Die Once Live Twice

by Lawrence Dorr

  “Tissue cultures forever change our study of microorganisms, for now we can selectively grow them in vitro. We do not need to grow them inside animals. What of equal importance has come from Harvard’s medical school?” Harrison turned the knife in Jonathan with a deadpan face.

  “Can we talk football?”

  Jonathan prepared his cultures with a virulent strain from Pigtown. In two to three days he would know if he had successfully isolated the virus. Growing germs on a plate or in a test tube—in vitro—opened multiple opportunities of study for researchers, but a difficulty remained. Germs would only grow in certain tissues. The infantile paralysis virus was an especially stubborn bug. Any time Jonathan tried to grow it outside nerve tissue, at least in quantities large enough to be useful, bacteria overwhelmed it. But if he could grow the poliomyelitis virus outside nervous tissue it would be a “shot heard ‘round the world.” It would allow a vaccine to be developed.

  Jonathan left the laboratory and climbed the stairs one floor to his office. He threw his white smock over his chair and his notes from the laboratory on his desk. His small desk was positioned in front of a window so he could see a glimpse of nature while he worked. Stacks of papers scattered on the floor were data from his studies and manuscripts. A bookshelf on the wall opposite the doorway was stuffed with journals and books. He meant to get them organized. On the wall behind him hung a portrait of his mother with William Welch. The only other picture was of Marion, and it stood on his desk facing his chair so he could readily admire her beauty. He leaned back in his chair. There was nothing more he could do today.

  That evening Marion met Jonathan at the Oak Room bar. Both were exhausted by the past days, but the anticipation of change gave them extra energy. Jonathan lit a cigar and ordered Louis XVI Cognac for himself and Puligny-Montrachet wine for Marion. Marion tasted her white wine and thanked the waiter. Jonathan noticed he was not the usual waiter. “Where’s Tony?”

  “His boy has the virus.”

  Marion’s shoulders slumped. “Flexner is so damn wrong and so are all the experts. This isn’t a disease of filth and it’s not from the immigrants.”

  “I believe you. With any luck my lab experiments will prove you right. What’s happening at your clinic?”

  “Today was just one sick kid after another. Lots of flu-like symptoms. That’s why I know it comes in through the stomach. It’s not through the nose. The worst part is I know we will start getting paralyzed kids next. They are all five years old or less. It is just tragic.”

  Jonathan took a long drag on his cigar. “This is a mean strain of the virus. This is the worst infantile paralysis epidemic in history. I think there are 15,000 cases already. That’s how bad it is.”

  “I’m telling you, honey, it’s all over the City. It’s in New Jersey, too,” Marion said. “Filth doesn’t cause it. My ward is clean and we’re swamped. Quarantines don’t stop it.”

  “Well, with any luck in three more days I can stop it!” Jonathan clinked glasses with Marion.

  The next day, Jonathan was thrilled to see that the tissue culture was not overgrown with bacteria. Some slight tissue destruction told him the virus was growing. He was getting close. The next morning, too restless to spend the whole day in the lab, Jonathan accompanied Marion to her clinic. All day mothers brought their children. Those without paralysis were sent home and their dwelling quarantined. Those with paralysis were sent to Willard Hospital. The only treatment was bed rest. There was little hope that the paralysis, once it occurred, would recede.

  By late afternoon he was at Rockefeller Institute. As he bounced down the stairs to gaze on his prize, doubt arose. Why would I be successful at what Flexner can’t do? Maybe this strain will be the one that is different. One look and depression replaced anticipation. Then anger filled him. The tissue was mush—necrotic. Clearly overgrown by bacteria. It was unavoidable as long as there was no chemical to add to the culture to kill bacteria and selectively grow virus. The bacteria always won. They are thugs. Jonathan didn’t bother looking at his preparation under the microscope. He didn’t want to give the bacteria the satisfaction of looking back up at him, their cellular faces grinning. Slamming his fist on the counter, he wheeled around and stomped out of the lab.

  Back upstairs, sitting at his desk looking at a beautiful tree outside the window, he resigned himself to his failure. Maybe he should stop this chase for the Holy Grail, give up pretending to have a medical lion’s heart. He wasn’t better than Flexner. This experiment to prove Flexner wrong and Marion right had only proved him wrong. He spoke to his picture of Marion. “Sorry, honey. I had a chance but this damn virus still won’t grow outside nervous tissue. Even worse than not proving Simon wrong is there can be no vaccine.” Closing his eyes, he felt beaten by his arch enemy, the germ. He let out a long sigh.

  After sitting in silence for nearly thirty minutes, Jonathan stood and reached for his suit coat hanging on a peg in the wall. He froze. He felt Katherine’s eyes boring into him. Lifting his head toward the portrait of his mother standing with William Welch, he stared back. Finally he moved again, sliding his arms into his coat. “Okay. Okay, Mother,” he said out loud. “I won’t quit. But maybe I’m not the one to be Richard, your lion-hearted hero.”

  When he exited his office he went back down the stairs to his laboratory. Defiantly he strode with purpose along the counter to his failed cultures. He looked straight down at the bacteria laden plates and yelled, “You fucking little buggers. You’ve controlled the earth through all time. But we’ll win. We’ll find a substance to kill you. Then I’ll grow all the viruses I want!”

  Chapter Twenty-six

  DREAM DENIED

  Jonathan sat in an overstuffed leather chair in the library of the Union Club, not far from his home on Fifth Avenue. He was entertaining the three graduating surgery residents from Rockefeller Hospital, all of whom had volunteered for the Medical Corp of the Army. It was July 3, 1917 and the United States was now in the Great War. Sipping on a twenty-five-year-old single malt scotch, Jonathan’s Cuban cigar was doing a slow burn as he continued his lecture to the residents on the war.

  “The Boche have been asking for it ever since they sank the Lusitania two years ago. Germany, Austro-Hungary, and Italy thought they were invincible. They didn’t count on the courage of the Frogs and Brits.”

  “Why in the world wouldn’t Congress arm the ships after the Zimmerman telegram?” demanded one resident who considered himself knowledgeable. “The German foreign minister openly saying they would begin destroying our shipping with their subs? And worse, offering to form an alliance with Mexico to open up a Western Hemisphere front? It took the sinking of three more ships two weeks later before they would do anything.”

  “At least the Mexicans weren’t foolish enough to take them up on the offer in order to get back New Mexico, Arizona, and Texas. They were probably just happy to have Pershing out of the country,” Jonathan laughed.

  “So now all three of us have to risk our lives to save France and Britain,” the same resident groused. “At least we’ll get lots of surgical experience.”

  “Yes, just be alert all the time for the Germans gassing your camp or your city. Since Ypres in 1915, we know the mustard gas is lethal and we have no antidote for it. So keep a gas mask handy,” Jonathan continued.

  “I hope I don’t get sick from the inoculations,” a second resident said.

  “Be glad the troops are vaccinated,” Jonathan answered. “This is the first war ever where disease is not the number one killer. Twenty years ago, in the Spanish-American War, thirteen men died from disease, mostly typhoid, for every one that died from trauma. It’s a feather in medicine’s cap that just as many men are dying from trauma as disease.”

  “But there are some pretty serious diseases over there,” said the first resident.

  Jonathan nodded. “One of the worst is typhus. It can travel on a louse passed from human to human, and with these men crowded in wet, filthy tren
ches it has a field day. Be sure your men get hosed off frequently. Then there’s trench foot. They need to change socks frequently to prevent that.”

  “I hope the troops will listen to me.”

  “We doctors have more respect than we’ve ever had. The generals know fewer men are sick and dying from disease. Our citizens expect their boys to return because the inoculations will”—Jonathan wiggled his first two fingers of each hand to simulate quote marks—“protect them.” He grinned wryly and stood. “Gentlemen, I must retire. My wife and I are motoring to Fort Washington with my friend Doctor Spanezzi tomorrow to have a 4th of July picnic. Good night to each of you.” Jonathan took their leave to walk home, quite certain they would savor their evening in the Union Club until it closed the bar.

  The next day was sunny and warm. “Magnificent day for a picnic,” Marion said as she dressed. “Let’s take the open car today.”

  Jonathan, just out of his bath and toweling off, patted Marion’s tummy as he passed her. “How’s my boy doing?” Marion was three months pregnant and her stomach showed it.

  She rubbed it in a circular motion and grinned. “You hope it’s a boy! But I think it is. He sure is growing fast.” She looked down at her stomach and continued rubbing, as if she wanted to confirm one more time there was a baby inside. Then she grabbed Jonathan’s arm. “Before you go to your closet, fix the clasp on this new-fangled brassiere.”

  Jonathan dropped his towel and fumbled with the clasp. “So this shows your bosom off better?”

  “Yes, it does. Now more men will look at me.”

  Jonathan pressed up against her back and reached under her arms, pushing his hands under the bra. “Yes, but only I get to touch them.” He leaned forward and kissed her neck. Now naked, his erection stiffened against her buttocks.

  “Oh, you would do that,” Marion whispered. “Now I want you. Undo this contraption.” After Jonathan unclasped the brassiere she took his hand and towed him to their bed.

  Two hours later, Spanezzi stood on the landing of the staircase and hollered toward their bedroom. “How long are you going to make us wait? You’re already pregnant, Marion!”

  Jonathan appeared at the top of the stairs in a tweed sport coat, an Ascot around his neck and holding a driving cap. “You know these women, Phil. They take forever. Let’s go wait with Danica.”

  Danica Lindstrom was a Scandinavian actress, about twenty-five years old, Jonathan figured, whom the forty-five-year-old Spanezzi had dated for a year. Blonde, full-busted, and five-feet, seven-inches tall, she was most pleasant to look at. When Marion joined them, Danica exclaimed, “Oh, Marion. You’re wearing one of those new breast supports.”

  Spaneezi looked at Marion, then at Danica, then back to Marion and said, “It makes yours look, well, crestfallen, Danica!”

  “Deezi, be nice.” Marion’s index finger wagged at him.

  Jonathan was impressed with Marion’s new appearance. Her blonde hair was tied in a ponytail, which Jonathan loved. “If we gave a picture of you to each of our soldiers and promised them a date when they returned home, the war would be won in a week.”

  “Until they found out I’m a pregnant woman!” she said with pride.

  Broadway, as the old Bloomingdale Road was now called, had been paved about a decade before, and although the latter parts of the road were still rough, Jonathan liked both the view of New Jersey’s Palisades from the highest point on Manhattan Island and the bucolic setting so different from the bustling neighborhoods they lived in. He had even been to Hilltop Park to watch the Highlanders play baseball while they rebuilt the Polo Grounds. He wasn’t at all sure he liked their new nickname, “Yankees,” which seemed to him much plainer and more prosaic. Jonathan’s new car was powerful, reaching forty miles per hour when the ground was level. He wore goggles to protect his eyes from dust and wore a dapper tan driving cap.

  “At the beginning of the Revolutionary War, George Washington held off the British here, until he was overwhelmed by Hessian mercenaries.”

  Marion tossed her head. “Jonathan, do you think we didn’t study history in Iowa?”

  Phil and Danica in the rumble seat could not hear their conversation, but Phil was busy with his hands anyway. As they climbed Washington Heights and were more exposed to the wind, Jonathan began to wish they had brought the sedan.

  Suddenly a car pulled out from a farm’s driveway without looking for other traffic. Both braked fiercely and swerved, trying to avoid each other, but the other car crashed into the left front side of Jonathan’s, blowing out the front tire. Jonathan’s car slid backwards into the ditch and the rumble seat slammed against the far bank, bringing the car to a sudden halt. Marion’s head pitched forward into the windshield, breaking the glass. Blood spattered onto broken glass and covered her face. She was motionless.

  Jonathan’s initial reaction was to scramble out of the car, unsure whether it would explode. His senses rapidly returned and he looked back at Marion. Horror shaped his face. He dove into the car and pulled her back into her seat, pressurizing the gash on her forehead with his hand. Spanezzi was standing outside the car. “We’re okay, Jonathan. Danica was knocked out briefly, but she is sitting on the grass. Just shaken.”

  “Take your shirt off, Phil. I need a bandage. I don’t want to let go.”

  Phil took off his leather coat, then his shirt, and climbed into the car next to Jonathan. “Let go,” he said and wrapped the shirt around Marion like a turban. She began to regain consciousness. “We need to lift her out of the car and lay her down. Let a real doctor take over here,” Phil smiled.

  Phil gripped Marion under her armpits and told her to push off with her feet. “Ouch,” she yelped as she was lifted and dragged out of the car and laid on the grass of the ditch. “My belly hurts, Jonathan.”

  The occupant of the other car, dressed in overalls, came up to Jonathan and began to apologize. Jonathan cut him off, saying, “My wife has been injured. Do you live nearby?” The man nodded and Jonathan said urgently, “Go back home and call an ambulance. Have them get here as soon as possible.”

  Phil examined Marion’s head. The forehead cut was now just oozing, but the mucous membranes of her eyelids and lips were pale. She has lost more blood than she would have from just this cut, he thought. He moved quickly to her chest, which was not bleeding, and pressed but she felt no pain. But as he went to examine her lower abdomen, Phil saw that her skirt was blood-soaked. In a strained, tight voice, he said, “Jonathan, look.” When Jonathan saw, he reached for the car to steady himself.

  Phil leaned forward to Marion and said, “Marion, you’re having a miscarriage and I have to extract the placenta or you’ll bleed to death.” Marion said nothing, but tears filled her eyes. She nodded that she understood. Phil felt that her pulse was racing and not strong, meaning her blood volume was low.

  Jonathan just watched. He didn’t know what to do and wasn’t thinking clearly. Phil unbuttoned Marion’s skirt and pulled it off, then removed her underwear. “Jonathan, I need you. Hold her knees apart!” As Jonathan moved into position to do as Phil asked, Phil moved quickly to the car and pulled out the seat cushion. “Lift her pelvis, Jonathan.” Phil slid the cushion under her buttocks to elevate her pelvis.

  Phil kneeled and motioned for Jonathan to spread Marion’s legs. Soon he had Marion’s blood all over his arms and legs and the ground beneath them was red with it. Jonathan watched Phil reach forcefully into Marion’s vagina and the image of him and Marion two hours earlier flashed in front of him. Marion moaned in pain, but by now she was only semi-conscious. Phil could feel that the mouth of her cervix was filled with fetal tissue and knew that if he couldn’t get the cervix to clamp shut, Marion would bleed to death. He grasped a fistful of tissue and pulled it out, throwing it on the ground. Jonathan turned sideways and vomited.

  Phil forced his hand inside her vagina again and used two fingers to reach inside the cervix. When he identified the umbilical cord, he pulled on it gently and felt it g
ive a little. The placenta was free. Pulling the cord, he retrieved the mass of the placenta and scraped it out of the cervix into the vagina. The cervical mouth was cleared and he withdrew his hand until he felt the cervix close. He pulled out the placenta, then turned to Jonathan. “It’s over. She’s safe there.” He looked at Jonathan through eyes wet with tears. No one knew better than Phil how much Marion and Jonathan had wanted a baby.

  Jonathan was thinking clearly again. “Phil, she feels clammy. Her pulse is weak. At least 150. What type blood are you?” Just in the last ten years was the ABO blood typing system defined by Karl Landsteiner, now working at Rockefeller Institute. Jonathan, Marion, and Phil had all volunteered for one of his experiments to learn their blood type.

  “I’m O,” Phil answered.

  “That’s what I remembered. Marion is O, too. We need to transfuse her.”

  Jonathan went back to his crumpled car and reached into a compartment behind his seat for his medical bag. Out of it he pulled two glass syringes, two needles, a rubber tube, and a glass bottle of iodine. “Sure glad these didn’t break,” he said to no one.

  Phil looked around for Danica and saw her by the road. She had flagged down a car in case they needed transportation. By now four cars were stopped, with people all gawking at the scene unfolding in front of them. Danica was telling them to not interfere. “They are both doctors,” she explained.

  Phil called Danica over to come help them. He explained they were going to transfuse blood from him to Marion and she needed to be their nurse. “This rubber tube is a tourniquet. It will be tightened on my arm to distend a vein to insert a needle. Then wrap it around Marion’s arm to distend a vein for Jonathan to put a needle into her. You’ll stay with Marion while Jonathan is drawing blood from me.”

  Phil lay down next to Marion and Jonathan knelt between them. Jonathan poured iodine over Phil’s arm, told Danica to do the same for Marion, then inserted a needle into Phil’s vein. Phil covered the open needle with his finger to stop the bleeding while Jonathan turned to Marion with a second needle. Finding a vein in Marion was hard because her low blood pressure collapsed the vein walls. Jonathan stuck her once, twice, and then a third time in the antecubital fossa of the left elbow until he succeeded. He began the transfusion by withdrawing 20 ccs of blood from Phil into the syringe. He detached the syringe from Phil, swiveled to connect the syringe to Marion’s needle, and pushed the blood into her. As he released the syringe, he said, “Danica, put your finger over the needle so the blood doesn’t back out. See what Phil is doing?”