ah.thefinaldiagnosis-第3节
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The thought of dishes caused Mrs。 Straughan to frown thoughtfully； and she propelled herself into the back section of the kitchen where the two big automatic dishwashers were installed。 This was a part of her domain less gleaming and modern than the other section； and the chief dietitian reflected； not for the first time； that she would be happy when the equipment here was modernized； as the rest of the kitchens had been。 It was understandable； though； that everything could not be done at once； and she had to admit she had browbeaten the administration into a lot of expensive new equipment in the two years she had held her job at Three Counties。 All the same； she decided as she moved on to check the steam tables in the cafeteria； she would have another talk with the administrator about those dishwashers soon。
The chief dietitian was not the only one in the hospital whose thoughts were on food。 In Radiology； on the second floor； an outpatient…Mr。 James Bladwick； vice…president of sales for one of Burlington's big…three automobile dealerships…was； in his own words； 〃as hungry as hell。〃
There was reason for this。 On his physician's instructions Jim Bladwick had fasted since midnight； and now he was in number one X…ray room； ready for a gastric series。 The X…rays would confirm or deny the suspicion that flourishing in the Bladwick interior was a duodenal ulcer。 Jim Bladwick hoped the suspicion was unfounded； in fact； he hoped desperately that neither an ulcer nor anything else would conspire to slow him down now that his drive and sacrifice of the past three years； his willingness to work harder and longer than anyone else on sales staff； were at last paying off。
Sure he worried； who wouldn't when they had a dealer sales quota to meet every month。 But it just couldn't be an ulcer； it had to be something else…something trivial that could be fixed up quickly。 He had been vice…president of sales only a matter of six weeks； but despite the high…sounding title he knew better than anyone that retention of it depended on a continued ability to produce。 And to produce you had to be on the ball…tough； available； fit。 No medical certificate would pensate for a declining sales graph。
Jim Bladwick had put this moment off for some time。 It was probably two months ago that he had bee aware of distress and a general aching in the stomach region； had noticed； too； he was burping a lot； sometimes at awkward moments with customers around。 For a while he had tried to pretend it was nothing out of the ordinary； but finally he had sought medical advice； and this morning's session was the oute。 He hoped； though； it was not going to take too long； that deal of Fowler's for six panel trucks was getting hot； and they needed the sale badly。 By God； he was hungry！
For Dr。 Ralph Bell； the senior radiologist…〃Ding Dong〃 to most of the hospital staff…this was just another G。I。 series； no different from any of a hundred others。 But； playing a mental game he sometimes indulged in； he decided to bet 〃yes〃 on this one。 This patient looked the type for an ulcer。 From behind his own thick…lensed； horn…rimmed glasses Bell had been watching the other man covertly。 He looked a worrier； Bell decided； he was obviously stewing right now。 The radiologist placed Bladwick in position behind the fluoroscope and handed him a tumbler of barium。 〃When I tell you；〃 he said； 〃drink this right down。〃
When he was ready he ordered； 〃Now！〃 Bladwick drained the glass。
In the fluoroscope Bell watched the path of the barium as it coursed first through the esophagus； then into the stomach； and from there into the duodenum。 Sharpened by the opaque liquid； the outline of each organ was clearly visible； and at various stages Bell thumbed a button recording the results on film。 Now he palpated the patient's abdomen to move the barium around。 Then he could see it…a crater in the duodenum。 An ulcer； clear and unmistakable。 He reflected that he had won the bet with himself。 Aloud he said； 〃That's all； Mr。 Bladwick； thank you。〃
〃Well； Doc； what's the verdict？ Am I going to live？〃
〃You'll live。〃 Most of them wanted to know what he saw in the fluoroscope。 Magic mirror on the wall； who is healthiest of all？ It wasn't his job to tell though。 〃Your own physician will get these films tomorrow。 I imagine he'll be talking to you。〃 Hard luck； my friend； he thought。 I hope you like lots of rest and a diet of milk and poached eggs。
Two hundred yards away from the main hospital block； in a run…down building that had once been a furniture factory and now did duty as a nurses' home； Student Nurse Vivian Loburton was having trouble with a zipper that refused to zip。
〃Damn and hellfire！〃 She addressed the zipper with an expression much favored by her father； who had made a fortable fortune felling tall trees and saw no reason to have one language for the woods and another at home。
Vivian； at nineteen； sometimes provided an interesting contrast between her father's robustness and her mother's innate New England delicacy which close contact with Oregon lumbering had never changed。 Now； in her fourth month of training as a nurse； Vivian had already found something of the traits of both parents in her own reaction to the hospital and nursing。 At one and the same time she was awed and fascinated； repulsed and disgusted。 She supposed that close contact with sickness and disease was always a shock for anyone new。 But knowing that did not help much when your stomach was ready to do flip…flops and it took all the will you possessed not to turn and run away。
It was after moments like this that she felt the need for a change of scene； a cleansing antidote； and to some extent she had found it in an old love…music。 Surprisingly； for a city of its size； Burlington had an excellent symphony； and； discovering this； Vivian had bee one of its supporters。 She found the switch in tempo； the balm of good music； helped to steady and reassure her。 She had been sorry when concerts had ended for the summer； and there had been moments recently when she had felt the need of something to replace them。
There was no time now； though； for odd； stray thoughts； the gap between morning classes and reporting to a ward for duty had been short enough。 Now this zipper！ 。 。 。 She tugged again； and suddenly the teeth meshed； the zipper closed。 Relieved； she ran for the door； then paused to mop her face。 Jeepers； it was hot！ And all that effort had made her sweat like crazy。
So it went…that morning as all mornings…through the hospital。 In the clinics； the nurseries； laboratories； operating rooms； in Neurology； Psychiatry； Pediatrics； Dermatology； in Orthopedics； Ophthalmology； Gynecology； Urology； in the charity wards and the private patients' pavilion； in the service departments…administration； accounting； purchasing； housekeeping； in the waiting rooms； corridors； halls； elevators； throughout the five floors； basement； and sub…basement of Three Counties Hospital the tides and currents of humanity and medicine ebbed and flowed。
It was eleven； o'clock on the fifteenth of July。
Two
Two blocks from Three Counties Hospital the clock…tower bell of the Church of the Redeemer was chiming the hour as Kent O'Donnell made his way from the surgical floor down to Administration。 The sound of the bell； off…key as always from a flaw in its long…ago casting； drifted in through an open stairway window。 Automatically O'Donnell checked his wrist watch； then moved aside as a group of interns passed him hurriedly on the staff stairway； their feet sounding noisily on the metal treads。 The interns quietened a little when they saw the medical…board president and offered a respectful 〃Good morning； Doctor；〃 as each went by。 On the second floor O'Donnell halted to let a nurse with a wheel chair pass。 In it was a girl of about ten with a bandage over one eye； a woman； plainly the mother； hovering protectively alongside。
The nurse； whom he smiled at but failed to recognize； appraised him covertly。 In his early forties； O'Donnell still rated second glances from women。 He had retained the build which had made him an outstanding quarterback in his college years…a tall； erect figure with big； broad shoulders and muscular arms。 Even nowadays he had a trick of squaring his shoulders when ready to do something difficult or make a decision…as if readying instinctively to stop the charge of a red…dogging tackle。 Yet despite his bulk…mostly bone and muscle with less than a pound of overweight…he still moved lightly； and regular sport…tennis in summer； skiing in winter…had kept him robust and lithe。
O'Donnell had never been handsome in the Adonic sense； but he had a rugged； creased irregularity of face （his nose still carried the scar of an old football injury） which women so often； and perversely； find attractive in men。 Only his hair showed the real trace of years； not so long ago jet black； now it was graying swiftly as if the color pigments had suddenly surrendered and were marching out。
Now； from behind； O'Donnell heard his name called。 He stopped and saw the caller was Bill Rufus； one of the seniors on surgical staff。
〃How are you； Bill？〃 O'Donnell liked Rufus。 He was conscientious； dependable； a good surgeon
