Sunday. The day of rest.


Until the Cholera was conquered, there was going to be no rest for the wicked or any of their associates.

Before I left the apartment for work, I checked on my microscope, still in its box in the closet. I had received it just before I left for Portland, a gift from the New York head of the Order of Arcesilaus. He had accompanied me to the station and, just before boarding, had handed me a wooden box with a cryptic comment.

“It has been suggested to me that you might find this useful. Open it later. It is from the Continent.”

Of course, I did not wait until I arrived in Portland, but took a glance inside and saw the microscope. I had been too busy or preoccupied on the ride back to look at it closely and, if it were indeed from the Continent, it was better examined in the alleged privacy of my rooms. Now, with the knowledge of possible animalcules causing the Cholera, I had a compelling reason to master my new microscope.

I opened the box and inside was a small, folded note I had missed on the train. The note read

A Camille S. Nachet Microscope. Keep it safe.

It was not signed.

Now I was really creeped out. Did someone—Who? How? —know about animalcules and the need for a microscope? Did someone think that the Cholera might be due to animalcules and wanted me to prove it? Or wanted me to take the blame for using Continental ideas to solve a Crown problem? Or was it serendipity? How did anyone in New York know there was going to be a Cholera outbreak when I arrived in Portland? The Cholera hadn’t started when I left the East Coast. Maybe someone was giving everyone in the Ministry microscopes in anticipation that one would be needed by someone, somewhere. That would be a pricey approach. Or had someone started the Cholera outbreak in Portland so I could discover the cause? I had to roll my eyes. That was crazy. It could be so easy to fall down a rat hole of lunacy and conspiracy.

In the box, covered with a thick cloth, was a small brass tube mounted on a stand. I stood in my living room, looking at the microscope. I probably looked like someone who had been handed a viper and was considering the wisdom of touching it. Included in the box were a stack of glass slides, some cover slips, a small bottle marked “oil,” and an instruction manual.

I thought again of the row of dead children. I had made myself a promise to stop the Cholera by whatever means possible. Well, the microscope was a possible means to that end. Hopefully, not my end. I had never seen a microscope before. As I thought about it, I did not know if there were microscopes in the Empire. I might have the only one. Fortunately, its function was straightforward. I read through the brief instructions. Not complicated. A source of light was directed by a mirror towards a platform where a specimen was placed. The tube moved up and down to focus the eyepiece on the platform. Very sturdy in construction, it was both simple and functional. But what to look at first?

I scanned the room and saw a dead insect in the windowsill. It was not an animalcule, but it was small. I slid the insect onto the platform, trying to center its head in the view area, adjusted the light, and peered through the eyepiece.

With a slow turn of the knob on the side, I brought the bug into focus and was startled by what appeared. Hair. Wings with veins. Eyes made of multiple lenses. The complexity was amazing. Who knew that flies were so intricate? To my mind, they were either moving too fast to examine or, if I were faster, a squished blob. Flies were made of as many pieces as a man, only so much smaller. I moved the insect around, marveling at the beauty that had been hidden without magnification.

I started looking at anything that would fit on the microscopes viewing platform. Some hair. Salt. Dirt under my nails. Oatmeal. Dandruff. Everything was amazing. The only thing that had nothing to see was a drop of tap water. It appeared to be empty, and the water itself was clear. I did not see anything I examined that looked like an animalcule, as if I knew what an animalcule looked like. Would I know one when I saw one?

Now that I considered it, just what would an animalcule look like? A miniature version of the creatures that wander the earth? Little horses and dogs and even smaller flies? Sea monkeys? Miniature people? And how would these miniatures cause the Cholera? Or would animalcules look different from creatures in the normal sized world? I didn’t know. How would I recognize something that had never been seen before? I should have asked Colvin.

I looked at my clock. Ugh. An hour had passed, and now rather than being early for work, I would be lucky to arrive on time, even for Sunday.

I found an old satchel from my college days. The microscope fit perfectly inside. Great. Now all I had to do was find something that contained the animalcules that caused the Cholera. How hard could that be?

Likely impossible.

The line at the tea shop was long and slow because church had just finished. The trolley was delayed by accident. My morning ran like broken clockwork to make sure I arrived at the office late. Reading the Times on the journey did not help my nerves.

Cholera Grows!

Over 446 cases!

Over 225 deaths!

No End in Sight

I sometimes wondered about headline writers. Did they follow some standard, or did they like bad puns? It was hard to tell.

Portland— The Cholera outbreak continues unabated in the East Portland neighborhood of Kenton. With over 446 cases and 225 deaths, the epidemic appears unstoppable, and the Ministry for Public Hygiene is helpless.

“All they do is count the dead and isolate the living,” said Maxwell Pettenkofer, Head of the Homeopathy Society, “while ignoring the one true cause, prevention, and treatment of the Cholera.”

This sentiment was echoed by the Master of Society of Naturopaths, Tristan Redmond.

“While there are occasional minor disagreements among the Medical Societies, it remains a fact that only we have the wisdom and experience to combat the Cholera, yet the Ministry for Public Hygiene has not asked for our help.”

Joseph Bosworth of the Ministry for Public Hygiene said, “We are doing everything in our power to counter the Cholera.”

Jordan Bruno, Chief of the Multnomah County division, continues to be unavailable for comment.

The Cholera has now spread to the west side with cases in both Lake Oswego and Hillsboro. There have been no deaths in the west side, and the disease has yet to spread beyond the involved households, in large part due to the care the family has received from their Homeopathic Philosopher, who was involved with some of the early Kenton cases.

How the Cholera jumped 20 miles remains a mystery and raises the issue as to just how safe the rest of the community is.

“It is time,” said Medical Philosopher Pettenkofer, “for the city, including the Ministry for Public Hygiene, to invest in the proven preventative that only Homeopathy can provide. Only by the widespread use of homeopathic remedies and offering them to the entire metropolitan area for free can this outbreak be stopped in its tracks.

“The Naturopathic Society has agreed to partner with The Homeopathic Society to provide the needed medical expertise and manpower to treat the entire population prophylactically.

Now it is up to the Crown and the Ministry for Public Hygiene to join in the fight and fund this effort to defeat the Cholera.”

I could not believe it. Two Societies joining forces. That never happened. Ever. They must have seen an opportunity to make a fortune by having the Crown buying and distributing remedies for 200,000 people. Although if each patient’s disease and treatment were unique, as was often touted by the Societies, how were they going to come up with 200,000 treatments tailored to everyone in the greater metropolitan area? Another mystery to be solved.

The lies from the heads of the Naturopathic and Homeopathic Societies did not surprise me. I had tried to get them involved, they refused, and now they were saying WE were doing nothing to include THEM. I was pissed.

When I arrived at the office, it was evident I was infuriated. George and Leo were both in the cubby room working, and Leo remarked, “You sure look bloody angry.”

“The heads of the Medical Societies are lying sacks of rubbish,” I said. “At least the Homeopaths and Naturopaths are. They said we did not try and involve them in the Cholera. We did. They refused. Arseholes. They are always attempting to protect their organizations and look good. But twice now they said I was unavailable for comment. They have never tried to talk with me. Ever. It really fries my bacon.”

I glanced at Leo, who was looking guilty. “Leo, is there something you want to tell me?”

“Well,” he said, “the newspapers have sent letters and telegrams asking for comments. They kept arriving in the afternoon when you were out in the field. So, I told them you were unavailable since you were in Kenton working on the Cholera. That’s how I phrased it. They were the ones who shortened it to an unqualified unavailable for comment.”

“Figures,” I said, “That would be the Times. Why did not you let me know?”

“I did. I put notes in your inbox.”

“Which I haven’t checked because I have been out of the office.” I sighed. “Next time the Times, or any other newspaper calls, set up a time the following morning for me to talk with them. Same for the Societies. I can’t have it suggested that the Ministry is avoiding the press or the Medical Societies, as much as I would like to do just that.”

“Yes, sir,” said Leo.

I looked around the cubby room. “Since I am a bit late, where is everyone?”

“Almost everyone is out and about, checking on new and old Cholera quarantine victims,” said Leo. “Sherman is upstairs finishing up the week’s schedule, or he was when I came down here for a minute.”

“And here I am,” said George, “About to get started on the day’s work with the reports and the cubbyholes. I haven’t seen Cassandra.”

“Because you haven’t turned around,” said a voice from the doorway. We all turned around to see Cassandra standing in the frame.

“I’m here early, as the sisters want George’s data twenty minutes ago. They are getting increasingly demanding. They are like opium addicts; the more they get, the more they want. So, I’m going to help George today while I wait for you to return with a tall stack of fresh information. So, get hopping.”

“Yes, ma’am,” I said with a mock salute. “On it. In a bit. I have a few things to do first.”

“OK.,” she said, “Just remember I warned you not to cross the sisters.”

“Tell me something I don’t know,” I said. “And do you have anything yet besides empty promises of insights to come?”

She grimaced. “Sorry. The sisters are extraordinarily meticulous. Maybe tomorrow?” She did not sound confident.

“Don’t worry. I have known the sisters for a long time. Whatever you come up with will almost certainly be worth the wait.”

I went up to my office and passed Sherman, who was on the way down. We stopped on the landing and chatted for a few minutes, getting caught up on his work. He had a preliminary work schedule for the week and again let me know we were increasingly behind in needed manpower.

“We need more help,” he said. “Or less Cholera. I’d prefer the latter but will settle for the former.”

“I’m on it,” I said. “But if the Cholera starts spreading in the west side, I doubt we will get any reinforcements. I would wager that those two cases will be enough to shut down any further outside assistance. What we have is what we get.”

“Then may I suggest less Cholera?” he said with a tired grin.

“I’m working on it.”

We went our separate ways. I went to my office and looked through my in-basket. There were the interview requests, as promised. I just wish Leo had told me in person.

I hate being psychic. In the morning mail were notes from Yamhill and Clackamas counties letting me know that now that the Cholera had reached their jurisdictions, they would assign their staff to the local control of the disease and would be unable to provide us additional manpower. Maybe some of the outlying counties would send help, but the time to travel the distance to Portland made that very unlikely. Except for the staff from Washington County, it looked like we were on our own. Again. I really did need to work on the “less Cholera” option.

After sending another request for more manpower that I felt certain would result in little, if any, help, I decided the paperwork could wait until Monday. I needed to get out and see the Cholera patients.

I decided to see the new cases to be put into the quarantine, rather than those at the end of their disease and the quarantine. That would be far harder emotionally as there would be more deaths. I did not want to see more bodies laid out for burial adding to my guilt, but I could not let my colleagues do it alone every day. So, I left the office early to meet up with Helen, whose turn it was again to see the new cases.

Lucky us.

I was getting rather sick of Paul Bunyan. Rather than a symbol of the building of the West, he was now my giant mascot for the Cholera outbreak. For me, every day in the field with the Cholera started with Paul.

For the first time since my daily trips to Kenton, something had changed. It was late on Sunday morning, a beautiful summer day. The area was empty. The streets should have been filled with people after church, going for late breakfast and shopping. But there was no traffic on the road, and the only person I saw was in the park, filling a container with water from the old pump.

No one was out and about. It looked like the Cholera was finally having an impact on the neighborhood. Almost everyone had either left the area or were not leaving their home. Not that I blamed them. With no idea how the Cholera was acquired, if it were not for work, I would avoid the areas of contagion as well.

It occurred to me that I had spent the last week in the thick of the Cholera, and I was free of the disease. So far. And so were all my colleagues. So far. Did that suggest the disease was not spread by air? Or by touch, as we were meticulous about the quarantine, not touching anything or anyone in an involved house?

Something they ate? And how would contaminated food explain cases in Lake Oswego and Hillsboro? Both were twenty miles from Kenton, and fifteen miles separated the two cases. What could possibly transport the Cholera that distance besides birds? And which birds? And how would I get a bird with under a microscope? And how could I determine if a bird had the Cholera? Didn’t birds have the flux at baseline?

The more questions I asked, the more complicated the Cholera became.

“You look worried,” I heard a voice say, and turned to find Helen standing next to me.

“Oh, hi,” I said. “Yep. I have an outbreak of the Cholera to control with no real understanding of how the disease spreads, Medical Societies that will not work with me, an insufficient number of people to meet the challenge, and the newspapers who want my head. Besides that—what, me worry?”

“It is one of the many reasons I never aspired to be an administrator,” said Helen. “Too much responsibility and not enough support. Why have the headaches? Life is too short.”

“And for some getting shorter. Shall we get to it?”

She nodded. “There are two of us looking at the new cases. I have all the cases to the west of the park. Fifteen cases in eight households left to see today.”

We started walking towards the first stop.

“Do you have anything yet that may help with the cause of the Cholera?” I asked. “You have been front and center with the outbreak. For example, why haven’t you contracted the Cholera?”

“No clue,” she said. “That is out of my pay grade. Every case and family, when they volunteer an explanation, seems to have a different explanation. There is no commonality that I can tell. Someday, maybe, someone will figure out the Cholera. That someone isn’t going to be me.”

As we reached the first house, she shrugged. “Until then, the best explanation remains the simplest. Shit happens for no damn good reason. Pun not intended.”

And on that cheery and optimistic note, we went back to work. The day was like the others, only worse since seeing the new cases meant seeing more deaths, which weighed more and more on my spirit. But I tried my best to push the angst aside.

I continued to ask my questions and fill my forms. Was anything unusual? What did you eat? Where have you been? What kind of medical care have you received?

And outside of the limited medical options, I thought there were as many responses as there were people. No commonality that stood out. But I was assured that the sisters really, really, really (three really’s made it all the more important) wanted this information. I still could not see why the information I was collecting would be of any help, but I knew the sisters were one hell of a lot smarter than me. So, I continued my work.

The last victim was a single male in an apartment. He had a moderate case of the Cholera and was able to answer the door. As I started my introduction he interrupted, “Hey,” he said. “Do I know you from somewhere?”

I had not looked at him that closely. He did look familiar. From?

“Maybe,” I said. As he ran off the toilet. When he came back, I looked at him more closely.

“Yesterday,” I said. “At the commons. You were getting water. You pumped it so I could have a drink.”

“Oh, yeah.”

“Sorry you have the Cholera,” I said.

“It’s not fun,” he said. “But I am getting some reading done. Not much else to do when you are sitting on the crapper. What can I do for you?”

I explained who we were and what our purpose was. I took a little more interest in his case, since he was the first Cholera victim, I had contact with outside of work and before they were symptomatic. I had to wonder if he was somehow contagious when we met in the park.

But despite asking every question I could think of, I could find no commonality. Outside of our brief interaction we had nothing in common and as I thought back, we had had no physical contact. If he were contagious, I could not see how he could spread the Cholera to me unless it was passed by breathing. I had become less enamored of the mal aria idea over the past few days as I had seen nothing in my rounds to support the idea. But it gave me a twinge of anxiety to consider the idea. Had I been infected? I focused on my belly. My bowels had no comment.

We thanked him for his time and continued on our way.

By the end of the day, I had a full stack of forms, but my mind remained empty. It had been a dispiriting day from start to finish, and the walk to the office was more of a slog. I suspected this is how Napoleon’s troops felt on the way back from Moscow.

The whole time, I saw nothing that I thought I should examine with my microscope. Should I use the microscope on food to look for those alleged Choleric animalcules? And what do I look for? Animalcules in the diarrhea? Ick. I did not think so. If there were animalcules to be found, I could not see where to look. For the Cholera, the world was terra incognita.

I arrived at the office, and Cassandra was waiting at the front door. She snatched the forms from my hands with an “about time” and immediately left with a quick wave of the hand.

At least someone was excited about their work on the Cholera.

After Cassandra left, I looked again at the cubby room, and all I saw was our failure, graphically represented by increasingly filled slots. More cases, more deaths, and the slow spread of the Cholera. I hated three-by-five cards. My “brilliant” organization of the data was only a reminder of all we had not accomplished.

I shook my head. I was tired ad depressed. I hoped that was the cause of my pessimism because it was not going to make the process any easier.

I went upstairs to my office to check my inbox, and there was another request from the Times, this time with an 11 a.m. meeting on Monday. At least I would not be accused of not being available.

I had been at my desk for about five minutes when there was a knock on the door, and John Bonham stuck his head in.

“You said you wanted to see me,” he said.

“I did. Come in and have a seat.”

He sat in the chair in front of the desk, slouching to be comfortable.

“How was your day?” I asked.

“It’s getting a bit overwhelming. The cases increase every day, but our response does not. We are falling behind rapidly, and I think the Cholera is only going to accelerate. I hate to be Mr. Pessimist, but if we can’t figure out a way to stop the Cholera in the next few days, I think we are on the verge of the whole thing spinning out of control.”

“I see,” I said. “And I can’t disagree with you. But I have an offer that may be of interest to you. I need a fresh mind, a fresh look at the problem of the Cholera. And I like your skepticism. You have a unique approach that I cannot emulate but could have real results.”

“That is very nice of you to say,” he said. “How can be of help?”

“A warning,” I said. “Because what I am going to discuss is only between you and me. What I want to tell you, while not illegal, is not approved by the Crown and has the potential to ruin your career. At worst.”

There was a pause while I let it sink in. I continued.

“Have you heard of people whose lives were ruined because they crossed the Crown?”

“There are rumors,” he replied, “But I have never known anyone myself. I thought it was a myth to keep people in line. A boogeyman.”

“No,” I said. “It is very real. It often follows contact with the Continent. The Crown wants to keep the Continent in its own quarantine. What happens on the Continent, stays on the Continent, even if it could, say, help stop the Cholera? The Crown responds poorly when Continental quarantine is crossed and the Continent is contacted, even if it is beneficial.

“That’s what we may have. Knowledge from the Continent that may, just may, help slow down or stop the Cholera. But I am going to give you a moment to think it over. If I proceed, you have to understand: what we discuss is between us and only us. If the source of these ideas leak out, it could be very detrimental to your career. And, I have to add, I have reason to believe that the Crown is actively keeping an eye on me because of it. So even if you don’t tell anyone, it may not matter. They may find out and act accordingly.”

“You mean the Crown is spying on you?”

“I suspect as much,” I replied. “Most likely the Crown. It makes the most sense, but I do not know it for a fact. I have no hard proof.”

There was another long pause as he thought it over. Finally, he nodded. “I’m in.”

“You sure?”

“Yes. This is too important. Lives, hundreds of lives, could potentially be saved. How could I say no?”

“Easily enough. But welcome to the point of no return.”

I spent the next thirty minutes telling him about the Méthode Empirique, the meeting with Colvin, the suggestion that unseen animalcules caused the Cholera, about the microscope, the issues with the Societies and the Skeptics in the Pub. I filled him in on the attempts by the sisters to make sense of the data using a UKM.

“To sum up—we don’t know how to control the Cholera. Maybe, just maybe, the sisters will come up with something with all the information we have given them. And maybe someone is watching us while at the same time someone else, or maybe the same people, are trying to get us to use Continental methods and devices to understand the Cholera instead of the Medical Societies. All in all, we are in deep and sinking fast. Welcome aboard.”

“Glad to be on the RMS Republic,” he said. “What now?”

“Tonight, there is a meeting of the Skeptics in the Pub at the Lying Husband. It may be helpful for you to attend, as I hope for some more information from some of the members. The Order has some independent research means, but it takes time. It has been a week since the last meeting, so I am hoping for an update.”

“I’ll be there,” Bonham said. “Anything else?”

“Not at the moment.”

“Then I’ll be off. You have given me a lot to think about. See you there.”

He left, and I followed a few minutes later. I was hungry.



  • 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