ah.thefinaldiagnosis-第14部分

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her　hand；　O'Donnell　was　aware　that　in　medicine　it　was　easy　to　have　hindsight；　but　it　was　quite　another　matter　to　do　an　emergency　on…the…spot　diagnosis　with　a　patient's　life　at　stake。
　All　of　this　the　chief　of　surgery　would　have　had　brought　out；　in　the　ordinary　way；　quietly　and　objectively；　at　the　mortality　conference。　Indeed；　he　would　probably　have　led　Gil　Bartlett　to　make　some　of　the　points　himself；　Bartlett　was　honest　and　not　afraid　of　self…examination。　The　point　of　the　discussion　would　have　been　evident　to　everyone。　There　would　have　been　no　need　for　emphasis　or　recriminations。　Bartlett　would　not　have　enjoyed　the　experience；　of　course；　but　at　the　same　time　he　would　not　have　been　humiliated。　More　important　still；　O'Donnell's　purpose　would　have　been　served　and　a　practical　lesson　in　differential　diagnosis　impressed　on　all　the　surgical　staff。
　Now　none　of　this　could　happen。　If；　at　this　stage；　O'Donnell　raised　the　points　he　had　had　in　mind；　he　would　appear　to　be　supporting　Pearson　and　further　condemning　Bartlett。　For　the　sake　of　Bartlett's　own　morale　this　must　not　happen。　He　would　talk　to　Bartlett　in　private；　of　course；　but　the　chance　of　a　useful；　open　discussion　was　lost。　Confound　Joe　Pearson！
　Now　the　uproar　had　quieted。　O'Donnell's　banging　of　the　gavel…a　rare　occurrence…had　had　effect。　Bartlett　had　sat　down；　his　face　still　angry　red。　Pearson　was　turning　over　some　papers；　apparently　absorbed。
　〃Gentlemen。〃　O'Donnell　paused。　He　knew　what　had　to　be　said；　it　must　be　quick　and　to　the　point。　〃I　think　I　need　hardly　say　this　is　not　an　incident　any　of　us　would　wish　to　see　repeated。　A　mortality　conference　is　for　learning；　not　for　personalities　or　heated　argument。　Dr。　Pearson；　Dr。　Bartlett；　I　trust　I　make　myself　clear。〃　O'Donnell　glanced　at　both；　then；　without　waiting　for　acknowledgment；　announced；　〃We'll　take　the　next　case；　please。〃
　There　were　four　more　cases　down　for　discussion；　but　none　of　these　was　out　of　the　ordinary　and　the　talk　went　ahead　quietly。　It　was　just　as　well；　Lucy　reflected；　controversy　Eke　that　was　no　help　to　staff　morale。　There　were　times　when　it　required　courage　to　make　an　emergency　diagnosis；　even　so；　if　you　were　unfortunate　and　guilty　of　error；　you　expected　to　be　called　to　account。　But　personal　abuse　was　another　matter；　no　surgeon；　unless　grossly　careless　and　inpetent；　should　have　to　take　that。
　Lucy　wondered；　not　for　the　first　time；　how　much　of　Joe　Pearson's　censure　at　times　like　this　was　founded　on　personal　feelings。　Today；　with　Gil　Bartlett；　Pearson　had　been　rougher　than　she　remembered　his　ever　being　at　any　mortality　meeting。　And　yet　this　was　not　a　flagrant　case；　nor　was　Bartlett　prone　to　mistakes。　He　had　done　some　fine　work　at　Three　Counties；　notably　on　types　of　cancer　which　not　long　before　were　considered　inoperable。
　Pearson　knew　this；　too；　of　course；　so　why　his　antagonism？　Was　it　because　Gil　Bartlett　represented　something　in　medicine　which　Pearson　envied　and　had　never　attained？　She　glanced　down　the　table　at　Bartlett。　His　face　was　set；　he　was　still　smarting。　But　normally　he　was　relaxed；　amiable；　friendly…all　the　things　a　successful　man　in　his　early　forties　could　afford　to　be。　Along　with　his　wife；　Gil　Bartlett　was　a　prominent　figure　in　Burlington　society。　Lucy　had　seen　him　at　ease　at　cocktail　parties　and　in　wealthy　patients'　homes。　His　practice　was　successful。　Lucy　guessed　his　annual　ine　from　it　would　be　in　the　region　of　fifty　thousand　dollars。
　Was　this　what　griped　Joe　Pearson？…Joe　Pearson　who　could　never　pete　with　the　glamor　of　surgery；　whose　work　was　essential　but　undramatic；　who　had　chosen　a　branch　of　medicine　seldom　in　the　public　eye。　Lucy　herself　had　heard　people　ask：　What　does　a　pathologist　do？　No　one　ever　said：　What　does　a　surgeon　do？　She　knew　there　were　some　who　thought　of　pathologists　as　a　breed　of　hospital　technician；　failing　to　realize　that　a　pathologist　had　to　be　first　a　physician　with　a　medical　degree；　then　spend　years　of　extra　training　to　bee　a　highly　qualified　specialist。
　Money　sometimes　was　a　sore　point　too。　On　Three　Counties'　staff　Gil　Bartlett　ranked　as　an　attending　physician；　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。〃