by Jeff High
I took the far seat at the counter, my usual perch. I knew the restaurant was a barometer where one could sense the mood of the town. The tenor of the chatter, the subtle glances, the eye contact, the smiling nods all revealed the telltale temperament of the collective mind. Today, it was mixed. There were a few friendly faces and kind acknowledgements, but also a degree of tension. As people saw me, their conversation changed. Body language became huddled and there was a sudden confidential tone and intensity to the discussions. It didn’t help matters that a few of the customers had hacking coughs that erupted occasionally above the low din of the lunch hour. No one came over to speak to me. No one called me by name.
I ordered a meat loaf sandwich and ate methodically, staring at the Village Voice before me. There was no mention of the rise in flu cases—appropriately so, since no one from the paper had contacted me for any information. Then again, I knew that the paper generally ran several days behind any real news.
I couldn’t know the thoughts of the people in the room, but I believed expressions of doubt were being cast in my direction. I tried not to let it bother me. I was an outsider, and in many ways I understood and even desired that standing. What I most dreaded was a dismissal, the shame of a ruined reputation, a collective verdict of failure. I finished eating, paid my bill, and returned to the clinic.
Two in the afternoon came and went with nothing but a few scheduled patients. By three, only two more flu cases had come through the door, and the staff was easing through the afternoon with the normal deceleration that occurred when the December sun started to fall behind the trees. The methodical pace of the clinic had returned. The crisis was over.
But an hour later, thirteen men and women sick with the flu had arrived. The day shift at the cabinet factory had ended at half past three; most of the patients had come from there along with a few from the Farmers’ Co-op. By five o’clock, fourteen more had joined them. Their symptoms were unmistakable. Once again, what most concerned me was the rapid onset and severity of the symptoms. My patients had been fine when they’d arrived at work that morning. By late afternoon they had developed horrific headaches, dangerously high temperatures, and congestive coughs. The disease was continuing to spread.
The staff worked diligently. I moved rapidly from room to room, making uncomfortably quick assessments and working hard not to miss anything important in my evaluations. Tension rose in the waiting room. The misery and pain, the profuse sweating from fever, the exhaustion and fear made hostile creatures of otherwise calm individuals. Family members sat nearby in a state of worry and alarm. People were shuffled in and out as calmly as possible, but we operated in a state of borderline chaos. It had all the trappings of an impending epidemic.
Nancy fielded a steady barrage of impatient complaints. At one point, I had to walk into the waiting room and address the heated crowd. I assured them that I would stay as long as necessary to treat everyone there and insisted that none of them leave.
The hours dragged on. Three of the patients had to be sent to the regional hospital in the next county. In my estimation, several others should have gone as well, but they refused. Pizza was ordered in for the staff, but little was eaten. Word had spread throughout the town. Mayor Hickman came by to talk with me. I had little to say short of the obvious. Watervalley was experiencing a serious outbreak of influenza. Those who had gotten their annual flu shots seemed to be just as vulnerable as those who hadn’t. The clinic’s in-house lab test proved positive in every case. The staff was doing the best they could. Walt nodded his understanding. There was little he could do. I moved on to the next exam room.
At almost ten that night I saw the last patient. The staff was emotionally and physically spent. I told everyone to go home and get some rest. I would close up. After turning off the front floodlights, I walked to my office. A few minutes later I returned to the front and turned them on again. I was spending the night there. Although I was no less tired than the others, I knew the disease would not discern night from day. I kept my phone on, knowing full well that more cases would likely surface during the night. I was right.
I washed my face and tried to eat some cold pizza. More and more the cabinet factory was turning out to be the hub of the outbreak. The disease could have spread with just one person working in close proximity to another. I was online researching the odd demographic manifestations of this flu when I heard a rapid knock on the front door. I opened it to find a man and woman with a toddler asleep on her shoulder. The man was holding the hand of a young boy of about twelve. It was the boy who was sick.
I brought them in, performed the exam, and gave him some medications for his pain and high fever while the parents stood there anxiously. The young fellow clearly had the flu, but fortunately he did not present the same severity as the adult patients I’d seen throughout the day. It was a demographic change, the first nonadult patient I’d seen. This added another layer of concern and raised more questions in my already fatigued mind. During the course of the exam I received two phone calls from more patients. I told them to come on in; I’d be here.
In between exams I caught a couple of short naps, lying uncomfortably on the sofa in my office. By daybreak, I’d seen eight more patients. Two of them were children between the ages of seven and fourteen. Tracking the source of the disease was becoming impossible. The flu was crossing age and social boundaries.
On two separate occasions during the night I stepped out onto the shadowed back porch of the clinic, hoping to revive myself. The cold air, charged with only the glittering light of the distant stars, shocked me awake. The midnight and shadowed world of Watervalley before me was frozen, bare, rimed with frost: a silent, lifeless town of closed shops and lonely streetlamps. The town was still, voiceless. I stood there numbly in the silent cold. My world had lost its order. This disease was coming at me unexpectedly, randomly, chaotically.
Hunger, worry, confusion, lack of sleep, frustration: all buzzed through my head. Despite the cold air, my eyes closed. Unknowingly, I swayed, listing. Nothing clicked, nothing made sense. I was drunk with fatigue, drifting from reality. The crunching of tires and sweeping headlights of a car pulling into the front parking lot aroused me enough to inhale deeply, filling my lungs with the frozen air, and then move back inside to find my stethoscope and resume work.
Around seven the next morning, the staff began to reappear. They quickly realized that I’d never gone home. Mary Jo confronted me in the kitchen. “Dr. Bradford, have you been here all night?”
I swallowed the last of my coffee and stared at her somberly. “This outbreak doesn’t respect office hours. Anyway, I got in a few short naps.”
I could sense a sharp-tongued scolding rising within her, but she held it in check. She read my face, my determination, my smoldering frustration. Patients also began to arrive. All of Watervalley seemed to be appearing on the clinic’s doorstep. Old, young, rich, poor, black, white, devout and otherwise were touched by the hand of the influenza. The epidemic respected no social bearing, no claims of affluence, no measure of piety.
Around noon I began placing calls to the Nashville office of the Centers for Disease Control to alert them and seek assistance. After being bounced around several times, I was ultimately put on speakerphone to a couple of people who expressed genuine concern but eventually realized that Watervalley was not in their jurisdiction and that the person I needed to talk to was on vacation that week. Furthermore, the idea of a new strain of flu seemed doubtful to them, so their focus settled on tracing the batch of flu vaccinations that Watervalley had received, in case it had been defective. They asked that I send an email detailing the number of cases along with a description of the disease presentation. They assured me that someone would get back to me within a day or so. The situation was insanely infuriating. I hung up the phone and sat for the longest time. I simply was not being taken seriously.
Then another idea struck me. I called the infectious diseases department of Vanderbilt’s m
edical school. The department secretary explained that most of the professors were either on vacation or at a regional conference in Gulf Shores, Alabama, and wouldn’t be back until the weekend. At my insistence, she offered to have someone call me. Several minutes later I received a return phone call from a second-year resident who reacted to all I had to say with sympathetic but disengaged curiosity. He agreed to pass the information along but offered little insight and no immediate assistance.
It seemed that I had an ocean of academic resources at my fingertips, but their availability was proving to be only inches deep. Remote Watervalley was simply not high on anyone’s list of priorities. To them, my patients were a batch of symptoms and numbers, but I was looking into the faces of panicked neighbors. A small voice of fear was whispering painfully in the back of my head. There would be no quick fix. I was on my own.
Before Wednesday came to a close—some ten hours later—I saw another forty-seven cases along with an array of other patients. I found the strength to deal with them from inner resources unknown to me. Occasionally I slept for five minutes in the chair in my office. I would set the alarm on my cell phone and wake in a confused state, rub my eyes, and proceed to the next exam room. The patients repeatedly asked me if I understood the cause of the outbreak or where it was coming from. I had no answers.
The cabinet factory, the Farmers’ Co-op, and a dozen other businesses announced their decision to close; they would reopen as soon as the epidemic subsided. The school system closed as well. The town came to a standstill. All eyes were on me. A reporter from The Village Voice made several attempts to talk with me about the crisis, but I had nothing to add to what they already knew. Shortly after eleven Wednesday night I arrived home. I’d not been there since six a.m. the day before.
Connie met me at the door. My defeated and anxious face told its simple story. The town was worried and scared and I had little to offer. I went directly upstairs and took a hot shower. Then I ate a few bites of dinner, drank a glass of iced tea in nearly one gulp, and walked back up to my bedroom, where I collapsed on the bed. Connie and I never spoke a word to each other. She turned off the lights, locked the door, and went home. My body drank deeply of a total and exhaustive sleep.
Thursday brought sixty-nine more flu patients for me to see. No one from Vanderbilt or the CDC had called back. This added to my sense of desperation. I was floundering in a squalling sea of patients who were full of confusion and worry with no end in sight. The exponential growth in cases had caused the disease to blow right past the capacity for a larger public health response. The flu outbreak was a roaring storm that had hit full force without ever showing up on radar. I knew that help would come eventually, but for now it was only the worn-out clinic staff and me. With each new patient I saw came the looming fear of who might be the first fatality. There were simply too many of them who were sick, too many with other health complications, too many who presented severe symptoms. And to make it worse, symptoms were all we were treating. Antihistamines for congestion, antipyretics for fever, a limited list of antiviral medications—these were only holding the disease at bay, not defeating it.
For the staff, tolerance was wearing thin. Tempers flared. Sharp exchanges occurred throughout the day, but they came to a peak when sunset arrived and the waiting room was still full. From inside one of the exam rooms I heard the bitter rise of angry words out in the hallway. It was Nancy, of all people, railing at Mary Jo.
“Jimmy Evans has been in exam room three for thirty minutes and you haven’t even gotten his vitals yet. What’s the problem?”
Mary Jo responded in a jagged tone. “What’s the problem? What do you think is the problem? Just because it takes you five seconds to point a finger to an exam room, you think everything else should happen in a snap. Here—take my stethoscope. Knock yourself out.”
Mary Jo’s voice could easily be heard by half the people in the building. I left my examination and walked into the hallway, grabbing each of them by the arm and pulling them into my office. I shut the door behind us.
“What’s the problem between you two?”
Immediately they both exploded in a tirade of accusations. I held up both hands and spoke in a short, firm voice: “Enough!”
Still stern faced, they were instantly silent, looking at me with lowly, contrite expressions. I wanted to give them a lecture, tell them to get past it. But I completely understood. I bit my lip and stood for a moment, surveying my office as if some buried wisdom could be found within the ancient woodwork. I exhaled deeply.
“Look. Both of you listen. Nancy, tell Cindy to drop off the lab work and go with Mary Jo to each exam and do all the documenting while she collects the vital signs. It’s not much, but it will buy five minutes with each patient. Get Cindy to report back to you with the paperwork so you can tell me who is next. You good with that, Nancy?”
She nodded and headed off. Mary Jo watched her leave and then turned to me.
“So. What do you want me to do?”
I stared at her silently for a moment, assessing her question. I spoke as I walked past her. “Just keep doing your job and try not to bite Cindy’s head off.”
It was a side to them I’d never seen. The aggravation and exhaustion of past days were beginning to strip them of civility. Still they pressed on. The day ended shortly before nine p.m.
I came back to the clinic four times over the course of Thursday night to treat more patients. They looked at me with beseeching eyes, sometimes frightened, sometimes angry, all wanting answers. I grew deeply discouraged. I slept little.
The front page of Friday morning’s Village Voice read “Flu Outbreak Baffles Local Doctor.” It was the final straw. I seethed with irritation. It seemed that the verdict of my incompetence was unassailable. Before the day ended, the staff and I had treated another seventy-two patients. Some of them were repeats whose symptoms had not improved. More people had to be sent to the nearby hospital for observation, particularly several of the elderly patients whose immune systems were more vulnerable, especially those who already had a bevy of chronic illnesses.
After the last patient left, I tried to gather my wits enough to analyze the demographics. Overall, the vast majority of patients from the last few days were adults in their twenties and thirties. But the number had also included nine children and almost a dozen seniors. Still, it was strange that the very old and the very young had less severe symptoms. Based on their comments, the onset was also markedly slower.
Thankfully, no children under the age of five had surfaced. Again, this didn’t fit the norm. The only infant I saw was Sam Akins and only because his mother had come to the clinic acutely ill. She apologized for bringing him and explained she had no one to keep him. She’d been sick since Wednesday and had tried to tough it out. There had been more than enough time for Sam to contract the disease, but he was perfectly healthy, as if somehow he was immune. I was thankful, yet still I could not make sense of it.
By the time I arrived home, shortly past eight on Friday evening, my annoyance and aggravation were past expression. What made matters worse was that the paper was right. I knew nothing more about what was causing this influenza outbreak than when the first cases had showed up over a week earlier. The clinic was officially closed and any new patients were being told by the recording on the main number to seek medical assistance at the hospital in the next county. It was a lousy solution, but I couldn’t do more. The staff needed a break.
I showered, put on jeans, and drank a beer. Connie had been off that day, so I was on my own for dinner. Now, beyond all else, I was desperately lonely. The four walls of my living room closed in on me. Rhett read my mood and followed close beside me with a hangdog manner. I wanted to be far away from Watervalley, away from the ignorance, the mistrust, the suspicion. But there was nowhere to go, no one to talk to. It was far too late to go visit John, and experience had taught me that he was not the best person upon whom to unburden my troubles. Besides, while I didn�
�t want to be alone, I did want anonymity. Finally, I grabbed my coat and keys and headed out the door. Pulling the Corolla out of the driveway, I headed toward the north end of the county. I had a pretty good idea where to find Indigo Road and the roadhouse everyone called the Alibi.
CHAPTER 27
The Alibi
The last light of evening had long passed and a full moon hung in the broad sky, casting a soft luminescence over the landscape. I turned the radio on loud, quickly leaving the solemn, sterile streetlights behind, and within minutes I was away from town, into the vast shadowed countryside. Only an occasional light from a farmyard could be seen in the frozen distance. Under the brilliant moonlight, the rolling fields looked cold, raw, barren. I traveled north amid their petrified silence for nearly ten miles.
Soon the narrow road changed from long, straight runs to constant curves and turns, and the open countryside gave way to thick wooded hills. At each crossroad I slowed to find a road sign. I sped past several unpaved lanes with no markings and was beginning to boil with frustration when the headlights caught a quick flash of an old hand-painted sign with an arrow on it. It read THE ALIBI.
I took the next left, following the direction the arrow pointed. After a mile I came upon a barnlike building with at least fifty cars parked in the gravel lot next to it. A neon sign told me I’d found the right place. From inside I could hear the muffled sounds of a live band playing country music. A half dozen people were clustered in the shadows of the parking lot. The night echoed with drunken laughter and reeked of cigarette smoke as couples leaned against the cars, embracing, passionate, oblivious.
I slid through the front door and moved inside, hands in my coat pockets, and was hit with an explosion of energy and sound. The room was a blur of neon beer signs. It teemed with blisteringly loud music, cacophonous chatter, and the musty scent of tobacco. The noise was deafening and the room seethed with the sly, furtive gestures of subtle seduction. The Alibi was the clearinghouse for all passions, the release point of anger, loneliness, desire, and the myriad inventory of human need. As men and women were emboldened by alcohol, all the components of self were potentially up for barter, anything to drown the emotion that had brought them there.