by Jody Shields
“So he monitored the patient’s pulse?”
“I don’t believe it’s the pulse he monitored. But what is it? A vibration? Temperature? Mind reading? The doctor called it mo. It’s something else. Perhaps he makes a diagnosis from the pressure of the vessels? There are twenty-four different qualities of mo.” He leaned forward, now eager to share what he’d learned. “I asked what his fingers sensed at the wrist. The Chinese doctor said the mo can be rough or smooth. Even slippery. I know, you smile. So did I. These descriptions are from an ancient text, the Mojing. Listen. Rough mo is ‘like sawing bamboo.’ Tense mo is like ‘palpating a rope.’ Faint mo signifies poor health, ‘extremely thin and soft as if about to disappear; it appears both to be there and not to be there.’” He sat back in the chair. “How could a doctor apply this description to a body? What is this skill that he has? It is not a diagnosis as we know a diagnosis.”
“‘To be there and not to be there.’” Messonier slowly repeated his words as if trying to memorize them.
“My knowledge of Chinese is too primitive to understand this subtle concept. My medical knowledge is too blunt. Too coarse. Like you, I was taught to recognize only hard and soft. But the Chinese are aware of many other states. Degrees of states. It’s as if the body possesses qualities—or transformations—that we can’t recognize. I couldn’t even ask the doctor an intelligent question. I’m provoked, mystified, and also enchanted, I must confess.”
“Could what the doctor felt and described possibly be true?”
“I believe so. But it seems miraculous to me. Like a saint’s miracles.” The Baron sighed. “You know what I believe? I believe that I was blessed by this experience. The Chinese doctor’s generous gift.”
“Faith.”
“Many kinds of faith.”
“As one description of love is unlike another.” Messonier hesitated. “I prepare tea for Maria Lebedev. I try to distract her from the hospital. What else can I offer? I have nothing. This city is without comfort. I never imagined courting a woman here. I came only to work.” His face reddened. “My residence is near St. Nikolas Cathedral. Our first morning together we woke to bells. She was blissful. Said it was our blessing. She’s very devout.”
When the Baron walked outside the building, he carried the aroma of the tea inside his mouth and nose. He exhaled and it was dispersed in a ragged cloud. Lately, he’d been troubled by strange thoughts. An image of his face and beard coated with ice, the plague bacilli preserved inside, particles finer than pollen, a bee swarm of contamination, ready to be released by melting. Then the familiar clutch of anxiety. He shook himself as if waking from sleep. It wasn’t a hallucination. It was caused by overwork, brain fatigue. Or was this ill feeling the beginning of an infection, the first symptom? Messonier understood his momentary lapses into silence, occasional lack of focus. Was he also distracted by bizarre images? Should he confess to Messonier?
Every night, he hungered for an object, something safe to touch that had no risk. Eyes closed, he would smooth Li Ju’s hair, exposing the nape of her neck. He knew she felt cold air before the warmth of his mouth on her skin. She coiled her arm back around his head. Locked him safe.
“Forty new patients were admitted to the Russian hospital with plague symptoms. Ten new corpses were discovered in the Chinese district. Some were buried in snow and others abandoned on the street.” The Baron spoke quietly to Messonier as they walked to the conference room. “I heard Dr. Mesny’s six patients died just ten hours after my visit to the ward.”
Messonier made a low whistle. “Sobering numbers. But just wait. Mesny will blame the patients for their own deaths.”
“Or he’ll blame Dr. Lebedev.”
Messonier exchanged a sharp look with him. “Now we have a battle ahead of us around the table and only weak tea to accompany it. I wish you well with your proposal, Baron.”
“It’s a death parade in the conference room.”
The hospital staff meetings were dreaded, as there was always a sense of uncertainty and, underneath it, fear. One doctor after another reported their unsuccessful attempts to save lives and the steadily increasing number of patient deaths. Their failures. It was as if a clock silently ticked away during the meeting. Many theories, hunches, and observations about the patients’ treatment were debated. One sick child had no fever but a cough. Treated with morphia, his condition slightly improved. Was this a possible solution? Yesterday a young woman’s prognosis seemed promising and it was hoped she’d be the first to survive the plague. But a few hours later she was dead. Scores of new patients were admitted every day but died so quickly that the numbers remained at the same level.
The Baron and Messonier greeted Mesny and Zabolotny, followed them into the conference room. We’re pallbearers, thought the Baron. Dr. Wu, Dr. Iasienski, and General Khorvat were already seated at the table.
Dr. Wu opened the meeting by focusing on what was known about the various stages of infection. “One of the unusual effects is that patients appear fairly healthy, with only a slightly elevated temperature and cough, until the rapid onset of catastrophic symptoms, quickly followed by death. We now can estimate the incubation period, the time between exposure to the bacilli and symptoms, at three to five days. Exposure could come from an infected person, animal, an object. A bite from an infected flea. A contaminated blanket or room. Nothing and no source can be ruled out at this point.”
“Rats are being eradicated all over the city under General Khorvat’s highly successful bounty program.” Zabolotny gestured at Khorvat, seated at the head of the table with Wu and his translator.
Khorvat acknowledged his praise. “The latest tally reported nearly five thousand dead rats have been collected. There’s great progress conquering the vermin problem. The streets will be made safe.”
“The effectiveness of the extermination will be demonstrated by a decline in the number of cases.”
Iasienski was increasingly impatient. “There’s another important issue to discuss. What procedure is in place for burying plague corpses?”
Wu’s response was immediate. “The dead won’t be returned to their families. It’s a risk to move corpses around the city. They’re infectious.”
“A field outside the city has been marked as a common grave,” Khorvat said. “A few rat hunters have been recruited to drive corpses to the field.”
“It’s fine to bury the corpses,” Mesny said, “but we need blood. We need tissue and samples from infected lungs and the lymphatic glands. Scrapings from the mucosa of the bronchi should be examined. We must autopsy corpses to determine how bacilli act.”
“Autopsies are against Chinese tradition. Opening up a body is prohibited. But Dr. Wu certainly has more knowledge than I do.” The Baron turned to assess Wu’s reaction and watched him glance at Zabolotny.
Several doctors were obviously relieved that Wu ignored the Baron and allowed his comment to pass.
Then Zabolotny widened his eyes in mock astonishment. “No autopsies? We risk our lives for this epidemic and we’re stopped by a quaint custom? What century is this?”
The Baron placed his hands on the table as a platform for his words. “Unlike Western medicine, Chinese medical practice doesn’t rely on autopsies. There’s no history of autopsy in China, so you can understand why it isn’t accepted. Their conception of the body is entirely foreign to us. It’s truly unimaginable. That’s not to say it has no basis in fact. The Chinese have had an established system of medicine for a thousand years.”
Mesny jumped in. “I welcome your lesson about Chinese medicine, but we’re here to stop an epidemic with our medicine. The Chinese have a proven history of failure with epidemics.”
“I’ll remind you, Dr. Mesny, that we have no cure for the plague,” the Baron said.
“Dr. Haffkine reports great progress with his serum.”
The Baron didn’t take Mesny’s bait. “On the street, they say the bodies of dead Chinese are harvested to make medicine for Rus
sians. Any Chinese who suspected their bodies would be eviscerated after death would refuse treatment in our hospital. This also relates to their religious beliefs. Without rites and a proper burial, they’re condemned in the afterlife. We’re all familiar with the concept of eternal damnation. We cannot solve this epidemic without their cooperation. There could be violence.”
Mesny dismissed his words. “Then we’d better cozy up to the Japanese for protection.”
“You joke, but the Chinese vastly outnumber Russians in Kharbin. Only a few years ago, Chinese mobs killed foreigners during the Boxer Rebellion. I hid in the woods for three days—” Messonier was interrupted.
With a gesture, Khorvat swept him aside. “Let’s finish the meeting. Time is wasting. It’s unlikely the Chinese will kill Russian doctors. Imagine how that would look to the world. They will lose face. China already struggles with foreign criticism, since no one believes they can manage the epidemic without international aid. That’s why doctors were brought in from several countries. Remember, the only hospitals in China were built by missionaries. That said, the Chinese look for any excuse to rid this place of Russians. This talk of harvesting Chinese bodies could incite protest. There aren’t enough Russian soldiers to contain hundreds of rioters. The situation is volatile.”
Khorvat’s point had a sobering effect. Messonier said the general’s warning should be respected.
But Mesny had burned through his patience. “So we accept these ridiculous restrictions about autopsies? I strongly protest. How would the Chinese even discover the autopsies?” His eyes were on the Baron and Wu.
“Now that I’ve heard everyone’s opinion, the best strategy is to petition the Imperial Throne for permission to conduct autopsies.” The disdain in Wu’s voice was apparent.
“The Chinese government will never support your request to violate their own traditions.” Mesny’s voice was querulous. “You like to gamble, Dr. Wu. If permission is denied, what will you do? Resign?”
Wu’s reaction was barely perceptible. “I’m confident the Imperial Throne will accept my petition.”
“Let’s hope their answer will be swift.”
Wu continued as if Mesny hadn’t spoken. “Once the Imperial Throne gives permission, unidentified corpses will be autopsied in secret to avoid alarming the Chinese.”
“Do you truly believe autopsies can be kept secret? We’ll be acting like murderers, trying to hide the mutilated corpses. No, the solution is obvious.” The Baron controlled his voice in spite of his anger. “It’s unethical to autopsy Chinese corpses. So we’ll autopsy Russian corpses.” Messonier flashed a grin as Khorvat pushed back his chair and called for order over the angry voices.
The Baron kept talking, refusing to be shouted down. “We need to work with Chinese patients and doctors.” Even before he’d finished his sentence, he sensed their disapproval but continued. “Who knows where the cure for plague will be found? Perhaps the Chinese already possess it.” He was breathless.
“I disagree.” Wu’s voice was cold. “Chinese doctors practice folklore, not medicine. They would undermine our work at the hospital. One of their treatments for plague is to wrap a chip of horse bone in red cloth and wear it in a small bag around the neck.”
“A horse bone? You must be joking.” The doctors permitted themselves shallow smiles. Messonier wasn’t amused.
The Baron kept his focus. “Dr. Wu, it’s obvious that not every remedy has potential. But how can we determine which treatments are acceptable? We need all types of knowledge. Why not expand our circle of information? Some of the most unlikely remedies have been proven effective. It’s a schoolboy’s lesson, but even smallpox vaccine, cultivated from infection, was rejected at first.”
“There’s no time to explore Chinese superstitions.”
Iasienski had been quiet but now thumped the table for emphasis. “I’ve heard about these superstitions. The Chinese make medicine from powdered deer hooves. They grind up pearls and insects. Fungus from trees. You’re a modern man, Dr. Wu. Better to dismiss it.”
The Baron persisted. “What harm is there in meeting Chinese medical men? It would ease mistrust between us. Bring them to the hospital. Discuss what they know about the plague. I will gladly translate for them.”
“Translation may tax your ability. If the prefect of Laichow were here, he’d tell us to throw black beans into a well during the last watch of the night. Everyone who drinks water from the well will be saved from plague.”
The laughter was audible this time.
As Wu spoke, the Baron realized he used his mockery of Chinese medicine to form a bond with the Russian doctors. It was the way to court their praise and acceptance. To eliminate the distance between them.
“Gentlemen.” General Khorvat loudly called for attention. “This discussion is also pertinent for my announcement. The merchants in the Chinese Chamber of Commerce have contributed funds to open a hospital in Fuchiatien. It will be staffed with Chinese doctors who practice traditional medicine. We suspect that the Imperial Throne is behind it and money was funneled from Beijing to support their effort.”
“Of course the goal is to prove their medical practices are legitimate.” Zabolotny looked to Mesny for support.
“A rival hospital is an insult to our hard work.”
Khorvat sketched a vague expansive movement with his cigarette.
Wu’s gaze moved around the table, avoiding the Baron. “I believe that I speak for everyone here. We will not cooperate with the Chinese medical men.” He turned away from the Baron as if to block him from the others at the table. A wall had been assembled. The Baron could sense it, almost touch it.
“The Chinaman has made a wise decision.” Mesny was oblivious to the disrespect in his comment. “Imagine if our colleagues heard we were advised by these so-called doctors.”
“I’d be mocked from my position at the Imperial Institute.”
“The Chinese probably hold the same scorn for our medicine,” the Baron said.
“You would defend them. You may find yourself chanting alone in a Chinese temple someday.”
Wu added to Mesny’s comment. “Baron, if you intend to practice unorthodox medicine here, please keep me informed. Not all the patients will welcome your experiments.”
“I imagine even a sick Chinese would refuse his care. They come here for Russian medicine, not some concoction from lotus pods and rainwater.”
Sounds of appreciation for Wu’s barb. He had skillfully isolated the Baron.
The Baron’s breath was measured. He wondered how Wu thought this mockery would aid their work.
Messonier began speaking in a reasonable tone. “I must point out that a crisis strains everyone’s nerves. Judgment becomes impaired. Some of us speak and act carelessly. Almost as if we’re drunk. Everyone here is at risk and it’s crucial to support each other. It could save lives. Even our own.” Because he wasn’t angry and his words were careful, they created space in the room. The doctors had been called to account.
The Baron wished Dr. Lebedev were present to witness Messonier’s tour de force. His own proposal for working with the Chinese was lost. He couldn’t see the arc of the epidemic but sensed a vast shape that they would try to name and control with their evidence. Build a fence of hypodermic needles.
Dr. Wu did not forget Mesny’s insults. He immediately sent a telegram to Alfred Sze at the Ministry of Foreign Affairs in Beijing, offering to resign as health commissioner. It was intolerable to work with Dr. Mesny, a foreigner who did not respect his position.
In private, the Baron began to criticize Dr. Wu, his English clothing, the thick tweed jackets and waistcoats. His inability to speak Chinese. His need for a translator. Wu was arrogant, constantly miscalculating the effect of his words and attitude on patients. This was an unforgivable flaw for a doctor. The Baron had lived in Manchuria for years, was fluent in the language, and respected the Chinese. Yet Wu didn’t ask for advice or recommendations. Never shared a cup of tea.
The man seemed to represent everything that was wrong with the system.
Standing onstage, Dr. Broquet waved a pair of floppy black rubber gloves overhead so they were visible to the Russian hospital staff in the assembly room. “Cover and protect yourself. Always wear rubber gloves.” His dark hair gleamed with pomade under the spotlight. Dr. Zabolotny, seated at a table next to him, watched the presentation. “Wash hands before and after you wear gloves.” Broquet’s voice was tremulous, as he was obviously uncomfortable speaking to a large group. Flustered, he dropped a glove, and Zabolotny made no effort to pick it up.
Broquet retrieved the glove and caught his breath before continuing. “Your life may depend on your face. A mask shields nose and mouth from plague bacilli circulating in the air. See here.” He held up a mask, pale, glowing, translucent as honey. “This mask is made of mica. Lightweight. It’s one piece, without holes so the mouth and eyes are covered. Visibility is affected.” He slipped the mask over his head; his features became tightly flattened and distorted behind its slightly glittering sheath. He turned left and right before awkwardly removing it. “After each use, sterilize the mask in boiling water. It can be worn several times.”
A question from the audience. “Dr. Broquet, will the mica mask protect us? What are the disadvantages?”
“Face moisture condenses inside the mask.” Broquet’s hand flapped. “It’s useless in the colder hospital wards. I wore this mask in the patients’ ward and was blinded by ice on my eyelashes.”
A young woman in the third row stood up. “I’ve heard it’s important to protect the eyes. Can plague bacilli infect the body this way?”
Broquet shared his hesitation with Zabolotny before answering. “Possibly. Probably. We aren’t certain.”