Lauchlin skimmed the rest of the letter and then put it down, feeling very tired. His twenty-eighth birthday had passed without anyone noticing it but him; perhaps, as Gerhard had once suggested, he should have settled in New York or Philadelphia upon his return from Paris, instead of coming here. He almost burned the other letter unread. A request for money from one of the newly founded medical schools, or an invitation to a dinner honoring a colleague he did not respect; he could not bear one more reminder of his failure to make his mark in this city.
But it was just possible that the letter was a referral, and so he slit the envelope.
May 2, 1847
Grosse Isle Quarantine Station
Dear Dr. Grant:
Dr. Perrault has been in touch with me, about your recent inquiry into the possibility of entering the field of public health. I am writing to ask if you might consider assisting me here at the Quarantine Station for the summer months. Every evidence suggests that the coming migration from Ireland will be extraordinarily large this year. We have news that vast numbers of emigrants began leaving Ireland in February, and I believe we may expect them here within a few weeks, now that the ice has finally cleared from the St. Lawrence.
No doubt you have read in the newspapers the various expressions of alarm by the citizens of Quebec and Montreal. Their alarm is justified, I believe. And likely you are also aware of the recent harsh legislation in the United States, which will almost surely have the effect of turning the bulk of the emigration toward us. However, I have not so far succeeded in convincing Buchanan of the probable seriousness of the situation. I have been granted hardly a tenth of the money I requested for preparations. Nonetheless, I have been empowered to hire several physicians to assist me.
Dr. Perrault has recommended you most warmly, and I pray, if your own business is not too pressing, that you consider joining this important effort. If you can see your way to doing this, I could use you at your earliest convenience. Our small steamer, the St. George, arrives at the King’s wharf on Fridays for supplies, departing Saturday, and is available to convey you. Please let me know your decision as soon as possible.
Yours sincerely,
Dr. George Douglas
[II.]
The island looked like this at first: low and verdant and beautiful, covered with turf and trees. The shrubs growing down to the water’s edge were mirrored in the St. Lawrence, so calm that day that the island seemed to hang suspended above a shadowy version of itself. A huge white porpoise rose, disturbing the silver surface, and gulls dove and then emerged with fish writhing in their beaks. As the St. George steamed past the coast, Lauchlin saw a series of miniature bays, craggy and appealing. Toward the island’s center, where the ground rose, were stands of large trees and a white steepled church. None of these conventional beauties eased the knot in his chest.
He had not called on Susannah to say farewell. Instead he’d sent her a brief, businesslike note, wishing her well in her efforts and telling her his destination. He’d asked that she welcome Arthur Adam home for him, thinking Arthur Adam would be sailing up to the King’s wharf any day, but he had not said, though he often thought: “What if I can’t do what’s asked of me? What if all my training isn’t enough?” She believed he was vain, and she might be right. He could not conquer his fierce desire to be recognized as intelligent and competent.
How tired he was of himself! He thought of Arthur Adam across the ocean, wielding his pen on behalf of the people he met, and he tried to set his self-absorption aside and concentrate on what he was seeing. Something that looked like a fort, something else that might have been the hospital—these disappeared in the trees as the St. George moved on. The island could not be more than three miles long, and was very much narrower than that. So green, so seductively rural. Brown cows grazed, all of them facing him. Parts of the countryside outside Paris had looked like this, offering the same relief from the sights of the crowded city. The view changed as the steamer rounded a point; a small village, and low white buildings near the water that might be the quarantine station. Beyond the wharf jutting into the river at the foot of the village, eight or ten large ships lay at anchor. A number of small rowing boats bustled among them, but Lauchlin could not determine what they were doing.
As the St. George eased alongside the wharf, a slight man in a straw hat came trotting down the planks and prepared to board a boat in which four rowers sat ready. He paused to watch the St. George tie up, and to exchange a few words with its pilot. In their conversation, Lauchlin thought he heard his own name. He smoothed his clothes and hair and took several deep breaths, aware that his hands were trembling. A few seconds later, the man cupped his hands to his mouth and shouted, “Dr. Grant! Dr. Lauchlin Grant!”
“Here,” Lauchlin said quietly; the man was no more than ten feet away.
“Wonderful!” the man said. “Come, come, come! I’m late already for the afternoon rounds, you’d better come with me and see what we’ve got. Three more ships came in at noon.” As he talked he guided Lauchlin off the steamer, down the wharf, and toward the boat where the rowers waited.
“But my luggage…” Lauchlin said. He was tired and hungry and a little queasy, as well as worried about his trunk. In it was everything important to him: his medical books, his lancet and lancet-case, a thermometer, some bandages, and some drugs. Morphine, calomel, ipecacuanha, sulfate of zinc, copper salts, sodium bicarbonate, sweet spirit of nitre, Dover’s powder. Some Madeira and brandy, of course, and a few sets of clothing. The man brushed his hesitations aside.
“Leave your trunk here, someone will take it up—Dr. Douglas arranged a room for you in the village. We’re delighted you’ve come. Just sit here, fit yourself in this corner if you can.”
If this wasn’t Dr. Douglas, who was it? The boat pushed off before Lauchlin had settled himself, and he banged his knees against the seat in front of him. He looked up to find a small, creased hand thrust at his waist. “Dr. Jaques,” the man said. “Inspecting physician. Pardon my manners. All this rush—but you’ll understand when you see. No one expected this. We’re very glad you’re here.”
“Glad to be here,” Lauchlin said.
And for the moment, despite the odd flurry of landing, he was. His last patient, before he closed the office, had been a wealthy neighbor who complained that his liver pained him when he drank more than a bottle of wine at dinner. Clutching the bulging flesh below his ribs, he’d whined like an old man but declined to modify his diet. But here were people, Lauchlin thought, among whom his skills might be useful. Almost surely there’d be dysentery, and perhaps a few cases of ship fever; also all the effects of the long starvation about which Arthur Adam had warned him. He braced himself; this was what he was trained for. Meanwhile he took care to sit with his back straight and his chin set, looking over the shoulders of the men who rowed.
It was several minutes before he noticed the water. No longer clear and blue, it was now streaked with dirty straw in which larger objects were suspended. Something floated past him that looked remarkably like a pillow; then several barrels, a blackened cooking pot afloat like a tiny boat, a mass of rags, and some broken planks. There were corked bottles half-filled with clear yellow fluid the color of urine, and baskets lined with scraps of maggoty food. A soggy bed-tick, still kept afloat by pockets of air in its stuffing, elicited a curse from one of the rowers. Two high-crowned hats spun on the water behind it.
“What are these?” Lauchlin asked Dr. Jaques. “These…things?”
Dr. Jaques was impatiently directing the rowers; they were nearing one of the ships. On the rigging white banners fluttered. It took Lauchlin a minute to realize the banners were tattered clothes, hanging out to dry.
“That’s the way they clean,” Dr. Jaques said shortly. “The captains aren’t idiots, even though the British ones run their ships like slavers. Before they signal that they’re ready for us to come, they tell the passengers that we won’t keep them in quarantine if the steerage l
ooks clean. They bully the passengers into throwing all their filthy bedding overboard, all their cooking utensils, the nasty straw: it gets foul down there—have you seen one of these holds? There are no…facilities, and the floors fill up with excrement and filth. They shovel the worst of it into buckets and heave it into the river before we arrive.” He pushed his hat back on his forehead and rubbed at the damp line there. “Sometimes they knock out the berths and toss the planks as well. If they’re healthy enough, they’ll scrub out the place with sand and water, maybe throw on a coat of whitewash. If you didn’t know better, you might think they’d sailed over under reasonable conditions. But you’ll see for yourself—although if this ship is anything like the ones that came in last week, you won’t find much cleaning’s been done.”
Lauchlin nodded, as if this were no less than what he’d expected. He stared at the floating filth and fought down the bile in his throat.
The next half-hour passed in a flurry that left him dumbfounded. On the deck, and then to the captain’s cabin; Dr. Jaques barking out orders and questions. Was there sickness on board? What kind? How many passengers dead and buried at sea? Any dead as yet unburied? How many patients now? The captain, Lauchlin saw, looked as confused as himself. Dr. Jaques had a tablet of paper, on which he scribbled the captain’s answers to his questions. He passed the captain a small book: “Directions,” he barked. “This will explain our procedures. But you must not expect everything to go as stated here. We have room for 150 patients in the hospital, and already we’ve 220 there. No beds. No beds, you understand—we’re building a shed, but we’re dangerously overcrowded already. We’ll do what we can. We’ll take some, the worst cases. The rest will have to be cared for on board until we make other arrangements. The hold, please.”
And then he was trotting back along the deck and down the hatch into the hold, Lauchlin at his heels. The smell was staggering. A single oil-lamp hung from the ceiling, and in the dim light Lauchlin saw the stalls and the narrow passages between them. Within the stalls were rows of bare berths stripped of their bedding and hardly more than shelves. In an open area, scores of unshaven men and emaciated women huddled together, some weeping. Children lay motionless. An old man sat on the floor, leaning his back against a cask and gasping for breath.
Dr. Jaques stopped beside the first berth in which a passenger was lying. “There is sickness here,” he said to Lauchlin.
Lauchlin gaped; did the man think him a fool? Dr. Jaques felt the young man’s pulse and examined his tongue, then gestured for Lauchlin to do the same. Lauchlin shook his head and stepped back, now seeing as his eyes adjusted to the light all the other people collapsed on the bare boards. They shook with chills, their muscles twitched, some of them muttered deliriously. Others were sunk in a stupor so deep it resembled death. On the chest of a man who had torn off his shirt, Lauchlin could see the characteristic rash; on another, farther along, the dusky coloring of his skin.
“Ship fever,” Dr. Jaques said, and headed quickly back up the ladder.
“Typhus,” Lauchlin said, behind him. “We’ll have to find beds for them at once…”
But Dr. Jaques was thrusting more papers into the hands of the mate, with instructions to have the captain fill them out by the following day. “We’ll send a steamer for the healthy,” he said. “As soon as we can. I’ll be back to inspect them before we load. I’ll write an order to admit ten of the patients to the hospital, but the rest will have to stay here for another few days.”
Before the mate was finished protesting, Dr. Jaques had returned to his boat, with Lauchlin reluctantly following. “Nothing else to do,” Dr. Jaques told Lauchlin. “Nothing. You’ll see why when we get back to the island.”
The second ship they boarded, a brig, was not quite so bad as the first; the passengers well enough to stand had cleaned and dressed themselves and were waiting on deck to be reviewed. They were very disappointed to learn that they were not to be carried immediately to Quebec or Montreal.
“Tomorrow,” Dr. Jaques told the captain. “Or the next day. We’re very short-handed just now.”
Meanwhile Lauchlin could see that the water-barrels were nearly empty, and the pig-pens and chicken-coops silent. The passengers’ beds had been thrown in the river. He said, “But…” and clutched the papers Dr. Jaques had asked him to hold. He said, “I’m sorry,” to the sputtering captain; then he said nothing. It was impossible to guess the right things to say or do.
The third ship they visited, a bark, was very much worse. The captain had died four days before reaching Grosse Isle, and the mate who’d brought the bark the rest of the way was sick himself, only capable of responding in broken phrases to Dr. Jaques’s questions. They had buried a hundred and seven at sea, he said. Or perhaps it was a hundred and seventy. When they ran out of old sails to use as shrouds they’d slipped the bodies into weighted meal-sacks and tipped them over the bulwarks on hatch-battens. There were many sick below. Along the rails a crowd stood pale and thin, some propped up by their companions but pretending desperately to be well. Two boys caught Lauchlin’s eye—still in their teens, dark-haired and gaunt, leaning against each other’s shoulders for support. Perhaps they were brothers. When they saw Lauchlin looking at them, they looked at the deck.
He said nothing to them, nor to Dr. Jaques; by now his silence seemed unbreakable. There was no way to make sense of this situation. From the deck he saw the green island, the sun glinting on whitecaps, the hills lolloping gently toward the horizon from the river’s edge. And for a moment he thought longingly of his clean, empty office at home.
Into the hold: again, again. Already Lauchlin felt as though he knew that place by heart. The darkness, of course; and the rotting food, and the filth sloshing underfoot. The fetid bedding alive with vermin and everywhere the sick. But a last surprise awaited him here. He inched up to a berth in which two people lay mashed side by side. He leaned over to separate them, for comfort, and found that both were dead.
He vomited into a corner, a place already so filthy he couldn’t make it worse. Then he scrambled up the ladder and hung breathing heavily over the rail. It was too much, it was impossible. He would go home at once, on the next steamer out, and when Susannah chided him he would tell her that this was not what he had bargained for: this was madness, he could be of no help. All the instruments he’d learned to use, all his theories and knowledge were worth nothing here. These people needed orderlies and gravediggers and maids and cooks; not physicians, not science. They needed food, sleep, baths, housing, priests.
Dr. Jaques came to fetch him. “Feel better?” he asked, offering a clean handkerchief. “Don’t be embarrassed—I did the same thing when I started. Everyone does. Dr. Moorhead fainted six times his first day out on the ships. Up and down like a Jack-in-the-box, you never saw a face that color in your life. You’ll be all right. Are you ready?”
He turned and backed down the companionway again, looking expectantly over his shoulder at Lauchlin. Lauchlin spat into the handkerchief one last time and steadied himself. Of course he had to follow Dr. Jaques. He was young, strong, healthy. “You’ll get used to it,” Dr. Jaques said, as the darkness folded over their heads. “They’re not all this bad. This is among the worst we’ve seen.”
Among the worst? What could be worse? Lauchlin turned his eyes from one impossible sight to the next, determined to follow Dr. Jaques’s lead. Dr. Jaques gave orders to some sailors behind him, sending one up on deck to recruit more hands and another back to his boat, with instructions to have him gather up whatever other boats were available.
“You men,” he said to the sailors who’d reluctantly come to join them. “You’ll have to help here—we have to get these bodies off the ship. There’s a sovereign in it for each of you who’ll do a good hour’s work.”
Even with that vast sum, there were not so many volunteers; he checked the passengers up on deck, but among them not one was strong enough to help. The remainder hunched in corners or lay on the plan
ks, shivering and dull-eyed. Lauchlin shed his coat and rolled up his shirt sleeves and did as Dr. Jaques directed. He and Dr. Jaques and the sailors formed a chain, as they might to pass buckets of water for a fire. Down the length of the hold, up the ladder, across the deck to the rail.
There were boathooks involved at the ladder, where the bodies had to make a transition from one level to the next, but Lauchlin could not bear to look at them or even admit their existence. No thinking, he told himself. Follow orders, do what’s needed. He would not, until this task was done, see the ropes binding bodies into bundles and then lowering them, heads and limbs dangling, down the side of the ship to the boats waiting below. Had he seen that journey’s last stage, he might not have been able to move, as he did, from berth to berth, gently turning bodies and closing eyes and lifting shoulders as Dr. Jaques lifted legs.
The eighteenth body he lifted and passed was a young woman, hardly more than a girl, who’d been dead for several days. Her feet were black and twice their normal size. The nineteenth body, almost crushed beneath the eighteenth, was another young woman, perhaps twenty-two or three. Her hair was very long, matted around her face and neck. Lauchlin had to move the hank aside before he could grasp her shoulders. His mother had had hair like this, black and heavy and perfectly straight; for an instant, as he touched it, he could see her face. It took him a second to realize that this woman’s flesh was still warm. As his fingers tightened reflexively on her arms, she groaned.
The woman, whose name was Nora Kynd, heard Lauchlin’s voice without at first understanding his words. In her delirious half-sleep, she was reliving the last week of her passage.
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