“Yes. You see our dilemma. The graves were opened for neither the contents nor the bodies themselves.”
“I wish I could be more help to you, Mr. Lewis, but I remember very little about Mr. Marshall other than his occupation and the fact that he was rather odd. I must admit that I hadn’t thought of him for years until you brought up his name. You could ask at the Baptist Church. Someone there might remember more.”
“We’ve spoken with them already. Unfortunately no one there remembered him at all. We’ll have to find some other line of inquiry. Thank you again. And someday I’ll come back and see your church, if I may.”
“Of course,” Finch said. “Any Sunday. We welcome everyone.”
Chapter 13
As it turned out, Luke had no difficulty finding an excuse to avoid social interaction with Perry and the Van Hansels. The medical practice turned very busy the next week, occupying the full attention of both physicians.
Luke was in the office, his nose buried in a copy of The Pathfinder, plucked randomly from the shelves of books in Dr. Christie’s parlour. He was delighted to realize that the Inland Sea in Cooper’s novel was, in fact, Lake Ontario. He had never before read a story that featured a geography that was so close to home. Ben’s shelves had contained mostly English and French titles, classical works, or books translated from German.
When a knock came at the door, he was surprised to open it to find Andrew Holden, the man whose toe he had amputated as the result of an accident with an axe, standing there. He had seen Holden exactly twice since, both times in order to change the bandage on the stump. The man had grumbled and complained on both occasions.
“Why’d you take if off, Doc?” he’d said. “I’ll have the devil of a time walking without it. Couldn’t you have sewn it back on?”
“No, I couldn’t have,” Luke said. “The nerves were completely severed. If I’d tried to put it back it would have turned septic and you’d have lost the entire leg.”
After he deemed that the wound was healing and no further visits were necessary, Luke expected not ever to see the grumbling Holden again.
“You’ll want Dr. Christie,” he said.
“I’ll take Christie if I have to,” Holden replied, “but I’d sooner have you. It’s the youngest. He’s got a fever.”
Luke grabbed his satchel and followed the limping man down the street. They were met at the door of the cottage by Holden’s wife, who held a mewling three-year-old wrapped in a blanket. The child had been well until the previous week, she said, when he began to run a slight fever. Over the course of the last few days he had become increasingly unwell, lethargic with an occasional nosebleed.
“I thought it was just summer complaint,” the woman said. “Now I’m not so sure.”
Luke left the child in his mother’s arms while he made his examination. He could tell by laying a hand on the boy’s forehead that he was spiking a high fever, and when he peeled back the blanket, he found rosy splotches on the child’s chest. He had hoped that the mother was right and that the boy had contracted one of the many minor intestinal complaints that seemed to rise out of nowhere and subside just as quickly, but as Luke counted up the symptoms he was seeing he became certain that he was looking at a case of typhoid fever. Just to be sure he reached for the trumpet-like stethoscope that would allow him to better hear a heartbeat. There it was — a slow thump, thump, thump — too slow for a three-year-old. And when he moved the trumpet to the child’s abdomen, the little boy flexed his knees in pain and batted the instrument away.
“What is it?” the woman asked anxiously when she saw the concerned look on Luke’s face.
“I’m afraid it might be typhoid,” he replied. It was the first of the season that he had seen, but he knew it wouldn’t be the last. Typhoid fever was the summer scourge of the city and its outlying regions. Many doctors blamed it on the miasma that emanated from the outflow of Toronto’s sewer, which emptied its vile, sludgy mess of human waste, animal dung, and butcher’s blood into the lake. The vapours, they claimed, spread out over the city whenever the wind blew and contaminated not only the air, but any surrounding water as well.
Yorkville had no reliable water supply of its own, so most of its residents used the city water drawn directly from the lake, in some cases from close to the offending sewer mouth. Odd that water should be such a problem in an area so close to an inland sea, Luke thought, and one that during most of the year was intersected by numerous creeks and one large river.
He reached for his fleam. Typhoid was caused by a congestion of the blood, and by removing some of the offending matter, the patient’s veins would run free again. The child screamed when he inserted the instrument, and continued to wail as the blood flowed into the basin Luke held beneath the punctured arm. He removed only a small quantity, no more than a quarter cup. That was enough for so small a body.
“You should make up a broth of beef tea,” Luke instructed Mrs. Holden when he was finished. “See if he will take a little of it. And barley water, as well, as often as you can get him to drink. Don’t wrap him in a blanket like that, he’s hot enough as it is, and you might sponge him down with a little cool water a few times a day. We need to get his fever down. I’ll leave you some calomel as well.”
“Is he going to die?” she asked.
“That I don’t know,” Luke said. “If he gets through the next few days, he may do well enough. We’ll have to wait and see.”
He knew they were expecting him to say something about the child being in God’s hands, and that they should pray for his recovery, but in Luke’s limited experience this seldom did much good, and he would not offer false hope.
“I’ll come back this evening,” he told them. He could hope that this was an isolated case, but feared that it was only the beginning of the season of misery, and in this he was soon proved correct. He was called to see two more patients with similar symptoms that afternoon, three the next day, and the numbers increased after that until even Dr. Christie was forced to leave the house to help with the workload.
The more patients they saw, the more the disease seemed to spread, until Luke began to feel as though he were back in Kingston, tending to the Irish emigrants who had flooded, sick and starving, into the city. This epidemic, however, could not be blamed on emigrants. It had been a light season for ocean crossings. Timber droghers no longer plied the Atlantic in the same numbers, and the laws regulating shipboard conditions for passengers were tightened. The Irish were no longer streaming into Canada. They chose, instead, to go to the United States, where they thought there was a better opportunity to scramble out of their poverty.
In spite of the severity of the typhoid outbreak, Luke was gratified to find that many patients asked for him personally. He was making a mark, apparently. People had confidence in his skills, although in many cases he wasn’t sure why some patients recovered and others succumbed so quickly. He did begin to wonder about the efficacy of bleeding. He generally preferred to be conservative with this treatment. Some physicians drew copious amounts of blood from their patients, but to Luke it had never made much sense to unduly weaken an already weak body. He continued to wield his fleam, but took smaller and smaller amounts when he did so. He could see no discernible difference in the outcome. The broths and teas he prescribed seemed to be a better help.
He and Christie were in constant attendance on their patients for ten days, snatching food when they could, napping for only an hour or two until they were called out again. The pace began to take its toll on the older man.
“Thank heaven you’re here, Luke,” he said at one point. “I couldn’t have handled this by myself.”
In a hasty conversation over a hurried breakfast, Luke asked Thaddeus if conditions were similar north of the city.
“Not anything like here,” Thaddeus said. “A few cases in Eglington, I hear. One or two in York Mills. Nothing north of there. Or at least I haven’t heard about it if there are.”
Luke was puzzled. His fathe
r’s report more or less supported the theory that a miasma from the city sewer had spread a cloud of contagion through the air, even as far as Yorkville, but had dissipated before it reached much farther. Yet, if contaminated air was the culprit, why weren’t there any cases at all in the more northerly villages? And why wasn’t everyone in Yorkville sick?
“Where do the villages get their water from?” Luke asked.
“I don’t really know for sure,” Thaddeus said. “Daniel Cummer has a lovely spring-fed well in a willow grove and it rarely goes dry, but I don’t know if that’s true for the rest of the wells at the settlement. And, of course, almost everyone in Thorne’s Hill drinks from Holy Ann’s well.”
“They don’t buy from the city supply?”
“I shouldn’t think so. They’re much too far away. Why do you ask?”
“I’m not sure. Just trying to figure something out, I guess. You certainly seem to have escaped contagion.”
In fact, now that he had a chance to have a close look at him, Luke realized that Thaddeus seemed hale and fit. He was tanned from his hours on the road and no longer moved with the stiffness that had plagued him in recent years. The air of melancholy that had hung over him for so long had disappeared. All in all, he seemed to be in tremendous spirits.
“Oh me,” Thaddeus said. “I’m a tough old bird. It would take more than fever to get me down. By the way, I’ll be staying at the Spicers’ for the next couple of nights. I promised to relieve Morgan. He’s been trying to keep watch. I expect he could use a good night’s sleep for once.”
“None of them have been sick, have they?” Luke asked. He suddenly realized that he hadn’t been called to the Spicer house, a fact that might have surprised him if he had noticed it before. Of course, they might rely on some other physician in the area. There was no reason to think that they should suddenly transfer their custom just because Luke’s father knew them.
But Thaddeus confirmed that the Spicer family was well in the extreme, except for Morgan’s lack of sleep. Luke was even more mystified. The incidences of typhoid were so hit and miss. One household could be struck down while their neighbours remained unscathed. Even within individual families the disease was selective, some members showing no symptoms at all while others were in a state of significant morbidity. Everyone had to breathe. It couldn’t be the air.
“Where do the Spicers get their water from?” he asked.
“I have no idea. Why all the questions about water?”
Luke shrugged. “You’re not the only one with a puzzle.”
He tried to mentally map the spread of sickness, but could come up with no coherent pattern that would allow him to pinpoint the locus of the disease.
In any event, he had no time to give it any further thought, at least that day. He had at least twenty homes to visit. One of them was the Holden house, where, much to his relief, the three-year-old child seemed to be on the mend. Although still feverish, his temperature was not nearly as high as it had been, he no longer flexed his legs and cried when Luke touched his abdomen, and, best of all, his heartbeat had returned to something more approaching normal. In fact, it was all his mother could do to restrain him from climbing out of bed to play with the small black kitten that chased dust motes around the kitchen.
“I don’t think he needs anything more than rest at this point. Keep giving him as much barley water as he will take, and try him with a little porridge tomorrow, but I really think he’ll be fine.”
Mrs. Holden burst into tears at the news. “Thank you, Dr. Lewis, thank you,” she said. “We’ve lost three already. I don’t think I could bear losing a fourth.”
Andrew Holden had a big grin on his face. “Well, now, you did a lot better with this than with my toe, didn’t you? No lopping things off this time.”
“Andrew! Stop grumbling about your toe!” Mrs. Holden said. Then she turned to Luke. “Pay him no mind. He likes to tease you to your face, but he’s been singing your praises to everyone else.”
Luke was pleased to hear this, but he had been getting the measure of Holden anyway. He would talk to him just like he talked to his brothers. Or to the Irish. “This is dreadful,” he said. “I’ve left you with nothing at all to bury. You’d better let me cut off another toe.”
Holden grinned and waved at him to go away. “Get out, you quack! You’ve done enough damage already.”
Luke’s pleasure at the successful outcome of this case buoyed him as he worked his way through the streets of Yorkville. Some patients were better. Others were still very ill. Only time would tell with most of them, but his efforts appeared to be doing some good.
He was hailed just as he was walking past the cottage where he had treated the old woman with cancer. It was the granddaughter, pallid and sickly looking. The entire Johnson family was ill, she said. Could Dr. Lewis please look at them?
Mrs. Johnson had only a mild case of fever, Luke judged. Her daughter was sicker, but the girl’s temperature was starting to come down. The most dramatically afflicted was the young man, Caleb, the boy who had wrestled with his conscience so desperately over the question of his urges. He was delirious, his abdomen was distended, his arms flailed and he kept throwing the blankets off the cot that was set up once more in the parlour. Or maybe it had never been taken away, Luke thought. It hadn’t been that long since the old woman had died.
“He’s been sick for a while,” Luke commented.
Mrs. Johnson nodded. “I didn’t call you right away. I thought it was just a summer fever and we all seemed to be getting over it.” She hesitated for a moment before she disclosed what Luke knew was the real reason she hadn’t called him sooner. “We still haven’t paid Dr. Christie for my mother’s sickness.”
“Don’t worry about that right now.” As much as Christie moaned about patients not paying bills, Luke was sure that he would never refuse to see someone because of an unpaid account, and that there were many sums on his books that would likely never be cleared. “What have you given him so far?”
“Just some oriental balsam.”
Oriental balsam was a proprietary medicine readily available to whoever chose to buy it, and in Luke’s opinion its purchase was a waste of good money. Its manufacturers claimed efficacy in cases of stomach pain, nausea, chlorosis, pallor, and apathy. Its principal ingredient was alcohol.
“Don’t give him any more,” he said to the woman. “I’ll leave you some calomel.”
He repeated the prescribed measures for all three of the Johnsons, opening their veins and removing various quantities of blood, and advised barley water, gruel, or beef tea. He was certain the woman would recover, and reasonably sure that the girl would, as well, but he was very worried about the condition of the boy. His abdominal pain appeared to be excruciating.
Luke opened his case and fingered the small bottle of pure opium extract that he always carried. He wondered about giving just a small dose. Just enough to take the edge off the pain Caleb was feeling, and to help calm the bowel, but the boy was already delirious and opium might well speed him into insensibility. Luke debated for a moment, but then shoved the bottle back into his bag. Caleb would have to battle the pain on his own while his body fought the disease. Luke knew, however, that he would have to be honest about the boy’s chances of recovery.
“It’s the typhoid fever that has everyone else down,” he said to Mrs. Johnson. “I’m afraid your son has a very serious case of it.”
The woman’s shoulders sagged. “I was counting on him. My husband died two years ago, and then I had Mother to look after. The boy’s been a great comfort.”
And the only one bringing any money into the house, Luke guessed. This family would be in dire straits indeed if he died.
“I’m sorry,” he said. “I’ve done what I can. I’m afraid the rest is up to him. He’s young and we can only hope that he has the strength to fight it off. I’ll come back this evening and let a little more blood. That may help.”
The next few patie
nts he saw seemed to be recovering, although one or two of them were still in danger of lapsing into the muttering delirium that signalled dire complications. He doggedly worked his way around the village, his buoyant mood gone. He became all too aware of how tired he was, and how helpless he felt when there was nothing more he could do than hand out the same old bromides of bleeding and calomel.
When he arrived back at Christie’s, a small boy was waiting anxiously by the door.
“Mrs. Johnson sent me. She said to tell you to come quick.”
Luke followed him down the street. When they arrived at the Johnson’s cottage, he turned to the boy. “Don’t go far. I may need you to take another message.”
“I live just there.” He pointed to the cottage next door. “I’ll wait in case you need me.”
Caleb Johnson was no longer muttering or fighting with his blankets. He was lying perfectly still, his breathing laboured. As soon as Luke entered the Johnsons’ parlour, he knew that the final stages of the disease had been reached, and much sooner than expected. The boy must have been sick for far longer than the mother had reported. Or perhaps he had hidden it as long as he could.
Luke exited the cottage and whistled for the neighbour boy.
“Can you take a message back to Dr. Christie’s for me?” he asked, handing over a coin. “Ring at the front door, and when the housekeeper answers tell her that I might be quite some time here. Tell her to let Dr. Christie know. Have you got that?”
The boy nodded.
“You may have to ring a number of times before she answers, but don’t give up until she opens the door.”
He nodded again and disappeared down the street.
Returning to the cottage, Luke shooed Mrs. Johnson and her daughter back to their beds. “Get what sleep you can,” he said. “You both need it. I’ll sit with him. I’ll call you if anything changes.”
He settled down on a chair at the parlour table. It could be a long night, he knew. The dying went when they were ready and it was surprising how often they clung to life long after one would have expected their bodies to finally give up. There was little hope of any other outcome in this case. All the portents were there — the distended abdomen, the unremitting fever, the lapse into unconsciousness.
The Burying Ground Page 15