ah.thefinaldiagnosis-第21章

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l　opposite　and　looked　over　the　case　notes。
　〃Fifty…five…year…old　woman。　Physician's　cause　of　death；　carcinoma　of　the　breast。〃
　〃Let　me　see。〃　Pearson　reached　for　the　file。　Sometimes　he　would　sit　patiently　while　the　resident　described　a　case；　at　other　times　he　would　want　to　read　everything　himself。　In　this；　as　in　all　things；　he　was　unpredictable。
　〃Hm。〃　He　put　down　the　papers　and　turned　off　the　running　water。　Then　he　reached　into　the　pail　and　groped　around　until　he　found　the　heart。　He　opened　it；　using　both　hands。
　〃Did　you　cut　this？〃
　The　resident　shook　his　head。
　〃I　didn't　think　so。〃　Pearson　peered　at　the　heart　again。　〃Seddons？〃
　McNeil　nodded　a　little　reluctantly。　He　had　noticed　himself　that　the　heart　was　badly　cut。
　〃He　left　the　mark　of　Zorro。〃　Pearson　grinned。　〃Looks　like　he　was　dueling　with　it。　By　the　way；　where　is　Seddons？〃
　〃I　believe　there　was　something　in　surgery。　A　procedure　he　wanted　to　see。〃
　〃Tell　him　from　me　that　while　any　resident　is　assigned　to　Pathology　I　expect　him　at　all　gross　conferences。　All　right；　let's　get　on　with　it。〃
　McNeil　balanced　a　clip　board　on　his　knee　and　prepared　to　write。　Pearson　dictated：　〃Heart　shows　a　slight　thickening　and　rolling　of　the　mitral　valve。　See　it　there？〃　He　held　it　out。
　Leaning　across；　McNeil　answered；　〃Yes；　I　do。〃
　Pearson　continued；　〃The　chordae　tendineae　are　fused；　shortened　and　thickened。〃　He　added　casually；　〃Looks　as　if　she　had　an　old　rheumatic　fever。　It　was　not　a　cause　of　death　though。〃
　He　cut　away　a　small　portion　of　tissue　and　put　it　into　a　labeled　jar　about　the　size　of　an　ink　bottle。　This　was　for　microscopic　examination　later。　Then　with　the　ease　of　long　practice　he　tossed　the　remainder　of　the　heart　accurately　into　a　hole　lower　down　the　table。　Beneath　the　hole　was　a　metal　bin。　Later　in　the　day　this　would　be　cleared　and　cleaned；　the　contents　being　burned　to　fine　ash　in　a　special　incinerator。
　Now　Pearson　had　the　lungs。　He　opened　the　first　lung　like　the　two　big　leaves　of　a　book；　then　dictated　to　McNeil；　〃Lungs　show　multiple　metastatic　nodules。〃　Again　he　held　out　the　tissue　for　the　resident　to　see。
　He　had　turned　his　attention　to　the　second　lung　when　a　door　behind　him　opened。
　〃You　busy；　Dr。　Pearson？〃
　Pearson　turned　around　irritably。　The　voice　was　that　of　Carl　Bannister；　senior　lab　technician　in　the　pathology　department。　Bannister　had　his　head　around　the　door　tentatively；　and　there　was　another　figure　behind　him　in　the　corridor。
　〃Of　course　I'm　busy。　What　do　you　want？〃　It　was　the　tone；　half　snarling；　half　bantering；　Pearson　habitually　used　to　Bannister。　Over　the　years　the　two　of　them　had　bee　accustomed　to　it；　anything　more　cordial　would　probably　have　confused　both。
　Bannister　was　unperturbed。　He　beckoned　to　the　figure　behind　him。　〃e　inside。〃　Then　to　Pearson　he　said；　〃This　is　John　Alexander。　You　remember…our　new　lab　technician。　You　hired　him　a　week　ago。　He　starts　work　today。〃
　〃Oh　yes。　I'd　forgotten　this　was　the　day。　e　in。〃　Pearson　sounded　more　cordial　than　he　had　been　with　Bannister。　McNeil　thought：　Maybe　he　doesn't　want　to　scare　a　new　employee　first　day　out。
　McNeil　looked　curiously　at　the　newer。　Twenty…two；　he　figured；　later　he　was　to　learn　he　was　exactly　right。　He　knew　from　what　he　had　heard　that　Alexander　was　fresh　from　college　with　a　degree　in　medical　technology。　Well；　they　could　do　with　someone　like　that　around　the　place。　Bannister；　for　sure；　wasn't　any　Louis　Pasteur。
　McNeil　turned　his　eyes　to　the　senior　technician。　As　usual；　Bannister's　appearance　made　him　something　of　a　minor　league　Pearson。　His　short；　paunchy　body　was　partially　covered　by　a　stained　lab　coat。　The　coat　was　not　buttoned　and　the　clothes　beneath　it　appeared　shabby　and　unpressed。　Bannister　was　mostly　bald；　and　such　hair　as　was　left　looked　as　if　it　were　permanently　ignored。
　McNeil　knew　something　of　Bannister's　history。　He　had　e　to　Three　Counties　a　year　or　two　after　Pearson's　arrival。　He　had　a　high…school　education；　and　Pearson　had　hired　him　for　odd　jobs…stock　clerk；　messenger；　washing　glassware。　Gradually；　as　the　years　passed；　Bannister　had　learned　a　lot　of　practical　things　around　the　lab；　being　more　and　more　a　right　hand　to　Pearson。
　Officially　Bannister's　work　was　in　serology　and　biochemistry。　But　he　had　been　in　the　department　so　long　that　he　could　fill　La　if　necessary；　and　often　did；　for　technicians　in　other　sections　of　the　lab。　Because　of　this　Pearson　had　pushed　a　good　deal　of　administrative　lab　work　onto　Bannister；　leaving　him；　in　effect；　in　charge　of　all　pathology　technicians。
　McNeil　thought　it　likely　that　in　Bannister's　heyday　he　had　been　a　good　technician　who；　with　more　education；　might　have　risen　to　better　things。　As　it　was　now；　McNeil　considered　Bannister　long　on　experience　and　short　on　theory。　From　observation　the　resident　knew　that　much　of　Bannister's　work　in　the　lab　was　from　rote　rather　than　reasoning。　He　could　do　serologic　and　chemical　tests　but　without　any　real　understanding　of　the　science　behind　them。　McNeil　had　often　thought　that　one　day　this　might　prove　dangerous。
　Alexander；　of　course；　was　a　different　proposition。　He　had　e　the　way　of　most　lab　technicians　nowadays；　with　three　years　of　college　behind　him；　the　last　year　in　an　approved　school　for　medical　technologists。　The　word　〃technologist〃　was　sometimes　a　sore　point　with　people　like　Bannister　who　only　rated　the　styling　〃technician。〃
　Pearson　waved　his　cigar　at　the　remaining　stool　around　the　table。　〃Sit　down；　John。〃
　〃Thank　you；　Doctor；〃　Alexander　answered　politely。　In　his　spotless　lab　coat；　with　a　recent　crew　cut；　pressed　pants；　and　shined　shoes；　he　presented　a　contrast　to　Pearson　as　well　as　Bannister。
　〃Do　you　think　you'll　like　it　here？〃　Pearson　looked　down　at　the　lungs　he　was　holding；　continuing　the　examination　while　he　talked。
　〃I'm　sure　I　will；　Doctor。〃
　Nice　kid；　this；　McNeil　thought。　He　sounds　as　if　he　means　it。
　〃Well；　John；〃　Pearson　was　saying；　〃you'll　discover　we　have　certain　ways　of　doing　things。　They　may　not　always　be　the　ways　you've　been　used　to；　but　we　find　they　work　pretty　well　for　us。〃
　〃I　understand；　Doctor。〃
　Do　you？　McNeil　thought　Do　you　understand　what　the　old　man　is　really　telling　you？…that　he　doesn't　want　any　changes　around　the　place；　that　there's　to　be　no　nonsense　with　ideas　you　may　have　picked　up　in　school；　that　nothing　in　the　department…no　matter　how　trifling…is　to　be　amended　without　his　blessing。
　〃Some　people　might　say　we're　old…fashioned；〃　Pearson　continued。　He　was　being　friendly　enough　in　his　way。　〃But　we　believe　in　tried　and　tested　methods。　Eh；　Carl？〃
　Called　on　for　endorsement；　Bannister　was　quick　to　answer。　〃That's　right；　Doctor。〃
　Pearson　had　finished　with　the　lungs　now　and；　dipping　into　the　pail；　somewhat　like　drawing　a　lottery；　had　e　up　with　a　stomach。　He　grunted；　then　held　out　an　open　section　to　McNeil。　〃See　that？〃
　The　resident　nodded。　〃I　saw　it　before。　We　have　it　listed。〃
　〃All　right。〃　Pearson　motioned　to　the　clip　board；　then　he　dictated；　〃There　is　a　peptic　ulcer　lying　just　below　the　pyloric　ring　in　the　duodenum。〃
　Alexander　had　shifted　slightly　to　get　a　better　look。　Pearson　saw　his　movement　and　slid　the　organ　across。　〃Are　you　interested　in　dissection；　John？〃
　Alexander　answered　respectfully；　〃I've　always　been　interested　in　anatomy；　Doctor。〃
　〃As　well　as　lab　work；　eh？〃　McNeil　sensed　that　Pearson　was　pleased。　Pathological　anatomy　was　the　old　man's　first　love。
　〃Yes；　sir。〃
　〃Well；　these　are　the　organs　of　a　fifty…five…year…old　woman。〃　Pearson　turned　over　the　case…history　pages　in　front　of　him。　Alexander　was　raptly　attentive。　〃Interesting　history；　this　case。　The　patient　was　a　widow；　and　the　immediate　cause　of　death　was　cancer　of　the　breast。　For　two　years　before　she　died　her　children　knew　she　had　trouble　but　they　couldn't　persuade　her　to　see　a　physician。　It　seems　she　had　a　prejudice　against　them。〃
　〃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