Thomas now knew what George had meant by his comment in the surgical lounge the previous afternoon. He closed his eyes and tried to control his rising anger. Obviously Jeoffry Washington was an example of the kind of case that was taking OR slots and cardiac surgical beds away from Thomas’s patients. Thomas was not alone in his reservations concerning operating on Jeoffry. One of the internists raised his hand and George recognized him. “I would seriously question the rationale for elective heart surgery in light of the patient’s having AIDS,” said the internist.
“That’s a good point,” said George. “I can say that Mr. Washington’s immunological picture is not grossly abnormal at present. He’s scheduled for surgery next week, but we will be following his helper T-cell and cytotoxic T-cell populations for any sudden decline. Dr. Sorenson of the department of immunology does not think the AIDS is an absolute contraindication for surgery at this time.”
A number of hands popped up in the audience, and George began to call on them. The animated discussion took the conference over its normal time, and even after it was officially over, groups of people stood in clumps to continue talking.
Thomas tried to leave immediately, but Ballantine had gotten up and blocked his way. “Good conference,” he beamed.
Thomas nodded. All he wanted to do was get away. His head felt as if it were in a vise.
George Sherman came up behind Thomas and clapped him on the back. “You and I really entertained them this morning. We should have charged admission.”
Thomas slowly turned to face George’s smiling, self-satisfied face. “To tell you the honest truth, I think the conference was a goddamn farce.”
There was an uncomfortable silence as the two men eyed one another in the midst of the crowd.
“Okay,” said George at length. “I suppose you are entitled to your opinion.”
“Tell me. Is this poor fellow, Jeoffry Washington, whom you paraded out here like some freak, occupying a cardiac surgical bed?”
“Of course,” said George, his own ire rising. “Where do you think he’d be, in the cafeteria?”
“All right, you two,” said Ballantine.
“I’ll tell you where he should be,” snapped Thomas while he jabbed George in the chest with his index finger. “He should be on the medical floor in case something can be done about his immunological problem. Having already had pneumocystic carini pneumonia there’s a good chance he’ll be dead before he ever gets into a life-threatening cardiac state.”
George knocked Thomas’s hand aside. “As I said, you’re entitled to your opinion. I happen to think Mr. Jeoffry Washington is a good teaching case.”
“Good teaching case,” scoffed Thomas. “The man is medically ill. He should not be taking up a scarce cardiac surgical bed. The bed is needed for others. Can’t you understand that? It’s for this kind of nonsense that I have to keep my patients waiting, patients with no medical problems, patients who will be making real contributions to society.”
George again knocked Thomas’s hand away. “Don’t touch me like that,” he snapped.
“Gentlemen,” said Ballantine, stepping between them.
“I’m not sure Thomas knows what the word means,” said George.
“Listen, you little shithead,” snarled Thomas, reaching around Ballantine and grabbing a handful of George’s shirt. “You’re making a mockery of our program with the cases you’re dredging up just to keep the so-called teaching schedule full.”
“You’d better let go of my shirt,” warned George, his face suffused with color.
“Enough,” shouted Ballantine, pulling Thomas’s hand away.
“Our job is to save lives,” said George through gritted teeth, “not make judgments about who is more worthy. That’s up to God to decide.”
“That’s just it,” said Thomas. “You’re so stupid you don’t even realize that you are making judgments about who should live. The trouble is your judgment stinks. Every time you deny me OR space another potentially healthy patient is condemned to death.”
Thomas spun on his heels and strode from the room. George took a deep breath, then adjusted his disheveled shirt.
“God! Kingsley is such a prig.”
“He is arrogant,” agreed Ballantine. “But he is such a damn good surgeon. Are you all right?”