THE DOME1 LIGHT ATOP OUR LADY OF ANGELS Hospital was a golden beacon2. High above the dome, at the top of the radio mast, the red aircraft-warning lamp winked3 in the gray mist, as if the storm were a living beast and this were its malevolent4 Cyclopean eye.
In the elevator, on the way from the garage to the fifth floor, Ethan listened to a lushly orchestrated version of a classic Elvis Costello number tricked up with violins and fulsome5 French horns. This cable-hung cubicle6, ascending7 and descending8 twenty-four hours a day, was a little outpost of Hell in perpetual motion.
The physicians’ lounge on the fifth floor, to which he’d been given directions by phone, was nothing more than a dreary9 windowless vending10-machine room with a pair of Formica-topped tables in the center. The orange plastic items that surrounded the tables qualified11 as chairs no more than the room deserved the grand name on its door.
Having arrived five minutes early, Ethan fed coins to one of the machines and selected black coffee. When he sipped12 the stuff, he knew what death must taste like, but he drank it anyway because he’d slept only four or five hours and needed the kick.
Dr. Kevin O’Brien arrived precisely13 on time. About forty-five, [347] handsome, he had the vaguely14 haunted look and the well-suppressed but still-apparent nervous edge of one who had spent two-thirds of his life in arduous15 scholarship, only to find that the hammers wielded16 by HMOs, government bureaucracy, and greedy trial attorneys were daily degrading his profession and destroying the medical system to which he’d dedicated17 his life. His eyes were pinched at the corners. He frequently licked his lips. Stress lent a gray tint18 to his pallor. Unfortunately for his peace of mind, he seemed to be a bright man who would not much longer be able to delude19 himself into believing that the quicksand under his feet was actually solid ground.
Although he was not Duncan Whistler’s personal internist, Dr. O’Brien had been the physician on duty when Dunny had gone flatline. He had overseen20 resuscitation21 procedures and had made the final call to cease heroic efforts. The death certificate carried his signature.
Dr. O’Brien brought with him the complete patient file in three thickly packed folders22. During their discussion, he gradually spread the entire contents across one of the tables.
They sat side by side in the orange pseudochairs, the better to review the documents together.
Dunny’s coma23 resulted from cerebral24 hypoxia, a lack of adequate oxygen to the brain for an extended period of time. Results revealed on EEG scrolls25 and by brain-imaging tests—angiography, CT scanning, MRI—led inescapably to the conclusion that if he had ever regained26 consciousness, he would have been profoundly handicapped.
“Even among patients in the deepest comas,” O’Brien explained, “where there’s little or no apparent activity in the cerebrum, there is usually enough function in the brain stem to allow them to exhibit some automatic responses. They continue to breathe unaided. Once in a while they might cough, blink their eyes, even yawn.”
Throughout most of his hospitalization, Dunny had breathed on his own. Three days ago, his declining automatic responses required that he be connected to a ventilator. He’d no longer been able to breathe without mechanical assistance.
[348] In his early weeks at the hospital, although deeply comatose28, he had at times coughed, sneezed, yawned, blinked. Occasionally he had even exhibited roving eye movements.
Gradually, those automatic responses declined in frequency until they ceased to be observed at all. This suggested a steady loss of function in the lower brain stem.
The previous morning, Dunny’s heart had stopped. Defibrillation and injections of epinephrine restarted the heart, but only briefly29.
“The automatic function of the circulatory system is maintained by the lower brain stem,” Dr. O’Brien said. “It was clear his heart had failed because brain-stem function failed. There’s no coming back from irreparable damage to the brain stem. Death inevitably30 follows.”
In a case like this, the patient would not be connected to a heart-lung machine, providing artificial circulation and respiration31, unless his family insisted. The family would need to have the means to pay because insurance companies would disallow32 such expenditures33 on the grounds that the patient could never regain27 consciousness.
“As regards Mr. Whistler,” O’Brien said, “you held a power of attorney in matters of health care.”
“Yes.”
“And you signed a release quite some time ago, specifying34 that heroic efforts, other than a ventilator, were not to be employed to keep him alive.”
“That’s right,” Ethan said. “And I’ve no intention of suing.”
This sincere assurance caused no visible relief on O’Brien’s part. Evidently he believed that even though the conscientious35 medical care given to Dunny was lawsuit-proof, a plague of lawyers would nonetheless rain down on him.
“Dr. O’Brien, whatever happened to Dunny once his body reached the hospital morgue is another matter altogether, unrelated to you.”
“But I’m not any less disturbed about it than you are. I’ve discussed it twice with the police. I’m ... bewildered.”
[349] “I just want you to know that I don’t hold the morgue employees at all responsible for his disappearance36, either.”
“They’re good people,” O’Brien said.
“I’m sure they are. Whatever’s going on here isn’t the fault of the hospital. The explanation is ... something extraordinary.”
The physician dared to let hope tweak a little color into his face. “Extraordinary? And what would that be?”
“I don’t know. But amazing things have happened to me in the past twenty-four hours, in some way all related to Dunny, I think. So why I wanted to speak to you this morning ...”
“Yes?”
Searching for words, Ethan pushed back from the table. He got to his feet, his tongue stilled by a thirty-seven-year-long reliance on reason and rationality.
He wished for a window. Gazing out at the rain would have given him an excuse not to look at O’Brien while he asked what needed to be asked.
“Doctor, you weren’t Dunny’s primary physician ...”
Talking while gazing moodily37 at a vending machine full of candy bars seemed eccentric.
“... but you were involved with his treatment.”
O’Brien said nothing, waited.
Having finished his coffee, Ethan scooped38 the paper cup off the table, crumpled39 it in his fist.
“And after what happened yesterday, I’d wager40 that you know his file better than anyone.”
“Backward and forward,” O’Brien confirmed.
Taking the paper cup to the waste can, Ethan said, “Is there anything in the file that you’d consider unusual?”
“I can’t find a single misstep in diagnosis41, treatment, or in the death-certification protocols42.”
“That’s not what I mean.” He tossed the crumpled cup in the can and paced, looking at the floor. “I’m sincere when I tell you that I’m [350] convinced you and the hospital are utterly43 blameless. When I say ‘unusual,’ what I really mean is ... strange, uncanny.”
“Uncanny?”
“Yeah. I don’t know how to put a finer point on it.”
Dr. O’Brien remained silent so long that Ethan stopped pacing and looked up from the floor.
The physician chewed on his lower lip, staring at the piles of documents.
“There was something,” Ethan guessed. He returned to the table, sat in the orange torture device. “Something uncanny, all right.”
“It’s here in the file. I didn’t bring it up. It’s meaningless.”
“What?”
“It could be misconstrued as evidence that he came out of the coma for a period, but he didn’t. Some attributed the problem to a machine malfunction44. It wasn’t.”
“Malfunction? What machine?”
“The EEG.”
“The machine that records his brain waves.”
O’Brien chewed his lip.
“Doctor?”
The physician met Ethan’s eyes. He sighed. He pushed his chair away from the table and got up. “It’ll be better if you actually see it yourself.”
收听单词发音 |
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dome
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| n.圆屋顶，拱顶 | |
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beacon
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| n.烽火，（警告用的）闪火灯，灯塔 | |
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winked
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| v.使眼色( wink的过去式和过去分词 )；递眼色（表示友好或高兴等）；（指光）闪烁；闪亮 | |
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malevolent
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| adj.有恶意的，恶毒的 | |
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fulsome
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| adj.可恶的，虚伪的，过分恭维的 | |
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cubicle
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| n.大房间中隔出的小室 | |
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ascending
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| adj.上升的，向上的 | |
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descending
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| n. 下行 adj. 下降的 | |
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dreary
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| adj.令人沮丧的，沉闷的，单调乏味的 | |
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vending
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| v.出售（尤指土地等财产）( vend的现在分词 )；（尤指在公共场所）贩卖；发表（意见，言论）；声明 | |
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qualified
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| adj.合格的，有资格的，胜任的，有限制的 | |
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sipped
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| v.小口喝，呷，抿( sip的过去式和过去分词 ) | |
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precisely
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| adv.恰好，正好，精确地，细致地 | |
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vaguely
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| adv.含糊地，暖昧地 | |
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arduous
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| adj.艰苦的，费力的，陡峭的 | |
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wielded
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| 手持着使用（武器、工具等）( wield的过去式和过去分词 )； 具有； 运用（权力）； 施加（影响） | |
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dedicated
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| adj.一心一意的；献身的；热诚的 | |
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tint
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| n.淡色，浅色；染发剂；vt.着以淡淡的颜色 | |
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delude
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| vt.欺骗；哄骗 | |
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overseen
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| v.监督，监视( oversee的过去分词 ) | |
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resuscitation
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| n.复活 | |
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folders
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| n.文件夹( folder的名词复数 )；纸夹；（某些计算机系统中的）文件夹；页面叠 | |
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coma
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| n.昏迷，昏迷状态 | |
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cerebral
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| adj.脑的，大脑的；有智力的，理智型的 | |
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scrolls
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| n.（常用于录写正式文件的）纸卷( scroll的名词复数 )；卷轴；涡卷形（装饰）；卷形花纹v.（电脑屏幕上）从上到下移动（资料等），卷页( scroll的第三人称单数 )；（似卷轴般）卷起；（像展开卷轴般地）将文字显示于屏幕 | |
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regained
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| 复得( regain的过去式和过去分词 )； 赢回； 重回； 复至某地 | |
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regain
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| vt.重新获得，收复，恢复 | |
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comatose
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| adj.昏睡的，昏迷不醒的 | |
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briefly
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| adv.简单地，简短地 | |
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inevitably
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| adv.不可避免地；必然发生地 | |
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respiration
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| n.呼吸作用；一次呼吸；植物光合作用 | |
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disallow
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| v.不允许；拒绝 | |
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expenditures
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| n.花费( expenditure的名词复数 )；使用；（尤指金钱的）支出额；（精力、时间、材料等的）耗费 | |
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specifying
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| v.指定( specify的现在分词 )；详述；提出…的条件；使具有特性 | |
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conscientious
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| adj.审慎正直的，认真的，本着良心的 | |
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disappearance
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| n.消失，消散，失踪 | |
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moodily
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| adv.喜怒无常地；情绪多变地；心情不稳地；易生气地 | |
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scooped
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| v.抢先报道( scoop的过去式和过去分词 )；（敏捷地）抱起；抢先获得；用铲[勺]等挖（洞等） | |
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crumpled
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| adj. 弯扭的, 变皱的 动词crumple的过去式和过去分词形式 | |
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wager
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| n.赌注；vt.押注，打赌 | |
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diagnosis
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| n.诊断，诊断结果，调查分析，判断 | |
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protocols
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| n.礼仪( protocol的名词复数 )；（外交条约的）草案；（数据传递的）协议；科学实验报告（或计划） | |
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utterly
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| adv.完全地，绝对地 | |
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malfunction
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| vi.发生功能故障，发生故障，显示机能失常 | |
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