The Final Diagnosis

From Lucy his thoughts switched to Denise Quantz. Since the invitation to call her, which she had given him the night they had met at Eustace Swayne’s house, O’Donnell had confirmed his attendance at a surgeons’ congress in New York. It occurred to him that the date was next week; if he were to meet Mrs. Quantz, he had better make the arrangements soon.

As he turned into his office the clock over his desk showed twenty minutes before his first operation was scheduled. He picked up the telephone, telling himself it was always a good idea to do things when you thought of them.

He heard the operator trace the number through New York Information, then there was a ringing tone and a click. A voice said, “This’s Mrs. Quantz’s apartment.”

“I have a long-distance call for Mrs. Denise Quantz,” the Burlington operator said.

“Mrs. Quantz’s not here now.”

“Do you know where she can be reached?” The telephone company’s ritual was in motion.

“Mrs. Quantz’s in Burlington, Pennsylvania. Do you wish the number there?”

“If you please.” It was the Burlington operator again.

“The number is Hunter 6-5735.”

“Thank you, New York.” There was a click, then the operator said, “Did you get that number, caller?”

“Yes, thank you,” O’Donnell said, and hung up.

With his other hand he had already reached for the Burlington phone directory. He thumbed through it until he came to “Swayne, Eustace R.” As he had expected, the number listed was the one he had just been given.

Lifting the phone, he dialed again.

A male voice said, “Mr. Eustace Swayne’s residence.”

“I’d like to speak with Mrs. Quantz.”

“One moment, please.”

There was a pause. Then, “This is Mrs. Quantz.”

Until this moment O’Donnell had forgotten how much her voice had attracted him before. It had a soft huskiness, seeming to lend grace to the simplest words.

“I wonder if you remember,” he said. “This is Kent O’Donnell.”

“Of course! Dr. O’Donnell, how nice to hear from you!”

He had a sudden vision of her beside the telephone, the soft dark hair tumbled about her shoulders. Then he said, “I just called you in New York. They gave me the number here.”

“I flew down last night,” Denise Quantz said. “Father had a touch of bronchitis. I thought I’d stay with him for a day or two.”

He asked courteously, “It’s not too serious, I hope?”

“Not really.” She laughed. “My father has the constitution of a mule—as well as the obstinacy.”

He thought: I can believe that. Aloud he said, “I was going to ask you to have dinner with me in New York. I expect to be there next week.”

“You can still ask me.” The reply was prompt and definite. “I’ll be back by then.”

On impulse he said, “Possibly I could anticipate. Do you have a free evening in Burlington?”

After a moment’s pause she said, “Tonight would be the only time.”

O’Donnell calculated quickly. His office appointments would go on until seven. But if nothing else came up . . .

His thoughts were interrupted. “Oh, wait!” It was Denise Quantz again. “I’d forgotten. Dr. Pearson is having dinner with my father; I think I ought to stay.” She added, “Unless you’d care to join us?”

Mentally he chuckled. Joe Pearson might be surprised to find him there. Instinct, though, told him it was not a good idea. He said, “Thank you, but I think perhaps we’d better postpone it.”

“Oh dear.” Her voice sounded disappointed; then she brightened. “I could meet you after dinner if you like. Father and Dr. Pearson are sure to get into one of their chess games, and when they do that anyone else might just as well not be there.”

He found himself suddenly delighted. “That would be wonderful. What time will you be free?”

“About nine-thirty, I imagine.”

“Shall I call for you?”

“It would probably save time if we met downtown. You tell me where.”

He thought for a moment, then said, “The Regency Room?”

“All right; at half-past nine. Good-by now.”

As O’Donnell replaced the phone he had a pleasant sense of anticipation. Then he glanced at the clock again. He would have to hurry if he were to be in the O.R. on time.

The after-dinner chess game between Eustace Swayne and Dr. Joseph Pearson had been in progress for forty minutes. The two old men faced each other across a low rosewood games table in the same paneled library where, three weeks earlier, O’Donnell and Swayne had had their verbal joust. Only two lights were burning in the room—one from a single pendant shade immediately above the table, the other a dimly glowing rococo lamp by the hallway door.

Both men’s faces were in shadow, the light between them playing directly on the inlaid chessboard in the table’s center. Only when one or the other leaned forward to make a move in the game were their features defined momentarily by the lamplight’s outer edges.

At this moment both were still, the room’s deep silence hovering like a padded mantle over the pair of Louis XV beechwood wing chairs in which they sat. Eustace Swayne had leaned back. Holding a brandy glass of ruby crystal lightly between his fingers, he surveyed the game as it had progressed so far.

The previous move had been Dr. Joseph Pearson’s. A minute or two ago, gently cradling the white queen from the exquisitely carved Indian-ivory chess set, he had moved the piece a single square ahead.

Now, putting down the brandy glass, Eustace Swayne selected a pawn from his far right wing and transferred it two squares forward. Then gruffly, breaking the silence, he said, “There have been changes at the hospital, I hear.”

Beyond the lamplight, Joe Pearson studied the chessboard. When he was ready he leaned forward and moved a pawn on his left wing one square forward, countering the other’s advance. Only then did he grunt the one word, “Some.”

Again the silence, peace, the sense of time halted. Then the old tycoon stirred in his chair. “Do you approve these changes?” He reached forward and slid his bishop diagonally two squares to the right. Half humorously he glanced across the table in the semi-darkness. His expression said: Beat that line-up if you can.

This time Joe Pearson answered before he made his move. “Not entirely.” He remained in shadow, studying the other’s gambit, pondering the alternatives ahead. Then, slowly, still handling the pieces tenderly, he moved his rook one square to the left, dominating an open line.

Eustace Swayne waited. A minute passed, two minutes, then three. Finally his hand reached out for his rook and made a similar move to the same open line, meeting his opponent’s challenge. Then he said, “You have a means of veto for the future if you choose to exercise it.”

“Oh? What kind of veto?” The question was casual but the action which accompanied it swift. Pearson picked up his queen’s knight and swung it over the pieces, lodging it on a central square.

Studying the board, assessing the strength of his own position, Swayne said, “I’ve told Orden Brown—and your chief of surgery—I’m willing to give a quarter million dollars to the building fund.” With the last word he made a corresponding move to Pearson’s, sending his king’s knight forward until it reached the square beside the strongly lodged knight of his opponent.

A long silence this time. At the end of it the pathologist took his bishop and, swooping down the board, removed an opposing pawn. He said quietly, “Check.” Then, “That’s a lot of money.”

“I’ve attached a condition.” Swayne, on the defensive now, moved his king one square to the right. “The money will only be given if you remain free to run your own department in the hospital the way you want for as long as you choose.”

This time Joe Pearson made no move. He seemed to be musing, looking away into the darkness over the other man’s head. Then he said simply, “I’m touched.” His eyes returned to the chessboard. After a while he lifted his knight to a square so that the piece attacked Swayne’s now cramped king.

Eustace Swayne had watched the action carefully. But before making his own move he reached for a brandy decanter, filled Pearson’s glass and then his own. Putting the decanter down, “It’s a young man’s world,” he said, “and I suppose it always has been. Except that sometimes old men still have power . . . and the sense to use it.” Then, his eyes glinting, he reached down, picked up the pawn in front of his king, and with it captured the troublesome knight.

Thoughtfully Pearson stroked his chin with thumb and forefinger. Then he selected his queen, moved it six squares down the open file, and captured the black king’s pawn. “You say . . . Orden Brown, O’Donnell . . . they know this?”

“I made it plain.” The old tycoon took his king’s bishop and captured his opponent’s bishop on king’s knight five.

Suddenly Joe Pearson chuckled. There was nothing to show whether the game or the conversation had caused his amusement. But swiftly he reached out. He moved his queen beside the black king. Then, softly, “Checkmate!”

Though defeated, caught unawares, Eustace Swayne had watched admiringly. He nodded, as if to confirm his own judgment.

“Joe,” he said, “there’s no doubt of it—you’re as good a man as ever!”

The music stopped, and the couples on the dance floor of the small but fashionable supper club—one of the few which existed in Burlington—began drifting back to their tables.

“Tell me what you were thinking then,” Denise Quantz said. She smiled at Kent O’Donnell across the small black-topped table which divided them.

“Frankly, I was thinking how pleasant it would be to do this again.”

Very slightly she raised the glass she was holding. It held the last of her second old-fashioned. “To more thoughts of the same kind.”

“I’ll drink to that.” He finished his own scotch and soda, then signaled a waiter to repeat their order. “Shall we dance?” The music had begun again.

“I’d love to.” She rose, turning half toward him as he followed her to the small, dimly lighted dance floor. He held out his arms and she moved into them. They danced close together. O’Donnell had never been an expert dancer; medicine had left him too little time to become accomplished. But Denise Quantz matched every movement to his own. As the minutes went by he could feel her body—tall, willowy—moving obediently, anticipating the music and his own motion. Once her hair brushed lightly against his face; it brought with it a breath of the same perfume he had noticed at their first meeting.

The five-piece orchestra, unobtrusive, its arrangements carefully attuned to the intimate setting, was playing a popular ballad of several years before.

See the Pyramids along the Nile,

Watch the sunrise on a tropic isle,

Just remember, darling—all the while

You belong to me.

For a moment he had a sense of borrowed time, of existing in a vacuum, insulated, away from medicine, Three Counties, all the other things he lived with daily. Then the music changed to a faster tempo, and he smiled at himself for sentimentality.

As they danced he asked, “Do you come here often—to Burlington, I mean?”

“Not really,” she answered. “Occasionally, to see my father, but that’s all. Frankly it’s a city I dislike.” Then laughingly, “I hope I’m not offending your civic pride.”

“No,” he said. “I’ve no strong views one way or the other. But weren’t you born here?” He added, “Denise—if I may.”

“Of course. Don’t let’s be formal.” She looked at him directly and flashed a smile. Answering his question, “Yes, I was born here,” she said. “I went to school and lived at home. My mother was alive then.”

“Then why New York—now?”

“I think I’m a New Yorker by instinct. Besides, my husband lived there; he still does.” It was the first time she had mentioned her marriage. She did it now, easily and unself-consciously. “After we separated I found I’d never want to leave. There’s no other city quite like it.”

“Yes,” he said, “I suppose that’s true.” He was thinking again how beautiful this woman was. She had a composure, a lack of artifice, that younger women could rarely attain. But nothing of her suggested a retreat from femininity; rather the reverse. To Kent O’Donnell, holding her now, her body moving evenly against his own, she seemed infinitely desirable. He suspected she could be extremely sensual.

Deliberately he switched his thoughts away. This was premature. He noticed again, as he had earlier, the gown she had on tonight. Worn off-shoulder, it was a brilliant scarlet, of rich peau de soie, curved closely around her figure and falling into fullness only below the hips. At one and the same time the effect was dramatic, discreet, expensive.

It was a reminder of another thought that had occurred to him this evening for the first time—the fact that Denise was obviously a rich woman. They had arrived at the Regency Room almost together. He had parked his own car and walked to the night club’s street entrance when a gleaming Cadillac had pulled up, a uniformed chauffeur hurrying around to open the door for Denise to alight. They had greeted each other, then she had turned to the chauffeur, now standing discreetly in the background. “Thank you, Tom. I don’t think you need come back. I expect Dr. O’Donnell will drive me home.”

The man had answered courteously, “Thank you, madam,” then to O’Donnell, “Good night, sir,” and had driven off.

Of course, if he had thought about it, O’Donnell would have realized that the daughter of Eustace Swayne was obviously an heiress. Not that the realization concerned him greatly; his own income nowadays was ample for a comfortable life and more besides. Nevertheless, a really rich woman was something new in his personal experience. Again he found his mind framing the comparison between Denise and Lucy Grainger.

With a modest crescendo the orchestra ended the group of selections. O’Donnell and Denise applauded briefly, then moved from the dance floor. Taking her arm lightly, he steered her to their table. A waiter was hovering; he held out their chairs and served the drinks O’Donnell had ordered.

Sipping the fresh old-fashioned, Denise said, “We talked about me. Now tell me about you.”

He poured more soda into his scotch. He liked the liquor well diluted—a practice most waiters seemed to abhor. “It’s pretty routine stuff.”

“I’m a pretty good listener, Kent.” Denise was speaking with half her mind. The other half was thinking: This is a man—all man! Her eyes took in the big frame, broad shoulders, the strong face. She wondered if he would kiss her tonight and what it might lead to later. She decided there were interesting possibilities in Dr. Kent O’Donnell.

O’Donnell told her about Three Counties, his work there, and what he hoped to do. She asked him questions about the past, his experiences, people he had known—admiring all the while the depth of thought and feeling which came through everything he said.

They danced again; the waiter replaced their drinks; they talked; they danced; the waiter returned; the sequence was repeated. Denise told him about her marriage; it had taken place eighteen years ago, had lasted ten. Her husband was a corporation lawyer with a busy practice in New York. There were two children—twins, Alex and Philippa—who had remained in Denise’s custody; in a few weeks the children would be seventeen.

“My husband is a perfectly rational being,” she said. “It’s simply that we were quite incompatible and wasted a lot of time coming to an obvious conclusion.”

“Do you ever see him now?”

“Oh, often. At parties and around town. Occasionally we meet for lunch. In some ways Geoffrey is quite delightful. I’m sure you’d like him.”

Both of them were talking more freely now. Without waiting to be told, the waiter put fresh drinks in front of them. O’Donnell asked her about divorce; was there some barrier toil?

“Not really.” She answered frankly. “Geoffrey is quite willing to divorce me but insists that I supply the evidence. In the state of New York, you know, it has to be adultery. So far I haven’t got around to it.”

“Has your husband never wanted to remarry?”

She seemed surprised, “Geoffrey? I don’t imagine so. In any case, he’s married to the law.”

“I see.”

Denise twirled the stem of her glass. “Geoffrey always considered that bed was a good place in which to read his legal briefs.” She said it softly, almost with intimacy. O’Donnell sensed a hint of why the marriage had failed. He found the thought exciting.

The waiter was at his elbow. “Excuse me, sir, the bar is closing in a few minutes. Do you wish to order now?”

Surprised, O’Donnell glanced at his watch. It was almost one o’clock in the morning. Though it seemed much less, they had been together for three and a half hours. He glanced at Denise; she shook her head.

He told the waiter, “No, thank you,” and paid the check the man presented. They finished their drinks and prepared to go. The waiter offered a friendly “Good night”; the tip had been generous. O’Donnell had a sense of comfort and well-being.

In the foyer he waited for Denise while an attendant went to the parking lot for his car. When she came she took his arm. “It’s such a shame to go. I almost wish we’d had that last drink after all.”

He had hesitated, then said lightly, tentatively, “We could stop at my apartment if you like. I have a well-stocked bar, and it’s on the way.”

For an instant he feared he had been unwise. He thought he detected a sudden coolness, a hint of pained surprise. Then it was gone. She said simply, “Why don’t we do that?”

Outside the Buick was waiting, the doors held open, the motor running. Going across town, he drove carefully, more slowly then usual, aware he had had a good deal to drink. It was a warm night and the car windows were down. From the other side of the front seat he caught a subtle breath of perfume once again. At his apartment he parked the car on the street and they went up in the elevator.

When he had mixed drinks he took them across and gave the old-fashioned to Denise. She was standing by an open window in the living room, looking out at the lights of Burlington below. The river which ran through the city cut a deep swath of darkness between both its banks.

Standing beside her, he said quietly, “It’s been a while since I mixed an old-fashioned. I hope it isn’t too sweet.”

She sipped from the glass. Then softly, huskily, “Like so much else about you, Kent, it’s absolutely right.”

Their eyes met and he reached out for her glass. When he had put it down she came gently, effortlessly, to him. As they kissed his arms tightened around her.

Then stridently, imperiously, in the room behind them a phone bell clamored out. There was no ignoring it.

Gently Denise disengaged herself. “Darling, I think you’d better answer it.” She touched his forehead gently with her lips.

As he crossed the room he saw her gather up her purse, stole, and gloves. It was obvious the evening was over. Almost angrily he picked up the phone, answered curtly, and listened. Then the anger dissolved. It was the hospital—the night-duty intern. One of O’Donnell’s own patients had developed symptoms which appeared to be serious. He asked two swift questions, then, “Very well, I’ll come at once. Meanwhile, alert the blood bank and prepare for a transfusion.” He broke the connection, then called the night porter to get a taxi for Denise.

Fourteen

Most nights of the week Dr. Joseph Pearson made a practice of going to bed early. Necessarily, though, on the evenings he played chess with Eustace Swayne he was much later—an occurrence which left him tired and more irritable than usual next morning. This effect, from last night’s session, was with him now.

Working his way through purchase requisitions for lab supplies—a task he detested ordinarily and more than ever at this moment—he snorted and put one of the vouchers aside. He scribbled a few more signatures, then paused again and snatched a second voucher from the pile. This time there was a scowl as well as the snort. An ultimate would have known the danger signs—Dr. Pearson was ready to blow his top.

The moment came when he hesitated over a third voucher. Then, explosively, he threw his pencil down, grabbed up all the papers in an untidy heap, and made for the door. Storming into the serology lab, he looked around for Bannister. He found the senior technician in a corner preparing a stool culture.

“Drop whatever you’re doing and come over here!” Pearson dumped the pile of papers on a center table. Several fell to the floor, and John Alexander bent down to retrieve them. He felt an instinctive relief that Bannister, and not himself, was the object of Dr. Pearson’s anger.

“What’s the trouble?” Bannister strolled across. He was so used to these outbursts that sometimes they had the effect of making him calmer.

“I’ll tell you what’s the trouble—it’s all these purchase orders.” Pearson himself was more subdued now, as if his ill temper was simmering instead of being on the boil. “Sometimes you seem to think we’re running the Mayo Clinic.”

“We gotta have lab supplies, haven’t we?”

Ignoring the question, “There are times I wonder if you eat the stuff. And besides, didn’t I tell you to put a note on anything out of the ordinary, explaining what it was for?”

“I guess I forgot.” Bannister’s tone was resigned.

“All right, you can start remembering.” Pearson picked a form from the top of the pile. “What’s the calcium oxide for? We never use that here.”

Bannister’s face creased in a malicious grin. “You asked me to get that. Isn’t it for your garden?” The senior technician was referring to a fact which both of them knew but seldom spoke of. As one of the county horticultural society’s leading rose growers, Joe Pearson absorbed a goodly quantity of hospital lab supplies in improving the growing power of his soil.

He had the grace to appear embarrassed. “Oh . . . yeah . . . okay, let that one go.” He put down the voucher and picked up a second. “What about this one? Why do we want Coombs serum all of a sudden? Who ordered that?”

“It was Dr. Coleman.” Bannister answered readily; this was a subject he had hoped would come up. Alongside him John Alexander had a sense of foreboding.

“When?” Pearson’s question was sharp.

“Yesterday. Dr. Coleman signed the requisition anyway.” Bannister pointed to the voucher, then added maliciously, “In the place where you usually sign.”

Pearson glanced down at the form. Until now he had not noticed there was a signature on it. He asked Bannister, “What does he want it for? Do you know?”

The senior technician relaxed. He had set the wheels of retribution in motion and now he could enjoy this scene as a spectator. He told John Alexander, “Go ahead. Tell him.”

A shade uneasily John Alexander said, “It’s for a blood-sensitization test, Dr. Pearson. For my wife. Dr. Dornberger ordered it.”

“Why Coombs serum?”

“It’s for an indirect Coombs test, Doctor.”

“Tell me—is there something special about your wife?” Pearson’s voice had an edge of sarcasm. “What’s wrong with the saline and high-protein tests? The same as we use for everybody else?”

Alexander swallowed nervously. There was a silence. Pearson said, “I’m waiting for an answer.”

“Well, sir.” Alexander hesitated, then blurted out, “I suggested to Dr. Coleman—and he agreed—it would be more reliable if, after the other tests, we did a—”

“You suggested to Dr. Coleman, eh?” The tone of the question left no doubt of what was about to happen. Sensing it, Alexander blundered on.

“Yes, sir. We felt that since some antibodies can’t be detected in saline and high protein, running the extra test—”

“Cut it out!” The words were loud, harsh, brutal. As he said them Pearson slammed his hand hard down on the pile of forms and the table beneath. There was silence in the laboratory.

Breathing hard, the old man waited, eying Alexander. When he was ready he said grimly, “There’s one big trouble with you—you’re just a bit too free with some of that stuff you picked up in technician’s school.”

As Pearson spoke his bitterness came through—the bitterness against all who were younger, who were interfering, trying to deprive him of authority—absolute and unquestioned—which until now had been his. In a different mood, and at another time, he might have handled this more tolerantly. Now, coming as it did, he had plainly decided, once and for all, to put this upstart lab assistant in his place.

“Listen to me and get this straight! I told you this once before and I don’t aim to do it again.” This was Authority speaking, the head of a department, heavy-handed, making it clear to a minor employee that there would be no more warnings, merely action, from this point on. His face close to Alexander’s, Pearson said, “I’m the one in charge of this department, and if you or anybody else have any queries, they come to me. Do you understand?”

“Yes, sir.” At this instant all Alexander wanted was for this to end. He already knew he had made his last suggestion. If this was what you got for thinking, from here on he would do his work and keep his thoughts to himself. Let other people do the worrying—and let them have the responsibility too.

But Pearson had not finished. “Don’t go running around behind my back,” he said, “and taking advantage of Dr. Coleman because he’s new.”

Briefly Alexander’s spirit flared. “I didn’t take advantage . . .”

“And I say you did! And I’m telling you to cut it out!” The old man shouted angrily, his face muscles working, his eyes fiery.

Alexander stood, crushed and silent.

For a moment or two Pearson surveyed the younger man grimly. Then, as if satisfied that his point was made, he went on to speak again. “Now I’ll tell you something else.” His tone this time, if not cordial, was at least less harsh. “As far as that blood test is concerned, a test in saline and high protein will give us all the information we need. And let me remind you I happen to be a pathologist and I know what I’m talking about. Have you got that?”

Dully Alexander answered, “Yes, sir.”

“All right. I’ll tell you what I’ll do.” Pearson’s voice became more moderate; it was almost as if he were offering a truce. “Since you’re so keen on this test being right, I’ll do it myself. Here and now. Where’s the blood specimen?”

“In the refrigerator,” Bannister said.

“Get it.”

Crossing the lab, Bannister decided this scene had not turned out exactly the way he would have liked. It was true the Alexander kid had needed to be taken down a peg, but, all the same, the old man had laid it on the kid a bit hard. Bannister would have liked to see some of the storm move in the direction of that snide young doctor. But maybe the old man was saving that for later. He selected the blood specimen marked “Alexander, Mrs. E.” and closed the refrigerator door.

Pearson took the blood sample, which already had the clot removed. As he did, Bannister noticed the purchase order which had been the cause of the trouble; it had fallen to the floor. He bent down and picked it up.

He asked Pearson, “What shall I do with this?”

The old pathologist had taken two clean test tubes. Now he was aspirating a portion of the blood serum into each. Without looking up he said irritably, “What is it?”

“It’s the purchase requisition—for Coombs serum.”

“We won’t need it now. Tear it up.” Pearson was scrutinizing the label of a small bottle containing Rh-positive cells. Prepared by a drug house, the solution was used as a reagent in testing Rh-negative blood.

Bannister hesitated. Much as he objected to Coleman, he knew there was a question of medical protocol involved. “You ought to let Dr. Coleman know,” he said doubtfully. “Do you want me to tell him?”

Pearson was having trouble with the cork of the bottle. He said impatiently, “No, I’ll tell him myself.”

Bannister shrugged. He had pointed something out; if there were any trouble now, it would not be his responsibility. He took the purchase requisition and tore it up, allowing the pieces to flutter down into a wastebasket below.

Roger McNeil, the pathology resident, suspected that no matter how many years he stayed in medicine he would never become hardened to performing autopsies on children. He had just completed one, and now, in the autopsy room, the red-gaping body of the four-year-old boy lay open, pathetically, before him. The sight disturbed McNeil as much as ever. He knew, as always, there would be little sleep for him tonight. This scene would keep recurring in his mind—particularly when he remembered, as inevitably he would, how unnecessary and futile this particular death had been.

Looking up, he saw Mike Seddons watching him. The surgical resident said, “Poor little bastard.” Then, bitterly, “How stupid can people get!”

McNeil asked, “Are the police still waiting?”

Seddons nodded. “Yes—and the others.”

“You’d better call Pearson.”

“All right.” There was a telephone in the autopsy-room annex, and Seddons went to it.

McNeil wondered if he were being cowardly in avoiding this responsibility. But this was a case the old man should be told of anyway. Then he could make the decision on who would break the news outside this room.