The Final Diagnosis (31 page)

“Right, Charlie.” Pearson slammed the receiver down and reached for a pile of forms in a tray marked “Signature.” As he did, the two telegraph envelopes caught his eye. Quickly he passed them to Coleman. “Take these. See what they say.”

Pearson riffled through the forms. The first time, in his haste, he missed the one he wanted; the second time through he found it. He lifted the telephone again, listened, then said brusquely, “Send Bannister in.” Replacing the phone, he scribbled a signature on the form he had removed.

“You want me?” Bannister’s tone and expression made it plain that he was still smarting from the reprimand earlier.

“Of course I want you!” Pearson held out the form he had signed. “Get this up to Dr. Dornberger—fast. He’s in Obstetrics. John Alexander’s wife is in trouble. She’s going to have a premie.”

Bannister’s expression changed. “Does the kid know? He’s down in——”

Impatiently Pearson cut him off. “Get going, will you! Get going!” Hastily Bannister went out with the form.

Dimly David Coleman had been aware of what was going on around him. His mind, however, had not yet grasped the details. For the moment he was too concerned with the awesome significance of the two telegrams which he held, opened, in his hand.

Now Pearson turned to him. The old man said, “Well, does the girl lose her leg or not? Are they both definite?”

Coleman thought: This is where pathology begins and ends; these are the borderlands where we must face the truth of how little we really know; this is the limit of learning, the rim of the dark, swirling waters of the still unknown. He said quietly, “Yes, they’re both definite. Dr. Chollingham in Boston says, ‘Specimen definitely malignant.’ Dr. Earnhart in New York says, ‘The tissue is benign. No sign of malignancy.’ ”

There was a silence. Then Pearson said slowly, softly, “The two best men in the country, and one votes ‘for,’ the other ‘against.’ ” He looked at Coleman, and when he spoke there was irony but no antagonism. “Well, my young pathologist friend, Lucy Grainger expects an answer today. She will have to be given one, and it will have to be definite.” With a twisted smile, “Do you feel like playing God?”

Sixteen

A police patrolman on duty at Main and Liberty heard the ambulance’s siren six blocks away. Moving out from the sidewalk, and with the skill of long practice, he began to expedite the traffic flow so as to leave the intersection clear. As the siren grew louder and the flashing warning light became visible, threading its way toward him, the patrolman inflated his cheeks and blew two sharp whistle blasts. Then, signaling a halt to all traffic in the side roads, he authoritatively waved the ambulance driver through a red light. Pedestrians at the intersection, turning their heads curiously, caught a blurred glimpse of a young woman’s white face as the ambulance swept by.

Inside, Elizabeth was only dimly conscious of their progress through the busy city streets. She sensed they were moving fast, but the buildings and people outside were a confused pattern racing past the window near her head. Momentarily, between each onset of pain, she could see the driver up ahead, his two big hands nursing the wheel, turning quickly, first right, then left, taking advantage of every opening as it occurred. Then the pain came back and all she could think of was to cry out and to hold on.

“Hold my wrists! And hang on all you want.” It was the ambulance attendant, leaning over her. He had a stubble of beard and a cleft chin, and for a moment Elizabeth believed it was her father come here now to comfort her. But her father was dead; hadn’t he been killed at the railroad? Or perhaps he had not and he was in this ambulance along with her, being taken to some place they could be cared for together. Then her head cleared and she saw it was not her father but a stranger whose wrists were red with the gouge marks her nails had made.

She had time to touch the marks before the next pain came. It was a gesture, all she could do. The man shook his head. “Don’t worry. Just you hold on all you want. We’ll be there soon. Old Joe up front is the best wagon driver in the city.” Then the pain again, worse than before, the intervals between growing shorter, the sensation as if all her bones were being twisted beyond endurance with the agony centered in her back, the torture of it overflowing into a flame of red, yellow, purple in front of her eyes. Her nails dug deeper and she screamed.

“Can you feel the baby coming?” It was the attendant again; he had waited until the last pain subsided, then leaned close.

She managed to nod her head and gasp. “I . . . I think so.”

“All right.” He eased his hands gently away. “Hang on to this for a minute.” He gave her a towel he had rolled tight, then turned back the blanket over the stretcher and began to loosen her clothing. He talked softly while he worked. “We’ll do the best we can if we have to. It wouldn’t be the first one I’ve delivered in here. I’m a grandfather, you see, so I know what it’s all about.” His last words were drowned out by her cry; once more, at her back, flooding around her, blinding, overpowering, the crescendo of agony, crushing, unrelenting. “Please!” She grasped for his wrists again, and he gave them, faint lines of blood appearing as her nails ripped flesh. Turning his head, he called forward, “How are we doing, Joe?”

“Just went through Main and Liberty.” The big hands turned the wheel sharply right. “There was a cop there; he had it sorted. Saved us a good minute.” A swing to the left, then the head leaned back. “You a godfather yet?”

“Not quite, Joe. It’s getting pretty close though, I reckon.”

Again the wheel spinning; a sharp turn to the right. Afterward: “We’re on the home stretch, boy. Try to keep the cork in a minute more.”

All Elizabeth could think, through the miasma that engulfed her, was: My baby—he’ll be born too soon! He’ll die! Oh God, don’t let him die! Not this time! Not again!

In Obstetrics, Dr. Dornberger was scrubbed and gowned. Emerging from the scrub room into the busy interior hallway which separated the labor rooms from the delivery areas, he looked around him. Seeing him through the glass partitions of her office, Mrs. Yeo, the head nurse, got up and came toward him, holding a clip board.

“Here’s the blood-sensitivity report on your patient, Dr. Dornberger. It just came in from Pathology.” She held out the board so he could read without touching it.

“About time!” Unusual for him, it was almost a growl. Scanning the form on top of the clip board, he said, “Sensitivity negative, eh? Well, there’s no problem there. Is everything else ready?”

“Yes, Doctor.” Mrs. Yeo smiled. She was a tolerant woman who felt that every man, including her own husband, was entitled to be grouchy now and then.

“How about an incubator?”

“It’s here now.”

As Dornberger glanced around, a nurse held the outer doorway wide while a woman orderly wheeled in an Isolette incubator. Holding the trailing cord clear of the floor, the orderly glanced inquiringly at Mrs. Yeo.

“In number two, please.”

The orderly nodded and wheeled the incubator through a second swing door immediately ahead. As it closed behind her a girl clerk came toward them from the nursing office.

“Excuse me, Mrs. Yeo.”

“Yes?”

“Emergency just phoned.” The girl turned to Dornberger. “Your patient just arrived, Doctor, and she’s on the way up. They say she’s well advanced in labor.”

Ahead of the hospital stretcher, to which she had been transferred from the ambulance, Elizabeth could see the young intern who had received her on arrival. Moving forward at a steady but unhurried pace, he was clearing a way, calmly and methodically, through the groups of people in the busy main-floor corridor. “Emergency . . . emergency, please.” The words were quiet, almost casual, but their effect was immediate. Passers-by halted, groups moved back against the wall, to allow the small procession—intern, stretcher, and nurse propelling it—to go by. At the corridor’s end an elevator operator had seen them and was clearing the car.

“Next car, please. This car for an emergency.” Obediently the occupants moved out and the stretcher rolled in. The smooth, established drill of hospital procedure was functioning effortlessly to admit another supplicant.

Something of the calm seemed to transfer itself to Elizabeth. Though the pain was continuous now, and a new pressure in her uterus was building up, she found herself able to endure both better than before. She discovered that by biting her lower lip, and by gripping the edge of the sheet which covered her, it was possible not to cry out. She knew, though, that the final stage of birth had begun; involuntarily she began to bear down and, between her thighs, felt the first beginning of emergence.

Now they were in the elevator with the doors gliding closed and the nurse behind reaching down and holding her hand. “Just a minute or two more; that’s all it will be.” Then the doors were opened again and she saw Dr. Dornberger, gowned and waiting for her.

As if there were a hope that he had misread them earlier, Dr. Pearson picked up the two telegrams again. Looking at them, he put them down one at a time. “Malignant! Benign! And no doubt in either one. We’re back where we started.”

“Not quite,” David Coleman said quietly. “We’ve lost almost three days.”

“I know! I know!” Joe Pearson was beating a bulky fist into his palm, uncertainty around him like a mantle. “If it
is
malignant, the leg has to be amputated quickly; otherwise we’ll be too late.” He turned to face Coleman directly. “But the girl’s nineteen. If she were fifty I’d say malignant and never turn a hair. But nineteen!—and maybe have your leg off when you didn’t need to.”

Despite his feelings about Pearson, despite his own conviction that the tissue they were speaking of was benign and not malignant, Coleman felt his sympathy for Pearson grow. The old man did have the final responsibility in the case; it was understandable that he should be troubled; the decision was extremely tough. He said tentatively, “It takes a lot of courage to make this kind of diagnosis.”

As if he had touched a match to open flame, Pearson flared up. “Don’t give me any of your high-school cliches! I’ve been doing this for thirty years!” He glared at Coleman, eyes blazing, the earlier antagonism returning. At that moment the telephone rang.

“Yes?” Though Pearson had answered the phone brusquely, as he listened his expression softened. Then he said, “All right, Lucy. I think you’d better come down. I’ll wait for you here.” Replacing the phone, he stood looking down at a point in the center of his desk. Then, without raising his head, he said to Coleman, “Lucy Grainger’s on her way. You can stay if you want.”

Almost as if he had not heard, Coleman said thoughtfully, “You know, there’s one other thing might work, might give us a better pointer.”

“What?” Pearson raised his head abruptly.

“That X-ray that was done.” Coleman was still going slowly, the words keeping pace with his thoughts. “It was taken two weeks ago. If there
is
a tumor, and it’s developing, another X-ray might show it.”

Without a word Pearson reached down and once more picked up the telephone. There was a click and then he said, “Get me Dr. Bell in Radiology.” Waiting, the old man eyed Coleman strangely. Then, covering the mouthpiece, he said with grudging admiration, “I’ll say this for you: you’re thinking—all the time.”

In the room which the hospital staff jestingly referred to as “the expectant father’s sweatbox” John Alexander butted a half-smoked cigarette into an ash stand. Then he got up from the padded leather chair where he had sat for the last hour and a half, looking up each time the door opened and someone had come in from the corridor outside. On each occasion, though, the news had been for someone else, and now, of the five men who had occupied the room ninety minutes ago, only he and one other remained.

Crossing to the big windows which looked down on the hospital forecourt and across other buildings to the industrial heart of Burlington, he saw that the streets and roofs were wet. It must have rained since he had come here without his noticing it. Now the area surrounding the hospital looked its worst—squalid and depressing, the roofs of mean houses and tenements stretching away toward the factories and grimy smokestacks lining both banks of the river. Glancing down at the street on which the hospital fronted, he saw a group of children run from an alley, nimbly dodging the pools of water left by the rain or broken sidewalks. Watching them, he saw one of the bigger boys in the group halt and put out a foot to trip a child behind. It was a small girl, probably four or five, and she fell face forward into one of the larger puddles, dirty water splashing up around her. She arose crying, wiping streaks of mud from her face and attempting pathetically to wring the water from her soiled, soaked dress. By now the others had stopped and they formed a ring around her, dancing and, from their expressions, chanting derision.

“Kids!” The disgusted voice came from alongside, and John was aware for the first time that the other occupant of the room had joined him at the window. Glancing sideways, he saw that the man was tall and pencil thin; hollow cheeks made him appear gaunt, and he was in need of a shave. Probably twenty years older than John, he wore a stained corduroy jacket with soiled coveralls beneath. With him across the room he brought an odor of grease and stale beer.

“Kids! They’re all alike!” The man turned away from the window and began fumbling in his pockets. After a moment he produced paper and tobacco and began to roll a cigarette. Looking sharply at John, he asked, “This your first?”

“Not really. It’s our second, but the first baby died.”

“We lost one like that—in between the fourth and the fifth. A good thing too.” The other man was searching his pockets. He asked, “You got a light?”

John produced a lighter and held it out. He asked, “You mean this is your sixth?”

“No—eighth.” The thin man had his cigarette going now. “Sometimes I reckon that’s eight too many.” Then he said sharply, “I suppose you wanted yours.”