his elbows on the table, Bellows placed his palms against his face so that his fingers could lightly massage his closed eyes. His hands rotated, bringing his fingers below his ears. With his face cradled in his hands, he looked at Susan sitting across from him in the hospital coffee shop. The place had a relatively clean appearance with indeterminate modern furnishings. It was primarily meant for visitors to the hospital, although the staff frequented it on occasion. The prices were higher than the cafeteria’s but the quality was equivalently better. At eleven-thirty it was crowded but Susan had found a table in the corner and had paged Bellows. She was pleased when he agreed to see her immediately.
“Susan,” continued Bellows after a pause, “you’ve got to give up this self-destructive crusade. I mean it’s absolutely sure suicide. Susan, there’s one thing about medicine, you’ve got to flow with the river or you’ll drown. I’ve learned that. God, whatever could have possessed you to go to Harris, especially after that little episode yesterday?”
Susan sipped her coffee in silence, keeping her eyes on Bellows. She wanted him to talk because it sounded good; he seemed to care. But also she wanted him to get involved, if that were at all possible. Bellows shook his head as he took a drink of his coffee.
“Harris is powerful, but he’s not omnipotent around here,” added Bellows. “Stark can reverse anything Harris does if he has reason to do so. Stark has raised most of the money for construction around here, millions. So people listen to what he says. So why not give him a reason; why not pretend to be a normal medical student for a few days? Christ, I need it myself. Guess who was on rounds this morning to welcome you medical students? Stark. And the first thing he wanted to know was why there were only three students out of five. Well I told him that, foolishly enough, I had taken you all in to see a case on the first day, and one of you had fainted and smashed his head on the floor. You can guess how that went over. And then I couldn’t think of anything appropriate to say about you. So I said you were doing a literature search on coma following anesthesia. I decided that since I couldn’t think of a good lie I might as well tell the truth. Well he immediately assumed that it had been my idea to put you on the project. I cannot repeat what he said to me in response. It should be enough for me to say that I need you to behave like a normal medical student. I’ve covered for you to the extent that I’m already overdrawn.”
Susan felt an urge to touch Bellows, kind of a reassuring people-to-people hug. But she didn’t; instead she played with her coffee spoon with her head down. Then she looked at Bellows.
“I’m really sorry if I’ve caused you some difficulties, Mark, really I am.
Needless to say, it was unintentional. I’m the first to admit this thing has gotten out of hand so rapidly that it’s uncanny. I started because of an emotional crisis of sorts. Nancy Greenly is the same age as I, and I’ve had some occasional irregularities with my periods, probably just like Nancy Greenly. I cannot help but feel some ... some kinship with her. And then Berman ... what a Goddamned coincidence. By the way, did Berman have an EEG?”
“Yeah, it was completely flat. The brain is gone.”
Susan searched Bellows’s face for some response, some sign of emotion.
Bellows lifted the coffee cup to his lips and took a sip.
“The brain is gone?”
“Gone.”
Susan bit her lower lip and looked down into her coffee cup. A small amount of oil opalesced on the surface in colorful swirls. Somehow she had expected the news, but it still cut into her and she fought with her mind, suppressing emotion as best she could.
“Are you OK?” asked Bellows, reaching across and gently lifting her chin with his hands.
“Don’t say anything for a second,” said Susan, not daring to look at him.
The last thing she wanted to do was cry and if Bellows persisted, it would happen. Bellows cooperated and returned to his coffee while keeping his eyes on Susan.
After a few moments Susan looked up; her eyelids were slightly reddened.
“Anyway,” continued Susan, avoiding eye contact with Bellows, “I started with an emotional sort of commitment, but that quickly mixed with intellectual commitment. I really thought I had stumbled onto something ... a new disease or a new complication of anesthesia or a new syndrome ... something, I don’t know what. But then there was another change. The problem loomed bigger than I had imagined initially. They’ve had coma cases on the medical floors as well as in surgery. On top of that, there were those deaths you told me about. I know you think it’s crazy, but I think they are related, and the pathologist intimated they have had a number of such cases. My intuition tells me there is something else in all this, something ... I don’t know how to explain it...
call it supernatural or call it sinister ...”
“Ah, now paranoia,” said Bellows, nodding his head in mock understanding.
“I can’t help it, Mark. There was something very strange about the reaction of Nelson and Harris. You have to admit that Harris’s reaction was totally inappropriate.”
Bellows tapped his forehead in succession with the heel of his hand.
“Susan, you’ve been staying up watching old horror movies. Admit it, Susan ... admit it or I’ll think you’re having a psychotic break. This is absurd. What do you suspect, some sort of sinister inversion layer spreading evil
