Coma

Susan moved up to the foot of the bed where Spallek had been standing. She studied the crumpled man next to her, Dr. Goodman. He looked pale and his hair was matted with perspiration to his forehead. He had a prominent nose, which Susan saw in perfect profile. His deep-set eyes were riveted to the patient. He did not blink.

Susan looked down at the patient, her eyes wandering to the wrist which Bellows was prepping for the arterial stick. With an exaggerated double-take, her eyes shot back to the face of the patient as recognition occurred. It was Berman!

In contrast to the tanned visage Susan recalled from their meeting in room 503 only ninety minutes ago, Berman’s face was a dusky gray color.

The skin was pulled taut over his cheekbones. An endotracheal tube protruded from the left side of his mouth and some dried secretion was crusted along his lower lip. His eyes were closed but not completely. His right leg was in a huge plaster cast.

“Is he all right?” blurted Susan looking from Harris to Goodman. “What happened?” Susan spoke from emotion, without thinking; she sensed something was wrong and she reacted impulsively. Bellows was surprised at her sudden questions and looked up from his work, holding the syringe in his right hand. Harris straightened up slowly and turned toward Susan.

Goodman’s eyes did not stray.

“Everything is absolutely perfect,” said Harris with a pronunciation suggesting an Oxford sojourn some time in his past. “Blood pressure, pulse, temperature all perfectly normal. However, he has apparently enjoyed his anesthetic slumber so much that he has decided not to wake up.”

“Not another one,” said Bellows, switching his attention to Harris and concerned that he was going to be saddled with another problem like Greenly. “What does the EEG look like?”

“You’ll be the first to know,” said Harris with a trace of sarcasm. “It’s been ordered.”

Comprehension for Susan was delayed by emotion, for hope was momentarily stronger than reason. But eventually it flooded over her.

“EEG?” asked Susan apprehensively. “You mean he’s like the patient down in the ICU?” Her eyes darted back and forth between Berman and Harris, then to Bellows.

“Which patient is that?” asked Harris, picking up the anesthesia record.

“The D&C mishap,” said Bellows. “You remember, about eight days ago, the twenty-three-year-old girl.”

“Well I hope not,” said Harris, “but it’s beginning to look that way.”

“What was the anesthesia?” asked Bellows lifting Berman’s right eyelid and glancing down into the widely dilated pupil.

“Neurolept anesthesia with nitrous,” said Harris. “The girl’s was halothane. If the problem is the same clinically, it wasn’t the anesthetic agent.” Harris looked up from the anesthesia record toward Goodman.

“Why did you give this extra cc of Innovar toward the end of the case, Norman?”

Dr. Goodman did not respond immediately. Dr. Harris called his name again.

“The patient seemed to be getting too light,” said Goodman, suddenly breaking his trance.

“But why Innovar so late in the case? Wouldn’t fentanyl alone have been more prudent?”

“Probably. I should have used the fentanyl alone. The Innovar was just handy and I knew that I’d only use an additional cc.”

“Can’t something be done?” asked Susan with a hint of desperation.

Images of Nancy Greenly streamed back with bits and pieces of the recent conversation with Berman. She could distinctly remember his vitality, which was in sharp contrast to the waxy, lifeless-appearing figure before her.

“It’s been done, whatever it was,” said Harris with finality, returning the anesthesia record to Goodman. “All we can do now is watch and see what kind of cerebral function returns, if any. The pupils are widely dilated and they do not react to light. That is not a good sign, to say the least. It probably means that there was extensive brain death.”

Susan experienced a sickening feeling rise up within herself. She shuddered and the feeling passed but she felt lightheaded. Above all, she felt helplessly desperate.

“This is too much,” said Susan suddenly and with obvious emotion. Her voice quivered. “A normal healthy man with a minor peripheral problem ends up like a ... like a vegetable. My God, this can’t go on. Two young people within just a couple of weeks. I mean, it’s an unacceptable risk.

Why doesn’t the Chief of Anesthesia close the department? Something’s got to be wrong. It’s absurd to allow ...”

Robert Harris’s eyes began to narrow as Susan began her tirade. Then he interrupted her with an obvious edge to his. voice. Bellows’s mouth had dropped open in total dismay.

“I happen to be the Chief of Anesthesia, young lady. And who, may I ask, are you?”

Susan started to speak, but Bellows cut in nervously. “This is Susan Wheeler, Dr. Harris, a third-year medical student who is rotating on surgery, and, ah ... we just wanted to get this blood drawn here, then we’ll be off.” Bellows recommenced his prep on Berman’s right wrist, stroking rapidly with the Betadine sponge.