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I did not bother going back to the office but decided to wander over the sisters to see if they had anything new from their research. I took a trolley to Southeast and hopped off early. It was a beautiful summer day, and it would do me good to walk. It was a pretty neighborhood with many trees and well-kept gardens. I planned to walk through the College campus to their house.

There were few people out enjoying the day as I walked in the darkening evening across campus. I zoned away, lost in no thought.

I was startled to find someone who had come up alongside me.

“Mr. Bruno,” he said with a nod.

I stopped walking, and he moved on a few paces. A nondescript man in nondescript clothes, I had no idea who he was. He gestured with his head.

“Let’s keep walking,” he said. “I am not here to rob you or any other…” He paused and smiled. “Nefarious acts. I am just here to pass on some information.” He swept his right arm forward. “Join me?”

I hesitated for a moment, then joined him, walking a bit slower, ready to bolt if needed. “And you are?” I said.

“No one of importance. An errand boy. I have been asked to pass on congratulations. Unofficial congratulations, of course. It has been noted that you have likely solved the riddle of the Cholera. Saved lives. Prevented a lockdown of the city. Embarrassed the Societies. All in two weeks’ time. There are those who are quite pleased with the turn of events. There may be attempts at adverse repercussions because of your actions. Those attempts will almost certainly go nowhere. It is recognized what you have done the city and the Empire a great service, and you will be rewarded. Thank you.”

And with that, he abruptly turned around and walked off. I kept going, more than a little astonished. I was certain crossing swords with the Societies would end in personal disaster. Now I was assured that, if anything, I would be protected from any fallout. Who knew?

I continued to the sisters and knocked on the door. It was Cassandra who again opened the door.

“What a surprise,” she said. “The hero of the hour. Were you expected?”

“No,” I said. “I have been a little aimless today. I thought I would wander here on the off chance you all had some new information.”

“Timely,” she replied. “We have just completed a run with the UKM and do have some new, albeit preliminary, information.”

She opened the door wide.

“Come on down.”

I followed her to the UKM room, and the sisters looked up as I entered.

“Perfect,” said Grace. “I was going to send a telegram to invite you over to see our latest results.”

“Oh?”

“Yes, I’ll let Cassandra explain. It was her idea, after all.”

I looked over to see her actually blush.

“It was our idea,” Cassandra said.

“Cass,” said Grace. “Credit where credit is due. It was your idea, and you did much of the work. Tell him.”

“I thought, what if we could represent the Cholera outbreak as a mathematical model, so we could predict what will happen under different situations. For example, what would happen if there were a treatment that was fifty percent effective, or ninety percent? Or how contagious is a cup of pump water? One hundred percent? Fifty percent? And so on. We made a mathematical representation of the Cholera based on these and other factors.”

“First, the representation had to accurately represent what has occurred in the past. Only then could we use it for predictions. So here are the results of the model.”

She showed me a graph of cases and deaths.

“It matches the known outbreak perfectly.”

“If nothing were done, people kept drinking the water from the pump, here is what we would see. The cases and deaths would increase exponentially. Of course, that is not going to happen as the disease would run out of people to sicken because they would die or leave the city. We assumed a twenty percent death rate.”

“If the saltwater treatment lowers the death rate to 1%, 5% or 10%, we get these curves. And if you shut down the source? You get these curves.”

“And combine the treatment with the boiling water and the pump shut down? Starting on day 7 of the epidemic?”
 

“As you can see, your discoveries should shut down the Cholera very rapidly. Assuming people comply and do three simple things. Boil water, avoid the Kenton pump water, and take the saltwater cure if they get ill.”

“One of three has happened,” I said. “Someone disabled the Kenton pump. No one will be drinking from it anytime soon.”
 

“Are you that someone?” asked Cass.

“Nope.”

“Good,” she said. “One down, and, with the River Weekly report, likely two others as well. The only issue is whether or not people can get the Cholera from some other source, like each other. It is suggested by the data that somewhere around twenty percent of cases have the source of the Cholera unaccounted for. If person-to-person spread were the case, we could potentially see a smaller, sustained outbreaks, as we might see in Lake Oswego and down the river. And there are the Homeopathic nosodes leading to the occasional outbreak. I hope no one continues to offer the Cholera nosodes.”

“But person-to-person spread could lead to outbreaks, and our model parallels the current outbreak nicely. If that is the case, we may get rid of the Portland outbreak, but continue with peripheral outbreaks scattered around the city that may continue until the winter.”

I looked at the graphs for a while, thinking about what they meant. The Cholera is more controlled than eradicated. Still, better than the alternative. A few cases were better than a deluge.

“This is great work,” I said. “Absolutely amazing. Can I have these?”

“Of course,” said Grace. “We thought you would like them.”

“Anything else I should know,” I asked.

“Not that I know of,” said Cass.

“Then, I will see you tomorrow. I’m tired.”

With the graphs gripped tightly in my hands, I left for the home.

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  • Mark Crislip, MD has been a practicing Infectious Disease specialist in Portland, Oregon, from 1990 to 2023. He has been voted a US News and World Report best US doctor, best ID doctor in Portland Magazine multiple times, has multiple teaching awards and, most importantly,  the ‘Attending Most Likely To Tell It Like It Is’ by the medical residents at his hospital. His multi-media empire can be found at edgydoc.com.

Posted by Mark Crislip

Mark Crislip, MD has been a practicing Infectious Disease specialist in Portland, Oregon, from 1990 to 2023. He has been voted a US News and World Report best US doctor, best ID doctor in Portland Magazine multiple times, has multiple teaching awards and, most importantly,  the ‘Attending Most Likely To Tell It Like It Is’ by the medical residents at his hospital. His multi-media empire can be found at edgydoc.com.