Coma

With its private offices Beard 8 resembled Beard 10. Susan walked down the corridor, stopping at room 810. The door had crisp black lettering across its aged but polished mahogany surface: “Department of Medicine, Professor J. P. Nelson, M.D., Ph.D.”

Nelson was Chief of Medicine, Stark’s counterpart, but associated with internal medicine and its subspecialties. Nelson was also a powerful figure in the medical center but not quite as influential as Stark, nor was he as dynamic, and as a fund raiser, he couldn’t even compare.

Nevertheless, it took a bit of fortitude on Susan’s part to get up the nerve to approach this Olympian figure. With some hesitation she pushed open the mahogany door and faced a secretary with wire-rimmed glasses and a comfortable smile.

“My name is Susan Wheeler and I called a few minutes ago to see Dr.

Nelson.”

“Yes of course. You’re one of our medical students?”

“That’s right,” said Susan, unsure of what “our” meant in that context.

“You’re lucky, Miss Wheeler, to catch Dr. Nelson in. Plus I believe he remembers you from a class or something. Anyway, he’ll be with you shortly.”

Susan thanked her and retreated to one of the stiff black waiting-room chairs. She pulled out her notebook to scan more of her notes, but instead found herself viewing the room, the secretary, and the lifestyle it meant for Dr. Nelson. As far as the value system in medical school was concerned, such a position represented the final triumph of years of effort and even luck. It was just the kind of luck Susan felt could be behind her present quest. All someone needed was one lucky break and the doors would open.

The reverie was cut short by the door to the inner office being opened.

Two doctors in long white coats came from within, continuing their conversation at the door. Susan could get bits and pieces and it seemed to be about an enormous amount of drugs that had been located in a locker in the surgical lounge. The younger of the two men was quite agitated and spoke in a whisper whose sound level was approximately equal to normal speech. The other gentleman had the portly bearing of a mature physician, replete with soft, knowing eyes, luxuriant graying hair, and a consoling smile. Susan knew it had to be Dr. Nelson. He seemed to be trying to console the other with reassuring words and a lingering pat on the shoulder. Once the other doctor had left, Dr. Nelson turned to Susan and beckoned for her to follow him.

Nelson’s office was a tumble of reprinted journal articles, scattered books, and stacks of letters. It appeared as if a tornado had swept through the room several years previously with no subsequent effort at reconstruction. The furniture consisted of a large desk and an old cracked leather chair that squeaked as Dr. Nelson lowered his weight into it. There were two other smaller leather chairs facing the desk.

Susan was motioned to take one of them as Dr. Nelson took one of his briars and opened a tobacco canister on the desk. Before filling the pipe he hit it on the palm of his left hand a few times. The few ashes that appeared were carelessly scattered on the floor.

“Ah yes, Miss Wheeler,” began Dr. Nelson, scanning a note card on his desk. “I remember you well from physical diagnosis class. You were from Wellesley.”

“Radcliffe.”

“Radcliffe, of course.” Dr. Nelson corrected his note card. “What can we do for you?”

“I’m not sure how to start. But I’ve become very interested in the problem of prolonged coma, and I have begun to look into it.”

Dr. Nelson leaned back, the chair squeaking in agony. He placed the tips of his fingers together.

“That’s fine, but coma is a big subject, and, more important, it is a symptom rather than a disease in itself. It is the cause of the coma that is important. What is the cause of the coma you have become interested in?”

“I don’t know. In short, that’s why I’m interested in it I’m interested in the kind, of coma that just seems to happen and no cause is found.”

“Are you concerned with emergency room patients or in-hospital patients?” asked Dr. Nelson, whose voice changed slightly.

“Inpatients.”

“Are you referring to the few cases that have occurred during surgery?”

“If you call seven few.”

“Seven,” said Dr. Nelson taking several long pulls from his pipe, “I believe is a rather high estimate.”

“It’s not an estimate. Six previous cases occurred during surgery.

Presently there is another case upstairs, operated on yesterday, that appears to fit into the same category. In addition, there have been at least five cases on the medical floor occurring in patients admitted for some seemingly unrelated complaint.”

“How did you get this information, Miss Wheeler?” asked Dr. Nelson with an altogether different tone of voice. The previous warmth was gone. His eyes regarded Susan without blinking. Susan was unaware of this change in apparent mood.

“I got the information from this computer printout right here.” Susan leaned forward with the printout and handed it across the desk to Dr.