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Counties； that the decision was firm； irrevocable； the direction set。 At La Guardia； on landing； he had sent a wire to Orden Brown。 It read simply； 〃I accept。〃
Now； looking down at the plans of what the administrator had called flippantly 〃the New Jerusalem；〃 O'Donnell thought back to the three and a half years which lay behind。 Orden Brown had been right when he had said they would not be easy。 All the obstacles which the board chairman had predicted had proven to be there。 Gradually； though； the most formidable had been overe。
After O'Donnell's arrival the former chief of surgery had slipped quietly out。 O'Donnell had rallied some of the surgeons already on staff who were sympathetic to raising the hospital's standards。 Between them they had tightened surgical rules and had formed a strong operating…room mittee to enforce them。 A tissue mittee； almost defunct； was reactivated…its job； to ensure that mistakes in surgery； particularly the unnecessary removal of healthy organs； were not repeated。
The less petent surgeons were gently but firmly urged to limit themselves to work within their capabilities。 A few of the botchers； the assembly…line appendix removers； the inpetents； were given the choice of resigning quietly or being ousted officially。 Though to some it meant partial loss of their livelihood； most chose to leave quietly。 Among the latter was one surgeon who had actually removed a kidney without ascertaining that the patient had already lost one in previous surgery。 The dreadful mistake had been revealed at autopsy。
Removal of that surgeon from the hospital's roster had been easy。 Some of the others； though； had proved more difficult。 There had been rows before the County Medical mittee； and two surgeons； formerly on Three Counties' staff； now had law suits pending against the hospital。 This； O'Donnell knew； was going to mean some bitter controversy in court； and he dreaded the publicity which was certain to surround it。
But despite these problems O'Donnell and those behind him had had their way and the gaps in staff were painstakingly filled with new； well…qualified men； some of them graduates from his own alma mater whom O'Donnell had cajoled and persuaded to set up practice in Burlington。
Meanwhile the Division of Medicine had a new head…Dr。 Chandler； who had been on staff under the old regime but had been frequently outspoken against it。 Chandler was a specialist in internal medicine； and while he and O'Donnell sometimes disagreed on hospital policy； and O'Donnell found the other man at times pompous； at least Chandler was unpromising when it came to upholding medical standards。
In O'Donnell's three and a half years administration methods had been changed as well。 A few months after his own arrival O'Donnell had told Orden Brown about a young assistant administrator； one of the best he had known in his hospital experience。 The chairman had flown off and； two days later； e back with a signed contract。 A month after that the old administrator； relieved to get out from under a job which had grown beyond him； had been honorably pensioned and Harry Tomaselli installed in his place。 Now the whole administrative side of the hospital reflected Tomaselli's brisk but smooth efficiency。
A year ago O'Donnell had been elected president of the hospital's medical board； which made him the senior practitioner at Three Counties。 Since then he； Tomaselli； and Dr。 Chandler had successfully broadened the hospital's intern and resident training program； and already applications for enrollment were growing in number。
There was still a long way to go。 O'Donnell knew that in some ways they were only at the beginning of a long program which would embrace the three basic tenets of medicine： service； training； research。 He himself was forty…two now； would be forty…three in a few months。 He doubted if； in the active years remaining to him； he would plete in full what he had set out to do。 But the start was good； that much was reassuring； and he knew that his decision on the airplane three and a half years earlier had been right。
There were soft spots； of course； in the present setup。 There had to be。 Nothing this big was achieved easily or quickly。 Some of the seniors on medical staff still fought off changes； and their influence was strong among the older members of the board； some of whom still remained…Eustace Swayne； as obstinate as ever； at their head。 Perhaps this was a good thing； O'Donnell reflected； and perhaps there was justice sometimes in the assertion that 〃young men make too many changes too quickly。〃 But because of this group and its influence there were occasions when planning had to be tempered with prudence。 O'Donnell accepted this fact himself but sometimes had difficulty in getting it across to the newer staff members。
It was just this situation which had made him thoughtful after talking with Bill Rufus。 The pathology department at Three Counties was still a stronghold of the old regime。 Dr。 Joseph Pearson； who ran it like a personal possession； had been thirty…two years at the hospital。 He knew most of the old board members intimately and was a frequent chess panion of Eustace Swayne。 More to the point； Joe Pearson was no inpetent； his record was good。 In his earlier days he had been recognized as an active researcher； and he was a past president of the State Pathology Association。 The real problem was that the work in Pathology had bee too much for one man to keep the reins in his own hands。 O'Donnell suspected； too； that some of the pathology department's lab procedures were in need of overhauling。 But desirable as changes might be； this one was going to be tough。
There was the drive for funds for the hospital extension to be considered。 If there were trouble between O'Donnell and Joe Pearson； how would Pearson's influence with Eustace Swayne affect Orden Brown's plans for raising all the money by fall next year？ Swayne's own donation would normally be a big one； and loss of that alone could be serious。 But equally serious was Swayne's influence with other people in the town； in some ways the old tycoon possessed the power to make or mar their immediate plans。
With so many things pending O'Donnell had hoped the problem of Pathology could be left for a while。 Nevertheless he had to take some action； and soon； about Bill Rufus' plaint。
He turned away from the plans。 〃Harry；〃 he said to the administrator； 〃I think we may have to go to war with Joe Pearson。〃
Three
In contrast with the heat and activity of the floors above； in the white…tiled corridor of the hospital's basement it was quiet and cool。 Nor was the quietness disturbed by a small procession…Nurse Penfield； and alongside her a stretcher gliding silently on ball…bearing casters and propelled by a male orderly wearing rubber…soled shoes below his hospital whites。
How many times had she made this journey； Nurse Penfield speculated； glancing down at the shrouded figure on the stretcher。 Probably fifty times in the past eleven years。 Perhaps more； because it was not something you kept score of…this final journey between the ward and the hospital's morgue； between the territory of the living and the dead。
A tr