Mrs. Clark’s lips pressed together, and her forehead wrinkled deeply. “He was dragging a bit this morning when he left for school. But he didn’t have a fever. He also didn’t have much of an appetite, now that I think on it. He hardly ate.”
So the Clark boy might be infected as well. “Andrew said Georgette Abbott was ill. Do you know if she has developed the rash?”
“I don’t know.”
Miriam frowned. “Are any of the other Abbott children ill?”
“Georgette is the only one too young for school. All the other children walked with my Frank this morning.”
“To school?”
Mrs. Clark nodded.
Goodness gracious. This may be at the school. “Mrs. Clark, may I have a word?”
They stepped across the room. Miriam wasn’t entirely certain of everything that needed to be done, but her absolute first step had to be gathering more information.
“It doesn’t look like measles,” Mrs. Clark said.
“It isn’t.” Miriam wished it were.
Mrs. Clark took a shaky breath. “I kept hoping somehow it was. Measles is bad, but it’s not as terrifying as what I’m afraid this is.”
“I believe you already know what we’re facing.”
“Scarlet fever.” Hers was a shaky, horrified whisper.
“Scarlet fever isn’t only dangerous.” Miriam held the woman’s gaze. “It is also catchy. No one quite knows how it spreads, only that it does, and does so like wildfire. Your oldest has likely contracted it as well, which means it may be all over the school by now. I need to get to town, but I cannot abandon your children here when they are ill, especially if it has spread to your neighbors.”
Mrs. Clark, to her credit, remained calm.
“Is your husband home?”
“He’s in the fields.”
“Fetch him so he can help get your children to town. Then I need you to go to the Abbotts’ and see if they have thrown a rash yet. If they have, send them to Dr. MacNamara’s home in town.”
Mrs. Clark agreed. She gave her girls a forced smile and wave and hurried out of the house.
Miriam wiped all traces of worry from her expression. She kept herself calm while the wagon was hitched and the girls set in the wagon bed as they drove to town. She held silent despite her spinning thoughts.
Scarlet fever. Heaven have mercy on us.
She had only just tucked the girls into bed at Gideon’s home when Cade arrived. She explained the situation to him in hushed tones near the top of the stairs.
“Am I needing to quarantine the town?”
“Not yet. But I need to see if it is at the school.”
“You believe it is.”
There was no keeping secrets from the man. “I am convinced of it. If I find even one child with this, especially one who is already throwing the rash, then we have to assume every child in the school is ill, even if he or she isn’t exhibiting symptoms yet.”
Cade gave a decisive nod. “That is where the quarantine has to be applied. To the children.”
“Precisely. All the medicine they need is here, so bringing them here makes the most sense. Since we don’t know where this illness is originating or precisely how it spreads, isolating those who are infected is our best option.” She pushed through her growing worry. “The disease is known enough, and feared enough, that parents will understand the necessity, but I know they will worry, especially with Gideon gone. They’ll want to be with their children, but there will not be room.”
“Don’t fret over the parents,” Cade said firmly. “They can be kept calm. What else do you need?” He certainly had a cool head in a crisis.
“Someone should check on the families who live a little further afield,” she said. “If this has reached that far out and they need medical attention—” She shook her head. “And we must warn those further away not to come to town until this has passed.”
Cade straightened his hat. “Don’t waste a single thought on anything other than doctorin’. You’ve a sheriff, a deputy, and two of the finest members of the marshal service in this town who’ll see to the rest.”
Hawk was quickly pressed into service, assigned to accompany Miriam to the schoolhouse. Cade headed to the jailhouse to update Andrew and Paisley and come up with a plan. Depending on what Miriam found, they might quickly be in a sticky situation.
“I lost two brothers to scarlet fever,” Hawk said as he and Miriam turned toward the school. “It is a fearsome opponent to face down.”
Miriam understood that well. She had acted as nurse for patients who’d contracted the deadly illness. She remembered all too vividly. The fever. The rash. Too many didn’t survive.
“I keep telling myself I’m not going to find anything worrisome at the school,” she said.
“But?”
She let out the tiniest of breaths. “I know I will. I know it.”
They stopped at the bottom of the steps, looking up at the schoolhouse door. “We’d best put on our most casual expressions,” Hawk said. “No use panicking the children the moment we walk in.”
“Their parents will panic enough when they hear the words ‘scarlet fever.’ I can only hope Miss Dunkle is made of sterner stuff.”
They climbed the steps and slipped inside the already open door.
Miss Dunkle, her hand on the back of a student whose head was laid on his desk, looked up as they entered. Not a moment’s confusion or surprise crossed her features. She looked utterly relieved.
“I don’t know how you knew,” Miss Dunkle said, “but I’m glad you did.”
That did not bode well. “How many children are ill?” Miriam asked.
“We’re at five now, though a few of the others are beginning to pale.”
Miriam did a quick visual inspection. A good number of children did, indeed, look less than well. “Who’s the worst off?”
She indicated the student directly beside her. “Frank Clark.” The boy kept his head on his desk.
Miriam caught Hawk’s eye. If the boy was too weak, she might need Hawk’s help examining him.
She knelt beside Frank. And there it was: the beginnings of the scarlet rash on his face. She undid the top button on his shirt and, as she’d feared, saw that the rash was on his chest as well.
A quick inspection of the other children who were feverish and sluggish revealed two more already showing the rash. Amongst the rest of the students, nearly all had sore throats or general feelings of being unwell. Some of that might have been worry manifesting itself as illness, but Miriam wasn’t about to take chances.
Miss Dunkle pulled her aside. “I know what that rash is, Nurse Bricks. This is no small thing.” She wrung her hands. “Why did Dr. MacNamara have to leave? Now, when we need him so much?”
“You aren’t entirely without help,” Miriam reminded her. “I have years of training and experience with this disease. I’ll do all I can.”
Miss Dunkle’s expression grew more worried. “You cannot possibly replace the training and experience of an actual doctor.”
“I didn’t—”
“You cannot promise me all of these children are going to be fine. I know you cannot.”
“Not even Dr. MacNamara could promise you that.” Miriam told herself to be patient. Behind Miss Dunkle’s critical words was an undeniable worry. She loved the children in her charge, and she was afraid for them. “Still, I have every intention of doing what I can to get word to him so he can decide what’s best to be done. Until then, I am all you have. And these children need to feel your confidence.”
Miss Dunkle nodded feebly.
“Now, rally the troops. We’re going to walk them to Dr. MacNamara’s house.”
Miss Dunkle hesitated. “I don’t know that Frank has the strength.”
“Hawk will see to Frank.�
�� Miriam knew she could make that vow with surety. Hawk wouldn’t leave a person suffering without doing all he could to help.
Miss Dunkle had the children organized and moving in orderly fashion down the street in no time. Miriam watched them all, noting which seemed healthiest and which were the most likely to throw spots soonest. At least half of them already had symptoms. How many more would by nightfall?
Chapter 26
“What do you mean he is not coming back?” Mrs. MacNamara’s usually cultured voice had turned decidedly shrill.
“He can’t leave Quarterville until he knows the patient he operated on is out of danger,” Hawk explained again.
Miriam had felt the same drop of her heart that had no doubt inspired Mrs. MacNamara’s outburst, but right on its heels had come the knowledge that Gideon was absolutely correct. He had to tend to his patient before he could come home.
She was sorely tempted to drop onto the sofa and allow herself some much-needed rest. But she firmly suspected if she permitted herself even a moment’s respite, she would never convince herself to get up again.
The instructions Gideon had sent back with Hawk hadn’t included anything she didn’t already know, but holding the note brought her reassurance. It was proof she’d been doing the right things in treating the children. It was a link to him and the calm confidence he exuded. And it brought the increasingly familiar warmth of his affection. He had, after all, taken the time to remind her to think of her own health as well.
“People will die without a doctor here,” Mrs. MacNamara insisted.
Miriam put Gideon’s note in the pocket of her apron and squared her shoulders. “People die of this even with a doctor.” It was the harsh reality of scarlet fever, and one they would all do well to accept. The coming days and weeks were going to be harrowing. “Gideon sent instructions, and they are exactly the things we have already been doing. The same treatments, the same approach.”
“We have been taking that approach for four days,” Mrs. MacNamara said. “The Clark children are growing worse almost by the minute.”
Miriam kept her posture confident despite the worry clutching her heart. “We are doing everything possible.”
Paisley and Cade were firmly on Miriam’s side of things. Tansy had also fallen in line with what Miriam had asked of her the last few days. Hawk gave Miriam a nod of encouragement.
She took a deep breath and pressed ahead. Their work was far from done, and they couldn’t waste more time on discussions. “We’ll keep taking it in turns. Two people sleeping at a time, with the others split between here and the jailhouse. Either Paisley, Cade, or Hawk will be on duty so someone can patrol the town and enforce the quarantine.”
Only Mrs. MacNamara shook her head in disagreement. “Marshal Hawking should go to Quarterville and tell Gideon to come home.”
Miriam was exhausted and keeping calm was not easy. “If he leaves Quarterville, his patient will have no one.”
Mrs. MacNamara tilted her chin upward. “We have no one.”
“We have me. I will have to be enough for you and enough for this town.” She was far too close to losing her temper. She dare not risk it. “Mr. MacNamara, I believe you and your wife are the next to be granted a few hours of sleep.”
He seemed to understand the urgency in her suggestion and quickly ushered his wife upstairs.
“Pais and I will head back to the jailhouse,” Cade offered.
So many were ill with the fever that they couldn’t all be accommodated at Gideon’s house.
“Tansy and Hawk, will you check on the patients here?” she asked once the O’Briens had left. “I will move between the two locations, helping where I’m most needed.”
Neither of them left to follow her instructions.
“When do you sleep, Miriam?” Hawk asked.
It was concern, not distrust, that made them hesitate. “In two more rotations,” she said. “Provided no new patients arrive, no new rashes appear, and no one—” Pain clutched at her heart. “And no one slips into convulsions.” Not that she could actually help at that point, but she would not allow anyone to suffer those final moments alone.
“I’ll check in on the first room.” Hawk slowly climbed the stairs.
Tansy remained behind. “How’re you holding up, Miss Miriam? No signs of an upcoming episode?”
“None,” Miriam said, grateful that Tansy had waited until they were alone to ask. “Though that is no guarantee.”
“Don’t work yourself into illness,” Tansy said. “That’d help no one, least of all you.”
Between Tansy and Gideon, she was being fretted over endlessly. She ought to have been annoyed, but instead found it touching.
She wandered into the kitchen, needing a moment to collect her thoughts and rally her courage. The coming hours and days would be brutal.
She pulled her sketchbook from its shelf and clutched it a moment. Could she allow herself a moment, even a brief one, to draw, to calm herself, to focus her mind once more? Could she afford not to?
Her eyes closed, she lowered herself to the floor, sitting with her knees up, the same pose she’d assumed so many times in her cell at Blackburn.
With a deep breath, she opened her eyes, untied the leather strap of her book, and turned to a new page. Quick strokes soon formed the familiar shape of Rupert’s face, his eyes not worried as they’d been in her first sketch of him. This time, they were feverish, cloudy. A lump formed in her throat as she shaded in the rash that had appeared on his face that morning. The horrid, terrifying rash.
She loved that sweet boy. What if she couldn’t save him?
Miriam hadn’t slept more than a few minutes in the past forty-eight hours. The Clark children were approaching the crisis point. She expected it to happen any moment. They needed her. She was all they had. The parents of her dozens of young patients were gathered at the reverend’s home, praying and hoping.
She pulled a length of bandaging from the armoire in Gideon’s room as Mrs. MacNamara stepped inside. Much of the woman’s blustering had dissipated, and now she looked at the children with true compassion and even spared a concerned glance for Miriam.
“I’ve been sent to tell you that you are overdue for a rest,” Mrs. MacNamara said.
“I can’t.” Miriam set the bandaging on the end table and worked to get the sling off her own arm. “The situation has grown dire. I might be able to save these children, but only if I’m awake.”
She bit back a groan of pain when her arm dropped from its position. If she could keep her upper arm near her side, it would hurt less, but the task would require another set of hands.
“I need your help,” she told Mrs. MacNamara. “I need to use this”—she held up the bandaging—“to secure my upper left arm to my side by wrapping the cloth around me, under my right armpit. I need help tying the knot.”
Mrs. MacNamara shook her head. “I’ve never tied any kind of important knot.”
Miriam had always found Mrs. MacNamara unsympathetic, above her company, uncooperative. But now she heard something new in the woman’s objections—an almost crippling lack of confidence. That was something she could relate to.
“Even a bow will do. It only needs to keep my arm still.”
“Wasn’t that the reason for the sling?”
“I need more use of my hand than the sling allows.” Miriam wrapped the bandage around herself, wincing with each stab of pain. She clutched the two ends of the bandage in her hand. “Will you tie it for me, please? There isn’t a particularly right or wrong way, I promise.”
Mrs. MacNamara’s fingers shook as she worked. “Do you need it tight?”
“Yes, as tight as possible.”
Another nod. More finger shaking. Was all of her blustering an attempt to hide her uncertainty? How many people hid behind such things?
“Will
that do?”
Miriam tried moving her arm. It held fairly still. That would do for now. “Thank you.”
She stepped out and made her way swiftly down the corridor to the room where the Clark children rested. Hawk bent over their forms, dabbing their foreheads with damp cloths.
“Any change?” she asked as she crossed to them.
“They ain’t moving around as much.”
“How have they been moving?” Surely she would have been sent for if they’d begun convulsing. With scarlet fever, once that started, there was no saving them. It was the violent throes of unavoidable death.
“Like they’re uncomfortable. Moaning and such.” Hawk’s brow pulled in worry, but he was calm, as always. She needed that from him.
The Clarks looked bad off. All three had been shaved that morning, cool cloths kept on their bare heads at all times, but it wasn’t helping. They weren’t breathing well, and their fevers were raging. They’d stopped vomiting, but likely because they had nothing left in their stomachs.
Miriam turned back to the doorway where Mrs. MacNamara stood. “I need ice. Their fevers have to come down.”
She rushed off. The trip to the town ice cellar was one made often these past days. The task, in fact, had been given to the anxious parents waiting for word of their children. A shout was issued from Gideon’s porch, and people rushed to the cellar, returning and leaving the ice on the steps.
Miriam would have more as quickly as the town could manage. She only hoped it would be enough, and that it would arrive in time.
Andrew appeared in the doorway next.
“Pour cups of water,” she said. Her arm wasn’t reliable enough for making the attempt. “If we can get them to drink, it’ll cool them from the inside.”
Andrew did as instructed without question or hesitation.
Miriam grabbed one of the damp rags and began sponging water on the children’s limbs.
She paused her ministrations long enough to check the chart on the bureau where she’d kept a record of the medicine she’d given. It wasn’t time for more. She prayed that what medicine she had been able to deliver was doing its job inside the children’s fever-ravaged bodies.
Healing Hearts Page 17