Endorphin Conspiracy, The
residency.
    “Well, Mark, it doesn’t look as though you got much sleep last night,” Geoff said.
    “Sleep? What’s that? I spent yesterday afternoon in the OR with some poor junkie named Jose whose friend shot him in the face, last night with an unfortunate twenty-five year old hang-glider who got in the way of a telephone pole. This little girl with a head injury just came in. The good news is someone else is on call tonight.”
    “Tell us about the hang-glider first,” said Geoff. He looked to his right, at the patient next door in bed seventeen. The man was tall, probably about six-two, muscular. A surgical dressing was wrapped around his ribs and upper torso. He had bruises around his eyes, and the lids were swollen shut. Sprouting from the top of his shaved head was a metal bolt with IV tubing connecting to a toaster-size box, on the front of which was a modulating digital readout. “By the looks of things, seems like he’s going to be off to the ward pretty soon.”
    The team drifted next door and assembled around the hang-glider in bed seventeen. The medical students raised pens to clipboards, their attention focused on Mark Jackson.
    “In a nutshell, John DeFranco is a twenty-five year old man who was in his usual state of good health until yesterday afternoon when he was hang-gliding up in Westchester County and caught a bad wind that sent him crashing into a utility pole. He was taken to Basset Hospital, where he was stabilized, then transferred here for observation. On admission, he was noted to be in a moderately deep coma due to a closed head injury. Amazingly, there was no spinal fracture or any other life-threatening injuries. Just a few broken ribs and a ruptured spleen.”
    “What did his admission PET scan show?” asked Geoff.
    “Moderate brain edema with a low level of endorphins in the brainstem.” Mark pointed to the intracranial pressure monitor next to the head of the bed. “His ICP has been hovering around fifteen all morning. That’s an improvement from yesterday. All in all, a decent prognosis,” said Mark.
    “Then why is he still comatose?” asked Karen Choy.
    “We have him snowed in a medically induced coma on phenobarbital to lessen his brain cells’ metabolic rate and need for oxygen. Once we drop the phenobarb level, he should wake up, hopefully by tomorrow.” Mark grasped the metal bolt protruding from the top of the patient’s head between his thumb and forefinger. “Then we can remove this ICP bolt and transfer him to the neuro ward where his rehabilitation can start.”
    “Good job, Mark,” said Geoff. “Let’s hear about the new patient in bed eighteen.”
    The team members regrouped around the little girl’s bed, Mark holding the clipboard, Geoff standing next to him near the head of the bed.
    “This one’s not so rosy.” Mark cleared his throat. “I’m sure we’ll hear about this on the news tonight, if not sooner. Jessica Humphries, an eight-year-old girl, was in otherwise good health until she was taken hostage earlier today by a lunatic at the Central Park Zoo. He threatened to blow himself and the girl up. The grenade exploded ripping him to shreds—that’s all that remained of the guy according to Suzanne Gibson in pathology—and throwing Jessica twenty feet in the air. Unfortunately, she landed on her head.”
    Geoff felt a pang of sadness. He studied the patient carefully. Her face was round and moon like, features swollen and distorted. Dark, bruised lids were taped tightly shut, and her lips were dry and cracked at the corners of her mouth where an airway tube had been taped to one side connecting her to the respirator that controlled her breathing. A patch of her fine, blood-crusted hair had been shaved on top for the ICP bolt, which had been inserted through the hole drilled in her skull, to monitor her intracranial pressure, as with the hang-glider in the next bed.
    “What is the extent of her injuries?” asked Karen Choy.
    “Her
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