by Otto Penzler
“This is my first report in three years,” Wood answered modestly. “And I’ve been operating at the rate of four or five daily, including holidays.”
“My dear Kenneth,” Dr. Hume said, “every surgeon is entitled to one murder in three years. A phenomenal record, in fact—when you consider the temptations.”
“Proceed with the crime,” Tick said.
“Well”—the strong-looking surgeon turned to his hospital colleague, the new member—“you know how it is with these acute gall bladders, Sam.”
Warner nodded abstractedly.
Dr. Wood went on: “Brought in late at night. In extreme pain. I examined her. Found the pain in the right upper quadrant of the abdomen. It radiated to the back and right shoulder. Completely characteristic of gall bladder. I gave her opiates. They had no effect on her, which, as you know, backs up any gall-bladder diagnosis. Opiates never touch the gall bladder.”
“We know that,” said the new member nervously.
“Excuse me,” Dr. Wood smiled. “I want to get all the points down carefully. Well, I gave her some nitroglycerin to lessen the pain then. Her temperature was 101. By morning the pain was so severe that it seemed certain the gall bladder had perforated. I operated. There was nothing wrong with her gall bladder. She died an hour later.”
“What did the autopsy show?” Dr. Sweeney asked.
“Wait a minute,” Wood answered. “You’re supposed to figure it out, aren’t you? Come on—you tell me what was the matter with her.”
“Did you take her history?” Dr. Kurtiff asked after a pause.
“No,” Wood answered.
“Aha!” Tick snorted. “There you have it! Blind man’s buff again.”
“It was an emergency.” Wood looked flushed. “And it seemed an obvious case. I’ve had hundreds of them.”
“The facts seem to be as follows,” Tick spoke up. “Dr. Wood murdered a woman because he misunderstood the source of a pain. We have, then, a very simple problem. What besides the gall bladder can produce the sort of pain that that eminent surgeon has described?”
“Heart,” Dr. Morris answered quickly.
“You’re getting warm,” said Wood.
“Before operating on anyone with so acute a pain, and in the absence of any medical history,” Tick went on, “I would most certainly have looked at the heart.”
“Well, you’d have done right,” said Wood quietly. “The autopsy showed an infraction of the descending branch of the right coronary artery.”
“Which a cardiogram would have told you,” said old Tick. “But you didn’t have to go near a cardiograph. All you had to do is ask one question. If you had even called up a neighbor of the patient she would have told you that previous attacks of pain came on exertion—which would have spelled heart, and not gall bladder.
“Murder by a sophomore,” old Tick pronounced wrathfully.
“The first and last,” said Wood quietly. “There won’t be any more heart-case mistakes in my hospital.”
“Good, good,” old Tick said. “And now, gentlemen, the crimes reported thus far have been too infantile for discussion. We have learned nothing from them other than that science and stupidity go hand in hand, a fact already too well known to us. However, we have with us tonight a young but extremely talented wielder of the medical saws. He has been sitting here for the last hour, fidgeting like a true criminal, sweating with guilt and a desire to tell all. Gentlemen, I give you our new and youngest culprit, Dr. Samuel Warner.”
Dr. Warner faced his fourteen eminent colleagues with a sudden excitement in his manner. His eyes glittered and the dusty look of hard work and near exhaustion already beginning to mark his youth lifted from his face.
The older men regarded him quietly and with various degrees of irritation. They knew, without further corroboration than his manner, that this medico was full of untenable theories and half-baked medical discoveries. They had been full of such things themselves once. And they settled back to enjoy themselves. There is nothing as pleasing to a graying medical man as the opportunity of slapping a dunce cap on the young of science. Old Tick, surveying his colleagues, grinned. They had all acquired the look of pedagogues holding a switch behind their backs.
Dr. Warner mopped his neck with his wet handkerchief and smiled knowingly at the medical peerage.
“I’ll give you this case in some detail,” he said, “because I think it contains as interesting a problem as you can find in practice.”
Dr. Rosson, the gynecologist, grunted, but said nothing.
“The patient was a young man, or rather a boy,” Warner went on eagerly. “He was seventeen, and amazingly talented. He wrote poetry. That’s how I happened to meet him. I read one of his poems in a magazine, and it was so impressive I wrote him a letter.”
“Rhymed poetry?” Dr. Wood asked, with a wink at old Tick.
“Yes,” said Warner. “I read all his manuscripts. They were sort of revolutionary. His poetry was a cry against injustice. Every kind of injustice. Bitter and burning.”
“Wait a minute,” Dr. Rosson said. “The new member seems to have some misconception of our function. We are not a literary society, Warner.”
“And before you get started,” Dr. Hume grinned, “no bragging. You can do your bragging at the annual surgeons’ convention.”
“Gentlemen,” Warner said, “I have no intention of bragging. I’ll stick to murder, I assure you. And as bad a one as you’ve ever heard.”
“Good,” Dr. Kurtiff said. “Go on. And take it easy and don’t break down.”
“Yes.” Dr. Wood grinned. “I remember when Morris here made his first confession. We had to pour a quart of whisky into him before he quit blubbering.”
“I won’t break down,” Warner said. “Don’t worry. Well, the patient was sick for two weeks before I was called.”
“I thought you were his friend,” Dr. Davis said.
“I was,” Warner answered. “But he didn’t believe in doctors.”
“No faith in them, eh?” old Tick cackled. “Brilliant boy.”
“He was,” said Warner eagerly. “I felt upset when I came and saw how sick he was. I had him moved to a hospital at once.”
“Oh, a rich poet,” Dr. Sweeney said.
“No,” said Warner. “I paid his expenses. And I spent all the time I could with him. The sickness had started with a severe pain on the left side of the abdomen. He was going to call me, but the pain subsided after three days, so the patient thought he was well. But it came back in two days and he began running a temperature. He developed diarrhea. There was pus and blood, but no amoeba or pathogenic bacteria when he finally sent for me.
“After the pathology reports I made a diagnosis of ulcerative colitis. The pain being on the left side ruled out the appendix. I put the patient on sulfaguanidin and unconcentrated liver extract, and gave him a high protein diet—chiefly milk. Despite this treatment and constant observation the patient got worse. He developed generalized abdominal tenderness, both direct and rebound, and rigidity of the entire left rectus muscle. After two weeks of careful treatment the patient died.”
“And the autopsy showed you’d been wrong?” Dr. Wood asked.
“I didn’t make an autopsy,” said Warner. “The boy’s parents had perfect faith in me. As did the boy. They both believed I was doing everything possible to save his life.”
“Then how do you know you were wrong in your diagnosis?” Dr. Hume asked.
“By the simple fact,” said Warner irritably, “that the patient died instead of being cured. When he died I knew I had killed him by a faulty diagnosis.”
“A logical conclusion,” said Dr. Sweeney. “Pointless medication is no alibi.”
“Well, gentlemen,” old Tick cackled from behind his table, “our talented new member has obviously polished off a great poet and close personal friend. Indictments of his diagnosis are now in order.”
But no one spoke. Doctors have a sense for things unseen and complic
ations unstated. And nearly all the fourteen looking at Warner felt there was something hidden. The surgeon’s tension, his elation and its overtone of mockery, convinced them there was something untold in the story of the dead poet. They approached the problem cautiously.
“How long ago did the patient die?” Dr. Rosson asked.
“Last Wednesday,” said Warner. “Why?”
“What hospital?” asked Davis.
“St. Michael’s,” said Warner.
“You say the parents had faith in you,” said Kurtiff, “and still have. Yet you seem curiously worried about something. Has there been any inquiry by the police?”
“No,” said Warner. “I committed the perfect crime. The police haven’t even heard of it. And even my victim died full of gratitude.” He beamed at the room. “Listen,” he went on, “even you people may not be able to disprove my diagnosis.”
This brash challenge irritated a number of the members.
“I don’t think it will be very difficult to knock out your diagnosis,” said Dr. Morris.
“There’s a catch to it,” said Wood slowly, his eyes boring at Warner.
“The only catch there is,” said Warner quickly, “is the complexity of the case. You gentlemen evidently prefer the simpler malpractice type of crime, such as I’ve listened to tonight.”
There was a pause, and then Dr. Davis inquired in a soothing voice, “You described an acute onset of pain before the diarrhea, didn’t you?”
“That’s right,” said Warner.
“Well,” Davis continued coolly, “the temporary relief of symptoms and their recurrence within a few days sounds superficially like ulcers—except for one point.”
“I disagree,” Dr. Sweeney said softly. “Dr. Warner’s diagnosis is a piece of blundering stupidity. The symptoms he has presented have nothing to do with ulcerative colitis.”
Warner flushed and his jaw muscles moved angrily. “Would you mind backing up your insults with a bit of science?” he said.
“Very easily done,” Sweeney answered calmly. “The late onset of diarrhea and fever you describe rule out ulcerative colitis in ninety-nine cases out of a hundred. What do you think, Dr. Tick?”
“No ulcers,” said Tick, his eyes studying Warner.
“You mentioned a general tenderness of the abdomen as one of the last symptoms,” said Dr. Davis smoothly.
“That’s right,” said Warner.
“Well, if you have described the case accurately,” Davis continued, “there is one obvious fact revealed. The general tenderness points to a peritonitis. I’m certain an autopsy would show that this perforation had walled off and spilled over and that a piece of intestine was telescoped into another.”
“I don’t think so,” Dr. William Zinner, the cancer-research man, said. He was short, bird-faced and barely audible. Silence fell on the room, and the others waited attentively for his soft voice.
“It couldn’t be an intussusception such as Dr. Davis describes,” he went on. “The patient was only seventeen. Intussusception is unusual at that age unless the patient has a tumor of the intestines. In which case he would not have stayed alive that long.”
“Excellent,” old Tick spoke.
“I thought of intussusception,” said Warner, “and discarded it for that very reason.”
“How about a twisted gut?” Dr. Wood asked. “That could produce the symptoms described.”
“No,” said Dr. Rosson. “A volvulus means gangrene and death in three days. Warner says he attended his patient for two weeks and that the boy was sick for two weeks before Warner was called. The length of the illness rules out intussusception, volvulus, and intestinal tumor.”
“There’s one other thing,” Dr. Morris said. “A left-sided appendix.”
“That’s out, too,” Dr. Wood said quickly. “The first symptom of a left-sided appendix would not be the acute pain described by Warner.”
“The only thing we have determined,” said Dr. Sweeney, “is a perforation other than ulcer. Why not go on with that?”
“Yes,” said Dr. Morris. “Ulcerative colitis is out of the question considering the course taken by the disease. I’m sure we’re dealing with another type of perforation.”
“The next question,” announced old Tick, “is what made the perforation?”
Dr. Warner mopped his face with his wet handkerchief and said softly, “I never thought of an object perforation.”
“You should have,” Dr. Kurtiff stated.
“Come, come,” old Tick interrupted. “Let’s not wander. What caused the perforation?”
“He was seventeen,” Kurtiff answered, “and too old to be swallowing pins.”
“Unless,” said Dr. Hume, “he had a taste for pins. Did the patient want to live, Warner?”
“He wanted to live,” said Warner grimly, “more than anybody I ever knew.”
“I think we can ignore the suicide theory,” said Dr. Kurtiff. “I am certain we are dealing with a perforation of the intestines and not of the subconscious.”
“Well,” Dr. Wood spoke, “it couldn’t have been a chicken bone. A chicken bone would have stuck in the esophagus and never got through to the stomach.”
“There you are, Warner,” old Tick said. “We’ve narrowed it down. The spreading tenderness you described means a spreading infection. The course taken by the disease means a perforation other than ulcerous. And a perforation of that type means an object swallowed. We have ruled out pins and chicken bones. Which leaves us with only one other normal guess.”
“A fishbone,” said Dr. Sweeney.
“Exactly,” said Tick.
Warner stood listening tensely to the voices affirming the diagnosis. Tick delivered the verdict.
“I think we are all agreed,” he said, “that Sam Warner killed his patient by treating him for ulcerative colitis when an operation removing an abscessed fishbone would have saved his life.”
Warner moved quickly across the room to the closet where he had hung his hat and coat.
“Where are you going?” Dr. Wood called after him. “We’ve just started the meeting.”
Warner was putting on his coat and grinning.
“I haven’t got much time,” he said, “but I want to thank all of you for your diagnosis. You were right about there being a catch to the case. The catch is that my patient is still alive. I’ve been treating him for ulcerative colitis for two weeks and I realized this afternoon that I had wrongly diagnosed the case—and that he would be dead in twenty-four hours unless I could find out what really was the matter with him.”
Warner was in the doorway, his eyes glittering.
“Thanks again, gentlemen, for the consultation and your diagnosis,” he said. “It will enable me to save my patient’s life.”
A half hour later, the members of the X Club stood grouped in one of the operating rooms of St. Michael’s Hospital. They looked different from the men who had been playing a medical Halloween in the Walton Hotel. There is a change that comes over doctors when they face disease. The oldest and the weariest of them draw vigor from a crisis. The shamble leaves them and it is the straight back of the champion that enters the operating room. Confronting the problem of life and death, the tired, red-rimmed eyes become full of greatness and even beauty.
On the operating table lay the unconscious body of a Negro boy. Dr. Warner in his surgical whites stood over him.
The fourteen other X Club members watched Warner operate. Wood nodded approvingly at his speed. Rosson cleared his throat to say something, but the swift-moving hands of the surgeon held him silent. No one spoke. The minutes passed. The nurses quietly handed instruments to the surgeon. Blood spattered their hands.
Fourteen great medical men stared hopefully at the pinched and unconscious face of a colored boy who had swallowed a fishbone. No king or pope ever lay ill with more medical genius holding its breath around him.
Suddenly the perspiring surgeon raised something aloft in his forceps.
“Wash this off,” he muttered to the nurse, “and show it to these gentlemen.”
He busied himself placing drains in the abscessed cavity and then powdered some sulfanilamide into the opened abdomen to kill the infection.
Old Tick stepped forward and took the object from the nurse’s hand.
“A fishbone,” he said.
The X Club gathered around it as if it were a treasure indescribable.
“The removal of this small object,” old Tick cackled softly, “will enable the patient to continue writing poetry denouncing the greeds and horrors of our world.”
—
That, in effect, was the story Hume told me, plus the epilogue of the Negro poet’s recovery three weeks later. We had long finished dinner and it was late night when we stepped into the war-dimmed streets of New York. The headlines on the newsstands had changed in size only. They were larger in honor of the larger slaughters they heralded.
Looking at them you could see the death-strewn wastes of battles. But another picture came to my mind—a picture that had in it the hope of a better world. It was the hospital room in which fifteen famed and learned heroes stood battling for the life of a Negro boy who had swallowed a fishbone.
Rogue: Simon Templar (The Saint)
The Damsel in Distress
LESLIE CHARTERIS
SIMON TEMPLAR, the adventurer created by Leslie Charteris (1907–1993), although commonly known as the Saint, is anything but. He is a romantic hero who works outside the law and has grand fun doing it. Like so many crooks in literature, he is imbued with the spirit of Robin Hood, which suggests that it is perfectly all right to steal, so long as it is from someone with wealth. Most of the more than forty books about the Saint are collections of short stories or novellas, and in the majority of tales, he also functions as a detective. Unconstricted by being an official policeman, he steps outside the law to retrieve money or treasure that may not have been procured in an honorable fashion, either to restore it to its proper owner or to enrich himself. Not unlike James Bond, a remarkable number of his cases involve damsels in distress.
