Comes a Time for Burning (21 page)

For a few heartbeats, Patterson didn’t speak, his eyes taking in the scene on the bed. “Elaine, this instant,” he said, one slender finger pointing out of the room. His voice was little more than a hiss, his face white. For a fleeting moment, he reminded Thomas of one of the professors at the university whose volatile temper was legendary. The elderly physician had once hurled a scalpel across the operating theater, where it stuck into the molding around the doorway. There it had remained for weeks as a grim reminder not to try Dr. Bolhman’s patience. Despite the tone that defied any contradiction, Patterson’s step-daughter didn’t move. Instead, she looked across at Thomas, who hadn’t changed his grip on the bulb or the rubber tube.

“Sir,” Thomas said quietly, “your wife is fighting the cholera. If we don’t do something to replace…” and that was as far as he got. Patterson crossed the room in two strides, and with one hand reached out and grabbed the child, practically snapping her small, lithe form off the bed and onto the floor. With the other hand, Patterson reached out and grabbed the rubber tube. His action was so unexpected that Thomas was caught completely off guard. Apparently not knowing where the other end of the tube actually
was
, Patterson jerked it hard from Thomas’ hand. The clamp ripped open from the bulb and the tube was yanked from its position, solution splattering.

“Get
out
of my house,” Patterson snarled, and he bent over and jerked the linens across his wife’s exposed body. “What kind of man are you?”

Flabbergasted, Thomas reached for the dislodged tube and bulb. “Good God, man, listen to me. If we don’t replace fluids…”

“Good God, indeed,” Patterson shouted, his face livid. As he spoke, Elaine pushed herself to her feet, coming into her father’s view. “And my
daughter
, for the love of God.” His anger soared to a point where he enunciated only spittle and his eyes bulged, and he turned his fury on his step-daughter. “Elaine, you will leave this room. This is no place for you.” He swept an arm wide, jabbing his finger toward the door.

“Sir, do you have any idea, any idea at all, what this is?” Thomas reached out and retrieved the tube, standing as he did so.

“You will leave my house.” Patterson spat each word, fists clenched. Thomas could see the pulse throbbing at the man’s temples. Would he actually lash out? Surely, no one could be so unreasonable, Thomas thought—especially with a loved one so frightfully ill. But the young physician was in no mood to negotiate.

“I don’t think so, Pastor.” He took a deep breath and shifted his weight, hands ready to defend himself. But he made no move from the end of the bed. “To do so will certainly jeopardize your wife’s life. She needs constant treatment, sir. She must be taken to the clinic where the nurses may deal with her distress day and night.” He held up the tube. “She cannot retain food or fluids, sir. She vomits them immediately. The unrelenting diarrhea drains her body. If that fluid is not replaced, then she dies.” He shook the tube again. “If not replaced via the mouth, then via the rectum. It is as simple as that.”

Patterson didn’t reply but stood rooted in place, eyes huge and glaring, lips pressed to a white line. What was the source of this odd man’s anger, Thomas wondered. Did Patterson really believe that
his
biding was the
only
biding? Apparently so. Thomas dropped the soiled black tube and bulb into the carbolic acid bath.

“What is she doing here?” Patterson managed, and Thomas looked down at Elaine. The last thing he wished to see was the transfer of the distraught man’s anger to the young girl…the only person so far to have showed the least modicum of nerve in the Patterson household.

“I need help, Pastor. That’s what your step-daughter is
doing
. If anything saves her mother’s life, it will be her brave, steadfast labors on her behalf…at considerable risk to her own safety, I might add. Many people cannot face…”

At that moment Mrs. Patterson let out a piteous cry, spasmed double, and ejected the latest assault on her gut. The geyser was so violent that it spattered the pastor’s perfectly creased trousers and highly polished shoes. Elaine darted into action with towels, at the same time catching her sister’s eye.

“Hot water now, Eli,” she ordered, and in any other circumstances the commanding tone in her little voice would have been comical. Eleanor left to do as she was told, commanded by a fourteen year-old girl.

Thomas drew the bulb and tube from the sterilization bath. “You’ll allow me to work?”

“What are you doing with that?” As the fires of temper died, Patterson appeared to wilt, losing an inch of stature. His tone managed to continue imperious, however.

“Essentially, what we are doing is providing hydration to your wife’s gut in the only way open to us, pastor. She cannot swallow, so she cannot drink. We provide liquid to her system. It is no cure, sir. But it is the only avenue open to us. Once we do that, it is up to God to do with it as he wills.”

“I never entertained the impression that you spoke with God,” Patterson said, his tone oddly neutral, neither sarcastic nor jocular.

“In my own fashion,” Thomas said, taking advantage of the lessening of tension. “Just as last fall, your wife tended to
you
following surgery when you could not fend for yourself, so the same is expected of you now.” Thomas saw the flare of temper rise again at the suggestion that Patterson might have been helpless.

“At least have the decency to cover her, young man.”

Thomas hesitated while he fought his own temper. “I cannot work with the task concealed in the dark,” he replied sharply. “If the sight of a human buttocks so offends you, then leave the work to Elaine and me. I’m sure, should your wife survive, that she will forgive the indiscretions. And she might even forgive those who allowed her to lie untended for so long. First the tuberculosis, and now this.”

The pastor’s face went from purple to ashen, but Thomas was in no mood to trade further barbs. The tussle of tempers was gaining them nothing, and only wasting time. He turned away from Patterson and prepared the bulb and tube. As he worked, he was conscious of the pastor standing immediately behind him. He could hear the man’s breath. And as he worked, he was aware that Elaine’s concentration on the task at hand was absolute, as if her step-father were absent from the room.

With the bulb emptying, Thomas let his breath ease out in relief.

“You are in a position to be of invaluable help,” he said, but earned no response from the pastor. “You can organize those in town who are most in danger. With the ability to culture the bacillus, we are able to…” The response was hearing Patterson’s boots on the floor as the man turned toward the door.

“Pastor Patterson?” When the man did not reply, he twisted around and looked at him. Patterson’s face was glacial.

“Your wife must be taken to the clinic. I have neither the supplies nor facilities to care for her here. We must have laboratory cultures from all who live in this house, even those who as yet show no signs of illness. And just as important, the contagion must be cleared from this dwelling.” He heard no reply. “It is not just your wife at risk, sir. It’s you and your children. It is every member of your congregation with whom
you
come in contact.” He glanced at the man’s stained trousers and shoes. “Even yourself, sir.”

Thomas turned back to his patient, continuing his gentle pressure on the bulb. He could feel that Pastor Patterson’s dark eyes were smoldering twin holes through the back of his skull, but the man offered not a word.

In a moment, his boot-steps receded and Thomas let out a long sigh of relief. Elaine’s attention had never wavered. If she had noticed that her step-father was beyond lifting a finger to help his wife, whether from incapability or fear, she gave no hint.

Chapter Twenty-six

Thomas felt a surge of triumph so strong that he let out a yelp. He held in his hand a population of the very demons that besieged Port McKinney, and he knew their origin. He had scraped a tiny sample of the culture to a slide and examined it under the Hiennenberg with extraordinary care. And there they were, the minute, lethal curls of bacilli. Both pages from the Mother Superior’s brief letter and the souvenir of linen habit had produced active cultures, the ‘wee beasties’ having traveled from India half way around the world in the little, protective pouch, protected from sun, perhaps dampened now and then from squall, mist, or ocean spray…just enough to keep them alive and hopeful.

He wondered if any sisters of the convent in India still lived, or if even as she penned the brief words, the Mother Superior had been feeling the first roiling in her own gut. He could imagine Ben Sitzberger weeks later, stricken with grief, reading the final, sad and stained letter over and over again, clasping the scrap of his sister’s clothing, perhaps bringing it to his nose for a final trace of her scent…the only worldly possession the nun might leave behind—that and the bacilli, who had responded with an astonishing reproductive virulence.

Thomas slid the glass culture dish back into the incubator and closed it securely. His cry of triumphant discovery was short lived, replaced with a morose sense of helplessness. He knew what the bacilli were, and now he had a good guess about where they had originated. That would make, come some peaceful day, a fine report for one of the scientific journals. Learned physicians the world over would read the Parks-Hardy article and shake their heads in wonder. But that pipe-dream was a distant one. First, one had to survive the onslaught, and there was no triumph yet to be had in this battle.

The cultures taken and prepared earlier in the day showed a sobering reality under the microscope. The warm, moist climate of the incubator would produce rapid, aggressive growth in those culture dishes, Thomas knew, but there was no point in waiting until that growth flourished. A quick survey showed infection in two other loggers, in addition to those evacuated. The cholera was also deeply entrenched in the Clarissa. Two of the sailors, including the first mate of the
Willis Head
, hosted the infection.

Not a single school child—including the two Snyder children—produced a positive culture.

The two loggers, testing positive but neither showing outward symptoms of the illness, had protested quarantine, Buddy Huckla more so because it had been Dr. Lucius Hardy who had cleaned his hand, then rebandaged and resplinted it, and done so with somewhat less patience and sympathy than Huckla might have liked. Both he and Todd Delaney grudgingly downed their Salol brew, but the clinic could offer little else. It was a matter of waiting.

In the second floor ward, two of the three young women, Mary Gates and Bessie Mae Winston, suffered in the earliest stages of cholera, and of the two, Mary’s less robust constitution collapsed at an astounding rate. They had roomed together on the third floor, directly across the hall from Letitia Moore. The robust Letitia had become the most pathetic advertisement for what cholera could do in short order to an otherwise healthy person. She deflated with astounding rapidity, the ferocious intensity of her headache reducing her ebullient nature to quiet gasps and whimpers. At the same time, she wept without end, her tears driven by the terrible depression and feeling of dread, despite now being too ill to afford giving up a single extra drop of moisture.

Mildred Patterson, the pastor’s failing wife, rested quietly in the rearmost bed of the ward, lying on her right side, eyes turned away from the world and the rest of the ward. Elaine had drawn a chair close to her bed and tended her mother with unflagging intensity.

Thomas had taken a few moments to visit with Sonny Malone, a one-way conversation that he carried out as he listened to the man’s heart and lungs, peered into his unresponsive eyes, and with the fine needle tested the various reflexes. Although showing little improvement, still Malone held his own, and that was something of a victory.

Leaving Malone, this time with a warm wrap around the bald, polished skull, Thomas returned to the dispensary and washed his hands again, grimacing at the red, tender skin. Enjoying the soothing lanolin, he walked to the clinic’s front door and stood on the step, breathing the sweet air deeply. Evening was approaching, the sun just ready to hide behind the hills that bordered the inlet. The afternoon had settled into a litany of desperate treatment, but had been interrupted by no new patients. Thomas knew it was too early to believe that they had made real progress toward stopping the epidemic.

In the timber, hundreds of loggers who had not yet consented to give culture, might be breeding the bacilli, might be spreading it far and wide.

To the north, several blocks down the hill toward the church and then the inlet, Thomas saw a plume of smoke. He had left instructions with Eleanor Patterson that included burning the bedding and the mattress, and he felt a surge of hope that the girl had managed the task.

But three important individual cultures remained uncollected, and that infuriated Thomas. Roland Patterson would be the last person on earth to consent to having a culture swabbed from his royal behind. The physician understood that, and short of wrestling the arrogant preacher to the floor and taking the culture by force, there was no practical way to force the issue. Patterson would take his chances.

But the two children, hopefully innocent of their father’s boneheaded stubbornness, had yet to be examined, let alone tested. While at the Patterson’s earlier, Thomas had requested the examination, and had been refused. Argument had been to no avail—ignored, in fact. Thomas had considered medicine at gunpoint.

Perhaps, in her own quiet, ineffectual way, Eleanor would prevail.

He found himself wishing he understood the inoculation procedures so effectively employed against diseases like smallpox. Would they work against cholera? Lowenthal reportedly had seen immunization results with attenuated cultures injected into certain animals, but the text was vague about methodology.

Still pondering that notion, Thomas turned away from the evening and trudged up the long flight of stairs to the clinic’s second floor. He found fourteen-year-old Elaine Patterson in intense, quiet conversation with Nurses Helen Whitman and Bertha Auerbach—and his wife Alvi—all gathered around Elaine’s mother. Mrs. Patterson, tiny, shrunken, febrile, was still able to move her lips for silent conversations with her daughter.

Alvi looked up and saw Thomas, no doubt correctly reading the flabbergasted expression on his face that quickly turned to angry impatience. She stepped away from the confab and walked the length of the ward to where her husband stood by the stairway.

“Do you have
any
idea what you’re doing?” Thomas whispered. “My God, Alvi…”

Reaching up, she curled her hand around the nape of his neck, her affectionate grasp ensuring that he paid attention to her. He flinched at her icy cold fingers, and smelled the antiseptic.

“I’m the delivery lady,” she explained. “I was mad for some exercise, and mad to be of some use. I brought a bottle of champagne from the house, and another small parcel of ice from Mr. Lindeman.”

“There are a hundred people who could do that,” Thomas snapped, and he saw the stubborn veil that settled over her expression.

“A
hundred
. My.” She turned and regarded the two nurses and the young girl. “Elaine tends her mother like a veteran, Doctor Thomas. And Berti has been
most
strict in not only explaining procedures to promote asepsis, but making sure that she follows those procedures to the letter. Elaine understands fully.”

“I’m not concerned with that. I am concerned with
you
, Alvi. You visit this place of contagion, and now risk its spread with you. You put yourself at risk, and you put the infant at risk…not to mention anyone else with whom you come in contact.”

“As do you, Doctor Thomas—if that is indeed the character of cholera. And your text is not the least bit supportive of that notion.”

“There is
always
a risk, the text be damned.” Thomas immediately wished he had curbed his tongue. The harsh words with Patterson rang too clearly in his memory, and he had no wish to add nonsense of his own. “I…” he started to say, but Alvi shushed him with an amused chuckle.

“Now
that’s
an interesting scientific position,” she said. “But precautions have been taken,” Alvi said. “Berti has given the girl the whites. She looks wonderful, does she not?”

He turned and saw that indeed Elaine looked crisp, clean, and professional in her starched whites, complete with a small nurse’s cap pinned to her raven hair.

“She will remain here,” Alvi continued. “Until her mother passes the crisis. She has no wish to go back to the house while her mother is here, but worries about the others.”

“I have given instructions. Eleanor knows that at the least hint of symptoms, the family is to come here. I need a culture from Patterson himself, but there is little hope of reasoning with him. In the meantime, they are disinfecting the home. I saw smoke from the fires just now.”

“And while all are at risk here, and there, and yonder, you think that I should become a clam with my shell snapped shut at One-oh-one, hiding my face?”

“Don’t be ridiculous. But you take needless risks, Alvina. You shouldn’t be here. For one thing, the walk itself may be too strenuous, merely a day after.”

“Well,” and she shrugged, giving Thomas’ neck another squeeze. “The walk was intoxicating, and here I am. I was musing through my father’s books in the library, and remember him talking about the use of champagne—how when iced it is an effective salve for the dry mouth.”

“Surely,” Thomas said. “I think we have used so much of it that we might be taken for drunkards. We thank you. Now…will you go home?”

“I think that I will do what I can here for a little while,” Alvi said.

Thomas took a long, slow breath. “Alvi—this is one time when your stubbornness is most exasperating. And dangerous, I might add. Needlessly so. There is nothing for you to do here that Nurse Auerbach or Nurse Whitman or Nurse Crowell can’t do. It is enough that Elaine is put at risk.”

“And yourself,” she said. “And Dr. Hardy, who is down at the Clarissa, by the way. I saw him go down the hill.”

“I know he’s there. We were loath for him to leave the building—heaven knows there is enough to do for all of us, but we had a few quiet moments, and he took the time.” He bent until his forehead touched hers. “For us, there is no choice, Alvi. For you, there is all the choice in the world. That’s my point. The baby…”

She looked askance at him. “You’re really angry, aren’t you.”

“Yes, a little. But more worried than angry.”

“May I work in your office for a while? Perhaps only an hour? John Thomas is fed to fatness, and sleeps like a satiated puppy. Gert was glad for the opportunity to rock the little angel. One hour. Would that satisfy you?”

“Doing what?”

“Well, the accounts lag behind. I’m certain of that.”

“Accounts?”

Alvi’s laugh was one of pure delight. She pulled his head down toward her own and kissed him so passionately that he could hardly fail to respond. Drawing back, she shook her head in mock exasperation. “Who do you suppose pays for all of this?” she said. “The procedures, the drugs, the care…Miss Auerbach’s salary, Miss Whitman’s and Mrs. Crowell’s, eventually perhaps even your own?”

“That is not an issue just now,” Thomas replied.

“Indeed not?” She patted his arm, rolling the fabric of his waist-coat between thumb and finger as if testing the quality of the weave. “In the coming weeks, it would be nice not to have to try and remember every procedure, every dose of drugs, every step along the way for a patient’s billing. I’ll set about making sense of all that. It’s what
I
do well, isn’t it?”

“My office, only,” Thomas said. “And only an hour.”

“Until I can no longer stand the smell,” Alvi said. “Then you can walk me home. Berti tells me that it’s been…how did she describe it…‘desperately quiet’ this afternoon. Like a war with little cannon fire.”

“The situation can change in a heartbeat, Alvi. But so far, we hold on. And Mrs. Patterson continues to fight. I believe it is seeing the child at her side that helps as much as anything.”

“But you don’t tell that little angel to go home, now, do you.”

Thomas sighed. “She will, when she can do no more to help.”

“As will I. With you on my arm.” She patted his cheek and turned to the stairs.