ah.thefinaldiagnosis-第4部分

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　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　with　a　busy　practice。　His　patients　trusted　him　because　of　a　forthright　integrity　which　came　through　when　he　talked。　He　was　respected　by　the　house　staff…interns　and　residents…who　found　Dr。　Rufus　to　have　a　painless；　pleasant　way　of　imparting　sound　instruction　while　treating　them　as　equals…a　condition　not　always　prevailing　with　other　surgeons。
　His　only　peculiarity；　if　you　could　call　it　that；　was　a　habit　of　wearing　impossibly　gaudy　neckties。　O'Donnell　shuddered　inwardly　as　he　noticed　the　creation　his　colleague　was　sporting　today…turquoise　circles　and　vermilion　zigzags　on　a　background　of　mauve　and　lemon　yellow。　Bill　Rufus　took　a　good　deal　of　ribbing　about　his　ties。　One　of　the　psychiatrists　on　staff　had　suggested　recently　that　they　represented　〃a　pus　crater　from　an　inner　seething　below　a　conservative　surface。〃　But　Rufus　had　merely　laughed　good…naturedly。　Today；　though；　he　seemed　troubled。
　〃Kent；　I　want　to　talk　to　you；〃　Rufus　said。
　〃Shall　we　go　to　my　office？〃　O'Donnell　was　curious　now。　Rufus　was　not　the　type　to　e　to　him　unless　it　were　something　important。
　〃No；　here's　as　good　as　anywhere。　Look；　Kent；　it's　about　surgical　reports　from　Pathology。〃
　They　moved　over　to　a　window　to　avoid　the　traffic　in　the　corridor；　and　O'Donnell　thought：　I　was　afraid　of　this。　To　Rufus　he　said；　〃What's　on　your　mind；　Bill？〃
　〃The　reports　are　taking　too　long。　Much　too　long。〃
　O'Donnell　was　well　aware　of　the　problem。　Like　other　surgeons；　Rufus　would　frequently　operate　on　a　patient　with　a　tumor。　When　the　tumor　was　exposed　he　would　remove　it　for　examination　by　the　hospital's　pathologist；　Dr。　Joseph　Pearson。　The　pathologist　would　then　make　two　studies　of　the　tissue。　First；　working　in　a　small　lab　adjoining　the　operating　room；　and　with　the　patient　still　under　anesthetic；　he　would　freeze　a　small　portion　of　tissue　and　examine　it　under　a　microscope。　From　this　procedure　could　e　one　of　two　verdicts…〃malignant；〃　meaning　the　presence　of　cancer　and　indicating　the　need　for　major　surgery　on　the　patient；　or　〃benign；〃　a　reprieve　which　usually　meant　that　nothing　more　need　be　done　once　the　tumor　was　out。　If　a　frozen　section　produced　a　〃malignant〃　verdict；　surgery　would　continue　at　once。　On　the　other　hand；　the　opinion　〃benign〃　from　the　pathologist　was　a　signal　for　the　surgeon　to　make　his　closure　and　send　the　patient　to　the　recovery　room。
　〃There's　no　delay　in　frozen　sections；　is　there？〃　O'Donnell　had　not　heard　of　any；　but　he　wanted　to　be　sure。
　〃No；〃　Rufus　said。　〃You'd　hear　plenty　of　howling　if　there　were。　But　it's　the　full　tissue　report　that's　taking　so　long。〃
　〃I　see。〃　O'Donnell　was　maneuvering　for　time　while　he　marshaled　his　thoughts。　His　mind　ran　over　procedures。　After　a　frozen　section　any　removed　tumor　went　to　the　pathology　lab　where　a　technician　prepared　several　slides；　more　carefully　and　working　under　better　conditions。　Later　the　pathologist　would　study　the　slides　and　give　his　final　opinion。　Sometimes　a　tumor　which　had　seemed　benign　or　doubtful　at　frozen　section　would　prove　malignant　during　this　subsequent；　more　close　examination；　and　it　was　not　considered　abnormal　for　a　pathologist　to　reverse　his　opinion　in　this　way。　If　this　happened　the　patient　would　be　returned　to　the　operating　room　and　the　necessary　surgery　done。　But　obviously　it　was　important　for　the　pathologist's　second　report　to　be　prompt。　O'Donnell　had　already　realized　that　this　was　the　nub　of　Rufus'　plaint。
　〃If　it　were　just　once；〃　Rufus　was　saying；　〃I　wouldn't　object。　I　know　Pathology's　busy；　and　I'm　not　trying　to　get　at　Joe　Pearson。　But　it　isn't　just　once；　Kent。　It's　all　the　time。〃
　〃Let's　get　specific；　Bill；〃　O'Donnell　said　crisply。　He　had　no　doubt；　though；　that　Rufus　would　have　facts　to　back　up　a　plaint　like　this。
　〃All　right。　I　had　a　patient　in　here　last　week；　Mrs。　Mason…breast　tumor。　I　removed　the　tumor；　and　at　frozen　section　Joe　Pearson　said　benign。　Afterward；　though；　on　surgical　report　he　had　it　down　as　malignant。〃　Rufus　shrugged。　〃I　won't　quarrel　with　that；　you　can't　call　them　all　the　first　time。〃
　〃But？〃　Now　that　he　knew　what　it　was　about；　O'Donnell　wanted　to　get　this　over　with。
　〃Pearson　took　eight　days　to　make　the　surgical　report。　By　the　time　I　got　it　the　patient　had　been　discharged。〃
　〃I　see。〃　This　was　bad　all　right；　O'Donnell　thought。　He　couldn't　duck　this　one。
　〃It　isn't　easy；〃　Rufus　was　saying　quietly；　〃to　call　a　woman　back　and　tell　her　you　were　wrong…that　she　does　have　cancer　after　all；　and　that　you'll　have　to　operate　again。〃
　No；　it　wasn't　easy；　O'Donnell　knew　that　too　well。　Once；　before　he　had　e　to　Three　Counties；　he　had　had　to　do　the　same　thing　himself。　He　hoped　he　never　would　again。
　〃Bill；　will　you　let　me　handle　this　my　way？〃　O'Donnell　was　glad　it　was　Rufus。　Some　of　the　other　surgeons　might　have　made　things　more　difficult。
　〃Sure。　As　long　as　something　definite　is　done。〃　Rufus　was　within　his　rights　to　be　emphatic。　〃This　isn't　just　an　isolated　case；　you　know。　It　just　happens　to　be　a　bad　one。〃
　Again　O'Donnell　knew　this　was　true。　The　trouble　was；　Rufus　was　not　aware　of　some　of　the　other　problems　which　went　with　it。
　〃I'll　talk　to　Joe　Pearson　this　afternoo