Nelson’s office was a tumble of reprinted journal articles, scattered books, and stacks of letters. It appeared as if a tornado had swept through the room several years previously with no subsequent effort at reconstruction. The furniture consisted of a large desk and an old cracked leather chair that squeaked as Dr. Nelson lowered his weight into it. There were two other smaller leather chairs facing the desk. Susan was motioned to take one of them as Dr. Nelson took one of his briars and opened a tobacco canister on the desk. Before filling the pipe he hit it on the palm of his left hand a few times. The few ashes that appeared were carelessly scattered on the floor.
“Ah yes, Miss Wheeler,” began Dr. Nelson, scanning a note card on his desk. “I remember you well from physical diagnosis class. You were from Wellesley.”
“Radcliffe.”
“Radcliffe, of course.” Dr. Nelson corrected his note card. “What can we do for you?”
“I’m not sure how to start. But I’ve become very interested in the problem of prolonged coma, and I have begun to look into it.”
Dr. Nelson leaned back, the chair squeaking in agony. He placed the tips of his fingers together.
“That’s fine, but coma is a big subject, and, more important, it is a symptom rather than a disease in itself. It is the cause of the coma that is important. What is the cause of the coma you have become interested in?”
“I don’t know. In short, that’s why I’m interested in it I’m interested in the kind, of coma that just seems to happen and no cause is found.”
“Are you concerned with emergency room patients or in-hospital patients?” asked Dr. Nelson, whose voice changed slightly.
“Inpatients.”
“Are you referring to the few cases that have occurred during surgery?”
“If you call seven few.”
“Seven,” said Dr. Nelson taking several long pulls from his pipe, “I believe is a rather high estimate.”
“It’s not an estimate. Six previous cases occurred during surgery. Presently there is another case upstairs, operated on yesterday, that appears to fit into the same category. In addition, there have been at least five cases on the medical floor occurring in patients admitted for some seemingly unrelated complaint.”
“How did you get this information, Miss Wheeler?” asked Dr. Nelson with an altogether different tone of voice. The previous warmth was gone. His eyes regarded Susan without blinking. Susan was unaware of this change in apparent mood.
“I got the information from this computer printout right here.” Susan leaned forward with the printout and handed it across the desk to Dr. Nelson. “The cases I’ve mentioned have been indicated with yellow ink. You’ll see that there is no mistake. Besides, this represents only coma cases for the last year. I don’t know what the incidence was before then, and I think it would be essential to get a year-by-year printout. In that way one could have a better idea if this problem is static or on a dynamic upswing. And perhaps even more important, or at least equally important, I have a feeling that a number of sudden deaths here at the Memorial could be ascribed to the same unknown category. I believe the computer could help on that as well. Anyway, it is for these reasons that I wanted to speak with you. I was wondering if you would support me on this endeavor. What I need is full clearance to use the computer and the opportunity to get the hospital charts on these patients. I came to you because I have an intuitive feeling that it represents some sort of unknown medical problem.”
With her case presented, Susan allowed herself to sit back into the chair. She felt she had put the matter fairly and completely; if Dr. Nelson was going to be interested, he certainly had enough to go on to make up his mind.
Dr. Nelson did not speak right away. Instead he continued to regard Susan; then he studied the printout, taking short, quick puffs on his pipe.
“This is all very interesting information, young lady. Of course I have been aware of the problem. However, there are other implications in these statistics and I can assure you that this apparent high incidence is occurring because … well, frankly … we have been lucky over the last five or six years that we haven’t had any such cases. Statistics have a way of catching up with you, though … and indeed that seems to be the case at present. As to your request, I’m afraid I’m not in a position to grant it. You undoubtedly understand one of the major impediments to our establishing our central computer information bank was the creation of adequate safeguards concerning the confidentiality of most of the information stored. It is impossible for me to give blanket authorization. In fact, this type of endeavor is really … what should I say … hmm … beyond … or above that which a medical student of your level is equipped to deal with. I think it would be in everyone’s best interest, yours included, if you would limit your research interests to more scientific projects. I’m certain I could find room for you in our liver lab, if you were interested.”