Race for the Dying (29 page)

Chapter Fifty

When they reached 101 Lincoln, Alvi raced on ahead, carrying Thomas' bulky medical bag. She plunged up the stairs to the second floor where her father kept his bedroom and a private study, and Thomas had managed only three stairsteps before she reappeared and descended to meet him, a sudden, desperate hug telling all.

Alvi released him. “I don't think there's anything you can do,” she whispered, and blinked back tears. Her eyes searched his as if she expected him to say, “I know just the cure.” The twelve stairsteps were narrow, but he crutched up quickly, back against the wall. Alvi followed, a hand offering balance.

Dr. John Haines sat in a rocker by the window. The late afternoon light flowed in over his shoulder, illuminating the book in his lap. Nothing was out of place, no brandy tumbler knocked over to stain the carpet, no spectacles dropped in his lap—simply an old man deep in a comfortable nap.

For Thomas, the absence of struggle erased any vestige of hope. The older man's head had sunk to his chest, but his hands remained on the book, two fingers of his right hand still curled around the corner of a page, as if poised to turn it just as the flood of bursting blood vessels somewhere deep in his brain eclipsed his thoughts.

Thomas leaned his crutches against the wall and bent over as far as he could, one hand grasping the back of the chair while he manipulated the stethoscope. A pulse so faint as to barely disturb the great arteries in the old man's neck could be felt with a gentle fingertip. Haines' eyes were half-lidded, jaw slack, skin unresponsive and ashen gray. Lifting first one eyelid and then the other, Thomas saw that the pupils were dramatically unequal and unresponsive.

“Let's get him onto the bed,” Thomas said. Gert James stood by the end of the bed, hands clasped at her bosom, face set in anguish. Alvi had stepped over to her, and stood with both hands on the older woman's shoulders. “Alvi,” Thomas prompted, “can we do that?”

“I'll fetch Horace,” she said, and enfolded Gert in another hug before leaving the room.

“I came up to fetch him for dinner when he didn't answer my call,” Gert whispered. “I knocked, but…” She shook her head in misery. “He never closes the door unless he's ill.”

“He might have known,” Thomas said, more to himself than to the others. The heavy
Universal Medical Advisor
was open to the page featuring the engraving of the massive clinic, left thumb marking the spot. He took the book gently and placed it on the dresser. Haines' fingers never moved.

“Had you spoken to him this afternoon?”

Gert shook her head. I heard him come in sometime—I don't remember just when. He said he wasn't feeling well. She pulled in a sniff and touched the end of her nose with her hankie. “He said he would take a little nap before dinner.”

Heavy boots clattered on the stairway, and Alvi and Horace James reappeared, this time with Zachary Riggs in tow.

“Oh, my,” Riggs said gently. As he advanced into the room, he reached out and squeezed Alvi's left arm in sympathy. “What may I do to assist?” he asked Thomas.

“I need to have him on the bed,” the young man replied. That took but a moment, and Alvi began unlacing her father's black boots.

“A bit on his left side,” Thomas directed, trying to turn Haines somewhat. “The stertor is from his tongue falling back.” He looked up at Alvi. “Several pillows to keep his head up, if you please. We must make his breathing as easy as possible.”

“Some venesection to lower the pulse tension?” Riggs asked.

“No,” Thomas snapped. “He has virtually no pulse tension, Zachary. He needs to lose no more blood.”

“Stimulant, then.”

“Yes.” He bent down close, smelling the patient's breath. “I'd like to see some calomel, if he'll swallow. Relaxing the bowels is only going to help. And Alvi, first some ammonia, to see if there's any response at all. We may be able to support the pulse with digitalis. I think that's the order of things.”

“Brandy?” Riggs asked.

“No. He's had enough brandy.” Thomas held up three fingers. “Ammonia, then digitalis, then calomel. We'll see where that puts us.” He pushed himself upright. “Let's see no restrictions from clothing. That should be first.”

A few moments later, any slight optimism prompted by their activity vanished. The pungent ammonia held directly under Haines' nose produced no reaction. The patient's bowels had released without aid of any drug, and it was Alvi who set about both preserving some small sense of modesty for the patient while at the same time removing the soiled linens and clothing. To that, Zachary Riggs reacted by backing toward the door.

“I think I'm only in the way,” he said apologetically.

“I need nurse Auerbach,” Thomas said before Riggs could disappear. “Zachary, will you do that?”

“You want her here, you mean?”

“No, at the clinic. We have a patient in the ward who shouldn't be left alone. Would you ask her to return to the clinic and remain as long as necessary?”

“Of course. I'll see to it, Thomas.” Riggs took on the confident, officious tone that suited him so well. “Do what you can here.” He left the room so quickly that he nearly ran over Horace, himself seeking a way to exit graciously.

In a few moments, it became abundantly clear to Thomas that there was nothing to be done, other than to keep the patient comfortable.

When he placed a small amount of digitalis extract on the back of Haines' tongue, the swallow reflex was feeble. He tried a tablespoon of brandy as well, and most of the liquor simply ran out of the corner of Haines' mouth, staining the pillowcase.

Something bumped the back of Thomas' leg, and he turned to see Alvi sliding a chair under him. He slumped down, and she rubbed the back of his neck briefly before turning away to sit on the other side of the bed.

They remained in silence for a long time, watching each of the patient's fragile breaths. Seeing nothing that needed doing, Gert James said softly, “Oh, my, you poor dear,” and left. The house grew silent. Even the aroma of dinner, at first as welcome as the fire on the hearth, gradually died, and 101 took on a somber, musty chill.

“If he makes it through the night, then there might be some small hope,” Thomas said at last. Alvi had been sitting with her elbows on the bed, her father's right hand held in both of hers.

“Do you believe that, really?” she asked.

“It helps to,” Thomas said.

Alvi heaved a long, deep sigh and shook her head. “What will we do?”

“We can only let nature take its course. At this point, that's all that can be done.”

“And then? Will you stay?”

Thomas looked at her in surprise. “Stay? Whatever do you mean?”

“Just that. Will you stay?”

“Of course,” he replied, still unsure what she meant.

She lifted her father's hand, touched it to her lips, and then placed it gently on the coverlet. For a long time, she seemed content to sit, eyes closed, alone with her thoughts.

Thomas listened again with the stethoscope and detected no change, as if the powerful heart had simply not been told that its command center had abdicated. Respiration had become a bit more ragged, uneven, and shallow. He folded the instrument and stretched back. Thomas rose and made his way to the window. Darkness had settled over the village. From this vantage point, he could see the roof of the clinic six blocks down the hill.

“Do you suppose Port McKinney will ever enjoy a telephone exchange?” he asked, and his voice sounded intrusively loud in the hushed room.

“By next year,” Alvi said.

“Really.” He turned to look at her. “You've heard that?”

“Yes. Zachary says it's coming. Seattle has enjoyed such a success, and other communities have followed. Mr. Birch agrees.”

“Imagine if the workers at Schmidt's mill had been able to telephone for help. We could have saved half an hour. That might have made the difference.”

“Right now, there's only one life I care anything about,” Alvi whispered.

“Of course. I'm sorry.” He turned away from the window, hearing the admonishments of Professor Roberts ringing in his ears.

“At this moment you have but the one patient,” Roberts would preach to the harried medical students, “and you owe him your complete and unflagging attention.”

“And must I lose them all?” Thomas whispered to himself. To watch a patient simply fade away wrenched at him. The list was too long for so few days in this community, he thought glumly: Mrs. Cleary, Charlie Grimes, both Kittrick brothers, the constable, Lawrence Beautard, and the other mill hand—and now John Haines himself was poised at the brink.

Thoroughly depressed, Thomas sighed and leaned on the bureau. He gazed down at the mammoth
Advisor
and then opened it to the fanciful rendering of the future clinic. Alvi was correct. The row of poles that walked along the water from the village to the imposing building carried the telephone or telegraph lines. Behind the clinic lay the last spit on land before the inlet, and from there a connection with the rest of the world. Regardless of how small and insignificant the village of Port McKinney might be, the clinic would be a beacon above the busy shipping lanes of Puget Sound, drawing patients from all over the world.

He turned and looked at Alvi, saw that she appeared to be whispering to her father, her face close to the old man's right ear. Thomas felt like an intruder. Will you stay? she had asked.

“What are you thinking?”

He realized that she was now looking at him, probing his thoughts.

“I…I don't know,” he managed.

“Will you just sit and wait with me? I need that.”

“Of course,” he said quickly, realizing at that moment that there was nothing more difficult that Alvi Haines could have asked of him.

Chapter Fifty-one

John Luther Haines, M.D., died at 5:17 a.m. on September 24, 1891. nine days before his sixty-seventh birthday.

Thomas and Alvi hadn't exchanged a word for more than an hour. The young physician was sitting with his head back, eyes closed, waiting for the clock downstairs to drag itself forward to chime the half hour.

Haines simply stopped breathing, and for a moment Thomas didn't understand the new silence in the room.

“He's gone,” Alvi said. Thomas jerked upright. She rose from her chair as Thomas explored with the stethoscope, the small mirror, then felt the jugular with the tips of his fingers. By the time he finished, she had moved to his side of the bed, and he rose awkwardly to take her in his arms.

For a long time they stood thus, her face buried in his left shoulder, one hand holding the back of his neck in a vise. She said nothing, and Thomas did nothing to interfere with her thoughts. Her breathing settled, and for a time it seemed as if she had actually dozed off. But eventually she pulled back. She reached out and brushed his collar.

“I'm sorry, Alvi,” he said, and the words sounded empty and foolish.

“Ah, we all are,” she said wistfully. “Very, very sorry.” She shook her head and patted his shoulder as she stepped away. She bent down and drew the coverlet up far enough to cover Haines' face. Without turning around, she added, “Mr. Lindeman promised to have the silver ready after breakfast this morning.” She turned to face Thomas. “Father was excited by the prospect of what you proposed, Thomas. I wish you could have seen how excited he was.”

“Mr. Deaton can wait,” Thomas said. “Now, with this…”

“Don't be ridiculous,” Alvi said with surprising vehemence. “Father would have none of that. His only worry would be that you might fall asleep at the knife halfway through the surgery.” She smiled faintly. “With both Bertha and me there to prod you along, we'll get through it. And that would make Father very, very proud.”

“What are the arrangements to be?”

“Let Gert, Horace, and me worry about that, Dr. Thomas.” She regarded the still form on the bed. “My father was most specific, and if I do anything other than what he instructed, I know he'll come back to haunt me. His wish was to be buried beside my mother, with only the simplest graveside ceremony. Nothing more.” She drew in a breath and slowly shook her head. “Ah, me.” Reaching an arm around Thomas once again, she drew him closer. “We all know these days will come, but somehow, we're never ready. I'm glad you're here, Dr. Thomas.”

“Someone should tell Zachary,” he said. She made no reply. “May I do that for you?”

“Of course. You're going to the clinic now?”

“Yes. I have two patients and no doubt a very tired nurse who awaits.”

“Horace will drive you. Let me fetch your bag.”

“I can manage, Alvi.”

“I know you can. But don't be ridiculous.”

He saw the hint of tears, but Alvina Haines had impressed him as the sort who would wait for a private, lonely moment to let her deep sorrow well unchecked to the surface. She packed the valise, and by the time Thomas had found his crutches, she was down the stairs. Thomas heard the yelp of grief from Gert, and the murmur of sympathy from Horace. By the time he reached the bottom of the stairway, Alvi and Gert were sitting together at the table by the kitchen range, arms around each other. Horace had retreated and now waited on the front porch.

“Damn shame,” he said as Thomas maneuvered through the front door.

“Yes,” the young man replied. “Yes, it is. Alvina is going to appreciate anything you can do, Horace.”

“Somebody's got to tell Winchell.”

“Alvi will let you know when she wants that done.” Thomas struggled into the buggy. “Right now, I need to be at the clinic. Later this morning, Lindeman will have a set of surgical pins that you might pick up for me.”

“Alvina told me about that,” Horace said, and snapped the reins. He drove down the middle of the street where enough morning light filtered through to highlight the worst of the ruts.

“You got him movin' around, I see,” Horace said, and Thomas was pulled out of his thoughts.

“I have what?”

“The mutt, there,” Horace said. He pointed toward the clinic, still a hundred yards distant. “I guess that's him. No other dog so god-awful ugly.”

Sure enough, the gray specter moved out of the side street beside the clinic and stopped in the middle of Gambel.

“Bertha must have let him out to do his business,” Thomas said. As they pulled to a stop, the dog retreated a step or two and staggered to one side.

“If you'd check with Mr. Lindeman the instant he opens for business?” Thomas asked as he prepared to lower himself from the buggy.

“You bet,” Horace said, but he hesitated. “What do you figure I ought to do?” From the troubled expression on the older man's gaunt face, Thomas knew that the question wasn't about surgical pins or the limping dog. He felt a pang of sympathy that this taciturn man was now so lost that he felt the need to ask a comparative stranger what to do next.

“Alvi will need you,” Thomas said. “She'll need both you and Gert more than ever. As will I.” He reached out his hand, and Horace's grip was strong, his hand rough. “We'll work it out together, Horace.”

He pulled his crutches from the buggy and saw that Prince had advanced a step or two.

“You aren't supposed to be out, old fellow.” Thomas stopped abruptly. Blood seeped from an angry furrow that began on the top of the dog's round skull and ripped across to the base of his left ear. A portion of the ear hung loose. As if reminded of the wound, the dog tried unsuccessfully to scratch the ear with his uninjured hind leg. a move that caused him to stagger sideways.

Thomas turned to look at Horace, who held up both hands. “Don't know,” Horace said.

“Did Nurse Auerbach go after you with a scalpel, old fellow?” Thomas asked, and made his way carefully to the front door. The dog followed, his right hind leg and now his left ear useless.

Thomas let himself through the unlocked front door. His office door was closed, the examining room open, one gaslight turned low. Crossing to his office, he opened the door and made his way to the nearest lamp. The dawn light was only adequate for counting shadows, and he turned the lamp up full.

“Stay put,” he said as the dog found his rug. “I'll tend you in a moment.” He closed the office door behind him as he hobbled out. As he entered the ward, he saw Bertha sitting beside Deaton's cot. Thomas stopped at the first gas lamp, and it hissed and popped as he turned it up.

“You've been here all night?” he asked.

“Since ten, perhaps,” Bertha replied. “Mr. Riggs came to fetch me. I'm to understand that Dr. Haines is gravely ill?” As Thomas drew closer, he saw that Bertha appeared neat and prim, as if fresh from her rest. A knitting project occupied her lap.

“John had a stroke last night, Bertha. He died this morning.”

“Oh, no!” Her shoulders slumped. “I'm so sorry to hear that. Alvi must be…”

“She's at one-oh-one with Gert and Horace at the moment.”

“He died near dawn, you say.”

“Just after five.”

“Oh, my.”

He bent over the teamster, who appeared to be sleeping peacefully.

“Mr. Riggs told me that you were going to transfer the patient to St. Mary's,” Bertha said, and Thomas caught the disapproval in her tone. “I told him that I was sure he had misunderstood you.”

“My God, indeed he has,” Thomas said. “Why would he invent such a notion?”

Bertha took a moment to fold her knitting carefully, sliding it into a bag near her chair. “In preparation for your leaving for up north,” she said quietly. “He says that you're likely to accept an offer from Pitt and Burgess.”

“Oh, I think not,” Thomas said angrily, and his face flushed. “Absolutely not. His friend Carlisle is a bit overeager.” He rested his hand on Deaton's forehead. “We'll go ahead with the surgery this morning. Alvi was insistent, and she's right, you know. There should be no delay.”

“Whatever I can do,” Bertha said.

“And by the way, what happened to Prince? He was waiting outside, with his ear torn to pieces.”

“Then he's come back,” Bertha said. “All I know is that he most certainly was not on his rug when I came in during the evening. I assumed that you or Alvina let him out. And it's his ear now?”

“Yes. We didn't let the dog out, Bertha. And if Zachary did, he's most likely upstairs now, missing part of his leg,” Thomas said.

“Surely…”

Thomas drew back from Deaton. “I'll need to take a look at it,” he said. “The ear, I mean.”

“They don't care for each other much,” Bertha observed. “Riggs and the dog.”

Thomas laughed. “That's an understatement.”

The nurse looked carefully at Thomas. “You look tired, young man.”

“I am tired. I've been up all night, as have you.”

“How is Alvina taking her father's passing?”

“She's philosophical,” Thomas replied. “At the moment, that is. I'm sure it will all sink in soon enough. I get the impression it wasn't altogether a surprise.”

“No, I don't think it was. But she's a very strong young woman,” Bertha observed. “Does Mr. Riggs know?”

“Not yet. He left one-oh-one early yesterday evening. After all, there was nothing he could do.”

“Or would,” Bertha said, and Thomas looked at her in surprise. “I'd be advised to keep my own counsel,” she added, rising quickly. “I'll make myself useful. There will be a full complement by the time you're ready for surgery, Doctor.” She left the ward quickly, as if loath to offer an opportunity to pursue her comment.

Thomas made his way back to the office, entered, and shut the door carefully behind him. The dog, sitting crookedly on his blanket, regarded Thomas expectantly. Leaning his crutches against the desk, Thomas relaxed into the wicker wheelchair, then rolled across to the dog, whose tail thumped once.

“Let me see what you've done,” Thomas whispered. “You tried to court another man's wife, old boy? Or another bad shot?”

The wound was ugly, but an instant's examination showed that it hadn't been caused by flailing teeth. The single furrow tracked across the dog's skull as straight as a bullet.

He gently slid his hand under the ear and lifted upward. The bullet had torn the back margin free from the animal's scalp for the better part of an inch. Already heavily crusted, the wound had evidently bled profusely.

“I could stitch you back together,” he said, “but you'd scratch it loose in an instant.” He bent down and looked closer. “Maybe it's better if it just adds to your character, my friend. Let's leave it be and see how it heals.” He brushed off his hands. “You have the habit of getting in the way of people's bullets.”

Without warning he found himself nearly capsized from the chair as the dog exploded off the pad, deep, furious barks erupting. Thomas made a grab for the dog's thin neck. At the same time he heard the heavy footsteps coming down the stairs.