ah.thefinaldiagnosis-第74章

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run　over　the　principal　early…stage　symptoms。　Generally　speaking；　there's　a　rising　fever；　chills；　and　a　slow　pulse。　There's　also　a　low　blood　count　and；　naturally；　the　characteristic　rose　spots。　In　addition　to　all　that　a　patient　will　probably　plain　of　a　dull　headache；　no　appetite；　and　general　aching。　Some　patients　may　say　they're　drowsy　in　the　daytime　and　that　they're　restless　at　night。　One　thing　to　look　out　for　also　is　bronchitis；　that's　quite　mon　with　typhoid；　and　you　may　encounter　nosebleed　too。　And；　of　course；　a　tender；　swollen　spleen。〃
　The　chief　of　medicine　sat　down。　O'Donnell　asked；　〃Any　questions？〃
　Lucy　Grainger　asked；　〃I　take　it　that　typhoid　shots　are　being　arranged。〃
　〃Yes；〃　Chandler　said；　〃for　all　employees　and　staff；　also　patients　who　are　well　enough　to　have　them。〃
　〃What　about　kitchen　arrangements？〃　The　question　was　from　Bill　Rufus。
　O'Donnell　said；　〃If　you　don't　mind；　we'll　e　to　that　shortly。　At　this　point　is　there　anything　more　medically？〃　He　looked　around；　there　was　a　shaking　of　heads；　〃Very　well；　then。　We'll　hear　from　Pathology。〃　He　announced　quietly；　〃Dr。　Pearson。〃
　Until　this　moment　there　had　been　background　noises　in　the　room…fidgeting；　the　movement　of　chairs；　murmurs　of　conversation　aside　from　the　main　discussion。　But　now　there　was　a　hush　as　eyes　turned　curiously　to　where；　halfway　down　the　long　table；　Joe　Pearson　sat。　Since　entering　he　had　not　spoken　but　had　remained　quite　still；　his　eyes　fixed　directly　ahead。　For　once　he　had　no　cigar　lighted；　and　the　effect　was　like　the　absence　of　a　familiar　trade…mark。　Even　now；　as　his　name　was　called；　he　made　no　move。
　O'Donnell　waited。　He　was　about　to　repeat　the　announcement　when　Pearson　stirred。　As　his　chair　went　back　the　old　pathologist　rose　to　his　feet。
　Slowly　his　eyes　swept　the　board　room。　They　went　the　length　of　the　table；　then　returned　to　its　head。　Looking　directly　at　O'Donnell；　Pearson　said；　〃This　epidemic　should　not　have　happened。　Nor　would　it；　if　Pathology　had　been　alert　to　a　breakdown　in　hygiene　precautions。　It　is　the　responsibility　of　my　department；　and　therefore　my　own　responsibility；　that　this　neglect　occurred。〃
　Again　a　silence。　It　was　as　if　history　had　been　made。　In　this　room　so　many　times　Joe　Pearson　had　charged　others　with　error　and　misjudgment。　Now　he　stood　himself…accuser　and　accused。
　O'Donnell　wondered　if　he　should　interrupt。　He　decided　not。　Again　Pearson　looked　around　him。　Then　he　said　slowly；　〃Having　allocated　some　of　the　blame；　we　must　now　prevent　the　outbreak　going　further。〃　He　glanced　across　the　table　at　Harry　Tomaselli。　〃The　administrator；　the　heads　of　departments；　and　I　have　formulated　certain　procedures　to　be　carried　out　at　once。　I　will　tell　you　what　they　are。〃
　Now　Pearson　paused；　and　when　he　resumed　there　was　a　stronger　note　to　his　voice。　It　was　almost；　O'Donnell　thought；　as　if　in　this　single　moment　the　old　man　were　throwing　off　some　of　his　years；　as　if　providing　a　glimpse　of　what　he　had　been　like　long　ago　as　a　younger　practitioner…intense；　earnest；　and　petent。　The　old　sardonic　humor；　the　air　of　borderline　contempt；　which　all　of　them　in　this　room　had　e　to　know　so　well；　were　gone。　In　their　place　were　authority　and　know…how　and　the　forthright　frankness　of　one　who　accepts　without　question　the　fact　that　he　is　speaking　with　equals。
　〃The　immediate　problem；〃　Pearson　said；　〃is　to　locate　the　source　of　infection。　Because　of　the　failure　to　check　food　handlers　properly　over　the　past　six　months　it　is　logical　that　we　should　suspect　food　as　a　means　of　contamination　and　should　begin　our　search　there。　For　this　reason　there　must　be　a　medical　inspection　of　all　food　handlers　before　the　next　hospital　meal　is　served。〃　From　his　frayed　woolen　vest　he　extracted　a　watch　and　placed　it　on　the　table。　〃The　time　is　now　2：15　P。M。　That　gives　us　two　and　three…quarter　hours。　In　that　time　every　employee　who　has　any　part　in　the　preparation　and　serving　of　hospital　food　is　to　be　given　a　thorough　physical　check。　Facilities　are　being　set　up　now　in　the　outpatient　clinics。　I　understand　that　all　the　internists　and　house　staff　were　notified　before　this　meeting。〃　He　glanced　around　and　there　was　a　nodding　of　heads。　〃Very　well。　As　soon　as　we　are　finished　here　Dr。　Coleman〃…Pearson　glanced　down　at　David　Coleman　beside　him…〃will　give　you　your　assignment　to　a　specific　room。〃
　Gesturing　toward　the　chief　dietitian；　Pearson　said；　〃Mrs。　Straughan　is　arranging　to　assemble　all　the　people　concerned；　and　they　will　be　reporting　to　Outpatients　in　batches　of　twelve。　That　means　ninety…five　people　to　be　examined　within　the　time　we　have。
　〃When　you　make　these　examinations；　by　the　way；　remember　that　the　typhoid　carrier…and　we　are　assuming　there　is　a　carrier…probably　has　none　of　the　symptoms　Dr。　Chandler　described。　What　you　should　look　for　particularly　is　any　lack　of　personal　cleanliness。　And　anyone　you　have　doubts　about　should　be　suspended　from　duty　for　the　time　being。〃
　Pearson　stopped　as　if　thinking。　So　far　he　had　consulted　no　notes。　Now　he　went　on　again。　〃Of　course；　we　are　all　aware　that　physical　checkups　will　not　give　us　the　whole　story。　We　may　be　lucky　and　find　the　individual　we're　looking　for　that　way；　but　the　chances　are　we　won't。　Most　likely　the　major　work　will　e　in　the　labs　as　soon　as　the　medicals　are　pleted。　All　the　people　you　examine　are　to　be　told　that　stool　cultures　are　required　and　stool　samples　must　be　in　the　hospital　by　tomorrow　morning。〃　There　was　the　ghost　of　a　smile。　〃Constipation　will　not　be　taken　as　an　excuse；　and　if　anyone　can　e　through　with　a　sample　today　we　will；　of　course；　accept　it　gratefully。
　〃The　labs　are　being　set　up　now　to　cope　with　all　the　cultures　we　shall　be　doing。　Of　course；　it　will　take　us　a　few　days…two　or　three　at　least…to　handle　all　those　stool　samples。〃
　A　voice…O'Donnell　thought　it　was　Gil　Bartlett's…said　quietly；　〃Ninety…five　people！　That's　a　lot　of　shit。〃　A　ripple　of　laughter　ran　around　the　table。
　Pearson　turned。　〃Yes；〃　he　said；　〃it　is　a　lot。　But　we　shall　do　our　best。〃
　With　that　he　sat　down。
　Lucy　signaled　with　her　hand；　and　O'Donnell　nodded　for　her　to　speak。　She　asked；　〃If　the　source　of　infection　is　not　found　immediately；　will　we　continue　to　use　the　hospital　kitchens…to　serve　food　here？〃
　〃For　the　moment…yes；〃　O'Donnell　answered。
　The　administrator　added；　〃My　office　is　checking　now　to　see　if　there's　any　outside　caterer　who　could　handle　food　supply　if　that　were　felt　necessary。　I　doubt；　though；　if　there's　anyone　in　town　who　has　facilities…at　short　notice　like　this…to　do　it。〃
　Bill　Rufus　asked；　〃What's　our　policy　to　be　on　admissions？〃
　〃I'm　sorry；〃　O'Donnell　said。　〃I　should　have　mentioned　that。　As　of　this　moment　we've　stopped　admissions。　The　admitting　department　has　already　been　notified。　But；　of　course；　we're　hoping　pathology　can　track　down　the　source　of　infection　quickly；　and　then　we'll　review　our　admissions　policy　again。　Anything　else？〃
　There　were　no　more　questions。　Looking　down　the　table；　O'Donnell　asked；　〃Dr。　Coleman；　do　you　have　anything　to　add？〃
　David　Coleman　shook　his　head。　〃No。〃
　O'Donnell　closed　the　file　which　had　been　open　in　front　of　him。　〃Very　well；　ladies　and　gentlemen；　I　suggest　we　get　started。〃　Then；　as　chairs　scraped　back　and　conversation　began；　he　asked　Pearson；　〃Joe；　could　I　have　a　word　with　you？〃
　Together　they　crossed　to　a　window；　away　from　the　others　who　were　filing　out　through　the　door。　O'Donnell　said　quietly；　making　sure　his　voice　did　not　carry；　〃Joe；　naturally　you'll　remain　in　charge　of　Pathology　during　this　outbreak。　But　I　think　I　must　make　clear　to　you　that；　concerning　other　things；　nothing　has　changed。〃
　Pearson　nodded　slowly。　〃Yes；〃　he　said；　〃I'd　already　figured　that。〃
　
　Twenty…two
　
　Like　a　general　appraising　his　forces　ahead　of　battle；　Dr。　Joseph　Pearson　surveyed　the　pathology　lab。
　With　him　were　David　Coleman；　the　pathology　resident　Dr。　McNeil；　Carl　Bannister；　and　John　Alexander。　Pearson；　Coleman；　and　McNeil　had　e　directly　from　the　emergency　staff　meeting　in　the　board　room。　The　other　two；　acting　on　earlier　instructions；　had　cleared　the　lab　of　all　but　immediate；　essential　work。
　When　Pearson　had　pleted　his　inspection　he　addressed　the　other　four。　〃Our　problem；〃　he　announced；　〃is　one　of　detection。　Out　of　a　field　of　approximately　ninety…five　people…the　food　handlers…it