“Remember,” said Michaels, “the program approaches radiology the same way you do. It’s your techniques that it utilizes.”
“Yeah, but it’s already better than me. It picked up this density variation when I didn’t see it. If it uses my techniques, how do you explain that?”
“Easy. Remember, the computer digitizes the image into a two-hundred-fifty-six by two-hundred-fifty-six grid of pixel points with gray values between zero and two hundred. When we tested you, you only could differentiate gray values of zero to fifty. Obviously the machine is more sensitive.”
“I’m sorry I asked,” said Philips.
“Have you run the program against any old skull X rays?”
“No,” admitted Philips, “I’m about to start.”
“Well, you don’t have to do everything in one night. Einstein didn’t. Why not wait until morning?”
“Shut up,” said Philips good-naturedly and hung up.
Armed with Lynn Anne Lucas’s hospital number, Philips found her X ray file with relative ease. It contained only two recent chest films and the skull series taken after the roller-skating accident when she was eleven. He put one of the old lateral skull films up on the viewer next to the X ray taken that evening. Comparing them, Philips ascertained that the abnormal density had developed since age eleven. To be perfectly certain. Philips fed one of the older films into the computer. It concurred.
Philips put Lynn Anne’s old X rays back into the envelope and put the new ones on top. Then he put the package on his desk, where he knew Helen wouldn’t touch it. Until Lynn Anne had her new studies, there was nothing else to be done on her case.
Martin wondered what he should do. Despite the hour he knew he was still too excited to sleep and besides he wanted to wait for Denise. He was hoping she’d come by his office when she finished whatever she was doing. He thought about paging her, but then thought better of it.
He decided to pass the time by getting some old skull X rays from the file room. He thought he might as well start the process of checking the computer program. In case Denise came back before he did he left a note for her on the door. “I’m in Central Radiology.”
At one of the terminals of the hospital’s central computer he painfully typed out what he wanted: a printout of the names and unit numbers of all patients having had skull X rays in the last ten years. When he was finished he pushed the “enter” button and swung around in the chair to face the output printer. There was a short delay. Then the machine spewed out paper at an alarming rate. When it finally stopped, Philips found himself holding a list of thousands of names. Just looking at it made him feel tired.
Undaunted, he sought out Randy Jacobs, one of the department’s evening employees, hired to file the day’s X rays and pull the films needed for the following day. He was a full-time pharmacy student, a talented flautist, and an out-of-the-closet gay. Martin found him sharp-witted, ebullient, and a fabulous worker.
To start, Martin asked Randy to pull the X rays on the first page of the list. That represented about sixty patients. With his usual efficiency, Randy had twenty lateral skull films on Philips’ alternator in as many minutes. But Philips did not run the films on the computer as Michaels had asked. Instead he began to examine them closely, unable to resist the temptation to look for more of the abnormal densities he had discovered on Marino’s and Lucas’s X rays. Using his paper with the hole as a screening device, he began to go from one film to another, advancing the viewing screens as needed by depressing the electrical lever with his foot. He’d processed about half of the X rays when Denise arrived.
“All your big talk about wanting to leave clinical radiology and you’re looking at X rays when it’s almost midnight.”
“It is a bit silly,” said Martin, leaning back in his chair and rubbing his eyes with his knuckles, “but I had these old films pulled and I thought I’d check to see if I could find another case like Lucas or Marino.”