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We walked downstairs and into the cubby room, where George was already at work with the day’s reports.

Grace and Allison looked at the wall of cubbyholes with raised eyebrows. “You need mail delivered?” asked Grace.

“Not yet. But here is the problem.”

I quickly explained how the cubbyholes were being filled, and what we thought they meant. We also had the problem of the unwieldy data from the telegraph, so that we had a stack of cards filled with information but no efficient way to analyze it for patterns or information. As I talked, I could see the sisters getting excited.

“Jordan,” said Grace, “I think we can be of a lot of help, but it may take a couple of days. We have some ideas on what to do with the UKM reports, and we can use information represented in these slots and run it through our UKM. This is just the sort of problem we have been working to solve.”

“We may have to involve a few of our advanced students,” said Allison. “They have been assisting us with our investigations on expanding the applications of the UKM. Is there a problem with that?”

“None that I know,” I replied. “As long as they don’t talk with the newspapers.”

“We will see to that,” said Grace. “Not to worry. We trust them.”

“OK then. Cassandra, I am going to make this your responsibility. It may be a waste of time, but I hope that buried in all these numbers is something important. A hint as to the whys and what-fors of the Cholera.”

Follow the Méthode Empirique, I thought. Step one, define a question. Or, in this case, questions. What was the Cholera, how was it acquired, how was it spread?

Right now, I was at step 2: Gather information and resources. If we could just organize this information, perhaps it would suggest an answer to these questions.

“Are you sure?” Cassandra worried. “I do not think our boss will be happy with me off on some wild goose chase.”

“Perhaps. But let me worry about that. I’ll give it until Friday. That’s two and a half days to help Grace and Allison get up to speed. Knowing them, I suspect they will need your help for a day.” I smiled at the sisters.

“You credit us with powers that we may not have,” said Grace, “but thank you for the confidence.”

“If there is nothing else, I will let you get to it.” I left the sisters and Cassandra, as they discussed some sort of approach to the data that I did not understand. I felt good about that.

I went back to my office and sat down. In front of me was a pile of papers, a partially eaten muffin, and a cold cup of tea. It looked like we had a plan for everything that was not the actual Cholera. We had the illusion of control, which was sometimes enough. Cholera or not, there was still work to do.

With everyone out of the office, I was undisturbed as I plowed through the papers. Before I knew it, there was a knock on the door, and Leo stuck in his head.

“It is 10:45. I thought you would like a bit of warning before your 11 o’clock.”

“Good thinking. Would you be so kind as to make a pot of tea? I am going to use the facilities.”

I freshened up and returned to my office.

And waited.

Finally, Leo stuck his head in again.

“Maxwell Pettenkofer, Master of the Homeopathy Society, is here for his 11 o’clock.”

I looked at the clock. 11:25. Power move to let me know who the boss was. Asshole.

“Thank you, Leo. Show him in.”

I stood up and crossed the room as Maxwell Pettenkofer entered the room. He was an elderly, well-dressed male who had a look on his face like he was smelling something slightly foul.

“Mr. Pettenkofer. A pleasure. Thank you for coming.”

I held out my hand, and after a pause, he gave it the briefest of limp shakes. Asshole.

“Master Pettenkofer or Philosopher Pettenkofer if you do not mind, Mr. Bruno.”

“Certainly. Please forgive me. Have a seat,” I said, gesturing at a chair. “Master Pettenkofer.”

He sat as I walked around to my seat. I wished, not for the first time, that my chair was on blocks so I could look down upon those across from me.

“I understand you are responsible for the Ministry’s response to the Cholera. How can the Homeopathy Society be of assistance?” Pettenkofer said, steepling his fingers under his nose, a gesture meant to convey wisdom and confidence. Asshole.

“At least a hundred people have been stricken with the Cholera, and there is every reason to think those numbers will continue to grow. Currently, the Ministry for Social Hygiene lacks the manpower and the expertise to cope with the sheer volume of disease. We need help and want to partner with all the Medical Societies to help manage what will likely soon be an overwhelming medical catastrophe. I have sent letters to all the Societies requesting a meeting. You are the first.”

“I see,” said Pettenkofer. “If I am the first, how do you explain why you were seen talking to the sub-Master of the Eastern Philosophers?”

Self-serving asshole. Be nice, I told myself.

“That meeting was serendipity. She happened to be taking care of some Cholera patients at the same time we were working on the quarantine. I had only sent out the meeting requests that morning. I took the opportunity to open up communications.”

“I see,” said Pettenkofer. “And the result?”

“She was interested, but it was clear that any substantive cooperation could only occur after an official meeting of the Eastern Philosophers and a review by their council.”

“I see,” said Pettenkofer again. “And what would you have from us?”

“The same,” I said. “Cooperation with the Ministry to prevent and treat the Cholera.”

“Understood,” said Pettenkofer. “There are important issues for us to consider. First, and most importantly, the other Societies are pretenders. They know nothing about the true causes of disease and its treatment. We of the Homeopathy Society do. And we cannot allow our knowledge and techniques to fall into the hands of the untrained and ignorant who will be unable to apply our Philosophy safely. So, if the other Societies are to be involved, we will likely need to pass.”

“But,” I objected, “the Societies always seem to get along.”

“We do,” he replied. “Publicly. And I would deny it if any suggestion were made that I behaved with anything but the utmost respect towards the other Medical Societies. The Crown, for the sake of public confidence, demands civility between Societies and Guilds. And we acquiesce, of course, to the wishes for the Crown. But do not mistake civility for foolishness. Homeopathy is the one true Philosophy, and our Society needs to protect that truth.

“I will go back and discuss your offer with our council, but I suspect that our position will be that we will be happy to be of assistance, as long as the other Societies are not included. We cannot take the risk. Knowledge of Homeopathy without the wisdom that comes with Homeopathic training will only further endanger the city, not help it. As was clearly demonstrated in the last outbreak, the Homeopathic Philosophy was the only Philosophy that was effective against the Cholera. Why would we dilute our response by involving others?”

Amazing. They put their own Society ahead of the health and well-being of the community. Assholes, everyone. But I, too, had to be civil.

“I understand,” I said. “Of course, we would be grateful for any assistance the Society could provide.” I stood up. “And I thank you for your time and consideration.”

Pettenkofer rose and walked towards the door, not bothering to shake hands. Asshole. “We will likely have an answer for you by the end of the day. The Society has a keen interest in the Cholera and the response of both the Ministry and the other Societies. Good day.”

And with that, he was gone.

What an asshole.

But it was safe to say it was both a worthless meeting and an educational one. I now knew the Homeopathy Society was not going to be of any help, and I suspected the other Societies would follow suit, for similar reasons. They would all rather protect their monopolies than help the city and its citizens.

I waited the rest of the day to meet with the other Societies. I waited in vain.

Eventually, the Chiropractic, Humourist, and Naturopathy Societies sent essentially the same note. They could not be bothered to meet, what with all the Cholera in the city; they were already stretched thin. While they would be happy to help, it would be with the understanding that they would have to be the only Society involved. For safety reasons, of course. Can’t let trade secrets fall into untrained, dangerous hands. Not to protect their turf and income.

Gloria Nutella-Aziz at least showed up briefly to give the regrets of the Eastern Medical Society. The same reason as the others. But I had a sense she was not happy with the decision. But what was she going to do? She was, she said, outvoted.

By four o’clock, it was obvious that the Ministry was on its own or had to choose one of the Societies to work with—which would be worse than working alone, since the remaining Societies would become our sworn enemies, probably actively working against us. It was an easy decision, especially with what I had learned at Skeptics in the Pub meeting. While it would be helpful from a public perception perspective, I doubted any Society would be of much help and more likely a hindrance. It was a relief. But a waste of a workday.

I finished the day by going down to the cubby room. George was just finishing as I entered.

“You look tired,” I said.

“Not really,” he replied. “It is just intense; it takes a lot of concentration to make sure there are no mistakes. There is no one checking my work, so I have to be doubly careful.”

“So, what can you tell me?”

“One slight change. Deaths have a black sticker on them and moved to the right side of a slot. So, you can see where the deaths as well as the total number of cases for each block. It is a quicker visual that way.”

I looked over the wall. It was easier to tell the distribution of cases and deaths. Most were concentrated in the center of the city, around the Kenton Commons. But the Cholera was spreading South and East.

“The Cholera keeps spreading,” I noted.

“And increasing. A hundred and fifty-one cases and fifty deaths by the last reports at the end of the day. Tomorrow will be worse.”

“Any pattern that you can see?”

“Not really. Most of the cases are still in the center of Kenton, but if there is a commonality, I can’t see it. The Humourists still have a greater death rate; bleeding to balance humours seems to be counterproductive in someone with overwhelming diarrhea. But those treated by Eastern Philosophers have had no further cases of gangrene. Not sure what that was all about, maybe just a fluke? I don’t have enough understanding of what they do to draw any conclusions.”

“I suffer from the same handicap,” I said. “It is hard to know what is going on when so much of what occurs is behind closed doors.” I looked at the slots again. “Still,” I mused, “To pat myself on the back, this is an interesting, if time-intensive, way to get a broad view of the Cholera, but may not be detailed enough to discover a reason for the Cholera. This is the forest, but the answer may be in the trees.”

As I said this, Cassandra entered the room. She looked at the wall for a long moment.

“The Cholera is intensifying,” she said. “Mostly in the center of Kenton, around the commons. Now, why around the commons? And why is the Cholera moving south and east, but not north or west?”

“North is the Columbia River, Hayden Island, and Vancouver,” I said. “I guess the Cholera does not want to go over the river.”

“Or to Hayden Island,” said George. “Which is mostly cow pasture. I wonder. Can cows get the Cholera? Or other animals? And how would you know?”

“Good question. Maybe we will have an answer if the cause is discovered. But why not north and west?” I asked. “If the Cholera spreads by air, how would the island or the river stop it? Same issue if birds or sea lions spread the disease. Neither the island nor the river should be a barrier to the spread of the Cholera.”

We all stared at the slots in silence. No one had an answer. I turned to Cassandra. “How goes it with the sisters and the UKM?”

“Slow, but steady,” she replied. “The problem is two-fold. The first is writing the query; UKMs are very finicky in what and how you can ask questions. I think we got it down, however. The second problem is the speed. It takes for…” she paused for several seconds, “… ever to get a result. Well, not quite forever. But hours and hours. So, we send out queries late this afternoon, and I hope to have some answers back sometime tomorrow afternoon. I hope.”

“I hope so as well,” I said. “We need some sort of breakthrough. I don’t want these slots to fill up.”

“None of us do,” said George.

We stared at the slots on the wall for another few seconds. There was a lot of death and suffering represented in those slots. The knot of anxiety and guilt in my chest grew and tightened. How would it do both at once? Stupid anxiety and guilt.

“Well, that’s it for today,” I said. “Have a good night’s sleep. Tomorrow will only be worse.”

I left for home. Again, I fretted about being spied upon. I could not help but feel I was being followed. Or I was a paranoid ass. I kept looking at those behind me. Nothing unusual. No one paid me any attention. But then, it is not like a spy would have a badge that said “undercover agent” or wearing an identifying uniform. Or be pointing at me.

When I got off the trolley, I walked for half a block in the opposite direction, then turned around abruptly and headed home. Looking over my shoulder, I saw no one turn and follow me. Paranoid ass it was.

I slept poorly that night, responsibility being an annoying bedfellow who tosses and turns. Although if I had bad dreams, I did not remember them in the morning.

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