ah.thefinaldiagnosis-第10节

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　white　fibrous　tissue。　It　was　a　signal　of　tuberculosis；　whether　old　or　recent　they　would　know　in　a　moment。　He　moved　aside　for　Seddons。
　〃Palpate　the　lungs；　Seddons。〃　It　was　Pearson。　〃I　imagine　you'll　find　some　evidence　there。〃
　The　surgical　resident　grasped　the　lungs；　probing　with　his　fingers。　The　cavities　beneath　the　surface　were　detectable　at　once。　He　looked　up　at　Pearson　and　nodded。　McNeil　had　turned　to　the　case…history　papers。　He　used　a　clean　knife　to　lift　the　pages　so　he　would　not　stain　them。
　〃Was　there　a　chest　X…ray　on　admission？〃　Pearson　asked。
　The　resident　shook　his　head。　〃The　patient　was　in　shock。　There's　a　note　here　it　wasn't　done。〃
　〃We'll　take　a　vertical　slice　to　see　what's　visible。〃　Pearson　was　talking　to　the　nurses　again　as　he　moved　back　to　the　table。　He　removed　the　lungs　and　cut　smoothly　down　the　center　of　one。　It　was　there　unmistakably…fibrocaseous　tuberculosis；　well　advanced。　The　lung　had　a　honeybed　appearance；　like　ping…pong　balls　fastened　together；　then　cut　through　the　center…a　festering；　evil　growth　that　only　the　heart　had　beaten　to　the　kill。
　〃Can　you　see　it？〃
　Seddons　answered　Pearson's　question。　〃Yes。　Looks　like　it　was　a　tossup　whether　this　or　the　heart　would　get　him　first。〃
　〃It's　always　a　tossup　what　we　die　of。〃　Pearson　looked　across　at　the　nurses。　〃This　man　had　advanced　tuberculosis。　As　Dr。　Seddons　observed；　it　would　have　killed　him　very　soon。　Presumably　neither　he　nor　his　physician　were　aware　of　its　presence。〃
　Now　Pearson　peeled　off　his　gloves　and　began　to　remove　his　gown。　The　performance　is　over；　Seddons　thought。　The　bit　players　and　stagehands　will　do　the　cleaning　up。　McNeil　and　the　resident　would　put　the　essential　organs　into　a　pail　and　label　it　with　the　case　number。　The　remainder　would　be　put　back　into　the　body；　with　linen　waste　added　if　necessary　to　fill　the　cavities　out。　Then　they　would　stitch　up　roughly；　using　a　big　baseball　stitch…over　and　under…because　the　area　they　had　been　working　on　would　be　covered　decorously　with　clothing　in　the　coffin；　and　when　they　had　finished　the　body　would　go　in　refrigeration　to　await　the　undertaker。
　Pearson　had　put　on　the　white　lab　coat　with　which　he　entered　the　autopsy　room　and　was　lighting　a　new　cigar。　It　was　a　characteristic　that　he　left　behind　him　through　the　hospital　a　trail　of　half…smoked　cigar　butts；　usually　for　someone　else　to　deposit　in　an　ash　tray。　He　addressed　himself　to　the　nurses。
　〃There　will　be　times　in　your　careers；〃　he　said；　〃when　you　will　have　patients　die。　It　will　be　necessary　then　to　obtain　permission　for　an　autopsy　from　the　next　of　kin。　Sometimes　this　will　fall　to　the　physician；　sometimes　to　you。　When　that　happens　you　will　occasionally　meet　resistance。　It　is　hard　for　any　person　to　sanction…even　after　death…the　mutilation　of　someone　they　have　loved。　This　is　understandable。〃
　Pearson　paused。　For　a　moment　Seddons　found　himself　having　second　thoughts　about　the　old　man。　Was　there　some　warmth；　some　humanity；　in　him　after　all？
　〃When　you　need　to　muster　arguments；〃　Pearson　said；　〃to　convince　some　individual　of　the　need　for　autopsy；　I　hope　you　will　remember　what　you　have　seen　today　and　use　it　as　an　example。〃
　He　had　his　cigar　going　now　and　waved　it　at　the　table。　〃This　man　has　been　tuberculous　for　many　months。　It　is　possible　he　may　have　infected　others　around　him…his　family；　people　he　worked　with；　even　some　in　this　hospital。　If　there　had　been　no　autopsy；　some　of　these　people　might　have　developed　tuberculosis　and　it　could　have　remained　undetected；　as　it　did　here；　until　too　late。〃
　Two　of　the　student　nurses　moved　back　instinctively　from　the　table。
　Pearson　shook　his　head。　〃Within　reason　there　is　no　danger　of　infection　here。　Tuberculosis　is　a　respiratory　disease。　But　because　of　what　we　have　learned　today；　those　who　have　been　close　to　this　man　will　be　kept　under　observation　and　given　periodic　checks　for　several　years　to　e。〃
　To　his　own　surprise　Seddons　found　himself　stirred　by　Pearson's　words。　He　makes　it　sound　good；　he　thought；　what's　more；　he　believes　in　what　he　is　saying。　He　discovered　that　at　this　moment　he　was　liking　the　old　man。
　As　if　he　had　read　Seddons'　mind；　Pearson　looked　over　to　the　surgical　resident。　With　a　mocking　smile：　〃Pathology　has　its　victories　too；　Dr。　Seddons。〃
　He　nodded　at　the　nurses。　Then　he　was　gone；　leaving　a　cloud　of　cigar　smoke　behind。
　
　Four
　
　The　monthly　surgical…mortality　conference　was　scheduled　for　2：30　P。M。　At　three　minutes　to　the　half…hour　Dr。　Lucy　Grainger；　a　little　harried　as　if　time　were　working　against　her；　hurried　into　the　administration　reception　office。　〃Am　I　late？〃　she　asked　the　secretary　at　the　information　desk。
　〃I　don't　think　they've　started；　Dr。　Grainger。　They　just　went　in　the　board　room。〃　The　girl　had　indicated　the　double　oak…paneled　doorway　down　the　hall；　and　now；　as　she　approached；　Lucy　could　hear　a　hum　of　conversation　from　inside。
　As　she　entered　the　big　room　with　its　pile　carpet；　long　walnut　table；　and　carved　chairs；　she　found　herself　close　to　Kent　O'Donnell　and　another　younger　man　she　did　not　recognize。　Around　them　was　a　babel　of　talk　and　the　air　was　thick　with　tobacco　smoke。　The　monthly　mortality　conferences　were　usually　looked　on　as　mand　performances；　and　already　most　of　the　hospital's　forty…odd　staff　surgeons　had　arrived；　as　well　as　house　staff…interns　and　residents。
　〃Lucy！〃　She　smiled　a　greeting　at　two　of　the　other　surgeons；　then　turned　back　as　O'Donnell　called　to　her。　He　was　maneuvering　the　other　man　with　him。
　〃Lucy；　I'd　like　you　to　meet　Dr。　Roger　Hilton。　He's　just　joined　the　staff。　You　may　recall　his　name　came　up　some　time　ago。〃
　〃Yes；　I　do　remember。〃　She　smiled　at　Hilton；　her　face　crinkling。
　〃This　is　Dr。　Grainger。〃　O'Donnell　was　always　punctilious　about　helping　new　staff　members　to　bee　known。　He　added；　〃Lucy　is　one　of　our　orthopedic　surgeons。〃
　She　offered　Hilton　her　hand　and　he　took　it。　He　had　a　firm　grasp；　a　boyish　smile。　She　guessed　his　age　at　twenty…seven。　〃If　you're　not　tired　of　hearing　it；〃　she　said；　〃wele！〃
　〃Matter　of　fact；　I'm　rather　enjoying　it。〃　He　looked　as　if　he　were。
　〃Is　this　your　first　hospital　appointment？〃
　Hilton　nodded。　〃Yes。　I　was　a　surgical　resident　at　Michael　Reese。〃
　Lucy　remembered　more　clearly　now。　This　was　a　man　whom　Kent　O'Donnell　had　been　very　keen　to　get　to　Burlington。　And　undoubtedly　that　meant　Hilton　had　good　qualifications。
　〃e　over　here　a　minute；　Lucy。〃　Kent　O'Donnell　had　moved　back　near　her　and　was　beckoning。
　Excusing　herself　to　Hilton；　she　followed　the　chief　of　surgery　to　one　of　the　board…room　windows；　away　from　the　immediate　press　of　people。
　〃That's　a　little　better；　at　least　we　can　make　ourselves　heard。〃　O'Donnell　smiled。　〃How　have　you　been；　Lucy？　I　haven't　seen　you；　except　in　line　of　duty；　for　quite　a　while。〃
　She　appeared　to　consider。　〃Well；　my　pulse　has　been　normal；　temperature　around　ninety…eight　point　eight。　Haven't　checked　blood　pressure　recently。〃
　〃Why　not　let　me　do　it？〃　O'Donnell　said。　〃Over　dinner；　for　example。〃
　〃Do　you　think　it's　wise？　You　might　drop　the　sphygmomanometer　in　the　soup。〃
　〃Let's　settle　for　dinner　then　and　forget　the　rest。〃
　〃I'd　love　to；　Kent；〃　Lucy　said。　〃But　I'll　have　to　look　at　my　book　first。〃
　〃Do　that　and　I'll　phone　you。　Let's　try　to　make　it　next　week。〃　O'Donnell　touched　her　lightly　on　the　shoulder　as　he　turned　away。　〃I'd　better　get　this　show　opened。〃
　Watching　him　ease　his　way　through　other　groups　toward　the　center　table；　Lucy　thought；　not　for　the　first　time；　how　much　she　admired　Kent　O'Donnell；　both　as　a　colleague　and　a　man。　The　invitation　to　dinner　was　not　a　new　thing。　They　had　had　evenings　together　before；　and　for　a　while　she　had　wondered　if　perhaps　they　might　be　drifting　into　some　kind　of　tacit　relationship。　Both　were　unmarried；　and　Lucy；　at　thirty…five；　was　seven　years　younger　than　the　chief　of　surgery。　But　there　had　been　no　hint　in　O'Donnell's　manner　that　he　regarded　her　as　anything　more　than　a　pleasant　panion。
　Lucy　herself　had　a　feeling　that；　if　she　allowed　it；　her　admiration　for　Kent　O'Donnell　could　grow　to　something　more　deep　and　personal。　But　she　had　made　no　attempt　to　force　the　pace；　feeling　it　better　to　let　things　develop　if　they　happened　to；　and　if　not…well；　nothing　was　lost。　That　at　least　was　one　advantage　of　maturity　over　the　first　flush　of　youth。　You　learned　not　to　hurry；　and　you　discovered　that　the　rainbow's　end　was　a　good　deal　further　than　the　next　city　block。
　〃Shall　we　get　started；　gentlemen？〃　O'Donnell　had　reached　the　head　of　the　table　and　raised　his　voice　across　the　heads　of　the　others。　He　too　had　savored　the　brief　moment　with　Lucy　and　found　the　thought　pleasing　that　he　would　be　meeting　her　again　shortly。　Actually　he　would　have　called　her　a　good　deal　sooner；　but　there　had　been　a　reason　for　hesitation。　The　truth　was　that　Kent　O'Donnell　found　himself　being　drawn　more　and　more　toward　Lucy　Grainger；　and　he　was　not　at　all　sure　this　was　a　good　thing　for　either　of　them。
　By　now　he　had　bee　fairly　set　in　his　own　mode　of　life。　Living　alone　and　being　independent　grew　on　you　after　a　while；　and　he　doubted　sometimes　if　he　could　adjust　to　anything　else。　He　suspected；　too；　that　something　of　the　same　thing　might　apply　to　Lucy；　and　there　might　be　problems　as　well　about　their　parallel　careers。　Nonetheless；　he　still　felt　more　fortable　in