Helen stood behind him reading a steady stream of messages she felt obligated to tell him. Dr. Rees had called asking about the CAT scan on his patient, the X ray unit in the second angiography room had been fixed and was functioning normally, the emergency room called saying that they were expecting a severe head injury that was going to need an emergency CAT scan. It was endless and it was routine. Philips told her to handle everything, which was what she’d planned to do anyway, and she disappeared back to her desk.
Philips removed his white coat and put on the lead apron he wore during certain X-ray procedures to protect himself from the radiation. The bib of the apron was distinguished by a faded Superman monogram, which had resisted all attempts at removal. It had been drawn there in jest two years previously by the neuroradiology fellows. Knowing the gesture had been made out of respect, Martin had not been annoyed.
As he was about to leave, his eyes swept across the surface of his desk for a reassuring glimpse of the program cassette, just to make certain he hadn’t fantasized Michaels’ news. Not seeing it, Martin walked over to shuffle through the more recent layers of debris. He found the cassette under Mannerheim’s X rays. Philips started to leave, but again stopped. He picked up the cassette and Lisa Marino’s latest lateral skull X ray. Yelling through the open door for Helen to tell the angio room he’d be right there, he walked over to his worktable.
He took off his lead apron and draped it over a chair. He stared at the computed prototype, wondering if it would really work. Then he held up Lisa Marino’s operative X ray to the light that came from the banks of viewing screens. He wasn’t interested in the electrode silhouettes and his mind eliminated them. What interested Philips was what the computer would say about the craniotomy. Philips knew they had not included the procedure in the program.
He flipped the switch on the central processor. A red light came on and he slowly inserted the cassette. He got it three-quarters of the way in, when the machine swallowed it like a hungry dog. Immediately the typewriter unit came alive. Philips moved over so he could read the output.
Hi! I am Radread, Skull I. Please enter patient name.
Philips pecked out “Lisa Marino” with his two index fingers and entered it.
Thank you. Please enter presenting complaint.
Philips typed: “seizure disorder,” and entered that.
Thank you. Please enter relevant clinical information.
Philips typed: “21-year female, one year history of temporal lobe epilepsy.”
Thank you. Please insert film in laser scanner.
Philips went over to the scanner. The rollers within the lips of the insertion slot were moving. Carefully Philips lined up the X ray with its emulsion side down. The machine grabbed it and pulled it inside. The output typewriter activated. Philips walked over. It said: Thank you. Have a cup of coffee. Philips smiled. Michaels’ sense of humor emerged when least expected.
The scanner emitted a slight electrical buzz; the output device stayed silent. Philips grabbed his lead apron and left the office.
There was silence in OR #21 as Mannerheim mobilized Lisa’s right temporal lobe and slowly lifted it from its base. A few small veins could be seen linking the specimen to the venous sinuses, and Newman skillfully coagulated and divided them. At last it was free, and Mannerheim lifted the piece of the brain out of Lisa’s skull and dropped it into a stainless steel dish held by Darlene Cooper, the scrub nurse. Mannerheim looked up at the dock. He was doing fine. As the operation had progressed, Mannerheim’s mood had changed again. Now he was euphoric and justly pleased with his performance. He’d done the procedure in half the usual time. He was certain he’d be in his office at noon.
“We’re not quite finished,” said Mannerheim, taking the metal sucker in his left hand and forceps in his right. Carefully he worked over the site where the temporal lobe had been, sucking out more brain tissue. He was removing what he called the deeper nuclei. This was probably the riskiest part of the procedure, but it was the part Mannerheim liked the best. With supreme confidence he guided the sucker, avoiding vital structures.