Coma

“That’s a risk I have to take. It’s probably safer than undergoing minor surgery here at the Memorial.”

“That’s not fair.”

“Fair? What a choice word. Why don’t you ask Berman if he thinks it’s fair?”

“I can’t.”

“You can’t?” Susan paused, waiting for Bellows to explain himself. Susan did not want to think of the worst but it came to her automatically.

Bellows started toward the tray rack without explaining himself.

“He’s still alive, isn’t he?” asked Susan with a tingle of desperation in her voice. She got up and walked behind Bellows.

“If you call that heart beating being alive, he’s alive.”

“Is he in the recovery room?”

“No.”

“The ICU?”

“No.”

“OK, I give up, where is he?”

Bellows and Susan put their trays into the rack and walked from the coffee shop. They were immediately engulfed by the mob in the hall and forced to quicken their steps.

“He was transferred to the Jefferson Institute in South Boston.”

“What the hell is the Jefferson Institute?”

“It’s an intensive care facility built as part of the area’s Health Maintenance Organization design. Supposedly it’s been designed to curtail costs by applying economics of scale in relation to intensive care.

It’s privately run but the government financed construction. The concept and plans came out of the Harvard-MIT health practices report.”

“I’ve never even heard about it. Have you visited it?”

“No, but I’d like to. I saw it from the outside once. It’s very modern ...

massive and rectilinear. The thing that caught my eye was that there were no windows on the first floor. God only knows why that caught my eye.” Bellows shook his head.

Susan smiled.

“There’s a tour organized for the medical community,” continued Bellows, “to visit the place on the second Tuesday of each month. Those that have gone have been really impressed. Apparently the program is a big success. All chronic-care ICU patients who are comatose or nearly so can be admitted. The idea is to keep the ICU beds in the acute-care hospitals available for acute cases. I think it’s a good idea.”

“But Berman just became comatose. Why would they transfer him so quickly?”

“The time factor is less important than stability. Obviously he’s going to be a long-term-care problem and I guess he was very stable, not like our friend Greenly. God, she’s been a pain in the ass. Just about every complication known, she’s had it.”

Susan thought about emotional detachment. It was difficult for her to understand how Bellows could be so out of touch emotionally with the problem Nancy Greenly represented.

“If she were stable,” continued Bellows, “even threatened stability, I’d transfer her to the Jefferson in a flash. Her case demands an inordinate amount of time with thin rewards. Actually, I have nothing to gain by her.

If I keep her alive until the services switch, then at least I’ve suffered no professional harm. It’s like all those Presidents keeping Vietnam alive.

They couldn’t win, but they didn’t want to lose either. They had nothing to gain but a lot to lose.”

They reached the main elevators and Bellows made sure one of the silently waiting crowd had pushed the “up” button.

“Where was I?” Bellows scratched his head, obviously preoccupied.

“You were talking about Berman and the ICU.”

“Oh, yeah. Well, I guess he was stable.” Bellows looked at his watch, then eyed the closed doors with hatred. “Goddamn elevators.

“Susan, I’m not one to give advice usually, but I can’t help myself. See Stark if you must, but remember I’ve gone out on a limb for you, so act accordingly. Then after you see Stark, give this crusade up. You’ll ruin your career before you begin.”

“Are you worried about my career or your own?”

“Both, I guess,” said Bellows standing aside for the disembarking elevator passengers.

“At least you’re honest.”

Bellows squeezed into the elevator and waved to Susan, saying something about seven-thirty. Susan presumed he meant their dinner date. At that moment her watch said eleven forty-five.

Tuesday, February 24, 11:45 A.M.

Bellows looked up at the floor indicator above the door. He had to cock his head way back, as he was almost directly under it. He knew that he had to hustle in order to be on time for his case, a hemorrhoid operation on a sixty-two-year-old man. It wasn’t his idea of a fascinating case but he loved to operate. Once he got going and felt the strange sense of responsibility which the knife afforded, he didn’t really care where he was working, stomach or hand, mouth or asshole.

Bellows thought about seeing Susan that night, and he felt a sense of pleasurable anticipation. Everything would be fresh and unspoiled. Their conversation could range over any one of a thousand topics. And physically? Bellows had no idea what to expect. In fact he wondered how he would be able to bridge the colleaguelike rapport they had already established. Within himself he sensed a very positive physical reaction toward Susan but it began to trouble him. In a lot of ways, sex meant aggression to Bellows, and he didn’t feel any aggression toward Susan, not yet.