The Final Diagnosis (47 page)

Mike Seddons sweated. He had plumbed the depths and found his own reflection.

Vivian said, “You needn’t explain, Mike.” This time her voice was choked.

“But I want to! I’ve got to! There are so many things we both have to think of.” Now the words came quickly, tumbling out in an eager effort to make Vivian understand, to know the agony of mind he had suffered before coming here. Even at this moment he needed her understanding.

He started to say, “Look, Vivian. I’ve thought about it and you’ll be better off . . .”

He found her eyes regarding him. He had never noticed before how steady and direct they were. “Please don’t lie, Mike,” she said. “I think you’d better go.”

He knew it was no good. All that he wanted now was to get away from here, not to have to meet Vivian’s eyes. But still he hesitated. He asked, “What will you do?”

“I really don’t know. To tell you the truth, I haven’t thought much about it.” Vivian’s voice was steady, but it betrayed the effort she was making. “Perhaps I’ll go on in nursing, if they’ll have me. Of course, I really don’t know if I’m cured, and if I’m not, how long I’ve got. That’s so, isn’t it, Mike?”

He had the grace to lower his eyes.

At the doorway he looked back for the last time. “Good-by, Vivian,” he said.

She tried to answer, but her self-control had been taxed too long.

From the second floor Mike Seddons used the stairway to reach Pathology. He entered the autopsy room and in the annex found David Coleman dissecting a leg. Seddons looked at the limb and saw it white and lifeless, the dark blood seeping out from Coleman’s knife cuts. For an instant of horror he pictured it nylon-sheathed, a high-heeled sandal upon the foot. Then, with an awful fascination, he crossed the room and read the name in the open case file.

When he had done so, Mike Seddons went into the corridor and vomited against the wall.

“Oh, Dr. Coleman! Do come in.”

Kent O’Donnell got up courteously from his office desk as the young pathologist entered the room. David Coleman had been cleaning up after the dissection when the message from the chief of surgery had reached him.

“Sit down, won’t you?” O’Donnell held out an engraved gold case. “Cigarette?”

“Thank you.” Coleman took a cigarette and accepted the light O’Donnell offered. He leaned back, relaxed, in one of the leather armchairs. An instinct told him that what was to follow would be a turning point in his life.

O’Donnell moved behind the desk to the office window. He stood with his back to it, the morning sun behind him. “I imagine you’ve heard,” he said, “that Dr. Pearson has resigned.”

“Yes, I’d heard.” Coleman answered quietly, then to his own surprise he heard himself saying, “You know, of course, these past few days he hasn’t spared himself. He’s been here day and night.”

“Yes, I know.” O’Donnell regarded the glowing tip of his cigarette. “But it doesn’t change anything. You realize that?”

Coleman knew that the chief of surgery was right. “No,” he said, “I don’t suppose it does.”

“Joe has expressed a wish to leave at once,” O’Donnell continued. “It means there will be an immediate vacancy here for a director of pathology. Shall you accept?”

For a second David Coleman hesitated. This was the thing he had coveted—a department of his own; freedom to reorganize, to mobilize the new aids of science, to practice good medicine, and to make pathology count as he knew it truly could. This was the cup he had sought. Kent O’Donnell had lifted it to his lips.

Then fear struck him. Suddenly he was appalled at the awesome responsibility he would have to hold. It occurred to him there would be no one senior to relieve him of decisions; the ultimate choice—the final diagnosis—would be his alone. Could he face it? Was he yet ready? He was still young; if he chose, he could continue as a second-in-command for several years more. After that there would be other openings—plenty of time to move ahead. Then he knew that there was no escaping, that this moment had been moving toward him since his own first arrival at Three Counties Hospital.

“Yes,” he said. “If it’s offered to me, I shall accept.”

“I can tell you that it will be offered.” O’Donnell smiled. He asked, “Would you tell me something?”

“If I can.”

The chief of surgery paused. In his mind he was choosing the right phrases for the question he wanted to put. He sensed that what was to be said next would be important to them both. Finally he asked, “Will you tell me what your attitude is—to medicine and to this hospital?”

“It’s hard to put into words,” Coleman said.

“Will you try?”

David Coleman considered. It was true there were things he believed, but even to himself he had seldom expressed them. Now, perhaps, was a time for definition.

“I suppose the real thing,” he said slowly, “is that all of us—physicians, the hospital, medical technology—exist only for one thing: for patients, for healing of the sick. I believe we forget this sometimes. I think we become absorbed in medicine, science, better hospitals; and we forget that all these things have only one reason for existence—people. People who need us, who come to medicine for help.” He stopped. “I’ve put it clumsily.”

“No,” O’Donnell said. “You’ve put it very well.” He had a sense of triumph and of hope. Instinct had not belied him; he had chosen well. He foresaw that the two of them—as chief of surgery and director of pathology—would be good together. They would go on and build and, with them, Three Counties would progress. Not all that they wrought would be perfect; it never was. There would be flaws and failures, but at least their aims were the same, their feelings shared. They would have to remain close; Coleman was younger than himself, and there were areas in which O’Donnell’s greater experience could be of help. In these past few weeks the chief of surgery himself had learned a good deal. He had learned that zeal could lead to complacency as surely as indifference, and that disaster could be reached by many routes. But from now on he would fight complacency on every front, and Pathology, with young Dr. Coleman at its head, could be a stout right arm.

A thought occurred to him. He asked, “One more thing. How do you feel about Joe Pearson and the way he’s leaving?”

“I’m not sure,” David Coleman said. “I’ve been wishing I knew.”

“It’s not such a bad thing to be unsure sometimes. It takes us away from rigid thinking.” O’Donnell smiled. “There are some things I think you should know though. I’ve been talking with some of the older men on staff; they’ve told me incidents, things I didn’t know about.” He paused. “Joe Pearson has done a great deal for this hospital in thirty-two years—things that are mostly forgotten now or that people like you and me don’t always get to hear about. He started the blood bank, you know. It’s strange to think of it, but there was a lot of opposition at the time. Then he worked for the formation of a tissue committee; I’m told a good many staff men fought him bitterly on that. But he got the committee and it did a lot to raise the standard of surgery here. Joe did some investigative work, too—on the cause and incidence of thyroid cancer. Most of it’s generally accepted now, but few people remember that it came from Joe Pearson.”

“I didn’t know,” Coleman said. “Thank you for telling me.”

“Well, these things get forgotten. Joe brought a lot of new things into the lab, too—new tests, new equipment. Unfortunately there came a time when he didn’t do new things any more. He let himself vegetate and get in a rut. It happens sometimes.”

Suddenly Coleman thought of his own father, his strong suspicion that the sensitized blood which killed the Alexanders’ child had stemmed from a transfusion his father had given years before—given without Rh typing, even though the dangers were already known to medicine.

“Yes,” he said. “I suppose it does.”

Both men had risen and moved to the door. As they went out O’Donnell said softly, “It’s a good thing for all of us to have compassion. You see, you never know whether someday you’ll need it yourself.”

Lucy Grainger said, “Kent, you look tired.”

It was early afternoon, and O’Donnell had paused in a main-floor corridor. Unnoticed, she had stopped beside him.

Dear Lucy, he thought—unchanged, warm and tender. Was it really less than a week ago that he had considered leaving Burlington and marrying Denise? At the moment it all seemed far away—a nostalgic interlude that now was nothing more. Here was where he belonged; in this place, for good or ill, was where his destiny lay.

He took her arm. “Lucy,” he said, “let’s meet soon. There’s a lot we have to talk about.”

“All right.” She smiled with affection. “You may take me to dinner tomorrow.”

Side by side, they moved on down the hallway, and it was somehow reassuring to have her beside him. He glanced sideways at her profile, and there came to him a sense of certainty that for both of them there was much that was good ahead. Perhaps it would take time to adjust, but in the end he knew they would find their future together.

Lucy was thinking: Dreams do come true; perhaps mine will—someday soon.

Dusk came early to Pathology. It was a price they paid for working in the hospital basement. Snapping lights on, David Coleman decided that one of his early projects would be to move the department to a better location. The day when pathologists were automatically relegated to the bowels of the hospital was over; light and air were as much requisites for them as for any other branch of medicine.

He entered the pathology office and found Pearson at his desk. The old man was emptying the contents of the drawers. He looked up as Coleman came in.

“It’s a funny thing,” he said, “how much junk you can accumulate in thirty-two years.”

For a moment David Coleman watched. Then he said, “I’m sorry.”

“Nothing to be sorry about.” Pearson answered gruffly. He closed the last drawer and put papers in a case. “I hear you’re getting a new job. Congratulations.”

Coleman said, and meant it, “I wish it could have been some other way.”

“Too late to worry now.” He snapped the locks on the case and looked around. “Well, I guess that’s everything. If you find anything else you can send it with my pension check.”

“There’s something I want to tell you,” Coleman said.

“What’s that?”

Coleman spoke carefully. “The student nurse—the one who had her leg amputated. I dissected the limb this morning. You were right. I was wrong. It was malignant. Osteogenic sarcoma without a doubt.”

The old man paused. He gave the impression that his thoughts were far away. “I’m glad I didn’t make a mistake,” he said slowly, “about that anyway.”

He picked up a topcoat and moved to the door. He seemed about to go, then turned back. Almost diffidently he asked, “Do you mind if I give you some advice?”

Coleman shook his head. “Please do.”

“You’re young,” Pearson said. “You’re full of spice and vinegar—that’s good. You know your stuff too. You’re up to date—you know things that I never did, never will now. Take my advice and try to keep it that way. It’ll be tough to do; make no mistake about it.” He waved toward the desk he had just vacated. “You’ll sit ha that chair and the phone will ring, and it’ll be the administrator—talking about budgets. Next minute one of the lab staff will want to quit; and you’ll have to smooth that out. And the doctors will come in, and they’ll want this bit of information and that.” The old man smiled thinly. “Then you’ll get the salesman—the man with the unbreakable test tube and the burner that never goes out. And when you’re through seeing him there’ll be another and another and another. Until at the end of a day you’ll wonder what happened to it and what you’ve accomplished, what you’ve achieved.”

Pearson stopped and Coleman waited. He sensed that in his words the old pathologist was reliving a part of his own past. He went on, “That’s the way the next day can go, and the next, and the one after that. Until you find a year has slipped by, and another, and another. And while you’re doing all this you’ll send other people on courses to hear about the new things in medicine—because you can’t take time out to go yourself. And you’ll quit investigation and research; and because you work so hard, you’ll be tired at night, and you won’t feel like reading textbooks. And then suddenly, one day, you’ll find everything you knew is out of date. That’s when it’s too late to change.”

Emotion-charged, the voice faltered. Pearson put a hand on Coleman’s arm. He said imploringly, “Listen to an old man who’s been through it all, who made the mistake of falling behind. Don’t let it happen to you! Lock yourself in a closet if you have to! Get away from the phone and the files and paper, and read and learn and listen and keep up to date! Then they can never touch you, never say, ‘He’s finished, all washed up; he belongs to yesterday.’ Because you’ll know as much as they do—and more. Because you’ll have experience to go with it . . .”

The voice trailed off and Pearson turned away.

“I shall try to remember,” Coleman said. He added gently, “I’ll come with you to the door.”

They climbed the stairs from Pathology, and on the hospital’s main floor the bustle of early-evening activity was just beginning. A nurse passed them hurriedly; she carried a diet tray, her starched uniform swishing. They moved aside to let a wheel chair by; in it was a middle-aged man, one leg in a cast, holding a pair of crutches like oars withdrawn into a boat. A trio of student nurses went past laughing. A Women’s Auxiliary worker propelled a cart with magazines. A man clutching a bouquet of flowers headed for the elevators. Somewhere out of sight a child was crying. It was the hospital world: a living organism, a mirror of the greater world outside.

Pearson was looking around him. Coleman thought: Thirty-two years, and he’s seeing it all, perhaps for the last time. He wondered: How will it be when my own time comes? Shall I remember this moment thirty years from now? Will I understand it better then?

On the public-address system a voice announced, “Dr. David Coleman. Dr. Coleman to the surgical floor.”