If you are stumbling upon this, the novel begins here.

Chapter 2a

I awoke at 5:30 a.m., earlier than I wanted. When I had arrived home the prior evening, there had been a telegram in the mailbox:

18 June 2017. 8:45 p.m.

Report to work at 7. High Priority.


Bosworth was Joseph Bosworth, the Commissioner of the Oregon Ministry for Social Hygiene, and my immediate boss. He reports directly to the Governor. There is nothing quite like the anxiety of your boss calling an early morning meeting to snap you awake before the alarm.

The Cholera had to be bad if they wanted me to report to work two hours early. That meant overtime, and the Ministry most definitely did not like authorizing overtime. But I am a servant of the Crown and being a servant does come with a few benefits. Like overtime.

I grabbed a hot tea and biscuit at the corner tea house and sat down on the streetcar to read the Oregon Journal. Today they had a front-page editorial that was surprisingly direct.

The Cholera Continues

Cases Mount in Kenton

20 Dead

No Cure in Sight


Portland — The Cholera continues in the Kenton Neighborhood of N.E. Portland, now totaling 20 dead and 44 cases. Included in yesterday’s deaths were three children and two adults.

As of this morning, both the Crown and the Medical Societies had no comments concerning the outbreak, although press conferences are scheduled for later today by both the Oregon Ministry for Social Hygiene and several of the Medical Societies.

There remain many unanswered questions about the Cholera: its cause, its treatment, its prevention, and its origin. The public is anxiously awaiting guidance from experts, both public and private, to help us in our battle against the Cholera, fearing a repeat of the outbreak of 1999 with its 2341 deaths.

But as of this morning, none has offered practical recommendations to combat the Cholera and prevent its spread. The current suggestion of avoiding hot, humid air is of uncertain utility and impractical as it amounts, in summer, to suggesting not breathing, an option only available to the dead.

The citizens of Portland and its surrounding communities are understandably concerned. The Cholera has attacked a community with no preparations and few resources to cope with what could be a repeat of the outbreak of 20 years ago. With a population that has almost doubled in the last two decades, the potential for a catastrophic outbreak of the Cholera, with thousands of deaths, is a real possibility.

The time to act is now. There needs to be coordination of the Crown and the Medical Societies. If they work in concert and in good faith, perhaps this scourge can be stopped in its infancy.

The citizens of Portland need answers, and we need them now.

The Editorial Board

That was unexpected. The Journal is the newspaper of the status quo, a relatively conservative daily that usually supports Crown and Tory policy. I had to wonder what led to such a strong, confrontational editorial. It was out of character unless there was some pressure from above. It was going to make my work more, let’s say, interesting than I would like it—nothing like encouragement from the press and, indirectly, from the Crown.

I made it to the office a few minutes early. The Multnomah County Division of the Oregon Ministry for Social Hygiene was not a large organization—me, two other scholars, three nurses, and two support staff. For a city of 320,000, we are far too few.

Childhood epidemics and sexually transmitted diseases are our primary responsibilities. The former because a century ago the Crown Prince died of the Measles, so the King became concerned about the Measles, although interest has faded with subsequent Royal generations. Our central role is in enforcing quarantine and contact tracing, which is valuable in controlling childhood epidemic diseases. I did not know if the quarantine would help with the Cholera. The quarantine had been used in the 1999 outbreak, but its effectiveness was uncertain. The quarantine was the only tool we had at our disposal, so we used it. We do what we do because we did it. Except for the addition of using contact tracing to apply the quarantine, the Ministry had no authority to investigate, treat, or otherwise be involved with disease outbreaks.

We were also involved with sexually transmitted diseases, primarily investigation and contact tracing. This was in part due to the sensitive nature of these diseases. The Societies did not want to be involved with telling a wife that her husband had lues or the clap. And they were never referred to as sexually transmitted or venereal diseases. There preferred term was VC, short for Venus’s Curse. We found the cases and referred the victims to the appropriate Society for therapy.

Although not known to the public, our involvement in VC was also due to Royal interest, mostly, it is said, because of widespread syphilis in the Royal family. I couldn’t vouchsafe the truth of that rumor. But it seemed a reasonable hypothesis given some of the behaviors occasionally reported in the press.

We were also responsible for Variolation. A century ago, Jenner had demonstrated that cowpox inoculation prevented the Smallpox, and it became the responsibility of Public Health officials, although we still did not how Variolation worked or the cause of the Smallpox. The Societies had never claimed the right to provide Variolation, perhaps as Variolation did not fit into their respective Philosophies. Every Medical Society had a different cause of Smallpox that predated Variolation, and they were always averse to change when the occasional new idea about disease arose. In fact, no one knew of any change in any Medical Society’s approach to disease in living memory. All new approaches to disease originated in the Guilds. Several years ago, the Naturopathic Society started to question the validity and safety of Variolation, but it is rumored that Crown gave them a gentle talking to and Variolation denial ceased.

Then there were the occasional emergencies, unexpected outbreaks, or unusual diseases like the Cholera. We get called to help control these maladies since our Ministry is the only one that could apply and enforce the quarantine. We were called in for a botulism outbreak last year that killed eighteen, although I doubt quarantine did much to halt that outbreak, the cause of which was never ascertained.

As I thought about it, while we explicitly did not have the authority to diagnose and treat diseases (it was in the regulations and the Royal Charters for the Societies), those regulations did not explicitly state we couldn’t investigate an outbreak. Contact tracing—identifying those who may have come into contact with an infected person and determining if they contracted the disease—was part of the duties of the Ministry. There was no reason contact tracing could not be applied to the Cholera as it was to Lues or the Measles. No one said we could not do it, so that meant we could. It is always easier to get forgiveness than permission. That reasoning would get me into deep trouble very quickly.

Our office was on the second floor of the city office annex, a 150-year-old red granite building. Which meant the interior was warm in the summer, even in the morning. I climbed the stairs and went to my office. Years before, when the city was smaller, our building had been the central post-office, and we still had some of their equipment and desks. Oak never wears out or goes out of style.

There was a large pile of papers on my desk. A quick glance showed me that most of the papers were case summaries of the Cholera victims. Reading those reports would likely be my first task after the morning meeting.

I picked up the papers and continued down the hall to the conference room, where I was the last to arrive. I glanced at my watch. I was early and quickly took a seat at the front of the room with a nod and a smile at my colleagues.

Joseph Bosworth walked into the room just as I sat down.

Fifty-four, balding, and very nearsighted, he was neither a good boss nor a bad one. A political appointee by the Governor, his goal was, as he liked to remind me, smooth sailing. No controversy, no mess-ups, stay out of the papers. Keep the Governor happy, and if the Governor was happy, then he was happy, and as a result, we would be happy. He accomplished this goal by letting us do our jobs undisturbed. He was ex-Royal Navy, a direct man of few words, he believed that one led by letting competent people do their jobs and removing those who were not. We had (mostly) free rein as long as we did not generate controversy. It was strictly no news is good news.

I was worried that it was about the change. Bosworth cleared his throat unnecessarily to get our attention in the dead quiet room and spoke.

“Thank you all for showing up early. I know it is an imposition to get out of bed at such a miserable hour of the day, but as I am sure you are aware, I would not do so unless it was important. And it is important.”

He paused and cleaned his glasses. “As you are aware, the Cholera has returned. Yesterday we had 15 deaths, and today we have reports of at least another five deaths and an increase in the number of cases. And it is still early in the day. The Governor has given me a simple directive. I will pass that directive on to you. Stop the Cholera.”

We immediately started to talk, and he raised a hand to quiet us. “I know. Not only a simple directive but an impossible one. No one in the history of the Empire has been able to stop the Cholera. He understands that. The Governor, I have noticed, always sets the bar high, but rarely gets angry when no one can jump over it. But we have to try.

“I expect a good effort, and I expect you will fail. The Governor expects the same. But the Cholera is now your only priority, and you might get lucky.

“So, for the duration, you will stop work on VC and the quarantine of childhood diseases. There is no Polio or any of the other illnesses currently circulating, so a change in focus will likely cause little, if any, harm. You will be paid the appropriate overtime, but don’t overdo it. A couple of hours a day should suffice. If needed, we can enlist a few people from the surrounding County Health Ministries as long as they avoid the Cholera. But try and make do with what we have. We have some extra resources, but they are limited. Any questions?”

Did I mention that Bosworth is not a noted motivator? I would sure hate to have had him as my King at Agincourt. St. Crispin’s Day Speech would likely have been short and to the point: “We can’t win but let us fight and die anyway.”

There were no questions.

“Good. Then I leave you to your work.”

We stood to go.

“Jordan. A moment?”

I sat back down as the others filed out. Cassandra Wherton, one of my fellow Collegiates, made a sour face and shook her head as she went past Bosworth.

“I saw that, Miss Wherton,” said Bosworth. “You really must pay more attention to reflective surfaces when you make a face.”

There was no animosity in his tone, and Cassandra at least had the decency to blush. “Sorry, sir.”

After everyone left the room, he shut the door and walked over and sat down next to me. “Jordan.”


“People are going to die, Jordan. Perhaps a lot of people. I lost my first wife in the last Cholera outbreak. It took her only four hours to die from the flux, and there was nothing I could do.”

“I am sorry, sir, I had no idea….”

“Thank you. I still have nightmares about the experience. The helplessness as a loved one dies. No one should have to go through that.”

He paused, searching for words. “The Crown,” he continued, “may seem removed from the daily activities of its citizens. They are not. The Crown is practical and has to be sensitive to the needs of the entire society with a priority of maintaining peace and prosperity. So, they keep an eye on those who may pose a risk to peace and stability. The Crown, as you know, is not keen about any change or new ideas that could threaten the status quo and with it, their authority.”

He paused again. I became very still and could feel my heart in my throat. “Not that we know anyone like that. Still, if there were such a person, I would tell them to be very careful indeed. But people should not die from the Cholera. The Crown is not without sympathy. And sometimes, new ideas are needed to solve problems, but one has to be cautious when revealing their provenance. Sometimes the where of an idea is more dangerous than the idea itself.” He paused again, then abruptly stood up. “Well, the Cholera calls both of us in different ways. Best of luck.”

He walked out of the room, and I sat there for a moment, collecting my thoughts. That had not been expected. He had suggested, however obliquely, that the Crown was keeping an eye on me—on Mary, on us, on the Skeptics—as potential enemies or at least subversives or troublemakers. That was the message. So far, they were doing nothing but watching. And my boss knew that perhaps I had been in contact, albeit indirectly, with the French. And while he did not exactly approve, he apparently wanted me to apply what I have learned from the Continent to the Cholera outbreak. Because his wife died of the Cholera? Because the Crown was sympathetic?

With a sigh, I pushed myself out of the chair to find my legs were a little wobbly.

Now what? I am a Collegiate, an alleged thinker, an administrator, trained at the Imperial College to manage a small part of the bureaucracy that managed the Empire. Being a clandestine subversive was not part of my training or temperament. I am not a spy or some character in a thriller. I am a faceless bureaucrat, a cog in a great machine. Things had just got a whole lot more complicated.

I had a job, no two jobs, to do.

I went back to my office, where I found the rest of the department.

“What did Bosworth want?” Cassandra asked.

“Believe it or not, a little pep talk.”

“And how was that? Are you inspired?”

I gave a thin grin. “A little. He basically repeated that he expects us to get the Cholera under control.”

No reason to tell them that it was to warn me the Crown is watching us.

“Good for him. I’m glad to know someone has confidence in us.”

Cassandra, our newest member, was a remarkably adept Collegiate for someone her age. I suspected it would be only a matter of time before she climbed past me on the institutional ladder, and one day she would be my boss. If only she was not prone to sarcasm.

“Well,” I said. “Nothing ventured, nothing lost.”

I looked at my team. Besides Cassandra, there was Sherman Galloway, the third Collegiate in the department. There were the three nurses, Susan Turney, Helen Finnegan, and Kerri Becker, and the two support staff, Leo Greaves and George Webster.

“So, what do we know?” I asked.

To be continued here.

And if you like this, a good review on Amazon  or Goodreads wouldn’t hurt. Just saying.

Posted by Mark Crislip

Mark Crislip, MD has been a practicing Infectious Disease specialist in Portland, Oregon, since 1990. 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.