ah.thefinaldiagnosis-第59部分

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f　in　the　second　row　of　chairs。　Immediately　in　front；　looking　over　a　page　of　handwritten　notes；　was　Dr。　Harvey　Chandler；　chief　of　medicine。　There　were　several　members　of　the　house　staff；　and　among　them　O'Donnell　noticed　McNeil；　the　pathology　resident。　Alongside　the　administrator；　attending　the　meeting　by　special　request；　was　Mrs。　Straughan；　the　chief　dietitian。　Nearby　was　Ernie　Reubens；　who　appeared　to　be　quizzically　appraising　the　dietitian's　quivering；　voluptuous　breasts。　Absent　from　the　meeting　was　the　familiar　figure　of　Charlie　Dornberger；　who　had　already　made　known　his　intention　to　retire　immediately。
　Looking　toward　the　door；　O'Donnell　saw　Lucy　Grainger　e　in；　she　caught　his　eye　and　smiled　slightly。　Seeing　Lucy　was　a　reminder　of　the　personal　decision　about　his　own　future　which；　when　all　this　was　settled　and　done；　he　had　still　to　face。　Then　suddenly　he　realized　that　since　this　morning　he　had　not　once　thought　of　Denise。　The　hospital　activity　had　driven　all　awareness　of　her　from　his　mind；　and　he　knew　that　for　the　next　day　or　two；　anyway；　there　would　be　other　occasions　when　the　same　thing　would　be　true。　O'Donnell　wondered　how　Denise　herself　would　react　about　taking　second　place　to　medical　affairs。　Would　she　be　understanding？　As　understanding；　say；　as　Lucy　would　be？　Fleeting　as　the　thought　was；　it　made　him　unfortable；　as　if　by　the　mental　parison　he　had　been　disloyal。　For　the　moment　he　preferred　to　think　of　present　things。　Now；　he　decided；　it　was　time　the　meeting　began。
　O'Donnell　rapped　for　silence；　then　waited　until　the　talk　stilled　and　those　who　had　been　standing　had　slipped　into　their　seats。　He　began　quietly。　〃Ladies　and　gentlemen；　I　think　all　of　us　are　aware　that　epidemics　in　hospitals　are　not　unique　and；　in　fact；　are　a　good　deal　more　frequent　than　most　members　of　the　public　realize。　In　a　way；　I　suppose；　one　might　say　that　epidemics　are　a　hazard　of　our　existence。　When　one　considers　how　many　diseases　we　harbor　inside　these　walls；　it's　surprising；　really；　there　are　not　more。〃　All　eyes　in　the　room　were　upon　him。　He　paused　for　a　moment；　then　continued。　〃I　have　no　wish　to　minimize　what　has　happened；　but　I　want　us　to　keep　a　sense　of　proportion。　Dr。　Chandler；　perhaps　you'd　be　kind　enough　to　lead　off。〃
　As　O'Donnell　sat　down　the　chief　of　medicine　rose　to　his　feet。
　〃To　begin　with；　let's　summarize。〃　Harvey　Chandler　was　holding　his　page　of　notes；　and　his　glance　moved　theatrically　around　the　room。　Harvey's　enjoying　this；　O'Donnell　thought；　but　then　he　always　does　enjoy　attention。　The　medical　chieftain　went　on；　〃The　picture　so　far　is　that　we　have　two　definite　cases　of　typhoid　and　four　suspected。　All　of　the　cases　are　hospital　employees；　and　we　may　count　ourselves　fortunate　that　no　patients　are　affected…yet。　Because　of　the　number　of　cases　I'm　sure　it's　evident　to　you；　as　it　is　to　me；　that　we　have　a　typhoid　carrier　somewhere　in　the　hospital。　Now；　I　may　say　I'm　as　shocked　as　everyone　else　must　have　been　to　learn　that　examination　of　food　handlers　here　hasn't　been　done　for　。　。　。〃
　At　the　mention　of　food　handlers　O'Donnell　had　jolted　to　attention。　Now　he　cut　in；　quietly；　as　politely　as　he　could。
　〃Excuse　me；　Doctor。〃
　〃Yes？〃　Chandler's　tone　made　it　plain　the　interruption　was　not　appreciated。
　Gently　O'Donnell　said；　〃We're　going　to　be　dealing　with　that　phase　very　shortly；　Harvey。　I　wonder　if；　for　the　moment；　you　would　outline　the　clinical　aspects。〃
　He　could　sense　the　other　man's　resentment。　Harvey　Chandler；　who　was　virtually　equal　to　O'Donnell　in　the　hospital　hierarchy；　did　not　like　this　at　all。　Moreover；　Dr。　Chandler　enjoyed　talking　at　length；　he　had　a　reputation　for　never　employing　one　word　where　it　was　possible　to　use　two　or　three。　Now　he　grumbled；　〃Well；　if　you　wish；　but　。　。　。〃
　Suavely；　but　firmly；　O'Donnell　put　in；　〃Thank　you。〃
　Chandler　shot　him　a　glance　which　said：　We'll　discuss　this　later　in　private。　Then；　after　a　barely　perceptible　pause；　he　went　on；　〃For　the　benefit　of　those　of　you　who　are　not　familiar　with　typhoid…and　I　realize　there　will　be　some；　because　there　isn't　too　much　of　it　around　nowadays…I'll　run　over　the　principal　early…stage　symptoms。　Generally　speaking；　there's　a　rising　fever；　chills；　and　a　slow　pulse。　There's　also　a　low　blood　count　and；　naturally；　the　characteristic　rose　spots。　In　addition　to　all　that　a　patient　will　probably　plain　of　a　dull　headache；　no　appetite；　and　general　aching。　Some　patients　may　say　they're　drowsy　in　the　daytime　and　that　they're　restless　at　night。　One　thing　to　look　out　for　also　is　bronchitis；　that's　quite　mon　with　typhoid；　and　you　may　encounter　nosebleed　too。　And；　of　course；　a　tender；　swollen　spleen。〃
　The　chief　of　medicine　sat　down。　O'Donnell　asked；　〃Any　questions？〃
　Lucy　Grainger　asked；　〃I　take　it　that　typhoid　shots　are　being　arranged。〃
　〃Yes；〃　Chandler　said；　〃for　all　employees　and　staff；　also　patients　who　are　well　enough　to　have　them。〃
　〃What　about　kitchen　arrangements？〃　The　question　was　from　Bill　Rufus。
　O'Donnell　said；　〃If　you　don't　mind；　we'll　e　to　that　shortly。　At　this　point　is　there　anything　more　medically？〃　He　looked　around；　there　was　a　shaking　of　heads；　〃Very　well；　then。　We'll　hear　from　Pathology。〃　He　announced　quietly；　〃Dr。　Pearson。〃
　Until　this　moment　there　had　been　background　noises　in　the　room…fidgeting；　the　movement　of　chairs；　murmurs　of　conversation　aside　from　the　main　discussion。　But　now　there　was　a　hush　as　eyes　turned　curiously　to　where；　halfway　down　the　long　table；　Joe　Pearson　sat。　Since　entering　he　had　not　spoken　but　had　remained　quite　still；　his　eyes　fixed　directly　ahead。　For　once　he　had　no　cigar　lighted；　and　the　effect　was　like　the　absence　of　a　familiar　trade…mark。　Even　now；　as　his　name　was　called；　he　made　no　move。
　O'Donnell　waited。　He　was　about　to　repeat　the　announcement　when　Pearson　stirred。　As　his　chair　went　back　the　old　pathologist　rose　to　his　feet。
　Slowly　his　eyes　swept　the　board　room。　They　went　the　length　of　the　table；　then　returned　to　its　head。　Looking　directly　at　O'Donnell；　Pearson　said；　〃This　epidemic　should　not　have　happened。　Nor　would　it；　if　Pathology　had　been　alert　to　a　breakdown　in　hygiene　precautions。　It　is　the　responsibility　of　my　department；　and　therefore　my　own　responsibility；　that　this　neglect　occurred。〃
　Again　a　silence。　It　was　as　if　history　had　been　made。　In　this　room　so　many　times　Joe　Pearson　had　charged　others　with　error　and　misjudgment。　Now　he　stood　himself…accuser　and　accused。
　O'Donnell　wondered　if　he　should　interrupt。　He　decided　not。　Again　Pearson　looked　around　him。　Then　he　said　slowly；　〃Having　allocated　some　of　the　blame；　we　must　now　prevent　the　outbreak　going　further。〃　He　glanced　across　the　table　at　Harry　Tomaselli。　〃The　administrator；　the　heads　of　departments；　and　I　have　formulated　certain　procedures　to　be　carried　out　at　once。　I　will　tell　you　what　they　are。〃
　Now　Pearson　paused；　and　when　he　resumed　there　was　a　stronger　note　to　his　voice。　It　was　almost；　O'Donnell　thought；　as　if　in　this　single　moment　the　old　man　were　throwing　off　some　of　his　years；　as　if　providing　a　glimpse　of　what　he　had　been　like　long　ago　as　a　younger　practitioner…intense；　earnest；　and　petent。　The　old　sardonic　humor；　the　air　of　borderline　contempt；　which　all　of　them　in　this　room　had　e　to　know　so　well；　were　gone。　In　their　place　were　authority　and　know…how　and　the　forthright　frankness　of　one　who　accepts　without　question　the　fact　that　he　is　speaking　with　equals。
　〃The　immediate　problem；〃　Pearson　said；　〃is　to　locate　the　source　of　infection。　Because　of　the　failure　to　check　food　handlers　properly　over　the　past　six　months　it　is　logical　that　we　should　suspect　food　as　a　means　of　contamination　and　should　begin　our　search　there。　For　this　reason　there　must　be　a　medical　inspection　of　all　food　handlers　before　the　next　hospital　meal　is　served。〃　From　his　frayed　woolen　vest　he　extracted　a　watch　and　placed　it　on　the　table。　〃The　time　is　now　2：15　P。M。　That　gives　us　two　and　three…quarter　hours。　In　that　time　every　employee　who　has　any　part　in　the　preparation　and　serving　of　hospital　food　is　to　be　given　a　thorough　physical　check。　Facilities　are　being　set　up　now　in　the　outpatient　clinics。　I　understand　that　all　the　internists　and　house　staff　were　notified　before　this　meeting。〃　He　glanced　around　and　there　was　a　nodding　of　heads。　〃Very　well。　As　soon　as　we　are　finished　here　Dr。　Coleman〃…Pearson　glanced　down　at　David　Coleman　beside　him…〃will　give　you　your　assignment　to　a　specific　room。〃
　Gesturing　toward　the　chief　dietitian；　Pearson　said；　〃Mrs。　Straughan　is　arranging　to　assemble　all　the　people　concerned；　and　they　will　be　reporting　to　Outpatients　in　batches　of　twelve。　That　means　ninety…five　people　to　be　examined　within　the　time　we　have。
　〃When　you　make　these　examinations；　by　the　way；　remember　that　the　typhoid　carrier…and　we　are　assuming　there　is　a　carrier…probably　has　none　of　the　symptoms　Dr。　Chandler　described。　What　you　should　look　for　particularly　is　any　lack　of　personal　cleanliness。　And　anyone　you　have　doubts　about　should　be　suspended　from　duty　for　the　time　being。〃
　Pearson　stopped　as　if　thinking。　So　far　he　had　consulted　no　notes。　Now　he　went　on　again。　〃Of　course；　we　are　all　aware　that　physical　checkups　will　not　give　us　the　whole　story。　We　may　be　lucky　and　find　the　individual　we're　looking　for　that　way；　but　the　chances　are　we　won't。　Most　likely　the　major　work　will　e　in　the　labs　as　soon　as　the　medicals　are　pleted。　All　the　people　you　examine　are　to　be　told　that　stool　cultures　are　required　and　stool　samples　must　be　in　the　hospital　by　tomorrow　morning。〃　There　was　the　ghost　of　a　smile。　〃Constipation　will　not　be　taken　as　an　excuse；　and　if　anyone　can　e　through　with　a　sample　today　we　will；　of　course；　accept　it　gratefully。
　〃The　labs　are　being　set　up　now　to　cope　with　all　the　cultures　we　shall　be　doing。　Of　course；　it　will　take　us　a　few　days…two　or　three　at　least…to　handle　all　those　stool　samples。〃
　A　voice…O'Donnell　thought　it　was　Gil　Bartlett's…said　quietly；　〃Ninety…five　people！　That's　a　lot　of　shit。〃　A　ripple　of　laughter　ran　around　the　table。
　Pearson　turned。　〃Yes；〃　he　said；　〃it　is　a　lot。　But　we　shall　do　our　best。〃
　With　that　he　sat　down。
　Lucy　signaled　with　her　hand；　and　O'Donnell　nodded　for　her　to　speak。　She　asked；　〃If　the　source　of　infection　is　not　found　immediately；　will　we　continue　to　use　the　hospital　kitchens…to　serve　food　here？〃
　〃For　the　moment…yes；〃　O'Donn