Coma

Johnston spun around in response to the sound of George’s head smashing against the floor. His surprise quickly metamorphosed into typically labile surgical anger.

“For Christ sake, Bellows, get these kids outa here until they can stand the sight of a few red cells.” Shaking his head, he went back to catching bleeders with his hemostats.

The circulating nurse broke a capsule under George’s nose and the acrid smell of the ammonia shocked him back to consciousness. Bellows bent down and felt along his neck and the back of his head. As soon as George was fully conscious, he sat up, somewhat confused about his whereabouts. Realizing what had happened, he felt immediately embarrassed.

Johnston meanwhile wouldn’t let the matter rest.

“Holy shit, Bellows, why didn’t you tell me these students were absolute greenhorns? I mean, what would have happened if the kid fell into my wound here?”

Bellows didn’t say anything. He helped George to his feet by degrees until he was satisfied George was really OK. Then he motioned for the group to leave OR No. 18.

Just before the OR door shut, Johnston could be heard angrily yelling at one of his junior residents, “Are you here to help me or hinder me ...?”

Monday, February 23, 11:15 A.M.

George Niles’s pride was hurt more than anything else. He developed a rather sizable lump on the back of his head but there was no laceration.

His pupils stayed equal in size and his memory was unimpaired. Consensus had it that he was going to make it. However, the episode dampened the spirits of the whole group. Bellows was nervous that the fainting would reflect on his judgment to bring the students into the OR on the first day. George Miles was concerned lest the incident foreshadowed similar responses every time he tried to watch a surgical case. The others were bothered to a greater or lesser degree simply because within a group, the actions of one individual tend to reflect the whole group’s performance. Actually Susan was not concerned with this aspect as were the others. Susan was more distressed about the sudden and unexpected response and change in attitude of Johnston and, to a lesser extent, Bellows. One minute they were jovial and friendly; the next minute they were angry, almost vengeful, simply because of an unexpected turn of events. Susan rekindled her preconceptions regarding the surgical personality. Perhaps such generalizations were appropriate.

After changing back to their street clothes, they all had a cup of coffee in the surgical lounge. It was surprisingly good coffee, thought Susan, trying to overcome the oppressive haze of cigarette smoke which hung like Los Angeles smog from the ceiling to a level about five feet from the floor. Susan was mindless of the people in the lounge until her eyes met the stare of a pasty white-skinned man hovering in the corner near the sink. It was Walters. Susan looked away and then back again, thinking that the man was not really watching her. But he was. His beady eyes burned through the cigarette haze. Walters’s omnipresent cigarette hung by some partially dried saliva holding the extreme tip in the corner of his lips. A trail of smoke snaked upward from the ash. For some unknown reason he reminded Susan of the hunchback of Notre Dame, only without a hunchback: a ghoulish figure out of place yet obviously at home in the shadows of the Memorial surgical area. Susan tried to look away but her eyes were involuntarily drawn toward the uncomfortable stare of Walters. Susan was glad when Bellows motioned to leave and they drained their cups. The exit was near to the sink, and as the group left the room, Susan had the feeling she was walking down Walters’s line of vision. Walters coughed and the phlegm rattled.

“Terrible day, eh, Miss,” said Walters as Susan passed.

Susan didn’t respond. She was glad to be rid of the staring eyes. It had added to her nascent dislike of the surgical environment of the Memorial.

The group moved en masse into the ICU. As the oversized ICU door closed, the outside world faded and disappeared. A surrealistic alien environment emerged out of the gloom as the students’ eyes adjusted to the lower level of illumination. The usual sounds like voices and footsteps were muted by the sound-absorbing baffling in the ceiling. Mechanical and electronic noises dominated, particularly the rhythmical beep of the cardiac monitors and the to-and-fro hiss of the respirators. The patients were in separate alcoves, in high beds with the side rails pulled up. There was the usual profusion of intravenous bottles and lines hanging above them, connected to impaled blood vessels by sharp needles. Some of the patients were lost in layer upon layer of mummylike bandages. A few of the patients were awake and their darting eyes betrayed their fear and the fine line that divided them from acute insanity.