''Bring him right into the examining room," he said.
Bob watched him check Jean-Claude's pulse and then immediately begin palpating the boy's abdomen. He heard the physician mutter, ''Oh, shit/' and thought to himself, That's a great diagnosis. This kid must be a student or something. I've got to get a real doctor. The young man snapped an order to a hovering nurse: "Get an IV into him immediately, and put in two g.m.'s of ampicillin and sixty m.g.'s of gentamicin. Prepare a nasogastric tube and have somebody get John Shelton fast."
She rushed off. The intern took the thermometer from Jean-Claude's mouth, squinted at it and again muttered to himself.
"What's wrong?" Bob asked impatiently.
"Can you step outside, sir?"
"Fll be right back," he told Jean-Claude, touching his icy cheeks. "Don't be afraid of anything." The boy nodded slightly. He looked terrified.
"Okay. What?" Bob demanded the instant they had left the room.
"Peritonitis," said the intern. "There's purulent fluid all over his peritoneal cavity."
"What the hell does that mean, dammit?"
"A burst appendix. His fever's 105 degrees. We've got to operate as soon as possible. We're sending for our best general surgeon. We think he's out on his boat—"
"Isn't there anybody here?" Bob asked, praying that there was someone already on the grounds more competent than this nervous kid.
"Dr. Keith is already in the OR with a patient. Really bad car accident. Besides, he's an orthopedic surgeon. Our best bet is to wait for Dr. Shelton."
"What do we do in tlie meanwhile?"
"He's very dehydrated, so Fm giving him intravenous fluid. And a large dose of antibiotics."
"And that's it?" Bob asked. "Can't we do anything else while we're waiting for this big shot?"
"We could be calm," said the intern pointedly. "Perhaps you might want to register him while you're waiting. . . ."
"Yeah," he said. "Okay. Thanks. Sorry." He turned away.
"Patient's nam.e?" He told the registering clerk, spelling it for her slowly.
"Address?" He gave the Wellfleet house.
"Occupation?"
"Child," said Bob sarcastically, and then gave the boy's age.
"Religion?" He didn't know. The clerk looked displeased. "None," Bob said. She looked even more displeased. "Uh—I suppose Catholic." That answer, it seemed, was satisfactory.
Less so was the fact that there was no Blue Cross, Blue Shield or other medical plan. Bob's offer to pay was looked at askance.
"Mr. Beckwith," a voice called from down the corridor. "Good news!"
It was the intern, who ran up, breathless and sweating.
"What?" Bob asked.
"Dr. Shelton was home on account of the weather. He's just come in now."
"Great," Bob replied. And they both charged down the hall.
He had streaks of gray in his hair and looked, thank heavens, calm and experienced. His manner was in fact a bit too unemotional.
"Have we the permission to operate?" Shelton asked the intern.
"I haven't gotten around to it, sir."
Shelton turned to Bob.
''Where are the boy's parents?" he asked.
"Tliey're . .. dead/' Bob answered.
"Well, someone has to sign in loco parentis. Are you his guardian?"
''No. It's a man named Venargues in France."
"Well, then he'll have to give us permission by telephone. That's legal if there's a second person hstening."
No, thought Bob, there isn't time. I haven't even got Louis's number with me. It's somewhere in my desk.
"Uh-can't I sign?" Bob asked.
"You have no legal authority," said Shelton. "Why don't we get this Frenchman on the phone. The child is very sick."
"Then operate," Bob ordered. "Operate now*'
"I can understand your concern, Mr. Beckwith. But surgeons, like everyone else, must live by the rules."
"Don't worry about a malpractice suit, dammit," Bob said angrily. "I'll indemnify you."
The surgeon remained phlegmatic and persistent. "Mr. Beckwith, my French is fluent. I can explain the entire situation to this Monsieur Venargues."
Bob was desperate.
"Doctor, may I tell you something in confidence?"
"We've both taken the Hippocratic oath," said Shelton, nodding in the direction of the intern.
"May I speak to you alone?" said Bob, steeling himself.
"Uh—I'll check on Dr. Keith's progress," said the fidgety young man. "We'll be using OR two." And he dashed off. Bob and Shelton were alone.
"Yes?'' said the surgeon.
"I can sign in loco parentis'' Bob feared this uptight martinet might think it was a dodge.