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“I guess so.” Pearson grunted and handed back the negatives. His attitude to X-rays was always that of one specialist groping on the unfamiliar territory of another. He said, “Shadows from shadow land. What does Radiology say?”

“Ralph Bell confirms the irregularity,” Lucy answered. “But he can’t see enough for a diagnosis. He agrees we should have a biopsy.”

Pearson turned back to the bed. “Do you know what a biopsy is, Vivian?”

“I have an idea.” The girl hesitated. “But I’m not really sure.”

“Haven’t taken it in your nursing course yet, eh?”

She shook her head.

Pearson said, “Well, what happens is that Dr. Grainger will take out a small piece of tissue from your knee—just where the trouble seems to be. Then it will come down to me and . . . I’ll study it.”

Vivian asked, “And can you tell from that . . . what’s the matter?”

“Most times I can.” He started to leave, then hesitated. “Do you play a lot of sports?”

“Oh yes, Doctor. Tennis, swimming, skiing.” She added, “I love horse riding too. I used to do a lot in Oregon.”

“Oregon, eh?” He said it thoughtfully; then, turning away, “All right, Vivian; that’s all for now.”

Lucy smiled. “I’ll be back later.” She gathered up the chart and X-rays and followed Pearson out.

As the door closed, for the first time Vivian felt an uneasy chill of fear.

When they were well down the corridor Lucy asked, “What’s your opinion, Joe?”

“It could be a bone tumor.” Pearson said it slowly, thinking.

“Malignant?”

“It’s possible.”

They came to the elevator and stopped. Lucy said, “Of course, if it’s malignant, I’ll have to amputate the leg.”

Pearson nodded slowly. Suddenly he looked very old. “Yes,” he said. “I was thinking of that.”

Eleven

The prop-jet Viscount turned evenly into wind and began to lose height. Landing gear and flaps down, it was lined up with number one runway of Burlington’s municipal airport, dead ahead. Watching the airplane’s approach from the public mezzanine, just below the control tower, Dr. Kent O’Donnell reflected idly that aviation and medicine had a good deal in common. Both were products of science; both were changing the world’s life and destroying old concepts; both were moving toward unknown horizons and a future only dimly seen. There was another parallel too. Aviation nowadays was having trouble keeping pace with its own discoveries; an aircraft designer he knew had told him recently, “If an airplane’s flying it’s already out of date.”

The practice of medicine, O’Donnell thought, shading his eyes from the bright afternoon sun of mid-August, was very much the same. Hospitals, clinics, physicians themselves, were never able to be entirely up to date. No matter how they tried, experimentation, development, new techniques were always ahead—sometimes by years. A man might die today when the drug that could save him was already invented and even, perhaps, in limited use. But it took time for new developments to become known and to gain acceptance. The same was true of surgery. One surgeon, or a group of surgeons, might develop a new life-saving technique. But before it could be used generally others must master it and pass their skill along. Sometimes it was a long process. Heart surgery, for example, was fairly general now and within reach of most who needed it badly. But for a long time only a handful of surgeons were qualified or willing to attempt it.

There was always the question, too, with new things: is this good; is it a wise development? Not all change meant progress. Plenty of times in medicine there were false scents, theories running contrary to fact, individuals with enthusiasms and obsessions who would go off half cocked, misleading others when they did. Sometimes it was hard to steer a mid-course between open-mindedness and reasonable caution. At Three Counties, with its quota of diehards and progressives—and with good men in both camps—it was a continuing problem for someone like O’Donnell to know, at any given moment, exactly where and with whom his allegiance lay.

His thoughts were broken by the Viscount taxiing in, the shrill whine of its motors drowning out the voices of others around him. O’Donnell waited until the motors stopped and passengers began to disembark. Then, seeing Dr. Coleman among them, he went down the stairs to greet the hospital’s new assistant director of pathology in the arrival lobby.

David Coleman was surprised to see the chief of surgery—tall, bronzed, standing out from the crowd—waiting for him with outstretched hand. O’Donnell said, “It’s good to see you. Joe Pearson couldn’t make it, but we thought that someone should be around to say ‘welcome.’ ” What O’Donnell failed to add was that Joe Pearson had flatly refused to go and, Harry Tomaselli being out of town, O’Donnell had taken the time to drive out himself.

As they moved through the hot, crowded lobby O’Donnell saw Coleman glance around him. He got the impression that the younger man was making a quick assessment of his surroundings. Perhaps it was a habit—if so, a good one. Certainly David Coleman would stand up to scrutiny himself. Though he had had a three-hour air journey, his gabardine suit was uncreased, his well-trimmed hair carefully parted and brushed, his shave recent. He wore no hat, which made him look younger than his thirty-one years. Though slighter than O’Donnell in build, his features were clear-cut and well defined; he had a longish face and an incisive jaw. The brief case under his arm added a professional touch; picture of a young scientist, O’Donnell thought. He steered Coleman toward the baggage counter. A trailerload of bags was being unloaded, and they joined the scrimmage with other passengers who had disembarked.

O’Donnell said, “This is the part of air travel I dislike.”

Coleman nodded and smiled faintly. It was almost as if he had said, Let’s not waste our talents on small talk, shall we?

This is a cool customer, O’Donnell thought. He noticed, as he had at their previous meeting, the steel-gray eyes and wondered what it took to penetrate behind them. Now Coleman was standing, unmoving among the crowd, glancing around. Almost as if by command, ignoring others, a redcap gravitated toward him.

Ten minutes later, as O’Donnell threaded his Buick through the airport traffic and headed toward town, he said, “We’ve put you up in the Roosevelt Hotel. It’s as comfortable as any and quiet. I believe our administrator wrote you about the apartment situation.”

“Yes, he did,” Coleman said. “I’d like to do something about that quite quickly.”

“You won’t have any problem,” O’Donnell said, then added, “Perhaps you’d like to take a day or two to fix up an apartment before you report at the hospital.”

“I don’t think so, thank you. I plan to start work tomorrow morning.”

Coleman was polite but definite. O’Donnell thought: This is a man who makes up his mind, then states his opinion plainly. He sounded, too, as if he were not dissuaded easily. O’Donnell found himself speculating on how Joe Pearson and David Coleman were going to get along. Superficially it looked as if they might clash. But you could never tell. Sometimes in a hospital the most unlikely people hit it off like lifetime friends.

Looking around him as they drove through the approaches to the city, David Coleman found himself close to a sense of excitement at the prospect ahead. This was unusual because mostly he took whatever came with a matter-of-fact acceptance. But it was, after all, his first staff appointment to a hospital. He told himself: a touch of down-to-earth humanity is nothing to be ashamed of, my friend, then smiled inwardly at the silent self-criticism. Old habits of thought, he reflected, were hard to break.

He wondered about O’Donnell, sitting beside him. Everything he had heard about the chief of surgery at Three Counties had been good. How was it, he wondered, that a man with O’Donnell’s background and qualifications would choose a place like Burlington? Did he, too, have a mixed-up motivation, or was there some other reason? Maybe he just liked it here. There were some people, Coleman supposed, whose preferences were straightforward and uncomplicated.