The Final Diagnosis

Left alone, John glanced at his watch again. He saw that it was an hour and three quarters since he had come here; surely there must be something soon in the way of news. He wished he had seen Elizabeth before she had gone into the delivery room, but everything had happened so quickly that there had not been time. He had been in the hospital kitchens when Carl Bannister had come to bring him the news. John had gone to the kitchens on Dr. Pearson’s instructions. Pearson had told him to take cultures from plates which had passed through the kitchen dishwashers; John gathered that the machines were suspected of being unhygienic. But he had left the work as soon as Bannister had told him about Elizabeth and had gone to Emergency, hoping to intercept her there. But by that time she had already arrived by ambulance and had gone upstairs to Obstetrics. It was after that that he had come straight here to wait.

Now the door from the corridor opened, and this time it was Dr. Dornberger. From his face John tried to read the news, but without success. He asked, “You are John Alexander?”

“Yes, sir.” Though, he had seen the elderly obstetrician several times in the hospital, this was the first time they had spoken to each other.

“Your wife is going to be all right.” Dornberger knew better than to waste time on preliminaries.

John’s first impression was of overwhelming relief. Then he asked, “The baby?”

Dornberger said quietly, “You have a boy. He was premature, of course, and I have to tell you, John—he’s very frail.”

“Will he live?” Only when he had asked the question did it occur to him how much depended on the answer.

Dornberger had taken out his pipe and was filling it. He said evenly, “Let’s say the chances are not as good as if he had gone to full term.”

John nodded dully. There seemed nothing to say, nothing that would matter now.

The older man paused to put away his tobacco pouch. Then in the same quiet, careful tone he said, “As near as I can tell, you have a thirty-two-week baby; that means he was born eight weeks early.” Compassionately he added, “He wasn’t ready for the world, John; none of us are that soon.”

“No, I suppose not.” John was scarcely conscious of speaking. His mind was on Elizabeth and what this baby was to have meant to them both.

Dr. Dornberger had produced matches and was lighting his pipe. When he had it going he said, “Your baby’s birth weight was three pounds eight ounces. Perhaps that will mean more if I tell you that nowadays we consider any baby less than five pounds eight ounces at birth to be premature.”

“I see.”

“We have the baby in an incubator, of course. Naturally we’ll do everything we can.”

John looked at the obstetrician directly. “Then there is hope.”

“There’s always hope, son,” Dornberger said quietly. “When we haven’t much else, I guess there’s always hope.”

There was a pause, then John asked, “May I see my wife now?”

“Yes,” Dornberger said. “I’ll come to the nursing station with you.”

As they went out John saw the tall, gaunt man watching him curiously.

Vivian was not quite sure what was happening. All she knew was that one of the staff nurses had come into her room and told her they were going to Radiology immediately. With help from another student nurse she had been put on a stretcher and now was being wheeled along the corridors where so short a time ago she had walked herself. Her movement through the hospital had a dream-like quality; it complemented the unrealness of everything else that had happened so far. Momentarily Vivian found herself abandoning fear, as if whatever followed could not matter to her in the end because it was inevitable and would not be changed. She found herself wondering if this feeling were a form of depression, of abandoning hope. She had known already that this was the day which might bring the verdict she had dreaded, a verdict which would make her a cripple, depriving her of freedom of movement, removing from her in one swift stroke so many things she had taken for granted until this time. With this latest thought the moment of passivity left her and fear came crowding back. She wished desperately that Mike were with her at this moment.

Lucy Grainger met the stretcher at the entrance to Radiology. “We’ve decided to do another X-ray, Vivian,” she said. “It won’t take long.” She turned to a white-coated man beside her. “This is Dr. Bell.”

“Hullo, Vivian.” He smiled at her through thick horn-rimmed glasses, then, to the nurse, “May I have the chart, please?” As he studied it, turning the pages quickly, Vivian moved her head to look around her. They were in a small reception room with a glass-enclosed nursing station in one corner. Against one wall other patients were seated—two men in wheel chairs wearing pajamas and hospital robes, and a woman and a man in street clothes, the latter with a cast around his wrist. The last two, she knew, would have come here either from Outpatients or Emergency. The man with the cast looked uncomfortable and out of place. In his good hand was clasped a printed form; he seemed to be clutching it as if it were a passport he would need to come and go from these alien surroundings.

Bell finished reading the chart and handed it back. He said to Lucy, “Joe Pearson phoned me. I gather that you’d like to re-X-ray, so we can see if there’s any change in the bone appearance.”

“Yes.” Lucy nodded. “It’s Joe’s idea that something”—she hesitated, aware that Vivian would hear her words—“might have become visible in the meantime.”

“It’s possible.” Bell had crossed to the nursing station and was scribbling an X-ray requisition. He asked a girl clerk behind the desk, “Which technicians are free?”

She consulted a list. “There’s Jane or Mr. Firban.”

“I think we’ll have Firban do this one. Will you find him, please?” He turned to Lucy as they moved back toward the stretcher. “Firban’s one of our best technicians, and we want good films.” He smiled at Vivian. “Dr. Pearson-asked me to take a personal interest in this case, so that’s what I’m doing. Now let’s go in this room over here.”

With help from Bell the nurse guided the stretcher out of the reception area and into a larger room opening from it. Most of the room was taken up by an X-ray table, with the machine’s picture tube above and suspended on overhead rollers. In an adjoining smaller section, behind thick glass, Vivian could see an electric control panel. Almost at once they were followed into the room by a short, youngish man with crew-cut hair and wearing a white lab coat. His movements were jerky and hurried, as though he wished to achieve whatever he was doing quickly but with a minimum of energy expended. He glanced at Vivian, then turned to Bell.

“Yes, Dr. Bell?”

“Oh, Karl, I’d like you to handle this case for me. By the way, do you know Dr. Grainger?” To Lucy, “This is Karl Firban.”

“I don’t think we’ve met.” Lucy offered her hand and the technician took it.

“How do you do, Doctor.”

“And our patient is Vivian Loburton.” Bell smiled down at the stretcher. “She’s a student nurse. That’s why we’re making such a fuss over her.”

“Hullo, Vivian.” Firban’s greeting was as taut as his other actions. Now, swinging the X-ray table from a vertical position to horizontal, he talked on with brisk brightness. “For special customers we offer a choice of Vista Vision or CinemaScope—all in glorious gray and black.” He glanced at the requisition which Bell had put down. “The left knee, eh? Anything special, Doctor?”

“We’ll want some good A.P., lateral and oblique views, and then I think a coned-down view of the knee area.” Bell paused and considered. “I’d say about five or six films, and then duplicates of the opposite extremity.”

“Do you want any views on a fourteen by seventeen, to include the anterior tibia and fibula?”

Bell considered, then nodded. “That might be a good idea.” To Lucy he said, “If it’s osteomyelitis there could be periosteal reaction further down the bone.”

“All right, Doctor. I’ll have something for you in half an hour.” It was a polite hint from Firban that he preferred to work alone, and the radiologist accepted it.

“We’ll have a coffee and come back.” Bell smiled in Vivian’s direction. “You’re in good hands.” Then, with Lucy ahead of him, he went outside.

“All righty. Let’s get to work.” The technician motioned to the nurse, and together they eased Vivian from the stretcher to the X-ray table. After the stretcher’s comparative softness the black ebonite table felt hard and unyielding.

“Not so comfortable, eh?” Firban was moving Vivian carefully into the position he wanted, leaving her left knee exposed. As she shook her head he went on, “You get used to it. I’ve slept on this table plenty of times when I’ve been on night duty and things have been quiet.” He nodded to the nurse, and the girl went to wait behind the glassed-in section.

With Vivian watching, the technician went through the routine movements of an X-ray series. Still with the same swift jerkiness, he took a film casette from an upright container built into the wall, inserting it deftly in a tray beneath the X-ray table. Next he positioned the tray below the area of Vivian’s knee. Then, using press-button controls suspended from the ceiling by a heavy electrical cord, he maneuvered the heavy X-ray tube along its rollers and downward, until it was immediately above the knee, the arrow on the machine’s calibrated height scale pointing to forty inches.

In contrast to so much else in the hospital, Vivian thought, this room appeared almost unearthlike and remote. The shining black and chrome machinery seemed monstrous as it slid slowly and in massive murmur. There was an aura of science and neutrality in this place, in a way as remote from medicine as a great ship’s engine room might seem from a sunlit bridge deck far above. And yet here, with these ominous, ponderous instruments, so much of medicine’s real detective work was done. The thought for a moment frightened her. There was a dreadful impersonality in it all, so little of people in these machines. Whatever they might discover was relayed and reported without warmth or pleasure, without sadness or regret. Good, bad—it was all the same. For a moment she fancied the picture tube suspended above her to be an eye of judgment, inflexible, dispassionate. What was its judgment now? Would there be hope, or even reprieve . . . or a solemn sentence from which there could be no appeal? Again she found herself wishing for Mike; she would call him as soon as she returned to the hospital room.

The technician had finished his preparation. “I think that will do.” He took a final look around. “I’ll tell you when to keep perfectly still. This is the only place in the hospital, you know, where we can say you won’t feel a thing and really mean it.”

Now he moved behind the inch-thick glass screen which protected the X-ray operator from radiation. Out of the periphery of her vision Vivian could see him moving, holding a check list, setting switches.