Coma

“Yeah. Apparently he’d learned that the drugs had been found, and he decided to take what he considered the easy way out.”

“Are you sure it was suicide?”

“I’m not sure of anything. I didn’t even see the note. I called the police and have gotten the details from Stark. But don’t suggest it wasn’t suicide. God, I couldn’t handle that. I’d probably be considered a suspect.

What on earth could make you suggest such a thing?” Bellows was intense.

“No reason. It just seems another strange coincidence to have happened at this time. Those drugs that were found may be important somehow.”

“I was afraid that your imagination would suggest that they were important. That was one of the reasons why I hesitated to tell you about the drugs in the first place. But look, all this is somewhat peripheral to the present problem, namely your presence here at the Memorial at this rather sensitive time. I mean, Susan, you are not supposed to be here.

It’s as simple as that.” Bellows paused and picked up one of the charts Susan had been extracting. “What the hell are you doing anyway?”

“I finally got some of the charts of the coma patients. Not all of them, but some of them.”

“God, you really are amazing. After getting yourself kicked out of the hospital, you still manage to have the balls, so to speak, to come back here and find a way to get these charts. I don’t imagine that they leave them lying around for anybody to look at who happens along. How did you manage to get them?”

Bellows looked expectantly at Susan, sipping his coffee and waiting for a response. Susan only smiled.

“Oh no!” said Bellows putting his hand to his forehead. “The nurse’s uniform.”

“Yup, worked like a charm. Great idea, I must admit.”

“Wait a minute. I don’t want any credit for it, believe me! What did you do? Get security to open McLeary’s or whoever-it-was’s office?”

“You’re getting more and more clever, Mark.”

“You do realize that you’re now breaking the law.”

Susan nodded in agreement, looking down at the pile of paper filled with her tiny writing.

Bellows’s eyes followed hers.

“Well, have they shed any light on this ... this crusade of yours?”

“Not much, I’m afraid. At least not yet, or at least I’ve not been clever enough to spot it. I wish I had all the charts. So far the ages have all been relatively young, twenty-five to forty-two. Otherwise they seem to be of random sex, racial background, social background. I can’t find any relationship in their previous medical histories. Their vital signs and progress up until the onset of coma were uncomplicated in all cases.

Their personal physicians were all different. Of the surgical cases, only two had the same anesthesiologist. The anesthetic agents were varied, as expected. There were some overlaps in the preoperative medications. A number of the cases had Demerol and Phenergan, but others had totally different agents. Innovar was used on two cases. But all that’s not surprising.

“It does seem, as far as I can tell without going up in the OR, that most if not all the surgical cases occurred in room eight. That does seem a little strange, but then again that’s the room used most often for the shorter operations. And this problem is most often associated with the shorter operations. So that’s probably to be expected as well.

Laboratory values are all generally normal. Oh, by the way, all cases seemed to have been blood-typed and tissue-typed. Is that normal procedure?”

“They blood-type most surgical patients, especially if they anticipate much blood loss during the operation. Tissue-typing is not usual, although the lab may be doing it as part of a check on new equipment or new tissue-typing sera. See if there is an accounting number on one of the lab reports on the typing.”

Susan flipped back through the pages of the chart in front of her until she located the tissue-type report.

“No, there’s no accounting number.”

“Well, that explains that, then. The lab is doing it at their expense.

That’s not abnormal.”

“The medical patients were all on I.V.s for one reason or another.”

“So are ninety percent of the people in the hospital.”

“I know.”

“Sounds like you got a lot of nothing.”

“I’d have to agree at this point.” Susan paused, sucking on her lower lip.

“Mark, before the endotracheal tube is placed in a patient during anesthesia, the anesthesiologist paralyzes the patient with succinylcholine. Isn’t that right?”

“Succinylcholine or curare, but usually succinyl.”

“And when a patient is given a pharmacological dose of succinylcholine, he can’t breathe.”

“That’s true.”

“Couldn’t an overdose of succinylcholine be the way these patients are rendered hypoxic? If they can’t breathe, then oxygen doesn’t get to the brain.”