Arthur Hailey - The Final Diagnosis

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.”

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 come 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 completed 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 is our business to track down a single individual whom we believe to be spreading typhoid germs within this hospital. It is also a problem of speed; the longer we take, the worse the epidemic will be. Our means of detection will be the stool specimens which will start coming in today, with the bulk of them arriving tomorrow.”

He addressed Roger McNeil. “Dr. McNeil, your job for the next few days will be to keep the lab clear of non-essential work. Check all routine requisitions coming in and decide how many of them should have priority and which can be postponed, at least for a day or two. The lab items which in your opinion are urgent can be handled by Carl Bannister. Work with him as much as you can, but don’t load him with any more than is essential; the rest of the time we’ll use him on our major project.” Pearson continued as McNeil nodded. “You yourself will have to take care of all surgical reports. Process those which appear urgent and accumulate anything that can wait. If there’s any diagnosis about which you’re not absolutely sure, call Dr. Coleman or myself.”

“Right. I’ll check with the office now.” McNeil went out.

To the others Pearson said, “We shall use a separate plate for each single stool culture. I don’t want to take the risk of putting several cultures together, then having one overgrow the others; it would mean we’d lose time and have to start again.” He asked Alexander, “Do we have sufficient MacConkey’s medium ready to handle close to a hundred cultures?”

John Alexander was pale and his eyes red-rimmed. He had returned from Elizabeth only a half-hour before. Nevertheless he responded promptly, “No,” he said, “I doubt if we’ve more than a couple of dozen. Normally that’s several days’ supply.”

When he had spoken, realizing that his reaction to a question about the lab had sprung from habit, John Alexander wondered what his own feelings were toward Dr. Pearson. He found he could not define them. He supposed he should hate this old man whose negligence had caused his own son’s death, and perhaps later on he would. But for now there was only a dull, deep aching and a sense of melancholy. Maybe it was as well for the time being that a great deal of work appeared to be facing them all. At least he could try to lose himself in some of it.

“I understand,” Pearson said. “Well, then, will you work in the media kitchen and stay with it until all the plates are ready for use? We must have them all by the end of today.”

“I’ll get started.” Alexander followed McNeil out.

Now Pearson was thinking aloud. “We shall have ninety-five cultures, say a hundred. Assume that 50 per cent will be lactose positive, leaving the other 50 per cent to be investigated further; it shouldn’t be more than that.” He glanced at Coleman for confirmation.

“I’d agree.” Coleman nodded.

“All right then; we shall need ten sugar tubes to a culture. Fifty cultures—that means five hundred subcultures.” Turning to Bannister, Pearson asked, “How many sugar tubes are ready—clean and sterilized?”

Bannister considered. “Probably two hundred.”

“Are you sure?” Pearson looked at him searchingly.

Bannister colored. Then he said, “A hundred and fifty anyway.”

“Then order three hundred and fifty more. Call the supply house and say we want them delivered today, and no excuses. Tell them we’ll take care of the paper work later.” Pearson went on. “When you’ve done that, begin preparing the tubes in sets of ten. Use those on hand first, then the others when they come. Check your sugar supplies too. Remember you’ll need glucose, lactose, dulcitol, sucrose, mannitol, maltose, xylose, arabinose, rhamnose, and one tube for indole production.”

Pearson had rattled off the names without hesitation. With the ghost of a smile he said to Bannister, “You’ll find the list and table of reactions for Salmonella typhi on page sixty-six of laboratory standing orders. All right, get moving.”

Hastily Bannister scurried to the telephone.

Turning to David Coleman, Pearson asked, “Can you think of anything I’ve forgotten?”

Coleman shook his head. The old man’s grasp of the situation, as well as his celerity and thoroughness, had left Coleman both surprised and impressed. “No,” he said, “I can’t think of a thing.”

For a moment Pearson regarded the younger man. Then he said, “In that case, let’s go and have coffee. It may be the last chance we’ll have for quite a few days.”

Now that Mike Seddons had gone, it came to Vivian just how big a gap his absence left behind and how long-drawn-out the next few days were going to seem without him. She believed, though, she had been right in asking Mike to remain away for a time. It would give them both a chance to adjust and to think clearly about the future. Not that Vivian needed any time to think herself; she was quite sure of her own feelings, but it was faker to Mike this way. Or was it? For the first time it occurred to her that by acting as she had perhaps she was asking Mike to prove his love for her, while accepting her own without question.

But that was not what she had intended. Vivian wondered uneasily, though, if Mike had taken it that way—if she had appeared to him untrusting and unwilling to accept his devotion at face value. He hadn’t seemed to, it was true; but perhaps after thinking things over, as she herself was doing at this moment, he might decide that was the way it was. She speculated on whether she should call him or send a note explaining what she had really intended—that is, if she were sure herself. Was she sure though—even now? At times it was so difficult to think clearly; you started out doing what you thought was right, then you wondered if someone else might misinterpret, might look for hidden meanings that you had never considered yourself. How could you be really sure what was the best thing to do about anything . . . anywhere . . . ever . . . ?