ah.thefinaldiagnosis-第57部分

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rstand。〃
　He　had　answered　emphatically；　〃Don't　talk　like　that！〃
　〃Why？〃　she　had　said。　〃Are　you　afraid　to　talk　about　it？〃
　〃No！〃　It　was　a　loud；　firm　protest；　but　even　as　he　made　it　he　had　known　it　to　be　a　lie。　He　was　afraid；　just　as　he　sensed　that　Vivian　was　not…not　now；　not　any　more。
　It　was　a　reflection　of　Vivian；　he　realized；　that　he　could　see　now　in　her　mother…or；　he　supposed；　the　other　way　around。　The　sense　of　strength　was　there；　unmistakable；　in　both。　Could　he　match　it　with　his　own？　For　the　first　time　a　feeling　of　uneasy　doubt　assailed　him。
　Mr。　Loburton　had　broken　his　routine。　He　had　stopped　halfway　between　the　window　and　the　chair。　〃Michael；〃　he　said；　〃it's　been　an　hour　and　a　half。　Can　they　be　very　much　longer？〃
　Seddons　found　Vivian's　mother　looking　at　him　too。　He　shook　his　head。　〃I　don't　believe　so。　Dr。　Grainger　said　she'd　e　here　。　。　。　immediately　after。〃　He　paused；　then　added；　〃We　should　all　know　something…very　soon。〃
　
　Nineteen
　
　Reaching　into　the　incubator　through　the　two　porthole…like　apertures　in　its　side；　Dr。　Dornberger　carefully　examined　the　Alexander　baby。　Three　and　a　half　days　had　gone　by　since　birth；　a　fact　which；　of　itself；　might　normally　be　taken　as　a　hopeful　sign。　But　there　were　other　symptoms；　increasingly　apparent；　which　Dornberger　knew　must　be　looked　on　with　disquiet。
　He　took　his　time　about　pleting　the　examination；　then　stood　back　thoughtfully；　weighing　the　available　evidence　in　his　mind；　filtering　it　through　his　long　years　of　experience　and　the　countless　other　cases　now　behind　him。　At　the　end　his　reasoning　confirmed　what　instinct　had　already　told　him；　the　prognosis　was　extremely　poor。　〃You　know；〃　he　said；　〃I　thought　for　a　while　he　was　going　to　make　it。〃
　The　young　nurse　in　charge　of　the　premature　nursery…the　same　nurse　whom　John　Alexander　had　seen　a　few　days　before…had　been　looking　at　Dornberger　expectantly。　She　said；　〃His　breathing　was　quite　steady　until　an　hour　ago；　then　it　became　weak。　That　was　when　I　called　you。〃
　A　student　nurse　around　the　other　side　of　the　incubator　was　following　the　conversation　closely；　her　eyes　above　her　gauze　mask　darting　from　Dornberger　to　the　charge　nurse　and　back　again。
　〃No；　he's　not　breathing　well；〃　Dornberger　said　slowly。　He　went　on；　thinking　out　loud；　trying　to　be　sure　there　was　nothing　he　had　missed；　〃There's　more　jaundice　than　there　should　be；　and　the　feet　seem　swollen。　Tell　me　again…what　was　the　blood　count？〃
　The　charge　nurse　consulted　her　clip　board。　〃R。B。C。　four　point　nine　million。　Seven　nucleated　red　cells　per　hundred　white。〃
　There　was　another　pause；　the　two　nurses　watching　while　Dornberger　digested　the　information。　He　was　thinking：　There's　altogether　too　much　anemia；　though　of　course　it　might　be　an　exaggerated　normal…type　reaction。　Aloud　he　said；　〃You　know；　if　it　weren't　for　that　sensitivity　report　I'd　suspect　this　child　had　erythroblastosis。〃
　The　charge　nurse　looked　surprised。　She　said；　〃But　surely；　Doctor；〃　then　checked　herself。
　〃I　know…it　couldn't　happen。〃　He　motioned　to　the　clip　board。　〃All　the　same；　let　me　see　that　lab　report…the　original　one　on　the　mother's　blood。〃
　Turning　over　several　sheets；　the　charge　nurse　found　the　form　and　extracted　it。　It　was　the　report　which　Dr。　Pearson　had　signed　following　the　altercation　with　David　Coleman。　Dornberger　studied　it　carefully；　then　handed　it　back。　〃Well；　that's　definite　enough…negative　sensitivity。〃
　It　should　be　definite；　of　course；　but　at　the　back　of　his　mind　was　a　nagging　thought：　Could　the　report　be　wrong？　Impossible；　he　told　himself；　the　pathology　department　would　never　make　a　mistake　like　that。　All　the　same；　he　decided；　he　would　drop　in　and　talk　with　Joe　Pearson　after　rounds。
　To　the　charge　nurse　Dornberger　said；　〃There's　nothing　more　we　can　do　at　the　moment。　Call　me　again；　please；　if　there's　any　change。〃
　〃Yes；　Doctor。〃
　When　Dornberger　had　gone　the　student　nurse　asked；　〃What　was　it　the　doctor　said…erythro　。　。　。　？〃　She　stumbled　on　the　word。
　〃Erythroblastosis…it's　a　blood　disease　in　babies。　It　happens　sometimes　when　the　mother's　blood　is　Rh　negative　and　the　father's　Rh　positive。〃　The　young　charge　nurse　with　the　red　hair　answered　the　question　carefully　but　confidently；　as　she　always　did。　The　students　liked　being　assigned　to　her；　as　well　as　having　a　reputation　for　being　one　of　the　most　able　nurses　on　staff；　she　was　little　more　than　twelve　months　away　from　her　own　student　days；　having　graduated　at　the　top　of　the　senior　class　the　year　before。　Knowing　this；　the　student　had　no　hesitation　in　extending　her　questioning。
　〃I　thought　when　that　happened　they　changed　the　baby's　blood　at　birth。〃
　〃You　mean　by　an　exchange　transfusion？〃
　〃Yes。〃
　〃That　only　happens　in　some　cases。〃　The　charge　nurse　went　on　patiently；　〃It　may　depend　on　the　sensitization　report　on　the　mother's　blood。　If　the　report　is　positive；　it　usually　means　the　baby　will　be　born　with　erythroblastosis　and　must　be　given　an　exchange　transfusion　immediately　after　birth。　In　this　case　the　lab　report　was　negative；　so　an　exchange　transfusion　wasn't　necessary。〃　The　charge　nurse　stopped。　Then　she　added；　thoughtfully；　half　to　herself；　〃It's　strange；　though；　about　those　symptoms。〃
　
　Since　their　argument　of　several　days　ago　on　the　subject　of　laboratory　checks　the　senior　pathologist　had　made　no　reference　to　David　Coleman's　activities　in　the　serology　lab。　Coleman　had　no　idea　what　this　silence　implied…whether　he　had　achieved　his　point　and　was　to　have　direct　charge　of　Serology；　or　if　Pearson　intended　to　return　to　the　attack　later。　Meanwhile；　though；　the　younger　pathologist　had　fallen　into　the　habit　of　dropping　into　the　lab　regularly　and　reviewing　the　work　being　done。　As　a　result　he　had　already　formulated　several　ideas　for　changes　in　procedure；　and　some　of　the　minor　ones　had　been　put　into　effect　during　the　last　day　or　two。
　Between　himself　and　Carl　Bannister；　the　elderly　lab　technician；　there　was　something　with　might　be　considered　close　to　an　armed　truce。　John　Alexander；　on　the　other　hand；　had　made　it　plain　that　he　weled　Coleman's　attention　to　the　lab　and　in　the　last　two　days　already　had　made　a　few　suggestions　which　Coleman　had　approved。
　Alexander　had　returned　to　work　the　day　after　his　wife　had　been　brought　to　the　hospital；　despite　a　gruff　but　kindly　suggestion　from　Pearson　that　he　could　take　time　off　if　he　wished。　Coleman　had　heard　Alexander　tell　the　old　pathologist；　〃Thank　you　all　the　same；　Doctor；　but　if　I　don't　work　I'll　think　too　much；　and　it　wouldn't　help。〃　Pearson　had　nodded　and　said　that　Alexander　could　do　as　he　pleased　and　leave　the　lab　to　go　upstairs　and　see　his　wife　and　baby　whenever　he　wished。
　Now　David　Coleman　opened　the　door　of　the　serology　lab　and　went　in。
　He　found　John　Alexander　at　the　center　lab　bench；　looking　up　from　a　microscope；　and；　facing　him；　a　white…coated　woman　with　extremely　large　breasts　whom　Coleman　recalled　vaguely　having　seen　around　the　hospital　several　times　since　his　own　arrival。
　As　he　entered　Alexander　was　saying；　〃I　think　perhaps　you　should　ask　Dr。　Pearson　or　Dr。　Coleman。　I'll　be　making　my　report　to　them。〃
　〃What　report　is　that？〃　As　Coleman　asked　casually；　the　heads　of　the　other　two　turned　toward　him。
　The　woman　spoke　first。　〃Oh；　Doctor！〃　She　looked　at　him　inquiringly。　〃You　are　Dr。　Coleman？〃
　〃That's　right。〃
　〃I'm　Hilda　Straughan。〃　She　offered　him　her　hand　and　added；　〃Chief　dietitian。〃
　〃How　do　you　do。〃　As　she　shook　his　hand　he　noticed；　fascinated；　that　her　magnificent　breasts　moved　with　her　arm…an　undulant；　whalelike　rolling　motion。　Checking　his　thoughts；　he　asked；　〃Is　there　some　sort　of　problem　we　can　help　you　with？〃　He　knew　from　his　own　experience　that　pathologists　and　dietitians　usually　worked　closely　in　matters　of　food　hygiene。
　〃There's　been　a　lot　of　intestinal　flu　these　past　few　weeks；〃　the　dietitian　said。　She　added；　〃Mostly　among　the　hospital　staff。〃
　Coleman　laughed。　〃Tell　me　a　hospital　where　it　doesn't　happen　now　and　again。〃
　〃Oh；　I　know。〃　Mrs。　Straughan　gave　the　faintest　hint　of　disapproval　at　the　flippancy。　〃But　if　food　is　the　reason…and　it　usually　is…I　like　to　pin　down　the　cause　if　it's　possible。　Then　one　can　try　to　prevent　the　same　thing　occurring　again。〃
　There　was　an　earnestness　about　this　woman　which　David　Coleman　found　himself　respecting。　He　asked　politely；　〃Do　you　have　any　ideas？〃
　〃Very　definitely。　I　suspect　my　dishwashing　machines；　Dr。　C。〃
　For　a　moment　Coleman　was　startled　at　the　form　of　address。　Then；　recovering；　he　asked；　〃Oh；　why？〃　Out　of　the　corner　of　his　eye　he　saw　Bannister　enter　the　room。　Now　both　lab　technicians　were　listening　to　the　conversation。
　The　dietitian　said；　〃My　hot…water　booster　system　is　quite　inadequate。〃
　The　phraseology　tempted　him　to　smile；　but　he　resisted　it　and　asked　instead；　〃Has　anyone　ever　pointed　that　out？〃
　〃I　certainly　have；　Dr。　C。〃　Obviously　this　was　a　subject　on　which　Mrs。　Straughan　had　strong　feelings。　She　went　on；　〃I've　talked　to　the　administrator；　Mr。　Tomaselli；　on　several　occasions。　It　was　my　last　talk　with　Mr。　T。；　in　fact；　which　caused　him　to　ask　Dr。　Pearson　for　new　lab　tests　on　the　dishwashers。〃
　〃I　see。〃　Coleman　turned　to　John　Alexander。　〃Did　you　run　some　tests？〃
　〃Yes；　Doctor。〃
　〃What　did　you　find？〃
　〃The　water　temperature　isn't　high　enough。〃　Alexander　consulted　a　clip　board