The Cole Trilogy: The Physician, Shaman, and Matters of Choice

by Noah Gordon

  Tobias Barr had held a clinic in Holden’s Crossing almost every Wednesday, but people had tended to go to it only for the most acute situations, and Rob J. found the same kind of problems he had discovered when first he had come to Holden’s Crossing, neglected hernias, rotted teeth, chronic coughs. When he went to the Schroeders’ he told them he was relieved to see Gustav hadn’t lost any more fingers in farm accidents, which was true even if he said it as a joke. Alma gave him chickory coffee and mandelbrot, and caught him up on the local news, some of which saddened him. Hans Grueber had dropped dead in his wheatfield last August. “His heart, I suppose,” Gus said. And Suzy Gilbert, who had always insisted that Rob J. stay for heavy potato pancakes, had died in the childbed a month ago.

  There were new people in town, families from New England and from New York State. And three families of Catholics, new immigrants from Ireland. “Can’t even speak der langvich,” Gus said, and Rob J. lost the fight to keep from smiling.

  In the afternoon he rode into the lane of the Convent of Saint Francis Xavier of Assissi, past what was now a respectable herd of goats.

  Miriam the Ferocious beamed to greet him. He sat in the bishop’s chair and told her what had happened to him. She was keenly interested to hear of Lanning Ordway and of Ordway’s letter to the Reverend David Goodnow in Chicago.

  She asked his permission to copy Goodnow’s name and address. “There are those who will be anxious to receive this information,” she said.

  In turn she told him of her world. The convent prospered. She had four new nuns and a pair of novitiates. Lay people came to the convent now for Sunday worship. If settlers continued to come, soon there would be a Catholic church.

  He suspected she had expected a visit, for he’d been there only a while before Sister Mary Peter Celestine served a platter of fresh-baked crackers and very good goat cheese. And real coffee, the first he’d tasted in more than a year, with creamy goat’s milk to lighten it.

  “The fatted calf, Reverend Mother?”

  “It is good you’re home,” she said.

  Each day he felt stronger. He didn’t overdo, sleeping late, eating good food with pleasure, walking about the farm. He saw a few patients every afternoon.

  Still, he had to become reaccustomed to the good life. On the seventh day he was home, his arms and legs ached and his back hurt. He laughed, and told Sarah he wasn’t used to sleeping in a bed.

  He was lying in the bed in the early hours of the morning when he felt the flutter in his stomach and tried to ignore it, because he didn’t want to get up. Finally he knew he had to, and he was halfway down the stairs when he began to lurch and run, and Sarah awoke.

  He didn’t make it to the outhouse, but stepped off the path and squatted in the weeds like a drunken soldier, grunting and sobbing as it burst out of him.

  She had followed him downstairs and out, and he hated it that she came upon him like that. “What?” she said.

  “Water … on the train,” Rob J. gasped.

  He had three more episodes during the night. In the morning he dosed himself with castor oil to clean the illness from his system, and when the malady was still on him that evening, he took Epsom salts. The following day he began to burn with fever, and terrible headaches started, and he knew what ailed him even before Sarah stripped him to bathe him that evening and they saw the red spots on his abdomen.

  She was resolute when he told her. “Well, we’ve nursed people with typhoid before and pulled them through. Tell me of the diet.”

  It made him nauseous to think of food, but he told her. “Meat broths, cooked with vegetables, if you can get some. Fruit juices. But this time of year …”

  There were still some apples in a barrel in the cellar, and Alden would crush them, she said.

  She kept herself busy, preferring to work so she wouldn’t worry, but in another twenty-four hours she knew she needed help, because she had been able to sleep only a little, what with bedpans, and constantly changing him and bathing him to fight the fever, and boiling fresh laundry. She sent Alden to the Catholic convent to request the help of the nursing nuns. A pair of them came—she had heard they always worked in pairs—a young baby-faced nun by the name of Sister Mary Benedicta and an older woman, tall and long-nosed, who said she was Mother Miriam Ferocia. Rob J. opened his eyes and saw them and smiled, and Sarah went to the boys’ room and slept for six hours.

  The sick chamber was kept orderly and sweet-smelling. The nuns were good nurses. When they had been there three days, Rob J.’s temperature dropped. At first the three women rejoiced, but it was the older one who showed Sarah when the stools began to get bloody, and she sent Alden riding to Rock Island for Dr. Barr.

  By the time Dr. Barr arrived, the stools were almost wholly composed of blood, and Rob J. was very pale. It was eight days since the first crampy onset.

  “It moved very quickly,” Dr. Barr said to him, as if they were at a meeting of the Medical Society.

  “It does that at times,” Rob J. said.

  “Perhaps quinine, or calomel?” Dr. Barr said. “Some believe it’s malarial.”

  Rob J. indicated that quinine and calomel were useless. “Typhoid fever isn’t malarial,” he said with effort.

  Tobias Barr hadn’t done as much anatomy work as Rob J., but they both knew the severe hemorrhaging meant the bowels were riddled with perforations caused by the typhoid, and the ulcers would become more pronounced, not better. It wouldn’t take many hemorrhages.

  “I could leave some Dover’s powders,” Dr. Barr said. Dover’s powder was a mixture of ipecac and opium. Rob J. shook his head, and Dr. Barr understood that he wanted to be conscious as long as possible, in his own room, in his own house.

  It was easier for Tobias Barr when the patient knew nothing, and he could leave hope in a bottle, with instructions about when to take it. He patted Rob J.’s shoulder and allowed his hand to stay there for a few moments. “I’ll come by tomorrow,” he said, his face composed; he had been through this so many times before. But his eyes were heavy with regret.

  “Can we not help you in some other way?” Miriam Ferocia asked Sarah. Sarah said she was a Baptist, but the three women knelt for a time in the hallway outside the bedchamber and prayed together. That evening, Sarah thanked the nuns and sent them away.

  Rob J. rested quietly until sometime before midnight, when he had a small bloody flow. He had forbidden her to allow the minister to visit, but now she asked him again if he would like to talk to the Reverend Blackmer.

  “No, I can do it as well as Ordway,” he said clearly.

  “Who is Ordway?” she asked, but Rob J. seemed too tired to answer.

  She sat by his bed. Soon he reached out his hand and she took it, and both of them fell into a light sleep. Just before two A.M. she awoke and at once was aware of the coolness of his hand.

  For a time she sat with him, and then she made herself get up. She turned up the lamps and then washed him for a final time, rinsing away the last large hemorrhage that had taken his life. She shaved his face and did the things he had shown her how to do for others down through the years, and then she dressed him in his best suit. Now it was too large, but she knew it didn’t matter.

  A good physician’s wife, she collected the linens that were too bloody for boiling and placed them in a sheet, to be burned. Then she heated water and prepared a bath in which she scrubbed herself with brown soap while she wept. By the time day broke, she was dressed in good clothes and seated in a chair by the kitchen door. As soon as she heard Alden pushing open the barn door, she went out to him and told him her husband was gone, and gave him the message to take to the telegraph office, asking her son to come home.

  PART SIX

  THE COUNTRY DOCTOR

  May 2, 1864

  58

  ADVISERS

  It was remarkable that when Shaman awoke he was assailed by two such contradictory emotions: the quick and bitter flood of reality that Pa was gone, and the familiar securit
y of home, as if every part of his body and mind had been milled with this place in mind and easily slipped into its vacancy and filled it in perfect comfort. The shuddering of the house before a sudden wind from the plains was a sensation he knew, the feel of the pillow and rough sheets on his skin, the breakfast scents that drifted up the stairway and lured him down, even the familiar glitter of the hot yellow sun in the dew of the backyard grass. When he left the privy he was tempted by the path to the river, but it would be several weeks yet before it was warm enough to swim.

  As he returned to the house, Alden came out of the barn and motioned for him to stop. “How long will you be staying, Shaman?”

  “I’m not certain, Alden.”

  “Well, thing is. There’s a heap of pasture barriers to be planted. Doug Penfield already plowed the strips, but we’re late dealin with the spring lambs and a dozen other things, what with every thin that’s happened. I could use a hand from you plantin the Osage orange. Mebbe it’ll take you four days.”

  Shaman shook his head. “No, Alden, I can’t.”

  When he saw the look of annoyance on the old man’s face he felt a guilty need to explain, but he resisted it. Alden still regarded him as the boss’s younger boy to be told what to do, the deaf one who wasn’t quite as good a farm worker as Alex. The refusal constituted a change in their status, and he tried to soften it. “Maybe I can do some work on the farm in a couple of days. But if not, you and Doug are going to have to manage by yourselves,” he said, and Alden turned away with a sour look.

  Shaman and his mother exchanged guarded smiles as he slid into his chair.

  They had learned to talk safely of unimportant things. He complimented her on the farm sausage and eggs, cooked perfectly, a breakfast he hadn’t had since he’d left home.

  She remarked that she’d seen three blue herons yesterday on her way to town. “I believe they’re more numerous this year than ever. I think perhaps they’ve been frightened away from some other places by the war,” Sarah said.

  He had been up late with his father’s journal. There were questions he would have liked to ask her, and he knew it was sad that he couldn’t.

  After breakfast he spent time with his father’s patient records. Nobody had kept better medical records than Robert Judson Cole. Bone weary or not, his father always had completed his records before going to bed, and now Shaman was able to make a careful list of all the people his father had treated in the few days after his return.

  He asked his mother if he could have the use of Boss and the trap for the day. “I want to call on the people Pa visited. Typhoid fever is such a spreadable disease.” She nodded. “It’s a good idea to take the horse and buggy. What of your lunch?” she asked.

  “I’ll just wrap a couple of your biscuits and carry them in my pocket.”

  “He often did that,” she said in a low voice.

  “I know he did.”

  “I’ll pack you a lunch.”

  “If you want to, Ma, that’ll be good.”

  He went to her and kissed her on the forehead. Sarah sat without moving, but she took her son’s hand and held it tightly. When finally she let go, Shaman was struck again by how beautiful she was.

  The first place he stopped was at the farm of William Bemis, who had injured his back delivering a calf. Bemis was limping about with a wry neck but said his back was better. “I’m about out of the stinky liniment your daddy left me, though.”

  “You been having any fever, Mr. Bemis?”

  “Hell, no. Just hurt my back, why would I have a fever?” He frowned at Shaman. “You chargin me for this visit? I didn’t send for no doctor.”

  “No sir, no charge. Glad you’re feeling better,” Shaman said, and threw in a refill of the stinky liniment so he could leave the patient happy.

  He tried to include stops he knew his father would make just to say hello to old friends. He reached the Schroeder place a little bit after noon. “In time for dinner,” Alma told him cheerfully, and pursed her lips in disdain when he told her he was carrying a lunch.

  “Well, you just bring it in, eat it while we have ours,” she said, and he did, happy for the company. Sarah had given him cold sliced lamb, and a baked sweet potato, and three biscuits sliced open and spread with honey. Alma brought out a platter of fried quail and peach turnovers. “You’re not gonna pass up the turnovers I made with the last of my preserves,” she said, and he had two, and a helping of the quail.

  “Your pa knew better than to carry in a lunch when he came to my house, dinnertime,” Alma told him scornfully. She looked him full in the eyes. “You gonna stay in Holden’s Crossing now, do our doctoring for us?”

  It made him blink. It was a natural question, a question he should have been asking himself, the one he’d been avoiding. “Why, Alma … I haven’t given it much thought,” he said lamely.

  Gus Schroeder leaned forward and whispered to him, as though conveying a secret, “Why don’t you think about it?”

  Midafternoon, Rob J. was at the Snow place. Edwin Snow raised wheat on a farm on the northern edge of the township, about as far as one could get from the Cole farm and still be in Holden’s Crossing. He was one of those who’d sent for Doc Cole when word got out he was back, because Ed had had a badly infected toe. Shaman found him walking around, no trace of a limp. “Oh, the foot’s fine,” he said cheerfully. “Your father had Tilda hold it while he slit it open with his little knife in his good hand, steady as a rock. I soaked it in salts like he said to, to draw out the stuff. Funny thing you should come by today, though. Tilda’s feelin poorly.”

  They found Mrs. Snow feeding the chickens, looking as though she didn’t have the strength to throw the corn. She was a big heavyset woman with a flushed face, and she admitted to being “a mite warm.” Shaman saw at once that she had a high fever, and he sensed her relief at being ordered to bed, although she protested all the way back to the house that it wasn’t necessary.

  She told him she had had a dull pain in her back for a day or so, and her appetite was off.

  Shaman was apprehensive, but he forced himself to speak easily, telling her to get some rest, that Mr. Snow could care for the chickens and the rest of the critters. He left them a bottle of tonic and said he’d drop in on them next day. Snow tried to argue when he refused payment, but Shaman was firm. “No charge. It’s not as though I’m your regular doctor. I’m just passing through,” he said, unable to accept money to treat an illness she might have caught from his father.

  He made the Convent of Saint Francis Xavier of Assisi his last stop for the day.

  Mother Miriam seemed genuinely happy to see him. When she asked him to sit, he chose the straight-backed wooden chair he’d sat on the few times he’d come to the convent with his father.

  “So,” she said. “You are looking about your old home?”

  “I’m doing more than that today. I’m trying to see if my father may have given typhoid fever to anyone else in Holden’s Crossing. Have you or Sister Mary Benedicta displayed any symptoms?”

  Mother Miriam shook her head. “No. Nor do I expect that we shall. We’re accustomed to nursing people with all kinds of diseases, as your father was. Probably you are the same way now, Ja?”

  “Yes, I think I am.”

  “I believe the Lord looks after people like us.”

  Shaman smiled. “I hope you’re right.”

  “Have you treated a good deal of typhoid in your hospital?”

  “We’ve seen our share of it. We keep people with transmissible diseases in a separate building, away from the others.”

  “Ja, that is sensible,” she said. “Tell me about your hospital.”

  So he told her about the Southwestern Ohio Hospital, beginning with the nursing staff because she would be interested in that, and then moving into the medical and surgical staff, and pathology. She asked good questions that drew him out. He told her of his work in surgery with Dr. Berwyn, and in pathology with Barney McGowan.

  “
So you have had good training, and good experience. And now what? Will you stay in Cincinnati?”

  Shaman found himself telling her what Alma Schroeder had asked him, and how unprepared he’d been to answer the question.

  Mother Miriam looked at him with interest. “And why do you find it so hard to answer?”

  “When I lived here, I always felt incomplete, a deaf boy growing up among people who could hear. I loved and admired my father and wanted to be like him. I yearned to be a doctor, worked and struggled, although everyone—even my father—said I couldn’t achieve it.

  “The dream always was to become a doctor. I’m already beyond where the dream ended. I’m no longer incomplete, and I’m back in the place that I love. To me, this place always will belong to the real doctor, my father.”

  Mother Miriam nodded. “But he is gone, Shaman.”

  Shaman said nothing. He could feel the thudding of his heart, as if he were receiving the news for the first time.

  “I want you to do something for me,” she said. She pointed to the leather chair. “Sit over there, where he always sat.”

  Reluctantly, almost stiffly, he rose from the wooden chair and sat in the upholstered one. She waited a moment. “It is not so uncomfortable, I think?”

  “It’s quite comfortable,” he said steadily.

  “And you fill it very well.” She smiled slightly and then gave him advice that was almost identical to what Gus Schroeder had told to him. “You must think about it,” she said.

  On the way home he stopped by the Howard place and bought a jug of whiskey. “Sorry about your pa,” Julian Howard muttered uncomfortably, and Shaman nodded, aware that neither man had had any use for the other. Mollie Howard said she figured that Mal and Alex had made it into the Confederate Army, because the Howards hadn’t heard a single thing from Mal since the boys had run off. “I figger if they was anywhere this side of the war line, one or the other would of sent word home,” she said, and Shaman told her he thought she was right.