Read Online A Brain by Robin Cook - Free Book Online Page B

SCANNER .
    Philips went over to the scanner. The rollers within the lips of the insertion slot were moving. Carefully Philips lined up the X ray with its emulsion side down. The machine grabbed it and pulled it inside. The output typewriter activated. Philips walked over. It said: T HANK YOU . H AVE A CUP OF COFFEE . Philips smiled. Michaels’ sense of humor emerged when least expected.
    The scanner emitted a slight electrical buzz; the output device stayed silent. Philips grabbed his lead apron and left the office.
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    There was silence in OR #21 as Mannerheim mobilized Lisa’s right temporal lobe and slowly lifted it from its base. A few small veins could be seen linking the specimen to the venous sinuses, and Newman skillfully coagulated and divided them. At last it was free, and Mannerheim lifted the piece of the brain out of Lisa’s skull and dropped it into a stainless steel dish held by Darlene Cooper, the scrub nurse. Mannerheim looked up at the clock. He was doing fine. As the operation had progressed, Mannerheim’s mood had changed again. Now he was euphoric and justly pleased with his performance. He’d done the procedure in half the usual time. He was certain he’d be in his office at noon.
    â€œWe’re not quite finished,” said Mannerheim, taking the metal sucker in his left hand and forceps in his right. Carefully he worked over the site where the temporal lobe had been, sucking out more braintissue. He was removing what he called the deeper nuclei. This was probably the riskiest part of the procedure, but it was the part Mannerheim liked the best. With supreme confidence he guided the sucker, avoiding vital structures.
    At one point a large globule of brain tissue momentarily blocked the opening of the sucker. There was a slight whistling noise, before the piece of tissue whooshed up the tube. “There go the music lessons,” said Mannerheim. It was a common neurosurgical quip, but coming from Mannerheim after all the tension he’d caused, it was funnier than usual. Everyone laughed, even the two Japanese doctors.
    As soon as Mannerheim had finished removing brain tissue, Ranade slowed the ventilation of the patient. He wanted to let Lisa’s blood pressure rise a little while Mannerheim inspected the cavity for any bleeding. After a careful check Mannerheim was satisfied the operative site was dry. Taking a needle holder he began to close the dura, the tough covering over the brain. At that point, Ranade began carefully to lighten Lisa’s anesthesia. When the case was over he wanted to be able to remove the tube in Lisa’s trachea without her coughing, or straining. This required a delicate orchestration of all the drugs he’d been using. It was imperative that Lisa’s blood pressure not go up.
    The dural closure went swiftly and with a deft rotation of his wrist, Mannerheim placed the last interrupted stitch. Lisa’s brain was again covered, although the dura dipped down and was darker where Lisa’s temporal lobe had been. Mannerheim cocked his head as he admired his handiwork, then stepping back, he snapped off his rubber gloves. The sound echoed in the room.
    â€œAll right,” said Mannerheim, “close her up. But let’s not make it your life’s work.”
    Motioning for the two Japanese doctors to come with him, Mannerheim left the room.
    Newman took Mannerheim’s position at Lisa’s head.
    â€œOkay, Lowry,” said Newman, echoing his boss, “let’s see if you can help me rather than hinder me.”
    After dropping the bone flap into place like the top of a Halloween pumpkin and tying the sutures, Newman was ready to close. With a pair of rugged tooth forceps, he grabbed hold of the edge of Lisa Marino’s wound and partially everted it. Then he plunged the needle deep into the skin of the scalp, making sure he picked up pericranium, and brought the needle out in the wound. Detaching the