The Final Diagnosis

“What was it, Dr. Pearson?”

“There was . . . something to do with the lab.” Pearson shook his head. “Well, it’s gone now . . . I’ll remember later.” He seemed about to turn away when another thought came to him. “I think you’d better take over the autopsy room. Starting tomorrow. Keep your eye on things. See they do a good job.”

“Very well. I’ll be glad to do that.” David Coleman had some clear-cut ideas about the performance of autopsies, and this would be an opportunity to put them into effect. It occurred to him that while they were talking he might as well bring up something else. He said, “I wonder if I could speak to you—about the laboratories.”

“The laboratories?” The old man’s mind still seemed to be elsewhere.

“You’ll remember in my letter I suggested you might consider giving me charge of some part of the laboratories.” It seemed a little odd to be discussing this here and now, but Coleman sensed the opportunity might not occur again.

“Yes . . . yes, I remember something being said.” Pearson appeared to be watching a group of three moving down the corridor away from them—a policeman and a little man, supporting a bigger man in the middle.

“I wonder if I might start in Serology,” Coleman said. “I’d like to do some checks on the procedures—standard lab checks, that is.”

“Um? What was that?”

It was annoying to have to keep repeating things. “I said I would like to make some lab checks in Serology.”

“Oh yes, yes . . . that’s all right.” Pearson said it absently. He was still looking away, down the corridor, when Coleman left.

Elizabeth Alexander was feeling good. About to begin lunch in Three Counties Hospital cafeteria, she realized she had been feeling that way for days, but especially so this morning. The child inside her was alive and stirring; even at this moment she could detect its movements faintly. She had just come from a department-store sale where, amid the melee of women, she had victoriously acquired some bright fabrics for the apartment, including one length for the tiny extra bedroom which was to be the baby’s. And now she had met John.

It was the first time they had had a meal together in the hospital. Use of the cafeteria by employees’ families was an unwritten privilege the hospital allowed, and John had learned about it a few days earlier. A few minutes ago they had lined up to select their food and Elizabeth had chosen a salad, soup, a roll, roast lamb with potatoes and cabbage, pie with cheese, and milk. John had asked good-humoredly, “Are you sure you have enough?”

Elizabeth selected a stick of celery. Biting into it, she said, “This is a hungry baby.”

John smiled. A few minutes earlier, on the way to lunch, he had felt defeated and depressed, this morning’s tongue-lashing by Dr. Pearson still fresh in mind. But Elizabeth’s infectious spirits had caused him to shrug it off, at least for the time being. After all, he reflected, there would be no more trouble in the lab because from now on he intended to watch his step carefully. In any case, Dr. Pearson had now done the sensitization tests himself—in saline and high protein—and had pronounced both test results negative. “So far as your wife’s blood is concerned,” he had said, “there is nothing for anyone to worry about.” In fact, he had been almost kindly about it—at least it seemed that way after the earlier outburst.

There was another thing to remember: Dr. Pearson was a pathologist and John was not. Maybe Dr. Pearson was right; perhaps John had placed too much importance on some of the things that were taught at technology school. Wasn’t it a well-known fact that schools always pumped a lot of theory into you that you had no use for in the practical world outside? Goodness knows, he thought, there are plenty of subjects in high school and college that you never work at again once final exams are over. Couldn’t this be the same thing? Couldn’t John himself have taken too seriously the school theory about the need for a third sensitization test, whereas Dr. Pearson, with all his practical knowledge, knew it was unnecessary?

What was it Dr. Pearson had said while he was doing the tests this morning? “If we changed our laboratory methods every time something new came up, there’d never be any end to it. In medicine there are new ideas coming out every day. But in a hospital we have to make sure they’re proven and valuable before we start to use them. Here we’re dealing with people’s lives and we can’t afford to take chances.”

John had not quite been able to see how an extra blood test would imperil anybody’s life, but, all the same, Dr. Pearson did have a point about the new ideas. John knew from his own reading that there were lots of them around and not all good. Of course, Dr. Coleman had been pretty definite about the need for a third sensitization test. But then he was a lot younger than Dr. Pearson; certainly he had not had as much experience . . .

“Your soup’s getting cold.” Elizabeth broke in on his thoughts. “What are you so pensive about?”

“Nothing, honey.” He decided to put the whole thing out of his mind. Elizabeth, at times, had a disconcerting habit of worming out his thoughts. “I meant to ask you last week,” he said. “How was your weight?”

“It’s about right,” Elizabeth answered cheerfully. “But Dr. Dornberger said I have to eat well.” She had finished her soup and was attacking the roast lamb hungrily.

Glancing up, John Alexander noticed Dr. Coleman approaching. The new pathologist was on his way to the tables where the medical staff usually sat. On impulse Alexander rose from his chair. “Dr. Coleman!”

David Coleman glanced across. “Yes?”

“Doctor, I’d like to have you meet my wife.” Then, as Coleman came toward them, “Elizabeth, honey, this is Dr. Coleman.”

“How do you do, Mrs. Alexander?” Coleman paused, holding the tray he had collected from the counter.

A trifle awkwardly John Alexander said, “You remember, honey?—I told you the doctor came from New Richmond too.”

“Yes, of course,” Elizabeth said. Then directly to Coleman, smiling, “Hullo, Dr. Coleman—I remember you very well. Didn’t you used to come into my father’s store sometimes?”

“That’s right.” He recalled her clearly now: a cheerful, long-legged girl who used to clamber obligingly around that cluttered, old-fashioned store, finding things that had got lost in the confusion. She didn’t seem to have changed much. He said, “I think you once sold me some clothesline.”

She answered brightly, “I believe I remember that. Was it all right?”

He appeared to ponder. “Now you mention it, I think it broke.”

Elizabeth laughed. “If you take it back, I’m sure my mother will exchange it. She still runs the store. It’s more of a mess than ever.” Her good humor was infectious. Coleman smiled.

John Alexander had pulled back a chair. “Won’t you join us, Doctor?”

For a moment Coleman hesitated. Then, realizing it would be churlish to refuse, “All right,” he said. He put down his tray—it contained a Spartan lunch—a small fruit salad and a glass of milk—and sat at the table. Looking at Elizabeth, he said, “If I remember, didn’t you have pigtails when I knew you?”

“Yes,” she answered promptly, “and bands on my teeth as well. I grew out of them.”

David Coleman found himself liking this girl. And seeing her here today had been like suddenly turning a page from the past. She reminded him of earlier years; Indiana had been a good place to live. He remembered the summers home from school, driving on rounds with his father in the doctor’s old and battered Chevrolet. He said reflectively, “It’s a long time since I was in New Richmond. My father died, you know, and Mother moved to the West Coast. There’s nothing to take me back there now.” Then drawing his thoughts away, “Tell me,” he said to Elizabeth, “how do you like being married to a medical man?”

Swiftly John Alexander put in, “Not a medical man—just a technologist.” When he had said it he wondered why. Perhaps it was a reflex action from what had happened this morning. A few minutes ago, when Coleman had joined them, John had considered telling him about the incident in the lab. But immediately afterward he had decided not to. Talking freely with Dr. Coleman had got him into enough trouble already. He decided to leave well enough alone.

“Don’t sell technology short,” Coleman said. “It’s pretty important.”

Elizabeth said, “He doesn’t. But sometimes he wishes he had become a doctor instead.”

Coleman turned to him. “Is that right?”

Alexander wished Elizabeth had not brought this up. He said reluctantly, “I did have ideas that way. For a time.”

Coleman speared some fruit salad with his fork. “Why didn’t you go to medical school?”

“The usual reasons—money mostly. I didn’t have any, and I wanted to start earning.”

Between mouthfuls Coleman said, “You could still do it. How old are you?”

Elizabeth answered for him. “John will be twenty-three. In two months’ time.”

“That’s pretty old, of course.” They laughed, then Coleman added, “You’ve still got time.”

“Oh, I know.” John Alexander said it slowly, thoughtfully, as if knowing in advance that his own argument was unconvincing. “The trouble is, it would mean a big financial struggle just when we’re beginning to get settled. And besides, with a baby coming . . .” He left the sentence hanging.

Coleman took the glass of milk and drank deeply. Then he said, “Plenty of people have gone through medical school with a baby. And financial problems.”

“That’s exactly what I’ve been saying!” Elizabeth said it intensely, leaning forward across the table. “I’m so glad to hear it from someone else.”

Coleman wiped his mouth with a napkin, then put it down. He looked directly at Alexander. He had a feeling that he had been right in his first impression of this young technologist. He seemed intelligent and conscientious; certainly he was interested in his work—that had been evident the other day. Coleman said, “You know what I think, John? I think 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.”

Alexander was looking down, absently moving his knife and fork.

Elizabeth asked, “There’s still a need for a lot of doctors in pathology, isn’t there?”

“Oh yes.” Coleman nodded emphatically. “Perhaps more in pathology than anywhere else.”

“Why is that?”

“There’s a need of research for one thing—to keep medicine moving ahead; to fill in the gaps behind.”

She asked, “What do you mean—the gaps behind?”

Momentarily the thought occurred to David Coleman that he was talking more freely than usual. He found himself about to express ideas which most of the time he kept locked in his own mind. But the company of these two had seemed refreshing, possibly because it was a change to be with someone younger after being around Dr. Pearson. Answering Elizabeth’s question, he said, “In a way medicine is like a war. And, just as in a war, sometimes there’s a spectacular advance. When that happens, people—doctors—rush to the new front. And they leave a lot of pockets of knowledge to be filled in behind.”