Coma

The Boston Memorial Hospital is certainly not an architectural landmark, despite the disproportionately large number of architects in the Boston area. The central building is attractive and interesting. It was constructed over a century ago with brownstone blocks carefully fitted together with skill and feeling. But the structure is inconveniently small and only two stories tall. Besides, it was designed with large, general wards, now outmoded. Hence its present-day practicality is minuscule.

Only the ooze of medical history which permeates its halls keeps the wreckers and the planners at bay.

The innumerable larger buildings are studies in American gothic.

Extending off at obtuse angles, millions upon millions of bricks join together to hold up dirty windows and flat monotonous roofs. The buildings were added in spurts, responding to the purported need for beds or the availability of funds. There is no doubt that it is an ugly combination of buildings, except perhaps for a few smaller research buildings. Those had architects and money to burn.

But very few people ever noticed the appearance of the buildings. The whole is larger than the sum of its parts; perception is too clouded by innumerable layers of emotional response. The buildings are not buildings by themselves. They are the famed Boston Memorial Hospital, containing all the mystery and wizardry of modern medicine. Fear and excitement intermingle in an ambivalent dialogue as lay people approach the structure. And for the professional individual, it is the mecca: the pinnacle of academic medicine.

The setting for the hospital adds very little. On one side a maze of railroad tracks leading to North Station and a bewildering array of elevated highways forms an enormous sculpture of rusting steel. On the other side is a modern housing project for low income families. Somehow that goal got mixed up in the renowned corruptness of the Boston government. The apartment buildings look like housing for the underprivileged because of their lack of outward design. But the rents are out of sight and only the rich and privileged live there. In front of the hospital is a stagnant corner of Boston Harbor with water like Mack coffee, sweetened with sewer gas. Separating the hospital and the water is a cement playground filled with discarded newspapers.

By seven-thirty this Monday morning all the operating rooms at the Memorial hummed with activity. Within a five-minute interval, twenty-one scalpels sliced through unresisting human skin as the scheduled operations commenced. The fate of a sizable number of people depended on what was done or not done, what was found or not found in the twenty-one tiled rooms. A furious pace was set which would not slow down until two or three in the afternoon. By eight or nine o’clock in the evening only two rooms would still be functioning, and they often continued until the seven-thirty rush the following morning.

In sharp contrast to the bustle in the OR area, the surgical lounge presented a luxuriant hush. Only two people were there, because the coffee break pattern did not begin until after nine. By the sink was a sickly-looking man appearing much older than his sixty-two years. He was busy trying to clean the sink without moving the twenty-odd coffee cups left there half-filled with water by their owners. Walters was his name, although few knew if it was his first or last name. His whole name was Chester P. Walters. No one at all knew what the P stood for, not even Walters himself. He’d been an employee of the Memorial OR since he was sixteen, and no one had the temerity to fire him despite the fact that he did almost nothing. He wasn’t well, he’d say, and, indeed, he did not look well. His skin was” a pasty white and every few minutes he’d cough. His cough rattled with phlegm deep within his bronchial tubes, but he never coughed hard enough to get it up and out. It was as if he was content to merely keep his tubes grossly patent without disturbing the cigarette he had constantly in the right corner of his mouth. Half the time he had to have his head cocked over to the left so that the smoke would not burn his eyes.

The other occupant of the surgical lounge was an intermediate surgical resident, Mark H. Bellows. The H stood for Halpern, his mother’s maiden name. Mark Bellows was busy writing on a yellow legal tablet. Walters’s coughing as well as Walters’s cigarette definitely bugged Bellows, and Bellows would look up each time Walters started yet another coughing sequence. To Bellows it was incomprehensible how an individual could do so much bodily damage to himself and still keep it up. Bellows did not smoke; Bellows had never smoked. It was equally incomprehensible to Bellows how Walters managed to stay around the OR despite his appearance, personality, and the fact that he didn’t do a damn thing.