Final Diagnosis by Arthur Hailey

Final Diagnosis by Arthur Hailey

I have roughly an year and half for retirement from service. At this point of time I want a lot of respect from all in the office, home and outside. But, I realise that it is not a want, but greed. I know there are higher officers who are younger than me and highly qualified than me. Also there are staff working under me who are also very talented than me at least in some aspects of work and life. So there is always a thought going through my mind – whether I am fit enough to expect respect from all in the world? But such sort of disillusionment is common in one’s life. I recall reading the novel “The Final Diagnosis” written by Sir Arthur Haily. It actually deals with the disillusionment of Dr. Joseph Pearson, the Cheif Pathologist of the Three Counties Hospital at Burlington, Pennsylvania.

          “ Final Diagnosis “ by Arthur Hailey is a book, written in 1959, which has in its centre a plot which describes the changes in the protagonist’s life and struggle to change with change. Three Counties Hospital at Burlington, Pennsylvania is a hospital, which has its best days behind it and facing a struggle for its existence. The hospital’s problems are self inflicted, mostly caused by its desire to move with the times but being unable to do so. The inability  is due to its own doctors who work in the hospital have their own agenda. The hospital is divided within itself into two groups, one is the reformers who want to modernize the institution and the other is the status quoists who are resistant towards changes. The reformers have their convincing reasons and so do the status quoists. Bickering, personal animosities and egoism among doctors take a heavy toll of the efficiency of the hospital.

          As the feud between the staff rages, the reputation of the hospital takes a severe beating. At the epicenter of the feud stands the tragic and flawed hero of the book, Dr Joseph Pearson. He is a man who is obstinate and even his enemies acknowledge him as a brilliant pathologist. His problem is his disdain towards change. The hospital suffers as the better doctors deserting it for greener pastures. The institution is left with the tired, the disgruntled and the plain incompetents. The hospital lurches from crisis to crisis but there appears no light at the end of the tunnel. The reformers are facing a losing battle pitted against the status quoists led by the formidable Dr Pearson and backed by Eustace Swank, the millionaire patron of the hospital.

          The mood in the hospital deepens into low spirits. A train of tragic events occurs at the hospital with several medical negligence cases, which occur with alarming frequency. The cases have a common feature about them – they all arise out of the faulty diagnosis reports from the pathology lab. Despite all the criticism, Dr Pearson refuses to see light and turns down well-meaning offers of help in running the lab.

Let’s see what the story is all about.

          When I started reading the novel there was a comment on the back cover by some newspaper, that The Final Diagnosis is a novel which is the story of a young pathologist who tries to change the standards of a hospital where everything is old and outdated.

          But when I was through I found out completely false. I was never able to find out the young pathologist struggling for changes and sure I was frustrated, not at Hailey but at the person who wrote such absurd comment.

          Now the story tells about the hospital politics and goes in the past of certain other important characters of the hospital. Story also goes in the lives of nurses and interns and residents at the hospital. Story goes deep into lives of some interns and nurses and talks about the romance of a resident and a nurse and finally how unfortunate the nurse had been to have a cancer in the knee at the age of 19 only and have her leg removed by amputation.

          Now story comes back to the Pathology department and the importance of pathology in the diagnosis and treatment of patients. I want to say again I am very impressed by the choice of Arthur Hailey, he chose Pathology which is not a much known field, normal patients seldom know how important pathology is. He could have chosen neurology or cardiology or any other department of a hospital but he chose pathology.

          Then comes a new character in the story ? John Alexander. He is a lab assistant and his wife is pregnant and being observerved by Three Counties hospital. He goes to the hospital obstetrician. He suggests a test because mother is Rh positive in blood group and father is Rh negative. It is about characteristics of blood ? It is explained very nicely in the novel.

          However, the standard procedure of this test requires three stages. Two of them are done in Three Counties but the third one which happens to be the most important of pregnant ladies is absent. When John asks Dr. Pearson about this, Dr Pearson is not happy and refuses to grant money to purchase rabbit serum to do the necessary test.

          Now comes another new character and the young pathologist I was waiting for ? Dr. Coleman. He is a young and brilliant pathologist who is just 31 years of age and has a record that can make any one envy. Coleman is a person who is intellectually superior than most of his colleagues. It just happens that John is from the same town as Dr. Coleman.

          Dr. Coleman is assistant head of Pathology department or assistant of Dr. Pearson. But Joe is a man who not likes assistants working under him because he doesn’t wants to decentralize his authority. Dr. Coleman orders the much required rabbit serum for the tests and Pearson is not very happy about it. He cancels the order. Now starts the tug of war between young and enthusiastic Coleman and old and experienced Pearson.

          But in the mean time the tests about that Rh thing are done and without rabbit serum. Now the Mrs. John Alexander gives birth to a child that is 8 week premature. The baby was so small. The child eventually dies and it is so discovered that if that rabbit serum or as the medical term was the cocoon serum test would have been done the child could have been saved by blood transfusion at the time of birth. Now it was impossible.

          There comes up another problem in the mean time. The catering department of the hospital says that there are problems in dish washer of the café. Then some one tells that there are typhoid cases in the hospital. Management is horrified at the idea of having an epidemic in the hospital. They order stool culture tests of all the employees of the hospital. The tests would have been done by pathology department long ago but they never did the routine checkup for six months and now there is a danger of epidemic. Dr. Pearson agrees for the tests of all 95 employees. They find the typhoid carrier in the Catering Department, who is taken into observation quickly.

Finally Dr. Pearson gives his resignation and Dr. Coleman becomes the in charge of the Pathology department. The dialogue between young Coleman and old and experienced Pearson in the end when Dr. Pearson is clearing the desk is simply great. You can simply envision the dialogue.

It tells us that how much is the importance of experience but with experience you start to grow old. Any person who starts as young and supporter of change eventually grows into a person who is cold and disapproving of change. Dr. Pearson then talks about the reasons why such things happen and advices Dr. Coleman to avoid such things.

That is the essence of the story. Change in a place where there are reluctant people who don’t want the change even when it is extremely necessary and for the benefit of the sick and the weak. It is a great story, good enough to be read at any time. Good enough to be read at any day of the week. I suggest to present young doctors, students of medicine and other doctors as well to read this novel, this can be a guiding factor is you can read between the lines.

For others I suggest read if freely, it is not meant for only people concerned with medicine. But people other than medicine, do not forget to use dictionary in the starting of novel, after some time you will get used to the terms. And understanding the meanings is very important because you will be able to understand the story better.