by Jean Stubbs
‘Typhus, scarlet fever, measles and smallpox rage amongst us,’ said Jamie to himself. ‘We make no preparation for them. We scramble our resources together to meet the need of the moment, and afterwards we make haste to forget. There should be special provision against such disasters. It is not enough to treat them. We should learn from them, study them in order to fight them better. No man would try to live for the rest of his days upon a handful of guineas earned in his youth, but most doctors expect the knowledge gained as a student to last them a lifetime!’
The expurgator lifted a pitchfork and began to feed a heap of clothes to the flames. Black smoke coiled slowly on the heavy air.
‘We need a fever hospital, Mr Bailey, which is also a teaching hospital, offering facilities for research…’
The little surgeon said, ‘I could not agree more, Dr Standish. But you know that such a decision does not rest with me.’
‘Nor with me, unfortunately. Though I shall do my utmost to bring it about.’
The guards opened the high wooden gates to allow the cholera van through. The horses galloped in, ears pricked, eyes starting, coats lathered with haste. The van rattled and swayed. As the gates closed behind it, a hail of stones spattered against them. The driver reined in the horses and sat stolidly in his seat, seeming to study the tip of his whip. Two more expurgators hurried out, cloths tied over their faces, rough gloves protecting their hands and arms. They began to unload patients from the vans with more speed than ceremony, stacking them on the ground in rows until the stretcher-bearers should arrive. Some were too far gone to notice, but others wailed and screamed for succour and were answered from beyond the walls with angry cries.
‘You appear to have more work ahead of you, Mr Bailey,’ said Jamie grimly, ‘and I must get back to my own!’
In the far corner of the enclosure, two grave-diggers stood back from the finished trench, and while the living waited, the sheeted dead were carried past them and laid in the earth side by side.
The man was trundling his barrow away to collect more rags. He glanced neither to his left nor right. For sixpence a day and a full belly, his eyes, his ears and his compassion had been stopped.
A dark spell lay over Wyndendale. Dr Standish’s official report to the Home Office confirmed that the valley was in the grip of cholera, and consequently in quarantine. Coaches stopped there only long enough to deliver and collect mail, and to change horses. Most of their passengers chose to stay mewed up inside, and those who joined the coach at Millbridge sat like lepers outside. All communications were clearly marked as coming from a stricken place, so that their recipients could take what precautions they fancied.
The whole country was in trouble that nightmare summer, as the monthly tolls doubled and trebled, and the holding of local fairs and wakes was forbidden. Now, in addition to the cholera figures, the newspapers were printing more and more obituary notices. It was expected that the poor should suffer, but it seemed strange and horribly improper to find the great and important suffering also.
Cholera mounted marble steps as easily as wooden stairs. Its calling card lay on silver salvers as well as on earthenware plates. Its evil spirit could sparkle in champagne or wink from the bottom of a beer tankard. In the open market stalls it blessed all produce, lingering a little longer in some than in others. It lay in wait in baskets of soiled laundry, in blankets, in stable straw. It rose again from the clothes of the dead. It seeped from water closets.
Down in Garth, all work on the tunnel had ceased. The remaining navvies struck camp and tramped out of Wyndendale to escape further affliction, and carried the affliction with them.
Like another king, cholera best loved the poor and was always with them. They drank to keep the thought of it away. But it sat by their sides in the cellars and tenements, kept them company at work, watched their revels, brooded over them as they slept. Nowhere was too deep, too filthy, too dangerous to daunt it: following miners down the ladder roads of Swarth Moor, unravelling the spinster’s thread, helping the shuttle to wear a weaver’s life away. It reeked in middens and sties. Flies were its messengers. Water its chief carrier. The pedlar displayed it, tradesmen bought and sold it, cattlemen drove it, vagrants wandered with it. Cholera was the street-singer’s song, the prostitute’s love, the prisoner’s freedom, and undisputed it reigned.
Zelah Howarth had been right. As the August slaughter mounted, the isolation unit could not deal with every stage of the sickness at once. All schools in the valley had been closed. Now they were opened and used as receiving stations. The official ambulances were supplemented by a fleet of carts, upon which the name of CHOLERA VAN was roughly printed. Houses such as Kingswood Hall, whose women were willing to ease the nursing load, were placed beneath the same restrictions as the official unit. Social life almost ceased. Even in church, each worshipper was wary of his neighbour.
Only devotion prevailed against the terror. Love might and must yield in flesh, but never in spirit. The mother rocked her tortured child and was afraid of nothing but to be separated from it. Husband nursed wife in secret and in secret gave a kiss to the lips that would infect him. Whole families locked and bolted themselves inside their homes and defended the privilege of dying together. Fearless among the sick moved such Christians as Zelah and Anna Howarth, out of humanity. And those who could not help themselves, and were carried forcibly away to hospital, had the bitter satisfaction of seeing their abductors showered with abuse and stones.
At first Jamie Standish had hoped to run his little army of helpers from a distance, so that he could fulfil his obligations as a private physician and as director of Millbridge Hospital. But when the pestilence moved into the genteel precincts of the Old Town and passed through the marble portals of Kersall Park, Jamie rolled up his shirtsleeves and fought the enemy at close quarters. He could make no distinction between one patient and another and avoided the eyes of old friends, noble clients and important acquaintances, as he issued the instructions which would turn them into social outcasts. Money could buy certain comforts and privileges, but it could not protect its owners against the ignominy of the disease.
Every newspaper in the valley placed its facilities at the young doctor’s disposal. All rivalry was laid aside in favour of the common cause. News was shared and exchanged freely. Local cholera figures were published weekly and posted on noticeboards in each district. Mr Bailey’s file grew thick.
‘What a capricious rogue he is!’ the surgeon said to himself, standing back from the cadaver on the mortuary table. ‘Why take some members of a family and leave others? Why should one expurgator last a month and another die in the first week? Why do I still go unharmed, though I face him a hundred times a day?’
The hubbub attending the arrival of the cholera van was noisier and more forceful than usual. He laid down his scalpel and looked through the window. The guards were struggling to let the van in and keep the people out. For a few moments, the result could have gone either way. Then, like a cork from a bottle, both van and mob burst into the compound. The guards fired their rifles into the air and shouted for assistance. The invaders scattered in all directions, without particular purpose, yelling and brandishing homely weapons. A shabby fellow, who appeared to be a ringleader, knocked the driver from his seat. Some snatched spades from the grave-diggers and began to unbury the dead. Others dragged the sick from the van and staggered towards the open gates with their stricken burdens.
A face flattening itself suddenly against Mr Bailey’s window became an open mouth of horror, crying, ‘He’s burking a body, lads! Come over here!’
The little surgeon was out of the door in an instant, striding towards the shabby ringleader. Two guards ran to his side, fixing their bayonets, and threatened those who came near.
‘You!’ roared Harold Bailey, pointing to the man. ‘As you value your life, and the lives of all poor souls here, tell me what in the name of God you think you are doing.’
The fellow walked slowly but def
iantly towards him.
‘We know what you’re up to,’ he shouted, so that his cohorts could hear him. ‘You won’t find no rich folk in this place. They’re all poor folks as canna speak up for theirselves. There’s nowt wrong wi’ them as a dose o’ rhubarb won’t cure, but you’re murdering them and selling their bodies to be burked. It’s a right Bastille, this place, and we’ve come to set ’em free. You won’t stop us, because there’s more of us than there is of you!’
‘Tell your friends,’ replied the surgeon, very clearly, ‘that if they stay here peaceably, and in good order, I’ll take you to inspect the hospital for yourself. You can go anywhere, and see anything you want to. You can ask any questions and I will answer them honestly. Does that seem fair to you?’
The fellow hesitated, then nodded. The mob stood, hushed and waiting. The soldiers were watchful, holding their rifles ready. Harold Bailey escorted the ringleader across the compound at a brisk pace, and opened the door of the main ward.
‘What’s your name?’ he asked curtly.
‘Jeremiah Vetch.’
‘Then welcome to the nethermost depths of hell, Jeremiah Vetch!’
A vile stench assailed their nostrils. The surgeon paid no attention to it, but Vetch’s eyes watered and his stomach heaved.
‘Walk in, man. Walk in.’
Vetch swayed on the threshold, assaulted by the sights and sounds of terminal cholera. He was staring down a long room full of the living dead, most of whom were of necessity left to their own devices. Mops and pails appeared to be most in use. Half a dozen poor women were cleaning up the worst messes. Two medical assistants were working their way steadily down each side of the ward, gauging the condition of over a hundred patients. The number of beds was not sufficient, and victims were crowded head to foot, and tossing on straw mattresses laid on the floor. The only peaceful occupants of this hospital bedlam were the cases in comas, lying white and shrunk and still under their soiled blankets.
Jeremiah Vetch’s expression changed from disbelief to terror.
‘Is there anyone here whom you think should be released?’ asked the surgeon sternly. ‘You may take them with you, if you wish.’
Vetch shook his head and tried to push past Harold Bailey to reach the open air, but the wiry surgeon held him fast and shook him.
‘Would you like to cure any of them with a dose of rhubarb?’
Vetch thrust him away, and vomited on the ground.
‘Oh, you will do better than that later on,’ said Mr Bailey grimly. ‘You should study the experts in that ward, my friend. They will show you how to fetch up what is no longer there!’ The man wiped his mouth on his sleeve, shaking.
‘Shall I show you the mortuary?’
The man shook his head.
‘Then leave us to do what we can for them, and take those idiots away with you! Now!’ said the surgeon, very low and fierce.
Jeremiah Vetch turned obediently and walked across the compound, and kept on walking. His fellows watched him approach and pass them. One man cried, ‘What’s up, Jem?’ Vetch shook his head. He could not speak. Reading his face, they fell in behind him, silently. Silently, the guards saw them all out, and closed and barred the gates.
The gravediggers picked up their spades and smoothed the long mound which had been disturbed. Two stretcher-bearers came quietly from a side-building, and began to carry away the sick. A fresh load of coffins was delivered and stacked up against the walls of the laundry. The iron fire-basket received its tribute.
Mr Bailey returned to the mortuary and picked up his scalpel. The eyes of the corpse seemed to be stretched to their utmost width, and stared from the hills of his cheekbones like green brilliants.
The number of cases reported for the month of September was half that of August. October saw fewer still, and a greater percentage of victims was recovering. In St Mark’s church, Millbridge, on the first Sunday in November, the Reverend Jarvis Pole held a special service of supplication for both the living and the dead. He spoke eloquently and movingly, not at the congregation but with them, having his own great loss to bear. His eldest daughter, Dorcas, now took her mother’s place in the family pew.
‘Let us sing in His praise,’ said Jarvis Pole, steadfast.
But as they lifted their voices more hopefully and heartily than at any time in the past terrible months, nineteen-year-old Dorcas was seized with stomach pains and sank to her knees, moaning. Those present hovered between prudence and charity, but the Reverend Jarvis dropped his hymn book in his haste to reach his daughter’s side and carried her from the church, still moaning pitifully, and most pitifully followed by his other children.
Six weeks earlier he could have hunted all day in vain for medical assistance, but it so happened that Jamie Standish was riding between his two hospitals and met the little procession at the head of Rectory Lane, and so came home with them.
A maid and Dorcas’s old nurse, Sarah Pratt, undressed the girl and put her to bed. There, in their presence, Dr Jamie most carefully examined her. But he could reach no conclusion other than the hideous one to which they had already come. Cholera.
Yet she has youth on her side, and the epidemic is declining, he thought. It is bad, but not hopeless. And since we have nothing to lose by it, we might as well try the saline treatment.
Aloud, he said, ‘No, I shall neither bleed nor purge her, for I am of the opinion, particularly in the light of recent experience, that such violent methods weaken the organism still further. I believe we might save her if we act quickly. I shall be back within the hour with Mr Bailey and one of his assistants. Meanwhile, you must keep her warm. Wrap her in hot blankets, build a good fire, put hot bricks to her feet and warming pans to her sides, and give her as much hot negus as she can take. If she complains of pain, apply a linseed poultice to the affected part.’
Then he was off, full of apprehension and excitement. For the saline method, first published in The Lancet the previous December, and tried two months later by Dr Thomas Latter of Leith, had struck him as being eminently sensible. Several lives had been saved by it, provided they caught the disease in its earliest stage. Yet other victims had failed to respond, and in the end its trials proved inconclusive. Finally the Edinburgh Board had rejected the treatment outright, and so he and Bailey had never attempted it.
Now he rode for the cholera hospital like a madman. Within the hour, as he had promised, the three of them were back. With them in the hospital van was a Read’s Patent High Quality Syringe, a bottle of saline solution, a wicker frame, a copper tube, a pint of pure alcohol and a thermometer.
Dorcas Pole had lapsed into a restless doze, and already her eyes seemed too deep in their dark sockets for comfort. At the foot of the bed, her father knelt and prayed. By her side sat the middle-aged woman who had seen her into the world and might well see her out of it.
‘Mr Pole,’ said Jamie kindly, ‘it would be best if you left us with Miss Dorcas and Mrs Pratt, and interceded with the Almighty downstairs. Each to his post, sir. I can assure you that we shall do everything within our power to help her.’
For good or ill, they were about to make medical history in Wyndendale, but that he did not say.
Jarvis Pole bowed his head, took out a lean purse, and murmured something about no expense being spared.
‘Sir,’ said Jamie, as kindly as before, ‘I am not concerned for my fee but for your daughter’s life. Put your purse away, sir. We can discuss such matters later.’
Harold Bailey automatically dipped his silver-tubed syringe into the alcohol, explaining with a little laugh of apology that this was an old habit of his in India, where water could be particularly foul.
Jamie turned his attention to the young medical assistant, and proceeded to instruct him in the heating of the saline solution, which had to be kept at a steady 112 degrees Fahrenheit.
‘Above all else, we must maintain the patient’s bodily heat!’
They placed the wicker frame over her legs to crea
te a miniature cave, and piled blankets upon it. The assistant filled a spirit lamp with alcohol, lit it, set it at the end of the bed, and connected the copper tube so that a current of hot air passed continually into the little cave beyond.
‘Keep your eye on that, too,’ Jamie ordered the lad, ‘and check the temperature inside the frame from time to time. It should be held at 140 degrees Fahrenheit.’ Then he turned to the surgeon, saying, ‘We may well be several hours before she is over the worst, and until then this treatment will keep all three of us employed! We shall have to rely entirely upon our judgement every step of the way, since we have neither the time nor the equipment to estimate accurately how much fluid and salts she is losing, or has lost already. But I believe that if we inject the solution now, and then each time she vomits or purges, we should be able to maintain a reasonable balance.’
Sarah Pratt spoke up, basins and towels to hand.
‘How do you want me to manage, sir? I must clean her, and that means disturbing your arrangements, no matter how careful I am.’
‘We’ll lift off the wicker cage when that is necessary. You must be as quick as you can, and we must start all over again. The method requires patience above all else.’
‘I think I can see why the Edinburgh Board discounted it!’ said the surgeon, only half-joking. ‘When a single patient demands the skill and energy of three medical men for an undetermined length of time, using sixpenn’orth of alcohol an hour, that is a treatment only to be ordered for the rich!’
‘Hang the cost,’ said Jamie briefly. Then, asking a great favour, ‘Can you spare a few hours from the hospital?’
The surgeon nodded, though he would have liked to sleep.
The girl gave a shriek and a gasp. Mrs Pratt held a basin in front of her, and wiped her face and forehead with a wet flannel when she had done. Then there was a violent attack of diarrhoea. They removed the frame and withdrew. A maid came in to help, and as soon as she came out with her bundle of soiled clothes and her pail of dirty water, they were back again, setting everything up.
