The Cole Trilogy: The Physician, Shaman, and Matters of Choice (120 page)

“On October 5 just past,”
Loomis wrote,
“another experiment, this time with
ether, was scheduled to take place in the operating dome of the Massachusetts General Hospital. Past attempts to kill pain with nitrous oxide had been complete failures, with galleries of students and doctors jeering and calling out ‘Humbug! Humbug!’ The attempts had taken on a tone of hilarity, and the scheduled operation at the Massachusetts General promised to be more of the same. The surgeon was Dr. John Collins Warren. I’m certain you’ll remember that Dr. Warren is a crusty, hardened cutter, more known for his swiftness with the scalpel than for his patience with fools. So a number of us flocked to the surgical dome that day as if attending an entertainment
.

“Picture it, Rob: the man delivering the ether, a dentist named Morton, is late. Warren, vastly annoyed, uses the delay to lecture on how he will proceed to cut a large tumor from the cancerous tongue of a young man named Abbott, who already sits in the red operating chair, half-dead with terror. In fifteen minutes Warren runs out of words and grimly takes out his watch. The gallery already has started to titter, when here arrives the errant dentist. Dr. Morton administers the gas and presently announces the patient is ready. Dr. Warren nods, still in fury, rolls up his sleeves, and selects his scalpel. Aides pull open Abbott’s jaw and grasp his tongue. Other hands pin him to the operating chair so he won’t thrash. Warren bends over him and makes the first swift, deep slash, a lightning motion that brings blood trickling from a corner of young Abbott’s mouth
.

“He doesn’t stir
.

“There is utter silence in the gallery. The slightest sigh or groan will be heard. Warren bends back to his task. He makes a second incision, and then a third. Carefully, quickly, he excises the tumor, scrapes it, applies stitches, presses a sponge to control bleeding
.

“The patient sleeps. The patient
sleeps.
Warren straightens up. If you can credit it, Rob, the eyes of that caustic autocrat are wet!

“ ‘Gentlemen,’ he says, ‘this is no humbug.’ ”

The discovery of ether as a surgical painkiller has been announced in the medical press of Boston, Harry reported.
“Our Holmes, ever quick off the mark, already has suggested that it be called
anaesthesia,
from the Greek word for insensibility.”

Geiger’s Pharmacy didn’t stock ether.

“But I’m a fair chemist,” Jay said thoughtfully. “I can make it, probably. I’d have to distill grain alcohol with sulfuric acid. I couldn’t use my metal still, because the acid would burn right through it. But I own a glass coil and a big bottle.”

When they searched his shelves, they found lots of alcohol but no sulfuric acid.

“Can you make sulfuric acid?” Rob asked him.

Geiger scratched his chin, clearly enjoying himself. “For that, I’ll need to mix sulfur with oxygen. I’ve plenty of sulfur, but the chemistry is a mite complicated. Oxidize sulfur once and you get sulfur dioxide. I’ll need to oxidize the sulfur dioxide again, to make sulfuric acid. But … sure, why not?”

In a few days, Rob J. had a supply of ether. Harry Loomis had explained how to assemble an ether cone out of wire and rags. First Rob tried the gas on a cat who remained insensible for twenty-two minutes. Then he deprived a dog of consciousness for more than an hour, such a long time that it became obvious ether was dangerous and must be treated with respect. He administered the gas to a male lamb before castration, and the gonads came off without a bleat.

Finally he instructed Geiger and Sarah in ether’s use, and they gave it to him. He was unconscious for only a few minutes, because nervousness made them miserly with the dose, but it was a singular experience.

Several days later, Gus Schroeder, already down to eight and one-half fingers, got the index finger of his good hand, the right hand, caught under his stone boat and ground to a pulp. Rob gave him the ether, and Gus woke up with seven and one-half fingers and asked when the operating would begin.

Rob was stunned by possibilities. He felt as though he had been given a glimpse of the limitless stretches beyond the stars, aware at once that ether was more powerful than the Gift. The Gift was shared by only a few members of his family, but every doctor in the world now would be able to operate without causing torturous pain. In the middle of the night Sarah came down to the kitchen and found her husband sitting alone.

“Do you feel all right?”

He was studying the colorless liquid in a glass bottle, as if memorizing it.

“If I’d had this, Sarah, I wouldn’t have hurt you, those times I operated.”

“You did very well without it. Saved my life, I know.”

“This stuff.” He held up the bottle. To her it looked no different from water. “It will save lots of lives. It’s a sword against the Black Knight.”

Sarah hated when he spoke of death as a person who might open the
door and walk into their house at any moment. She hugged her heavy breasts with her white arms and shivered with the night chill. “Come to bed, Rob J.,” she said.

Next day Rob began to contact doctors in the region, inviting them to a meeting. It was held a few weeks later in a room above the feed store in Rock Island. By that time Rob J. had used ether on three other occasions. Seven doctors and Jason Geiger assembled and listened to what Loomis had written, and Rob’s report of his own cases.

Reactions ranged from great interest to open skepticism. Two of those present ordered ether and ether cones from Jay. “It’s a passing fad,” Thomas Beckermann said, “like all that nonsense about hand-washing.” Several of the doctors smiled, because everyone was aware of Rob Cole’s eccentric use of soap and water. “Maybe metropolitan hospitals can spend time on such things. But no bunch of doctors in Boston should try to tell us how to practice medicine on the western frontier.”

The other doctors were more discreet than Beckermann. Tobias Barr said he liked the experience of meeting with other physicians to share ideas, and he suggested that they form the Rock Island County Medical Society, which they proceeded to do. Dr. Barr was elected president. Rob J. was elected corresponding secretary, an honor he couldn’t refuse, because everyone present was given an office or the chairmanship of a committee that Tobias Barr described as being of genuine importance.

That was a bad year. On a hot, sticky afternoon toward the end of summer, when the crops were reaching ripeness, very quickly the sky became heavy and black. Thunder rumbled and lightning cleaved the roiling clouds. Weeding her garden, Sarah saw that far out on the prairie a slim funnel extended earthward from the cloud mass. It twisted like a giant snake and emitted a serpentine hissing that became a loud roar as its mouth reached the prairie and began to suck up dirt and debris.

It was moving away from her, but still Sarah ran to find her children and bring them down into the cellar.

Eight miles away, Rob J. had watched the tornado from afar too. It was gone in a few minutes, but when he rode up to Hans Buckman’s farm he saw that forty acres of prime corn had been leveled. “As if Satan wielded a great big scythe,” Buckman observed bitterly. Some farmers lost both corn
and wheat. The Muellers’ old white mare was sucked up into the vortex and spat out lifeless in an adjoining pasture a hundred feet away. But no human lives had been lost, and everyone knew that Holden’s Crossing had been lucky.

People were still congratulating themselves when epidemic broke out in the autumn. It was the season when the cool crispness of the air was supposed to guarantee vigor and good health. The first week of October eight families came down with a malady Rob J. couldn’t put a name to. It was a fever accompanied by some of the bilious symptoms of typhoid, yet he suspected it wasn’t typhoid. When he began to hear of at least one new case every day, he knew they were in for it.

He had started toward the longhouse to tell Makwa-ikwa to prepare to ride out with him, but he changed directions and walked to the kitchen of his own house.

“People are beginning to get a nasty fever, and it’ll spread, for certain. I may be out there for weeks.”

Sarah was nodding gravely, to show she understood. When he asked if she wanted to come with him, her face came alive in a way that dispelled his doubts.

“You’ll be away from the boys,” he cautioned.

“Makwa will care for them while we’re gone. Makwa’s really good with them,” she said.

They left that afternoon. This early in an epidemic, it was Rob’s way to ride to any house where he heard the disease was present, trying to put out the fire before it became a conflagration. He saw that each case started the same way, with sudden high temperature or with inflamed throat followed by the fever. Usually there was diarrhea early, with lots of yellow-green bile. In every patient the mouth became covered with small papillae, regardless of whether the tongue was dry or moist, blackish or whitish.

Within a week Rob J. knew that if the patient had no additional symptoms, death was coming. If the early symptoms were followed by chills and pain in the extremities, often severe, the patient probably would recover. Boils and other abscesses, erupting at the end of the fever, were favorable signs. He had no idea how to treat the disease. Since the early diarrhea often broke the high fever, he sometimes tried to encourage its onset by administering physic. When the patients shook with chills, he gave them Makwa-ikwa’s
green tonic doctored with a little alcohol, to induce sweating, and blistered them with mustard plasters. Soon after the epidemic began, he and Sarah met Tom Beckermann riding out to fever victims.

“Typhoid, for sure,” Beckermann said. Rob didn’t think so. There were no red spots on the abdomen, and no one was hemorrhaging from the anus. But he didn’t argue. Whatever was striking people down, calling it by one name or another wouldn’t make it any less scary. Beckermann told them two of his patients had died the previous day, following copious bleeding and cupping. Rob did his best to argue against bleeding a patient to fight fever, but Beckermann was the kind of physician unlikely to follow any treatment recommended by the only other doctor in town. They didn’t spend more than a few minutes with Dr. Beckermann before saying good-bye. Nothing bothered Rob J. more than a bad physician.

At first it felt strange to have Sarah with him instead of Makwa-ikwa. Sarah couldn’t have tried harder, hastening to do whatever he asked. The difference was that he had to ask and he had to teach, whereas Makwa had come to know what was needed without his telling her. In front of patients or riding between houses, he and Makwa had maintained long and comfortable silences; at first Sarah talked and talked, happy for a chance to be with him, but as they treated more patients and exhaustion became the rule, she turned quieter.

The disease spread quickly. Usually, if someone in a household became sick, all the other family members caught it. Yet Rob J. and Sarah went from house to house and didn’t come down with anything, as if they wore invisible armor. Every three of four days they tried to return home for a bath, a change of clothing, a few hours of sleep. The house was warm and clean, full of the smell of the hot food Makwa prepared for them. They held their sons for a little while, then packed the green tonic Makwa had brewed while they were gone and had mixed with a little wine at Rob’s instruction, and they rode out again. In between visits home, they slept huddled together wherever they could drop, usually in haylofts or on the floor in front of somebody’s fire.

One morning a farmer named Benjamin Haskell walked into his barn and became pop-eyed at the sight of the doctor with his arm up his woman’s skirt. That was the closest they came to making love during the entire epidemic, six weeks. The leaves had been turning color when it began, and there was a dusting of snow on the ground when it ended.

The day they came home and realized it was unnecessary for them to ride out again, Sarah sent the children in the buckboard with Makwa to Mueller’s farm to fetch baskets of winter apples for making sauce. She took a long soak in front of the fire and then boiled more water and prepared Rob’s bath, and when he was in the tin tub she came back and washed him very slowly and gently, the way they had washed patients, yet very different from that, using her hand instead of a washcloth. Damp and shivering, he hastened after her through the chill house, up the stairs, under the warm bedcovers, where they stayed for hours, until Makwa was back with the boys.

Sarah was briefly with child a few months later, but she miscarried early, frightening Rob because her blood splashed, fairly leaping out of her before the hemorrhages finally ceased. He realized it would be dangerous for her to conceive again, and after that he took precautions. He watched anxiously for signs of black shadows settling over her, as often happened after a woman aborted a fetus, but aside from a pale pensiveness that manifested itself in long periods of thought with her violet eyes closed, she appeared to recover as quickly as could be hoped.

“No daughter,” she said one night after he had banked the fire, taking his hand and placing it on her flat stomach.

“No. But,” he pointed out, “come spring, you’ll be able to ride out with me to fight the fevers,” and she allowed that that was so.

24

SPRING MUSIC