The Final Diagnosis (45 page)

Now, on the fourth day, all the stool samples were finally in. They had been obtained from everyone on the hospital staff involved in any way with the receiving, preparation, or distribution of food, and the task of processing them would continue until well into tomorrow. At the moment the 280 subcultures which John Alexander had referred to were distributed in racks around the lab and in incubators. But although on many of these the final checks were complete, none so far had revealed the individual—the suspected typhoid carrier—whom, anxiously and diligently, they had been seeking day and night.

The telephone bell rang and Pearson, nearest to the lab wall phone, answered it. “Yes?” He listened, then said, “No; nothing yet. I keep telling you—I’ll call as soon as we find anything.” He replaced the instrument.

John Alexander, succumbing to a sudden tiredness, completed an entry on a data sheet, then dropped into a straight-back lab chair. Momentarily he closed his eyes with relief at his own sudden inactivity.

From alongside David Coleman said, “Why don’t you take an hour or two off, John—maybe go upstairs and stay with your wife for a while?”

Alexander got to his feet again. He knew that if he remained seated too long he could easily fall asleep. “I’ll do one more series,” he said, “then I think I will.”

Taking a rack of subcultures from the incubator, he collected a fresh data sheet and began to line up the ten sugar tubes he was about to check. Glancing at the lab wall clock, he noted with surprise that another day was running out. The time was ten minutes to five.

Kent O’Donnell replaced the telephone. Answering Harry Tomaselli’s unspoken question, he said, “Joe Pearson says there’s nothing new.”

In the administrator’s birch-paneled office there was a silence, both men bleakly aware of the implications of this latest lack of news. Both knew, too, that around them, outside the administration suite, the work of the hospital was grinding to a halt.

Since early afternoon the plan for contraction of patient service, devised by Harry Tomaselli several days earlier and now made necessary by the impending shutdown of the hospital kitchens, had been going steadily into effect. Commencing with breakfast tomorrow, one hundred meals for patients on regular diet would be prepared by two local restaurants, combining forces for the occasion, and would be delivered to the hospital for seriously ill patients who could not be moved. Of the remaining patients, as many as possible were being discharged to their homes, while others, for whom hospital care was still essential, were being transferred to other institutions in and around Burlington, now mobilizing their own facilities to meet the emergency influx from Three Counties.

An hour ago, knowing that the process of transfer would have to continue far into the night, Harry Tomaselli had given the order for evacuation to begin. Now a line of ambulances, summoned by telephone from all available points, had begun to assemble outside the emergency entrance. Meanwhile, in the wards and private pavilion, nurses and doctors were working briskly, moving patients from beds to stretchers and wheel chairs in readiness for their unexpected journey. For those with time for thinking it was a sad and somber moment. For the first time in its forty-year history Three Counties Hospital was turning the sick and the injured away from its doors.

There was a light tap, and Orden Brown entered the administrator’s office. He listened attentively while Harry Tomaselli reported what had been done since their meeting four hours earlier. At the end the board chairman asked, “The city health authorities—have they been here again?”

“Not yet,” Tomaselli answered. “We’re expecting them now.”

Orden Brown said quietly, “Then if you don’t mind, I’ll wait with you.”

After a pause the board chairman turned to O’Donnell. “Kent, this isn’t important now, but I’ll tell you while I think of it. I’ve had a call from Eustace Swayne. When all this is over he would like you to go and see him.”

For an instant the effrontery of the request left O’Donnell speechless. It was obvious why Eustace Swayne wanted to talk with him; there could be only one reason—despite everything the old man intended to use his money and influence in an attempt to intercede for his friend, Dr. Joseph Pearson. After all that had happened over the past few days it seemed unbelievable that such blindness and presumption could exist. A boiling fury seethed within O’Donnell. He said explosively, “To hell with Eustace Swayne and all his works!”

“May I remind you,” Orden Brown said icily, “that you happen to be speaking of a member of the hospital board. Whatever your disagreements, he at least is entitled to be treated with courtesy.”

O’Donnell faced Orden Brown, his eyes blazing. Very well, he thought, if this is the showdown, then let’s have it. I’ve finished with hospital politics—for good and as of now.

At the same moment a buzzer sounded on the administrator’s desk. “Mr. Tomaselli,” a girl’s voice said on the intercom, “the public-health officers have just arrived.”

It was three minutes to five.

As they had on a morning six weeks earlier—the day on which, as he realized now, Kent O’Donnell had received his first warning of impending disruption in the hospital—the chimes of the Church of the Redeemer announced the hour as the small group threaded its way through the corridors of Three Counties. Led by O’Donnell, it included Orden Brown, Harry Tomaselli, and Dr. Norbert Ford, city health officer of Burlington. Behind them were Mrs. Straughan, the chief dietitian, who had arrived at the administration suite as they were leaving, and a young assistant health officer whose name O’Donnell had missed in the flurry of introductions.

Now that his initial anger was over, the chief of surgery was relieved that the interruption of a few minutes ago had prevented what could have become a major quarrel between himself and Orden Brown. He realized that all of them, himself included, had become unnaturally tense over the past few days, and the board chairman had, after all, done no more than relay a message. O’Donnell’s real quarrel was with Eustace Swayne, and he had already resolved to meet the old tycoon face to face as soon as this present business was over. Then, whatever overtures Swayne chose to make, O’Donnell planned to respond with plain, blunt words, no matter what the consequences might be.

It had been Kent O’Donnell’s suggestion that the group should visit the pathology department. He had told the city health officer, “At least you’ll see we’re doing everything possible to trace the source of infection.”

Dr. Ford had at first demurred. “There’s been no suggestion that you’re not, and I doubt if I could add anything to what your pathologists are doing,” he had said. But at O’Donnell’s insistence he had agreed to go, and now they were en route to the basement pathology lab.

John Alexander glanced up as the group entered, then continued with the sugar test he was carrying out. Pearson, on seeing O’Donnell and Orden Brown, moved forward to meet them, wiping both hands on his already soiled lab coat. At a signal from Harry Tomaselli, David Coleman followed him.

O’Donnell handled the introductions. As Pearson and Dr. Norbert Ford shook hands the health officer asked, “Have you come up with anything?”

“Not yet.” Pearson gestured around the lab. “As you can see, we’re still working.”

O’Donnell said, “Joe, I thought you should know. Dr. Ford has ordered the closing of our kitchens.”

“Today?” There was disbelief in Pearson’s voice.

The health officer nodded gravely. “I’m afraid so.”

“But you can’t do that! It’s ridiculous!” This was the old aggressive Pearson, his voice belligerent, eyes flashing behind the mask of tiredness. He stormed on, “Why, man alive, we’ll be working all night, and every subculture will be finished by midday tomorrow. If there’s a carrier, all the chances are we’ll have learned who it is.”

“I’m sorry.” The health officer shook his head. “We can’t take that chance.”

“But closing the kitchens means closing the hospital.” Pearson fumed. “Surely you can wait until morning—at least until then.”

“I’m afraid not.” Dr. Ford was polite but firm. “In any case, the decision is not entirely mine. The city simply cannot afford the possibility of a wider epidemic. At the moment your outbreak is within these walls, but at any point it could spread outside. It’s that we’re thinking of.”

Harry Tomaselli put in, “We’re serving the evening meal, Joe, and that will be the last. We’re sending home all the patients we can and transferring most of the others.”

There was silence. Pearson’s face muscles were working. His deep-set, red-rimmed eyes seemed close to tears. His voice near a whisper, he said, “I never thought I’d see the day . . .”

As the group turned away O’Donnell added quietly, “To tell the truth, Joe, neither did I.”

They had reached the door when John Alexander announced, “I have it.”

As a unit the group turned. Pearson asked sharply, “You have what?”

“A definite typhoid.” Alexander pointed to the row of sugar tubes on which he had been working.

“Let me see!” Almost at a run, Pearson crossed the lab. The others had turned back into the room.

Pearson looked at the row of tubes. Nervously his tongue touched his lips. If Alexander were right, this was the moment they had worked for. “Call off the list,” he said.

John Alexander picked up a textbook open at a double page. It was a tabulated chart of biochemical reactions of bacteria in sugar tubes. Putting a finger on the column headed “Salmonella typhi,” he prepared to read down.

Pearson picked up the first of the ten tubes. He called out, “Glucose.”

Checking the list, Alexander answered, “Acid formation, but no gas.”

Pearson nodded. He replaced the tube and selected a second. “Lactose.”

“No acid, no gas,” Alexander read.

“Right.” A pause. “Dulcitol.”

Again Alexander read, “No acid, no gas.”

“Sucrose.”

“No acid, no gas.” Once more the correct reaction for typhoid bacilli. The tension in the room was mounting.

Pearson took another tube. “Mannitol.”

“Acid formation, but no gas.”

“Correct.” Another. “Maltose.”

“Acid, but no gas.”

Pearson nodded. Six down, four to go. Now he said, “Xylose.”

Once more Alexander read, “Acid, but no gas.”

Seven.

“Arabinose.”

John Alexander said, “Either acid but no gas or no reaction at all.”

Pearson announced, “No reaction.”

Eight. Two more.

“Rhamnose?”

“No reaction.”

Pearson looked at the tube. He said softly, “No reaction.”

One to go.

From the last tube Pearson read, “Indole production.”

“Negative,” Alexander said, and replaced the book.

Pearson turned to the others. He said, “There’s no question. This is the typhoid carrier.”

“Who is it?” The administrator was first to ask.

Pearson turned over a petri dish. He read off, Number seventy-two.”

David Coleman had already reached for a ledger. There was a list with entries in his own handwriting. He announced, “Charlotte Burgess.”

“I know her!” Mrs. Straughan said quickly. “She works on the serving counter.”

As if by instinct, all eyes swung to the clock. It was seven minutes after five.

Mrs. Straughan said urgently, “The dinner! They’re beginning to serve the evening meal!”

“Let’s get to the dining room fast!” As he spoke, Harry Tomaselli was already at the door.

On the hospital’s second floor the nursing supervisor entered Vivian’s room with a harassed air, glancing at the door number as she came in.

“Oh yes, you’re Miss Loburton.” She consulted a clip board and made a penciled notation. “You’ll be transferred to the West Burlington Clinic.”

Vivian asked, “When will it be, please?” She had already learned, earlier in the afternoon, of the impending move and the reason for it.

“The ambulances are very busy now,” the supervisor said. “I expect it will be several hours—probably about nine o’clock tonight. Your own nurse will be in to help you with your things in plenty of time.”

“Thank you,” Vivian said.

Her mind back with the clip board, the supervisor nodded and went out.

This was the time, Vivian decided, to call Mike. Their five days of separation were not due to end until tomorrow, but neither of them had contemplated anything like this. Besides, she had already come to regret the whole idea of having a period of time apart; she saw it now as a stupid and unnecessary notion which she wished had never occurred to her.

Her hand went out for the bedside telephone, and this time there was no hesitation. When the operator answered Vivian said, “Dr. Michael Seddons, please.”

“One moment.”

There was a wait of several minutes, then the operator came on the line. “Dr. Seddons is away from the hospital with one of the transfer ambulances. Can someone else help?”

“No, thank you,” Vivian said. “I’d like to leave a message though.”

The operator asked, “Is this a medical matter?”

She hesitated. “Well, not really.”

“We can only take urgent medical messages now. Will you make your call later, please.” There was a click as the line went dead. Slowly Vivian replaced the telephone.

Outside in the hallway she could hear commotion and raised voices. She sensed an undercurrent of excitement; there was a sharp order given, then a clatter as an object fell to the floor, and someone laughed. It all sounded commonplace, and yet at this moment her mind clamored to share in it, to be a part of whatever was going on. Then her eyes fell to the bedclothes, to where the coverlet went flat at the point where her left leg ended. Suddenly, for the first time, Vivian felt fearfully and desperately alone.

“Oh, Mike!” she whispered. “Mike darling—wherever you are, please come to me soon!”

Nurse Penfield was about to enter the cafeteria when she saw the group bearing down toward her. She recognized the administrator and the chief of surgery. Behind them, her big breasts bouncing with the effort of keeping up, was Mrs. Straughan, the chief dietitian.