ah.thefinaldiagnosis-第37部分

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　〃It's　the　danger　of　infection　I'm　worried　about；　Mr。　T。　There's　been　a　lot　of　intestinal　flu　among　the　hospital　staff　lately。　Of　course；　when　that　happens　everyone　blames　the　food。　But　it　wouldn't　surprise　me　if　this　was　the　cause　of　it。〃
　〃We'd　need　considerably　more　evidence　to　be　sure　of　that。〃　Harry　Tomaselli's　patience　was　beginning　to　wear　thin。　Mrs。　Straughan　had　e　to　him　on　an　exceptionally　busy　morning。　There　was　a　board　meeting　this　afternoon；　and　right　now　he　had　several　pressing　problems　to　consider　in　advance　of　it。　Hoping　to　wind　up　the　interview；　he　asked；　〃When　did　Pathology　last　run　a　bacteria　test　on　the　dishwashers？〃
　Hilda　Straughan　considered。　〃I　could　check；　but　I　think　it's　about　six　months　ago。〃
　〃We'd　better　have　them　do　another。　Then　we'll　know　exactly　where　we　stand。〃
　〃Very　well；　Mr。　T。〃　Mrs。　Straughan　resigned　herself　to　acplishing　nothing　more　today。　〃Shall　I　speak　to　Dr。　Pearson？〃
　〃No；　I'll　do　it。〃　The　administrator　made　a　penciled　note。　At　least；　he　thought；　I　can　save　Joe　Pearson　a　similar　session　to　this。
　〃Thank　you；　Mr。　T。〃　The　chief　dietitian　eased　herself　upward　and　out　of　the　chair。　He　waited　until　she　had　gone；　then　carefully　moved　the　file　tray　back　to　its　original　position。
　
　David　Coleman　was　returning　to　Pathology　from　lunch　in　the　cafeteria。　Making　his　way　through　the　corridors　and　down　the　basement　stairway；　he　pondered　over　the　time　he　had　spent　so　far　with　Dr。　Joseph　Pearson。　Up　to　this　moment；　he　decided；　it　had　been　unsatisfactory　and　inconclusive。
　Pearson　had　been　cordial　enough…later；　if　not　at　the　beginning。　On　finding　Coleman　waiting　in　his　office　his　first　remark　had　been；　〃So　you　really　meant　what　you　said　about　starting　right　away。〃
　〃There　didn't　seem　much　point　in　waiting。〃　He　had　added　politely；　〃I've　been　looking　around　the　labs。　I　hope　you　don't　mind。〃
　〃That's　your　privilege。〃　Pearson　had　said　it　with　a　half…growl；　as　if　it　were　an　invasion　he　did　not　like　but　had　to　put　up　with。　Then；　as　if　realizing　his　own　ungraciousness；　he　had　added；　〃Well；　I　guess　I　should　wele　you。〃
　When　they　had　shaken　hands　the　older　man　had　said；　〃First　thing　I　have　to　do　is　get　some　of　this　work　cleared　away。〃　He　gestured　at　the　untidy　pile　of　slide　folders；　dockets；　and　loose　memoranda　on　his　desk。　〃After　that　maybe　we　can　figure　out　what　you'll　be　doing　around　here。〃
　Coleman　had　sat；　with　nothing　else　to　do　but　read　a　medical　journal；　while　Pearson　had　plowed　through　some　of　the　papers。　Then　a　girl　had　e　in　to　take　dictation；　and　after　that　he　had　acpanied　Pearson　to　a　gross　conference　in　the　autopsy…room　annex。　Sitting　beside　Pearson　with　two　residents…McNeil　and　Seddons…on　the　opposite　side　of　the　dissecting　table；　he　had　felt　very　much　like　a　junior　resident　himself。　There　had　been　almost　nothing　for　him　to　contribute；　Pearson　had　conducted　the　gross　conference　with　Coleman　merely　a　spectator。　Nor　had　the　older　man　made　any　acknowledgment　of　Coleman's　status　as　the　new　assistant　director　of　the　entire　department。
　Later　he　and　Pearson　had　gone　to　lunch　together　and；　in　the　course　of　it；　Pearson　had　introduced　him　to　a　few　people　on　the　medical　staff。　Then　the　older　pathologist　had　excused　himself　and　left　the　table；　saying　there　was　some　urgent　work　he　had　to　attend　to。　Now　Coleman　was　returning　to　Pathology　alone；　weighing　in　his　mind　the　problem　which　seemed　to　face　him。
　He　had　anticipated　some　slight　resistance　from　Dr。　Pearson；　of　course。　From　odd　pieces　of　information　which　had　e　to　him　he　had　pieced　together　the　fact　that　Pearson　had　not　wanted　a　second　pathologist；　but　he　had　certainly　not　expected　anything　quite　like　this。
　He　had　assumed；　at　the　very　least；　that　there　would　be　an　office　ready　for　him　on　arrival　and　a　few　clearly　defined　duties。　Certainly　David　Coleman　had　not　expected　to　take　over　a　great　number　of　major　responsibilities　at　once。　He　had　no　objection　to　the　senior　pathologist　checking　on　him　for　a　while；　in　fact；　in　Pearson's　position；　he　himself　would　take　the　same　precaution　with　a　newer。　But　this　situation　went　far　beyond　that。　Apparently；　despite　his　letter；　no　thought　whatever　had　been　given　to　what　Coleman's　duties　were　to　include。　The　idea　seemed　to　be　that　he　should　sit　around　until　Dr。　Pearson　could　take　enough　time　away　from　his　mail　and　various　other　chores　to　hand　out　a　few　tasks。　Well；　if　that　were　the　case；　some　of　the　thinking　would　have　to　be　changed…and　soon。
　David　Coleman　had　long　been　aware　of　defects　in　his　own　character；　but　he　was　equally　aware　of　a　number　of　important　qualities。　Among　the　most　significant　was　his　own　record　and　ability　as　physician　and　pathologist。　Kent　O'Donnell　had　stated　nothing　more　than　truth　when　he　had　referred　to　Coleman　as　highly　qualified。　Despite　his　youthfulness　he　already　had　qualifications　and　experience　which　many　practicing　pathologists　would　find　it　hard　to　match。　Certainly　there　was　no　reason　for　him　to　stand　in　awe　of　Dr。　Joseph　Pearson　and；　while　he　was　prepared　to　defer　a　little　to　the　other　man's　age　and　seniority；　he　had　no　intention　of　being　treated；　himself；　like　a　raw　and　inexperienced　hand。
　There　was　another　strength；　too：　a　feeling　which　overrode　all　other　considerations；　whether　of　character；　attempts　at　tolerance；　or　anything　else。　It　was　a　determination　to　practice　medicine　unpromisingly；　cleanly；　honestly…even　exactly；　as　far　as　exactness　was　possible　in　medical　affairs。　For　any　who　did　less…and　even　in　his　own　few　years　he　had　seen　and　known　them…the　promisers；　the　politicians；　the　lazy；　the　at…any…cost　ambitious…David　Coleman　had　only　anger　and　disgust。
　If　he　had　been　asked　from　whence　this　feeling　sprang；　he　would　have　found　it　hard　to　answer。　Certainly　he　was　no　sentimentalist；　nor　had　he　entered　medicine　because　of　some　overt　urge　to　aid　humanity。　The　influence　of　his　own　father　might　have　had　some　effect　but；　David　Coleman　suspected；　not　too　much。　His　father；　he　realized　now；　had　been　an　averagely　good　physician；　within　the　limits　of　general　practice；　but　there　had　always　been　a　striking　difference　between　their　two　natures。　The　elder　Coleman　had　been　a　warm；　outgoing　personality　with　many　friends；　his　son　was　cool；　hard　to　know；　often　aloof。　The　father　had　joked　with　his　patients　and　casually　given　them　his　best。　The　son…as　an　intern；　before　pathology　cut　him　off　from　patients…had　never　joked　but　carefully；　exactly；　skillfully；　had　given　a　little　better　than　the　best　of　many　others。　And　even　though；　as　a　pathologist；　his　relationship　with　patients　had　changed；　this　attitude　had　not。
　Sometimes；　in　his　moments　of　honest　self…examination；　David　Coleman　suspected　his　approach　would　have　been　the　same；　whether　his　occupation　had　been　medicine　or　something　else。　Basically；　he　supposed；　it　was　a　quality　of　exactitude　bined　with　intolerance　of　mistake　or　failure…the　feeling；　too；　that　whoever　and　whatever　you　set　out　to　serve　was　entitled；　by　right；　to　the　utmost　you　had　to　give。　In　a　way；　perhaps；　the　two　feelings　were　contradictory。　Or　possibly　they　had　been　summed　up　accurately　by　a　medical　classmate　who　had　once　drunk　an　ironic　toast　to　〃David　Coleman…the　guy　with　the　antiseptic　heart。〃
　Passing　now　through　the　basement　corridor；　his　mind　returned　to　the　present　and　instinct　told　him　that　conflict　lay　very　close　ahead。
　He　entered　the　pathology　office　to　find　Pearson　hunched　over　a　microscope；　a　slide　folder　open　in　front　of　him。　The　older　man　looked　up。　〃e　and　take　a　look　at　these。　See　what　you　make　of　them。〃　He　moved　away　from　the　microscope；　waving　Coleman　toward　it。
　〃What's　the　clinical　story？〃　Coleman　slipped　the　first　slide　under　the　retaining　clips　and　adjusted　the　binocular　eyepiece。
　〃It's　a　patient　of　Lucy　Grainger's。　Lucy　is　one　of　the　surgeons　here；　you'll　meet　her。〃　Pearson　consulted　some　notes。　〃The　case　is　a　nineteen…year…old　girl；　Vivian　Loburton…one　of　our　own　student　nurses。　Got　a　lump　below　her　left　knee。　Persistent　pain。　X…rays　show　some　bone　irregularity。　These　slides　are　from　the　biopsy。〃
　There　were　eight　slides；　and　Coleman　studied　each　in　turn。　He　knew　at　once　why　Pearson　had　asked　him　for　an　opinion。　This　was　a　hairline　case；　as　difficult　as　any　came。　At　the　end　he　said；　〃My　opinion　is　'benign。'　〃
　〃I　think　it's　malignant；〃　Pearson　said　quietly。　〃Osteogenic　sara。〃
　Without　speaking　Coleman　took　the　first　slide　again。　He　went　over　it　once　more；　patiently　and　carefully；　then　repeated　the　process　with　the　other　seven。　The　first　time　around　he　had　considered　the　possibility　of　osteogenic　sara；　now　he　did　so　again。　Studying　the　red…　and　blue…stained　transparencies　which　could　reveal　so　much　to　the　trained　pathologist；　his　mind　ticked　off　the　pros　and　cons　。　。　。　All　the　slides　showed　a　good　deal　of　new　bone　formation…osteoblastic　activity　with　islands　of　cartilage　within　them　。　。　。　Trauma　had　to　be　considered。　Had　trauma　caused　a　fracture？　Was　the　new　bone　formation　a　result　of　regeneration…the　body's　own　attempt　to　heal？　If　so；　the　growth　was　certainly　benign。　。　。　。　Was　there　evidence　of　osteomyelitis？　Under　a　microscope　it　was　easy　to　mistake　it　for　the　more　deadly　osteogenic　sara。　But　no；　there　were　no　polymorphonuclear　leukocytes；　characteristically　found　in　the　marrow　spaces　between　the　bone　spicules　。　。　。