The Final Diagnosis

His feelings about Vivian had not wavered; if anything, they had become more intense. He hoped he had conveyed this in the time he had spent last evening with Vivian’s parents after their initial meeting at the hospital. At first, as was to be expected, all of them—Mr. and Mrs. Loburton, Vivian, and himself—had been constrained, their talk awkward and at times formal. Even afterward it had seemed that the Loburtons’ meeting with a prospective son-in-law, which in other circumstances might have been an important occasion, had taken second place to their concern with the immediate problem of Vivian’s health. In a sense Mike Seddons felt he had become accepted because there was no time for anything else.

Back at the Loburtons’ hotel, though, they had talked briefly about himself and Vivian. Henry Loburton, his big frame spilling from an overstuffed chair in the sitting room of their hotel suite, had asked Mike Seddons about his future, more, Seddons suspected, from courtesy than from any real concern. He had responded by telling them briefly of his own intention to practice surgery in Philadelphia when his residency at Three Counties ended. The Loburtons had nodded politely and had left the matter there.

Certainly, it seemed, there would be no opposition to a marriage. “Vivian has always seemed to know what she wanted,” Henry Loburton had observed at one point. “It was the same way when she wanted to be a nurse. We were doubtful about it, but she had already made up her mind. There wasn’t much else to say after that.”

Mike Seddons had expressed the hope that they would not consider Vivian too young to marry. It was then that Angela Loburton had smiled. “I imagine it would be rather difficult to object on that account,” she had said. “You see, I was married at seventeen. I ran away from home to do it.” She smiled at her husband. “We didn’t have any money, but we managed to get by.”

Seddons had said with a grin, “Well, that much we’ll have in common—anyway, until my practice gets going.”

That had been last night. This morning, after the visit with Vivian, he had felt for some reason a sense of lightness and relief. Perhaps he had been depressed unnaturally long and brighter spirits were seeking an outlet. But, whatever the cause, he felt himself seized by a cheerful conviction that everything would turn out well. The feeling was with him now—in the autopsy room where he was assisting Roger McNeil with the autopsy of an elderly woman patient who had died last night in the hospital. It had prompted him to begin telling humorous stories to McNeil; Mike Seddons had a fund of them—another reason for his reputation as a joker.

Pausing in the middle of the latest, he asked McNeil, “Have you any cigarettes?”

The pathology resident motioned with his head. He was sectioning the heart he had just removed from the body.

Seddons crossed the room, found the cigarettes in McNeil’s suit coat, and lighted one. Returning, he continued, “So she said to the undertaker, ‘Thank you for doing that, even though it must have been a lot of trouble.’ And the undertaker said, ‘Oh, it wasn’t any trouble really. All I did was change their heads.’ ”

Grim as the jest was in these surroundings, McNeil laughed aloud. He was still laughing as the autopsy-room door opened and David Coleman stepped inside.

“Dr. Seddons, will you put out that cigarette, please?” Coleman’s voice cut quietly across the room.

Mike Seddons looked around. He said amiably, “Oh, good morning, Dr. Coleman. Didn’t see you there for a minute.”

“The cigarette, Dr. Seddons!” There was ice in Coleman’s tone, his eyes steely.

Not quite understanding, Seddons said, “Oh . . . oh yes.” none, moved his hand toward the autopsy table with the body upon it.

“Not there!” Coleman rapped out the words, stopping the surgical resident short. After a moment Seddons moved across the room, found an ash tray, and deposited the cigarette.

“Dr. McNeil.”

“Yes, Dr. Coleman,” Roger McNeil answered quietly.

“Will you . . . drape the face, please?”

Uncomfortably, knowing what was going through Coleman’s mind, McNeil reached out for a towel. It was one they had used earlier; it had several big bloodstains. Still with the same soft intensity, Coleman said, “A clean towel, please. And do the same for the genitals.”

McNeil nodded to Seddons, who brought over two clean towels. McNeil placed one carefully across the face of the dead woman; the other he used to cover the external genitalia.

Now the two residents stood facing Coleman. Both showed traces of embarrassment. Both sensed what was coming next.

“Gentlemen, I think there is something I should remind you of.” David Coleman still spoke quietly—at no time since entering the room had he raised his voice—but there was no mistaking the underlying purpose and authority. Now he said deliberately, “When we perform an autopsy we do so with permission from the family of the one who has died. Without that permission there would be no autopsy. That is quite clear to you, I presume?”

“Quite clear,” Seddons said. McNeil nodded.

“Very well.” Coleman glanced at the autopsy table, then at the others. “Our own objective is to advance medical learning. The family of the deceased, for its part, gives us the body in trust, expecting that it will be treated with care, respect, and dignity.” As he paused there was silence in the room. McNeil and Seddons were standing very still.

“And that is the way we will treat it, gentlemen.” Coleman emphasized the words again, “With care, respect, and dignity.” He went on, “At all autopsies the face and genitals will be draped and there will be no smoking in the room at any time. As for your own demeanor, and particularly the use of humor”—at the word Mike Seddons flushed a deep red—“I think I can leave that to your imagination.”

Momentarily Coleman looked directly at each man in turn. Then, “Thank you, gentlemen. Will you carry on, please?” He nodded and went out.

For several seconds after the door had closed neither spoke. Then, softly, Seddons observed, “We appear to have been skillfully taken apart.”

Ruefully McNeil said, “With some reason, I think. Don’t you?”

As soon as they could afford it, Elizabeth Alexander decided, she would buy a vacuum cleaner. The old-fashioned carpet sweeper she was using now collected the superficial dirt, but that was about all. She pushed it back and forth a few more times over the rug and inspected the result critically. Not very good, but it would have to do. She must remember to have a talk with John tonight. Vacuum cleaners were not terribly expensive, and one extra monthly payment shouldn’t make all that difference. The trouble was, though, there were so many things they needed. It was a problem, deciding which should come first.

In a way, she supposed, John was right. It was all very well to talk of making sacrifices and doing without things so that John could go to medical school. But when you came right down to it, it was hard to manage on any reduced income once you became accustomed to a certain standard. Take John’s salary at the hospital, for example. It certainly did not put them in the big brackets, but it had made their life together comfortable and they were able to enjoy small luxuries which a few months ago had been out of reach. Could they surrender those things now? Elizabeth supposed so, but it would be difficult all the same. Medical school would mean another four years of struggling, and even after that there would be internship and perhaps residency, if John decided to specialize. Would it be worth it? Weren’t they perhaps better off taking their happiness as they found it at this moment, accepting a role—even if a modest one—in the here and now?

That made sense, didn’t it? And yet, somehow, Elizabeth was still unsure. Should she still continue to urge John to aim higher, to enter medical school, at whatever cost? Dr. Coleman obviously believed he should. What was it he had said to John?—If you feel like this, and don’t go to medical school while you have the chance, it may be something you’ll regret the rest of your life. At the time the words had made a deep impression on Elizabeth and, she suspected, on John too. Now, remembering, they seemed more significant than ever. She frowned; perhaps they had better talk over the whole subject again tonight. If she were convinced of what John really wanted, maybe she could force him into a decision. It would not be the first time Elizabeth had had her own way about things that concerned them both.

Elizabeth put the sweeper away and began to move around the apartment, tidying and dusting. Now, dismissing more serious thoughts for the time being, she sang as she worked. It was a beautiful morning. The warm August sun, shining brightly into the small but comfortable living room, showed off to advantage the new draperies she had made and had hung last night. Elizabeth stopped at the center table to rearrange a vase of flowers. She had removed two blooms which had faded and was about to cross to the tiny kitchen when the pain struck her. It came suddenly, without warning, like a blazing, searing fire and worse, much worse, than the day before in the hospital cafeteria. Drawing in her breath, biting her lip, trying not to scream aloud, Elizabeth sank into a chair behind her. Briefly the pain went away, then it returned, even—it seemed—more intensely. It was as if it were a cycle. Then the significance dawned upon her. Involuntarily she said, “Oh no! No!”

Dimly, through the enveloping anguish, Elizabeth knew she had to act quickly. The hospital number was on a pad by the telephone. Suddenly the instrument on the other side of the room became an objective. Biding her time between each onset of pain, grasping the table for support, Elizabeth eased out of the chair and moved across. When she had dialed and a voice answered, she said, gasping, “Dr. Dornberger . . . it’s urgent.”

There was a pause and he came on the line. “It’s . . . Mrs. Alexander,” Elizabeth said. “I’ve started . . . to have . . . my baby.”

David Coleman knocked once on the door of Dr. Pearson’s office, then went in. He found the senior pathologist seated behind the desk, Carl Bannister standing alongside. The lab technician’s face had a taut expression; after a first glance he studiously avoided looking Coleman’s way.

“You wanted to see me, I believe.” Coleman had been returning from doing a frozen section on the surgical floor when his name had been called on the public-address system.

“Yes, I did.” Pearson’s manner was cool and formal. “Dr. Coleman, I have received a complaint concerning you from a member of the staff. Carl Bannister here.”

“Oh?” Coleman raised his eyebrows. Bannister was still looking straight ahead.

Pearson went on, “I understand you two had a little brush this morning.”

“I wouldn’t call it exactly that.” Coleman kept his voice casual and unperturbed.

“What would you call it then?” There was no mistaking the acidity in the old man’s tone.

Coleman said levelly, “Frankly, I hadn’t planned to bring the matter to your attention. But, since Mr. Bannister has chosen to, I think you had better hear the whole story.”