ah.thefinaldiagnosis-第18节
按键盘上方向键 ← 或 → 可快速上下翻页，按键盘上的 Enter 键可回到本书目录页，按键盘上方向键 ↑ 可回到本页顶部！
————未阅读完？加入书签已便下次继续阅读！
roach failed； he would have to resort to more direct methods。 Sometimes； he reflected； it might be simpler if medical protocol were less plicated。 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〃 prised 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 remendation。
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 mitted 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 e and see us。 If this had not e 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
