For once, I beat the alarm clock by a good hour. Anxiety is better than sunrise for becoming and staying awake. I had too many things to do, and neither the time nor the skill set to accomplish them. As the week progressed, I had become increasingly aware that every hour we did not act meant more death and disease—and I could not shake the feeling that it was my fault.

The Monday Times—or maybe I should call it the Daily Cholera—did little to ease my sense of guilt, which was only exacerbated by large fonts and exclamation marks.


275 DEAD!!





More inspiring headlines.

Portland— The Cholera epidemic continues unchecked as the Crown authorities only count the sick and the dead. As of press time, no solution to the epidemic is forthcoming.

However, the Naturopathic and Homeopathic Societies have combined their resources and knowledge to offer the city the only proven, safe, and effective remedy and preventative for the Cholera.

“Homeopathic remedies, based on the tried-and-true idea that like cures like, were more effective than any other therapy for the treatment of the Cholera in the 1999 outbreak,” noted Maxwell Pettenkofer, Head of the Homeopathic Society. “And we feel that combined with the unique herbal and nutritional support offered by the Naturopathic Society, we could further improve the survival from the Cholera as well as prevent more cases.

“However,” he continued, “It is beyond the resources of even our combined Societies to acquire the necessary material to produce and distribute these remedies and preventatives. Only the Crown has the required financial resources and infrastructure to support such an endeavor,

“To date, the Ministry for Public Hygiene has shown no interest in investing in these remedies.”

Joseph Bosworth, head of the Ministry for Public Hygiene, when asked to comment, noted that it was outside of the Ministry’s charter to treat or prevent any disease and that that was the “purview of the Medical Societies.”

Continued on page 4.

I turned to page 4 and noticed an advertisement for a Cholera preventative.

Cholera Prophylactic

The First of Its Kind

As the Cholera continues to spread, the Homeopathic and Naturopathic Societies have combined their expertise and experience to offer a one-of-a-kind prophylactic for the Cholera.

The Cholera Nosode.

Based on the established homeopathic principles of like curing like combined with the principals of Jenner’s Variolation with none of the complications and side effects.

The power of Homeopathy derives from Immutable Laws, including the Law of Similars, whereby if a substance causes symptoms in healthy humans, that same substance can be used to cure an individual with a disease that manifests with the same symptoms.

Like cures like.

The other Law is that of the Minimum Dose. Homeopathic medicines are prepared through a series of dilutions combined with vigorous agitation, called succussion. As a result, the greater the dilution combined with succussion, the more potent the homeopathic remedy.

Unlike Jenner’s Variolation, where smallpox matter is rubbed directly into the skin, the Homeopathic Nosode takes advantage of these Laws to produce the perfect preventative: effective and completely non-toxic.

The Choleric Quintessence is serially diluted and potentized, resulting in the ultimate Prophylactic with unmatched power to prevent the Cholera.

Due to limited availability, the Choleric Quintessence can be found only at select Naturopathic and Homeopathic practices.

Homeopathy: when you need to diagnose, treat, cure, or prevent any disease.

I stared at the advertisement, trying to understand, “The Choleric Quintessence.” Were they talking about using Cholera diarrhea as the active agent in their nosode? Were they actually using human shit as a basis for treatment? No way. If nothing else, that would be gross. But why else call it Choleric Quintessence if not to disguise its origin? Unbelievable if true.

And the nosode had nothing to do with the Law of Similar. That Law would suggest that diarrhea given to healthy people would cause diarrhea. Was that true? Nausea and vomiting I could understand. But could you give someone a case of the flux by feeding them someone else’s diarrhea? Ew. Who would test that idea? A Homeopathic Philosopher evidently. Things were getting weird, probably in a way Portlanders would not want.

The trolley reached my stop, and I tossed the paper in the rubbish as I left.

When I reached the office, Bosworth was again waiting in the lobby. This was getting to be a pattern I did not like.

“Sir?” I said.

“Let’s take a walk around the block and chat,” he said.

As we started, I said, “May I ask why the walk instead of my office?”

“Sometimes walls have ears, and I have been made aware that the Societies and Times seem to know an awful lot about what has been occurring within the Multnomah Ministry when it appears you have had no official contact with them. Have you had official contact with the Times?”

“No, Sir. At least not yet. I have a meeting later this morning with a reporter from the Times.”

“It would suggest that someone in your Ministry is passing information on to the newspapers. Any ideas as to who that might be?”

I thought a bit. I could not imagine any of my colleagues doing that. “I do not have a clue,” I said. “It does not seem like something anyone would do.”

Bosworth nodded. “That may be. But be watchful.”

“Just what I need,” I said. “More paranoia.”

“As the saying goes, just because you are paranoid doesn’t mean they are not out to get you. What do you intend to tell the newspapers?”

“It depends on what they ask. But there is one message I want the papers to disseminate.”

I filled him in on the seawater treatment without saying exactly where I received the information. I decided to wait on the idea that the water pump at the park had animalcules that caused the Cholera until I had more proof. That was just too far-fetched and speculative, although I found it oddly compelling. But what Bosworth did not know could not hurt me, or so I hoped.

“So how are you going to deal with the source of this information?” he asked. “You will be asked.”

“I was thinking of lying, although I find it somewhat distasteful. Or at least stretching the truth. I could say that people from the Caribbean have used it as a folk remedy and that it has been effective. It came to us along with Haitian immigrants who fled the French. Make it vague enough that they can’t check up on it. Unless you have a better idea.”

Bosworth shook his head. “Sounds like a plan. Focus on the benefit, not where you got the information. Have you made any more headway into the Cholera?”

“Maybe. But it is too preliminary and perhaps wrong. I need another couple of days to check it out.”

“I am not sure that we have a couple of days,” Bosworth said. “For the short term, there is no more help to be had for your Ministry, and the Crown has been slow to respond. Very slow. I have sent requests for money and manpower, and they have answered that they are “evaluating the options.” So, for the time being, we are on our own. If we don’t solve this problem on our own, then I fear it will grow well beyond our ability to control it.”

“And the Medical Societies?” I asked.

“Those at the top seem primarily interested in protecting their monopoly. They are very prickly about any real or perceived challenge to their privilege. You have to tread very carefully around them.”


We had gone around the block. It was a quick walk on a mostly empty street. The protesters had gone. Thank goodness.

“Back to where we started,” he said. “Anything else?”

“No, sir.”

“Well, I will let you get to it. Be circumspect. There are a lot more people paying attention to you and your investigations than you might suppose. And not everyone is your friend.”

He continued walking down the street, leaving me feeling even more paranoid than I had before. Who was keeping an eye on the doings of the Ministry? I wonder where they found the time and energy. Wouldn’t it be easier if everyone just helped to combat the Cholera?

I went down to the cubby room, where the collection and organization of the Cholera cards continued. I could see there was another problem I had not anticipated. Many of the slots were filling up, another indication the Cholera was accelerating beyond our ability to track the cases even on 3-by-5 cards. The cards would soon overload the slots as Cholera overloaded the city.

As I was looking at the wall, both Cassandra and George entered the room. George had a small box filled with the day’s reports.

“Hey Jordan,” Cassandra said, smiling. “I did not expect you here this time of day. I thought you had paperwork to do.”

“I do. But I had a conversation with Mr. Bosworth, and I thought I would see how you were doing.” I pointed at the wall. “It looks like you are filling up with cases.”

“Yes. I need to talk with the sisters about ways to change how we file the cards to increase their utility. Is there some way to have the slots parallel the UKM analysis? It still takes the UKM a long time to generate its results. By mirroring its output, the sisters say they can move on to other issues since, with this arrangement of the slots, they don’t have to tie up the UKM reproducing what they already know.”

“So, what are you going to do as the cubbies fill up?”

“Colored Roman numerals,” said Cassandra.


“That was the inspiration.” She continued. “You know how X is 10 and L is 50 and C is 100?

“Like I can remember Roman numerals?” I said.

“Let’s pretend you can. It’s how cricket matches are numbered after all. So, we are going to use colored cards like Roman numerals. The red is 10, and blue is 50, green is 100. Yellow is 500, and here’s hoping we never have to use a yellow card. It also makes it easier to count the number of cases. Three green cards in a slot would three hundred cases. Simpler than counting three hundred single cards. That was George’s idea.”

I looked at the Kenton slot. Two green cards in the case box. Two hundred cases. One blue, one red in the death cubby. Sixty dead.

“Now I see it,” I said. “That’s genius. It adds to the visual of what is going on with the Cholera and how it is spreading. It is still heading more west than south, into Portsmouth and VanPort. Excellent work.” I looked at the wall again. “Any other patterns that you have noticed?”

“Yes, although the reports we receive always seem to be incomplete,” said Cassandra. “More cases in adults, more deaths in children. More people with cases treated by homeopaths and naturopaths, although we do not know the nature of the treatments. And while Kenton remains the center of the Cholera, it is spreading. The sisters are doing some manipulation of the information that they may have at the end of today. Again, they want more data. Always more data. So, I am going to help George. Are you going to the field again today?”

“Yes and no,” I said. “I am meeting Bonham, doing some investigations into the cause of the Cholera.”

Cassandra looked surprised. “You have a cause of the Cholera?”

“Maybe. Look, I shouldn’t have even mentioned it. What I just said? Mum’s the word for now.

“Understood. But the sisters are going to want to know what you find. I suggest, very strongly, that you don’t delay feeding their needs.”

“Got it,” I said. “Can you tell them I will stop by their house on the way home, perhaps around 7? Plus or minus an hour. If that does not work, send me a telegram. I’ll stop by here at the end of the day. Have fun. I hear the Times calling my name.”

I went upstairs to the office, looked at the pile of papers on my desk, and got to work. There was a note on my desk from Bonham confirming our meeting at 1 p.m. The next several hours were paperwork. It is too bad no one has invented a paperless office. Work would be so much easier.

At 10:55 there was a knock on the door, and a face I did not recognize peeked through. “Mr. Bruno?”

“Yes. And you are?”

“Jarod Pender. Of the Times. We have an 11 o’clock. Everyone was busy and told me it was fine to come on up.”

“Yes, yes, come in, come in. Have a seat.” I stood up and shook his hand. Pender was a middle-aged man with thick hair and even thicker lenses in his glasses.

“Thank you for seeing me.”

“No problem,” I said. “I have been spending a lot of time in the field, helping with the quarantine. It is a rare event to be in the office at this time. How can I be of help?”

“For starters,” he said, taking out a note pad and pencil, “from the perspective of the Ministry for Public Hygiene, how is it going with the Cholera?”

“Honestly? We are barely keeping our heads above water. The cases are increasing, and we have just enough manpower to keep up with the quarantine. I worry what the rest of the week will bring, for both the city and the Ministry.”

I went on for several minutes explaining the quarantine, the number of cases of the Cholera, and why we were barely keeping up. He took a few notes while I talked.

“Why then,” he asked, “is the Ministry for Public Hygiene doing nothing to prevent and treat the Cholera?”

So here it was, the question that suggested the Cholera was the responsibility of the Ministry and that we had the ability to practice Medical Philosophy. I did not expect it so soon.

“You must have talked to Mr. Bosworth. I am sure you are aware of the limitations, both financial and, more importantly, legal, under which we operate. By statute, we are limited to tracking diseases, and instituting, maintaining, and removing the quarantine. Also, and it is important to remember, those in the Ministry have no education or training in the Medical Philosophies. We are all laypeople. Prevention and treatment of diseases are, by law and training, the purview of the Medical Societies.”

“Would you like that to change? Would you like your department to be involved in the prevention and treatment of diseases?”

“It would be nice in theory. But we are not Medical Philosophers trained by the Societies. We lack experience and expertise. And even if we did, we currently do not have the resources, financial or manpower, to do that.”

“Then why not involve the Medical Societies?”

I paused a moment. That was a loaded question. Time to be a weasel and not answer the question directly?

“We have always welcomed the involvement of the Medical Societies.”

“Then, where are they? Why are they not involved?”

“I would refer you to the Medical Societies for an answer to that question.”

“So, you have invited their participation?”

“As I said, we have always welcomed the involvement of the Medical Societies.”

“Ah,” said Pender. He smiled and made a note. “The non-answer that is an answer. Are you planning to run for elected office someday?”

I just smiled and shook my head no.

“Is there anything else you would like our readers to know?”

“The Ministry for Public Hygiene is doing everything in its authority to help battle the Cholera.” I paused. “There is one more thing. It has come to our attention that there is a treatment, not sanctioned by the Societies by any means, that may minimize the effects of the Cholera. It is a simple remedy that historically has been associated with a decrease in deaths from the Cholera. A folk remedy if you will, not Society approved. Rather than drinking fresh water, if you get the Cholera, drink seawater diluted 4 to 1 with regular water with added sugar, twenty-five grams to the quart.”

He looked surprised. “Really? Sweetened seawater? That seems far-fetched. Just how do you know that?”

I again paused and shrugged. “Some of the households with the Cholera are from the Caribbean islands, where they have a long history with the Cholera. It is a standard remedy in that part of the world. And it appears to work as they say there are almost no deaths in those that have used the treatment.”

“Seems too good to be true,” Pender said. “Which often means it isn’t. True, that is. Can you give me the names of these victims who have survived the Cholera?”

“Again, by statute, we are not allowed to release the names of those who we place in quarantine unless they break that quarantine.” I shrugged again. “You will have to take me at my word.”

“Hardly,” he said. “I will need better corroboration before I can publish such a treatment. It has never been heard of before, and it runs counter to any of the treatments recommended by the Societies or the Guild. Plus, we are ninety miles from the ocean. Before the Times recommends the time and expense of transporting large quantities of seawater inland to treat the Cholera, we need some compelling and independently confirmed information validating the approach. Do you have that?”

I shook my head. “All I have is what I told you.”

“And it is not even close to being enough to publish.”

“I’m sorry.”

“Anything else?” he asked.


“Then, thank you for your time. If you should get further information on the seawater treatment that I can confirm, please let me know.”

“I will.”

He stood, we shook hands, and he left.

Well, that went well. Shitte, piss, and industrial waste. I do not think I could have been more inept if I had tried. Now what? How was I going to get the information to the Cholera victims and their families about the seawater treatment? Publish my own pamphlet? That did not seem likely.

I wrote a letter to Shaun Colvin at the River Weekly, detailing the saltwater cure and my creative story about its origin. Colvin, at least, might take me at my word and would be likely to publish the information. We had an understanding, at least. I think.

I glanced at the clock—time to go meet Bonham in Kenton.

I got off the trolley and walked over to Paul Bunyan. The area was still quiet, with few people on the street. Like yesterday, it should have been much busier with people on their lunch hour and shopping.

I again stood at the foot of Paul, looking over the park. There were two people, a man and a woman, at the pump, filling large containers with water. I walked down to them.

“Hi,” I said. “My name is Jordan Bruno, with the Ministry for Public Hygiene. Do you mind if I ask you a few questions about what you are doing?”

They looked at each other for a moment, and the man nodded.

“Sure,” he said. “What can I do for you?”

I gestured at the pump. “I was just wondering why you are using this water.”

“It is natural,” he said. “Pure. Not treated like the city water, and tastes better.”

“You think so as well?” I asked. “I tend to agree but I wonder if it is just my imagination.”

“Absolutely better,” he said, “The city water is filtered and processed, and it goes through miles of pipes to reach the faucet. The filtering removes elemental components from the water that are vital to how water supports health. And the pipes add toxins and poisons. I will shower in the stuff, but I like to drink as little as possible.”

“I agree,” the woman responded. “Fresh water is superior to tap water. Tastes better and is healthier.”

“Is that why most people use this water?” I asked.

They both shrugged.

“No idea,” he said. “We have friends who like to use it for cooking. They think the food tastes better. But other than that, I can’t say. And it is free. A penny saved and all that.”

“So how often do you get this water?”

“About once a week. We keep it in the cellar where it stays cool.”

“And you don’t worry about it?

“Why would we?”

I shrugged. “Just asking.”

“It’s water, fresh and pure from the earth, untouched by humans or animals. The safest thing on the planet.”

I wondered about the water and the Cholera. Should I tell them? And what to say that would be believed? Besides, we had no proof it was the water. It was a wild idea at best.

“Well,” I began. “The Ministry is worried there might be a connection between this pump and the Cholera. You might want to be careful about drinking it.”

They looked surprised.

“It can’t be the water,” she said. “Our chiropractor says the Cholera is due to subluxations of the spine. We see her every week for alignment to keep our spinal health maximized. So, we can’t get the Cholera. And we haven’t. Water is the safest thing you can drink. It can’t spread disease. That’s impossible. Whoever heard of such nonsense.”

“I’m not so sure,” I said. “You might just be careful, better safe than sorry, as it were.”

They finished filling up the containers.

“Thanks for the warning,” he said. “But that’s crazy.”

They left with their water. I had a bad feeling, but what could I have done except to confiscate the water? That would go over well. Being arrested for disorderly conduct and assault is a great way to start the workweek. I was looking at the pump when Bonham walked up.



  • 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