Coma (novel)
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''Coma'' is
Robin Cook Robert Finlayson "Robin" Cook (28 February 19466 August 2005) was a British Labour politician who served as a Member of Parliament (MP) from 1974 until his death in 2005 and served in the Cabinet as Foreign Secretary from 1997 until 2001 wh ...
's first commercially successful
novel A novel is a relatively long work of narrative fiction, typically written in prose and published as a book. The present English word for a long work of prose fiction derives from the for "new", "news", or "short story of something new", itself ...
, published by Signet Book in 1977. ''Coma'' was preceded in 1973 by Cook's lesser-known novel ''
Year of the Intern ''The Year of the Intern'', the first novel by Robin Cook and very different from his thrillers, follows the journey of intern Dr. Peters through his year of placement. Plot introduction It is an insider's perspective of the medical world. As ...
''.


Synopsis

Susan Wheeler is a third-year medical student at Boston Memorial Hospital. She and four other students take rounds in surgery rooms and
ICUs 220px, Intensive care unit An intensive care unit (ICU), also known as an intensive therapy unit or intensive treatment unit (ITU) or critical care unit (CCU), is a special department of a hospital or health care facility that provides intensiv ...
, recording post-treatment notations on the patients' health. Dr. Mark Bellows, a surgery resident in the hospital, is the instructor and this group's supervisor. The book is a journey into the inner workings of a hospital. As these students complete their three-month surgical rotation, the dilemmas and problems faced by a woman in a male-dominated profession are also highlighted. Susan notices that two patients, Nancy Greenly and Sean Berman, mysteriously went into
coma A coma is a deep state of prolonged unconsciousness in which a person cannot be awakened, fails to respond normally to painful stimuli, light, or sound, lacks a normal wake-sleep cycle and does not initiate voluntary actions. Coma patients exhi ...
s immediately after their
surgeries Surgery ''cheirourgikē'' (composed of χείρ, "hand", and ἔργον, "work"), via la, chirurgiae, meaning "hand work". is a medical specialty that uses operative manual and instrumental techniques on a person to investigate or treat a pat ...
. These were attributed to
anesthesia Anesthesia is a state of controlled, temporary loss of sensation or awareness that is induced for medical or veterinary purposes. It may include some or all of analgesia (relief from or prevention of pain), paralysis (muscle relaxation), ...
complications. Nancy Greenly became comatose due to her brain receiving insufficient oxygen during surgery. Similarly, Sean Berman, a healthy young man in his 30s, underwent a 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 these two patients, Susan investigates their cases and other recent coma victims. She discovers that the oxygen line to Operating Room 8 has been tampered with to induce
carbon monoxide poisoning Carbon monoxide poisoning typically occurs from breathing in carbon monoxide (CO) at excessive levels. Symptoms are often described as " flu-like" and commonly include headache, dizziness, weakness, vomiting, chest pain, and confusion. Large ...
in patients during surgery, ultimately causing 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 reduce high medical costs. Patients declared
brain dead Brain death is the permanent, irreversible, and complete loss of brain function which may include cessation of involuntary activity necessary to sustain life. It differs from persistent vegetative state, in which the person is alive and some aut ...
or "vegetables" are referred to the institute. Here, Susan finds that patients are suspended from the ceiling by wires in rooms walled by glass, and 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 (without family consent) and then sold on the black market. Howard Stark, chief of the Department of Surgery at Boston Memorial, is revealed as the main
antagonist An antagonist is a character in a story who is presented as the chief foe of the protagonist. Etymology The English word antagonist comes from the Greek ἀνταγωνιστής – ''antagonistēs'', "opponent, competitor, villain, enemy, ri ...
. Stark confronts Susan over her findings, then drugs her, intending to put her in an irreversible coma under the pretext of an
appendectomy An appendectomy, also termed appendicectomy, is a surgical operation in which the vermiform appendix (a portion of the intestine) is removed. Appendectomy is normally performed as an urgent or emergency procedure to treat complicated acute appe ...
. However, Bellows disables 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.


Background

After Cook's first book failed to sell well, he studied the common ingredients of bestsellers and felt that for an unknown writer, mystery thrillers had the best chance of success. He was particularly influenced by ''
Jaws Jaws or Jaw may refer to: Anatomy * Jaw, an opposable articulated structure at the entrance of the mouth ** Mandible, the lower jaw Arts, entertainment, and media * Jaws (James Bond), a character in ''The Spy Who Loved Me'' and ''Moonraker'' * ...
'', ''
Seven Days in May ''Seven Days in May'' is a 1964 American political thriller film about a military-political cabal's planned takeover of the United States government in reaction to the president's negotiation of a disarmament treaty with the Soviet Union. The ...
'' and the novels of
Eric Ambler Eric Clifford Ambler OBE (28 June 1909 – 22 October 1998) was an English author of thrillers, in particular spy novels, who introduced a new realism to the genre. Also working as a screenwriter, Ambler used the pseudonym Eliot Reed for bo ...
. His original publisher rejected the idea but
Little Brown Little, Brown and Company is an American publishing company founded in 1837 by Charles Coffin Little and James Brown in Boston. For close to two centuries it has published fiction and nonfiction by American authors. Early lists featured Emily ...
agreed to give Cook a $10,000 advance.


Critical response

''Coma''s literary awards and acclaims include a long tenure on the ''New York Times'' best seller list, reaching its high position of #6 in the fiction category. The novel was included in the Fiction category of "''
The New York Times ''The New York Times'' (''the Times'', ''NYT'', or the Gray Lady) is a daily newspaper based in New York City with a worldwide readership reported in 2020 to comprise a declining 840,000 paid print subscribers, and a growing 6 million paid ...
'' Outstanding Book of the Year" listing (the forerunner to ''The New York Times''' current "100 Notable Books of ear listing) from which the "Best Book of the Year" is selected. ''
The New York Times Book Review ''The New York Times Book Review'' (''NYTBR'') is a weekly paper-magazine supplement to the Sunday edition of ''The New York Times'' in which current non-fiction and fiction books are reviewed. It is one of the most influential and widely rea ...
'' also called ''Coma'' 1977's "number one thriller of the year."


Adaptations

The story was made into the highly successful 1978 film ''
Coma A coma is a deep state of prolonged unconsciousness in which a person cannot be awakened, fails to respond normally to painful stimuli, light, or sound, lacks a normal wake-sleep cycle and does not initiate voluntary actions. Coma patients exhi ...
'', directed by
Michael Crichton John Michael Crichton (; October 23, 1942 – November 4, 2008) was an American author and filmmaker. His books have sold over 200 million copies worldwide, and over a dozen have been adapted into films. His literary works heavily feature tech ...
. The story was adapted again into a two-part television
miniseries A miniseries or mini-series is a television series that tells a story in a predetermined, limited number of episodes. "Limited series" is another more recent US term which is sometimes used interchangeably. , the popularity of miniseries format ...
that aired in September 2012 on the A&E television network.


Editions

* (2003) * (2002) * (1977) * (paperback) (1978)


References

{{Organ transplantation in fiction 1977 American novels 1977 science fiction novels American novels adapted into films Debut science fiction novels Medical novels Novels by Robin Cook Novels set in Boston Novels set in hospitals American novels adapted into television shows 1977 debut novels