A Case of Need: A Novel by Michael Crichton, Jeffery Hudson

it was not. The chest of the patient was still open and the heart was still incised; they had not even begun suturing. There I was not going to interrupt them; I’d have to come back later and try and get the chart.
    But I stayed a moment to watch. There is something compelling about open-heart surgery, something fantastic and fabulous, a mixture of dream and nightmare, all come true. There were sixteen people in the room below me, including four surgeons. Everyone was moving, working, checking in smooth, coordinated movements, like a kind of ballet, like a surrealistic ballet. The patient, draped in green, was dwarfed by the heart-lung machine alongside him, a giant complex as large as an automobile, shining steel, with smoothly moving cylinders and wheels.
    At the head of the patient was the anesthetist, surrounded by equipment. There were several nurses, two pump technicians who monitored the dials and gauges on the machine, nurses, orderlies, and the surgeons. I tried to tell which was Randall, but I could not; in their gowns and masks, they all looked the same, impersonal, interchangeable. That was not true, of course. One of those four men had responsibility for everything, for the conduct of all sixteen workers present. And responsibility for the seventeenth person in that room, the man whose heart was stopped.
    In one corner, displayed on a television, was the electrocardiogram. The normal EKG is a briskly bouncing line, with spikes for every heartbeat, every wave of electrical energy that fires the heart muscle. This one was flat: just a meaningless squiggle. That meant that according to one major criterion of medicine, the patient was dead. I looked at the pink lungs through the open chest; they were not moving. The patient was not breathing.
    The machine did all that for him. It pumped his blood, oxygenated it, removed the carbon dioxide. In its present form, the machine had been in use for about ten years.
    The people below me did not seem in awe of the machine or the surgical procedure. They worked matter-of-factly at their jobs. I suppose that was one reason why it all seemed so fantastic.
    I watched for five minutes without realizing the time. Then I left. Outside, in the corridor, two residents slouched in a doorway, still wearing their caps with their masks hanging loosely around their necks. They were eating doughnuts and coffee, and laughing about a blind date.
    1 See Appendix III: Battlefields and Barberpoles .

NINE
    R OGER WHITING, M.D ., lived near the hospital in a third-floor walk-up on the sleazy side of Beacon Hill, where they dump the garbage from Louisburg Square. His wife answered the door. She was a plain girl, about seven months’ pregnant. She looked worried.
    “What do you want?”
    “I’d like to talk to your husband. My name’s Berry. I’m a pathologist at the Lincoln.”
    She gave me a hard suspicious glance. “My husband is trying to sleep. He’s been on call for the last two days, and he’s tired. He’s trying to sleep.”
    “It’s very important.”
    A slim young man in white ducks appeared behind her. He looked more than tired; he looked exhausted and afraid. He said, “What is it?”
    “I’d like to talk to you about Karen Randall.”
    “I’ve been over it,” he said, “a dozen times. Talk to Dr. Carr about it.”
    “I did.”
    Whiting ran his hands through his hair, then said to his wife, “It’s O.K., honey. Get me some coffee, would you?” He turned to me. “Want some coffee?”
    “Please,” I said.
    We sat in the living room. The apartment was small, the furniture cheap and rickety. But I felt at home: it had been only a few years since I had done my own internship. I knew all about the money problems, the stresses, the hellish hours, and the slop work you had to do. I knew about the irritating calls from nurses in the middle of the night, asking you to okay another aspirin for patient Jones. I knew how you could drag yourself out of bed to see a patient