“Look,” Harper said after a pause, “I’ve got a lot of patients to see.” Martin realized that instead of making the man relax, his questions were making him more ill-at-ease.
“Just one more thing,” said Philips. “When a Pap smear is reported as atypical, what’s usually done?”
“That depends,” said Harper warily. “There’re two categories of atypical cells. One is atypical but not suggestive of tumor, whereas the other is atypical and suggestive of tumor.”
“Whether it’s in either class, shouldn’t something be done? I mean, if it’s not normal, it should be followed up. Isn’t that right?”
“Yeah,” said Harper evasively. “Why are you asking me these questions?” He had the distinct feeling he was being backed into a corner.
“Just out of interest,” said Martin. He held up Collins’ chart. “I’ve come across several patients who’d had atypical Pap smears in this clinic. But reading the GYN notes, I can’t find any reference to Schiller’s test, thoughts about a biopsy, or colposcopy … just repeat smears. Isn’t that … irregular?” Philips eyed Harper, sensing his discomfort. “Look, I’m not here casting any blame. I’m just interested.”
“I couldn’t say anything unless I saw the chart,” said Harper. He’d intended the comment to end the conversation.
Philips handed Collins’ chart to Harper and watched as the resident opened it. When Harper read the name, “Katherine Collins,” his face became tense. Martin watched curiously as the man rapidly flipped through the chart, too quickly to read anything adequately. When he got to the end, he looked up and handed it back.
“I don’t know what to say.”
“It is irregular, isn’t it?” asked Martin.
“Put it this way: It’s not the way I’d handle it. But I’ve got to get back to work now. Excuse me.” He pushed past Philips, who had to press up against the wall to give him room to go by.
Surprised at the precipitous end to the conversation, Martin watched the resident hurry into one of the examining rooms. Philips had not intended his questions to be taken personally and he wondered if he had sounded more accusatory than he realized. Still the resident’s response when he had opened Katherine Collins’ chart had been strange. Philips had no doubt about that.
Believing there was no point in trying to talk further with Harper, Martin went back out to the receptionist and inquired after Kristin Lindquist. Ellen Cohen at first acted as if she hadn’t heard the question. When Philips repeated it, she snapped that Miss Lindquist was with the nurse and would be out shortly. Having not liked Kristin initially, the receptionist hated her even more now that Philips seemed interested in her. Unaware of Ellen Cohen’s jealousies, Martin just felt incredibly confused about the university’s GYN clinic.
A few minutes later, Kristin came out of the examining room, aided by a nurse. Martin had seen the nurse before, probably in the cafeteria, remembering her thick black hair, which she wore piled on her head in a tight bun.
He stood up as the woman approached the desk and heard the nurse instruct the receptionist to give Kristin an appointment in four days. Kristin looked very pale.
“Miss Lindquist,” Martin called. “Are you finished?”
“I think so,” said Kristin.
“How about that X ray?” asked Philips. “Do you feel up to it?”
“I think so,” managed Kristin, again.
Suddenly the black-haired nurse strode back to the desk. “If you don’t mind my asking, what kind of X rays are you talking about?”
“A lateral skull film,” said Martin.
“I see,” said the nurse. “The reason I ask is that Kristin has had an abnormal Pap test and we’d prefer she avoid abdominal or pelvic films until her Pap smear status is normal.”
“No problem,” said Philips. “In my department we’re only interested in the head.” He’d never heard of such an association between Pap smears and diagnostic X rays, but it sounded reasonable.
The nurse nodded, then left. Ellen Cohen slapped an appointment card in Kristin’s waiting hand before turning and pretending to busy herself with her typewriter. “California slut,” she muttered under her breath.
Martin guided Kristin away from the bustle of the clinic and led her through a connecting door into the hospital proper. Once the fire door had been passed, the scene looked very pleasant in contrast to the clinic. Kristin was surprised.