ah.thefinaldiagnosis-第37章

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r　portion　of　her　body。
　Lucy　nodded　to　her　assisting　intern。　He　lifted　Vivian's　left　leg；　and　Lucy　began　to　remove　the　towels　which　were　taped　around　it。　Earlier　this　morning；　before　Vivian　had　been　brought　to　the　operating　floor；　the　leg　had　been　shaved；　bathed　thoroughly；　and　painted　with　merthiolate。　Now　Lucy　repeated　the　antiseptic　procedure　and　draped　fresh　sterile　towels　above　and　below　the　knee。
　On　the　other　side　of　the　operating　table　the　scrub　nurse　was　holding　a　folded　green　sheet。　With　Lucy　taking　one　side；　they　draped　it　over　the　table　so　that　a　hole　in　the　sheet　was　immediately　above　the　exposed　knee。　The　anesthetist　reached　over；　fastening　the　top　of　the　sheet　to　a　metal　bar　above　Vivian's　head；　so　that　her　view　of　the　rest　of　the　operating　room　was　cut　off。　As　he　looked　down　at　her　he　said；　〃Just　stay　relaxed；　Miss　Loburton。　This　is　really　like　having　a　tooth　out…only　a　lot　more　fortable。〃
　〃Knife；　please。〃　Lucy　held　out　her　hand　and　the　scrub　nurse　put　a　scalpel　into　it。　Using　the　belly　portion　of　the　blade；　she　made　a　quick；　firm　incision；　just　below　the　knee　and　about　four　centimeters　long。　Immediately　blood　welled　up。
　〃Mosquito　clamps。〃　The　scrub　nurse　was　ready；　and　Lucy　clamped　off　two　small　spurters。　〃Will　you　tie　off；　please？〃　She　moved　back　to　allow　the　intern　to　put　ligatures　around　both　clamps。
　〃We'll　make　our　incision　through　the　periosteum。〃　The　intern　nodded　as　Lucy　applied　the　knife　she　had　used　previously　to　the　thick　fibrous　tissue　above　the　bone；　cutting　cleanly　down。
　〃Ready　for　the　saw。〃　The　scrub　nurse　passed　Lucy　a　Stryker　oscillating　saw。　Behind　her　a　circulating　nurse　held　the　trailing　electric　cable　clear　of　the　operating　table。
　Talking　again　for　the　intern's　benefit；　Lucy　said；　〃We　shall　take　a　wedge…shaped　sample　of　bone。　About　half　to　three…quarters　of　an　inch　should　be　enough。〃　She　glanced　up　at　the　X…ray　films；　in　place　on　a　lighted　screen　at　the　end　of　the　room。　〃We　must　be　sure；　of　course；　that　we　are　into　the　tumor　and　don't　take　a　piece　of　normal　bone　that　has　been　forced　outward。〃
　Lucy　switched　on　the　saw　and　applied　it　twice。　There　was　a　soft　crunching　sound　each　time　it　bit　into　bone。　Then　she　switched　off　and　passed　the　saw　back。　〃There；　I　think　that　will　do。　Tweezers！〃
　Gingerly　she　extracted　the　bone　sample；　dropping　it　into　a　small　jar　of　Zenker's　solution　which　the　circulating　nurse　was　holding　out。　Now　the　specimen…identified　and　acpanied　by　a　surgical　work　requisition…would　go　to　Pathology。
　The　anesthetist　asked　Vivian；　〃Still　feel　all　right？〃
　She　nodded。
　He　told　her；　〃They　won't　be　long　now。　The　bone　sample　is　out。　All　they　have　to　do　is　zip　up　your　knee。〃
　At　the　table　Lucy　was　already　sewing　the　periosteum；　using　a　running　suture。　She　was　thinking：　If　only　this　were　all；　how　simple　everything　would　be。　But　this　was　merely　exploratory。　The　next　move　would　depend　on　Joe　Pearson's　verdict　about　the　bone　sample　she　was　sending　to　him。
　The　thought　of　Joe　Pearson　reminded　Lucy　of　what　she　had　learned　earlier　from　Kent　O'Donnell：　that　this　was　the　day　on　which　the　hospital's　new　assistant　pathologist　was　due　to　arrive　in　Burlington。　She　hoped　that　things　would　go　smoothly　with　the　new　man…for　O'Donnell's　sake　as　much　as　any　other　reason。
　Lucy　respected　the　chief　of　surgery's　efforts　to　achieve　improvement　within　the　hospital　without　major　upheavals；　though　she　knew　from　observation　that　O'Donnell　would　never　shun　an　issue　if　it　really　became　necessary　to　meet　it　head　on。　There　she　went　again；　she　reflected：　thinking　about　Kent　O'Donnell。　It　was　strange　how；　just　recently；　her　thoughts　had　kept　returning　to　him。　Perhaps　it　was　the　proximity　in　which　they　worked；　there　were　few　days　when　the　two　of　them　failed　to　meet　sometime　during　their　stint　in　surgery。　Now　Lucy　found　herself　wondering　how　soon　it　would　be　before　he　invited　her　to　dinner　once　more。　Or　perhaps　she　could　arrange　a　small　dinner　party　at　her　own　apartment。　There　were　a　few　people　she　had　been　planning　to　invite　for　some　time；　and　Kent　O'Donnell　could　be　among　them。
　Lucy　let　the　intern　move　in　to　sew　the　subcutaneous　tissue。　She　told　him；　〃Use　interrupted　sutures；　three　should　be　sufficient。〃　She　watched　closely。　He　was　being　slow　but　careful。　She　knew　some　of　the　surgeons　at　Three　Counties　gave　interns　very　little　to　do　when　they　were　assisting。　But　Lucy　remembered　how　many　times　she　herself　had　stood　by　an　operating　table；　hoping　for　at　least　a　little　practice　in　tying　knots。
　That　had　been　in　Montreal…all　of　thirteen　years　ago　since　she　had　begun　her　internship　at　Montreal　General；　then　stayed　on　to　specialize　in　orthopedic　surgery。　She　had　often　thought　how　much　chance　there　was　in　the　specialty　which　anyone　in　medicine　decided　to　enter。　Often　so　much　depended　on　the　kind　of　cases　you　became　involved　in　as　an　intern。　In　her　own　case；　in　pre…med　school　at　McGill；　and　later　at　Toronto　University　School　of　Medicine；　her　interest　had　switched　first　to　one　field；　then　to　another。　Even　on　return　to　Montreal　she　had　been　undecided　whether　to　specialize　at　all　or　enter　general　practice。　But　then　chance　had　caused　her　to　work　for　a　while　under　the　tutelage　of　a　surgeon　known　to　the　hospital　generally　as　〃Old　Bones；〃　because　of　his　concern　with　orthopedics。
　When　Lucy　first　knew　him；　Old　Bones　had　been　in　his　mid…sixties。　In　terms　of　behavior　and　personality；　he　was　one　of　the　most　objectionable　people　she　had　ever　met。　Most　teaching　centers　have　their　prima　donnas；　in　Old　Bones　the　worst　habits　of　them　all　had　appeared　to　be　bined。　He　regularly　insulted　everyone　in　the　hospital…interns；　residents；　his　own　colleagues；　patients…with　equal　impartiality。　In　the　operating　room；　if　crossed　at　all；　he　had　shouted　abuse　at　nurses　and　assistants　in　language　borrowed　from　the　barroom　and　the　water　front。　If　handed　a　wrong　instrument；　on　his　normal　days　he　would　throw　it　back　at　the　offender；　in　a　more　tolerant　mood　he　would　merely　hurl　it　at　the　wall。
　Yet；　for　all　the　performance；　Old　Bones　had　been　a　master　surgeon。　He　had　worked　mostly　on　correcting　bone　deformities　in　crippled　children。　His　spectacular　successes　had　made　his　fame　world…wide。　He　never　modified　his　manner；　and　even　the　children　he　dealt　with　got　the　same　rough　treatment　as　their　elders。　But；　somehow；　children　seldom　seemed　to　fear　him。　Lucy　had　often　wondered　if　childish　instinct　were　not　a　better　barometer　than　adult　reasoning。
　But　it　was　the　influence　of　Old　Bones　that　really　decided　Lucy's　future。　When　she　had　seen　at　first　hand　what　orthopedic　surgery　could　acplish；　she　had　wanted　to　share　the　acplishment　herself。　She　had　stayed　at　Montreal　General　as　a　three…year　intern；　assisting　Old　Bones　whenever　it　was　possible。　She　had　copied　everything　from　him　except　his　manner。　Even　toward　Lucy　that　had　never　changed；　though　near　the　end　of　her　senior　internship　she　took　pride　in　the　fact　that　he　had　shouted　at　her　a　good　deal　less　than　at　other　people。
　Since　then；　in　the　time　she　had　been　in　practice；　Lucy　had　had　successes　of　her　own。　And　in　Burlington　her　referrals　from　other　physicians　nowadays　made　her　one　of　the　busiest　people　on　Three　Counties'　staff。　She　had　gone　back　to　Montreal　only　once…on　an　occasion　two　years　earlier；　to　attend　Old　Bones'　funeral。　People　said　it　was　one　of　the　biggest　funerals　of　a　medical　man　the　city　had　ever　seen。　Practically　everyone　the　old　man　had　ever　insulted　had　been　present　in　the　church。
　Her　mind　switched　back　to　the　present。　The　biopsy　was　almost　plete。　At　a　nod　from　Lucy　the　intern　had　gone　on　to　sew　up　the　skin；　again　using　interrupted　sutures。　Now　he　was　putting　in　the　final　one。　Lucy　glanced　at　the　wall　clock　above　her。　The　whole　procedure　had　taken　half　an　hour。　It　was　3　P。M。
　
　At　seven　minutes　to　five　a　sixteen…year…old　hospital　messenger　sashayed；　whistling；　hips　swaying；　into　the　serology　lab。　Usually　he　came　in　this　way　because　he　knew　it　infuriated　Bannister；　with　whom　he　maintained　a　state　of　perpetual　running　warfare。　As　usual；　the　senior　lab　technician　looked　up　and　snarled　at　him。　〃I'm　telling　you　for　the　last　time　to　stop　making　that　infernal　racket　every　time　you　e　in　here。〃
　〃I'm　glad　it's　the　last　time。〃　The　youth　was　unperturbed。　〃Tell　you　the