From the conclusion of “Coma”, novel by Robin Cook

Stark put his hands together and rotated in his chair so that he could see out over the black waters of the harbor. "Tell me if you can think of any other reasons for this fantastic operation you have so cleverly exposed.”

“You mean, other than money?”

“Yes, other than money.”

“Well, it is a good way to get rid of someone you don’t want around.”

Stark laughed inappropriately, or so it seemed to Susan.

“No, I mean a real benefit. Can you think of any benefits other than financial?”

“I guess the recipients of the organs get a certain benefit, if they don’t have to know how the donor organ was obtained.”

“I mean a more general benefit. A benefit for society.”

Susan again tried to think, but her eyes wanted to close. She straightened up again. Benefit? She looked at Stark. The meaning of the conversation was becoming diffuse, strange.

“Dr. Stark, I hardly think this is the time …”

“Come on, Susan. Try. You’ve done such a remarkable job at uncovering this thin. Try to think. It’s important.”

“I can’t. It’s such a horror that I have difficulty even considering the word benefit.” Susan’s arms began to feel heavy. She shook her head. For a second she though she had actually fallen asleep.

“Well, then I’m surprised at you, Susan. From the intelligence that you yhave so amply displayed over the last couple of days, I thought that you would have been one of the few to see the other side.”

“Other side?” Susan closed her eyes tightly, then opened them, hoping they would stay open.

“Exactly.” Stark rotated back toward Susan, leaning forward, arms on the desk. Sometimes there are situations where … what should I say .. the common folk, if you will, cannot be depended upon to make decisions which will provide long-term benefits. The common man thinks only of his short-term needs and selfish requirements.”

Stark got up and wandered over to the corner where the expansive walls of glass joined. He looked out over the great medical complex he had helped to build. Susan felt herself unable to move. She even had difficulty turning her head. She knew she was tired but she never felt so heavy, so languorous. Besides, Stark kept going in and out of focus.

“Susan,” Stark said suddenly, turning around to face her again, “you must realize that medicine is on the brink of probably the biggest breakthrough in all of its long history. The discovery of anesthesia, the discovery of antibiotics … any of the epochal achievements will pale before the next giant step. We are about to crack the mystery of the immunological mechanisms. Soon we’ll be able to transplant all humans organs at will. The fear of most cancer will become a thing of the past. Degenerative disease, trauma… the scope is infinite.

“But such breakthroughs do not come easy, not without hard work and sacrifice. Not without a price. We need first-rate institutions, like the Memorial and its facilities. Next we need people like myself, indeed like Leonardo Da Vinci, willing to step beyond restrictive laws in order to ensure progress. What if Leonardo Da Vinci had not dug up his bodies for dissection? What if Copernicus had knuckled under to the laws and dogma of the church? Where would we be today? What we need for the breakthrough to actually happen is data, hard data. Susan, you have the mind to appreciate that.”

Despite the darkening cloud she felt settling over her brain, Susan began to realize what Stark was saying. She tried to get up, but she found she could not lift her arms. She strained but only succeeded in knocking the remains of her drink to the floor. The ice cubes shattered.

“You do understand what I am saying, Susan? I think you do. Our legal system is not geared to handle our needs. My God, they cannot make a decision to terminate a patient even after it is certain that his brain has turned to lifeless Jell-O. How can science proceed under a public policy handicap of that proportion?

“Now Susan, I want you to think carefully. I know it is a little hard for you to think at this moment, but try. I want to say something to you and I want your response. You are a bright, very bright, girl. You’re obviously one of the what should I say? … elite sounds too much like a cliché, but you know what I mean. We need you, people like you. What I want to say is that the people who run the Jefferson Institute are on our side. Do you understand, our side?”

Stark paused, looking Susan. She struggled to keep her eyelids above her pupils. It took all her strength.

“What do you say to that, Susan? Are you willing to dedicate that brain of yours to the good of society, science, and medicine?”

Susan’s mouth formed words but they came out in a whisper. Her face was expressionless. Stark leaned forward to hear. He had to bring his head up to within inches of Susan’s lips.

“Say it again, Susan. I’ll be able to hear if you say it again.”

Susan’s mouth struggled to bring her lower lip against her upper teeth to form the first consonant. It spilled out in a whisper.

“Fuck you, you cra—“ Susan’s head slumped back, her mouth gaping and her respirations coming in regular deep-sounding breaths. Stark looked at Susan’s drugged body for a few moments. Susan’s defiance angered him. But after a few moments of silence his emotion faded into disappointment. “Susan, we could have used the brain of yours.” Stark shook his head slowly. “Well, maybe you can still be useful.”

Stark turned to his phone and called the emergency room. He asked for the admitting resident.