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She reached for his hand。 〃Mike…in there； I wanted to； as much as you。 Then this。〃 Again the pain。
He said； 〃I'm sorry； Vivian。 I thought 。 。 。〃
She said； 〃I know what you thought。 But it wasn't that。 Honestly。〃
〃All right。 Tell me what's wrong。〃 He was the doctor now。 Back in there he had forgotten。
〃It's my knee。 All of a sudden…the sharpest pain。〃
〃Let me see。〃 He was down in front of her。 〃Which one？〃
She lifted her skirt and indicated the left knee。 He felt it carefully； his hands moving lightly。 For the moment Mike Seddons dismissed the thought that this was a girl to whom； a few minutes earlier； he had been about to make love。 His behavior now was professional； analytical。 As he had been trained to do； his mind went methodically over the possibilities。 He found Vivian's nylons impeded his sense of touch。
〃Roll down your stocking； Vivian。〃 She did so； and his probing fingers moved over the knee again。 Watching him； she thought： He's good； he'll be a fine doctor； people will e to him for help and he'll be kind and do the utmost that he can。 She found herself wondering what it would be like…the two of them together always。 As a nurse there would be so much she could do to help him and to understand his work。 She told herself： This is ridiculous； we scarcely know each other。 Then； momentarily； the pain returned and she winced。
Mike asked； 〃Has this happened before？〃
For a moment the absurdity of the situation struck her and she giggled。
〃What is it； Vivian？〃 Mike sounded puzzled。
〃I was just thinking。 A minute or two ago 。 。 。 And now here you are； just like in a doctor's office。〃
〃Listen； kid。〃 He was serious。 〃Has this happened before？〃
She said； 〃Just once。 It wasn't as bad as this though。〃
〃How long ago？〃
She thought。 〃About a month。〃
〃Have you seen anybody about it？〃 He was all professional now。
〃No。 Should I have？〃
Nonmittally he said； 〃Maybe。〃 Then he added； 〃You will tomorrow anyway。 I think Dr。 Grainger would be the best one。〃
〃Mike； is something wrong？〃 Now she felt an undercurrent of alarm。
〃Probably not；〃 he reassured her。 〃But there's a small lump there that shouldn't be。 Lucy Grainger will give us the word though。 I'll talk with her in the morning。 Now we have to get you home。〃
The earlier mood was gone。 It could not be recaptured； not tonight anyway； and both of them knew it。
Mike helped her up。 As his arm went around her； he had a sudden feeling of wanting to help and protect her。 He asked； 〃Do you think you can walk？〃
Vivian told him； 〃Yes。 The pain's gone now。〃
〃We'll just go to the gate；〃 he said； 〃we can get a taxi there。〃 Then because she looked glum he added cheerfully； 〃That patient was a cheap skate。 He didn't send any cab fare。〃
Nine
〃Give me the details。〃
Hunched over the binocular microscope； Dr。 Joseph Pearson half grunted the words to Roger McNeil。
The pathology resident looked at his folder of notes。 〃Case was a forty…year…old man； admitted for appendicitis。〃 McNeil was seated opposite Pearson at the desk of the pathology office。
Pearson took out the slide he had been studying and substituted another。 He asked； 〃What did the tissue look like at gross？〃
McNeil； who had made the gross examination when the removed appendix came down from the operating room； said； 〃Grossly it looked normal enough to me。〃
〃Hm。〃 Pearson moved the slide around。 Then he said； 〃Wait a minute； here's something。〃 After a pause he slipped the second slide out and selected a third。 Now he said； 〃Here it is…an acute appendicitis。 It was just beginning in this section。 Who was the surgeon？〃
McNeil answered； 〃Dr。 Bartlett。〃
Pearson nodded。 〃He got it good and early。 Take a look。〃 He made way at the microscope for McNeil。
Working with the resident； as the hospital's teaching program required him to； Pearson was endeavoring to catch up on the pathology department's surgical reports。
Despite his best efforts； though； both men knew they were seriously in arrears with work。 The slides being studied now had been sectioned from a patient's appendix removed several weeks earlier。 The patient had long since been discharged； and in this case the report would merely confirm or deny the surgeon's original diagnosis。 In this instance Gil Bartlett had been entirely right； in fact； creditably so； since he had caught the disease in its early stages and before the patient could have had much distress。
〃Next。〃 Pearson moved back to the microscope as McNeil returned to the other side of the desk。
The resident pushed over a slide folder and； as Pearson opened it； McNeil consulted a fresh set of notes。 As they worked Bannister entered the room quietly。 With a glance at the other two he passed behind them and began to file papers into a cabinet。
〃This is a current one；〃 McNeil said。 〃It came down five days ago。 They're waiting to hear what we say。〃
〃You'd better give me any like this first；〃 Pearson said sourly； 〃otherwise there'll be more bleating from upstairs。〃
McNeil was on the point of saying that several weeks ago he had suggested changing their procedure in just that way； but Pearson had insisted on reviewing all specimens in the order they came into the department。 However； the resident checked himself。 Why bother？ he thought。 He told Pearson； 〃It's a fifty…six…year…old woman。 The specimen is a skin lesion…superficially a mole。 Question is： Is it a malignant melanoma？〃
Pearson put in the first slide and moved it around。 Then he nipped over the highest…powered lens and adjusted the binocular eyepiece。 〃It could be。〃 He took the second slide； then two more。 After that he sat back thoughtfully。 〃On the other hand it could be a blue nevus。 Let's see what you think。〃
McNeil moved in。 This one； he knew； was important。 A malignant melanoma was a tumor that was viciously malignant。 Its cells could spread rapidly and murderously in the body。 If diagnosed as such from the small portion already removed； it would mean immediate major surgery for the woman patient。 But a blue nevus tumor was entirely harmless。 It could stay where it was in the body； doing no harm； for the rest of the woman's life。
From his own studies McNeil knew that a malignant melanoma was not mon； but he also knew that a blue nevus was extremely rare。 Mathematically the odds were on this being malignant。 But this was not mathematics。 It was pathology at its purest。
As he had learned to do； McNeil ran over in his mind the parative features of the two types of tumor。 They were distressingly similar。 Both were partly scarred； partly cellular； with a good deal of pigmentation in them。 Again； in both； the cellular structure was very pronounced。 Something else McNeil had been taught was to be honest。 After looking at all the slides he said to Pearson； 〃I don't know。〃 He added； 〃What about previous cases？ Could we get any out？ To pare them。〃
〃It'd take us a year to find any。 I don't remember when I last had a blue nevus。〃 Pearson was frowning。 He said heavily； 〃One of these days we've got to set up a cross file。 Then when a doubtful case like this es up we can go back and pare it。〃
〃You've been saying that for five years。〃 Bannister's dry voice came from behind； and Pearson wheeled。 〃What are you doing here？〃
〃Filing。〃 The senior lab technician answered laconically。 〃Something the clerks should be doing if we had some proper help。〃
And probably a lot better； McNeil thought。 He knew the department badly needed more clerical staff and the filing methods used now were hopelessly archaic。 The reference to a cross file； too； had reminded him of a gaping hole in their administrative system。 There were few good hospitals now whose pathology departments did not have one。 Some called them organ…lesion files； but； whatever the name； one purpose of the system was to help resolve the kind of problem they were facing at this moment。
Pearson was studying the slides again。 He mumbled； as a lot of pathologists did when they were mentally crossing off some factors and confirming others。 McNeil heard； 〃It's a little small 。 。 。 absence of hemorrhage 。 。 。 no necrosis of the tissue 。 。 。 negative but no indication 。 。 。 yes； I'm satisfied。〃 Pearson straightened up from the microscope； replaced the last slide； and closed the slide folder。 Motioning to the resident to write； he said； 〃Diagnosis…a blue nevus。〃 Courtesy of Pathology； the woman patient had been reprieved。
Methodically； for McNeil's benefit； Pearson ran over the reasons for his decision again。 As he passed the slide folder he added； 〃You'd better study these。 It's a specimen you won't see often。〃
McNeil had no doubt that the old man's finding was right。 This was one place where years of experience paid off； and he had e to respect Pearson's judgment in matters of pathological anatomy。 But when you've gone； he thought； looking at the old man； that's when this place will need a cross file…badly。
They studied two more cases； both fairly straightforward； then Pearson slipped in the first slide from the next series。 He took one look through the microscope eyepiece； straightened up； and told McNeil explosively； 〃Get Bannister！〃
〃I'm still here。〃 It was Bannister； calmly； behind them at the file cabi