further treatment, and predicting the patient’s future.”
Lucy herself had fared well in her relationship with Joe Pearson. For some reason she was not sure of, he had seemed to like her, and there were moments she found herself responding and liking him also. Sometimes this could prove a help when she needed to talk with him about a diagnosis.
Now the discussion was ending, O’Donnell winding things up. Lucy brought her attention back into focus. She had let it wander during the last case; that was not good—she would have to watch herself. The others were rising from their seats. Joe Pearson had collected his papers and was shambling out. But on the way O’Donnell stopped him; she saw the chief of surgery steer the old man away from the others.
“Let’s go in here a minute, Joe.” O’Donnell opened the door to a small office. It adjoined the board room and was sometimes used for committee meetings. Now it was empty. Pearson followed the chief of surgery in.
O’Donnell was elaborately casual. “Joe, I think you should quit riding people at these meetings.”
“Why?” Pearson was direct.
All right, O’Donnell thought, if that’s the way you want it. Aloud he said, “Because it gets us nowhere.” He allowed his voice to take on an edge. Ordinarily in dealing with the old man he deferred a little to the gap of years between them. But this was a moment to exercise his own authority. Although, as chief of surgery, O’Donnell had no direct control of Pearson’s activities, he did have certain prerogatives when the work of Pathology cut across his own division.
“I pointed out a wrong diagnosis—that’s all.” Pearson was aggressive himself now. “Do you suggest we keep quiet about such things?”
“You know better than to ask that.” O’Donnell slammed out the answer, this time not bothering at all to keep the ice from his voice. He saw Pearson hesitate and suspected the old man knew he had gone too far.
Grumblingly he conceded, “I didn’t mean that; not that way.”
Despite himself Kent O’Donnell smiled. Apologizing did not come easily to Joe Pearson. It must have cost him quite a lot to say that. Now O’Donnell went on more reasonably, “I think there are better ways to do it, Joe. If you don’t mind, at these meetings I’d like you to give us the autopsy findings, then I’ll lead the discussion afterward. I think we can do it without getting tempers frayed.”
“I don’t see why anybody has to get in a temper.” Pearson was still grumbling, but O’Donnell sensed he was backing down.
“All the same, Joe, I’d like to do it my way.” I don’t want to ram it down his throat, O’Donnell thought, but this is the time to make things clear.
Pearson shrugged. “If that’s the way you want it.”
“Thanks, Joe.” O’Donnell knew he had won; it had been easier than he had expected. Maybe this would be a good time to raise the other thing. “Joe,” he said, “while we’re here, there’s something else.”
“I’ve got a lot to do. Couldn’t it wait?” As Pearson spoke, O’Donnell could almost read his mind. The pathologist was making it clear that though he had conceded one point he had not abandoned his independence.
“I don’t think it can. It’s about surgical reports.”
“What about them?” The reaction was aggressively defensive.
O’Donnell went on smoothly. “I’ve had complaints. Some of the reports have been a long time coming through Pathology.”
“Rufus, I suppose.” Pearson was openly bitter now. You could almost hear him saying: Another surgeon causing trouble.
O’Donnell determined not to be provoked. He said quietly, “Bill Rufus was one. But there have been others. You know that, Joe.”
For a moment Pearson made no answer, and O’Donnell reflected that in a way he felt sorry for the old man. The years were slipping by. Pearson was sixty-six now; at best he had another five or six years of active work ahead of him. Some people reconciled themselves to change like that, to younger men moving into prominence and taking over leadership. Pearson had not, though, and he made his resentment plain. O’Donnell wondered what was back of his attitude. Did he feel himself slipping, unable to keep up with new developments in medicine? If so, he would not be the first. And yet Joe Pearson, for all his disagreeable ways, had a lot to commend him. That was one of the reasons why O’Donnell trod circumspectly now.
“Yes, I know.” Pearson’s reply held a tone of resignation. He had accepted the fact though. That was typical of him, O’Donnell thought. Right from the beginning at Three Counties he had liked Pearson’s directness and at times had made use of it in raising surgical standards.
O’Donnell remembered that one of the problems he had faced in his early months at the hospital had been the elimination of needless surgery. Under this heading had come an unnatural number of hysterectomies, and in too many cases healthy, normal uteri were being removed by a few staff surgeons. These were men who found surgery a convenient and profitable remedy for any female pain, even those which might have responded to internal medication. In such instances euphemisms in diagnosis like “chronic myometritis” or “fibrosis of uterus” were resorted to as a smoke screen to cover up the pathology report on the removed tissue. O’Donnell remembered telling Pearson: “When we’re reporting on tissue we’ll call a spade a spade and a healthy uterus a healthy uterus.” Pearson had grinned and co-operated fully. As a result most of the unnecessary surgery had stopped. Surgeons found it embarrassing to have tissue they had removed from patients listed for all their colleagues to see as normal and uninfected.
“Look, Kent.” Pearson was more conciliatory now. “Just lately I’ve been up to my ears. You’ve no idea how much work there is.”
“I do have an idea, Joe.” This was the opening O’Donnell had hoped for. “Some of us think you’ve too much to do. It isn’t fair to you.” He was tempted to add “at your age” but thought better of it. Instead he added, “How about getting some help?”
The reaction was immediate, Pearson almost shouting. “You’re telling me to get more help! Why, man alive, I’ve been asking for months for more lab technicians! We need three at least, so what am I told I can have? One! And stenographers! I’ve got reports that have been piling up for weeks, and who’s going to type them?” Not waiting for an answer, he went storming on. “Me? If the administration would get off its fanny we might get a few things done—including faster surgicals. By God! When you tell me I should get more help, that’s really something to hear.”
O’Donnell had listened quietly. Now he said, “Finished, Joe?”
“Yeah.” Pearson seemed chastened, half ashamed at his outburst.
“It wasn’t technicians or office staff I was thinking about,” O’Donnell told him. “When I meant help I meant another pathologist. Someone to help you run the department. Maybe modernize it here and there.”
“Now look here!” at the word “modernize” Pearson had bridled, but O’Donnell brushed the objection aside. “I listened to you, Joe. Now you hear me out. Please.” He paused. “I was thinking of maybe some bright young fellow who could relieve you of some duties.”
“I don’t need another pathologist.” It was a flat statement, vehement and uncompromising. “Why, Joe?”
“Because there’s not enough work for two qualified men. I can handle all the pathology myself—without any help. Besides, I’ve already got a resident in the department.”
O’Donnell was quietly persistent. “A resident is with us for training, Joe, and usually for just a short time. Sure, a resident can carry some of the work. But you can’t give him responsibility and we can’t use him for administration. That’s where you need some help right now.”
“Let me be the judge of that. Give me a few days and we’ll be caught up in surgicals.”
It was obvious that Joe Pearson had no intention of giving way. O’Donnell had expected resistance to bringing in a new pathologist, but he wondered about the other man’s forcefulness. Was it because he was unwilling to divide his personal empire, or was he simply protecting his job—fearful that a new and younger man might undermine him? Actually the idea of removing Pearson had not occurred to O’Donnell. In the field of pathological anatomy alone Joe Pearson’s long experience would be hard to replace. O’Donnell’s objective was to strengthen the department and thereby the hospital organization. Perhaps he should make this clear.
“Joe, there’s no question of any major change. No one has suggested it. You’d still be in charge . . .”
“In that case let me run Pathology my own way.”
O’Donnell found his patience ebbing. He decided that perhaps he had pressed the point enough for now. He would let it go for a day or two, then try again. He wanted to avoid a showdown if he could. He said quietly, “I’d think it over if I were you.”
