ah.thefinaldiagnosis-第5部分

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O'Donnell　had　sensed　the　older　man's　dedication。
　〃If　you　came　here；〃　Brown　had　said　to　him　near　the　end；　〃I　couldn't　promise　you　a　thing。　I'd　like　to　say　you'd　have　a　free　hand；　but　I　think　the　chances　are　you'd　have　to　fight　for　everything　you　wanted。　You'd　meet　opposition；　entrenchment；　politics；　resentment。　There　would　be　areas　in　which　I　couldn't　help　you　and　in　which　you　would　have　to　stand　alone。〃　Brown　had　paused；　then　added　quietly；　〃I　suppose　the　only　good　thing　you　could　say　about　this　situation…from　the　point　of　view　of　someone　like　yourself…is　that　it　would　be　a　challenge；　in　some　ways　the　biggest　challenge　a　man　could　take　on。〃
　That　was　the　last　word　Orden　Brown　had　said　that　night　about　the　hospital。　Afterward　they　had　talked　of　other　things：　Europe；　the　ing　elections；　the　emergence　of　Middle　East　nationalism…Brown　was　a　much…traveled　and　well…informed　man。　Later　his　host　had　driven　O'Donnell　to　the　airport　and　they　had　shaken　hands　at　the　ramp。　〃I've　enjoyed　our　meeting；〃　Orden　Brown　had　said；　and　O'Donnell　had　returned　the　pliment；　fully　meaning　it。　Then　he　had　boarded　the　airplane；　intending　to　write　off　Burlington　and　to　think　of　his　journey　there　as　a　learning　experience。
　On　the　flight　back　he　had　tried　to　read　a　magazine…there　was　an　article　about　championship　tennis　which　interested　him。　But　his　mind　wouldn't　register　the　words。　He　kept　thinking　about　Three　Counties　Hospital；　what　he　had　seen　there　and　what　was　needing　to　be　done。　Then　suddenly　for　the　first　time　in　many　years　he　began　to　examine　his　own　approach　to　medicine。　What　does　it　all　mean？　he　had　asked　himself。　What　do　I　want　for　myself？　What　kind　of　achievement　am　I　seeking？　What　have　I　got　to　give？　At　the　end　what　will　I　leave　behind？　He　had　not　married；　probably　he　never　would　now。　There　had　been　love　affairs…in　bed　and　out…but　nothing　of　permanence。　Where　is　it　leading；　he　wondered；　this　trail　from　Harvard；　Presbyterian；　Bart's　。　。　。　to　where？　Then　suddenly　he　had　known　the　answer；　known　that　it　was　Burlington　and　Three　Counties；　that　the　decision　was　firm；　irrevocable；　the　direction　set。　At　La　Guardia；　on　landing；　he　had　sent　a　wire　to　Orden　Brown。　It　read　simply；　〃I　accept。〃
　Now；　looking　down　at　the　plans　of　what　the　administrator　had　called　flippantly　〃the　New　Jerusalem；〃　O'Donnell　thought　back　to　the　three　and　a　half　years　which　lay　behind。　Orden　Brown　had　been　right　when　he　had　said　they　would　not　be　easy。　All　the　obstacles　which　the　board　chairman　had　predicted　had　proven　to　be　there。　Gradually；　though；　the　most　formidable　had　been　overe。
　After　O'Donnell's　arrival　the　former　chief　of　surgery　had　slipped　quietly　out。　O'Donnell　had　rallied　some　of　the　surgeons　already　on　staff　who　were　sympathetic　to　raising　the　hospital's　standards。　Between　them　they　had　tightened　surgical　rules　and　had　formed　a　strong　operating…room　mittee　to　enforce　them。　A　tissue　mittee；　almost　defunct；　was　reactivated…its　job；　to　ensure　that　mistakes　in　surgery；　particularly　the　unnecessary　removal　of　healthy　organs；　were　not　repeated。
　The　less　petent　surgeons　were　gently　but　firmly　urged　to　limit　themselves　to　work　within　their　capabilities。　A　few　of　the　botchers；　the　assembly…line　appendix　removers；　the　inpetents；　were　given　the　choice　of　resigning　quietly　or　being　ousted　officially。　Though　to　some　it　meant　partial　loss　of　their　livelihood；　most　chose　to　leave　quietly。　Among　the　latter　was　one　surgeon　who　had　actually　removed　a　kidney　without　ascertaining　that　the　patient　had　already　lost　one　in　previous　surgery。　The　dreadful　mistake　had　been　revealed　at　autopsy。
　Removal　of　that　surgeon　from　the　hospital's　roster　had　been　easy。　Some　of　the　others；　though；　had　proved　more　difficult。　There　had　been　rows　before　the　County　Medical　mittee；　and　two　surgeons；　formerly　on　Three　Counties'　staff；　now　had　law　suits　pending　against　the　hospital。　This；　O'Donnell　knew；　was　going　to　mean　some　bitter　controversy　in　court；　and　he　dreaded　the　publicity　which　was　certain　to　surround　it。
　But　despite　these　problems　O'Donnell　and　those　behind　him　had　had　their　way　and　the　gaps　in　staff　were　painstakingly　filled　with　new；　well…qualified　men；　some　of　them　graduates　from　his　own　alma　mater　whom　O'Donnell　had　cajoled　and　persuaded　to　set　up　practice　in　Burlington。
　Meanwhile　the　Division　of　Medicine　had　a　new　head…Dr。　Chandler；　who　had　been　on　staff　under　the　old　regime　but　had　been　frequently　outspoken　against　it。　Chandler　was　a　specialist　in　internal　medicine；　and　while　he　and　O'Donnell　sometimes　disagreed　on　hospital　policy；　and　O'Donnell　found　the　other　man　at　times　pompous；　at　least　Chandler　was　unpromising　when　it　came　to　upholding　medical　standards。
　In　O'Donnell's　three　and　a　half　years　administration　methods　had　been　changed　as　well。　A　few　months　after　his　own　arrival　O'Donnell　had　told　Orden　Brown　about　a　young　assistant　administrator；　one　of　the　best　he　had　known　in　his　hospital　experience。　The　chairman　had　flown　off　and；　two　days　later；　e　back　with　a　signed　contract。　A　month　after　that　the　old　administrator；　relieved　to　get　out　from　under　a　job　which　had　grown　beyond　him；　had　been　honorably　pensioned　and　Harry　Tomaselli　installed　in　his　place。　Now　the　whole　administrative　side　of　the　hospital　reflected　Tomaselli's　brisk　but　smooth　efficiency。
　A　year　ago　O'Donnell　had　been　elected　president　of　the　hospital's　medical　board；　which　made　him　the　senior　practitioner　at　Three　Counties。　Since　then　he；　Tomaselli；　and　Dr。　Chandler　had　successfully　broadened　the　hospital's　intern　and　resident　training　program；　and　already　applications　for　enrollment　were　growing　in　number。
　There　was　still　a　long　way　to　go。　O'Donnell　knew　that　in　some　ways　they　were　only　at　the　beginning　of　a　long　program　which　would　embrace　the　three　basic　tenets　of　medicine：　service；　training；　research。　He　himself　was　forty…two　now；　would　be　forty…three　in　a　few　months。　He　doubted　if；　in　the　active　years　remaining　to　him；　he　would　plete　in　full　what　he　had　set　out　to　do。　But　the　start　was　good；　that　much　was　reassuring；　and　he　knew　that　his　decision　on　the　airplane　three　and　a　half　years　earlier　had　been　right。
　There　were　soft　spots；　of　course；　in　the　present　setup。　There　had　to　be。　Nothing　this　big　was　achieved　easily　or　quickly。　Some　of　the　seniors　on　medical　staff　still　fought　off　changes；　and　their　influence　was　strong　among　the　older　members　of　the　board；　some　of　whom　still　remained…Eustace　Swayne；　as　obstinate　as　ever；　at　their　head。　Perhaps　this　was　a　good　thing；　O'Donnell　reflected；　and　perhaps　there　was　justice　sometimes　in　the　assertion　that　〃young　men　make　too　many　changes　too　quickly。〃　But　because　of　this　group　and　its　influence　there　were　occasions　when　planning　had　to　be　tempered　with　prudence。　O'Donnell　accepted　this　fact　himself　but　sometimes　had　difficulty　in　getting　it　across　to　the　newer　staff　members。
　It　was　just　this　situation　which　had　made　him　thoughtful　after　talking　with　Bill　Rufus。　The　pathology　department　at　Three　Counties　was　still　a　stronghold　of　the　old　regime。　Dr。　Joseph　Pearson；　who　ran　it　like　a　personal　possession；　had　been　thirty…two　years　at　the　hospital。　He　knew　most　of　the　old　board　members　intimately　and　was　a　frequent　chess　panion　of　Eustace　Swayne。　More　to　the　point；　Joe　Pearson　was　no　inpetent；　his　record　was　good。　In　his　earlier　days　he　had　been　recognized　as　an　active　researcher；　and　he　was　a　past　president　of　the　State　Pathology　Association。　The　real　problem　was　that　the　work　in　Pathology　had　bee　too　much　for　one　man　to　keep　the　reins　in　his　own　hands。　O'Donnell　suspected；　too；　that　some　of　the　pathology　department's　lab　procedures　were　in　need　of　overhauling。　But　desirable　as　changes　might　be；　this　one　was　going　to　be　tough。
　There　was　the　drive　for　funds　for　the　hospital　extension　to　be　considered。　If　there　were　trouble　between　O'Donnell　and　Joe　Pearson；　how　would　Pearson's　influence　with　Eustace　Swayne　affect　Orden　Brown's　plans　for　raising　all　the　money　by　fall　next　year？　Swayne's　own　donation　would　normally　be　a　big　one；　and　loss　of　that　alone　could　be　serious。　But　equally　serious　was　Swayne's　influence　with　other　people　in　the　town；　in　some　ways　the　old　tycoon　possessed　the　power　to　make　or　mar　their　immediate　plans。
　With　so　many　things　pending　O'Donnell　had　hoped　the　problem　of　Pathology　could　be　left　for　a　while。　Nevertheless　he　had　to　take　some　action；　and　soon；　about　Bill　Rufus'　plaint。
　He　turned　away　from　the　plans。　〃Harry；〃　he　said　to　the　administrator；　〃I　think　we　may　have　to　go　to　war　with　Joe　Pearson。〃
　
　Three
　
　In　contrast　with　the　heat　and　activity　of　the　floors　above；　in　the　white…tiled　corridor　of　the　hospital's　basement　it　was　quiet　and　cool。　Nor　was　the　quietness　disturbed　by　a　small　procession…Nurse　Penfield；　and　alongside　her　a　stretcher　gliding　silently　on　ball…bearing　casters　and　propelled　by　a　male　orderly　wearing　rubber…soled　shoes　below　his　hospital　whites。
　How　many　times　had　she　made　this　journey；　Nurse　Penfield　speculated；　glancing　down　at　the　shrouded　figure　on　the　stretcher。　Probably　fifty　times　in　the　past　eleven　years。　Perhaps　more；　because　it　was　not　something　you　kept　score　of…this　final　journey　between　the　ward　and　the　hospital's　morgue；　between　the　territory　of　the　living　and　the　dead。
　A　tradition；　this　last　walk　with　a　patient　who　had　died；　discreetly　timed　and　routed　through　back　corridors　of　the　hospital；　then　downward　in　the　freight　elevator；　so　that　the　living　should　take　no　darkness　or　depression　from　death　so　close　at　hand。　It　was　the　last　service　from　nurse　to　her　charge；　an　acknowledgment　that；　though　medicine　had　failed；　it　would　not　dismiss　the　patient　summarily；　the　motions　of　care；　service；　healing；　would　continue　for　at　least　a　token　time　beyond　the　end。
　The　white　corridor　forked　two　ways　here。　From　a　passage　to　the　right　came　the　hum　of　machinery。　Down　there　were　the　hospital's　mechanical　departments…heating　plant；　hot…water　systems；　electrical　shops；　emergency　generators。　Pointing　the　other　way；　a　single　sign　read：　〃Pathology　Department。　Morgue。〃
　As　Weidman；　the　male　orderly；　swung　the　stretcher　left；　a　janitor…either　on　work　break　or　stolen　time…lowered　the　Coke　he　had　been　drinking　and　moved　aside。　He　wiped　his　lips　on　the　back　of　his　hand；　then　gestured　to　the　shroud。　〃