A Brain (11 page)

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Authors: Robin Cook

BOOK: A Brain
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Now as Martin walked back to their table, Denise felt a rush of affection, and gratitude. At the same time she recognized he was a man, and she was afraid of assuming a commitment he did not feel.

“This is not my day,” said Martin, sitting down across from her. “That was Dr. Reynolds. Marino is not being autopsied.”

“I thought she'd have to be,” said Denise, surprised and trying to switch her mind back to medicine.

“True. It was a medical examiner's case, but in deference to Mannerheim, the examiner released the body to our Path department. The Path department approached the family for permission, and the family refused. Apparently they were pretty hysterical.”

“That's understandable,” said Sanger.

“I suppose,” said Philips, dejectedly. “Damn . . . . Damn!”

“Why not pull some X rays of patients with known multiple sclerosis and see if you can find similar changes.”

“Yeah,” said Philips with a sigh.

“You could think a little about the patient rather than your own disappointment.”

Martin stared at Denise for several minutes, making her feel that she had overstepped an unspoken boundary. She hadn't meant to be moralizing. Then his face changed and he smiled broadly.

“You're right!” he said. “In fact you just gave me a fabulous idea.”

 

Directly across from the emergency room desk was a gray door with a sign that read
EMERGENCY ROOM STAFF
. It was the lounge for the interns and residents,
although it was rarely used for relaxation. In the back was a lavatory with showers for the men; the women doctors had to go upstairs to the Nurses' lounge. Along the side there were three small rooms with two cots each, but they weren't used much except for short naps. There was never time.

Dr. Wayne Thomas had taken the one comfortable chair in the lounge: an old leather monster with some of its stuffing extruding through an open seam like a dehisced wound.

“I think Lynn Anne Lucas is sick,” he was saying with conviction.

Around him, either leaning against the desk or seated in one of the wooden chairs, were Dr. Huggens, Dr. Carolo Langone, Resident in Internal Medicine; Dr. Ralph Lowry, Resident in Neurosurgery; Dr. David Harper, Resident in Gynecology; and Dr. Sean Farnsworth, Resident in Ophthalmology. Separated from the group were two other doctors reading EKG's at a counter.

“I think you must be horny,” said Dr. Lowry with a cynical smile. “She's the best-looking chick we've seen all day and you're trying to find some excuse to admit her on your service.”

Everyone laughed but Dr. Thomas. He didn't move except for his eyes, which turned to Dr. Langone.

“Ralph has a point,” admitted Langone. “She's afebrile, normal vital signs, normal blood work, normal urine, and normal cerebral spinal fluid.”

“And normal skull X ray,” added Dr. Lowry.

“Well,” said Dr. Harper, getting up from his chair. “Whatever it is, it ain't GYN. She's had a couple of abnormal Pap smears, but that's being followed in the clinic. So I'm going to leave you to solve this problem
without me. To tell you the truth, I think she's being hysterical.”

“I agree,” said Dr. Farnsworth. “She claims to have trouble seeing but her ophthalmology exam is normal and with this near vision card she can read the small row of numbers with ease.”

“What about her visual fields?” asked Dr. Thomas.

Farnsworth got to his feet, preparing to leave. “Seem normal to me. Tomorrow we can have a Goldmann field done, but we don't do them on an emergency basis.”

“And her retinas?” asked Dr. Thomas.

“Normal,” said Farnsworth. “Thanks for the consult. It's been swell.” Picking up his suitcase of instruments, the ophthalmologist left the room.

“Swell! Shit,” said Dr. Lowry. “If I have one more Goddamn prissy eyeball resident tell me they don't do Goldmann fields at night, I think I'll punch him out.”

“Shut up, Ralph,” said Dr. Thomas. “You're starting to sound like a surgeon.”

Dr. Langone stood up and stretched. “I got to be going too. Tell me Thomas, why do you think this girl is sick: just because of her decreased sensation? I mean, that's pretty subjective.”

“It's a feeling I have. She's scared, but I'm sure she's not hysterical. Besides, her sensory abnormalities are very reproducible. She's not faking. There's something screwy going on in her brain.”

Dr. Lowry laughed. “The only thing screwy about this case is what you'd like to be doing if you met her under more social circumstances. Come on, Thomas. If she were a dog, you woulda' just told her to come back to clinic in the
A
.
M
.”

The whole lounge laughed. Dr. Thomas waved
them away as he pulled himself from the easy chair. “I give up with you clowns. I'll handle this case myself.”

“Be sure to get her phone number,” said Dr. Lowry as Thomas left. Dr. Huggens laughed, he'd already thought it wasn't a bad idea.

Back in the ER Thomas looked around. From seven to nine there was a relative respite, as if people took time out from misery, pain, and illness while they ate. By ten, the drunks, the auto accidents, and the victims of thieves and psychos would begin to arrive; by eleven it would be the crimes of passion. So Thomas had a little time to think about Lynn Anne Lucas. Something was nagging him about the case; he felt as if he were missing some important clue.

Stopping at the main desk, he asked one of the ER clerks if Lynn Anne Lucas's hospital chart had arrived from the record room. The clerk checked, said no, but then reassured him that he'd call again. Dr. Thomas nodded absently, wondering if Lynn Anne had taken any exotic drugs. Turning down the main corridor, he headed back to the examination room, where the girl was waiting.

 

Denise had no inkling what Martin's “fabulous idea” was. He had asked her to come back to his office around 9
P
.
M
. It was about a quarter past when she had a break from reading trauma films in the emergency room. Using the stairs across from the closed hospitality shop, she reached the Radiology floor. The corridor seemed a different place from the commotion and chaos of the day. At the very end of the hall one of the janitors was using a power polisher on the vinyl floor.

The door to Philips' office was open, and Denise could hear his dictating monotone. When she entered, she found him finishing up the day's cerebral angiograms. In front of him on his alternator was a series of angiographic studies. Within each X ray of the skull the thousands of blood vessels showed up as white threads which appeared like an upside-down root system to a tree. While he spoke he pointed with his finger at the pathology for Denise's benefit. She looked and nodded, although it was incomprehensible how he knew the names and the normal size and position of each vessel.

“Conclusion:” said Philips, “Cerebral angiography shows a large arteriovenous malformation at the right basal ganglia in this nineteen-year-old male. Period. This circulatory malformation is supplied by the right middle cerebral artery via the lenticulostriate branches as well as from the right posterior cerebral artery via the thalamoperforate and the thalamogeniculate branches. Period.” End of dictation. Please send a copy of this report to doctors Mannerheim, Prince, and Clauson. Thank you.”

With a click, the recorder stopped, and Martin swung around in his chair. He was wearing a mischievous smile and he rubbed his hands together like a Shakespearean rogue.

“Perfect timing,” he said.

“What's gotten into you?” she asked, pretending to be scared.

“Come,” said Philips, leading her outside. Against the wall was a loaded gurney complete with IV bottles, linen, and a pillow. Smiling at her surprise, Martin began pushing the gurney down the hall. Denise caught up to him at the patient elevator.


I
gave you this fabulous idea?” she asked, helping guide the gurney into the car.

“That's right,” said Philips. He hit the button for the subbasement and the doors closed.

They emerged in the bowels of the hospital. A tangle of pipes, like blood vessels, ran off in both directions, twisting and turning on one another as if in agony. Everything was painted gray or black, eliminating all sense of color. The light, which was sparse, came from wire-mesh encased fluorescent bulbs placed at distant intervals, causing contrasting patches of white glare to be separated by long stretches of heavy shadow. Across from the elevator was a sign: M
ORGUE
: F
OLLOW RED LINE
.

Like a trail of blood, the line ran along the middle of the corridor. It traced a complicated route through the dark passages, winding sharply when the corridor branched. Ultimately it ran down a sloping incline, which nearly pulled the gurney from Martin's hands.

“What in God's name are we doing down here?” asked Denise, her voice echoing with their footsteps in the lifeless spaces.

“You'll see,” said Philips. His smile had waned and his voice sounded tense. His original playfulness had given way to a nervous concern about the prudence of what he was doing.

The corridor abruptly opened up into a huge underground cavern. The lighting here was equally as meager as in the corridor, and the two-story-high ceiling was lost in shadow. On the left wall was the closed door to the incinerator, and the hiss of hungry flames could be heard.

Ahead were the double swinging doors leading into the morgue. In front of them the red line on the floor
ended with abrupt finality. Philips left the gurney and advanced toward the entrance. Pushing open the door on the right he looked inside. “We're in luck,” he said, returning to the gurney. “We have the place to ourselves.”

Denise followed reluctantly.

The morgue was a large neglected room, which had been allowed to decay to the point that it resembled one of those unearthed porticoes of Pompeii. A multitude of hooded lights hung on bare wires from the ceiling, but only a few had bulbs. The floor was constructed of stained terrazzo, while walls were surfaced with cracked and chipped ceramic tile. In the center of the room was a partially sunken pit containing an old marble autopsy slab. It had not been used since the twenties, and standing amid the debris, it appeared like an ancient pagan altar. Autopsies were currently done in the department of Pathology on the fifth floor, in a modern stainless steel setting.

Numerous doors lined the walls of the room, including a massive wooden one that resembled a meat refrigerator in a butcher shop. On the far wall was an inclined corridor that led up in utter darkness to a door opening on a back alley of the hospital complex. It was deathly quiet. The only noise was an occasional drip from a sink and the hollow sounds of their own footsteps.

Martin parked the gurney and hung up the IV bottle.

“Here,” he said, handing Denise a corner of one of the fresh sheets and directing her to tuck it around the pad on the gurney.

He went over to the large wooden door, pulled the pin from the latch, and with great effort opened it up.
An icy mist flowed out, layering itself on the terrazzo floor.

After finding the light switch Martin turned and noticed Denise had not budged.

“Come on! And bring the gurney.”

“I'm not moving until you tell me what's going on,” she said.

“We're pretending it's the fifteenth century.”

“What do you mean?”

“We're going to snatch a body for science.”

“Lisa Marino?” asked Denise incredulously.

“Exactly.”

“Well I'm not going to have any part of this.” She backed up as if about to flee.

“Denise, don't be silly. All I'm going to do is get the CAT scan and X rays I wanted. Then the body is coming right back. You don't think I'm going to keep it, do you?”

“I don't know what to think.”

“What an imagination,” said Philips as he grabbed the end of the gurney and pulled it into the antique walk-in refrigerator. The IV bottle clanked against its metal pole. Denise followed, her eyes rapidly exploring the interior which was completely tiled; walls, ceiling and floor. The tiles had once been white; now they were an indeterminate gray. The room was thirty feet long and twenty feet wide. Parked in rows on each side were old wooden carts with wheels the size of those on a bicycle. Down the center of the room was an open lane. Each cart supported a shrouded corpse.

Philips slowly moved down the center aisle, glancing from side to side. At the back of the room he turned around and began lifting the corner of each
sheet. Denise shivered in the damp cold. She tried not to look at the bodies closest to her, which had been the gory result of one of the rush-hour traffic accidents. A foot, still wearing its shoe, stuck out at a crazy angle, advertising that the leg had been broken in mid-calf. Somewhere out of sight an old compressor chugged to life.

“Ah, here she is,” said Philips, peering under one of the sheets. Thankfully, for Denise, he left the shroud in place and motioned for her to bring the gurney down. She did it like an automaton.

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