Philips let his mind drift back to Goldblatt. The nerve of the man to think that he had the right to dictate Philips' personal life, or even his research, was astounding. Perhaps if the department funded Philips' research there might be some justification, but it didn't. Radiology's contribution was Martin's time. Funding that had been needed for hardware and programming fees, which had been considerable, came from sources available through Michaels' Department of Computer Science.
Suddenly Martin realized that a patient had approached the receptionist and was asking the meaning of an atypical Pap smear. She seemed to speak with effort, and she leaned weakly on the receptionist's desk.
"That, dearie," said Ellen Cohen, "is something you'll have to ask Ms. Blackman about." The receptionist immediately sensed Philips' attention. "I'm not a doctor," she laughed, mostly for his benefit. "Sit down. Ms. Blackman will be out shortly."
Kristin Lindquist had had all the frustration she could deal with that day.
"I was told that I'd be seen immediately," she said, and went on to tell the receptionist that she'd experienced a headache, dizziness, and changes in her vision that morning, so that she really could not wait like she had the day before. "Please tell Ms. Blackman right away that I'm here. She'd phoned me and promised there would be no delay."
Kristin turned and made her way over to a chair across from Philips. She moved slowly, like a person unsure of her balance.
Ellen Cohen rolled her eyes when she caught Philips', suggesting that the girl was unreasonably demanding, but she did get up to find the nurse. Martin turned to look at Kristin. His mind was busy making associations between atypical Pap smears and vague neurological symptoms. Kristin had closed her eyes so Philips could look at her without making her feel self-conscious. He guessed she was about twenty. Quickly Philips opened Katherine Collins' chart and rapidly flipped through the pages until he'd found the initial neurological note. Headache, dizziness, and visual symptoms were described as the presenting complaints.
He looked back at Kristin Lindquist. Could this woman in front of him be another case with the same radiological picture? Philips felt it was possible. With all the difficulties he'd encountered trying to get more X rays on the other patients, the idea of finding a new case was enormously seductive. He could take all the proper X rays right from the beginning.
Needing no more encouragement, he walked over and tapped Kristin on the shoulder. She jumped in surprise and brushed a wisp of blond hair from her face. The fear in her expression gave her a particularly vulnerable appearance and Martin suddenly became aware of the girl's beauty.
Choosing his words carefully, Martin introduced himself, saying he was from the Department of Radiology, and that he'd overheard her describe her symptoms to the receptionist. He told her that he had seen X rays on four girls with similar problems and felt it might be to her advantage to have an X ray. He was careful to emphasize that it was purely precautionary and that she should not be alarmed.
For Kristin, the hospital was full of surprises. On her first visit the day before she'd been kept waiting for hours. Now she was confronted by a doctor who was apparently soliciting patients.
"I'm not very fond of hospitals," she said. She wanted to add doctors, but it seemed too disrespectful.
"To tell you the truth, I feel the same way," said Philips. He smiled. He'd taken an immediate liking to this attractive young woman and he felt protective. "But an X ray wouldn't take long."
"I still feel ill and I think it would be best if I get home as quickly as possible."
"It will be quick," said Philips. "I can promise you that. One film. I'll take you over myself."
Kristin hesitated. On the one hand she detested the hospital. On the other hand she still felt ill and she was susceptible to Philips' concern.
"How about it?" he said persistently.
"All right," said Kristin finally.
"Wonderful. How long will you be here at the clinic?"
"I don't know. They said not long."
"Good. Don't leave without me," said Martin.
Within minutes Kristin was called. Almost simultaneously another door opened and Dr. Harper emerged.
Philips recognized Harper as one of the residents he'd seen on occasion in and around the hospital. He'd never met the man but his polished head was hard to forget. Philips got up and introduced himself. There was an awkward pause. As a resident, Harper did not have an office and since both examining rooms were occupied, there was no place to talk. They ended up in the narrow corridor.
"What can I do for you?" asked Harper, somewhat suspiciously. It was bizarre for the Assistant Director of Neuroradiology to be visiting Gynecology, since their interests and expertise lay at opposite ends of the medical spectrum.
Philips began his questioning in rather vague terms, expressing an interest in the way the clinic was manned, how long Harper had been there, and whether he enjoyed it. Harper's responses were abrupt and his small eyes darted over Philips' face as he explained that the university's clinic was a two-month elective rotation for a senior resident, adding that it had become a symbolic stepping-stone for being asked to join the staff following completion of the residency.
"Look," Harper said after a pause, "I've got a lot of patients to see." Martin realized that instead of making the man relax, his questions were making him more ill-at-ease.
"Just one more thing," said Philips. "When a Pap smear is reported as atypical, what's usually done?"
"That depends," said Harper warily. "There're two categories of atypical cells. One is atypical but not suggestive of tumor, whereas the other is atypical and suggestive of tumor."
"Whether it's in either class, shouldn't something be done? I mean, if it's not normal, it should be followed up. Isn't that right?"
"Yeah," said Harper evasively. "Why are you asking me these questions?" He had the distinct feeling he was being backed into a corner.
"Just out of interest," said Martin. He held up Collins' chart. "I've come across several patients who'd had atypical Pap smears in this clinic. But reading the GYN notes, I can't find any reference to Schiller's test, thoughts about a biopsy, or colposcopy… just repeat smears. Isn't that… irregular?" Philips eyed Harper, sensing his discomfort. "Look, I'm not here casting any blame. I'm just interested."
"I couldn't say anything unless I saw the chart," said Harper. He'd intended the comment to end the conversation.
Philips handed Collins' chart to Harper and watched as the resident opened it. When Harper read the name, "Katherine Collins," his face became tense. Martin watched curiously as the man rapidly flipped through the chart, too quickly to read anything adequately. When he got to the end, he looked up and handed it back.
"I don't know what to say."
"It is irregular, isn't it?" asked Martin.
"Put it this way: It's not the way I'd handle it. But I've got to get back to work now. Excuse me." He pushed past Philips, who had to press up against the wall to give him room to go by.
Surprised at the precipitous end to the conversation, Martin watched the resident hurry into one of the examining rooms. Philips had not intended his questions to be taken personally and he wondered if he had sounded more accusatory than he realized. Still the resident's response when he had opened Katherine Collins' chart had been strange. Philips had no doubt about that.
Believing there was no point in trying to talk further with Harper, Martin went back out to the receptionist and inquired after Kristin Lindquist. Ellen Cohen at first acted as if she hadn't heard the question. When Philips repeated it, she snapped that Miss Lindquist was with the nurse and would be out shortly. Having not liked Kristin initially, the receptionist hated her even more now that Philips seemed interested in her. Unaware of Ellen Cohen's jealousies, Martin just felt incredibly confused about the university's GYN clinic.