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My usual reaction to the clang of the alarm clock. It is a harsh way to be awakened.

6 a.m. Double blech

I showered, dressed, and was out the door in less than half an hour. No messages in the mailbox; I purchased a tea and muffin from a cart along with a copy of the Portland Times. I settled into my seat on the trolley, took a bite of the muffin, and opened the paper. Not good.

Cholera Out of Control

44 dead 110 stricken

Ministry for Social Hygiene to Blame says Homeopathic Society

PORTLAND— The Cholera epidemic is gaining momentum. As of this morning, there have been 110 stricken with the disease and 44 deaths.

The outbreak has wholly baffled the Ministry for Public Hygiene, which is allowing the Cholera epidemic to spiral out of control.

Three days ago, there were only 31 cases and 15 deaths. In the span of two days, the number of cases has tripled, and the number of fatalities has more than doubled. And in this time, all the Ministry for Public Hygiene has accomplished is to put quarantine signs on the door while our citizens sicken and die.

Yesterday the head of the Multnomah County Division of the Ministry for Public Hygiene was observed consulting with Gloria Nutella-Aziz, the Sub-Master of the local Eastern Medicine Society. And the result? Nothing beneficial. The Cholera continues unabated.

“Shit, shit, shit,” I thought, as I read that I’d been observed talking with Gloria Nutella-Aziz. “What the hell?”

I continued reading.

“Cholera,” said Maxwell Pettenkoffer, Master of the Homeopathy Society, “Is a serious and often fatal illness. We of the Homeopathy Society have the only complete understanding of the Cholera, its causes, prevention, and treatment. The 1999 outbreak clearly demonstrated the superiority of Homeopathy. Yet the Ministry for Public Hygiene chooses to consult with the Eastern Medicine Society, to the detriment of the health of the city. As a result, the cases continue unabated. If it is desired that the Cholera stop, I suggest that the Ministry for Social Hygiene seek consultation with those who understand health and illness the best, the Homeopathy Society.

“It is understood that the underlying cause of the Cholera is miasmas, and that only the Homeopathy Society has the expertise to interfere with these miasmas to treat and prevent the Cholera, and therefore avert the impending catastrophe.”

The Ministry for Public Hygiene was asked for comment. None was forthcoming.

Continue reading page 4.

“Shite, piss, and industrial waste,” I thought. “I was never contacted by the newspaper.”

I turned to the page to continue reading, but my eye was drawn to the advertisement on page 5.

The Cholera Is Back

The Cholera Is Deadly

There is a CURE


The Eastern Medical Society

The Cholera has returned to the Great Pacific Northwest. A plague upon humanity for centuries, there is only One Philosophy that has the proven record to prevent and treat the Cholera.

The Eastern Medical Society

The diagnosis, treatment, and prevention of the Cholera available from the Eastern Medical Society are unsurpassed in the history of medicine.

Ancient Eastern wisdom, time-tested, time-proven, unrivaled in the ability to alter the course of all human ailments, including the Cholera.

The Great 1908 Beijing Cholera outbreak was stopped by the application of the techniques of the Eastern Medical Philosophy.

Acupuncture. Gua Sha. Moxibustion. Eastern Herbs.

The proven remedies that can prevent and cure all afflictions.

The Cholera is here

Rely on the best



The Eastern Medical Society

Consultation is available at a clinic near you.

Eastern Medicine: when you intend to diagnose, treat, cure, or prevent any disease.


I finished reading the advertisement as the trolley came to a stop.

Damn. The Ministry was being blamed for the spread of the Cholera. This was going to make a complicated situation worse. There also appeared to be cracks in the wall of the Medical Philosophers’ unanimity. That was a first. Times were changing if Homeopathy Philosophers were willing to denigrate the competition. Fights between the Societies would not help in the battle against the Cholera.

I walked the block to the office, and much to my surprise, Mr. Bosworth was waiting in the lobby. So, things would go from bad to worse.

“Jordan,” he said before I could say anything. “A moment of your time.”

“Of course, sir.”

“Let’s go to your office.”

We walked up the stairs to my office, entered, and closed the door.

“I assume to have seen today’s Portland Times.”


“And?” he asked.

“I was out seeing Cholera cases yesterday, and Gloria Nutella-Aziz was taking care of a family with the Cholera. As I had directed my secretary to arrange meetings with all the Societies just that morning, I took the opportunity to discuss the Cholera with her. We sat on the front steps of the house where she was consulting. It was not an official meeting. I was just trying to open some lines of communication. Someone must have seen us and jumped to the wrong conclusion. And I have yet to have any contact with the Homeopathy Society. Not a word. I do not know where that came from.”

“I thought as much,” said Bosworth. “This outbreak will be political and vicious and bring out the worst in some. To have the Homeopathy Society go on the record and show disrespect for another Society is unheard of. As you know, despite projecting the idea to the public that they are the best of friends, the Medical Societies have at best an uneasy alliance. As far as the Societies are concerned, health and illness are a fixed pie, and they can eat more only if others eat less. They all have their piece of the pie and will protect it. I expect they will try and use the Cholera to their advantage to increase their influence at the expense of other Societies. So, if you show any favoritism, expect to get roasted by one Philosophy or another. The publisher of the Times is married to a Homeopath, so expect no sympathy from that quarter if any slight or preference is noticed, real or not. The Times will not be fair as they have a dog in this fight. So, be careful. The Medical Societies are more interested in their position than in fairness. Tread lightly. I will not be able to provide much, if any, protection. They have money, connections, and power and will not hesitate to use it if they feel threatened or slighted.”

I nodded. “Understood.”

“Otherwise, any progress?”

“None. At all. I worry that if the Cholera progresses like 1999, we will soon be unable to cope with the volume of disease. We may be overwhelmed sooner than you might expect.”

“Yes,” said Bosworth. “I received your request for additional help. Do you think you will need that many extra positions?”

“I think I likely underestimated the need.”

Bosworth grimaced. “I will see what I can do. But remember, the Societies have a lot of influence and are very sensitive to their position. I have little authority in this matter, and there is little I can do to protect you should they decide that you, and not the Cholera, are the enemy.”

“Thank you for the warning, sir. I understand. And I will do my best.”

“I expect nothing less.”

He glanced at his watch.

“And I have a meeting with Pettenkofer in an hour. I will deflect his anger as best I can.”

“Thank you, sir, and good luck.”

Bosworth left the office, and less than a minute later, everyone from the Department was in my office.

“What was that all about?” Cassandra asked.

“We have enemies in high places,” I said. “And we do not want to make them angry. The Medical Societies are jealous of their position and place their privilege at a higher priority than their patients. At least the Homeopathy Philosophers do. Mr. Bosworth has reminded me of the fact. So, let us do our best to keep the rich and powerfully happy.”

I looked at the faces of my colleagues. They were not happy faces.

“Don’t worry,” I said. “If anyone gets shit-canned, it will be me. While Mr. Bosworth was clear that he could do little to protect me should we slip up, I will not treat you the same way. I will try to have your backs. Now, what is the score today?”

“We now have one hundred and thirty cases with forty-five deaths,” said Sherman. “And the case reports keep coming.”

“That is more than the newspaper reported.”

“Yes,” Sherman said. “The papers get the end of the day summary for the morning edition. This represents those plus the cases from overnight.”

I nodded. “The outbreak will always look marginally better in the papers since the results lag. We should be getting some extra help today from nearby County Ministries, and I suspect they will be less than thrilled to be here. Sherman, I will put you in charge of deciding where they will best be used.”

“New quarantines more than follow-up,” Sherman replied. “We are going to have trouble seeing new cases, much less checking on the old. But the prior cases should needless follow-up. Most people respect the quarantine, or at least fear violating it. I think if we saw old cases every two days to remove the quarantine, it would likely cause no harm.”

“Good Idea. Let’s do it. Leo?” I said. “Any luck with the meetings with the Medical Societies?”

“The Homeopathic Society has replied. You have a meeting here at 11 a.m. No word from the rest.”

I grimaced. Great. But I should not have been surprised. To judge from the report in the newspaper, the Homeopathic Society were the ones feeling the most slighted.

“That will be fun. Everyone read the morning Times?” I asked. All nodded. “Then you have a hint about what Bosworth was here to discuss. Hopefully, we will hear from the other Medical Societies. I would like to get these meetings over with as soon as possible. I don’t want any more negative newspaper reports.”

“So, Sherman, Helen, Kerri, and Kerry will organize the new help and coordinate the quarantine. George, can you keep up with information in the cubbies?”

He nodded.

“And me?” asked Cassandra, just as Grace and Allison Ford appeared in the doorway.

“Cassandra, you get to continue working with the Professors Ford. I hope they will have an answer to our problem with information overload. If no questions, let’s get to work.”

Grace and Allison entered the room after the others had left.

“Let’s head down to the cubby room,” I said, “And make some plans.”

To be continued….



  • 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

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