The Final Diagnosis

“Some people do.” It was Bannister. He gave a high-pitched giggle which dried up as he caught Pearson’s eye.

“Just cut out the snide remarks. I’m giving John here some information. Might not do you any harm either.” Anyone but Bannister would have been crushed by Pearson’s rejoinder. As it was, the technician merely grinned.

“What happened, Doctor?” Alexander asked.

“It says here: ‘Daughter states that for the past two years the family has been noticing drainage from the mother’s left breast area. Fourteen months before admission bleeding was noticed from the same area. Otherwise she appeared in normal health.’ ”

Pearson turned a page. “It seems this woman went to a faith healer.” He chuckled grimly. “Guess she didn’t have enough faith, though, because she finally collapsed and they brought her to this hospital.”

“By then, I suppose, it was too late.”

This isn’t politeness, McNeil thought. This guy Alexander is really interested.

“Yeah,” Pearson answered. “But if she had gone to a doctor at the beginning she could have had a radical mastectomy—that’s removal of the breast.”

“Yes, sir. I know.”

“If she’d had that she might still be alive.” Pearson tossed the stomach neatly through the hole.

Something was troubling Alexander. He asked, “Didn’t you just say, though, she had a peptic ulcer?”

Good for you, McNeil thought. Pearson, it seemed, had the same reaction, for he turned to Bannister. “There you are, Carl. Here’s a boy who keeps his ears open. You watch out or he’ll be showing you up.”

Bannister was grinning, but McNeil suspected a little sourness. What had been said might prove uncomfortably true. “Well, John”—Pearson was really expansive now—“she might have had trouble with that. Then again she might not.”

“You mean she’d never have known about it?”

McNeil thought it was time he said something himself. “It’s surprising,” he told Alexander, “what people have wrong with them besides the things they die of. Things they never know about. You see a lot of that here.”

“That’s right.” Pearson nodded agreement. “You know, John, the remarkable thing about the human body is not what kills us but what we can have wrong inside and still go on living.” He paused, then abruptly changed the subject. “Are you married?”

“Yes, sir. I am.”

“Your wife here with you?”

“Not yet. She’s coming next week. I thought I’d find us a place to live first.”

McNeil remembered that Alexander had been one of the out-of-town applicants for the job at Three Counties. He seemed to recall that Chicago had been mentioned.

Alexander hesitated, then he added, “There was something I wanted to ask you, Dr. Pearson.”

“What’s that?” The old man sounded wary.

“My wife is pregnant, Doctor, and coming into a new town, we don’t know anyone.” Alexander paused. “This baby is pretty important to us. You see, we lost our first child. A month after she was born.”

“I see.” Pearson had stopped work now and was listening carefully.

“I was wondering, Doctor, if you could recommend an obstetrician my wife could go to.”

“That’s easy.” Pearson sounded relieved. Plainly he had wondered what was coming. “Dr. Dornberger’s a good man. He has an office right here in the hospital. Would you like me to call him?”

“If it’s not too much trouble.”

Pearson motioned to Bannister. “See if he’s in.”

Bannister picked up the telephone behind them and asked for an extension. After a pause he said, “He’s in,” and offered the instrument to Pearson.

With both hands gloved and wet, the old man motioned his head irritably. “Hold it! Hold it!”

Bannister moved in closer and held the receiver against Pearson’s ear.

“That you, Charlie?” The pathologist boomed into the mouthpiece. “I’ve got a patient for you.”

In his office three floors above Dr. Charles Dornberger smiled and moved the telephone slightly away from his ear. He asked, “What can obstetrics do for your kind of patients?” At the same time he reflected that this call was convenient. Since the meeting which O’Donnell had called yesterday, Charles Dornberger had speculated on the best method of approach to Joe Pearson. Now, it seemed, an opportunity was presenting itself.

Down in Pathology Pearson maneuvered the cigar to a corner of his mouth. He always enjoyed exchanges with Dornberger.

“This isn’t a dead patient, you old fool. It’s a live one. Wife of one of my lab boys here—Mrs. John Alexander. They’re new in town. Don’t know anybody.”

As Pearson mentioned the name Dornberger opened a file drawer and selected a blank card.

“Just a minute.” He cradled the phone in his shoulder and, using his left hand to hold the card, wrote in a fine script with the right, “Alexander, Mrs. John.” It was typical of Dornberger’s organized approach to his practice that this was the first thing he did. Now he said, “Be glad to oblige, Joe. Will you have them call me for an appointment?”

“All right. Be some time next week. Mrs. Alexander won’t be in town till then.” He grinned at Alexander, then added, still almost shouting, “And if they want twins, Charlie, it’s up to you to see they get them.”

Pearson listened to Dornberger’s answer and chuckled. A thought struck him. “And hey! Another thing! None of your fancy fees for this job. I don’t want the boy coming to me for a raise so he can pay his doctor’s bill.”

Dornberger smiled. He said, “Don’t worry.” On the card he made a notation, “Hospital employee.” It was a signal to himself that this was a patient he would charge no fee. Into the phone he said, “Joe, there’s something I want to talk to you about. When would be a convenient time to come and see you?”

“Can’t make it today, Charlie,” Pearson said. “Got a full schedule. How about tomorrow?”

Dornberger consulted his own appointment list. “I’m crowded tomorrow myself. Let’s make it the day after. How about around ten in the morning? I’ll come to your office.”

“That’ll be all right. Unless you want to tell me now—on the phone.” Pearson’s voice sounded curious.

“No, Joe,” Dornberger said, “I’d rather come and see you.”

In Pathology Pearson answered, “All right, Charlie. See you then. So long.” Impatiently he motioned the telephone away and Bannister replaced it.

To Alexander, Pearson said, “That’s all fixed. Your wife can be admitted to this hospital when she comes to term. Because you’re an employee you’ll get a twenty per cent discount on your bill.”

Alexander was beaming. McNeil thought: Yes, go ahead; enjoy it, my friend. This is one of the old man’s good moments. But make no mistake—there’ll be others, and those you won’t enjoy at all.

“I’ll only be a moment.” In his office Dornberger smiled at the student nurse who had come in while he was talking with Pearson. He motioned her to the chair alongside his desk.

“Thank you, Doctor.” Vivian Loburton had brought a patient’s chart that Dornberger had asked to see. Ordinarily physicians didn’t get this kind of service; they would have to walk to the ward and look at the chart there. But Dornberger was a favorite with the nurses; they were always doing little things for him, and when he had phoned a few minutes ago the staff nurse had sent Vivian off promptly.

“I like to do one thing at a time when I can.” Dornberger was writing in pencil now, noting on the card the new facts Joe Pearson had given him. Later, when he had more information from the patient, he would erase the pencil notes and complete the card in ink. Still writing, he asked the girl, “You’re new here, aren’t you?”

“Fairly new, Doctor,” Vivian said. “This is my fourth month in nursing school.”

He noticed she had a soft voice with a lilt. Pretty too. He wondered if she had slept yet with any of the interns or residents. Or had things changed since his own student years? He occasionally suspected that interns and residents nowadays were getting more conservative than they used to be. A pity. If true, they were missing a good deal. Aloud he said, “That was Dr. Pearson, our pathologist. Have you met him yet?”

“Yes,” Vivian said. “Our class went to an autopsy.”

“Oh dear. How did you . . .” He was going to say “like it” but changed it to, “How did you find it?”

Vivian considered. “At first it was rather a shock. Afterward I didn’t mind too much though.”

He nodded sympathetically. He had finished writing now and put the card away. This had been a quieter day than usual; it was a luxury to be able to clean up one piece of work before going on to another. He held out his hand for the chart. “Thank you.” He added, “I’ll only be a moment with this, if you’d like to wait.”

“All right, Doctor.” Vivian decided a few more minutes’ respite from the rush of ward work would be welcome. She settled back in the chair. It was cool in here with the air conditioning. There was no such luxury in the nurses’ home.

Vivian watched Dr. Dornberger as he studied the chart. He was probably about the same age as Dr. Pearson, she thought, but certainly a lot different to look at. While the pathologist was round-faced and heavy-jowled, Dr. Dornberger was lean and angular. In other ways, too, his appearance was a contrast, with the thatch of white hair carefully combed and parted. She noticed his hands were manicured, his white hospital jacket pressed and spotless.

Dornberger handed back the chart. “Thank you,” he said. “It was good of you to bring it.” He has a sparkle to him, Vivian thought. She had heard he was much beloved by his women patients. There was little need to wonder why.

“We’ll be seeing each other, I expect.” Dornberger had risen and opened the door courteously. “Good luck in your studies.”

“Good-by, Doctor.” She went out, leaving a trace of fragrance behind her, Dornberger thought. Not for the first time the contact with someone youthful left him wondering about himself. He returned to the swivel chair and leaned back meditatively. Almost absently he took out his pipe and began to fill it.

He had been in medicine now for almost thirty-two years; in a week or two he would being his thirty-third. They had been full years and rewarding ones. Financially he had no problems. His own four children were married, and he and his wife could live comfortably on the careful investments he had made. But would he be content to retire and rusticate? That was the rub.

In all his years in medicine Charles Dornberger had prided himself in keeping up to date. He had made up his mind long ago that no young newcomer was going to surpass him, either in technique or knowledge. As a result he had read avidly and still continued to do so. He subscribed to many of the medical journals which he read thoroughly and occasionally contributed articles himself. He was a regular attender at medical conventions and conscientiously took in most of the business sessions. Early in his career, long before the present boundary lines were drawn in medicine, he had foreseen the need for specialization. His own choice had been obstetrics and gynecology. It was a choice he had never regretted, and he often felt it had helped him to keep young in mind.