Now Harry Tomaselli was in love with his work. He shared Kent O’Donnell’s views about the standards of good medicine and respected the business acumen and caginess of the board chairman, Orden Brown. As administrator, it was Tomaselli’s business to see that all hospital services—nursing, housekeeping, engineering, building, accounting, and their subsidiaries—measured up to the standards the other two men required.
He did this by delegation—he had a happy faculty of appointing good department heads—and also by an intense personal interest in everything that went on within the hospital. Almost nothing of importance escaped Harry Tomaselli. Each day his short, stocky figure could be seen bustling along the corridors but pausing frequently while he talked with nurses, patients, janitors, clerks, cooks—anyone who could tell him something about the hospital or make a suggestion on how to run it better. New ideas excited him; his own enthusiasm engendered more in others. Sometimes, head thrust forward, eyes gleaming behind his big black-rimmed glasses, he would talk volubly, his thoughts moving at a gallop, his hands underscoring points as he made them.
In all his peregrinations Harry Tomaselli seldom made a written note. His lawyer’s training enabled him to carry assorted facts readily in his head. But after each inspection tour he fired off a barrage of staccato memoranda on all points, big and little, where he felt the administration of Three Counties could be improved.
Yet, for all this, he had a diplomat’s sense of tone and language that seldom gave offense. Verbally he would hand out a reprimand, then talk cheerfully of something else. And though he never wasted words, his written memos were always gracious. He hated to fire a hospital employee unless the provocation were really strong. He frequently told his department heads, “If anyone has worked here more than a month, we have an investment in their experience. It’s to our advantage to mold them if we can, rather than try for someone new who may have other faults we haven’t thought of.” Because this policy was known and respected, employee morale was high.
There were still things about the organization that worried him. Some departments, he knew, could be made more efficient. There were areas where service to patients could be improved. A good deal of old equipment needed junking and replacement. There was newly developed equipment—the cine-radiography unit was an example—which, under ideal conditions, the hospital should have. The new building program would make good some of these deficiencies but not all. Like O’Donnell, he knew there were years of work ahead and that some objectives perhaps would remain beyond reach. But, after all, that was the road to achievement; you always tried for a little more than you knew you could accomplish.
His thoughts were brought back to the present by Orden Brown. The chairman was telling O’Donnell, “There’ll be a good deal of social activity, of course, once the campaign gets going. Oh, and something else. I believe it would be a good thing, Kent, if we put you in as a speaker at the Rotary Club. You could tell them what the new building will do, our plans for the future, and so on.”
O’Donnell, who disliked public meetings, especially the regimented bonhomie of service clubs, had been about to grimace but checked himself. Instead he said, “If you think it will help.”
“One of my people is on Rotary executive,” Orden Brown said. “I’ll have him fix it up. That had better be the opening week of the campaign. Then the following week we might do the same thing with Kiwanis.”
O’Donnell considered suggesting that the chairman leave him some time for surgery, otherwise he might have trouble meeting his own quota. But he thought better of it.
“By the way,” Orden Brown was saying, “are you free for dinner the day after tomorrow?”
“Yes, I am,” O’Donnell answered promptly. He always enjoyed the quiet, formal dignity of dinner at the house on the hill.
“I’d like you to come with me to Eustace Swayne’s.” Seeing O’Donnell’s surprise, the chairman added, “It’s all right—you’re invited. He asked me if I’d tell you.”
“Yes, I’ll be glad to come.” All the same, the invitation to the home of the board of directors’ most die-hard member was unexpected. Naturally O’Donnell had met Swayne a few times but had not come to know him well.
“As a matter of fact, it’s my suggestion,” Brown said. “I’d like you to talk with him about the hospital generally. Let him absorb some of your ideas if you can. Frankly, at times he’s a problem on the board, but you know that, of course.”
“I’ll do what I can.” Now that he knew what was involved, O’Donnell did not relish the thought of getting close to board politics. So far he had managed to steer clear of them. But he could not say no to Orden Brown.
The chairman picked up his brief case and prepared to leave. Tomaselli and O’Donnell rose with him.
“It will be just a small party,” Orden Brown said. “Probably half a dozen people. Why don’t we pick you up on the way across town? I’ll phone before we leave.”
O’Donnell murmured his thanks as, nodding pleasantly, the chairman went out.
The door had scarcely closed on Orden Brown when tall, slim Kathy Cohen, Tomaselli’s secretary, came in. “I’m sorry to interrupt,” she said.
“What is it, Kathy?”
She told the administrator, “There’s a man on the phone who insists on talking to you. A Mr. Bryan.”
“I’m busy with Dr. O’Donnell now. I’ll call him back.” Tomaselli sounded surprised. Normally he would not have to tell Kathy anything so elementary.
“I told him that, Mr. Tomaselli.” She sounded doubtful. “But he’s very insistent. He says he’s the husband of a patient. I thought you ought to know.”
“Maybe you should talk with him, Harry.” O’Donnell smiled at the girl. “Take him off Kathy’s mind. I don’t mind waiting.”
“All right.” The administrator reached for one of his two telephones.
“It’s line four.” The girl waited until the connection was made, then went back to the outer office.
“Administrator speaking.” Tomaselli’s tone was friendly. Then he frowned slightly, listening to what was coming from the other end of the line.
O’Donnell could hear the receiver diaphragm rattling sharply. He caught the words, “Disgraceful situation . . . imposition on a family . . . should be an inquiry.”
Tomaselli put his hand over the phone’s mouthpiece. He told O’Donnell, “He’s really boiling. Something about his wife. I can’t quite make put . . .” He listened for a moment more, then said, “Now, Mr. Bryan, supposing you start at the beginning. Tell me what this is all about.” He reached for a pad and pencil, then said, “Yes, sir.” A pause. “Now tell me, please, when was your wife admitted to hospital?” The phone rattled again and the administrator made a swift note. “And who was your physician?” Again a note. “And the date of discharge?” A pause. “Yes, I see.”
O’Donnell heard the words, “Can’t get any satisfaction,” then Tomaselli was talking again.
“No, Mr. Bryan, I don’t remember the particular case. But I will make some inquiries. I promise you that.” He listened, then answered, “Yes, sir, I do know what a hospital bill means to a family. But the hospital doesn’t make any profit, you know.”
O’Donnell could still hear the voice on the telephone, but it sounded calmer, responding to Tomaselli’s conciliatory approach. Now the administrator said, “Well, sir, it’s the physician who decides how long a patient remains in hospital. I think you should have another talk with your wife’s physician, and what I’ll do meanwhile is have our treasurer go over your bill, item by item.” He listened briefly, then, “Thank you, Mr. Bryan. Good-by.”
He hung up the phone, tore off the page of notes, and put it in a tray marked “Dictation.”
“What was the trouble?” O’Donnell asked the question casually. In a busy hospital complaints about service and charges were not unique.
“He claims his wife was kept in too long. Now he has to go into debt to pay the bill.”
O’Donnell said sharply, “How does he know she was in too long?”
“He says he’s checked around—whatever that means.” Tomaselli said thoughtfully, “It may have been necessary, of course, but she was here nearly three weeks.”
“So?”
“Normally I wouldn’t think much about it. But we’ve had an unusual number of these complaints. They’re not always as strong as this—but on the same lines.”
Something flashed through O’Donnell’s mind: the word Pathology. Aloud he said: “Who was the attending physician?”
Tomaselli glanced at his notes. “Reubens.”
“Let’s see if we can get him and clear this up now.”
Tomaselli touched an intercom set. “Kathy,” he said, “see if you can locate Dr. Reubens.”
They waited in silence. From the corridor outside they could hear a soft voice on the hospital public-address system. “Dr. Reubens. Dr. Reubens.” After a moment the phone buzzed. Tomaselli lifted the receiver and listened. Then he passed it to O’Donnell.
“Reub? It’s Kent O’Donnell.”
“What can I do for you?” O’Donnell could hear the thin, precise voice of Reubens, one of the senior surgeons, at the other end of the line.
“Do you have a patient”—he looked at Tomaselli’s notes which the administrator had pushed toward him—“a Mrs. Bryan?”
“That’s right. What’s the matter? Has her husband been complaining?”
“You know about it then?”
“Of course I know about it.” Reubens sounded annoyed. “Personally I think he has good reason to complain.”
“What’s the story, Reub?”
“The story is that I admitted Mrs. Bryan for possible carcinoma of the breast. I removed a tumor. It turned out to be benign.”
“Then why keep her here for three weeks?” As he asked, O’Donnell remembered that you always had to go through this question-and-answer performance with Reubens. The other man seldom volunteered information.
Now he answered, “You’d better ask Joe Pearson that!”
“Be simpler if you told me, Reub.” O’Donnell was quietly insistent. “After all, she’s your patient.”
There was a silence. Then the thin, clipped voice said, “All right. I told you the tumor was benign. But it was two and a half weeks before I found out. That’s how long it took Pearson to get it under his microscope.”
“Did you remind him about it?”
“If I called him once I called him half a dozen times. He’d probably have been longer if I hadn’t kept after it.”
“And that’s why you kept Mrs. Bryan in—for three weeks?”
“Naturally.” The voice on the phone took on a note of sarcasm. “Or are you suggesting I should have discharged her?”
There was reason for Reubens to be sour on the subject, O’Donnell thought. Unquestionably he had been put in a difficult position. If he had discharged the patient, he might have had to call her back for more surgery, as had happened to Bill Rufus. On the other hand, every additional day in hospital meant an extra financial burden for the family. He answered noncommittally, “I’m not suggesting anything, Reub. Just making some inquiries.”
The thing had obviously been on Reubens’ mind. “Then you’d better talk to some of the other men,” he said. “I’m not the only one this has happened to. You know about Bill Rufus?”
“Yes, I know. Frankly, I thought things had been improving a little.”
“If they have, it’s not so’s you’d notice it. What do you propose to do about Bryan’s bill?”
“I doubt if we can do anything. After all, his wife was here for three weeks. Hospital money is tight, you know.” O’Donnell wondered what Reubens’ reaction would be when he heard he was being asked to give six thousand dollars himself to the hospital building fund.
“It’s too bad. Husband’s a decent little guy—a carpenter or something like that, works for himself. He didn’t have any insurance. This’ll set ’em back for a long time.” O’Donnell made no answer. His mind was already running ahead, thinking of what came next. Again the thin voice on the phone: “Well, is that all?”
“Yes, Reub; that’s all. Thanks.” He handed the telephone back to Harry Tomaselli.
“Harry, I want a meeting this afternoon.” O’Donnell had made up his mind what had to be done. “Let’s try to get half a dozen of the senior people on staff. We’ll meet here, if that’s convenient, and I’d like you to be here too.”
Tomaselli nodded. “Can do.”
O’Donnell was checking over names in his mind. “We’ll want Harvey Chandler, of course, as chief of medicine. Better have Bill Rufus, and Reubens should be included, I think.” He paused. “Oh yes, and Charlie Dornberger. He might be useful. How many is that?”
The administrator checked the names he had written. “Six with you and me. How about Lucy Grainger?”
Briefly O’Donnell hesitated. Then he said, “All right. Let’s make it seven then.”
“Agenda?” Tomaselli had his pencil poised.
O’Donnell shook his head. “We won’t need one. There’s just one subject—changes in Pathology.”
When the administrator had mentioned Lucy Grainger’s name, O’Donnell had hesitated for one reason only: it had reminded him of a meeting between himself and Lucy the night before.
They had met for dinner—the outcome of O’Donnell’s invitation to Lucy the day of the mortality conference—and in the Palm Court of the Roosevelt Hotel they had had cocktails, then a leisurely meal. It had been a pleasant, relaxed occasion, and they had talked lightly of themselves, of people they had known, and their own experiences in and out of medicine.
Afterward O’Donnell had driven Lucy home. She had recently moved into Benvenuto Grange, a large, fashionable apartment block on the north side of town. She had said, “You’ll come in for a nightcap, of course?”
He had left his car for the uniformed doorman to park and followed her. They rode the gleaming, silent elevator to the fifth floor, then turned down a birch-paneled corridor, their footsteps silenced in deep broadloom. He had raised his eyebrows and Lucy smiled. “It is a little awesome, isn’t it? I’m still impressed myself.”
She had used her key to open a door and inside touched a switch. Tasteful, subdued lighting sprang up around an elegant interior lounge. He could see the partly opened door of a bedroom directly ahead. “I’ll mix us a drink,” she said.
Her back was to him. Ice clinked in glasses. O’Donnell said, “Lucy, you’ve never married?”
“No.” She had answered without turning.
He said softly, “I’ve sometimes wondered why.”
“It’s very simple really. It’s quite some time since I was asked.” Lucy turned, carrying the drinks she had mixed. She gave O’Donnell his, then moved to a chair. She said thoughtfully, “Now I think of it, there was only one occasion—at least, only one that mattered. I was a good deal younger then.”
O’Donnell sipped his drink. “And your answer was ‘no’?”
“I wanted a career in medicine. At the time it seemed terribly important. That and marriage didn’t seem to go together.”
He asked casually, “Any regrets?”
Lucy considered. “Not really, I suppose. I’ve achieved what I wanted, and it’s been rewarding in many ways. Oh, sometimes one wonders how things would have turned out with a different decision, but after all, that’s human, isn’t it?”
“I suppose so.” O’Donnell was conscious of being strangely moved. There was a sense of depth and tenderness about Lucy, a feeling of peacefulness and coming home. She should have children, he thought. He had asked, “Do you still feel the same way about marriage and medicine—for you, that is?”
“I’m no longer dogmatic about anything.” She smiled. “That, at least, I’ve learned.”
O’Donnell wondered what, from his own point of view, marriage to Lucy would be like. Would there be love and mellowness? Or had each of their careers gone parallel too far and too long for change and adjustment now. If married, how might they spend their hours of leisure? Would the talk be intimate and domestic? Or would it be of hospital affairs, with charts on the table at dinner and diagnostic problems for dessert? Would he perhaps, instead of gaining sanctuary, find merely another offshoot of medicine and his daily work. Aloud he said, “I’ve always thought, you know, that we have a good deal in common.”
“Yes, Kent,” Lucy answered, “so have I.”
O’Donnell had finished his drink, then risen to leave. He realized they had both said a good deal more than had passed in words. Now he wanted time to think and to reason things through. Too much was involved for hasty decisions.
“There’s really no need to go, Kent. Stay if you wish.” Lucy had said it simply, and he knew if he stayed it would be up to him what happened next.
Part of his mind had told him to remain, but caution and habit won out. He took her hands. “Good night, Lucy. Let’s think about all this.”
When the elevator doors had closed she was still standing at the open apartment door.
Six
Seven
He did this by delegation—he had a happy faculty of appointing good department heads—and also by an intense personal interest in everything that went on within the hospital. Almost nothing of importance escaped Harry Tomaselli. Each day his short, stocky figure could be seen bustling along the corridors but pausing frequently while he talked with nurses, patients, janitors, clerks, cooks—anyone who could tell him something about the hospital or make a suggestion on how to run it better. New ideas excited him; his own enthusiasm engendered more in others. Sometimes, head thrust forward, eyes gleaming behind his big black-rimmed glasses, he would talk volubly, his thoughts moving at a gallop, his hands underscoring points as he made them.
In all his peregrinations Harry Tomaselli seldom made a written note. His lawyer’s training enabled him to carry assorted facts readily in his head. But after each inspection tour he fired off a barrage of staccato memoranda on all points, big and little, where he felt the administration of Three Counties could be improved.
Yet, for all this, he had a diplomat’s sense of tone and language that seldom gave offense. Verbally he would hand out a reprimand, then talk cheerfully of something else. And though he never wasted words, his written memos were always gracious. He hated to fire a hospital employee unless the provocation were really strong. He frequently told his department heads, “If anyone has worked here more than a month, we have an investment in their experience. It’s to our advantage to mold them if we can, rather than try for someone new who may have other faults we haven’t thought of.” Because this policy was known and respected, employee morale was high.
There were still things about the organization that worried him. Some departments, he knew, could be made more efficient. There were areas where service to patients could be improved. A good deal of old equipment needed junking and replacement. There was newly developed equipment—the cine-radiography unit was an example—which, under ideal conditions, the hospital should have. The new building program would make good some of these deficiencies but not all. Like O’Donnell, he knew there were years of work ahead and that some objectives perhaps would remain beyond reach. But, after all, that was the road to achievement; you always tried for a little more than you knew you could accomplish.
His thoughts were brought back to the present by Orden Brown. The chairman was telling O’Donnell, “There’ll be a good deal of social activity, of course, once the campaign gets going. Oh, and something else. I believe it would be a good thing, Kent, if we put you in as a speaker at the Rotary Club. You could tell them what the new building will do, our plans for the future, and so on.”
O’Donnell, who disliked public meetings, especially the regimented bonhomie of service clubs, had been about to grimace but checked himself. Instead he said, “If you think it will help.”
“One of my people is on Rotary executive,” Orden Brown said. “I’ll have him fix it up. That had better be the opening week of the campaign. Then the following week we might do the same thing with Kiwanis.”
O’Donnell considered suggesting that the chairman leave him some time for surgery, otherwise he might have trouble meeting his own quota. But he thought better of it.
“By the way,” Orden Brown was saying, “are you free for dinner the day after tomorrow?”
“Yes, I am,” O’Donnell answered promptly. He always enjoyed the quiet, formal dignity of dinner at the house on the hill.
“I’d like you to come with me to Eustace Swayne’s.” Seeing O’Donnell’s surprise, the chairman added, “It’s all right—you’re invited. He asked me if I’d tell you.”
“Yes, I’ll be glad to come.” All the same, the invitation to the home of the board of directors’ most die-hard member was unexpected. Naturally O’Donnell had met Swayne a few times but had not come to know him well.
“As a matter of fact, it’s my suggestion,” Brown said. “I’d like you to talk with him about the hospital generally. Let him absorb some of your ideas if you can. Frankly, at times he’s a problem on the board, but you know that, of course.”
“I’ll do what I can.” Now that he knew what was involved, O’Donnell did not relish the thought of getting close to board politics. So far he had managed to steer clear of them. But he could not say no to Orden Brown.
The chairman picked up his brief case and prepared to leave. Tomaselli and O’Donnell rose with him.
“It will be just a small party,” Orden Brown said. “Probably half a dozen people. Why don’t we pick you up on the way across town? I’ll phone before we leave.”
O’Donnell murmured his thanks as, nodding pleasantly, the chairman went out.
The door had scarcely closed on Orden Brown when tall, slim Kathy Cohen, Tomaselli’s secretary, came in. “I’m sorry to interrupt,” she said.
“What is it, Kathy?”
She told the administrator, “There’s a man on the phone who insists on talking to you. A Mr. Bryan.”
“I’m busy with Dr. O’Donnell now. I’ll call him back.” Tomaselli sounded surprised. Normally he would not have to tell Kathy anything so elementary.
“I told him that, Mr. Tomaselli.” She sounded doubtful. “But he’s very insistent. He says he’s the husband of a patient. I thought you ought to know.”
“Maybe you should talk with him, Harry.” O’Donnell smiled at the girl. “Take him off Kathy’s mind. I don’t mind waiting.”
“All right.” The administrator reached for one of his two telephones.
“It’s line four.” The girl waited until the connection was made, then went back to the outer office.
“Administrator speaking.” Tomaselli’s tone was friendly. Then he frowned slightly, listening to what was coming from the other end of the line.
O’Donnell could hear the receiver diaphragm rattling sharply. He caught the words, “Disgraceful situation . . . imposition on a family . . . should be an inquiry.”
Tomaselli put his hand over the phone’s mouthpiece. He told O’Donnell, “He’s really boiling. Something about his wife. I can’t quite make put . . .” He listened for a moment more, then said, “Now, Mr. Bryan, supposing you start at the beginning. Tell me what this is all about.” He reached for a pad and pencil, then said, “Yes, sir.” A pause. “Now tell me, please, when was your wife admitted to hospital?” The phone rattled again and the administrator made a swift note. “And who was your physician?” Again a note. “And the date of discharge?” A pause. “Yes, I see.”
O’Donnell heard the words, “Can’t get any satisfaction,” then Tomaselli was talking again.
“No, Mr. Bryan, I don’t remember the particular case. But I will make some inquiries. I promise you that.” He listened, then answered, “Yes, sir, I do know what a hospital bill means to a family. But the hospital doesn’t make any profit, you know.”
O’Donnell could still hear the voice on the telephone, but it sounded calmer, responding to Tomaselli’s conciliatory approach. Now the administrator said, “Well, sir, it’s the physician who decides how long a patient remains in hospital. I think you should have another talk with your wife’s physician, and what I’ll do meanwhile is have our treasurer go over your bill, item by item.” He listened briefly, then, “Thank you, Mr. Bryan. Good-by.”
He hung up the phone, tore off the page of notes, and put it in a tray marked “Dictation.”
“What was the trouble?” O’Donnell asked the question casually. In a busy hospital complaints about service and charges were not unique.
“He claims his wife was kept in too long. Now he has to go into debt to pay the bill.”
O’Donnell said sharply, “How does he know she was in too long?”
“He says he’s checked around—whatever that means.” Tomaselli said thoughtfully, “It may have been necessary, of course, but she was here nearly three weeks.”
“So?”
“Normally I wouldn’t think much about it. But we’ve had an unusual number of these complaints. They’re not always as strong as this—but on the same lines.”
Something flashed through O’Donnell’s mind: the word Pathology. Aloud he said: “Who was the attending physician?”
Tomaselli glanced at his notes. “Reubens.”
“Let’s see if we can get him and clear this up now.”
Tomaselli touched an intercom set. “Kathy,” he said, “see if you can locate Dr. Reubens.”
They waited in silence. From the corridor outside they could hear a soft voice on the hospital public-address system. “Dr. Reubens. Dr. Reubens.” After a moment the phone buzzed. Tomaselli lifted the receiver and listened. Then he passed it to O’Donnell.
“Reub? It’s Kent O’Donnell.”
“What can I do for you?” O’Donnell could hear the thin, precise voice of Reubens, one of the senior surgeons, at the other end of the line.
“Do you have a patient”—he looked at Tomaselli’s notes which the administrator had pushed toward him—“a Mrs. Bryan?”
“That’s right. What’s the matter? Has her husband been complaining?”
“You know about it then?”
“Of course I know about it.” Reubens sounded annoyed. “Personally I think he has good reason to complain.”
“What’s the story, Reub?”
“The story is that I admitted Mrs. Bryan for possible carcinoma of the breast. I removed a tumor. It turned out to be benign.”
“Then why keep her here for three weeks?” As he asked, O’Donnell remembered that you always had to go through this question-and-answer performance with Reubens. The other man seldom volunteered information.
Now he answered, “You’d better ask Joe Pearson that!”
“Be simpler if you told me, Reub.” O’Donnell was quietly insistent. “After all, she’s your patient.”
There was a silence. Then the thin, clipped voice said, “All right. I told you the tumor was benign. But it was two and a half weeks before I found out. That’s how long it took Pearson to get it under his microscope.”
“Did you remind him about it?”
“If I called him once I called him half a dozen times. He’d probably have been longer if I hadn’t kept after it.”
“And that’s why you kept Mrs. Bryan in—for three weeks?”
“Naturally.” The voice on the phone took on a note of sarcasm. “Or are you suggesting I should have discharged her?”
There was reason for Reubens to be sour on the subject, O’Donnell thought. Unquestionably he had been put in a difficult position. If he had discharged the patient, he might have had to call her back for more surgery, as had happened to Bill Rufus. On the other hand, every additional day in hospital meant an extra financial burden for the family. He answered noncommittally, “I’m not suggesting anything, Reub. Just making some inquiries.”
The thing had obviously been on Reubens’ mind. “Then you’d better talk to some of the other men,” he said. “I’m not the only one this has happened to. You know about Bill Rufus?”
“Yes, I know. Frankly, I thought things had been improving a little.”
“If they have, it’s not so’s you’d notice it. What do you propose to do about Bryan’s bill?”
“I doubt if we can do anything. After all, his wife was here for three weeks. Hospital money is tight, you know.” O’Donnell wondered what Reubens’ reaction would be when he heard he was being asked to give six thousand dollars himself to the hospital building fund.
“It’s too bad. Husband’s a decent little guy—a carpenter or something like that, works for himself. He didn’t have any insurance. This’ll set ’em back for a long time.” O’Donnell made no answer. His mind was already running ahead, thinking of what came next. Again the thin voice on the phone: “Well, is that all?”
“Yes, Reub; that’s all. Thanks.” He handed the telephone back to Harry Tomaselli.
“Harry, I want a meeting this afternoon.” O’Donnell had made up his mind what had to be done. “Let’s try to get half a dozen of the senior people on staff. We’ll meet here, if that’s convenient, and I’d like you to be here too.”
Tomaselli nodded. “Can do.”
O’Donnell was checking over names in his mind. “We’ll want Harvey Chandler, of course, as chief of medicine. Better have Bill Rufus, and Reubens should be included, I think.” He paused. “Oh yes, and Charlie Dornberger. He might be useful. How many is that?”
The administrator checked the names he had written. “Six with you and me. How about Lucy Grainger?”
Briefly O’Donnell hesitated. Then he said, “All right. Let’s make it seven then.”
“Agenda?” Tomaselli had his pencil poised.
O’Donnell shook his head. “We won’t need one. There’s just one subject—changes in Pathology.”
When the administrator had mentioned Lucy Grainger’s name, O’Donnell had hesitated for one reason only: it had reminded him of a meeting between himself and Lucy the night before.
They had met for dinner—the outcome of O’Donnell’s invitation to Lucy the day of the mortality conference—and in the Palm Court of the Roosevelt Hotel they had had cocktails, then a leisurely meal. It had been a pleasant, relaxed occasion, and they had talked lightly of themselves, of people they had known, and their own experiences in and out of medicine.
Afterward O’Donnell had driven Lucy home. She had recently moved into Benvenuto Grange, a large, fashionable apartment block on the north side of town. She had said, “You’ll come in for a nightcap, of course?”
He had left his car for the uniformed doorman to park and followed her. They rode the gleaming, silent elevator to the fifth floor, then turned down a birch-paneled corridor, their footsteps silenced in deep broadloom. He had raised his eyebrows and Lucy smiled. “It is a little awesome, isn’t it? I’m still impressed myself.”
She had used her key to open a door and inside touched a switch. Tasteful, subdued lighting sprang up around an elegant interior lounge. He could see the partly opened door of a bedroom directly ahead. “I’ll mix us a drink,” she said.
Her back was to him. Ice clinked in glasses. O’Donnell said, “Lucy, you’ve never married?”
“No.” She had answered without turning.
He said softly, “I’ve sometimes wondered why.”
“It’s very simple really. It’s quite some time since I was asked.” Lucy turned, carrying the drinks she had mixed. She gave O’Donnell his, then moved to a chair. She said thoughtfully, “Now I think of it, there was only one occasion—at least, only one that mattered. I was a good deal younger then.”
O’Donnell sipped his drink. “And your answer was ‘no’?”
“I wanted a career in medicine. At the time it seemed terribly important. That and marriage didn’t seem to go together.”
He asked casually, “Any regrets?”
Lucy considered. “Not really, I suppose. I’ve achieved what I wanted, and it’s been rewarding in many ways. Oh, sometimes one wonders how things would have turned out with a different decision, but after all, that’s human, isn’t it?”
“I suppose so.” O’Donnell was conscious of being strangely moved. There was a sense of depth and tenderness about Lucy, a feeling of peacefulness and coming home. She should have children, he thought. He had asked, “Do you still feel the same way about marriage and medicine—for you, that is?”
“I’m no longer dogmatic about anything.” She smiled. “That, at least, I’ve learned.”
O’Donnell wondered what, from his own point of view, marriage to Lucy would be like. Would there be love and mellowness? Or had each of their careers gone parallel too far and too long for change and adjustment now. If married, how might they spend their hours of leisure? Would the talk be intimate and domestic? Or would it be of hospital affairs, with charts on the table at dinner and diagnostic problems for dessert? Would he perhaps, instead of gaining sanctuary, find merely another offshoot of medicine and his daily work. Aloud he said, “I’ve always thought, you know, that we have a good deal in common.”
“Yes, Kent,” Lucy answered, “so have I.”
O’Donnell had finished his drink, then risen to leave. He realized they had both said a good deal more than had passed in words. Now he wanted time to think and to reason things through. Too much was involved for hasty decisions.
“There’s really no need to go, Kent. Stay if you wish.” Lucy had said it simply, and he knew if he stayed it would be up to him what happened next.
Part of his mind had told him to remain, but caution and habit won out. He took her hands. “Good night, Lucy. Let’s think about all this.”
When the elevator doors had closed she was still standing at the open apartment door.
Six
“I asked you here,” O’Donnell told the group around the board-room table, “because I’d like your support in something I want to do.” The others were listening attentively. Of those they had asked, all had come except Reubens, who had a herniorrhaphy scheduled. O’Donnell went on, “I think we all know there’s a problem in Pathology. I believe, too, you’ll agree it’s a personal problem as well as medical.”
“What kind of a problem?” It was Charlie Dornberger. As the elderly obstetrician talked he filled his pipe. “I’m not sure I know what you’re getting at, Kent.”
O’Donnell had expected something like this. He knew that Dornberger and Pearson were close friends. Politely he said, “I’d like you to hear me out, Charlie, if you will. I’ll try to make it clear.”
Methodically he went over the issues involved—the delays in surgical reports, the increasing service the hospital required from its pathology department, his own doubts that Joe Pearson could cope with them alone. He related the incident of Bill Rufus’ patient, turning to Rufus for confirmation, and followed it with the report he had had from Reubens that morning. He told them of his own interview with Pearson and the old man’s refusal to accept a second pathologist. He concluded: “I’m convinced we do need a new man to help Joe out. I want your support in seeing that one is brought in.”
“I’ve been concerned about Pathology too.” Promptly, as if to ensure the observance of protocol, Harvey Chandler, the chief of medicine, followed O’Donnell. His words held the suggestion of a judicial opinion weightily delivered; as usual, his simplest statements contained an air of mild pomposity. He continued, “But the situation may be difficult with Joe Pearson feeling the way he does. After all, he’s a department head, and we ought to avoid any suggestion of undermining his authority.”
“I agree,” O’Donnell responded, “and that’s why I want some help.” He drummed his fingers on the desk top for emphasis. “Some help in convincing Joe Pearson that changes are necessary.”
“I’m not sure I like the way we’re doing this,” Bill Rufus said.
“Why, Bill?” O’Donnell noticed that Rufus was wearing one of his more subdued neckties today. It had only three colors instead of the usual four.
“I don’t think a few of us, meeting like this, have any right to talk about a change in Pathology.” Rufus looked around at the others. “Certainly I’ve had some run-ins with Joe Pearson. I guess most of us have. But that doesn’t mean I’m going to join some hole-and-corner conspiracy to boot him out.”
O’Donnell was glad this had come up; he was ready for it. “Let me say emphatically,” he said, “there is no intention on my part or anybody else’s of—as you put it”—he glanced at Rufus—“booting Dr. Pearson out.” There was a murmur of assent.
“Look at it this way,” O’Donnell said. “There seems to be agreement that changes in Pathology are necessary. Take surgical reports alone. Every day’s delay where surgery is needed means danger to the patient. I know I don’t need to emphasize that.”
Harry Tomaselli interjected, “And don’t let us forget that these delays are tying up hospital beds we need badly. Our waiting list for admissions is still very long.”
O’Donnell took over again. “Of course, instead of handling things this way I could have called the executive committee together.” He paused. “I still will if I have to, but I think you know what might happen. Joe is a member of the executive himself and, knowing Joe as we all do, any discussion will mean a showdown. In that case, assuming we force the issue, what have we gained? We’ve proven to Joe Pearson that he’s no longer in charge of his own department. And medically, and every other way—just as Harvey said—we’ll have undermined ourselves and the hospital.” O’Donnell thought, too, of what he could not tell the others: that he was also weighing Pearson’s influence with the old guard on the hospital board and the political repercussions which a showdown might create.
“I’m not saying I go along with you, but what’s your suggestion?” The question came from Charlie Dornberger. He punctuated it with puffs of smoke as his pipe got going.
Rufus sniffed. “We’d better hurry this up. It won’t be fit to breathe in here soon. Do you import that camel dung, Charlie?”
As the others smiled, O’Donnell decided to lay it on the line. “My suggestion, Charlie, is that you approach Joe—on behalf of the rest of us.”
“Oh no!” The reaction from Dornberger was much what O’Donnell had anticipated. He settled in to be persuasive.
“Charlie, we know you’re a close friend of Joe’s and I had that in mind when I asked you here. You could persuade him about this.”
“In other words, you want me to carry your ax,” Dornberger said dryly.
“Charlie, it isn’t an ax, believe me.”
Dr. Charles Dornberger hesitated. He observed that the others were watching him, waiting for his answer. He debated: should he do as O’Donnell asked or not? He was torn by two conflicting feelings—his concern for the hospital’s good and his own relationship with Joe Pearson.
In a way the news of the state of affairs in Pathology was not entirely unexpected; it was a condition he had suspected for some time. Nevertheless the two incidents concerning Rufus and Reubens, which O’Donnell had revealed, had shocked him inexpressibly. Dornberger knew also that O’Donnell would not have called this meeting unless he had been seriously concerned, and he respected the chief of surgery’s judgment.
At the same time Charles Dornberger wanted to help Joe Pearson if he could, and at this moment he found himself resenting the tide of events which seemed to be engulfing the elderly pathologist. And yet O’Donnell had appeared to be sincere when he said there was no intention of booting Pearson out, and the others seemed to share this feeling. He decided that perhaps he could be the intermediary. Possibly this way he could help Joe best.
Dornberger looked around at the others. He asked, “Is this unanimous?”
Lucy Grainger said thoughtfully, “I’m very fond of Joe. I think we all are. But I do believe some changes in Pathology are necessary.” It was the first time Lucy had spoken. She too had wondered about this meeting with Kent O’Donnell. What had passed between them in her apartment last night had left her strangely disturbed in a way she had not remembered for years. Afterward she had wondered if she were in love with O’Donnell, then told herself—only half believing—that those kind of phrases were all very well for the young and ardent, but at her age—with maturity, independence, and a professional practice—one reasoned and rationalized, eschewing hastily conceived emotions. At this moment, though, she found herself able to separate personal and professional feelings and to think about the problem in Pathology. In medicine you learned to do that—to push things out of your mind when immediate concerns were more important.
O’Donnell looked at Rufus. “Bill?”
The surgeon nodded. “All right—if Charlie will approach Pearson, I agree.”
Harvey Chandler was next. The chief of medicine told Dornberger ponderously, “In my opinion this is the best way to handle the situation, Charlie. You will be doing all of us, as well as the hospital, a very real service.”
“Very well,” Dornberger said. “I’ll see what I can do.”
There was a momentary silence, and O’Donnell sensed a feeling of relief. He knew the problem had been understood and now, at least, something would be done. Then, if this approach failed, he would have to resort to more direct methods. Sometimes, he reflected, it might be simpler if medical protocol were less complicated. In industry, if a man was not doing his job adequately, you fired him. If you wanted him to take an assistant, you told him to do so and usually that was that. But in medicine and in a hospital it was less straightforward. The lines of authority were seldom clear-cut, and a medical-department head, once appointed, was pretty well master in his own domain. What was even more important—you hesitated to do really drastic things because you were dealing with more than just a job. You were questioning the ability of a man who, like yourself, was dependent on his professional reputation. It was a delicate issue in which a single decision could affect the entire future and livelihood of a fellow practitioner. That was why you proceeded warily, keeping things like this under wraps and carefully guarded from outside scrutiny.
Harry Tomaselli said softly, “I take it, then, we’re going to look for an available pathologist.”
“I think we should begin to look around.” O’Donnell answered the administrator, then glanced at the others. “I imagine most of us have contacts where we might pass the word along. If you hear of anyone—a good man who’s just finishing his residency perhaps—I’d like you to let me know.”
“Pathologists can be pretty choosy nowadays,” Bill Rufus said.
“I know. This may not be easy.” O’Donnell added, “It’s all the more reason for handling Joe carefully.”
Harry Tomaselli had reached into one of his desk drawers and removed a file folder. He said, “Something here may interest you.”
Harvey Chandler asked him, “What is it you have?”
“I’ve been receiving the ‘open list’ on pathologists lately,” Tomaselli answered. “Frankly, I anticipated something like this and asked for it. This name came in a week or two ago.”
“May I see?” O’Donnell reached for the paper Tomaselli had produced. He knew the so-called “open list” was circulated periodically to hospitals on request. It contained information on pathologists available for appointments, and the men concerned had given permission for their names to be used. There was also a “closed list,” but this was retained in confidence by the pathologists’ professional society. Mostly the “closed list” comprised men dissatisfied with their present appointments who were seeking discreetly to make a change. In this case a hospital would advise the society of its need for a pathologist and those on the “closed list” had this information passed along to them. If he chose, an individual could then approach a hospital direct. Yet with all this machinery in existence, O’Donnell knew that most pathology appointments were still made on the basis of personal contacts and recommendation.
He glanced over the sheet the administrator had given him. The listing was for a Dr. David Coleman, his age thirty-one. O’Donnell’s eyebrows went up as he noted Coleman’s record and experience. An N.Y.U. honors graduate. Intern at Bellevue. Two years in the Army, mostly in pathology. A five-year pathology residence spread over three good hospitals. Here was a man who plainly shopped for the best in education.
He passed the paper to Rufus. “I doubt very much if he’d look at us,” he told Tomaselli. “Not with those qualifications and what we could pay to begin with.” O’Donnell knew, from an earlier talk with the administrator, that salary level would have to be around ten thousand dollars a year.
Rufus glanced up. “I agree. This man can take his pick of the big city hospitals.” He passed the sheet to Harvey Chandler.
“Well, as a matter of fact . . .” Tomaselli paused; he sounded unusually diffident, as if weighing his words carefully.
O’Donnell asked curiously, “What is it, Harry?”
“Well, the fact is, Dr. Coleman is interested in this hospital.” Tomaselli paused. “I gather he’s heard something of our recent changes and plans for the future.”
O’Donnell broke the sudden stillness. “How do you know?”
“I know because we’ve had some correspondence.”
Rufus said, “Isn’t that a little unusual, Harry?”
“Perhaps I was being premature, but after this came”—Tomaselli indicated the paper which had now passed to Lucy—“I wrote to Dr. Coleman. I said nothing definite, of course. It was just a tentative approach, sounding him out.” He turned to O’Donnell. “It was after our conversation a couple of weeks ago. You may remember, Kent.”
“Yes, I do.” O’Donnell was wishing that Harry had briefed him about this beforehand. Of course, as administrator Tomaselli had a right to correspond with anyone he chose. He hadn’t committed the hospital in any way. The correspondence was presumably confidential. Possibly it might prove to have been a good move. He said to Tomaselli, “You say he’s interested?”
“Yes. He’d like to come and see us. If this had not come up today, I’d intended to speak to you about it.”
Dornberger had the paper now. He tapped it with a forefinger. “What do you want me to do about this?”
O’Donnell glanced at the others, seeking confirmation. “I think you should take it with you, Charlie,” he said. “And I suggest you show it to Joe Pearson.”
“What kind of a problem?” It was Charlie Dornberger. As the elderly obstetrician talked he filled his pipe. “I’m not sure I know what you’re getting at, Kent.”
O’Donnell had expected something like this. He knew that Dornberger and Pearson were close friends. Politely he said, “I’d like you to hear me out, Charlie, if you will. I’ll try to make it clear.”
Methodically he went over the issues involved—the delays in surgical reports, the increasing service the hospital required from its pathology department, his own doubts that Joe Pearson could cope with them alone. He related the incident of Bill Rufus’ patient, turning to Rufus for confirmation, and followed it with the report he had had from Reubens that morning. He told them of his own interview with Pearson and the old man’s refusal to accept a second pathologist. He concluded: “I’m convinced we do need a new man to help Joe out. I want your support in seeing that one is brought in.”
“I’ve been concerned about Pathology too.” Promptly, as if to ensure the observance of protocol, Harvey Chandler, the chief of medicine, followed O’Donnell. His words held the suggestion of a judicial opinion weightily delivered; as usual, his simplest statements contained an air of mild pomposity. He continued, “But the situation may be difficult with Joe Pearson feeling the way he does. After all, he’s a department head, and we ought to avoid any suggestion of undermining his authority.”
“I agree,” O’Donnell responded, “and that’s why I want some help.” He drummed his fingers on the desk top for emphasis. “Some help in convincing Joe Pearson that changes are necessary.”
“I’m not sure I like the way we’re doing this,” Bill Rufus said.
“Why, Bill?” O’Donnell noticed that Rufus was wearing one of his more subdued neckties today. It had only three colors instead of the usual four.
“I don’t think a few of us, meeting like this, have any right to talk about a change in Pathology.” Rufus looked around at the others. “Certainly I’ve had some run-ins with Joe Pearson. I guess most of us have. But that doesn’t mean I’m going to join some hole-and-corner conspiracy to boot him out.”
O’Donnell was glad this had come up; he was ready for it. “Let me say emphatically,” he said, “there is no intention on my part or anybody else’s of—as you put it”—he glanced at Rufus—“booting Dr. Pearson out.” There was a murmur of assent.
“Look at it this way,” O’Donnell said. “There seems to be agreement that changes in Pathology are necessary. Take surgical reports alone. Every day’s delay where surgery is needed means danger to the patient. I know I don’t need to emphasize that.”
Harry Tomaselli interjected, “And don’t let us forget that these delays are tying up hospital beds we need badly. Our waiting list for admissions is still very long.”
O’Donnell took over again. “Of course, instead of handling things this way I could have called the executive committee together.” He paused. “I still will if I have to, but I think you know what might happen. Joe is a member of the executive himself and, knowing Joe as we all do, any discussion will mean a showdown. In that case, assuming we force the issue, what have we gained? We’ve proven to Joe Pearson that he’s no longer in charge of his own department. And medically, and every other way—just as Harvey said—we’ll have undermined ourselves and the hospital.” O’Donnell thought, too, of what he could not tell the others: that he was also weighing Pearson’s influence with the old guard on the hospital board and the political repercussions which a showdown might create.
“I’m not saying I go along with you, but what’s your suggestion?” The question came from Charlie Dornberger. He punctuated it with puffs of smoke as his pipe got going.
Rufus sniffed. “We’d better hurry this up. It won’t be fit to breathe in here soon. Do you import that camel dung, Charlie?”
As the others smiled, O’Donnell decided to lay it on the line. “My suggestion, Charlie, is that you approach Joe—on behalf of the rest of us.”
“Oh no!” The reaction from Dornberger was much what O’Donnell had anticipated. He settled in to be persuasive.
“Charlie, we know you’re a close friend of Joe’s and I had that in mind when I asked you here. You could persuade him about this.”
“In other words, you want me to carry your ax,” Dornberger said dryly.
“Charlie, it isn’t an ax, believe me.”
Dr. Charles Dornberger hesitated. He observed that the others were watching him, waiting for his answer. He debated: should he do as O’Donnell asked or not? He was torn by two conflicting feelings—his concern for the hospital’s good and his own relationship with Joe Pearson.
In a way the news of the state of affairs in Pathology was not entirely unexpected; it was a condition he had suspected for some time. Nevertheless the two incidents concerning Rufus and Reubens, which O’Donnell had revealed, had shocked him inexpressibly. Dornberger knew also that O’Donnell would not have called this meeting unless he had been seriously concerned, and he respected the chief of surgery’s judgment.
At the same time Charles Dornberger wanted to help Joe Pearson if he could, and at this moment he found himself resenting the tide of events which seemed to be engulfing the elderly pathologist. And yet O’Donnell had appeared to be sincere when he said there was no intention of booting Pearson out, and the others seemed to share this feeling. He decided that perhaps he could be the intermediary. Possibly this way he could help Joe best.
Dornberger looked around at the others. He asked, “Is this unanimous?”
Lucy Grainger said thoughtfully, “I’m very fond of Joe. I think we all are. But I do believe some changes in Pathology are necessary.” It was the first time Lucy had spoken. She too had wondered about this meeting with Kent O’Donnell. What had passed between them in her apartment last night had left her strangely disturbed in a way she had not remembered for years. Afterward she had wondered if she were in love with O’Donnell, then told herself—only half believing—that those kind of phrases were all very well for the young and ardent, but at her age—with maturity, independence, and a professional practice—one reasoned and rationalized, eschewing hastily conceived emotions. At this moment, though, she found herself able to separate personal and professional feelings and to think about the problem in Pathology. In medicine you learned to do that—to push things out of your mind when immediate concerns were more important.
O’Donnell looked at Rufus. “Bill?”
The surgeon nodded. “All right—if Charlie will approach Pearson, I agree.”
Harvey Chandler was next. The chief of medicine told Dornberger ponderously, “In my opinion this is the best way to handle the situation, Charlie. You will be doing all of us, as well as the hospital, a very real service.”
“Very well,” Dornberger said. “I’ll see what I can do.”
There was a momentary silence, and O’Donnell sensed a feeling of relief. He knew the problem had been understood and now, at least, something would be done. Then, if this approach failed, he would have to resort to more direct methods. Sometimes, he reflected, it might be simpler if medical protocol were less complicated. In industry, if a man was not doing his job adequately, you fired him. If you wanted him to take an assistant, you told him to do so and usually that was that. But in medicine and in a hospital it was less straightforward. The lines of authority were seldom clear-cut, and a medical-department head, once appointed, was pretty well master in his own domain. What was even more important—you hesitated to do really drastic things because you were dealing with more than just a job. You were questioning the ability of a man who, like yourself, was dependent on his professional reputation. It was a delicate issue in which a single decision could affect the entire future and livelihood of a fellow practitioner. That was why you proceeded warily, keeping things like this under wraps and carefully guarded from outside scrutiny.
Harry Tomaselli said softly, “I take it, then, we’re going to look for an available pathologist.”
“I think we should begin to look around.” O’Donnell answered the administrator, then glanced at the others. “I imagine most of us have contacts where we might pass the word along. If you hear of anyone—a good man who’s just finishing his residency perhaps—I’d like you to let me know.”
“Pathologists can be pretty choosy nowadays,” Bill Rufus said.
“I know. This may not be easy.” O’Donnell added, “It’s all the more reason for handling Joe carefully.”
Harry Tomaselli had reached into one of his desk drawers and removed a file folder. He said, “Something here may interest you.”
Harvey Chandler asked him, “What is it you have?”
“I’ve been receiving the ‘open list’ on pathologists lately,” Tomaselli answered. “Frankly, I anticipated something like this and asked for it. This name came in a week or two ago.”
“May I see?” O’Donnell reached for the paper Tomaselli had produced. He knew the so-called “open list” was circulated periodically to hospitals on request. It contained information on pathologists available for appointments, and the men concerned had given permission for their names to be used. There was also a “closed list,” but this was retained in confidence by the pathologists’ professional society. Mostly the “closed list” comprised men dissatisfied with their present appointments who were seeking discreetly to make a change. In this case a hospital would advise the society of its need for a pathologist and those on the “closed list” had this information passed along to them. If he chose, an individual could then approach a hospital direct. Yet with all this machinery in existence, O’Donnell knew that most pathology appointments were still made on the basis of personal contacts and recommendation.
He glanced over the sheet the administrator had given him. The listing was for a Dr. David Coleman, his age thirty-one. O’Donnell’s eyebrows went up as he noted Coleman’s record and experience. An N.Y.U. honors graduate. Intern at Bellevue. Two years in the Army, mostly in pathology. A five-year pathology residence spread over three good hospitals. Here was a man who plainly shopped for the best in education.
He passed the paper to Rufus. “I doubt very much if he’d look at us,” he told Tomaselli. “Not with those qualifications and what we could pay to begin with.” O’Donnell knew, from an earlier talk with the administrator, that salary level would have to be around ten thousand dollars a year.
Rufus glanced up. “I agree. This man can take his pick of the big city hospitals.” He passed the sheet to Harvey Chandler.
“Well, as a matter of fact . . .” Tomaselli paused; he sounded unusually diffident, as if weighing his words carefully.
O’Donnell asked curiously, “What is it, Harry?”
“Well, the fact is, Dr. Coleman is interested in this hospital.” Tomaselli paused. “I gather he’s heard something of our recent changes and plans for the future.”
O’Donnell broke the sudden stillness. “How do you know?”
“I know because we’ve had some correspondence.”
Rufus said, “Isn’t that a little unusual, Harry?”
“Perhaps I was being premature, but after this came”—Tomaselli indicated the paper which had now passed to Lucy—“I wrote to Dr. Coleman. I said nothing definite, of course. It was just a tentative approach, sounding him out.” He turned to O’Donnell. “It was after our conversation a couple of weeks ago. You may remember, Kent.”
“Yes, I do.” O’Donnell was wishing that Harry had briefed him about this beforehand. Of course, as administrator Tomaselli had a right to correspond with anyone he chose. He hadn’t committed the hospital in any way. The correspondence was presumably confidential. Possibly it might prove to have been a good move. He said to Tomaselli, “You say he’s interested?”
“Yes. He’d like to come and see us. If this had not come up today, I’d intended to speak to you about it.”
Dornberger had the paper now. He tapped it with a forefinger. “What do you want me to do about this?”
O’Donnell glanced at the others, seeking confirmation. “I think you should take it with you, Charlie,” he said. “And I suggest you show it to Joe Pearson.”
Seven
In an annex to the autopsy room Roger McNeil, the pathology resident, was almost ready for gross conference. All that was necessary to begin was the presence of Dr. Joseph Pearson.
At Three Counties, as at many hospitals, a gross conference was the second stage after autopsy. Half an hour ago George Rinne, diener of the morgue, had brought in the organs removed at three autopsies earlier in the week. Two sets of organs now stood neatly arrayed in white enameled pails, and alongside them, in glass jars, were three brains. Centerpiece of the gross-conference room was a stone table with a large sink let into it and with a water tap above. At present the tap was turned on and beneath it was the third pail of organs, the water washing out the formalin in which the organs had been preserved, as well as some of the more objectionable odor.
McNeil looked around, making a final check. Pearson was always irascible if everything was not ready at hand. McNeil reflected that the room in which they did their work was appropriately macabre—particularly when the organs were laid out, as they would be in a few minutes, making the place look somewhat like a butcher’s shop. He had been in hospital dissecting rooms where everything was gleaming stainless steel; but that was the modern way which had not touched Three Counties’ pathology department yet. Now he heard the familiar, half-shuffling footsteps, and Pearson came in, the inevitable cloud of cigar smoke with him.
“Can’t waste any time.” Pearson seldom bothered with preliminaries. “It’s a week and a half since I had that set-to with O’Donnell, and we’re still behind.” The cigar bobbed up and down. “When this is through I want a check on all surgicals outstanding. What’s the first case?” While he had been talking he had put on a black rubber apron and rubber gloves. Now he came to the center table and sat down at it. McNeil perched himself on a stool opposite and looked over the case notes.
“Fifty-five-year-old woman. Physician’s cause of death, carcinoma of the breast.”
“Let me see.” Pearson reached for the file. Sometimes he would sit patiently while the resident described a case; at other times he would want to read everything himself. In this, as in all things, he was unpredictable.
“Hm.” He put down the papers and turned off the running water. Then he reached into the pail and groped around until he found the heart. He opened it, using both hands.
“Did you cut this?”
The resident shook his head.
“I didn’t think so.” Pearson peered at the heart again. “Seddons?”
McNeil nodded a little reluctantly. He had noticed himself that the heart was badly cut.
“He left the mark of Zorro.” Pearson grinned. “Looks like he was dueling with it. By the way, where is Seddons?”
“I believe there was something in surgery. A procedure he wanted to see.”
“Tell him from me that while any resident is assigned to Pathology I expect him at all gross conferences. All right, let’s get on with it.”
McNeil balanced a clip board on his knee and prepared to write. Pearson dictated: “Heart shows a slight thickening and rolling of the mitral valve. See it there?” He held it out.
Leaning across, McNeil answered, “Yes, I do.”
Pearson continued, “The chordae tendineae are fused, shortened and thickened.” He added casually, “Looks as if she had an old rheumatic fever. It was not a cause of death though.”
He cut away a small portion of tissue and put it into a labeled jar about the size of an ink bottle. This was for microscopic examination later. Then with the ease of long practice he tossed the remainder of the heart accurately into a hole lower down the table. Beneath the hole was a metal bin. Later in the day this would be cleared and cleaned, the contents being burned to fine ash in a special incinerator.
Now Pearson had the lungs. He opened the first lung like the two big leaves of a book, then dictated to McNeil, “Lungs show multiple metastatic nodules.” Again he held out the tissue for the resident to see.
He had turned his attention to the second lung when a door behind him opened.
“You busy, Dr. Pearson?”
Pearson turned around irritably. The voice was that of Carl Bannister, senior lab technician in the pathology department. Bannister had his head around the door tentatively, and there was another figure behind him in the corridor.
“Of course I’m busy. What do you want?” It was the tone, half snarling, half bantering, Pearson habitually used to Bannister. Over the years the two of them had become accustomed to it; anything more cordial would probably have confused both.
Bannister was unperturbed. He beckoned to the figure behind him. “Come inside.” Then to Pearson he said, “This is John Alexander. You remember—our new lab technician. You hired him a week ago. He starts work today.”
“Oh yes. I’d forgotten this was the day. Come in.” Pearson sounded more cordial than he had been with Bannister. McNeil thought: Maybe he doesn’t want to scare a new employee first day out.
McNeil looked curiously at the newcomer. Twenty-two, he figured; later he was to learn he was exactly right. He knew from what he had heard that Alexander was fresh from college with a degree in medical technology. Well, they could do with someone like that around the place. Bannister, for sure, wasn’t any Louis Pasteur.
McNeil turned his eyes to the senior technician. As usual, Bannister’s appearance made him something of a minor league Pearson. His short, paunchy body was partially covered by a stained lab coat. The coat was not buttoned and the clothes beneath it appeared shabby and unpressed. Bannister was mostly bald, and such hair as was left looked as if it were permanently ignored.
McNeil knew something of Bannister’s history. He had come to Three Counties a year or two after Pearson’s arrival. He had a high-school education, and Pearson had hired him for odd jobs—stock clerk, messenger, washing glassware. Gradually, as the years passed, Bannister had learned a lot of practical things around the lab, becoming more and more a right hand to Pearson.
Officially Bannister’s work was in serology and biochemistry. But he had been in the department so long that he could fill La if necessary, and often did, for technicians in other sections of the lab. Because of this Pearson had pushed a good deal of administrative lab work onto Bannister, leaving him, in effect, in charge of all pathology technicians.
McNeil thought it likely that in Bannister’s heyday he had been a good technician who, with more education, might have risen to better things. As it was now, McNeil considered Bannister long on experience and short on theory. From observation the resident knew that much of Bannister’s work in the lab was from rote rather than reasoning. He could do serologic and chemical tests but without any real understanding of the science behind them. McNeil had often thought that one day this might prove dangerous.
Alexander, of course, was a different proposition. He had come the way of most lab technicians nowadays, with three years of college behind him, the last year in an approved school for medical technologists. The word “technologist” was sometimes a sore point with people like Bannister who only rated the styling “technician.”
Pearson waved his cigar at the remaining stool around the table. “Sit down, John.”
“Thank you, Doctor,” Alexander answered politely. In his spotless lab coat, with a recent crew cut, pressed pants, and shined shoes, he presented a contrast to Pearson as well as Bannister.
“Do you think you’ll like it here?” Pearson looked down at the lungs he was holding, continuing the examination while he talked.
“I’m sure I will, Doctor.”
Nice kid, this, McNeil thought. He sounds as if he means it.
“Well, John,” Pearson was saying, “you’ll discover we have certain ways of doing things. They may not always be the ways you’ve been used to, but we find they work pretty well for us.”
“I understand, Doctor.”
Do you? McNeil thought Do you understand what the old man is really telling you?—that he doesn’t want any changes around the place, that there’s to be no nonsense with ideas you may have picked up in school, that nothing in the department—no matter how trifling—is to be amended without his blessing.
“Some people might say we’re old-fashioned,” Pearson continued. He was being friendly enough in his way. “But we believe in tried and tested methods. Eh, Carl?”
Called on for endorsement, Bannister was quick to answer. “That’s right, Doctor.”
Pearson had finished with the lungs now and, dipping into the pail, somewhat like drawing a lottery, had come up with a stomach. He grunted, then held out an open section to McNeil. “See that?”
The resident nodded. “I saw it before. We have it listed.”
“All right.” Pearson motioned to the clip board, then he dictated, “There is a peptic ulcer lying just below the pyloric ring in the duodenum.”
Alexander had shifted slightly to get a better look. Pearson saw his movement and slid the organ across. “Are you interested in dissection, John?”
Alexander answered respectfully, “I’ve always been interested in anatomy, Doctor.”
“As well as lab work, eh?” McNeil sensed that Pearson was pleased. Pathological anatomy was the old man’s first love.
“Yes, sir.”
“Well, these are the organs of a fifty-five-year-old woman.” Pearson turned over the case-history pages in front of him. Alexander was raptly attentive. “Interesting history, this case. The patient was a widow, and the immediate cause of death was cancer of the breast. For two years before she died her children knew she had trouble but they couldn’t persuade her to see a physician. It seems she had a prejudice against them.”
“Some people do.” It was Bannister. He gave a high-pitched giggle which dried up as he caught Pearson’s eye.
“Just cut out the snide remarks. I’m giving John here some information. Might not do you any harm either.” Anyone but Bannister would have been crushed by Pearson’s rejoinder. As it was, the technician merely grinned.
“What happened, Doctor?” Alexander asked.
“It says here: ‘Daughter states that for the past two years the family has been noticing drainage from the mother’s left breast area. Fourteen months before admission bleeding was noticed from the same area. Otherwise she appeared in normal health.’ ”
Pearson turned a page. “It seems this woman went to a faith healer.” He chuckled grimly. “Guess she didn’t have enough faith, though, because she finally collapsed and they brought her to this hospital.”
“By then, I suppose, it was too late.”
This isn’t politeness, McNeil thought. This guy Alexander is really interested.
“Yeah,” Pearson answered. “But if she had gone to a doctor at the beginning she could have had a radical mastectomy—that’s removal of the breast.”
“Yes, sir. I know.”
“If she’d had that she might still be alive.” Pearson tossed the stomach neatly through the hole.
Something was troubling Alexander. He asked, “Didn’t you just say, though, she had a peptic ulcer?”
Good for you, McNeil thought. Pearson, it seemed, had the same reaction, for he turned to Bannister. “There you are, Carl. Here’s a boy who keeps his ears open. You watch out or he’ll be showing you up.”
Bannister was grinning, but McNeil suspected a little sourness. What had been said might prove uncomfortably true. “Well, John”—Pearson was really expansive now—“she might have had trouble with that. Then again she might not.”
“You mean she’d never have known about it?”
McNeil thought it was time he said something himself. “It’s surprising,” he told Alexander, “what people have wrong with them besides the things they die of. Things they never know about. You see a lot of that here.”
“That’s right.” Pearson nodded agreement. “You know, John, the remarkable thing about the human body is not what kills us but what we can have wrong inside and still go on living.” He paused, then abruptly changed the subject. “Are you married?”
“Yes, sir. I am.”
“Your wife here with you?”
“Not yet. She’s coming next week. I thought I’d find us a place to live first.”
McNeil remembered that Alexander had been one of the out-of-town applicants for the job at Three Counties. He seemed to recall that Chicago had been mentioned.
Alexander hesitated, then he added, “There was something I wanted to ask you, Dr. Pearson.”
“What’s that?” The old man sounded wary.
“My wife is pregnant, Doctor, and coming into a new town, we don’t know anyone.” Alexander paused. “This baby is pretty important to us. You see, we lost our first child. A month after she was born.”
“I see.” Pearson had stopped work now and was listening carefully.
At Three Counties, as at many hospitals, a gross conference was the second stage after autopsy. Half an hour ago George Rinne, diener of the morgue, had brought in the organs removed at three autopsies earlier in the week. Two sets of organs now stood neatly arrayed in white enameled pails, and alongside them, in glass jars, were three brains. Centerpiece of the gross-conference room was a stone table with a large sink let into it and with a water tap above. At present the tap was turned on and beneath it was the third pail of organs, the water washing out the formalin in which the organs had been preserved, as well as some of the more objectionable odor.
McNeil looked around, making a final check. Pearson was always irascible if everything was not ready at hand. McNeil reflected that the room in which they did their work was appropriately macabre—particularly when the organs were laid out, as they would be in a few minutes, making the place look somewhat like a butcher’s shop. He had been in hospital dissecting rooms where everything was gleaming stainless steel; but that was the modern way which had not touched Three Counties’ pathology department yet. Now he heard the familiar, half-shuffling footsteps, and Pearson came in, the inevitable cloud of cigar smoke with him.
“Can’t waste any time.” Pearson seldom bothered with preliminaries. “It’s a week and a half since I had that set-to with O’Donnell, and we’re still behind.” The cigar bobbed up and down. “When this is through I want a check on all surgicals outstanding. What’s the first case?” While he had been talking he had put on a black rubber apron and rubber gloves. Now he came to the center table and sat down at it. McNeil perched himself on a stool opposite and looked over the case notes.
“Fifty-five-year-old woman. Physician’s cause of death, carcinoma of the breast.”
“Let me see.” Pearson reached for the file. Sometimes he would sit patiently while the resident described a case; at other times he would want to read everything himself. In this, as in all things, he was unpredictable.
“Hm.” He put down the papers and turned off the running water. Then he reached into the pail and groped around until he found the heart. He opened it, using both hands.
“Did you cut this?”
The resident shook his head.
“I didn’t think so.” Pearson peered at the heart again. “Seddons?”
McNeil nodded a little reluctantly. He had noticed himself that the heart was badly cut.
“He left the mark of Zorro.” Pearson grinned. “Looks like he was dueling with it. By the way, where is Seddons?”
“I believe there was something in surgery. A procedure he wanted to see.”
“Tell him from me that while any resident is assigned to Pathology I expect him at all gross conferences. All right, let’s get on with it.”
McNeil balanced a clip board on his knee and prepared to write. Pearson dictated: “Heart shows a slight thickening and rolling of the mitral valve. See it there?” He held it out.
Leaning across, McNeil answered, “Yes, I do.”
Pearson continued, “The chordae tendineae are fused, shortened and thickened.” He added casually, “Looks as if she had an old rheumatic fever. It was not a cause of death though.”
He cut away a small portion of tissue and put it into a labeled jar about the size of an ink bottle. This was for microscopic examination later. Then with the ease of long practice he tossed the remainder of the heart accurately into a hole lower down the table. Beneath the hole was a metal bin. Later in the day this would be cleared and cleaned, the contents being burned to fine ash in a special incinerator.
Now Pearson had the lungs. He opened the first lung like the two big leaves of a book, then dictated to McNeil, “Lungs show multiple metastatic nodules.” Again he held out the tissue for the resident to see.
He had turned his attention to the second lung when a door behind him opened.
“You busy, Dr. Pearson?”
Pearson turned around irritably. The voice was that of Carl Bannister, senior lab technician in the pathology department. Bannister had his head around the door tentatively, and there was another figure behind him in the corridor.
“Of course I’m busy. What do you want?” It was the tone, half snarling, half bantering, Pearson habitually used to Bannister. Over the years the two of them had become accustomed to it; anything more cordial would probably have confused both.
Bannister was unperturbed. He beckoned to the figure behind him. “Come inside.” Then to Pearson he said, “This is John Alexander. You remember—our new lab technician. You hired him a week ago. He starts work today.”
“Oh yes. I’d forgotten this was the day. Come in.” Pearson sounded more cordial than he had been with Bannister. McNeil thought: Maybe he doesn’t want to scare a new employee first day out.
McNeil looked curiously at the newcomer. Twenty-two, he figured; later he was to learn he was exactly right. He knew from what he had heard that Alexander was fresh from college with a degree in medical technology. Well, they could do with someone like that around the place. Bannister, for sure, wasn’t any Louis Pasteur.
McNeil turned his eyes to the senior technician. As usual, Bannister’s appearance made him something of a minor league Pearson. His short, paunchy body was partially covered by a stained lab coat. The coat was not buttoned and the clothes beneath it appeared shabby and unpressed. Bannister was mostly bald, and such hair as was left looked as if it were permanently ignored.
McNeil knew something of Bannister’s history. He had come to Three Counties a year or two after Pearson’s arrival. He had a high-school education, and Pearson had hired him for odd jobs—stock clerk, messenger, washing glassware. Gradually, as the years passed, Bannister had learned a lot of practical things around the lab, becoming more and more a right hand to Pearson.
Officially Bannister’s work was in serology and biochemistry. But he had been in the department so long that he could fill La if necessary, and often did, for technicians in other sections of the lab. Because of this Pearson had pushed a good deal of administrative lab work onto Bannister, leaving him, in effect, in charge of all pathology technicians.
McNeil thought it likely that in Bannister’s heyday he had been a good technician who, with more education, might have risen to better things. As it was now, McNeil considered Bannister long on experience and short on theory. From observation the resident knew that much of Bannister’s work in the lab was from rote rather than reasoning. He could do serologic and chemical tests but without any real understanding of the science behind them. McNeil had often thought that one day this might prove dangerous.
Alexander, of course, was a different proposition. He had come the way of most lab technicians nowadays, with three years of college behind him, the last year in an approved school for medical technologists. The word “technologist” was sometimes a sore point with people like Bannister who only rated the styling “technician.”
Pearson waved his cigar at the remaining stool around the table. “Sit down, John.”
“Thank you, Doctor,” Alexander answered politely. In his spotless lab coat, with a recent crew cut, pressed pants, and shined shoes, he presented a contrast to Pearson as well as Bannister.
“Do you think you’ll like it here?” Pearson looked down at the lungs he was holding, continuing the examination while he talked.
“I’m sure I will, Doctor.”
Nice kid, this, McNeil thought. He sounds as if he means it.
“Well, John,” Pearson was saying, “you’ll discover we have certain ways of doing things. They may not always be the ways you’ve been used to, but we find they work pretty well for us.”
“I understand, Doctor.”
Do you? McNeil thought Do you understand what the old man is really telling you?—that he doesn’t want any changes around the place, that there’s to be no nonsense with ideas you may have picked up in school, that nothing in the department—no matter how trifling—is to be amended without his blessing.
“Some people might say we’re old-fashioned,” Pearson continued. He was being friendly enough in his way. “But we believe in tried and tested methods. Eh, Carl?”
Called on for endorsement, Bannister was quick to answer. “That’s right, Doctor.”
Pearson had finished with the lungs now and, dipping into the pail, somewhat like drawing a lottery, had come up with a stomach. He grunted, then held out an open section to McNeil. “See that?”
The resident nodded. “I saw it before. We have it listed.”
“All right.” Pearson motioned to the clip board, then he dictated, “There is a peptic ulcer lying just below the pyloric ring in the duodenum.”
Alexander had shifted slightly to get a better look. Pearson saw his movement and slid the organ across. “Are you interested in dissection, John?”
Alexander answered respectfully, “I’ve always been interested in anatomy, Doctor.”
“As well as lab work, eh?” McNeil sensed that Pearson was pleased. Pathological anatomy was the old man’s first love.
“Yes, sir.”
“Well, these are the organs of a fifty-five-year-old woman.” Pearson turned over the case-history pages in front of him. Alexander was raptly attentive. “Interesting history, this case. The patient was a widow, and the immediate cause of death was cancer of the breast. For two years before she died her children knew she had trouble but they couldn’t persuade her to see a physician. It seems she had a prejudice against them.”
“Some people do.” It was Bannister. He gave a high-pitched giggle which dried up as he caught Pearson’s eye.
“Just cut out the snide remarks. I’m giving John here some information. Might not do you any harm either.” Anyone but Bannister would have been crushed by Pearson’s rejoinder. As it was, the technician merely grinned.
“What happened, Doctor?” Alexander asked.
“It says here: ‘Daughter states that for the past two years the family has been noticing drainage from the mother’s left breast area. Fourteen months before admission bleeding was noticed from the same area. Otherwise she appeared in normal health.’ ”
Pearson turned a page. “It seems this woman went to a faith healer.” He chuckled grimly. “Guess she didn’t have enough faith, though, because she finally collapsed and they brought her to this hospital.”
“By then, I suppose, it was too late.”
This isn’t politeness, McNeil thought. This guy Alexander is really interested.
“Yeah,” Pearson answered. “But if she had gone to a doctor at the beginning she could have had a radical mastectomy—that’s removal of the breast.”
“Yes, sir. I know.”
“If she’d had that she might still be alive.” Pearson tossed the stomach neatly through the hole.
Something was troubling Alexander. He asked, “Didn’t you just say, though, she had a peptic ulcer?”
Good for you, McNeil thought. Pearson, it seemed, had the same reaction, for he turned to Bannister. “There you are, Carl. Here’s a boy who keeps his ears open. You watch out or he’ll be showing you up.”
Bannister was grinning, but McNeil suspected a little sourness. What had been said might prove uncomfortably true. “Well, John”—Pearson was really expansive now—“she might have had trouble with that. Then again she might not.”
“You mean she’d never have known about it?”
McNeil thought it was time he said something himself. “It’s surprising,” he told Alexander, “what people have wrong with them besides the things they die of. Things they never know about. You see a lot of that here.”
“That’s right.” Pearson nodded agreement. “You know, John, the remarkable thing about the human body is not what kills us but what we can have wrong inside and still go on living.” He paused, then abruptly changed the subject. “Are you married?”
“Yes, sir. I am.”
“Your wife here with you?”
“Not yet. She’s coming next week. I thought I’d find us a place to live first.”
McNeil remembered that Alexander had been one of the out-of-town applicants for the job at Three Counties. He seemed to recall that Chicago had been mentioned.
Alexander hesitated, then he added, “There was something I wanted to ask you, Dr. Pearson.”
“What’s that?” The old man sounded wary.
“My wife is pregnant, Doctor, and coming into a new town, we don’t know anyone.” Alexander paused. “This baby is pretty important to us. You see, we lost our first child. A month after she was born.”
“I see.” Pearson had stopped work now and was listening carefully.