After the war, faced with the choice of returning to law or remaining in hospital work, he had chosen the latter and enrolled in the School of Hospital Administration at Columbia University. He had graduated from Columbia at a time when there was growing recognition of hospital administration as a specialized field of endeavor in which a medical degree was neither necessary nor particularly useful. This had opened up a brisk demand for good administrators, and after two years as an assistant he had accepted Orden Brown’s offer of the top post at Three Counties.
Now Harry Tomaselli was in love with his work. He shared Kent O’Donnell’s views about the standards of good medicine and respected the business acumen and caginess of the board chairman, Orden Brown. As administrator, it was Tomaselli’s business to see that all hospital services—nursing, housekeeping, engineering, building, accounting, and their subsidiaries—measured up to the standards the other two men required.
He did this by delegation—he had a happy faculty of appointing good department heads—and also by an intense personal interest in everything that went on within the hospital. Almost nothing of importance escaped Harry Tomaselli. Each day his short, stocky figure could be seen bustling along the corridors but pausing frequently while he talked with nurses, patients, janitors, clerks, cooks—anyone who could tell him something about the hospital or make a suggestion on how to run it better. New ideas excited him; his own enthusiasm engendered more in others. Sometimes, head thrust forward, eyes gleaming behind his big black-rimmed glasses, he would talk volubly, his thoughts moving at a gallop, his hands underscoring points as he made them.
In all his peregrinations Harry Tomaselli seldom made a written note. His lawyer’s training enabled him to carry assorted facts readily in his head. But after each inspection tour he fired off a barrage of staccato memoranda on all points, big and little, where he felt the administration of Three Counties could be improved.
Yet, for all this, he had a diplomat’s sense of tone and language that seldom gave offense. Verbally he would hand out a reprimand, then talk cheerfully of something else. And though he never wasted words, his written memos were always gracious. He hated to fire a hospital employee unless the provocation were really strong. He frequently told his department heads, “If anyone has worked here more than a month, we have an investment in their experience. It’s to our advantage to mold them if we can, rather than try for someone new who may have other faults we haven’t thought of.” Because this policy was known and respected, employee morale was high.
There were still things about the organization that worried him. Some departments, he knew, could be made more efficient. There were areas where service to patients could be improved. A good deal of old equipment needed junking and replacement. There was newly developed equipment—the cine-radiography unit was an example—which, under ideal conditions, the hospital should have. The new building program would make good some of these deficiencies but not all. Like O’Donnell, he knew there were years of work ahead and that some objectives perhaps would remain beyond reach. But, after all, that was the road to achievement; you always tried for a little more than you knew you could accomplish.
His thoughts were brought back to the present by Orden Brown. The chairman was telling O’Donnell, “There’ll be a good deal of social activity, of course, once the campaign gets going. Oh, and something else. I believe it would be a good thing, Kent, if we put you in as a speaker at the Rotary Club. You could tell them what the new building will do, our plans for the future, and so on.”
O’Donnell, who disliked public meetings, especially the regimented bonhomie of service clubs, had been about to grimace but checked himself. Instead he said, “If you think it will help.”
“One of my people is on Rotary executive,” Orden Brown said. “I’ll have him fix it up. That had better be the opening week of the campaign. Then the following week we might do the same thing with Kiwanis.”
O’Donnell considered suggesting that the chairman leave him some time for surgery, otherwise he might have trouble meeting his own quota. But he thought better of it.
“By the way,” Orden Brown was saying, “are you free for dinner the day after tomorrow?”
“Yes, I am,” O’Donnell answered promptly. He always enjoyed the quiet, formal dignity of dinner at the house on the hill.
“I’d like you to come with me to Eustace Swayne’s.” Seeing O’Donnell’s surprise, the chairman added, “It’s all right—you’re invited. He asked me if I’d tell you.”
“Yes, I’ll be glad to come.” All the same, the invitation to the home of the board of directors’ most die-hard member was unexpected. Naturally O’Donnell had met Swayne a few times but had not come to know him well.
“As a matter of fact, it’s my suggestion,” Brown said. “I’d like you to talk with him about the hospital generally. Let him absorb some of your ideas if you can. Frankly, at times he’s a problem on the board, but you know that, of course.”
“I’ll do what I can.” Now that he knew what was involved, O’Donnell did not relish the thought of getting close to board politics. So far he had managed to steer clear of them. But he could not say no to Orden Brown.
The chairman picked up his brief case and prepared to leave. Tomaselli and O’Donnell rose with him.
“It will be just a small party,” Orden Brown said. “Probably half a dozen people. Why don’t we pick you up on the way across town? I’ll phone before we leave.”
O’Donnell murmured his thanks as, nodding pleasantly, the chairman went out.
The door had scarcely closed on Orden Brown when tall, slim Kathy Cohen, Tomaselli’s secretary, came in. “I’m sorry to interrupt,” she said.
“What is it, Kathy?”
She told the administrator, “There’s a man on the phone who insists on talking to you. A Mr. Bryan.”
“I’m busy with Dr. O’Donnell now. I’ll call him back.” Tomaselli sounded surprised. Normally he would not have to tell Kathy anything so elementary.
“I told him that, Mr. Tomaselli.” She sounded doubtful. “But he’s very insistent. He says he’s the husband of a patient. I thought you ought to know.”
“Maybe you should talk with him, Harry.” O’Donnell smiled at the girl. “Take him off Kathy’s mind. I don’t mind waiting.”
“All right.” The administrator reached for one of his two telephones.
“It’s line four.” The girl waited until the connection was made, then went back to the outer office.
“Administrator speaking.” Tomaselli’s tone was friendly. Then he frowned slightly, listening to what was coming from the other end of the line.
O’Donnell could hear the receiver diaphragm rattling sharply. He caught the words, “Disgraceful situation . . . imposition on a family . . . should be an inquiry.”
Tomaselli put his hand over the phone’s mouthpiece. He told O’Donnell, “He’s really boiling. Something about his wife. I can’t quite make put . . .” He listened for a moment more, then said, “Now, Mr. Bryan, supposing you start at the beginning. Tell me what this is all about.” He reached for a pad and pencil, then said, “Yes, sir.” A pause. “Now tell me, please, when was your wife admitted to hospital?” The phone rattled again and the administrator made a swift note. “And who was your physician?” Again a note. “And the date of discharge?” A pause. “Yes, I see.”
O’Donnell heard the words, “Can’t get any satisfaction,” then Tomaselli was talking again.
“No, Mr. Bryan, I don’t remember the particular case. But I will make some inquiries. I promise you that.” He listened, then answered, “Yes, sir, I do know what a hospital bill means to a family. But the hospital doesn’t make any profit, you know.”
O’Donnell could still hear the voice on the telephone, but it sounded calmer, responding to Tomaselli’s conciliatory approach. Now the administrator said, “Well, sir, it’s the physician who decides how long a patient remains in hospital. I think you should have another talk with your wife’s physician, and what I’ll do meanwhile is have our treasurer go over your bill, item by item.” He listened briefly, then, “Thank you, Mr. Bryan. Good-by.”