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I agreed and went back to the office after grabbing lunch. As I ate, I was pleasantly surprised to have a courier bring in a freshly printed stack of forms an hour and a half later. I was good to go, so I left the office to join Susan Turney for her follow-ups of those in the quarantine.

I did not get much information on my first trip to Kenton. I was too overwhelmed and lacked a framework with which to investigate the Cholera. I hoped my standardized report would help.

As I left the trolley and walked over to Paul Bunyan to meet Susan, the hair on the back of my neck felt like it was standing up. Was I in someone’s figurative crosshairs? Or real ones? Was I being followed? I could always tell when someone was staring at me. I could feel it and I felt it now.

I resisted the urge, and failed utterly, to look around. As I walked, I did a 360 looking to see if anyone turned away.

Nothing, although I received the stink eye from an older woman whose dog I almost stepped on. Of course, if they were professionals, they would know not to look at me directly or turn away if I looked at them. It would be someone who was not obviously watching me who would be watching me. That means anyone and everyone could be the one who was following me. Like the old lady with the dog. Perfect. Who would suspect?

I stopped suddenly.

This was nuts. The only way I was going to function was to put all this nonsense out of my head. If someone was following me, there was nothing I could do about it. My best approach was to do my job to the best of my ability and to do nothing illegal. If there were consequences, so be it. I had to stop worrying about being watched.

I saw Susan at Paul and, as I started walking—one last time, really, I just had to—I spun around. Nothing. The old lady was gone. To give her report? Last time, I promised myself. Right. And no more chocolate buns. And even though that scab really itches, I will not scratch it. I really should not make promises to myself that I can’t keep.

“What was that twirl about?” asked Susan as I walked up.

“I thought I heard someone yell my name,” I said.

“Hrhm,” she replied.

“What’s the plan this afternoon?” I asked.

“I have around two dozen follows ups, households that had the Cholera but should be finished with their illness and ready to stop quarantine. Most people are ill for three days, so it should be over for them.”

“Let’s go,” I said.

The first stop was a house with a family of five.

“The Murphy’s. Only one had the Cholera,” said Susan. “The father.”

We knocked on the door, and Mrs. Murphy answered it.

“Ministry for Public Hygiene,” said Susan. “How is your husband?”

“Fine,” she said. “A little weak. But the flux ended last night.”

“And no one else has become ill?”

“No.”

“Good,” said Helen. “It looks like the quarantine is over for you tomorrow.”

She reached up and took off the sign.

“Do not forget. If the flux should return…”

“Don’t leave the house and notify you immediately,” said Mrs. Murphy.

The risk of large fines does make our job easier.

“May I ask a few questions?” I asked. “My name is Jordan Bruno, and I also work for the Ministry. We are trying to get to the bottom of the cause of the Cholera.”

“Sure,” she said. “Come in.”

We entered a three-bedroom flat that was nicely decorated and surprisingly clean given that five people had not been allowed to leave for four days. Mr. Murphy was sitting on the couch, looking thin and tired, but he managed a weak smile. At the kitchen table were three children. She gestured at her children.

“Keep doing your homework,” she said. She turned to me. “I don’t want them to get behind in summer school. Now Mr. Bruno, what can we do for you?”

“Thank you,” I said. “We are looking for clues as to the cause of the Cholera. So, we are asking everyone about their experience with the Cholera.” I took out a form. “I have a series of questions I would like to ask you.”

I went through the list. It took only five minutes. There was, as best I could tell, nothing that separated the husband from the rest of the family, except that he worked in a brewery as a deliveryman.

Beer and horses were his only exposures. The children went to a summer school a short trolley ride to the east in Parkrose, where there were no cases of the Cholera. Yet. The mother stayed at home. I looked at the form. Nothing.

“Why do you think you had the Cholera when the rest of the family did not?” I asked the father. “Is there anything different or similar that you noticed?”

There was a pause while the Murphy’s looked at each other.

“I can’t think of anything in particular,” she said. “You, hun?”

“Nope. I came down ill the day after working back-to-back shifts at the brewery. But nothing unusual happened at work that I know of. I think I am the only one at the brewery with the Cholera.”

“And we were here all week,” said Mrs. Murphy. “The kids are in summer school, and I was taking care of the household. Nothing unusual.”

“Nothing new or different or out of the ordinary?” I asked.

“Nothing. Why did we get the Cholera? We are good people, God-fearing people, who try and live our lives by the teaching in the Bible. It was God’s will, and He had a reason. He always does.”

I looked at the form. “And you did not receive care from any of the Medical Societies?” I asked.

“No, sir. We are Christian Scientists. We seek care from God through prayer. We credit Him for the blessing of health.”

“I see,” I said.

I made notes on the form. Gather information and resources. Observe. But what information is essential?

The rest of the day went much the same. I filled out forms and asked questions. The answers were the same. Nothing out of the ordinary had occurred in any of the Cholera victims. Life continued much the same in the days and weeks before the Cholera hit. Work, play, eat, sleep.

No commonalities. No reason I could see for anyone getting the Cholera. And why did some avoid the Cholera and others survived it? Anything and everything were credited with the disease and its results. God, prayer, smoking, homeopathy, chiropractic, cold baths, magnets, whiskey, naturopathy, sleep, hot baths, steam baths, vegetarian diet, fresh air, hot air, and a variety of other ointments and nostrums.

I wrote all the answers down, but there were more preventatives and treatments than there were people who developed the Cholera. They could not all be true, could they? Is everything a potential treatment of the Cholera? Can everything also be a preventative? That seemed unlikely. Were they all false? I thought back to the Mesmer report, and now they determined whether or not Animal Magnetism was effective in treating illness.

The key had been comparing two groups, one group who received animal magnetism and the other group did not, but neither group knew which treatment they are receiving. When the two groups were compared, they found similar results. Real animal magnetism had the same outcomes as fake animal magnetism. That allowed the French to determine that the effects of animal magnetism were all due to the imagination of the patients rather than that of animal magnetism.

To do a similar evaluation of treatments and preventives for the Cholera, I would need to make twenty or thirty different comparisons, one for each treatment. The logistics made that approach unrealistic. A trial comparing a Cholera treatment to a fake treatment was going nowhere short term. It would be best to focus on the cause of the Cholera so people could avoid whatever caused it. Evaluating potential treatments were beyond our current logistical ability.

We finished interviewing the last family, and I said farewell to Susan. “Good news,” I said. “Tomorrow, I will join Kerri on her rounds.”

She smiled. “You were not all that bad work with. Say hi to Kerri for me. We haven’t seen much of each other since this outbreak began.”

“I will do that,” I replied.

When I got back to the office, Cassandra was in the cubby room, making notes and scanning the holes. She had a pile of 3 × 5 cards in front of her.

“Got time for an update?” I asked.

“Of course.”

I pulled up a chair.

“What’s going on with that?” I said, pointing at the stack of cards.

“You have no idea what the Ford sisters are doing. It is amazing. Incredible. It is like some sort of magic. They can take all this information, all the numbers, and words. They translate it into language the Babbage-Ada Universal Knowledge Machine can understand. Ada. I told you about it. Programming, they call it. They run it through the UKM. Time passes. The wheels and the cogs and the cylinders of the UKM turn and turn and turn for hours while we chat and drink tea. And then, the UKM either summarizes the data or shows relationships between the information. It all depends on the kind of question you ask. The Ford sisters are really smart. I mean, really smart. I do not know if I have ever met such deep thinkers. Ever.”

“I know,” I replied. “Scary smart. I am glad they are on our side and not in France. They have always been silent as to why they are here in the middle of nowhere, Oregon, and not at Harvard or Oxford. Then what happened?”

“Somehow, and I am not sure precisely how, as I am still learning Ada, the sisters tell the UKM to look at the information, to sort it, to compare it, to understand it. Then, and it takes a while, the Babbage-Ada Universal Knowledge Machine replies.”

She paused and shook her head in wonder.

“I half wonder,” she said, “if the UKM is alive, a disembodied brain made of copper and bronze and gears and wires. An intelligence made of metal. And what if it were aware? How horrible would that be?”

She shook her head again and continued. “The UKM replies through the teletype. It talks to you. Kind of. But the information that it produces is not the information that was sent to it. It prints out reams of information, all showing how the information we gave it is related. And then it makes pictures, graphs of the information with an automatic drafting table the sisters designed and connected to the UKM. It is unreal. The sisters tell me that much of how they program the UKM is of their own invention and unique to their particular machine. They suspect that their investigations are far ahead of what any of the UKMs in the Crown are capable of. And,” she added, looking around the room. “They impressed upon me the importance of not sharing any of this with anyone, except you. For some reason, they trust you. And me.”

“We go way back,” I said. “I have known them since I was at the College. So, have there been any results? Anything I can use?”

“Not yet. But soon. They tell me that the information they have is incomplete and that as a result, the results may be inaccurate.

“We need more pieces of information, especially from the cubbies. That is why I was here. They want all the updated results from these slots. “A bigger sample size,” they keep saying. Evidently, drawing conclusions from a few examples is unreliable. Very unreliable. So maybe in a day or two. And, as they keep emphasizing, it will be preliminary.

“They seem to be quite the sticklers about doing it right, although their idea of right seems a bit bonkers to me. I mean, why not rely on the results in one or two people? It seems OK to me. But they assure me that it is not so and will teach me the mathematics of it when we are done with the Cholera. If they were not so smart, I don’t know that I would believe them. But I have to take much of what they tell me at their word. They want more information; they will get more information. And so here I am, updating the information from the cubbyholes. I will drop it off at their house on my way home. I am just about done.”

“Then I will let you get to it,” I said. “And I have this to add.” I showed her the day’s forms I had collected. “These are the notes, a structured questionnaire, from each of the quarantined homes I saw this afternoon. I have been trying to tease out why some are getting the Cholera, and others are not and what remedies are effective in prevention and treatment. To be honest, I do not have a clue either what I am doing or what I am looking for.”

Gather information and resources. Observe, I thought. “But there is additional information not found in the official reports. Do you think the sisters can do anything with it?”

She took the forms from my hands. “Are you kidding? For the sisters, the information they can offer the UKM is like opium. They will love this. But be warned. They will want more. A lot more.”

“Thank you for the warning. Oh. And I need to have these reports back. Ministry property and all that.”

As Cassandra finished up her work, I stepped back to look again at the wall cubbyholes. Some were filling up, marking the outbreak in the Kenton neighborhood. But like yesterday, there were cubby holes with cards in them that showed the disease continued to creep a bit farther out from the Kenton neighborhood.

Cases and deaths were increasing. I knew that by the numbers, but the visual of the cubby holes filling up made it concrete. If a picture was worth a thousand words, then the slots on the wall was a mural of human pain and loss.

And still no clue as to what and why. I considered stopping for a beer or three on the way home. Beer always dulled the anxiety, evaporating the guilt away from the ball in my chest. I decided against. In the long run, or even the short term, the best way to remove that psychic mass was to stop the Cholera.

I sighed and called it a day.

 

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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.