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Drug of Choice
By Michael Crichton
OPEN ROAD INTEGRATED MEDIACopyright © 1970 Centesis Corporation
All rights reserved.
ANGEL IN COMA
The cop, positioned at the intersection of the Santa Ana Freeway and U.S. 85, saw it all. At three in the afternoon an Angel went past him, hunched over his bike, doing a hundred and ten. The cop later remembered that the Angel had a maniacal grin on his face as he raced forward, weaving among the passenger cars.
The policeman gave chase, light flashing and siren wailing, but traffic was heavy and the Angel managed to keep his distance. He left the freeway in the foothills, and headed north into the mountains, still going more than a hundred miles an hour. The cop followed, but the bike was taking chances, and managed to pull further ahead.
After twenty minutes, the police car came around a bend and the cop saw the bike at the side of the road, lying on its side. The motor was still on, spinning the rear wheel.
The Angel lay sprawled on the ground a short distance away. He had apparently been moving slowly at the time of the accident, because he was unmarked—no cuts, no bruises, no scrapes. He was, however, comatose, and could not be roused. The policeman checked the pulse, which was strong and regular. He tried for several minutes to awaken the Angel, and then returned to his car to call an ambulance.
Roger Clark, resident in internal medicine, went on duty at the Los Angeles Memorial Hospital at six. When he arrived on the floor, he went to see Baker, the day resident. Baker was in the dressing room, changing from his whites to street clothes. He looked tired.
"How're things?" Clark said, stripping off his sportcoat and putting on a white jacket.
"Okay. Not much excitement, except for Mrs. Leaver. She still pulls out her intravenous lines when she thinks nobody's looking."
Clark nodded, stepping to the mirror and straightening his tie.
"And then Henry," Baker said. "He had the DT's this morning, and sat in the corner arguing with the little green men."
"How is he now?"
"We gave him some librium, but watch him. One of the nurses said he felt her up last night."
"Alice? He must really be hallucinating if he felt her up."
"Well, just don't mention it to Alice. She's very sensitive."
Baker finished dressing, lit a cigarette, and rapidly went through the status of the other patients. Nothing much had changed since Clark had gone off duty twenty-four hours before.
"Oh," Baker said. "Almost forgot a new admission. One of those Hell's Angels. The cops brought him in after he had a motorcycle accident. He was comatose and he hasn't come out yet."
"You ask for a neurological consult?"
"Yeah, but they probably won't get around to it until morning."
"What's his status now?"
"We did the usual stuff. Skull films negative, CSF normal, chest films okay, EEG vaguely abnormal, but nothing specific. All his reflexes are there."
"Nope. He's just fine. To look at him, you'd think he was asleep."
"No, we're waiting for the consult. Let the neuro boys play around with him for a while."
"Okay. Anything else?"
"No. That's it." Baker smiled. "See you tomorrow."
When he was alone, Clark made a quick round of the wards, checking on the patients. Everyone seemed in pretty good shape. When he came to the comatose Angel, he paused.
The patient was young, in his early twenties. Nobody had washed him since admission; his hair was greasy, his face was unshaven and streaked with grit, and his fingernails were rimmed with black. He lay quietly in bed, not moving, breathing slowly and easily. Clark checked him over, listening to the heart, tapping out the reflexes. He could find nothing wrong. They had put an intravenous line into him, and had catheterized him in case of urinary retention. The catheter tube led to a bottle on the floor. He looked at it.
The urine was bright blue.
Frowning, he held the bottle up to the light and looked closely. It was an odd, vivid blue, almost fluorescent.
What turned urine blue?
He went back to the desk, hoping to catch Baker and ask about the urine, but Baker was gone. Sandra, the night nurse, was there.
"Were you on duty when they brought that Angel in?"
"Arthur Lewis? Yes."
Sandra shrugged. "The police brought him into the emergency ward. They figured he'd had an accident, so they took him up to X-ray and checked him over. No broken bones, nothing. All the enzymes and electrolytes came back normal. The EW couldn't figure it out, so they shipped him up here. It's all very mysterious. He was going a hundred before the accident, but the police think he slowed way down before it happened. The policeman who found him said it was just as if he had suddenly fallen asleep."
"Ummm," Clark said. He bit his lip. "What about his urine?"
"What about it?"
"Has it always been blue?"
Sandra frowned and left the desk. She went into the ward and looked at the bottle, then returned. "I've never seen anything like that," she said.
"Neither have I."
"What turns urine blue?"
"I was just wondering the same thing," Clark said. "Why don't you call down to neurology and say the guy is still in a coma, but urinating blue. Maybe that'll bring them up."
Ten minutes later, Harley Spence, Chief of Neurology, appeared on the seventh floor, panting slightly. He was a white-haired man in his middle fifties, very proper in a three-piece suit.
His first words to Clark were: "Urinating blue?"
"That's right, sir."
"How long has this been going on?"
"Apparently it just started, within the last few minutes."
"Fascinating," Spence said. "Perhaps a new kind of porphyria. Or some idiosyncratic drug reaction. Whatever it is, it's definitely reportable."
Clark nodded. In his mind, he saw the journal article: "H.A. Spence: Unusual Urinary Pigment in a Comatose Man. Report of a Case."
They walked to the patient's bed. Clark ran through the story while Spence began his examination. Arthur Lewis, twenty-four, unemployed, first admission through the EW in a coma after a motorcycle accident ...
"Motorcycle accident?" Spence said.
"He's unmarked. Not a scratch on him. Would you say that's likely?"
"No sir, but that's the police story."
Muttering to himself, Spence conducted his neurological examination. He worked briskly at first, and then more slowly. Finally he scratched his head.
"Remarkable," he said. "Quite remarkable. And this urine—bright blue."
Spence stared at the bottle, hesitated, then turned to Clark. "What makes urine blue?"
Spence shook his head, put the bottle down. He stepped back from the patient and looked at him.
"Jesus Christ, blue piss," he said. "What a patient."
And he walked off.
The metabolic boys came around an hour later; they collected several samples for analysis, amid a lot of vague talk about tubular secretory rates and refractile indices; Clark listened to them until he was sure they had no idea what was going on. Then, as he was leaving, one of them said, "Listen, Rog, what do you make of this?"
"I don't make anything of it," Clark said.
"Do you think it's a drug thing? You're the local expert."
Clark smiled. "Hardly." He had done two years of drug testing at Bethesda, but it had been boring work, measuring excretion and metabolism of experimental drugs in animals and, occasionally, in human subjects. He had only done it because it got him out of the army.
"Well, could it be a bizarre drug reaction?"
Clark shrugged. "It could. Of course it could. Even a common drug like aspirin can produce strange reactions in certain people."
Someone else said, "What about an entirely new drug?"
"I don't know. But these Angels will take anything in a capsule. Remember the guy we got who had swallowed a hundred birth control pills?"
"I don't think that birth control pills would turn—"
"No, no, of course not. But what if this is some entirely new drug, some new thing like STP or THC or ASD?"
"Possible," Clark said. "Anything's possible." On that note, the metabolic boys went back to the labs, clutching their urine samples, and Clark went back to work.
Word of the Angel quickly spread through the hospital. A constant stream of doctors, residents, interns, students, nurses, and orderlies appeared on the floor to look at Arthur Lewis and his urine bottle. During all this time, the patient continued to sleep peacefully. Repeated attempts to rouse him by calling his name, shaking him, or pinching him were unsuccessful.
At midnight, everything on the floor seemed quiet, and Clark went to bed. He stretched out on the cot in the resident's room, fully dressed, and fell asleep almost immediately.
At five in the morning, he got a call from Sandra. She needed him on the seventh floor; she couldn't say more. She sounded frightened, so he went right up.
When he arrived, he found Sandra talking to an immense, bearded man in black leather. Though all the lights on the floor had been turned off except the nightlights, the man wore sunglasses. He had a huge naked angel painted on the back of his leather jacket, and on his hand was a tattoo of a heart pierced by an arrow. Underneath, in gold lettering, it said "Twat."
Clark walked up to him. "I'm Dr. Clark. Can I help you?"
Sandra gave a sigh of relief and sat down. The Angel turned to Clark, looked him up and down. He was a head taller than Clark.
"Yeah, man. You can help me."
"You can let me see Artie-baby."
"I'm afraid that's not possible."
"Come on, not possible. What is this not possible shit? You sound like a doctor."
"I am a doctor."
"Then you can let me see Artie-baby. All the time, this one keeps saying she can't let me see him because she's not a doctor. So okay, I buy it, right? It's a slide, but I buy it. Now you start in. What is this?"
"Look," Clark said, "it's five in the morning. Visiting hours don't begin until—"
"Visiting hours are for creeps, man."
"I'm sorry. We have certain rules here."
"Yeah, but you know what happens if I come visiting hours? I see all the sickies, and it makes me depressed, you know? It's a down, a real bummer. But now it's dark."
"Yeah, so okay. Right?"
"I'm sorry. Your friend is in a coma now. You can't see him."
"Little Jesus? In a coma? Naw: he wouldn't do a thing like that."
Clark said, "Little Jesus?"
"That's his name, man. He had the crucifixion thing, you know. Every trip, he wants to get nailed. His bag: too much money, he had an unhappy childhood."
Not knowing what else to say, Clark said, "You'd better go now. Come back in the morning."
"I'll be flying by then, man. Soon as I leave, I'm flying."
Clark paused. "Does your friend also fly?"
"Sure, man. All the time. He doesn't like his momma, see, so he does a lot of flying. He saw a shrink, too, but that wasn't as good as a long flight."
"What was he flying?"
"You name it. Dope, Gold, Mishra, glue, acid when he was up to it, B's all the time, goofies ..."
"Did he ever try anything really unusual?"
The Angel frowned. "You got a line on something?"
"No," Clark said. "Just wondered."
"Naw, he was pretty straight. Never shot stuff, even. He's the oral type, you know." The Angel paused. "Now how about it. Do I see him, or what?"
Clark shook his head. "He's in a coma."
"You keep talking this coma crap."
There was a moment of silence, and the Angel reached into his pocket Clark heard a metallic click as the switchblade snapped open. The knife glinted in the light.
"I don't want to call the police," Clark said.
"I don't want to carve your guts out. Now lead the way. I just wanna see him, and then I'll leave. Right?"
Clark felt the tip against his stomach. He nodded.
They went into the ward. The Angel stood at the foot of the bed and watched Arthur Lewis for several minutes. Then he reached into his pocket fumbled, and frowned. He whispered, "Shit. I forgot it."
They went back outside.
"Were you bringing him something?" Clark asked.
"No, man. Forget it, huh?"
The Angel stepped to the elevator. Clark watched him as he got in.
"One last thing," the Angel said. "Cool it with the security guards, or we'll have blood in the lobby."
Clark said cheerfully, "You can see him tomorrow, if you like. Visiting hours from two to three-thirty."
"Man, he won't be here that long."
"His coma is quite deep."
"Man, don't you understand? He isn't in no coma."
The doors closed, and the elevator descended.
"I'll be damned," Clark said, to no one in particular. He went back to bed.
Visit rounds began at ten. The visit today was Dr. Jackson, a senior staff member of the hospital. Clark disliked Jackson, and always had. The feeling was mutual.
Jackson was a tall man with short black hair and a sardonic manner. He made little cracks as he accompanied Clark and the interns around from patient to patient. Late in the morning, they came to Arthur Lewis. Clark presented the case, summarizing the now-familiar story of the motorcycle accident, and the police, the admission through the emergency ward ...
Jackson interrupted him before he finished. "That man isn't comatose. He's asleep."
"I don't think so, sir."
"You mean to tell me," Jackson said, "that that son-of-a-bitch lying there is in a coma?"
"Yes, sir. The chief of neurology, Dr. Spence, thought so too. He saw the patient—"
"Spence is an old fart. Step aside." He pushed past the interns and stepped to the head of the bed. He peered closely at Lewis, then turned to Clark.
"Watch closely, doctor. This is how you wake a sleeping patient."
Clark suppressed a smile, and managed a solemn nod.
Jackson bent over Arthur Lewis.
"Mr. Lewis, Mr. Lewis."
The patient did not stir.
"Wake up, Mr. Lewis."
Jackson shook the patient's head gently, then with increasing force. There was no response.
"Mr. Lew-is. Time to get up ..."
He continued this for several moments, and then, suddenly, slapped Arthur Lewis soundly across the face.
Clark stepped forward. "Sir, I don't think—"
At that moment, Arthur Lewis blinked his eyes, opened them, and smiled.
Jackson stepped back from the bed with a grin of triumph. "Exactly, Dr. Clark. You don't think. This man is simply a heavy sleeper, difficult to rouse. My youngest son is the same way."
He turned to the patient. "How do you feel?"
"Great," Arthur Lewis said.
"Have a good sleep?"
"Yeah, great." He sat up. "Where am I?"
"You're in the LA Memorial Hospital, where the resident staff believes that there is something wrong with you."
"Me? Wrong with me? I feel great."
"I'm sure you do," Jackson said, with a quick glance at Clark. "Would you mind walking around for us?"
"Sure, man." The Angel started to get up, then stopped. He felt under the sheets. "Hey, what's going on here? Somebody's been fooling with my—"
At that moment, for the first time, Clark remembered the blue urine. He moved around to the side of the bed and picked up the bottle. "By the way, Dr. Jackson," he said, "there is one unsolved question here. This man's urine. It's blue."
Clark held up the bottle.
"It is?" Jackson said, frowning.
Clark looked at the bottle. The urine was yellow.
"Well," he said lamely, "it was."
"Isn't that interesting," Jackson said, with a pitying smile.
"Hey, listen," the Angel said. "Get this damned tube outa me. It feels funny. What kinda pervert did a thing like that, anyhow?"
Jackson rested a reassuring hand on the patient's shoulder. "We'll take care of it right away. Just lie back for a minute. As long as you're here, you might as well have lunch with the other patients."
The rounds group moved off to the next case. The interns were muttering among themselves. Clark stared at the floor.
"I swear to you, sir. Last night his urine was bright blue. I saw it; Dr. Spence saw it; the metabolic boys saw—"
"At this moment," said Dr. Jackson, "I am perfectly willing to believe that you saw polka-dot urine. In this hospital, anything is possible."
The patient, Arthur Lewis, was discharged at 1:00 P.M. Before he left, Clark talked with him. The patient remembered nothing about a motorcycle accident, or the police. He claimed he had been sitting in his room, smoking a cigarette, when he fell asleep. He awoke in the hospital; he remembered nothing in between. When Clark asked if he had ever urinated blue before, the Angel gave him a funny look, laughed, and walked away.
There were jokes about Clark at lunch that day, and for several weeks afterward. But eventually it blew over, and was forgotten. For Clark, there was only one really disturbing aspect to the whole situation.
The day Arthur Lewis was discharged, Clark had stopped at the front desk on his way home, and talked to the lobby staff.
"I hope there wasn't any trouble about that Angel in here last night," he said.
"Oh, he was discharged this morning," a receptionist said.
"No, I mean his friend. A huge guy. Came up to the seventh floor at five A.M. with a switchblade."
Excerpted from Drug of Choice by Michael Crichton. Copyright © 1970 Centesis Corporation. Excerpted by permission of OPEN ROAD INTEGRATED MEDIA.
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