Hunting for Hippocrates. Warren J. Stucki

any of my patients while I was gone?”

      “No, not really. Oh—Laura Slembosky passed her stone, so I canceled her lithotripsy for tomorrow.”

      “Guess I should have done her before I left,” Rusty joked. “After New Orleans, I need the money,”

      Moe did not laugh. “How were the meetings?”

      “Great! When we get a minute, I want to talk to you about a new procedure for stress incontinence, the vaginal sling. The initial patient trials show up to a ninety percent success at five years,” Rusty gushed.

      “Yeah, I’ve heard of it. Reminds me of what Mark Twain said about statistics. You going to be here much longer?”

      “Nah, just going through some of my messages.”

      “Smell like formalin in here to you?” Moe asked as he sniffed the air.

      “Uh—uh, probably the cleaning solution housekeeping is using.”

      “Yeah, probably. You’ll lock-up?”

      “Of course.”

      With an uneasy blend of relief and hostility, Rusty watched the old bastard leave. With his thumb, he recapped the specimen vial, then idly toyed with the vials. After a minute, he placed the specimen vials in the pathology outbox, turned out the lights and left.

      The courier, clothed in a white lab coat, stopped at the office of Urology Associates at precisely 5:00 p.m. the next afternoon. There she collected blood and tissue specimens, a service provided by the lab of Dixie Pioneer Hospital to their private physicians. From Urology Associates, the last stop on her route, she collected three biopsy specimens, two from Dr. Mathis dated the previous day and one from Dr. Wright labeled with today’s date.

      Her carrying tray was packed to over-flowing with specimens, mostly blood tubes and biopsy vials. She had missed two collections, yesterday evening and this morning. Her baby, Geoff, had been sick with otitis media and the day care would not take him until he was better. But this afternoon, her mother had agreed to watch the child so she could make her evening pick-ups. Anyway, a few hours really didn’t really matter. All the biopsy specimens were pickled in formalin and the blood tubes contained preservatives. Nothing was damaged.

      After leaving Urology Associates, the courier delivered the specimens to the hospital lab, placing the histology specimens in the histology receiving box and the blood products in the hematology box.

      Histology technician Tammy Everett retrieved the specimens five minutes later and wrote down in her log book the time, date and the vial serial numbers, which had been pre-stamped into the specimen containers by the manufacturer. For the first container, she entered into the log, Howard H. Swensen-#001198-G, then, Robert E. Robinson-#001199-G and the third, Joseph P. Kuck-#001201-G. After the paperwork, she then began the time-consuming task of preparing the tissue for pathological examination. The entire procedure was pretty much automated. Tammy just had to get things started. First, she placed each specimen in a cassette, then submerged the cassettes into a formalin solution. Through the day the cassettes would systematically rotate from the formalin, through a solution of 80 percent alcohol, then a solution of 90 percent alcohol, followed by a solution of 100 percent alcohol and lastly, through a solution of xylene. By morning, the tissue would be properly dried, then imbedded in molten paraffin wax. The paraffin wax would then be cooled, the tissue oriented and sliced with a microtome, and eventually fixed on a glass slide. As a final step, the tissue would be stained with hematoxylin and eosin (H&E), then placed on the pathologists’ desk to be read. After analyzing the slides through a microscope, the pathologist would dictate a report. The slides and any excess tissue would then be catalogued and stored for future reference.

      Two days later, Dr. Catherine Connelly picked up the three sets of newly processed tissue slides. When she saw Dr. Mathis’ name, she was immediately flooded with anger and clenched her teeth. It was involuntary—a gut reaction. Through the years, Catherine had grown used to this response. Every time she saw any pathological specimen with his name on it, she felt the old fury. Moe Mathis was a son-of-a-bitch!

      Catherine had always been an over-achiever, though it hadn’t been easy in a profession dominated by men. In spite of this, she had done well in a society where women were considered chattel and second-class citizens, and were usually relegated to raising children or simple clerical jobs. It infuriated Catherine that women’s work usually consisted of waiting on men, whether in the workplace or at home. All her life, she’d had to battle this archaic attitude, especially prevalent in Utah, and had surreptitiously developed a seething dislike for men. Particularly men in positions of power. Men in power were to society like untreated gangrene to a leg. If left unchecked and untreated, it would ultimately kill the patient.

      In her thirty-nine years of life, Catherine could only remember one man she’d not had to struggle with for respect, Joe Connelly, and she had married him. Sweet sensitive Joe, wouldn’t raise a foot to kill a spider. She had met Joe at the University of Washington in Seattle where they were both students. As luck would have it, they were seated together in biochemistry her senior year. Joe was majoring in pharmacy, while she was pre-med. They often studied together, eventually started dating and were married in the summer just after they both graduated from college.

      From the onset, it was apparent to both of them that Catherine was more intelligent, more ambitious and had a better chance to succeed. Without giving it another thought, Joe acquiesced, dropped out of pharmacy school and got a job, while she continued on in medical school. After medical school, she took a residency in pathology at the University of Utah. During this time, Joe continued to support her.

      Catherine and Joe had one child, a girl, who with true medical precision, was calendar-timed to arrive about a month after she had finished her fourth year of residency. Their timing, though not perfect, was adequate. The baby was delivered about three weeks after graduation.

      Following her residency, Catherine accepted a position at Dixie Pioneer Hospital in the pathology department working with that pseudo-intellectual, that rumpled slob, Dr. Ray Mosdell. With her making a good salary, Joe no longer had to work so he managed the domestic part of married life, taking care of the house and raising their daughter.

      Immediately after arriving at Dixie Pioneer Hospital, Catherine had trouble with Dr. Mathis. Moe was Chief of Staff at the time and was in the process of preparing the annual staff committee assignments. Initially he had assigned her as chairwoman of the safety committee, a fairly insignificant committee when compared to the more powerful surgery, medical or credentials committees. However, she had derived a certain satisfaction at being appointed to chair a committee in her first year on the staff.

      Then inexplicably, Moe called her and told her he was switching her assignment. Instead of chairwomen of the safety committee he was putting her on the pharmacy committee, and not as chairman. And Dr. Ray Mosdell would continue as chairman of the safety committee. Catherine was furious and she and Moe had words. Moe had tried to convince her the reason for the re-shuffle was that the safety committee was in the middle of several safety audits and the committee members had unanimously asked for Dr. Mosdell to continue as chairman until these projects were completed. Catherine didn’t buy this, not for a minute. She accused Moe of being a chauvinistic bastard and hinted that staff government was being conducted by the good ole boy system, with Moe being the worst example. But Chief of Staff Mathis did not capitulate to her tirade, and through the ensuing years she and Moe had been cordial, but were never friends. Fortunately, time had corrected that mistake. She was now chairwoman of the more influential peer review committee.

      Five years ago, Joe had started passing blood in his urine. Catherine was in a quandary on which urologist to use. Without a doubt, Moe had the better reputation as a surgeon. Eventually, she put her pride in her purse and asked Moe if he would evaluate Joe for the bleeding. Of course, he was happy to do it and started Joe’s work-up with an intravenous pyelogram then cystoscopy. The cystoscopy was negative, but the IVP showed a large mass in the upper pole of the right kidney. The CAT scan confirmed it was a solid