ah.thefinaldiagnosis-第2部分

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…it　was　one　of　the　lesser　known　effects　which　sometimes　followed　removal　of　tonsils　from　an　adult。　Like　most　surgeons；　O'Donnell　was　aware　that　even　with　extreme　operative　care　a　tiny　portion　of　tonsil　sometimes　escaped　the　surgeon's　forceps　and　was　drawn　into　the　lung　where　it　formed　an　abscess。　Now　he　recalled　a　group　of　pictures　he　had　of　the　trachea　and　lung；　portraying　this　condition；　they　had　been　taken　during　an　autopsy。　He　told　Bartlett；　〃I　think　so。　I'll　look　them　out　tonight。〃
　Lucy　Grainger　said；　〃If　you　don't　have　one　of　the　trachea；　give　him　the　rectum。　He'll　never　know　the　difference。〃　A　laugh　ran　round　the　surgeons'　room。
　O'Donnell　smiled　too。　He　and　Lucy　were　old　friends；　in　fact；　he　sometimes　wondered　if；　given　more　time　and　opportunity；　they　might　not　bee　something　more。　He　liked　her　for　many　things；　not　least　the　way　she　could　hold　her　own　in　what　was　sometimes　thought　of　as　a　man's　world。　At　the　same　time；　though；　she　never　lost　her　essential　femininity。　The　scrub　suit　she　was　wearing　now　made　her　shapeless；　almost　anonymous；　like　the　rest　of　them。　But　he　knew　that　beneath　was　a　trim；　slim　figure；　usually　dressed　conservatively　but　in　fashion。
　His　thoughts　were　interrupted　by　a　nurse　who　had　knocked；　then　entered　discreetly。
　〃Dr。　O'Donnell；　your　patient's　family　are　outside。〃
　〃Tell　them　I'll　be　right　out。〃　He　moved　into　the　locker　room　and　began　to　slip　out　of　his　scrub　suit。　With　only　one　operation　scheduled　for　the　day　he　was　through　with　surgery　now。　When　he　had　reassured　the　family　outside…he　had　just　operated　successfully　for　removal　of　gallstones…his　next　call　would　be　in　the　administrator's　office。
　
　One　floor　above　surgical；　in　private　patient's　room　48；　George　Andrew　Dunton　had　lost　the　capacity　to　be　affected　by　heat　or　coolness　and　was　fifteen　seconds　away　from　death。　As　Dr。　MacMahon　held　his　patient's　wrist；　waiting　for　the　pulse　to　stop；　Nurse　Penfield　turned　the　window　fan　to　〃high〃　because　the　presence　of　the　family　had　made　the　room　unfortably　stuffy。　This　was　a　good　family；　she　reflected…the　wife；　grown　son；　and　younger　daughter。　The　wife　was　crying　softly；　the　daughter　silent　but　with　tears　coursing　down　her　cheeks。　The　son　had　turned　away　but　his　shoulders　were　shaking。　When　I　die；　Elaine　Penfield　thought；　I　hope　someone　has　tears　for　me；　it's　the　best　obituary　there　is。
　Now　Dr。　MacMahon　lowered　the　wrist　and　looked　across　at　the　others。　No　words　were　needed；　and　methodically　Nurse　Penfield　noted　the　time　of　death　as　10：52　A。M。
　
　Along　the　corridor　in　the　other　wards　and　private　patients'　rooms　this　was　one　of　the　quieter　times　of　day。　Morning　medications　had　been　given；　rounds　were　over；　and　there　was　a　lull　until　lunch　time　would　bring　the　cycle　of　activity　to　a　peak　once　more。　Some　of　the　nurses　had　slipped　down　to　the　cafeteria　for　coffee；　others　who　remained　were　writing　their　case　notes。　〃plains　of　continued　abdominal　pains；〃　Nurse　Wilding　had　written　on　a　woman　patient's　chart　and　was　about　to　add　another　line　when　she　paused。
　For　the　second　time　that　morning　Wilding；　gray…haired　and　at　fifty…six　one　of　the　older　nurses　on　staff；　reached　into　her　uniform　and　took　out　the　letter　she　had　read　twice　already　since　it　had　been　delivered　to　her　desk　along　with　the　patients'　mail。　A　snapshot　of　a　young　naval　lieutenant；　j。g。；　with　a　pretty　girl　on　his　arm；　fell　out　as　she　opened　it；　and　for　a　moment　she　gazed　down　at　the　picture　before　reading　the　letter　again。　〃Dear　Mother；〃　it　started。　〃This　will　e　as　a　surprise　to　you；　but　I　have　met　a　girl　here　in　San　Francisco　and　we　were　married　yesterday。　I　know　in　some　ways　this　will　be　a　big　disappointment　since　you　always　said　you　wanted　to　be　at　my　wedding；　but　I'm　sure　you'll　understand　when　I　tell　you　。　。　。〃
　Nurse　Wilding　let　her　eyes　wander　from　the　letter　and　thought　of　the　boy　she　remembered　and　of　whom　she　had　seen　so　little。　After　the　divorce　she　had　taken　care　of　Adam　until　college；　then　there　had　been　Annapolis；　a　few　weekends　and　brief　holidays；　after　that　the　Navy；　and　now　he　was　a　man；　belonging　to　someone　else。　Later　on　today　she　must　send　them　a　telegram　of　love　and　good　wishes。　Years　ago　she　had　always　said　that　as　soon　as　Adam　was　on　his　own　and　self…supporting　she　would　quit　nursing；　but　she　never　had；　and　now　retirement　would　e　soon　enough　without　hastening　it。　She　put　the　letter　and　photograph　back　in　her　uniform　pocket　and　reached　for　the　pen　she　had　laid　down。　Then　in　careful　script　she　added　to　the　chart：　〃Slight　vomiting　with　diarrhea。　Dr。　Reubens　notified。〃
　
　In　Obstetrics；　on　the　fourth　floor；　there　was　never　any　time　of　day　which　could　be　predictably　quiet。　Babies；　Dr。　Charles　Dornberger　thought；　as　he　scrubbed　alongside　two　other　obstetricians；　had　an　annoying　habit　of　ing　in　batches。　There　would　be　hours；　even　days；　when　things　would　be　orderly；　quiet；　and　babies　could　be　delivered　in　tidy　succession。　Then　suddenly　all　hell　would　break　loose；　with　half　a　dozen　waiting　to　be　born　at　once。　This　was　one　of　those　moments。
　His　own　patient；　a　buxom；　perpetually　cheerful　Negress；　was　about　to　deliver　her　tenth　child。　Because　she　had　arrived　at　the　hospital　late；　and　already　advanced　in　labor；　she　had　been　brought　up　on　a　stretcher　from　Emergency。　While　he　was　still　scrubbing　Dornberger　could　hear　part　of　her　duologue　outside　with　the　intern　who　had　escorted　her　to　Obstetrics。
　Apparently；　as　was　normal　for　an　urgent　case；　the　intern　had　cleared　the　passenger　elevator　down　below　on　the　main　floor。
　〃All　them　nice　peopl'　movin'　out　of　th'　elevator　fo'　me；〃　she　was　saying。　〃Why；　ah　nevah　felt　so　important　befo'　in　all　mah　life。〃　At　this　point　Dornberger　heard　the　intern　tell　the　patient　to　relax　and　the　answer　came　back；　〃Relax；　sonny？　Ah　am　relaxed。　Ah　always　relaxes　when　ah　has　a　baby。　That　th'　only　time　there's　no　dishes；　no　washin'；　no　cookin'。　Why；　ah　look　forward　to　in'　in　here。　This　just　a　holiday　fo'　me。〃　She　paused　as　pain　gripped　her。　Then；　partly　through　clenched　teeth；　she　muttered；　〃Nine　children　ah've　got；　and　this'll　be　the　tenth。　Th'　oldest　one's　as　big　as　you；　sonny。　Now　you　be　lookin'　fo'　me　a　year　from　now。　Ah　tell　you；　ah'll　be　back。〃　Dornberger　heard　her　chuckling　as　her　voice　faded；　the　delivery　room　nurses　taking　over；　while　the　intern　went　back　to　his　post　in　Emergency。
　Now　Dornberger；　scrubbed；　gowned；　sterile；　and　sweating　from　the　heat；　followed　his　patient　into　the　delivery　room。
　
　In　the　hospital　kitchens；　where　the　heat　was　less　of　a　problem　because　people　who　worked　there　were　used　to　it；　Hilda　Straughan；　the　chief　dietitian；　nibbled　a　piece　of　raisin　pie　and　nodded　approvingly　at　the　senior　pastry　cook。　She　suspected　that　the　calories；　along　with　others；　would　be　reflected　on　her　bathroom　scales　a　week　from　now　but　quelled　her　conscience　by　telling　herself　it　was　a　dietitian's　duty　to　sample　as　much　as　possible　of　the　hospital　fare。　Besides；　it　was　somewhat　late　now　for　Mrs。　Straughan　to　be　fretting　on　the　subject　of　calories　and　weight。　The　accumulated　result　of　many　earlier　samplings　caused　her　nowadays　to　turn　the　scales　around　two　hundred　pounds；　a　good　deal　of　which　was　in　her　magnificent　breasts…twin　Gibraltars；　famed　through　the　hospital；　and　which　made　her　progress　not　unlike　the　majesty　of　an　aircraft　carrier　preceded　by　an　escort　of　twin　battleships。
　But；　as　well　as　food；　Mrs。　Straughan　was　in　love　with　her　job。　Glancing　around　her　with　satisfaction；　she　took　in　her　empire…the　shining　steel　ovens　and　serving　tables；　the　gleaming　utensils；　the　sparkling　white　aprons　of　the　cooks　and　their　assistants。　Her　heart　warmed　at　the　sight　of　all　of　it。
　This　was　a　busy　time　in　the　kitchens…lunch　was　the　heaviest　meal　of　the　day　because；　as　well　as　patients；　there　was　the　full　hospital　staff　to　be　fed　in　the　cafeteria。　In　twenty　minutes　or　so　the　diet　trays　would　be　going　up　to　the　wards；　and　for　two　hours　afterward　the　service　of　food　would　continue。　Then；　while　the　kitchen　help　cleared　and　stacked　dishes；　the　cooks　would　begin　preparing　the　evening　meal。
　The　thought　of　dishes　caused　Mrs。　Straughan　to　frown　thoughtfully；　and　she　propelled　herself　into　the　back　section　of　the　kitchen　where　the　two　big　automatic　dishwashers　were　installed。　This　was　a　part　of　her　domain　less　gleaming　and　modern　than　the　other　section；　and　the　chief　dietitian　reflected；　not　for　the　first　time；　that　she　would　be　happy　when　the　equipment　here　was　modernized；　as　the　rest　of　the　kitchens　had　been。　It　was　understandable；　though；　that　everything　could　not　be　done　at　once；　and　she　had　to　admit　she　had　browbeaten　the　administration　into　a　lot　of　expensive　new　equipment　in　the　two　years　she　had　held　her　job　at　Three　Counties。　All　the　same；　she　decided　as　she　moved　on　to　check　the　steam　tables　in　the　cafeteria；　she　would　have　another　talk　with　the　administrator　about　those　dishwashers　soon。
　
　The　chief　dietitian　was　not　the　only　one　in　the　hospital　whose　thoughts　were　on　food。　In　Radiology；　on　the　second　floor；　an　outpatient…Mr。　James　Bladwick；　vice…president　of　sales　for　one　of　Burlington's　big…three　automobile　dealerships…was；　in　his　own　words；　〃as　hungry　as　hell。〃
　There　was　reason　for　this。　On　his　physician's　instructions　Jim　Bladwick　had　fasted　since　midnight；　and　now　he　was　in　number　one　X…ray　room；　ready　for　a　gastric　series。　The　X…rays　would　confirm　or　deny　the　suspicion　that　flourishing　in　the　Bladwick　interior　was　a　duodenal　ulcer。　Jim　Bladwick　hoped　the　suspicion　was　unfounded；　in　fact；　he　hoped　desperately　that　neither　an　ulcer　nor　anything　else　would　conspire　to　slow　him　down　now　that　his　drive　and　sacrifice　of　the　past　three　years；　his　willingness　to　work　harder　and　longer　than　anyone　else　on　sales　staff；　were　at　last　paying　off。
　Sure　he　worried；　who　wouldn't　when　they　had　a　dealer　sales　quota　to　meet　every　month。　But　it　just　couldn't　be　an　ulcer；　it　had　to　be　something　else…something　trivial　that　could　be　fixed　up　quickly。　He　had　been　vice…president　of　sales　only　a　matter　of　six　weeks；　but　despite　the　high…sounding　title　he　knew　better　than　anyone　that　retention　of　it　depended　on　a　continued　ability　to　produce。　And　to　produce　you　had　to　be　on　the　ball…tough；　available；　fit。　No　medical　certificate　would　pensate　for　a　declining　sales　graph。
　Jim　Bladwick　ha