ah.thefinaldiagnosis-第13部分

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hysician；　receiving　no　payment　from　the　hospital；　only　from　his　patients。　Lucy　herself；　and　all　the　other　attending　physicians；　were　on　staff　on　the　same　basis。　But；　in　contrast；　Joe　Pearson　was　an　employee　of　the　hospital；　receiving　a　salary　of　twenty…five　thousand　dollars　a　year；　roughly　half　of　what　a　successful　surgeon…many　years　his　junior…could　earn。　Lucy　had　once　read　a　cynical　summation　of　the　difference　between　surgeons　and　pathologists：　〃A　surgeon　gets　500　for　taking　out　a　tumor。　A　pathologist　gets　five　dollars　for　examining　it；　making　a　diagnosis；　remending　further　treatment；　and　predicting　the　patient's　future。〃
　Lucy　herself　had　fared　well　in　her　relationship　with　Joe　Pearson。　For　some　reason　she　was　not　sure　of；　he　had　seemed　to　like　her；　and　there　were　moments　she　found　herself　responding　and　liking　him　also。　Sometimes　this　could　prove　a　help　when　she　needed　to　talk　with　him　about　a　diagnosis。
　Now　the　discussion　was　ending；　O'Donnell　winding　things　up。　Lucy　brought　her　attention　back　into　focus。　She　had　let　it　wander　during　the　last　case；　that　was　not　good…she　would　have　to　watch　herself。　The　others　were　rising　from　their　seats。　Joe　Pearson　had　collected　his　papers　and　was　shambling　out。　But　on　the　way　O'Donnell　stopped　him；　she　saw　the　chief　of　surgery　steer　the　old　man　away　from　the　others。
　〃Let's　go　in　here　a　minute；　Joe。〃　O'Donnell　opened　the　door　to　a　small　office。　It　adjoined　the　board　room　and　was　sometimes　used　for　mittee　meetings。　Now　it　was　empty。　Pearson　followed　the　chief　of　surgery　in。
　O'Donnell　was　elaborately　casual。　〃Joe；　I　think　you　should　quit　riding　people　at　these　meetings。〃
　〃Why？〃　Pearson　was　direct。
　All　right；　O'Donnell　thought；　if　that's　the　way　you　want　it。　Aloud　he　said；　〃Because　it　gets　us　nowhere。〃　He　allowed　his　voice　to　take　on　an　edge。　Ordinarily　in　dealing　with　the　old　man　he　deferred　a　little　to　the　gap　of　years　between　them。　But　this　was　a　moment　to　exercise　his　own　authority。　Although；　as　chief　of　surgery；　O'Donnell　had　no　direct　control　of　Pearson's　activities；　he　did　have　certain　prerogatives　when　the　work　of　Pathology　cut　across　his　own　division。
　〃I　pointed　out　a　wrong　diagnosis…that's　all。〃　Pearson　was　aggressive　himself　now。　〃Do　you　suggest　we　keep　quiet　about　such　things？〃
　〃You　know　better　than　to　ask　that。〃　O'Donnell　slammed　out　the　answer；　this　time　not　bothering　at　all　to　keep　the　ice　from　his　voice。　He　saw　Pearson　hesitate　and　suspected　the　old　man　knew　he　had　gone　too　far。
　Grumblingly　he　conceded；　〃I　didn't　mean　that；　not　that　way。〃
　Despite　himself　Kent　O'Donnell　smiled。　Apologizing　did　not　e　easily　to　Joe　Pearson。　It　must　have　cost　him　quite　a　lot　to　say　that。　Now　O'Donnell　went　on　more　reasonably；　〃I　think　there　are　better　ways　to　do　it；　Joe。　If　you　don't　mind；　at　these　meetings　I'd　like　you　to　give　us　the　autopsy　findings；　then　I'll　lead　the　discussion　afterward。　I　think　we　can　do　it　without　getting　tempers　frayed。〃
　〃I　don't　see　why　anybody　has　to　get　in　a　temper。〃　Pearson　was　still　grumbling；　but　O'Donnell　sensed　he　was　backing　down。
　〃All　the　same；　Joe；　I'd　like　to　do　it　my　way。〃　I　don't　want　to　ram　it　down　his　throat；　O'Donnell　thought；　but　this　is　the　time　to　make　things　clear。
　Pearson　shrugged。　〃If　that's　the　way　you　want　it。〃
　〃Thanks；　Joe。〃　O'Donnell　knew　he　had　won；　it　had　been　easier　than　he　had　expected。　Maybe　this　would　be　a　good　time　to　raise　the　other　thing。　〃Joe；〃　he　said；　〃while　we're　here；　there's　something　else。〃
　〃I've　got　a　lot　to　do。　Couldn't　it　wait？〃　As　Pearson　spoke；　O'Donnell　could　almost　read　his　mind。　The　pathologist　was　making　it　clear　that　though　he　had　conceded　one　point　he　had　not　abandoned　his　independence。
　〃I　don't　think　it　can。　It's　about　surgical　reports。〃
　〃What　about　them？〃　The　reaction　was　aggressively　defensive。
　O'Donnell　went　on　smoothly。　〃I've　had　plaints。　Some　of　the　reports　have　been　a　long　time　ing　through　Pathology。〃
　〃Rufus；　I　suppose。〃　Pearson　was　openly　bitter　now。　You　could　almost　hear　him　saying：　Another　surgeon　causing　trouble。
　O'Donnell　determined　not　to　be　provoked。　He　said　quietly；　〃Bill　Rufus　was　one。　But　there　have　been　others。　You　know　that；　Joe。〃
　For　a　moment　Pearson　made　no　answer；　and　O'Donnell　reflected　that　in　a　way　he　felt　sorry　for　the　old　man。　The　years　were　slipping　by。　Pearson　was　sixty…six　now；　at　best　he　had　another　five　or　six　years　of　active　work　ahead　of　him。　Some　people　reconciled　themselves　to　change　like　that；　to　younger　men　moving　into　prominence　and　taking　over　leadership。　Pearson　had　not；　though；　and　he　made　his　resentment　plain。　O'Donnell　wondered　what　was　back　of　his　attitude。　Did　he　feel　himself　slipping；　unable　to　keep　up　with　new　developments　in　medicine？　If　so；　he　would　not　be　the　first。　And　yet　Joe　Pearson；　for　all　his　disagreeable　ways；　had　a　lot　to　mend　him。　That　was　one　of　the　reasons　why　O'Donnell　trod　circumspectly　now。
　〃Yes；　I　know。〃　Pearson's　reply　held　a　tone　of　resignation。　He　had　accepted　the　fact　though。　That　was　typical　of　him；　O'Donnell　thought。　Right　from　the　beginning　at　Three　Counties　he　had　liked　Pearson's　directness　and　at　times　had　made　use　of　it　in　raising　surgical　standards。
　O'Donnell　remembered　that　one　of　the　problems　he　had　faced　in　his　early　months　at　the　hospital　had　been　the　elimination　of　needless　surgery。　Under　this　heading　had　e　an　unnatural　number　of　hysterectomies；　and　in　too　many　cases　healthy；　normal　uteri　were　being　removed　by　a　few　staff　surgeons。　These　were　men　who　found　surgery　a　convenient　and　profitable　remedy　for　any　female　pain；　even　those　which　might　have　responded　to　internal　medication。　In　such　instances　euphemisms　in　diagnosis　like　〃chronic　myometritis〃　or　〃fibrosis　of　uterus〃　were　resorted　to　as　a　smoke　screen　to　cover　up　the　pathology　report　on　the　removed　tissue。　O'Donnell　remembered　telling　Pearson：　〃When　we're　reporting　on　tissue　we'll　call　a　spade　a　spade　and　a　healthy　uterus　a　healthy　uterus。〃　Pearson　had　grinned　and　co…operated　fully。　As　a　result　most　of　the　unnecessary　surgery　had　stopped。　Surgeons　found　it　embarrassing　to　have　tissue　they　had　removed　from　patients　listed　for　all　their　colleagues　to　see　as　normal　and　uninfected。
　〃Look；　Kent。〃　Pearson　was　more　conciliatory　now。　〃Just　lately　I've　been　up　to　my　ears。　You've　no　idea　how　much　work　there　is。〃
　〃I　do　have　an　idea；　Joe。〃　This　was　the　opening　O'Donnell　had　hoped　for。　〃Some　of　us　think　you've　too　much　to　do。　It　isn't　fair　to　you。〃　He　was　tempted　to　add　〃at　your　age〃　but　thought　better　of　it。　Instead　he　added；　〃How　about　getting　some　help？〃
　The　reaction　was　immediate；　Pearson　almost　shouting。　〃You're　telling　me　to　get　more　help！　Why；　man　alive；　I've　been　asking　for　months　for　more　lab　technicians！　We　need　three　at　least；　so　what　am　I　told　I　can　have？　One！　And　stenographers！　I've　got　reports　that　have　been　piling　up　for　weeks；　and　who's　going　to　type　them？〃　Not　waiting　for　an　answer；　he　went　storming　on。　〃Me？　If　the　administration　would　get　off　its　fanny　we　might　get　a　few　things　done…including　faster　surgicals。　By　God！　When　you　tell　me　I　should　get　more　help；　that's　really　something　to　hear。〃
　O'Donnell　had　listened　quietly。　Now　he　said；　〃Finished；　Joe？〃
　〃Yeah。〃　Pearson　seemed　chastened；　half　ashamed　at　his　outburst。
　〃It　wasn't　technicians　or　office　staff　I　was　thinking　about；〃　O'Donnell　told　him。　〃When　I　meant　help　I　meant　another　pathologist。　Someone　to　help　you　run　the　department。　Maybe　modernize　it　here　and　there。〃
　〃Now　look　here！〃　at　the　word　〃modernize〃　Pearson　had　bridled；　but　O'Donnell　brushed　the　objection　aside。　〃I　listened　to　you；　Joe。　Now　you　hear　me　out。　Please。〃　He　paused。　〃I　was　thinking　of　maybe　some　bright　young　fellow　who　could　relieve　you　of　some　duties。〃
　〃I　don't　need　another　pathologist。〃　It　was　a　flat　statement；　vehement　and　unpromising。　〃Why；　Joe？〃
　〃Because　there's　not　enough　work　for　two　qualified　men。　I　can　handle　all　the　pathology　myself…without　any　help。　Besides；　I've　already　got　a　resident　in　the　department。〃
　O'Donnell　was　quietly　persistent。　〃A　resident　is　with　us　for　training；　Joe；　and　usually　for　just　a　short　time。　Sure；　a　resident　can　carry　some　of　the　work。　But　you　can't　give　him　responsibility　and　we　can't　use　him　for　administration。　That's　where　you　need　some　help　right　now。〃
　〃Let　me　be　the　judge　of　that。　Give　me　a　few　days　and　we'll　be　caught　up　in　surgicals。〃
　It　was　obvious　that　Joe　Pearson　had　no　intention　of　giving　way。　O'Donnell　had　expected　resistance　to　bringing　in　a　new　pathologist；　but　he　wondered　about　the　other　man's　forcefulness。　Was　it　because　he　was　unwilling　to　divide　his　personal　empire；　or　was　he　simply　protecting　his　job…fearful　that　a　new　and　younger　man　might　undermine　him？　Actually　the　idea　of　removing　Pearson　had　not　occurred　to　O'Donnell。　In　the　field　of　pathological　anatomy　alone　Joe　Pearson's　long　experience　would　be　hard　to　replace。　O'Donnell's　objective　was　to　strengthen　the　department　and　thereby　the　hospital　organization。　Perhaps　he　should　make　this　clear。
　〃Joe；　there's　no　question　of　any　major　change。　No　one　has　suggested　it。　You'd　still　be　in　charge　。　。　。〃
　〃In　that　case　let　me　run　Pathology　my　own　way。〃
　O'Donnell　found　his　patience　ebbing。　He　decided　that　perhaps　he　had　pressed　the　point　enough　for　now。　He　would　le