The Final Diagnosis

“But that’s the point, Doctor—the test.”

“What about it?” Coleman was puzzled. He was not at all clear about what this young lab assistant was getting at.

Alexander said, “I think we should be doing an indirect Coombs test on all these samples, after the tests in saline and high protein.”

“Of course.”

There was a silence which Alexander broke. “Would you mind saying that again, Doctor?”

“I said ‘of course.’ Naturally there should be an indirect Coombs.” Coleman still could see no point in this discussion. For a serology lab this sort of thing was elementary, basic.

“But we’re not doing an indirect Coombs.” Alexander shot a triumphal glance at Ba

At first Coleman was sure Alexander must be wrong. Apparently the young technologist had been working here only a short time; no doubt he had become confused. Then Coleman remembered the tone of conviction in which the statement had been made. He asked Ba

“The way we do all our tests are according to Dr. Pearson’s instructions.” The elderly technician made it plain that in his opinion the entire discussion was a waste of time.

“Perhaps Dr. Pearson doesn’t know you’re doing the Rh tests that way.”

“He knows all right.” This time Ba

Coleman decided to ignore the senior technician’s tone. Whether he liked it or not he was going to have to work with this man for a while. All the same, this thing had to be cleared up now. He said, “I’m afraid I don’t quite understand. Surely you know that some antibodies in the blood of pregnant women will get past a saline test and a high-protein test, whereas they won’t if you go on and do a further test in Coombs serum.”

Alexander interjected, “That’s what I’ve been saying.”

Ba

“What shall we do about this test?” Alexander asked. “And the others from here on?”

Coleman answered, “Do them in all three mediums, of course—saline, high protein, and Coombs serum.”

“We haven’t any Coombs serum in the lab, Doctor.” Alexander was very glad now that he had brought this up. He liked the look of this new pathologist. Maybe he’d change some other things around the place. Goodness knows, he thought, there’s plenty that can stand it.

“Then let’s get some.” Coleman was deliberately brisk. “There’s no shortage anywhere.”

“We can’t just go out and get lab supplies,” Ba

Coleman carefully kept his feelings in check. Sometime soon it might be necessary to have a showdown with this man Ba

Briefly the older technician hesitated. Then he opened a drawer and produced a pad of forms which he handed to Coleman.

“A pencil, please?”

With the same reluctance Ba

Coleman scribbled the order and signed it. With a tight, cool smile, “I expect to have a good deal more responsibility here than just ordering fifteen dollars’ worth of rabbit serum,” he said. “There you are.” As he handed back the pad and pencil the phone rang on the other side of the lab.

It was an excuse for Ba

He answered icily, “You can go ahead.”

With the incident closed Coleman found himself more angry than he had realized. What kind of discipline existed which allowed insolence like this from a lab technician? The inadequate procedure was serious enough. But having to correct it over the objections of someone like this man Ba

With Ba

“Is this the way the lab is usually kept?” Coleman asked.

“It isn’t very tidy, is it?” Alexander felt a surge of shame that anyone should see this place the way it was. What he could not say was that he had already offered to reorganize it but Ba

“I’d put it a little stronger than that.” Coleman ran one of his fingers over a shelf. It came away grimed with dust. He thought disgustedly: All this is something to be changed. On second thought, though, it might have to wait awhile. He knew he was going to have to be cautious in his dealings with people here, and his own experience had already taught him that there were limits to what you could accomplish quickly. All the same, he knew it would be hard to curb his own natural impatience, especially with this sort of mess visible right under his nose.

For the past few moments John Alexander had been watching Coleman closely. Ever since this new doctor had first come in with Ba

“It’s possible.” Coleman was elaborately casual. Because he had supported this man in one incident, he did not want him to get any impression there was some sort of alliance between them. Then it occurred to him that perhaps he had been a little too curt. He added, “I interned at Bellevue, then I was at Walter Reed and Massachusetts General.”

“No.” Alexander shook his head. “It must have been before then. Have you ever been in Indiana? New Richmond?”

“Yes,” Coleman said, startled, “I was born there.”

John Alexander beamed. “I should have remembered the name, of course. Your father would be . . . Dr. Byron Coleman?”

“How do you know that?” It had been a long time since someone other than himself had recalled his father’s name.

“I’m from New Richmond too,” Alexander said. “So is my wife.”

“Really?” Coleman asked. “Did I know you there?”

“I don’t think so, though I remember seeing you a couple of times.” In the social life of New Richmond, John Alexander had been several stages removed from the orbit of the doctor’s son. As the thought occurred to him, there was a “ping” from the centrifuge timer. He paused to remove the blood sample which had been spun down, then went on, “My father was a truck farmer. We lived a few miles outside town. You may remember my wife though. Her family had the hardware store. She was Elizabeth Johnson.”