Coma

“I’m bleeding very fast,” said Nancy calmly, “but it’s nothing to get alarmed about. An extra-heavy period, I guess. I just should go to the hospital right away. So please call the ambulance.”

The ambulance ride had been uneventful, without sirens or drama. She had to wait longer than she thought reasonable in the holding area of the emergency room. Dr. Major had appeared and for the first time awakened a feeling of gladness in Nancy. She had always detested the routine vaginal exams to which she had submitted and has associated the face, the bearing, and the smell of Dr. Major with them. But when he appeared in the emergency room, she felt glad to see him, to the point of suppressing tears.

The vaginal examination in the emergency room had been, without doubt, the worst she had ever experienced. A flimsy curtain, which was constantly being whisked back and forth, was the sole barrier between the throng in the emergency room and Nancy’s flayed self-respect. Blood pressure was taken every few minutes; blood was drawn; she had to change from her clothes into the hospital gown; and each time something was done the curtain flashed aside and Nancy was confronted with an array of faces in white clothes, children with cuts, and old, tired people.

And there was the bedpan sitting there right in the open for everyone to gape at. It contained a large, semiformed dark red blood clot. Meanwhile Dr. Major was down there between her legs touching her and talking to the nurse about another case. Nancy closed her eyes as tightly as she could and cried silently.

But it was all to be over shortly, or so Dr. Major had promised. In great detail he had told Nancy about the lining of her uterus and how it changes during the normal cycle and what happens when it doesn’t change. There was something about the blood vessels and the need for an egg to be released from the ovary. The definitive cure was a dilation and curettage. Nancy had agreed without question and asked that her parents not be notified. She could do that herself after the fact. She was sure her mother would think she had had to have an abortion.

Now, as Nancy gazed up at the large overhead operating room light, the only thought that made her the slightest bit happy was the fact that the whole goddamned nightmare was going to be over within the hour, and her life would return to normal. The activity in the operating room was so totally foreign to her that she avoided looking at anyone or anything, save for the light above.

“Are you comfortable?”

Nancy glanced to the right. Deep brown eyes regarded her from between the synthetic fibers of the surgical hood. Gloria D’Mateo was folding the draw sheet around Nancy’s right arm, securing it to her side and immobilizing her further.

“Yes,” answered Nancy with a certain detachment. Actually she was as uncomfortable as hell. The operating table was as hard as her cheap Formica kitchen table. But the Phenergan and Demerol she had been given were beginning to exert their effects somewhere within the depths of her cerebrum. Nancy was far more awake than she would have liked; but at the same time she was beginning to feel a detachment and dissociation from her surroundings. The atrophine she had been given was having an effect as well, making her throat and mouth feel dry and her tongue sticky.

Dr. Robert Billing was engrossed with his machine. It was a tangle of stainless steel, upright manometers, and a few colorful cylinders of compressed gas. A brown bottle of halothane stood on top of the machine. On the label was written: “2-bromo-2-chloro-1,1,1-tri-fluoroethane (C2HBrClF3).” An almost perfect anesthetic agent.

“Almost” because every so often it seemed to destroy the patient’s liver.

But that rarely happened, and halothane’s other characteristics far overshadowed the potential for liver damage. Dr. Billing was crazy about the stuff. Somewhere in his imagination he pictured himself developing halothane, introducing it to the medical community in the lead article of the New England Journal of Medicine, and then walking up to receive his Nobel prize in the same tuxedo he had worn when he was married.

Dr. Billing was a damned good anesthesiology resident, and he knew it.

In fact, he thought most everyone knew it. He was convinced he knew as much anesthesiology as most of the attendings, more than some. And he was careful, very careful. He had had no serious complications as a resident, and that was indeed rare.

Like a 747 pilot, he had made himself a checklist, and religiously he adhered to a policy of checking off each step of the induction procedure.