Artropods and Human Disease 23 page

O’Donnell handled the introductions. As Pearson and Dr. Norbert Ford shook hands the health officer asked, “Have you come up with anything?”

“Not yet.” Pearson gestured around the lab. “As you can see, we’re still working.”

O’Donnell said, “Joe, I thought you should know. Dr. Ford has ordered the closing of our kitchens.”

“Today?” There was disbelief in Pearson’s voice.

The health officer nodded gravely. “I’m afraid so.”

“But you can’t do that! It’s ridiculous!” This was the old aggressive Pearson, his voice belligerent, eyes flashing behind the mask of tiredness. He stormed on, “Why, man alive, we’ll be working all night, and every subculture will be finished by midday tomorrow. If there’s a carrier, all the chances are we’ll have learned who it is.”

“I’m sorry.” The health officer shook his head. “We can’t take that chance.”

“But closing the kitchens means closing the hospital.” Pearson fumed. “Surely you can wait until morning—at least until then.”

“I’m afraid not.” Dr. Ford was polite but firm. “In any case, the decision is not entirely mine. The city simply cannot afford the possibility of a wider epidemic. At the moment your outbreak is within these walls, but at any point it could spread outside. It’s that we’re thinking of.”

Harry Tomaselli put in, “We’re serving the evening meal, Joe, and that will be the last. We’re sending home all the patients we can and transferring most of the others.”

There was silence. Pearson’s face muscles were working. His deep-set, red-rimmed eyes seemed close to tears. His voice near a whisper, he said, “I never thought I’d see the day . . .”

As the group turned away O’Donnell added quietly, “To tell the truth, Joe, neither did I.”

They had reached the door when John Alexander announced, “I have it.”

As a unit the group turned. Pearson asked sharply, “You have what?”

“A definite typhoid.” Alexander pointed to the row of sugar tubes on which he had been working.

“Let me see!” Almost at a run, Pearson crossed the lab. The others had turned back into the room.

Pearson looked at the row of tubes. Nervously his tongue touched his lips. If Alexander were right, this was the moment they had worked for. “Call off the list,” he said.

John Alexander picked up a textbook open at a double page. It was a tabulated chart of biochemical reactions of bacteria in sugar tubes. Putting a finger on the column headed “Salmonella typhi,” he prepared to read down.

Pearson picked up the first of the ten tubes. He called out, “Glucose.”

Checking the list, Alexander answered, “Acid formation, but no gas.”

Pearson nodded. He replaced the tube and selected a second. “Lactose.”

“No acid, no gas,” Alexander read.

“Right.” A pause. “Dulcitol.”

Again Alexander read, “No acid, no gas.”

“Sucrose.”

“No acid, no gas.” Once more the correct reaction for typhoid bacilli. The tension in the room was mounting.

Pearson took another tube. “Mannitol.”

“Acid formation, but no gas.”

“Correct.” Another. “Maltose.”

“Acid, but no gas.”

Pearson nodded. Six down, four to go. Now he said, “Xylose.”

Once more Alexander read, “Acid, but no gas.”

Seven.

“Arabinose.”

John Alexander said, “Either acid but no gas or no reaction at all.”

Pearson announced, “No reaction.”

Eight. Two more.

“Rhamnose?”

“No reaction.”

Pearson looked at the tube. He said softly, “No reaction.”

One to go.

From the last tube Pearson read, “Indole production.”

“Negative,” Alexander said, and replaced the book.

Pearson turned to the others. He said, “There’s no question. This is the typhoid carrier.”

“Who is it?” The administrator was first to ask.

Pearson turned over a petri dish. He read off, Number seventy-two.”

David Coleman had already reached for a ledger. There was a list with entries in his own handwriting. He announced, “Charlotte Burgess.”

“I know her!” Mrs. Straughan said quickly. “She works on the serving counter.”

As if by instinct, all eyes swung to the clock. It was seven minutes after five.

Mrs. Straughan said urgently, “The dinner! They’re beginning to serve the evening meal!”

“Let’s get to the dining room fast!” As he spoke, Harry Tomaselli was already at the door.

On the hospital’s second floor the nursing supervisor entered Vivian’s room with a harassed air, glancing at the door number as she came in.

“Oh yes, you’re Miss Loburton.” She consulted a clip board and made a penciled notation. “You’ll be transferred to the West Burlington Clinic.”

Vivian asked, “When will it be, please?” She had already learned, earlier in the afternoon, of the impending move and the reason for it.

“The ambulances are very busy now,” the supervisor said. “I expect it will be several hours—probably about nine o’clock tonight. Your own nurse will be in to help you with your things in plenty of time.”

“Thank you,” Vivian said.

Her mind back with the clip board, the supervisor nodded and went out.

This was the time, Vivian decided, to call Mike. Their five days of separation were not due to end until tomorrow, but neither of them had contemplated anything like this. Besides, she had already come to regret the whole idea of having a period of time apart; she saw it now as a stupid and unnecessary notion which she wished had never occurred to her.

Her hand went out for the bedside telephone, and this time there was no hesitation. When the operator answered Vivian said, “Dr. Michael Seddons, please.”

“One moment.”

There was a wait of several minutes, then the operator came on the line. “Dr. Seddons is away from the hospital with one of the transfer ambulances. Can someone else help?”

“No, thank you,” Vivian said. “I’d like to leave a message though.”

The operator asked, “Is this a medical matter?”

She hesitated. “Well, not really.”

“We can only take urgent medical messages now. Will you make your call later, please.” There was a click as the line went dead. Slowly Vivian replaced the telephone.

Outside in the hallway she could hear commotion and raised voices. She sensed an undercurrent of excitement; there was a sharp order given, then a clatter as an object fell to the floor, and someone laughed. It all sounded commonplace, and yet at this moment her mind clamored to share in it, to be a part of whatever was going on. Then her eyes fell to the bedclothes, to where the coverlet went flat at the point where her left leg ended. Suddenly, for the first time, Vivian felt fearfully and desperately alone.

“Oh, Mike!” she whispered. “Mike darling—wherever you are, please come to me soon!”

Nurse Penfield was about to enter the cafeteria when she saw the group bearing down toward her. She recognized the administrator and the chief of surgery. Behind them, her big breasts bouncing with the effort of keeping up, was Mrs. Straughan, the chief dietitian.

Passing through the cafeteria entrance, Harry Tomaselli slowed his pace. He told Mrs. Straughan, “I want this done quickly and quietly.”

The dietitian nodded, and together they entered the kitchens through a service doorway.

O’Donnell beckoned Nurse Penfield. “Come with me, please. I’d like you to help us.”

What happened next was done with swiftness and precision. One moment a middle-aged woman was serving at the cafeteria counter. The next, Mrs. Straughan had taken her arm and had steered her into the diet office at the rear. O’Donnell told the bewildered woman, “One moment, please,” and motioned Nurse Penfield to remain with her.

“Take the food she was serving and incinerate it,” he instructed Mrs. Straughan. “Get back any you can that’s already been served. Remove any dishes she may have touched and boil them.”

The chief dietitian went out to the serving counter. In a few minutes O’Donnell’s instructions had been followed and the cafeteria line was moving once more. Only a few individuals closest to the scene were aware of what had occurred.

In the office at the rear O’Donnell told the woman kitchen worker, “Mrs. Burgess, I must ask you to regard yourself as a patient in the hospital.” He added kindly, “Try not to be alarmed; everything will be explained to you.”

To Nurse Penfield he said, “Take this patient to the isolation ward. She’s to have contact with no one. I’ll call Dr. Chandler and he’ll issue instructions.”

Gently Elaine Penfield led the frightened woman away.

Afterward Mrs. Straughan asked curiously, “What happens to her now, Dr. O.?”

“She’ll be well looked after,” O’Donnell said. “She’ll stay in isolation, and the internists will study her for a while. Sometimes, you know, a typhoid carrier may have an infected gall bladder, and if that’s the case she’ll probably be operated on.” He added, “There’ll be follow-up checks, of course, on all the other people who have been affected. Harvey Chandler will see to that.”

On the diet-office telephone Harry Tomaselli was telling an assistant, “That’s what I said: cancel everything—transfers, discharges other than normal, catered meals, the whole works. And when you’ve done that you can call the admitting office.” The administrator grinned across the desk at O’Donnell. “Tell them that Three Counties Hospital is back in business.”

Tomaselli hung up the phone and accepted the cup of coffee which the chief dietitian had poured him from her private percolator.

“By the way, Mrs. Straughan,” he said, “there hasn’t been time to tell you before, but you’re getting your new dishwashers. The board has approved the expenditure and the contract has been let. I expect the work will begin next week.”

The dietitian nodded; obviously the information was something she had anticipated. Now her mind had moved ahead to other things. “There’s something else I’d like to show you while you’re here, Mr. T. I need my refrigerator enlarged.” She eyed the administrator sternly. “I hope this time it won’t require an epidemic to prove my point.”

The administrator sighed and rose to his feet. He asked O’Donnell, “Do you have any more problems today?”

“Not today,” O’Donnell answered. “Tomorrow, though, there’s one item of business I intend to deal with personally.”

He was thinking of Eustace Swayne.

Twenty-four

David Coleman had not slept well. Through the night his thoughts had kept returning to Three Counties Hospital, its pathology department, and Dr. Joseph Pearson.

None of the events of the past few days had changed in the slightest degree Dr. Pearson’s culpability in the death of the Alexander baby. Whatever his responsibility a week ago, it still remained the same. Nor had Coleman revised his own opinion that pathology at Three Counties was an administrative mess, bogged down by outdated concepts and handicapped by antiquated methods and equipment which should have been shaken loose long since.

And yet, uneasily over the past four days, David Coleman had found his feelings toward Pearson changing and moderating. Why? A week ago he had looked on Pearson as a near-senile incompetent, clinging to power beyond his time. Since then nothing tangible had happened to change that conviction. What reason was there, then, for his own uneasiness about it now?

It was true, of course, that the old man had handled the typhoid outbreak and its aftermath with a decision and competence that was perhaps a good deal better than Coleman could have managed himself. But was that so surprising? After all, experience counted for something; and the situation being what it was, it was understandable that Pearson should want to rise to it well.

But it was his own total view of Pearson that was less clear-cut, less firm. A week ago he had classified the old pathologist—whatever his achievements of the past—among the intellectual “havenots.” Now David Coleman was no longer sure. He suspected that in time to come he would be unsure about a good deal more.

The sleeplessness had brought him early to the hospital, and it was a little after 8 a.m. when he entered the pathology office. Roger McNeil, the resident, was at Pearson’s desk.

“Good morning,” McNeil said. “You’re the first. I guess the others are sleeping in.”

David Coleman asked, “Did we get very far behind—with other work?”

“It isn’t too bad,” McNeil said. “There’s quite a bit of non-urgent stuff, but I kept pace with all the rest.” He added, “Seddons helped a lot. I’ve told him he should stick with pathology instead of going back to surgery.”

Another thought had been troubling Coleman. He asked the resident, “That student nurse—the one who had the amputation. Has the leg been dissected yet?” He was remembering that this was the diagnosis on which Pearson and himself had differed.

“No.” McNeil selected a case file from several on the desk. “Vivian Loburton,” he read out, “that’s the girl’s name. It wasn’t urgent, so I left it. The leg is still in the refrigerator. Do you want to do it yourself?”

“Yes,” Coleman said. “I think I will.”

He took the file and went to the autopsy-room annex. From the morgue refrigerator he obtained the leg and began to remove the gauze wrappings. Exposed, the flesh was cold and white, the blood coagulated where the limb had been severed halfway up the thigh. He felt for the area of tumor and encountered it at once—a hard lumpish mass on the medial side, just below the knee. Taking a knife, he cut down deeply, his interest mounting at what he saw.

The manservant took Kent O’Donnell’s topcoat and hat, hanging them in a closet of the gloomy, lofty hallway. Looking about him, O’Donnell wondered why anyone—wealthy or not—would choose to live in such surroundings. Then he reflected that perhaps to someone like Eustace Swayne the gaunt spaciousness, the beamed and paneled opulence, the walls of cold chiseled stone, conveyed a feudal sense of power, linked through history to older days and places. O’Donnell speculated on what would happen to this house when the old man died. More than likely it would become a museum or an art gallery or perhaps merely stand empty and decay as so many of these places had. The notion that someone else would take it as a home seemed inconceivable. This was a place which, logic said, should close its doors at five until next morning. Then he remembered that within these austere walls Denise must have spent her childhood. He wondered if she had been happy here.

“Mr. Swayne is a little tired today, sir,” the manservant said. “He asked if you would mind if he received you in his bedroom.”

“I don’t mind,” O’Donnell said. It occurred to him that perhaps the bedroom might be an appropriate place for what he had to say. If Eustace Swayne had apoplexy as a result, at least there would be a handy place to lie him down. He followed the manservant up the wide, curved stairway, then down a corridor, their footsteps silenced by deep broadloom. At a heavy, studded door the man tapped lightly and lifted a wrought-iron latch. He ushered O’Donnell into the spacious room beyond.

At first O’Donnell failed to see Eustace Swayne. Instead his eyes were caught by a massive fireplace framing a roaring log fire. The heat from the fire was like an impact, the room almost unbearably hot on the already mild late-August morning. Then he saw Swayne, propped up by pillows in a huge four-poster bed, a monogrammed robe draped around his shoulders. As he approached O’Donnell noticed with shock how frail the old man had become since their last meeting—the night of the dinner with Orden Brown and Denise.

“Thank you for coming,” Swayne said. His voice, too, was weaker than before. He motioned his visitor to a chair beside the bed.

As he seated himself O’Donnell said, “I heard you wanted to see me.” In his own mind he was already revising some of the forthright statements which earlier he had planned to make. Nothing would change his own stand, of course, concerning Joe Pearson, but at least he could be gentle. O’Donnell had no wish now to tangle with this ailing old man; any contest between them would be too uneven.

“Joe Pearson has been to see me,” Swayne said. “Three days ago, I think it was.”

So that was where Pearson had been those missing hours when they were trying to locate him. “Yes,” O’Donnell answered, “I imagined he would.”

“He told me that he’s leaving the hospital.” The old man’s voice sounded weary; there was no hint so far of the denunciation of O’Donnell which the chief of surgery had expected.

Curious about what was coming next, he answered, “Yes, that’s true.”

The old man was silent. Then he said, “I suppose there are some things no one can control.” There was a trace of bitterness now. Or was it resignation? It was hard to be sure.

“I think there are,” O’Donnell answered gently.

“When Joe Pearson came to see me,” Eustace Swayne said, “he made two requests. The first was that my donation to the hospital building fund should have no stipulations attached. I have agreed.”

There was a pause, O’Donnell silent, as the significance of the words sank in. The old man went on, “The second request was a personal one. You have an employee at the hospital—his name is Alexander, I believe.”

“Yes,” O’Donnell said wonderingly. “John Alexander—he’s a laboratory technologist.”

“They lost a child?”

O’Donnell nodded.

“Joe Pearson asked that I pay the boy’s way through medical school. I can do it, of course—quite easily. Money at least has a few remaining uses.” Swayne reached for a thick manila envelope which had been lying on the quilt. “I have already instructed my lawyers. There will be a fund—enough to take care of fees and for him and his wife to live comfortably. Afterward, if he chooses to specialize, there will be money for that too.” The old man paused, as if tired by speaking. Then he continued, “What I have in mind now is something more permanent. Later there will be others—I suppose equally deserving. I would like the fund to continue and to be administered by the Three Counties’ medical board. I shall insist on only one condition.”

Eustace Swayne looked squarely at O’Donnell. He said defiantly, “The fund will be named the Joseph Pearson Medical Endowment. Do you object?”

Moved and ashamed, O’Donnell answered, “Sir, far from objecting, in my opinion it will be one of the finest things you have ever done.”

“Please tell me the truth, Mike,” Vivian said. “I want to know.”

They faced each other—Vivian in the hospital bed, Mike Seddons standing, apprehensively, beside it.

It was their first meeting following their time apart. Last night, after cancellation of Vivian’s transfer order, she had tried a second time to reach Mike by telephone, but without success. This morning he had come, without her calling, as they had arranged six days ago. Now her eyes searched his face, fear nudging her, instinct telling what her mind refused to know.

“Vivian,” Mike said, and she could see him trembling, “I’ve got to talk to you.”

There was no answer, only Vivian’s steady gaze meeting his own. His lips were dry; he moistened them with his tongue. He knew that his face was flushed, felt his heart pounding. His instinct was to turn and run. Instead he stood, hesitating, groping for words which refused to come.

“I think I know what you want to say, Mike.” Vivian’s voice was flat; it seemed drained of emotion. “You don’t want to marry me. I’d be a burden to you—now, like this.”

“Oh, Vivian darling—”

“Don’t, Mike!” she said. “Please don’t!”

He said urgently, imploringly, “Please listen to me, Vivian—hear me out! It isn’t that simple . . .” Again his speech faltered.

For three days he had sought the right words and phrases to meet this moment, yet knowing whatever form they took the effect would be the same. In the interval between their last meeting Mike Seddons had probed the inner chasms of his soul and conscience. What he had found there had left him with disgust and self-contempt, but he had emerged with truth. He knew with certainty that a marriage between himself and Vivian would never succeed—not because of her inadequacy, but through his own.

In moments of searching self-examination he had forced himself to consider situations the two of them might meet together. In a flood light of imagination he had seen them entering a crowded room—himself young, virile, unimpaired; but Vivian on his arm, moving slowly, awkwardly, perhaps with a cane, and only as an artificial limb allowed. He had seen himself dive through surf, or lie on a beach near-naked in the sun, but with Vivian dressed decorously, sharing none of it because a prothesis was ugly when exposed and, if removed, she would become a grotesque, immobile freak—an object for pitying or averted eyes.

And more than this.

Overcoming every reluctance and instinctive decency, he had let himself consider sex. He had pictured the scene at night, before bed. Would Vivian unstrap her synthetic leg alone, or would he help her? Could there be intimacies of undressing, knowing what lay beneath? And how would they make love—with the leg on or off? If on, how would it be—the hard, unyielding plastic pressing against his own urgent body? If off, how would the stump feel beneath him? Would there be fulfillment—in intercourse with a body no longer whole?

Mike Seddons sweated. He had plumbed the depths and found his own reflection.

Vivian said, “You needn’t explain, Mike.” This time her voice was choked.

“But I want to! I’ve got to! There are so many things we both have to think of.” Now the words came quickly, tumbling out in an eager effort to make Vivian understand, to know the agony of mind he had suffered before coming here. Even at this moment he needed her understanding.

He started to say, “Look, Vivian. I’ve thought about it and you’ll be better off . . .”

He found her eyes regarding him. He had never noticed before how steady and direct they were. “Please don’t lie, Mike,” she said. “I think you’d better go.”

He knew it was no good. All that he wanted now was to get away from here, not to have to meet Vivian’s eyes. But still he hesitated. He asked, “What will you do?”

“I really don’t know. To tell you the truth, I haven’t thought much about it.” Vivian’s voice was steady, but it betrayed the effort she was making. “Perhaps I’ll go on in nursing, if they’ll have me. Of course, I really don’t know if I’m cured, and if I’m not, how long I’ve got. That’s so, isn’t it, Mike?”

He had the grace to lower his eyes.

At the doorway he looked back for the last time. “Good-by, Vivian,” he said.

She tried to answer, but her self-control had been taxed too long.

From the second floor Mike Seddons used the stairway to reach Pathology. He entered the autopsy room and in the annex found David Coleman dissecting a leg. Seddons looked at the limb and saw it white and lifeless, the dark blood seeping out from Coleman’s knife cuts. For an instant of horror he pictured it nylon-sheathed, a high-heeled sandal upon the foot. Then, with an awful fascination, he crossed the room and read the name in the open case file.

When he had done so, Mike Seddons went into the corridor and vomited against the wall.

“Oh, Dr. Coleman! Do come in.”

Kent O’Donnell got up courteously from his office desk as the young pathologist entered the room. David Coleman had been cleaning up after the dissection when the message from the chief of surgery had reached him.

“Sit down, won’t you?” O’Donnell held out an engraved gold case. “Cigarette?”

“Thank you.” Coleman took a cigarette and accepted the light O’Donnell offered. He leaned back, relaxed, in one of the leather armchairs. An instinct told him that what was to follow would be a turning point in his life.

O’Donnell moved behind the desk to the office window. He stood with his back to it, the morning sun behind him. “I imagine you’ve heard,” he said, “that Dr. Pearson has resigned.”

“Yes, I’d heard.” Coleman answered quietly, then to his own surprise he heard himself saying, “You know, of course, these past few days he hasn’t spared himself. He’s been here day and night.”

“Yes, I know.” O’Donnell regarded the glowing tip of his cigarette. “But it doesn’t change anything. You realize that?”

Coleman knew that the chief of surgery was right. “No,” he said, “I don’t suppose it does.”

“Joe has expressed a wish to leave at once,” O’Donnell continued. “It means there will be an immediate vacancy here for a director of pathology. Shall you accept?”

For a second David Coleman hesitated. This was the thing he had coveted—a department of his own; freedom to reorganize, to mobilize the new aids of science, to practice good medicine, and to make pathology count as he knew it truly could. This was the cup he had sought. Kent O’Donnell had lifted it to his lips.

Then fear struck him. Suddenly he was appalled at the awesome responsibility he would have to hold. It occurred to him there would be no one senior to relieve him of decisions; the ultimate choice—the final diagnosis—would be his alone. Could he face it? Was he yet ready? He was still young; if he chose, he could continue as a second-in-command for several years more. After that there would be other openings—plenty of time to move ahead. Then he knew that there was no escaping, that this moment had been moving toward him since his own first arrival at Three Counties Hospital.

“Yes,” he said. “If it’s offered to me, I shall accept.”

“I can tell you that it will be offered.” O’Donnell smiled. He asked, “Would you tell me something?”

“If I can.”

The chief of surgery paused. In his mind he was choosing the right phrases for the question he wanted to put. He sensed that what was to be said next would be important to them both. Finally he asked, “Will you tell me what your attitude is—to medicine and to this hospital?”

“It’s hard to put into words,” Coleman said.

“Will you try?”

David Coleman considered. It was true there were things he believed, but even to himself he had seldom expressed them. Now, perhaps, was a time for definition.

“I suppose the real thing,” he said slowly, “is that all of us—physicians, the hospital, medical technology—exist only for one thing: for patients, for healing of the sick. I believe we forget this sometimes. I think we become absorbed in medicine, science, better hospitals; and we forget that all these things have only one reason for existence—people. People who need us, who come to medicine for help.” He stopped. “I’ve put it clumsily.”

“No,” O’Donnell said. “You’ve put it very well.” He had a sense of triumph and of hope. Instinct had not belied him; he had chosen well. He foresaw that the two of them—as chief of surgery and director of pathology—would be good together. They would go on and build and, with them, Three Counties would progress. Not all that they wrought would be perfect; it never was. There would be flaws and failures, but at least their aims were the same, their feelings shared. They would have to remain close; Coleman was younger than himself, and there were areas in which O’Donnell’s greater experience could be of help. In these past few weeks the chief of surgery himself had learned a good deal. He had learned that zeal could lead to complacency as surely as indifference, and that disaster could be reached by many routes. But from now on he would fight complacency on every front, and Pathology, with young Dr. Coleman at its head, could be a stout right arm.

A thought occurred to him. He asked, “One more thing. How do you feel about Joe Pearson and the way he’s leaving?”

“I’m not sure,” David Coleman said. “I’ve been wishing I knew.”

“It’s not such a bad thing to be unsure sometimes. It takes us away from rigid thinking.” O’Donnell smiled. “There are some things I think you should know though. I’ve been talking with some of the older men on staff; they’ve told me incidents, things I didn’t know about.” He paused. “Joe Pearson has done a great deal for this hospital in thirty-two years—things that are mostly forgotten now or that people like you and me don’t always get to hear about. He started the blood bank, you know. It’s strange to think of it, but there was a lot of opposition at the time. Then he worked for the formation of a tissue committee; I’m told a good many staff men fought him bitterly on that. But he got the committee and it did a lot to raise the standard of surgery here. Joe did some investigative work, too—on the cause and incidence of thyroid cancer. Most of it’s generally accepted now, but few people remember that it came from Joe Pearson.”

“I didn’t know,” Coleman said. “Thank you for telling me.”

“Well, these things get forgotten. Joe brought a lot of new things into the lab, too—new tests, new equipment. Unfortunately there came a time when he didn’t do new things any more. He let himself vegetate and get in a rut. It happens sometimes.”

Date: 2014-12-21; view: 672