Coma Page #4

---

Nobody will be there after midnight.

I think we're looking

at cortical anoxia.

- I'll check the Babinski.

- How old is he?

Thirty-five.

When did you administer

the additional dosage?

At the onset of cardiac irritability.

The surgeon said he was light.

Surgeons know nothing about anesthesia.

What'd you give?

Two cc's push.

There was no reason

there'd be a problem.

Just seemed a little light.

Some PVC in runs,

transient hypotension...

...but no sign of hypoxia.

Skin color and blood

were all red and fully oxygenated.

The pupils are fixed and dilated,

I must presume brain death.

Any relation to your other case?

Completely different.

Different staffs,

different anesthetic agents.

- He better be trached.

- Do we need a pulmonary consult?

Request the consult...

...but go ahead with the tracheotomy.

This is a long-term

management problem.

- Come on.

- It happened again.

That's Dr. George, chief of anesthesia.

He's got it under control.

Is there a research protocol

this case would fit?

He's a good research case.

Excellent teaching material.

It's true, Mr. Murphy

presents challenges...

...electrolyte balance IV,

caloric maintenance...

...possible pseudomonas infection.

There may be additional

risk of staph osteomyelitis.

But I think you'll be

agreeably surprised, Dr. George.

We can keep him alive...

...in stable vital signs, a year...

...two years, indefinitely.

You can't just look the other way.

Nobody's looking the other way.

Mark, twice in two days.

It's not normal.

- In certain cases, patients always...

- You told me that.

Two in two days.

You're just sensitized to it.

It just happened to a friend

and now you're looking for it.

Twice in two days

is just our lousy luck.

- Did Harris take the readout?

- Yes.

All right, then forget it.

The hospital has

review boards and committees.

They'll look into it.

Now, you got a job to do,

so forget about this.

You're right. You're right.

I'll see you at dinner?

This is Dr. Wheeler.

I know about the conference

but I'm tied up with a patient now.

Well, I'm afraid I can't

make it there in time.

Where am I?

I'm in the emergency ward.

Yes, it is important.

Will you hold on?

Well, that's funny,

but all these charts you wanted...

...they're all signed out to Dr. George,

the chief of anesthesiology.

Good afternoon, Dr. George.

Good afternoon, staff.

We have a happy lab here.

It's precise.

There's nothing left to chance.

There are no mistakes.

The charts are right here.

There's no mystery.

They're right here.

What is it you wanted?

I'd like to look at them.

For what reason?

I'm interested in unexplained coma

following routine surgery.

You're interested?

I'm more than interested.

My anesthesiology staff

is more than interested.

We're deeply concerned.

I understand.

I'm not sure you do.

Perhaps something was missed?

Missed?

Every professor of anesthesia,

most of our staff...

...more than 40 experts

have gone over these charts.

You think something was missed?

But if anything

links them together...

If anything linked them,

we'd know it.

Here they are, 10 cases.

There are now 12.

Different ages and sexes.

Different surgeons and anesthetists.

Different methods of induction.

They share nothing in common except

they all emerged with unexplained coma.

We're certainly not neglecting

that problem.

I didn't say you were.

Do you mind if I have a look?

I'm afraid I do mind.

Thank you for your interest,

however misplaced.

Good afternoon.

Oh, my God, you did...

How could you do that?

Dr. George is a past president...

...of the American Society

of Anesthesiologists.

He's a member of the AAAS.

He's on the board of the NIH...

...and you tell him

he's doing his job wrong.

- I just wanted to see the charts.

- That's not your area.

That's not your responsibility.

You're way off base.

You know who his wife is?

- I don't care.

- Well, you should.

His wife is Amy Cabot.

She's related to Godfrey Lowell.

I don't care about Boston society.

Dr. George's wife...

...is worth somewhere between

50 and 100 million dollars.

When she dies,

that money will go somewhere.

So what?

So he has a lot of muscle here.

He's the wrong man to cross.

You afraid to be seen with me?

Come in.

- Hi, Bill.

- How are you?

Good.

Sit down.

You know, Mark...

...I always thought that you'd have

this job when I leave next year.

Everybody thinks so.

You're the logical choice.

You're a good surgeon.

You're well-organized.

You run a good service.

Well, thank you very much, Bill.

I'd hate to see anything

stand in your way.

You know what I mean.

She has the chiefs of service

in an uproar.

- She's under a lot of pressure.

- And so are we.

They're talking about releasing her

from her position here at the Mem.

But nobody really wants

that kind of...

...adverse publicity, that commotion.

Of course not.

You have influence with her?

I don't know. She's paranoid.

She thinks there's a conspiracy.

George keeping the charts

from her did not help.

Does she think you're involved?

No, I don't think so.

Let's hope not, Mark. What happens

to Susan may depend on you.

I understand that, Bill.

You know, a good chief resident...

...handles problems

like this every day.

I think if you're able to exert

some influence over her...

...people would be appreciative.

Well, I'll try.

Good man.

Where's Greenly?

That coma case? She was to be

transferred to the Jefferson Institute.

I guess she went there.

Liz, did Greenly go to Jefferson?

No, she arrested at six

this morning.

- She's down in pathology.

- In pathology?

Yeah, they're probably doing

the autopsy now.

Do you have a patient

named Greenly?

I don't know. Check in there.

I can't keep track of names.

In microscopic section,

we may expect evidence...

...of fatty degeneration in cells...

...with polymorphs and histiocytes

around them.

Okay, incise the kidney there.

Looks normal.

Okay, remove it.

Greenly?

This is Howard.

Greenly's over there.

Hi, Jim.

Hi, Sue. What brings you here?

Interested in this case?

That's right.

Hell of a puzzler.

Young girl, good health...

...in for a therapeutic AB,

comes out comatose.

Found anything?

Naturally, we started with the brain.

Grossly, it was normal.

I'm doing a section. Want to see?

Ordinarily, these coma cases

get shipped to Jefferson.

- What's Jefferson?

- Jefferson Institute.

A chronic-care facility.

Government thing.

They take care of the vegetables.

Sometimes they die before

they get there, like this one.

More work for us.

Now we'll get an idea.

We're looking for anything.

Micro-infarcts, staph loci...

...gross hemorrhagic areas,

congenital defects...

Nothing. Just like the

other cases, we come up cold.

I know it sounds silly...

...but if you wanted to put people

in a coma, what would you do?

On purpose?

Diethyl para-amino tannadol.

No, it leaves a serum trace.

Rate this script:0.0 / 0 votes