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Coma (novel) Author(s) Robin Cook Genre(s) Thriller Publication date 1977 Pages 306 Synopsis Susan Wheeler is the protagonist of the novel. She is an attractive 23-year-old third-year medical student working as a trainee at Boston Memorial Hospital. Susan, along with four other students—George, Harvey, Geoffrey, and Paul—takes rounds in surgery rooms and ICUs for making post-treatment notations on the health of patients. Mark Bellows, a surgery resident in the hospital, is the instructor and supervisor of this group. The book is a journey into the inner workings of a hospital. There are two patients, Nancy Greenly and Sean Berman, who mysteriously went into comas immediately after their operations. These incidents were attributed to complications within their surgeries due to anesthesia. Nancy Greenly became comatose when her brain did not receive sufficient oxygen during surgery. Similarly, Sean Berman, a young man in his 30s in good physical condition, underwent a scheduled knee operation. Despite the operation's success, Sean failed to regain consciousness. Medically, the odds for such occurrences are one in 100,000; however, such odds seemed resolutely higher at the Boston Memorial Hospital. Baffled by the comas of these two patients, Susan decides to investigate the mystery behind these peculiar events and of other recent coma victims. Susan discovers the oxygen line to Operating Room 8 has been tampered with to cause the patients carbon monoxide poisoning during surgery and, hence, brain death. At the same time Susan develops a brief, but intimate, relationship with Bellows and discusses her findings with him. After unraveling further details, and evading pursuit by a man hired to kill her, Susan is led to the Jefferson Institute. The institute is hailed as an intensive care facility designed to cut down on heavy medical costs. All patients who are declared brain dead or "vegetables" are referred to the institute. Here, she finds that patients are suspended from the ceiling by wires in rooms walled by glass and are moved from room to room with little human involvement. The "samples" are kept alive and healthy until a call for an organ comes in. The organ of choice is removed surgically (and without consent) and then sold on the black market. At the end of the story Howard Stark, chief of the Department of Surgery at Boston Memorial, is revealed as the main antagonist. Stark confronts Susan over her findings and then drugs her, intending to put Susan in a coma under the pretext of an appendix operation. However, Bellows manages to disable to the oxygen line during the operation, thereby preventing a full dose of carbon monoxide poisoning. Stark is arrested but Susan's fate is left in doubt. ¨ Main characters: ¨ Nancy Greenly --- in a coma after a routine D&C (dilation and curettage, a routine gynecological procedure) ¨ Susan Wheeler, an attractive 23 year old third year medical student and a new intern at Boston Memorial. A Radcliff graduate, Susan is an intelligent and persistent woman in a profession dominated by males. Susan makes ruffles the feathers of the hospital's head doctors and is not afraid of speaking her mind. ¨ Mark Bellows --- a 29-year-old resident doctor at Boston Memorial for two ½ years working towards the position of chief resident and tying not to make waves. Mark is in charge of the latest group of third year students on their three-month surgical rotation and the current interns. ¨ Dr. Howard Stark --- Chief of the Department of Surgery at Boston Memorial. ¨ Dr. Harris --- Chief of Anesthesia at Boston Memorial. ¨ The five new medical students at Boston Memorial included George Niles, Harvey Goldberg, Susan Wheeler, Geoffrey Fairweather III, and Paul Carpin. The new interns were Daniel Cartwright and Robert Reid. ¨ Sean Berman --- a good-looking man in his thirties tanned and in good physical condition. In perfect health except for the knee operation that he was scheduled for. The operation was a success, but Sean never woke up. ¨ D'Ambrosio --- the improvising, athletic psychopathic murderer. Susan Wheeler identifies with the patient in a coma, Nancy Greenly. Miss Greenly had become comatose when her brain did not get the oxygen and she never woke up. The odds should be one in a hundred thousand, but as Susan learns later, the odds at Boston Memorial are much worse. Robin Cook develops the character of Susan Wheeler with all her doubts and fears at becoming a doctor. Although she is assertive, it is a man's profession and she must fight the wars of subtle discrimination. Susan dives into the background of Nancy Greenly's case and makes copious notes on Nancy's background history. Susan gets so involved in the investigation that she starts skipping lectures and missing rounds. Susan finds out that the complication of prolonged coma after anesthesia is about one hundred times more prevalent at Boston Memorial than for the rest of the country in the past year. Susan's investigation leads us to the Jefferson Institute in South Boston. An intensive care facility designed to curtail costs and scare the "begebies" out of you! This place translated well in the movie version of COMA. Bodies are suspended from the ceiling by wires and moved from room to room with little human intervention. Susan dons the trappings of a nurse and finds that she can move anywhere within the hospital without notice or challenge. In her travels she is chased, shot at, and almost crushed by an oncoming train. What I liked best about this book: Robin Cook novels are always "page turners", and this was one of his best. Although a short book at 306 pages, Cook explains the hospital environment and procedures in a way that we can understand. He does not talk down to the reader, but usually includes references at the end of the story for further reading on the topic. There is always an element of the underworld in his novels. He likes to mix politics, bad guys and medicine. The Author's main point was to entertain and to make us think at the same time.