by Jeff High
“This is just some kinda forty-eight-hour thing, isn’t it, Doc? It will pass in a few days, won’t it?”
I knew this probably wasn’t true, but I didn’t want to panic him further. “It may take a little longer to shake off. If you don’t give yourself a chance to get rid of it, it could turn into pneumonia, and that’s very bad news. Did you by chance get a flu shot?”
“No, I meant to but never got around to it. Candice did, though. I guess she should be okay.”
I knew this provided no assurance. “I hope so. But we’ll see.”
I wrote the prescriptions, told Lexie to take care, and departed. As I walked through the exam room door, my mind was racing.
This same pattern of interview, symptoms, and assessment repeated itself throughout the morning. More and more patients showed up. For some time it seemed they were literally swarming into the clinic. With every opening and closing of the front door came a clamor, a building storm of concern and subdued fear. Some were terribly sick and had to be placed into an exam room right away. This caused frustration and anger in patients who had already been waiting. Bad news always seems to have a faster stride than the other kind, and by the afternoon the town was in an uproar of gossip.
I worked feverishly, doing my best to convey a sense of calm and assurance to each patient. I desperately tried to find a pattern of contact, a source of connection to the spread of the disease. Only a handful worked at the cabinet factory, so it was not the only point of origin. Beyond that, nothing came up. There were some similar demographics. Most of the patients were male, blue-collar, and in their twenties or thirties, but there were exceptions.
The only commonality seemed to be the speed of onset. The patients were upset and anxious and pressed me to explain what was happening to them. I found myself spending as much time reassuring them as I did assessing them. But it troubled me. My patients wanted answers, and I was clueless.
Considering the normal movements of daily life for most people, the matrix of infection would grow exponentially and any chance of determining its source would be lost in a matter of hours. A random handshake or sneeze in a grocery store, bank, or public place would cross any and all lines. I knew beyond doubt that this matter was deeply serious, and I feared that it was already spinning out of control.
CHAPTER 25
Encounter
By midafternoon, I had seen more than thirty cases. The appearance of extended family members of some of the staff added to the mounting anxiety, and bluntly brought the illness home to the clinic. This was not just an unfortunate condition affecting vaguely familiar names and isolated acquaintances. This was a terrifying reality announcing its presence in the panicked faces of loved ones. My sense of time had been wiped out. Although I was painfully discouraged, all I could do was screw in my determination and make the best of the situation. At half past three there was a slight lull. No new patients had come in for an hour, although a half dozen were still in the waiting area. I finally looked at my watch and realized I’d not eaten any lunch. I found Nancy and told her to get as many patients as possible into exam rooms while I took a quick half-hour break to go home, get lunch, and clear my head. She nodded and patted me on the shoulder.
“We’ll take care of everything until you get back, Dr. Bradford.”
I nodded and exited out the back door.
The day was gray, cold, overcast. I started the Corolla and headed toward Fleming Street. As I passed through downtown, I saw people in small clusters of conversation. Their faces were strained. I knew the salty voice of rumor was likely now rampant and would be quickly permeating the talk on streets and in stores. I felt as if a whole parliament of eyes was upon me looking for answers that I didn’t possess. As I passed by, a few people recognized me and waved halfheartedly, but all the expressions were somber.
Pulling into my driveway, I stared vacantly at the house. My mind was still churning, absorbing all that I had heard that morning, looking for some connection among all those who’d been infected. My inability to understand the source and violent onset of the disease greatly distressed me. I could think of little else.
As I got out of the Corolla, I noticed an unfamiliar car parked in the Foxes’ driveway. A woman was standing on their front porch knocking on the door. It was Christine. We shared a brief moment of eye contact. I offered a nod and a perfunctory wave and then turned toward my porch steps. With the insanity of this day, I was in no mood for yet another encounter with her. But after taking only two steps, I heard her say, “Luke?”
This caught me by surprise and I stopped short. She had never called me by my first name. As I turned around she was approaching.
Looking down at the ground for a moment, I pursed my lips and nodded as I looked up at her. “Hi, Christine,” I said, content to let her carry the conversation.
She was wearing a heavy overcoat that seemed to do little to mask her tall, graceful lines. To my surprise, her eyes were full of a soft tenderness. There was almost a beseeching quality to her voice.
“I’m looking for Will and his mother. Have you seen them the last few days?”
“Yeah, I saw them over the weekend a couple of times. Why? What’s wrong?”
“He’s been very withdrawn lately. He doesn’t do his homework and is failing all of his tests. I’ve sent several notes home, but have gotten no response. He wasn’t at school today, so I thought I’d stop by to check on him.”
I looked over at the Foxes’ house. “I don’t think they’re home. The car is gone. As far as Will is concerned, I haven’t seen or talked to him much lately. So I can’t say I’ve noticed anything.”
Christine nodded. “I’m just a little worried. Rumor at school is that there’s quite a bit of sickness going around. I was wondering if something had happened.”
“Wow. Word travels fast,” I said, though I was not surprised. For every patient I saw in the clinic, there were probably two more who were experiencing the symptoms and yet chose to self-medicate and avoid the doctor.
“Actually, I was a little surprised to see you home this early,” said Christine.
“As a matter of fact, this is lunch. It has been pretty crazy at the clinic today, so I came to grab a quick bite. I imagine I’ve got some long hours in front of me.”
Christine nodded and looked down, seeming unsure of what to say. “I won’t keep you. If you do see Will or his mom, would you let them know I stopped by and ask her to give me a call?”
“Sure.”
We both stood there, waiting. Waiting for the other to speak, to open up, to bring life to the buried thoughts and emotions that seemed to whisper in the air between us. Pensively, she looked at me with an expression of strained uncertainty. For the first time in our few conversations it seemed that she was struggling to find some way to prolong the encounter. Ultimately, she simply nodded and turned toward her car.
I watched her walk away, smiling to myself. Her enchantment over me was unmistakable. There was a sensuous poetry to her movements even from the departing view.
I knew what I wanted to say, but hesitated. Finally I spoke, almost blurting out the words. “Did she have her stomach stapled?”
Christine stopped and looked at me. “Excuse me?”
I walked slowly toward her. The day had exhausted me and my voice and manner were wooden. “Your mother. Did she have her stomach stapled? She did, didn’t she?” We were now standing within a foot of each other.
She was puzzled. “Yes, as a matter of fact. About a year ago. But how did you know?” The ardent and protective Christine I had known was beginning to surface.
“Look, technically it’s not my business. She’s not my patient. But I thought you would like to know that she does not have Alzheimer’s or dementia. What she has is a vitamin B12 deficiency. If she had had it all her life, it would have shown up a long time ago. So something had to have happened to her gastric intrinsic factor, the enzyme that absorbs B12. Heavy drinking can do this, but she doesn’t
fit the profile. So my guess was stomach surgery. Tell her doctor to give her some B12 injections. She should be fine.”
“And you know this from meeting her in the grocery store for five minutes?”
The question annoyed me. I responded flatly. “Yeah, I do. The makeup she was wearing didn’t hide the anemia and she was rubbing her hands constantly, an obvious sign of numbness. Both are indications of B12 deficiency. I saw the vitamins in your grocery cart, so I know she’s getting B12. But the dose is too low for her to absorb it effectively.”
“You don’t know anything about my mother and I don’t appreciate you—”
I held up my hand, cutting her off. Then I spoke calmly, carefully. “Just stop. Look, get mad all you want. It doesn’t matter. All you’ve done is treat me with suspicion. But I’m right. So do it for your mother’s sake. Tell her doctor. Your mother seems like a lovely woman. She deserves it.”
Christine was now furious with me, and likely for good reason. I knew I was right, but my patience was gone and she had caught the brunt of my aggravation. She stared at me with the look of a cornered cat, a mixture of fear and ferocity. “All right,” she whispered. “I’ll mention it.”
I turned back toward the house. Now I had one more thing to add to my list of frustrations for the day.
When I returned to the clinic a while later, a new wave of cases had shown up. I wouldn’t see my last patient until after seven that evening. Making matters worse, Lewis, the first flu case from Thursday of the week before, had returned. His temperature was still spiking and he was as white as a sheet. I had the EMTs drive him to the hospital in Gunther County to be admitted. There they could pump fluids into him and get him stabilized. I feared the normal regimen of antivirals was not working against this strain of influenza and that more of my patients would need to be hospitalized. I also knew that many in Watervalley would try to self-diagnose or just tough it out, never coming to the clinic or coming too late. It was a potent recipe for needless, meaningless death. I was determined that this would not happen. Not in my practice and not on my watch. But deep inside I knew there were too many factors I couldn’t control and the tools at hand simply weren’t sufficient.
I could see the deep-seated apprehension growing in the faces of the staff. They were exhausted. I told them all to go home, get some sleep, and cross their fingers for tomorrow. Privately, I knew it would likely be worse.
When I arrived home, Connie was waiting for me in the kitchen, her mood unusually subdued. There was a protective tone in the few words she did say. I was not in a talkative frame of mind either. We had grown to know each other well. Almost like a married couple, we read the moment and moved through the motions accordingly.
I sat at the table, picking at my food in a deep and troubled frame of mind. But even Connie didn’t realize what was at the heart of my despair. The flu outbreak, the frustration and fear of my patients, and my lack of answers were all bad enough. But the encounter with Christine had taken me down an even deeper shaft of misery. For weeks I had secretly thought of her. I’d hoped we could somehow find common ground, a way to move upon my tremendous attraction to her. Today she’d been actually kind, engaging. But I had snapped at her. I was confident about my diagnosis of her mother, Madeline Chambers, so I had tried to justify my rude insistence. Yet I knew that I’d blown yet another opportunity with Christine, and an additional one would likely not come along.
“Your food all right, Doctor?”
“What? Oh, sure. I’m sure it’s tasty as always, Connie. I’ve just got a lot on my mind tonight.”
“Any ideas what this influenza outbreak is all about?”
“Not a clue. If this keeps up, and I’m afraid it will, I’ll need to call the Centers for Disease Control and get them involved.”
Connie nodded. “I hear that even patients who got the vaccine are coming down with it. Makes it awfully hard to understand where this strain came from and who brought it here.”
“Yes, it does.” The heavy breath of frustration was in my voice.
“You can’t expect to have it figured out in one day, Dr. Bradford.”
“Oh, hell—it’s not that, Connie. It’s not this flu thing. Although heaven knows it has me baffled. It’s just—well, it’s something else.”
“Heavens, boy. What can you be talking about?”
I didn’t appreciate her tone. The yearnings of my heart were my business. “Nothing,” I replied.
Connie was taken aback. She realized that somehow she had stepped over into a world that even she knew nothing about. For the first time in our relationship, she sounded humbled. “What is it, Luke?”
This got my attention. I looked at her, and then, with a shrug of resignation, I revealed a small part of my heart. “What do you know about Christine Chambers?”
Connie sat for a few moments staring at me. The question I asked told a story. She could see that there was a whole chapter in my life that I’d kept hidden between the pages of the larger narrative she saw every day.
“Have you met her?” she asked.
“Yeah, I have. Actually, we’ve talked on several occasions. Not particularly friendly conversations, though. We— Well, we seem to have gotten off on the wrong foot and it’s kind of gone downhill from there. But that doesn’t matter. What can you tell me about her?”
“Let’s see. You mean beside the obvious, that she’s quite the looker and independent minded. No steady relationship that I know of. Choosy, I think.”
“Yeah, I’ve picked up on as much.”
Connie’s gaze went up to the ceiling. She rubbed her chin with her hand. “Christine would be about twenty-eight now. Her father passed away five years ago. He was a farmer, killed in a tractor accident. Anyway, she was Miss You Name It around here.”
“You mean like beauty queen stuff?”
“Oh, no. She wanted no part of that. I’m talking about valedictorian, National Merit Scholarship winner, math club—that sort of thing. On top of that, she can sing like a bird.”
“Really?” I responded with mild surprise. My mood lightened.
“Oh, yeah. That girl is smart and, Lord, she has the most velvet voice. But that’s not what everybody around here remembers her for. Everybody knows her from basketball.”
“Basketball?”
“Christine was the best point guard in Watervalley’s history. When she was a high school senior, she carried the girls to the state championship, Watervalley girls’ one and only. I remember the paper had a weekly column called the ‘Christine Watch’ to see where she was going to sign for college. She was the pride of the county. Had a full-ride offer to Tennessee, but turned it down. Went to Agnes Scott instead. It upset a lot of folks around here. They wanted her to go to UT and play for a national championship. People in Watervalley can be a little plainspoken, and I think their disappointment was expressed pretty bluntly to Christine and her mother. Ever after that, the Chamberses seemed to keep their business pretty private.”
“Really? Agnes Scott? The Presbyterian college near Atlanta?”
“Mmm-hmm. Played basketball there. Studied to be a teacher like her mom. Came back a couple of months ago because Madeline’s been sick, or so I hear.”
“So you don’t know either Christine or Madeline well. No bridge club, mah-jongg, or yoga classes you have in common?”
Connie gave me a perturbed look. “Madeline has always been one to keep to herself. She is as good and gracious a soul as you will find, although I think a little intolerant of foolishness. She’s a lot more private, much more so than her sister was.”
“And when you say sister, you mean Molly Harris, John’s deceased wife?”
“Yes. Why?”
“Help me understand something here. In all the times I’ve talked with John, he’s never mentioned having family here. I even mentioned Christine’s name to him once and he played it off, giving me the impression that he didn’t even know her. Do you have any idea what that’s all about?”
>
“Oh, I can assure you he loves Christine dearly. But there was a pretty serious falling-out between John and Madeline when Molly died. I don’t know the details, but I don’t think the two of them have talked since.”
“Really?”
“Yeah, the Harrises and Chamberses are headstrong people like that. Very reserved. They tend to nurse their sores in private. Anyway, I imagine Christine is caught in the middle. All John ever did was dote over her. Since they had no children of their own, John and Molly were almost like second parents to her. But as long as Madeline and John are at odds, Christine’s going to keep her distance.”
For the longest time, the two of us sat in silence. My world was in discord. And now in the late, weary hours came the helpless realization that, among those I had come to know, there were wounds that my med school training could do little to mend.
CHAPTER 26
The Brink
Tuesday I decided to forgo my morning run and arrived at the clinic at six thirty a.m. Within a few minutes, the staff began to appear. The mood was subdued. We moved obediently about our duties, but our faces wore the pallid look of worry. We were soldiers dug into our defenses, awaiting the imminent assault. I called them together, determined to be upbeat. After giving a pep talk, I thanked them for all they’d done the previous day. I encouraged them but also warned them to take precautions, given the easy spread of the disease. We joked a little, smiled a lot, and I did my best to hide my own fear. For the most part, I succeeded.
Some scheduled appointments were scattered throughout the morning, but fortunately the day allowed for ample time to take on the expected storm. To everyone’s relief, it didn’t happen. Only three new cases came in that morning, and by midday everyone began to exhale a communal sigh of relief. A little past noon I decided to walk over to the Depot for lunch, feeling almost lighthearted.