Coma

One did not feel a part of it. While walking down the long corridor Susan felt a certain excitement mixed with fear of the mortality of people. As they passed OR after OR, Susan could see clusters of figures bent over what she knew were sleeping patients with their fragile insides open to the elements. A hospital gurney approached them with a scrub nurse pulling and an anesthesiologist pushing. As the group came abreast Susan could see that the anesthesiologist was matter-of-factly holding the patient’s chin back while the patient retched violently. “I hear there’s almost forty inches of packed powder at Waterville Valley,” said the anesthesiologist to the scrub nurse. “I’m going Friday right after work,”

returned the scrub nurse as the pair passed by Susan toward the recovery room. The image of the tortured face of the patient so recently operated on imprinted itself in Susan’s susceptible consciousness and she shuddered involuntarily.

The group pulled up in front of room 18.

“Try to keep the chatter to a minimum,” said Bellows, looking through the window in the door. “The patient is already asleep. Too bad, I wanted you to see that. Well, no matter. There will be a lot of moving around during the draping procedure, etcetera, so stay back against the right wall. Once they get underway, move around so that you can see something. If you have questions, save them until later, OK?” Bellows looked at each student He smiled anew when he met Susan’s gaze, then pushed open the OR door.

“Ah, Professor Bellows, welcome,” boomed a large, gowned, gloved, and sterile figure hovering in the background near some X-rays. “Professor Bellows has brought his brood of students to watch the fastest hands in the East,” he said laughing. He held up his arms in an exaggerated Hollywood surgical fashion with the hands up and bent outward as far as they would go. “I hope you have told the impressionable youths that the spectacle they are about to see is a rare treat.”

“That hulk,” said Bellows to the students while motioning toward the laughing character by the X-rays and loud enough for all in the OR to hear, “is the result of staying in the program too long. That’s Stuart Johnston, one of the three senior residents. We only have to put up with him for four more months. He had promised me he’d be civil, but I cannot be sure of that.”

“You’re just a poor sport, Bellows, because I stole this case from you,”

said Johnston, still laughing. Then to his two assistants he said without laughing, “Let’s get the patient draped, you guys. What are you trying to do, make this your life’s work?”

The draping proceeded rapidly. A small piece of tubular metal arched over the top of the patient’s head and separated the anesthesiologist from the surgical area. By the time the draping was completed, only a small portion of the patient’s right upper abdomen was exposed.

Johnston moved to the patient’s right side; one of the assistants went over to the left side. The scrub nurse moved over the draped Mayo stand, straining with a full compliment of surgical instruments. A profusion of hemostats was lined up in a perfect array along the back of the tray. The scalpel had a new razor-sharp blade snapped into its jaws.

“Knife,” said Johnston. The scalpel slapped into his gloved right hand.

With his left hand he pulled the abdominal skin away from him to provide countertraction. The medical students all moved forward silently and strained to see with a foreboding curiosity. It was like watching an execution. Their minds tried to prepare themselves for the image that was going to be imminently transmitted to their brains.

Johnston held the scalpel about two inches above the pale skin while he looked over the screen at the anesthesiologist The anesthesiologist was slowly letting the air out of the blood pressure cuff and watching the gauge, 120/80. He looked up at Johnston and gave an imperceptible nod, tripping the poised guillotine. The scalpel dived deep into the tissues, and then with a smooth soundless slice, slid down the skin at an angle of approximately 45 degrees. The wound fell open and little jets of pulsating arterial blood sprayed the area, then ebbed and died.

Meanwhile curious phenomena occurred in George Niles’s brain. The image of the knife plunging into the skin of the patient was displayed instantly in his occipital cortex. Association fibers picked up the message and transported the information to his parietal lobe, where it was associated. The association spread so rapidly and so widely that it activated an area of his hypothalamus, causing widespread dilation of his blood vessels in his muscles. The blood literally drained from his brain to fill all the dilated vessels, causing George Niles to lose consciousness. In a dead faint he fell straight backward. His flaccid neck snapped his head against the vinyl floor with a resonant thump.