Meomartino looked at the house officers. “Can you imagine what would have happened if we had gone into this man’s colon with all that solid waste present? Can you imagine trying to clamp bleeders through a mess like that? Can you imagine the excess of contamination? Take my word for it, you can’t imagine it until you’ve been through it.”

“Doctor,” the patient said anxiously, “should I leave the rest of my meal?”

“You finish your chicken and enjoy it,” he said. “Tomorrow morning you’ll go on the diet you should have been on today, a liquid diet. If anyone tries to give you anything more solid than Jello tomorrow, don’t you eat it. You send for me right away, comprende?”

The man nodded.

Mysteriously, none of the nurses knew who had served Mr. Roche his breakfast and his lunch.

Twenty minutes later Meomartino sat in his office. He prepared a service complaint against the unidentified nurse who had served the two trays, and signed it with an angry scrawl.

That afternoon there was a telephone call from Longwood.

“I’m not at all happy with the number of post-mortem permissions you’ve turned in.”

“I’ve done my best to get them,” he said.

“Surgical fellows on other services have gotten twice as many permissions as you have.”

“Perhaps there were more deaths on their services.”

“On your own service this year another surgeon has gotten a lot more permissions than you.”

He didn’t have to ask Longwood to name the surgeon. “I’ll try harder,” he said.

In a little while Harry Lee came into the office.

“I just got my tail reamed, Harry. Dr. Longwood wants more postmortem permissions from me. I’m going to pass that reaming along to any house officer working on one of my cases.”

“We’ve all but gone on our knees to the family every time we’ve lost a patient,” the Chinese resident said. “You know that. When they’ve agreed to a post we’ve gotten their signatures. If they have strong personal reasons for refusing . . .” He shrugged.

“Longwood indicated Adam Silverstone has been turning in lots more permissions than I have.”

“I didn’t realize you were in a race.” Lee looked at him curiously.

“Now you realize.”

“Now I realize. You know how some services get permissions?”

Rafe waited.

“They frighten the resistance out of the survivors, hint that the entire family may share some mysterious weakness that killed the patient, and that all the surgeon wants to do is save their lives by conducting an autopsy.”

“That’s disgusting.”

“I agree. Do you want us to start doing that, too?”

Rafe looked at him and smiled. “No, just do your best. How many post permission slips did we hand in last month?”

“None,” Lee said.

“Goddammit. That’s exactly what I mean.”

“We couldn’t very well get permissions for autopsies,” Lee said mildly.

“Why the hell not?”