ah.thefinaldiagnosis-第4部分

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and　it　was　not　considered　abnormal　for　a　pathologist　to　reverse　his　opinion　in　this　way。　If　this　happened　the　patient　would　be　returned　to　the　operating　room　and　the　necessary　surgery　done。　But　obviously　it　was　important　for　the　pathologist's　second　report　to　be　prompt。　O'Donnell　had　already　realized　that　this　was　the　nub　of　Rufus'　plaint。
　〃If　it　were　just　once；〃　Rufus　was　saying；　〃I　wouldn't　object。　I　know　Pathology's　busy；　and　I'm　not　trying　to　get　at　Joe　Pearson。　But　it　isn't　just　once；　Kent。　It's　all　the　time。〃
　〃Let's　get　specific；　Bill；〃　O'Donnell　said　crisply。　He　had　no　doubt；　though；　that　Rufus　would　have　facts　to　back　up　a　plaint　like　this。
　〃All　right。　I　had　a　patient　in　here　last　week；　Mrs。　Mason…breast　tumor。　I　removed　the　tumor；　and　at　frozen　section　Joe　Pearson　said　benign。　Afterward；　though；　on　surgical　report　he　had　it　down　as　malignant。〃　Rufus　shrugged。　〃I　won't　quarrel　with　that；　you　can't　call　them　all　the　first　time。〃
　〃But？〃　Now　that　he　knew　what　it　was　about；　O'Donnell　wanted　to　get　this　over　with。
　〃Pearson　took　eight　days　to　make　the　surgical　report。　By　the　time　I　got　it　the　patient　had　been　discharged。〃
　〃I　see。〃　This　was　bad　all　right；　O'Donnell　thought。　He　couldn't　duck　this　one。
　〃It　isn't　easy；〃　Rufus　was　saying　quietly；　〃to　call　a　woman　back　and　tell　her　you　were　wrong…that　she　does　have　cancer　after　all；　and　that　you'll　have　to　operate　again。〃
　No；　it　wasn't　easy；　O'Donnell　knew　that　too　well。　Once；　before　he　had　e　to　Three　Counties；　he　had　had　to　do　the　same　thing　himself。　He　hoped　he　never　would　again。
　〃Bill；　will　you　let　me　handle　this　my　way？〃　O'Donnell　was　glad　it　was　Rufus。　Some　of　the　other　surgeons　might　have　made　things　more　difficult。
　〃Sure。　As　long　as　something　definite　is　done。〃　Rufus　was　within　his　rights　to　be　emphatic。　〃This　isn't　just　an　isolated　case；　you　know。　It　just　happens　to　be　a　bad　one。〃
　Again　O'Donnell　knew　this　was　true。　The　trouble　was；　Rufus　was　not　aware　of　some　of　the　other　problems　which　went　with　it。
　〃I'll　talk　to　Joe　Pearson　this　afternoon；〃　he　promised。　〃After　the　surgical…mortality　conference。　You'll　be　there？〃
　Rufus　nodded。　〃I'll　be　there。〃
　〃See　you　then；　Bill。　Thanks　for　letting　me　know　about　this。　Something　will　be　done；　I　promise　you。〃
　Something；　O'Donnell　reflected　as　he　moved　down　the　corridor。　But　what　exactly？　He　was　still　thinking　about　it　as　he　turned　into　the　Administration　suite　and　opened　the　door　to　Harry　Tomaselli's　office。
　O'Donnell　did　not　see　Tomaselli　at　first；　then　the　administrator　called　to　him。　〃Over　here；　Kent。〃　On　the　far　side　of　the　birch…paneled　room；　away　from　the　desk　at　which　he　spent　most　of　his　working　hours；　Tomaselli　was　leaning　over　a　table。　Unrolled　before　him　were　whiteprints　and　sketches。　O'Donnell　crossed　the　thick　pile　carpet　and　looked　down　at　them　too。
　〃Daydreaming；　Harry？〃　He　touched　one　of　the　sketches。　〃You　know；　I'm　sure　we　could　put　you　a　fancy　penthouse　there…on　top　of　the　East　Wing。〃
　Tomaselli　smiled。　〃I'm　agreeable；　providing　you'll　convince　the　board　it's　necessary。〃　He　took　off　his　rimless　glasses　and　began　to　polish　them。　〃Well；　there　it　is…the　New　Jerusalem。〃
　O'Donnell　studied　the　architect's　profile　of　Three　Counties　Hospital　as　it　would　appear　with　the　magnificent　new　extension；　now　in　the　advanced　stages　of　planning。　The　new　buildings　were　to　prise　an　entire　wing　and　a　new　nurses'　home。　〃Any　more　news？〃　He　turned　to　Tomaselli。
　The　administrator　had　replaced　his　glasses。　〃I　talked　with　Orden　again　this　morning。〃　Orden　Brown；　president　of　the　second　largest　steel　mill　in　Burlington；　was　chairman　of　the　hospital's　board　of　directors。
　〃So？〃
　〃He's　sure　we　can　count　on　half　a　million　dollars　in　the　building　fund　by　January。　That　means　we'll　be　able　to　break　ground　in　March。〃
　〃And　the　other　half　million？　Last　week　Orden　told　me　he　thought　it　would　take　until　December。〃　Even　at　that；　O'Donnell　reflected；　he　had　considered　the　chairman　to　be　erring　toward　optimism。
　〃I　know；〃　Tomaselli　said。　〃But　he　asked　me　to　tell　you　that　he's　changed　his　mind。　He　had　another　session　with　the　mayor　yesterday。　They're　convinced　they　can　get　the　second　half　million　by　next　summer　and　wind　up　the　campaign　by　fall。〃
　〃That　is　good　news。〃　O'Donnell　decided　to　shelve　his　earlier　doubts。　If　Orden　Brown　had　gone　out　on　a　limb　like　that；　he　would　e　through　all　right。
　〃Oh；　and　by　the　way；〃　Tomaselli　said　with　elaborate　casualness；　〃Orden　and　the　mayor　have　an　appointment　with　the　governor　next　Wednesday。　Looks　like　we　may　get　that　increased　state　grant　after　all。〃
　〃Anything　else？〃　O'Donnell　snapped　at　the　administrator　in　mock　sharpness。
　〃I　thought　you'd　be　pleased；〃　Tomaselli　said。
　More　than　pleased；　O'Donnell　reflected。　In　a　way　you　might　call　all　of　this　the　first　step　toward　fulfillment　of　a　vision。　It　was　a　vision　which　had　had　its　beginnings　at　the　time　of　his　own　arrival　at　Three　Counties　three　and　a　half　years　ago。　Funny　how　you　could　get　used　to　a　place；　O'Donnell　thought。　If　someone　had　told　him　at　Harvard　Medical　School；　or　later　when　he　was　chief　surgical　resident　at　Columbia　Presbyterian；　that　he　would　wind　up　in　a　backwater　hospital　like　Three　Counties；　he　would　have　scoffed。　Even　when　he　had　gone　to　Bart's　in　London　to　round　out　his　surgical　experience；　he　had　fully　intended　to　e　back　and　join　the　staff　of　one　of　the　big…name　hospitals　like　Johns　Hopkins　or　Massachusetts　General。　With　the　background　he　had　he　could　pretty　well　have　taken　his　choice。　But　before　there　was　time　to　decide　Orden　Brown　had　e　to　meet　him　in　New　York　and　persuaded　him　to　visit　Burlington　and　Three　Counties。
　What　he　had　seen　there　had　appalled　him。　The　hospital　was　run　down　physically；　its　organization　slack；　its　medical　standards…with　a　few　exceptions…low。　The　chiefs　of　surgery　and　medicine　had　held　their　posts　for　years；　O'Donnell　had　sensed　that　their　objective　in　life　was　to　preserve　an　amiable　status　quo。　The　administrator…key　man　in　the　relationship　between　the　hospital's　lay　board　of　directors　and　its　medical　staff…was　a　doddering　inpetent。　The　hospital's　intern　and　resident　training　program　had　fallen　into　disrepute。　There　was　no　budget　for　research。　Conditions　under　which　nurses　lived　and　worked　were　almost　medieval。　Orden　Brown　had　shown　him　everything；　concealed　nothing。　Then　they　had　gone　together　to　the　chairman's　home。　O'Donnell　had　agreed　to　remain　for　dinner　but　afterward　planned　to　catch　a　night　flight　back　to　New　York。　Disgusted；　he　never　wanted　to　see　Burlington　or　Three　Counties　Hospital　again。
　Over　dinner　in　the　quiet；　tapestried　dining　room　of　Orden　Brown's　home　on　a　hillside　high　above　Burlington　he　had　been　told　the　story。　It　was　not　an　unfamiliar　one。　Three　Counties　Hospital；　once　progressive；　modern；　and　rated　high　in　the　state；　had　fallen　prey　to　placency　and　lassitude。　The　chairman　of　the　board　had　been　an　aging　industrialist　who　most　of　the　time　had　delegated　responsibility　to　someone　else；　appearing　at　the　hospital　only　for　the　occasional　social　function。　The　lack　of　leadership　had　permeated　downward。　Heads　of　divisions　had　mostly　held　their　posts　for　many　years　and　were　averse　to　change。　Younger　men　beneath　them　had　at　first　fretted；　then；　being　frustrated；　had　moved　elsewhere。　Finally　the　hospital's　reputation　became　such　that　young；　highly　qualified　graduates　no　longer　sought　to　join　the　staff。　Because　of　this　others　with　lesser　qualifications　had　been　allowed　in。　This　was　the　situation　at　the　time　O'Donnell　had　e　on　the　scene。
　The　only　change　had　e　with　the　appointment　of　Orden　Brown　himself。　Three　months　earlier　the　aged　chairman　had　died。　A　group　of　influential　citizens　had　persuaded　Brown　to　succeed　him。　The　choice　had　not　been　unanimous；　a　section　of　the　old　guard　on　the　hospital　board　had　wanted　the　chair　for　a　nominee　of　their　own…a　long…time　board　member　named　Eustace　Swayne。　But　Brown　had　been　chosen　by　a　majority；　and　now　he　was　trying　to　persuade　other　board　members　to　adopt　some　of　his　own　ideas　for　modernization　of　Three　Counties。
　It　was　proving　an　uphill　fight。　There　was　an　alliance　between　a　conservative　element　on　the　board；　for　whom　Eustace　Swayne　was　spokesman；　and　a　group　among　the　senior　medical　staff。　Together　they　resisted　change。　Brown　was　having　to　tread　warily　and　to　be　diplomatic。
　One　of　the　things　he　wanted　was　authority　to　increase　the　size　of　the　hospital　board　and　bring　in　new；　more　active　members。　He　had　planned　to　recruit　some　of　the　younger　executives　and　professional　men　from　Burlington's　business　munity。　But　so　far　the　board　had　not　been　unanimous　and　temporarily　the　plan　was　shelved。
　If　Orden　Brown　had　wanted；　he　had　explained　frankly　to　O'Donnell；　he　could　have　forced　a　showdown　and　had　his　own　way。　He　could；　if　he　wished；　have　used　his　influence　to　ease　some　of　the　elderly；　inactive　members　out　of　office。　But　this　would　have　been　shortsighted；　because　most　were　wealthy　men　and　women　and　the　hospital　needed　the　legacies　which　normally　came　to　it　when　its　patrons　died。　If　defeated　now；　some　of　the　people　concerned　might　well　change　their　wills；　cutting　the　hospital　off。　Eustace　Swayne；　who　controlled　a　department…store　empire；　had　already　hinted　that　this　might　happen。　Hence　the　need　by　Orden　Brown　for　diplomacy　and　caution。
　Some　progress　had　been　made；　though；　and　one　step　which　the　chairman　had　undertaken　with　approval　from　a　majority　of　the　board　members　was　to　negotiate　for　a　new　chief　of　surgery。　That　was　why　he　had　approached　O'Donnell。
　Over　dinner　O'Donnell　had　shaken　his　head。　〃I'm　afraid　it's　not　for　me。〃
　〃Perhaps　not；〃　Brown　had　said。　〃But　I'd　like　you　to　hear　me　out。〃
　He　was　persuasive；　this　man　of　industry　who；　though　a　scion　of　a　wealthy　family；　had　worked　his　way　from　puddler；　through　the　mills；　to　the　administrative　office　and　eventually　the　president's　chair。　He　had　a　feeling；　too；　for　people；　the　years　in　which　he　had　rubbed　shoulders　daily　with　laborers　in　the　mill　had　given　him　that。　This　may　have　been　a　reason　he　had　accepted　the　burden　of　lifting　Three　Counties　out　of　the　mire　into　which　it　had　fallen。　But　for　whatever　reason；　even　in　the　short　time　they　had　been　together　O'Donnell　had　sensed　the　older　man's　dedication。
　〃If　you　came　here；〃　Brown　had　said　to　him　near　t