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It was more than the debatable question of medical ethics. Berman had made Susan feel like a woman. All at once it came to Susan. The biggest difference between herself and Carpin was that Susan had an extra obstacle. She knew that both of them wanted to become doctors; to act like doctors, think like doctors, to be taken for doctors. But for Susan there was an additional step. Susan wanted also to become a woman; to feel like a woman, to be taken for and respected as a woman. When she had entered medicine, she knew it was a male-dominated career choice.

That had been one of the challenges. Susan had never imagined that medicine would make it difficult for her to achieve fulfillment in a social sense. Academically she could compete; she was reasonably sure of that.

The next step was going to be harder, an uncharted course. And Carpin?

Well, for him the social part was easy. He was a male in a recognized male role. Being in medicine only supported his image of himself as a man.

Carpin only had to worry about convincing himself he was a doctor; Susan had to convince herself that she was a doctor and a woman.

Arriving on the second floor, Susan was greeted by a sign which stated in bold letters: “Operating Room Area: Unauthorized Entry Forbidden.”

But the sign wasn’t necessary. To Susan’s momentary consternation, the door was locked! Her overly active imagination suddenly had all the doors from the stairwell locked, and she thought of herself caught within a vertical prison. It was a fleeting thought, totally irrational. “Wheeler, you’re too much,” she said aloud for her own benefit and encouragement.

She quickly descended to the first floor. The door opened easily and Susan joined the surging mob on the main floor.

She took the elevator and returned to the ICU entrance. It took a bit of fortitude to begin to open the door. Once she started, it took strength. The ICU door was massive and very heavy.

Susan stepped once again into the nether world of the ICU interior.

One of the nurses looked up from the desk but then went back to an EKG

tracing in front of her. As Susan scanned the room, she was again struck by the purely mechanical appearance, the lack of human voices, even the lack of movement save for the fluorescent blips tracing their incessant patterns. And there was Nancy Greenly, as immobile as a statue, a casualty of medicine, a victim of technology. Susan wondered about her life, her loves. Everything was gone, all because of a simple menstrual irregularity, a routine D&C.

Susan forced her eyes away from Nancy Greenly and ascertained that her group had since departed from the ICU, presumably for Grand Rounds. At the same instant Susan acknowledged to herself her acute discomfort about being in the ICU. The psychological and technical complexity of the room caused any residual euphoria from the I.V.

episode to vanish. Her imagination forced her to ponder the situation if something suddenly went wrong with one of the patients while she was standing there. What if someone expected her to make some life-death decision to go along with her white coat and her impotent stethoscope in her pocket?

Controlling the urge to succumb to a minor panic, Susan tugged at the inertia of the door and escaped into the corridor. Retracing her steps to the elevator, Susan mused about the difference between fact and fancy, between reality and mythology, between what it really was like being a medical student and what people thought it was like.

Remembering Bellows’s comment about Grand Rounds on 10, Susan pushed the tenth-floor button and allowed herself to be compressed toward the rear of the elevator. It was a miserable trip. The car was a potpourri of human beings with every conceivable affliction, and it stopped at every floor. The air was heavy and hot, particularly since one rude passenger was smoking despite the sign plainly forbidding it. The occupants did not look at each other; they stared blankly at the light progressing from number to number, as did Susan, wishing the doors would open and close more quickly.

Impetuously she pushed her way to the front of the elevator at the ninth floor. At 10, she broke from the crowded cubicle with relief.

The atmosphere changed immediately. The tenth floor was carpeted and the walls shone with an even luster of newly applied semigloss paint.

Gilded frames set off portraits of former Memorial greats in their sartorial academic splendor. Chippendale tables topped with a variety of lamps were interspersed between comfortable chairs along the length of the corridor. Neat piles of New Yorker magazines were arranged at rational intervals.

A large sign opposite the elevator directed Susan to the conference room. As she walked down the corridor she could see into the offices.

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