Coma

by Robin Cook

  Swinging doors opened from the dressing rooms to the OR receiving area. Susan stepped into it. Here the appearance was more traditional. The lighting came from fluorescent bulbs in the ceiling alongside the omnipresent tracks for the patient trolleys. There was a faint glow that Susan remembered from the main ward, and she guessed there was an ultraviolet component to the light. The floor was of white vinyl, the walls surfaced in white ceramic tile.

  The OR reception area was not large. In the center was an empty desk. There were apparently four operating rooms, two on each side, with ancillary rooms between. Susan’s attention was attracted by muffled sounds from the first OR. Light coming through a small window suggested that an operation was in progress.

  A dark window in the door of the adjacent ancillary room suggested that it was empty. Susan walked over, peered in, and stepped into the darkness.

  This service room was dimly lit through a window of a door leading to the occupied OR.

  Susan waited for her eyes to adjust to the darkness. Slowly the objects in the room took form. There was a central table supporting several large objects from which emanated a low-pitched continuous noise. Countertops ran around the room. In the left countertop there was a large sink. Immediately to her right she could see the form of a gas sterilizer.

  As quietly as possible, Susan opened the cabinet beneath the sink, and with her hands she ascertained that there would be enough room to squeeze in if necessary. She then returned to the hall door and ran her fingers along its edge until she found the knob and depressed the lock. Then she paused and listened to make sure there had been no change in the pattern of noises from the OR. Susan looked at the objects on the central table, but the light was too poor to distinguish them.

  Susan trod lightly to the OR door and raised herself on tiptoe. She saw two surgeons, gowned and gloved in the usual fashion, bending over a patient. But she could see no anesthesiologist. There was no operating table. The patient was still strung up in a frame. But he was maintained on his right side; an incision gaped across his loins. The surgeons were closing, and Susan could hear their conversation with relative ease.

  “I wonder where that heart’s going from that previous case?”

  “San Fran,” said the second surgeon, running down a knot, pulling it tight. “I think it’s only bringing seventy-five thousand dollars. It was a poor match, only two out of four, but it was a rush order.”

  “Can’t win ’em all,” said the first surgeon, “but this kidney is a four-tissue match, and I understand it’s going for almost two hundred thousand. Besides, they might want the other one in a few days.”

  “Well, we don’t let it go until we find a market for the heart,” added the other, tying another rapid knot.

  “The real problem is finding a tissue match for Dallas. The offer is a million dollars for a four-match. The kid’s father is in oil.”

  The second surgeon whistled. “Any luck so far?”

  “We found a three-tissue match scheduled for a T&A at the Memorial next Friday and . . .”

  Susan’s mind was desperately trying to find some alternate explanation for what she thought she was hearing, but before she could, the door from the reception hall jiggled as someone tried to open it. Susan’s first impulse was to run into the other empty OR. Instead, she raced back to the sink, as she heard someone enter the lighted operating room. She squeezed herself into the cabinet under the counter, wincing at the sound of several jars that tipped over when she pulled her feet in after her. It was tight quarters; she struggled to get her arms in. She was unable to close the door completely by the time the door to the OR opened and the room lights went on. Susan held her breath.

  With her head twisted sideways, and the cabinet door slightly ajar, she could see two Plexiglas structures sitting on the table. They resembled fish tanks. Then she understood the pumping noise she had heard when she entered the room. It came from two self-contained machines, battery-driven, which perfused the two Plexiglas tanks. The first contained a human heart, suspended in a fluid. It was quivering, but not beating. The other contained a human kidney, also suspended in a fluid.

  Suddenly the whole nightmare was clear to Susan. Now she had a motive, a horrible motive for making patients comatose. The Jefferson Institute was a clearinghouse for black-market human organs!

  Susan had little time to think. A man walked past the sink, his trousers brushing against the half-closed cabinet door. He unlocked the door to the hall, then he went over to the table. Audibly straining, he lifted the tank which contained the heart and carried it away, leaving the light on and the door ajar.

  Susan’s mind raced back over all the details of her investigation: the T-valve on the oxygen line, D’Ambrosio’s face, the image of Nancy Greenly, and the heart in the Plexiglas container. She remembered the conversation in the morgue below, and she realized that the heart must have been Berman’s. She began to feel a sense of urgency, a sense of pervading panic. The concept of this lurid affair was too overwhelming. She had to get away and, for the first time, she realized how difficult that was going to be. This was no ordinary hospital. At least some of the people running it were criminals. She had to get out and get to someone who could comprehend what was going on. Stark. She had to get to Stark. He would be able to appreciate the whole business and was powerful enough to do something about it.

  Carefully Susan moved her left hand out of the cabinet onto the floor, pushing open the door as she did so. She listened. There were no noises except for the quiet whir of the pump perfusing the kidney on the table. With great effort she began to pull her right leg from the far corner of the cabinet. Then she heard footsteps in the hall. There was only a second. Her foot went back where it had been. She pulled in her arm, pushing herself into the cabinet as far as possible. The elbow of the drain from the sink above dug into her back.

  The man came back into the room at a fast walk. He came between the sink and the table and kicked the cabinet door shut. The sound and compression made Susan’s ears ring. She heard him strain with the second tank. Then his footsteps left the room and receded down the corridor.

  Susan stayed still for another two or three minutes before she dared to move, listening. There were no footsteps, only a muffled laugh from the first OR. Susan extracted her cramped body from beneath the sink. A spray can fell out onto the floor and rolled a short distance. Susan froze. Nothing. Then she ran for the door into the unlit operating room.

  She had to pause once again to allow her eyes to adjust to the darkness. Here the forms of the overhead operating lights were visible. Carefully Susan moved to the common wall with the corridor, feeling for the door handle. Once she found it, she cracked the door and looked into the scrub area immediately beyond.

  At that instant a piercing alarm shattered the stillness and all the lights went on in the previously darkened room. In a panic Susan let go of the door and turning threw herself against the wall expecting an assailant.

  The room was empty.

  A red light was blinking on and off next to a small loudspeaker. The loudspeaker crackled: “There is an unauthorized intruder in the building. Female. She must be detained immediately. I repeat . . . there is an unauthorized individual in the building . . . detain immediately.” The loudspeaker went dead. Susan sighed in relief. She left the OR and peered around the wall of the scrub area. The corridor was clear.

  Two white-uniformed guards strode briskly through the main ward, oblivious to the hundred-odd human beings strung up around them. Each had a pistol in his hand. The larger of the two was listening to his Sony two-way radio. He replaced it on his belt. “I’m to take the elevator in the computer room up to two. You’re to head through the morgue and down to the machinery spaces.”

  The two men entered the corridor beyond the ward.

  “And remember, our orders are clear. If you find her and she comes along willingly, fine; if not then shoot her. But shoot her in the head. They may want the kidneys or the heart, dependin
g on her tissue type.”

  The two men split. The large man walked down the corridor and entered the computer room. Methodically he checked the room, then he summoned the elevator.

  Susan dashed down the OR reception area, past the first operating room. She opened the door to the dressing area but heard voices within. Without hesitation she changed her plan and turned for a door she knew must open into the main corridor. Then she spotted a large pair of scissors on the reception desk. She picked them up; they were a weapon of sorts. Then she let herself into the main corridor.

  The corridor was still empty, to Susan’s intense relief. She could see all the way down to the closed elevator doors at the far end. Taking a deep breath, she sped toward the elevator.

  She was about halfway down the hundred-and-fifty-foot hall when the elevator arrived. Susan slowed as the doors quivered and opened. The guard stepped out and Susan stopped. Each was startled to see the other.

  “All right, young lady, we’d like to talk to you downstairs.” The guard’s voice was not threatening. He began to advance slowly toward Susan, keeping his pistol behind his back.

  Susan took a few indecisive steps backward, then she spun and raced toward the OR area. The guard pelted after her. In desperation Susan tried several doors. The first was locked; so was the second. The guard was almost on her. The handle of the third door turned and the door opened.

  She rolled around the door, trying to slam it shut. But the guard gripped the edge of the door with his left hand and wedged his left foot between the door and the casing.

  Susan pushed with every ounce of strength she could muster but it was hardly an even match. The guard was over two hundred pounds, and his weight and strength prevailed despite Susan’s efforts. The door began to open.

  Keeping her shoulder and left hand against the door, Susan gripped the scissors like a dagger. With a quick overhand stroke, she plunged the scissors into the guard’s hand.

  The point of the scissors struck between the knuckles of the second and third fingers. The force of the blow carried the blades between the metacarpal bones, shredding the lumbrical muscles and exiting through the back of the hand. The guard screamed in agony, letting go of the door. He staggered back into the corridor with the scissors still embedded in his hand. Holding his breath and grinding his teeth, he pulled them out. A small arterial pumper squirted blood in short pulsating arcs onto the opaque plastic floor, forming a pattern of red polka dots.

  Susan slammed the door shut and locked it. She whirled to survey the room. It was a small laboratory, with a laboratory bench in the center. To the left were two desks back to back. Against the wall were several filing cabinets. At the far end was a window.

  The guard in the hall recovered enough to wrap a handkerchief about his left hand and curb the spurting blood. He passed the cloth between his index and middle fingers and tied it around his wrist. He was furiously angry, as he fumbled with his passkeys. The first key would not turn in the lock. The second key he selected would not fit it. The third key also would not turn. Finally, the fourth key turned, and the lock mechanism sprang back, releasing the door. With his foot, the guard kicked the door open with such force that the knob went through the plaster wall to the right. With his pistol cocked, the guard sprang into the room, spinning around. Susan was gone. The window was open and frigid February air was streaming into the warm room. The guard ran to the window and leaned out enough to see the ledge. He returned to the room and took out his two-way radio.

  “OK. I found the girl, floor two, the tissue lab. She’s something. She stabbed me, but I’m OK. She went out the window onto the ledge. . . . No, I can’t see her. The ledge goes around the corner. . . . No, I don’t think that she would jump. Did the Dobermans get released? . . . Good. The only worry is that she might attract some attention if she gets to the front of the building. . . . OK. . . . I’ll check the ledge on the other side.”

  The guard put his radio back on his belt, closed the window and locked it. Then he ran out of the room, clutching his wounded hand.

  Thursday

  February 26

  5:47 P.M.

  The heavy industrial-weight vinyl ceiling tile was slowly slipping from Susan’s grip, and she clenched her teeth. Her hands were numb from holding it with just the tips of her fingers, forcing the tile against its metal supports on the opposite side of its six-foot expanse. She could hear the guard below talking on his two-way radio. If the tile fell, he’d find her. She closed her eyes as tightly as she could to take her mind off her fingers and her aching forearms. It was slipping. It was going to fall. The guard switched off. Then the window closed. Susan held on somehow. She didn’t hear the guard exit, but the tile fell with a dull thud that jarred the whole suspended ceiling. Susan listened intently as blood rushed into her tingling fingers, painfully. There was no sound below. She let herself take a deep breath.

  Susan was up in the ceiling space above the tissue lab. It was ironic that before her search of the ORs at the Memorial, Susan never knew of the existence of ceiling spaces. Now clambering up there had saved her life. Thank God for the filing cabinet on which she had stood to lift the tile.

  Susan took out her floor plans and tried to examine them in the sparse light filtering up through the edges of the ceiling tiles. She found it impossible even after her eyes had adjusted. Looking around in the gloom, she noticed a rather concentrated beam of light coming from some larger fissure in the ceiling about twenty feet from her position. With the help of the upright studding marking the wall of the tissue lab and a neighboring office, Susan managed to work her way over to the light source and position herself so that she could see the plans. What she wanted to find was the main chase like the one she had seen at the Memorial. She thought that if it were big enough it would be a possible way out. But the chase was not listed in the key. However she did find a rectangular enclosure drawn next to the elevator shaft. Susan decided that it probably represented the chase she was after.

  She moved along the top of the wall of the tissue lab, holding onto the upright studs until she reached the step up to the fixed ceiling of the corridor. It was made of concrete, to support the tracks for the trolleys. Once on it, the going was much easier. She moved toward the elevator shaft.

  The closer she got to the elevator shaft the more difficult was her progress both because it got significantly darker and because more and more pipes, wires, and ducts converged in the direction she was heading. She had to move by feel, advancing a foot forward slowly, blindly. Several times she touched a steam pipe and it burned her. The smell of burnt flesh drifted into her nose.

  In utter darkness she reached the elevator shaft and felt the vertical concrete. Rounding its corner, she followed a pipe with her hands and felt it turn down at a ninety-degree angle. Other pipes did the same. Leaning over them, she looked down into the darkness. A faint light filtered up from far below.

  With her hands Susan determined the size of the chase. It was about four feet square. The wall common to the elevator shaft was concrete. She selected a pipe about two inches in diameter. Lowering herself into the chase, she put her back against the concrete wall and grabbed the pipe with both hands. Then she put her feet against other pipes and pushed back firmly against the concrete wall. In this fashion she inched herself down the chase, like a mountaineer in a chimney.

  The going was not easy. Moving only inches at a time, she tried, although not always successfully, to avoid the steam pipes, which were blistering hot. After a while she was able to distinguish the pipes in front of her. Looking into the darkness, she could see vague forms, and she realized that she had reached the ceiling space of the first floor. She was making progress and she felt a certain elation. But it was tempered by the thought that if she could use the chase to go down, someone could use it to go up. And she realized then how relatively easy it was for someone to gain access to the T-valve in the oxygen line at the Memorial.

  Susan continued inching downward. Below
her there was a bit more light filtering upward. There was also the progressively louder sound of electrical machinery. As she approached the basement level, Susan realized that there was no suspended ceiling below her in the basement. There would be no way to conceal herself and move laterally. She worked herself down until her eyes cleared the structural floor on the first level, then stopped her movement, wedging herself securely against the concrete to survey the scene.

  The machinery room and its power plant were lit by a few work lights. The pipe Susan was using for her descent, apparently a water pipe from its feel, continued to the floor. But several other pipes, larger than the one she was holding, angled off horizontally, hanging by metal straps about four feet below the concrete slab of the building’s first floor. They ran high above the machinery area.

  Susan stepped onto one of these pipes. She was no acrobat, but perhaps her natural ability as a dancer helped. With her right hand and her head pressed against the solid concrete, she moved crouching along the pipe, trying not to look down.

  She teetered a bit but gained confidence. Ahead she saw a wall and beyond, another ceiling space. By maintaining pressure on the ceiling above she did a tightrope walk along the pipe. Susan passed directly over the power plant and was within four feet of her goal when there was a startling flash of light very close to her, almost causing her to lose her balance. The lights had come on in the machinery room.

  Susan shut her eyes, pressing her hands against the ceiling and hooking the groove of her shoes against the pipe. Beneath her a guard moved slowly around the machinery, a big flashlight in one hand, a pistol in the other.

  The next fifteen minutes were probably the longest single period of time in Susan’s life. She felt so exposed, with a white dress against the dark pipes and ceiling, that she could not fathom why she was not seen. The guard searched carefully, even the cabinets under the workbench. But he never looked up. Susan’s arms began to tremble from the tension necessary to keep her balance secure. Then her legs followed, so that she was afraid her shoes would soon be tapping a message against the pipe. Finally the guard was satisfied and left, turning out the main lights.