Susan was oblivious to the mental havoc she was inadvertently causing.
“This chart here shows the order of incidence of the various types of acute fatal coma appearing at the emergency room at the Boston City Hospital,” said Susan, running her fingers along the lines. “One of the most amazing facts is that only fifty percent of the cases are ever diagnosed. I find that amazing; wouldn’t you agree? That means that fifty percent of the cases are never diagnosed. They just come in to the ER in coma and die. Just like that.”
“Yeah, it’s amazing,” said Bellows, putting his left hand up to his temple to try to keep from seeing what he was seeing.
“And look here, Mark, at the causes of the cases which they do diagnose: sixty percent are due to alcohol, thirteen percent due to trauma, ten percent to strokes, three percent to drugs or poisons, and the rest divided up among epilepsy, diabetes, meningitis, and pneumonia. Now obviously…,” said Susan, sitting back down and relieving the stress on Bellows’s hypothalamus.
Bellows glanced around once more to make sure that no one had noticed the episode.
“…we can dismiss alcohol and trauma as far as causing acute coma in the OR is concerned. So… that leaves us with strokes, then drugs or poisons, and the others in decreasing probability as possible culprits.”
“Wait a second, Susan,” said Bellows pulling himself together. He put his elbows on the table with his forearms up in the air, his hands drooped but engaged. His head was down at first, then he picked it up and looked at Susan. “That’s all very interesting. A little farfetched, but interesting.”
“Farfetched?”
“Yeah. You cannot possibly extrapolate data from the ER to the OR. But anyway, I didn’t come in here looking for you to argue about that. I came in here because you haven’t been answering your pages. I know, because it was me who was paging you. Look, I’m going to have trouble if you don’t show up for conferences. You’re going to make trouble for yourself, and the fact of the matter is that, while you’re on my service, your trouble is my trouble. I can only make excuses for you for so long. I mean, you can be drawing blood or scrubbing just so often. Stark will be asking questions before you know it. He’s phenomenal. He knows everything that’s going on around here. Besides, you’ll get the reputation of being a phantom among your own section students. Susan, I’m afraid you’re going to have to restrict your research proclivities to after-hours.”
“Are you finished?” asked Susan, rising to the defense.
“I’m finished.”
“Well, answer me this one question. Has Berman or Greenly awakened yet?”
“Of course not…”
“Then frankly, I believe that my current activities eclipse the importance of a few boring surgical conferences.”
“Oh my aching back! Susan, be reasonable. You’re not going to save the world during your first week on surgery. I’m going out on a limb for you as it is.”
“I appreciate it, Mark. Really I do. But listen. My few hours here in the library have already provided some very interesting information. The complication of prolonged coma after anesthesia is about one hundred times more prevalent here at Memorial than the incidence given for the rest of the country over the past year. Mark, I think I’m onto something. When I started, it was more of an emotional thing which I thought I could work out in a day or two here in the library. But one hundred times! God, I could be on the track of something big, like a new disease, or a lethal combination of normally safe drugs. What if this is some sort of viral encephalitis, or even the result of a previous infection which makes the brain somehow more susceptible to certain drugs or mild lack of oxygen?”
Susan had been part of the medical world for only two years, and yet she was already cognizant of the potential benefits which would accrue to someone who discovered a new disease or syndrome. She thought this one might become known as the Wheeler syndrome, and Susan’s success within the medical community would be guaranteed. More often than not, the discoverer of the new disease became far more famous than the discoverer of the cure for the same disease. Eponyms abound in medicine like the tetralogy of Fallot, Cogan’s disease, the Tolpin syndrome, or Depperman’s degeneration. Whereas names like the Salk vaccine are an anomaly. Penicillin is called penicillin, not Fleming’s agent.
“We could call it the Free Wheeler Syndrome,” said Susan, allowing herself to laugh at her own enthusiasm.
“Christ,” said Bellows, cradling his head in his hands. “What an imagination. But that’s OK. Naiveté has a certain license. But, Susan, you are in a real world situation with certain specific responsibilities. You are still a medical student, low man—or woman—on the totem pole. You’d better get your tail in gear and honor your surgery rotation obligations or, believe me, your ass will be grass. I’ll give you one more day for this project, provided you show up for rounds in the morning. After that you work on it in your free time. Now, if I need you I’ll page Dr. Wheels instead of Wheeler, so answer it, understand?”
“Understood,” said Susan looking squarely at Bellows. “I’ll do that, if you do something for me.”
“What’s that?”
“Pull out these articles and have them Xeroxed. I’ll pay you later.” Susan tossed her list of references to Bellows, jumped up from the table and breezed out of the room before Bellows could respond. He found himself looking at a list of thirty-seven journal articles. Since he knew the library like the bones of his hand, he located the volumes with ease, marking each article with a piece of paper. He took the first group over to the desk and told the girl to copy the indicated articles and put it on his library charge. Bellows knew that he had been manipulated again, but he didn’t mind. It had taken only ten minutes. He would get them back with interest.
And he had been right; she had a dynamite figure.
14
Monday, February 23, 5:05 P.M.
As she had been telling Bellows that the incidence of coma following anesthesia at the Memorial was one hundred times the national incidence, Susan had realized that she was basing her calculations on the six cases Harris had mentioned in his outburst. Susan had to check that figure. If it was actually higher, she would have more ammunition to base her commitment to the project. Besides, she needed the names of the coma victims so that she could obtain then” charts. What she needed more than anything else, she recognized, was hard data.
Susan knew that she had to get access to the central computer. Harris would be unwilling to supply the names of the patients. Susan was certain of that. Bellows might have been able to get them if he were sufficiently motivated. But that was a big if. Susan felt that the best route was for her to try to get the information herself. So she was thankful she had taken the introductory course in PL 1 computer programming as a junior in college. Already it had paid off in surprising ways, and her need for the information at hand was just another example.
The computer center in the hospital was located in the Hardy wing, occupying the entire top floor. Many people joked about the symbolic aspects of the computer being above everything else in the hospital, and it had added a new meaning to the phrase “with a little help from above.”
As the elevator door slid open on the foyer of the eighteenth floor, Susan knew she was going to have to improvise if she were to be successful. Beyond the foyer Susan could see through glass partitions into the main computer reception area. The place had the appearance of a bank. The only difference was that the medium of exchange here was information, not currency.