Philips leaned over so that he had to support himself on Denise's shoulder. He pointed to the image on the screen. "Here's a lesion in the temporal lobe, and at least one, maybe two, in the frontal." He turned to the medical students. "I noted in the chart that the patient is a heavy smoker. What does all this suggest to you?"
The students stared at the image afraid to make any gesture. For them it was like being at an auction without money; any slight movement could have been interpreted as a bid,
"Let me give you all a hint," said Philips. "Primary brain tumors are usually solitary, whereas tumors coming from other parts of the body, what we call metastasis, can be single or multiple."
"Lung cancer," blurted one of the students as if he were on a TV game show.
"Very good," said Philips. "At this stage you can't be one hundred percent sure, but I'd be willing to put money on it."
"How long does the patient have to live?" asked the student, obviously overwhelmed by the diagnosis.
"Who's the doctor?" asked Philips.
"He's on Curt Mannerheim's neurosurgical service," said Denise.
"Then he doesn't have long to live," said Martin. "Mannerheim will operate on him."
Denise turned quickly. "A case like this is inoperable."
"You don't know Mannerheim. He operates on anything. Especially tumors." Martin again bent over Denise's shoulder, smelling the unmistakable aroma of her freshly washed hair. It was as unique to Philips as a fingerprint, and despite the professional setting, he felt a faint stirring of passion. He stood up to break the spell.
"Doctor Sanger, can I speak to you for a moment," he said suddenly, motioning her over to a corner of the room.
Denise complied willingly, with a bewildered expression.
"It's my professional opinion…" said Philips in the same to entertain the idea of leaving the Med Center for another hospital where he would have a shot at the top.
Martin turned down the corridor leading to surgery. He passed through the double swinging doors, whose sign warned visitors that they were entering a restricted area, and went through another set of swinging doors, to the patient-holding room. Here stood a swarm of gurneys filled with anxious patients awaiting their turn to be dissected. At the end of this large area was a long built-in white Formica desk guarding the entrance to the thirty operating rooms and to the recovery area. Three nurses in green surgical scrub dresses were busy behind the desk making sure the right patient got into the right room so he'd get the right operation. With almost two hundred operations in any twenty-four-hour period, this was a full-time job.
"Can someone tell me about Mannerheim's case?" asked Philips as he leaned over the desk.
All three nurses looked up and began to speak at once. Martin, being one of the few eligible doctors, was a welcome visitor to the OR. When the nurses realized what had happened, they laughed and then made an elaborate ceremony of deferring to one another.
"Maybe I should ask someone else," said Philips, pretending to leave.
"Oh, no," said the blond nurse.
"We can go back in the linen closet to discuss it," suggested the brunette. The OR was the one place in the hospital where inhibitions were relaxed. The atmosphere was totally different from any other service. Philips thought that perhaps it had something to do with everyone wearing the same pajama-like clothing, plus the potential for crisis, where sexual innuendos provided a relief valve. Whatever it was, Philips remembered it very well. He'd been a surgical resident for one year before deciding to go into radiology.
"Which one of Mannerheim's cases are you interested in?" asked the blond nurse. "Marino?"
"That's right," said Philips.
"She's right behind you," said the blond nurse.
Philips turned. About twenty feet away was a gurney supporting the covered figure of a twenty-one-year-old woman. She must have heard her name through the fog of her preoperative medication because her head slowly rolled in Philips' direction. Her skull was totally shaved in anticipation of her surgery, and the image reminded Philips of a small songbird without its feathers. He'd seen her briefly twice before when she was having her preoperative X rays, and Philips was shocked how different she looked now. He had not realized how small and delicate she was. Her eyes had a pleading quality like an abandoned child, and Philips had all he could do to turn away, directing his attention back to the nurses. One of the reasons he'd switched from surgery to radiology had been a realization he couldn't control his empathy for certain patients.
"Why haven't they started her?" he asked the nurse, angry the patient was being left to her fears.
"Mannerheim's been waiting for special electrodes from Gibson Memorial Hospital," said the blond nurse. "He wants to make some recordings from the part of the brain he's going to remove."
"I see…" said Philips, trying to plan his morning. Manner-heim had a way of upsetting everyone's schedules.
"Mannerheim's got two visitors from Japan," added the blond nurse, "and he's been putting on a big show all week. But they'll be starting in just a couple of minutes. They've called for the patient. We just haven't had anybody to send with her."
"Okay," said Philips, already starting back across the patient-holding area. "When Mannerheim wants his localization X rays, call my office directly. That should save a few minutes."
As he retraced his steps, Martin remembered he still had to shave and headed for the surgical lounge. At eight-ten it was almost deserted since the seven-thirty cases were all under way and the "to follow" cases could not hope to begin for some time. Only one surgeon was there talking on the telephone to his stockbroker while absentmindedly scratching himself. Philips passed into the changing area and twirled the combination to his foot-square locker, which Tony, the old man who took care of the surgical area, had allowed him to keep.
As soon as he had his face completely lathered, Philips' beeper went off making him jump. He hadn't realized how taut his nerves were. He used the wall phone to answer, trying to keep the shaving cream from the receiver. It was Helen Walker, his secretary, informing him that William Michaels had arrived and was waiting for him in his office.
Philips went back to his shaving with renewed enthusiasm. All his excitement about William's surprise came roaring back. He splashed himself with cologne and struggled back into his long white coat. Passing back through the surgical lounge, he noticed the surgeon was still on the phone with his broker.
When Martin reached his office he was at a half run. Helen Walker looked up from her typing with a start as the blurred image of her boss passed by her. She began to get up, reaching for a pile of correspondence and phone messages, but stopped when the door to Philips' office slammed shut. She shrugged and went back to her typing.
Philips leaned against the closed door, breathing heavily. Michaels was casually leafing through one of Philips' radiology journals.
"Well?" said Philips excitedly. Michaels was dressed as usual in his ill-fitting, slightly worn tweed jacket, which had been purchased during his third year at M.I.T. He was thirty but looked twenty, with hair so blond that it made Philips' look brown by comparison. He smiled, his small impish mouth expressing satisfaction, his pale blue eyes twinkling.
"What's up?" he said, pretending to go back to the magazine.
"Come on," said Philips, "I know you're just trying to rile me. The trouble is that you're being too successful."
"I don't know what…" began Michaels, but he didn't get any further. In one swift motion, Philips stepped across the room and tore the magazine from his hands.