by Ginny Dye
Carrie got his message. “I won’t lose hope,” she said quietly. “My friends and I are determined to raise our voices and be heard. We have been given the legacy of a country mired in deep troubles. Turning our backs isn’t an option.”
“Good!” Dr. Benson exclaimed briskly. “The Metropolitan Board of Health was finally created when people could no longer refute the facts of just how bad New York has become. It can be easy to turn a blind eye to poverty and disease when it doesn’t touch you. Our facts show us that ninety-three percent of New York illnesses, and ninety percent of our deaths, come from the tenements. As devastating as those statistics are, there are far too many people who have believed the people in the tenements bring it on themselves because they are poor and illiterate.”
“Preposterous!” Abby snorted.
“I agree,” Dr. Benson said calmly. “I hear the same arguments about the freed slaves.”
“Who simply need a chance to learn and create a new life,” Janie interjected.
“True again,” Dr. Benson agreed. “Unfortunately, the people around this table are not representative of the American population as a whole. Too many want to turn their backs on the immigrants and wish for the day when America was full of a different kind of people.”
“But was it ever?” Carrie questioned. “Wasn’t American populated by people desperate for a new beginning in a new land? How are the new immigrants any different?”
“Good question,” Dr. Benson replied. “In spite of efforts to believe it is different, I agree with you that it is not. I don’t believe it ever will be. The plight of the immigrants has pushed itself to the forefront because cholera entered our harbor last December. When it last visited America in 1849 it proved it was not controlled by typical borders. It hit the wealthy as badly as it hit the destitute. That reality helped us push through all the naysayers to create the Metropolitan Board of Health. The wealthy and powerful in New York City finally understand they can only protect themselves and their families by protecting everyone in the city.”
“The Board was officially created in February,” Elizabeth commented. “Is it possible to make a difference so quickly?”
“We’re about to find out,” Dr. Benson responded. “We’ve been working hard since then to change things. Now that the first case of cholera has been reported, we will discover if we’ve done enough. We’re not finished by any means, and we’re not so naïve as to think we can stop it entirely in such a short time, but we have hopes the death toll won’t be as high as before.”
“How many died in 1849?” Alice asked.
Janie answered before Dr. Benson could speak. “Five thousand died in New York City, but they had less than half the population then and things weren’t as dire. One hundred fifty thousand died throughout the country, with another two hundred thousand dying in Mexico.” She smiled briefly. “I’ve been studying.”
“That’s right, Janie,” Dr. Benson said approvingly. “If cholera takes the city the way it did before, the death toll will be much, much higher this time. And it will spread much faster throughout the country.”
Carrie thought about everything she had learned about cholera. “Dr. Benson, do you agree with Dr. Snow’s conclusion that cholera is carried through contaminated water?”
Dr. Benson raised his eyebrows. “I thought you were just beginning medical school, Carrie. How do you know about Dr. Snow?”
Carrie smiled. “I’ve been reading medical books and journals for the last six years. Especially ones from Europe. My father and Abby have made sure I have them.” She looked fondly at Abby. “Abby even bought them and saved them all for me during the war. I’ve done a lot of reading since the war ended.”
“Why especially Europe?” Dr. Benson asked, watching her closely.
Carrie looked at him directly. “Because European medicine is far more advanced than American medicine,” she replied evenly. “I find they develop their medical protocols based more on fact than religious dogma or belief.”
Dr. Benson held her gaze. “So you don’t believe the people in the tenements carry most of the illnesses because they are a lower class of people or because of the sin in their lives?”
Carrie didn’t try to contain her snort. “Or because they can’t pay the high pew rents the churches demand? The churches deem them immoral because they don’t attend church, but yet they make it impossible for them to do so.” She stared at Dr. Benson. “It makes me wonder who is the most immoral.” She made no apology for her directness.
Dr. Benson nodded slowly, a smile lighting his eyes. “Are you sure you don’t want to stay here in the city and work with us?” His eyes swept the table. “All of you.”
Alice chuckled. “I’m quite happy in Philadelphia for now. Even though we have been in school longer than Carrie, none of us have her experience or her vast knowledge. I basically feel ignorant any time I have a conversation with her.” She softened her words with a playful smirk at Carrie.
“That’s not true!” Carrie laughingly protested. Then she turned back to Dr. Benson, questions swarming through her mind. “So you do agree with Dr. Snow?”
“I do. When Dr. Snow first entered medicine in England, it was believed cholera was caused by poisonous gases thought to arise from sewers, swamps, garbage pits, open graves, and other sites of organic decay.” He paused. “Dr. Snow’s careful research during the last London cholera epidemic proved it is transported through the water supply. In spite of the fact there are many American doctors who still believe it spread through the air because of sinful behavior,” he said ruefully, “we believe drinking water is how cholera is spread so virulently, but it can also be transferred through contamination caused by a patient.”
“Through their bodily fluids,” Elizabeth stated. “I heard a little about the crews you have prepared to follow up on cholera cases.”
“Yes,” Dr. Benson said firmly. “It is imperative we isolate the disease. We already know there is no cure for cholera. Since we can’t cure it, we have to prevent it. Which means it is important to stop in its tracks. The reason Michael knows about the first case is because we have been working closely with the police department ever since we formed the new board. We identify problem areas and then the police enforce the actions we take. Matthew, will you tell them how it works?”
Matthew nodded. “Each case is to be reported directly to the closest police precinct station. As soon as we heard about the case today, we telegraphed the Board’s central office. They immediately dispatched a wagonload of disinfectants to the infected tenement. In less than an hour they had a team of well-trained men disinfecting the clothing, house, and belongings of the victim.”
“What do they disinfect with?” Florence asked, her blue eyes sharp with intensity.
“They are very thorough,” Michael explained. “The beddings, pillows, old clothing, and utensils — basically, anything that might be contaminated with bodily fluids — were piled in an open area and burned. Then they scatter chloride of lime through the house. After that, they distribute five barrels of coal tar and other disinfectants around the surrounding area.” He paused. “The tenement house with the first case is one of the worst I’ve seen. It is full of waste and filth, and it reeked of alcohol.”
“You were there?” Nancy asked quickly, her eyes dark with concern.
“I had to go by and confirm the illness,” Michael said soothingly. “I was very careful.”
“I suppose that should make me feel better,” Nancy said ruefully, “but I would much prefer you weren’t anywhere near it.”
Wally’s eyes snapped with worry as they landed on his son. “It’s time for you to go to law school, son.”
Michael shrugged away the comment with an easy grin. “I’ll go soon. Right now I’m needed.”
Abby rested her hand on his arm. “You’re a good man, Michael.”
“Yes,” Nancy sighed. “Sometimes I wish he was a little more selfish, but then I suppose I wouldn’t be so proud
of him.”
Carrie was still full of questions. “If you destroyed the patient’s belongings, what are they going to do?”
“Good question,” Dr. Benson replied. “Part of our plan was to stockpile clothes and household belongings so we could replace what has to be restored.”
“Impressive,” Carrie murmured. “I’m learning medical care is about much more than just treating a patient.” She paused, pulling her thoughts together. “What have you been doing the last six weeks to prepare?”
Dr. Benson scowled. “Moving waste,” he stated simply. “Quite simply, parts of our city are buried under waste created by humans and animals. Add snow, ice, and dirt into the mix and it is a huge job. We delivered our first clean up order on March fourteenth. As of today, we have delivered close to seventy-six hundred such orders. We have been cleaning yards, emptying dirty cisterns, and disinfecting privies. We have already moved hundreds of tons of waste. It is nasty, thankless work. The men performing it are heroes.”
“Where are you putting it all?” Carrie asked with horrified fascination. It was difficult to even imagine what he was describing. Her mind contained vivid images of mistreated horses pulling wagons heavily laden with waste and rotting carcasses through streets clogged with snow and ice. She controlled her shudder and forced herself to listen.
“We’re hauling it out of the city and forming mountains,” Dr. Benson said wryly. “It’s the best we can do for right now, but if this city is going to survive, we will have to work together to create sewers and clean water systems. It will be a huge undertaking, but people are finally beginning to understand that health begins with cleanliness — not just personally, but throughout all civilization.”
“Have you provided a quarantine hospital?” Elizabeth asked.
Dr. Benson shook his head heavily. “No. In spite of our best efforts, we’ve not been able to secure a location.”
Carrie searched her mind for what she had read about New York City medical establishments. “There was a quarantine hospital on Staten Island,” she remembered. “What happened to it?”
“It was burned,” Dr. Benson replied. “A group of thirty arsonists destroyed the entire compound in 1858 after some neighborhoods on Staten Island were infected with smallpox. The people were convinced it was because of the hospital.”
“Could it have been?” Carrie asked. “If we’re just discovering the true causes of these diseases, isn’t it possible the surrounding neighborhoods were in danger?”
“Unfortunately, the answer is yes,” Dr. Benson admitted. “It was also unfortunate to lose such an extensive facility.”
“All the patients were killed?” Abby asked with horror.
“No,” Dr. Benson answered quickly. “Evidently the administrators had been warned of the attack. When the fires started, the few staff working that night tried to rescue the patients, as well as the animals they used to feed them. No one was there.”
Alice gaped. “They had evacuated everyone? Where did they take them?”
“That’s a good question,” Dr. Benson said grimly. “The fires that destroyed the quarantine hospital forced the patients into areas not so well protected, but no one ever revealed where they were taken because they were afraid the same thing would happen.”
“People are terrified of getting ill,” Abby observed. “With good reason.”
“True,” Dr. Benson agreed, “but that still leaves us with no facilities in case there is another serious cholera outbreak. We find buildings that could work, but the judges block us.”
“I thought the Board of Health was given unprecedented freedom,” Wally protested. “How can the judges stop your efforts to move forward?”
“The joy of politics,” Dr. Benson said mirthlessly. “The judges owe their seats on the bench to people with power and money. They are quite adept at blocking our efforts. When they created the board, they gave us quite broad power in dealing with outbreaks, but we have very little power when it comes to prevention. A quarantine hospital is considered preventative right now, so every move we make is blocked.”
“But that’s absurd!” Carrie cried. “Isn’t it far better to take action before people are sick and dying?”
“Welcome to the real world. It would be so simple if logic was the criteria for decision making. Unfortunately, that is not always the case,” Wally said, his eyes shining with sympathy. “I believe New York will rise above all its challenges, but it is only going to happen because there are enough of us who refuse to stop working to make things better. It seems like every time we take two steps forward we get knocked back, but we’re not going to stop trying,” he said firmly. “Failure is simply not an option. There is too much at stake. Too many people are counting on us.”
A long silence fell on the table as everyone absorbed his words.
“How are the patients going to be treated?” Florence asked.
Dr. Benson stared into his coffee cup for a long moment and then slowly shook his head. “There is no treatment for cholera,” he replied. “There are things doctors do, but we have learned they are ineffective. About half of everyone who comes down with cholera will die from the disease. The best we can do is keep them warm, give them liquids to try to keep them from becoming dehydrated, and do everything we can to keep it from spreading.”
“There are still doctors who believe bleeding them, or purging the patients of fluids will help,” Janie observed.
“There are also people who still believe the earth is flat, but that doesn’t make them right,” Carrie responded angrily. “I was appalled by how many doctors at Chimborazo used old methods that had been proven not to work.”
Dr. Benson nodded. “Doctors feel they have to do something. Unfortunately, their methods do nothing to help the patient, and in many cases actually increase their suffering and quicken their death. Patients who have cholera die from dehydration. Purging or bleeding them simply speeds up their death, making them more miserable in the process.”
Carrie felt sick as the truth of his statement sank in. “There are good reasons that the European medical establishment looks down on American medicine.”
“Why do you say that?” Dr. Benson asked keenly.
Carrie plunged ahead, not caring if he was offended by her observation. After so many years of dreaming of becoming a doctor, she was determined to let nothing stand in her way. People were already offended by women becoming doctors. They were also offended by outspoken women who didn’t observe the traditional roles expected of women. She didn’t care that she fit in both categories. She didn’t think Dr. Benson thought either of those things, but it wouldn’t have mattered if he did. “Too many medical colleges have abysmal requirements for their students. They seem to view their schools as nothing but a business endeavor. As long as someone can pay, they are willing to give them a medical degree. Every time that happens, the respect for our profession is diminished.”
Dr. Benson nodded thoughtfully. “I agree with you.” He held her with his gaze. “Are you quite certain The Women’s Medical College is different?”
“I am,” Carrie said confidently. “Women willing to go against the tide of societal expectations will accept nothing but the best. We expect to be challenged and pushed. Dean Preston is working hard to continually raise the standards, and she is also pushing for us to get even more clinical experience by working with the Philadelphia College of Medicine.”
“And she believes the men will allow that?” Dr. Benson asked, his voice skeptical.
“It will be a fight,” Carrie agreed. “But when something is important, you simply keep fighting until you win.” She eyed Dr. Benson. “Surely you understand that. You have had to fight tremendous challenges as a black man to become a doctor and have the influence you do.”
“Oh, I understand it too well,” Dr. Benson replied with a smile. “I was just making sure you are up for the challenge.” His smile deepened into a grin. “My conclusion is that anyone who attempts to stand in y
our way will simply be rolled over.”
Carrie laughed along with everyone else, but she felt warmed by his approval. She glanced around the table. “I’m afraid I have monopolized the conversation,” she said apologetically.
“Not at all, my dear,” Nancy replied. “We have all learned things. I find I have a better understanding of my own city after all your questions.” She turned to Dr. Benson. “I do have another question. I’m aware a colleague of yours moved to Memphis, Tennessee in the last six months. Dr. Pearlman is a longtime friend of my family. I’ve known him since I was a child. He used to come for dinner every Sunday. Have you heard from him?”
Dr. Benson hesitated. “I have,” he answered carefully.
“What’s wrong?” Nancy asked, concern once more darkening her eyes. “And, please just tell me the truth.”
Dr. Benson exchanged a long look with Elsie. “I got a letter from Howard just a couple days ago. He is thinking about leaving Memphis.”
“Why?” Nancy pressed.
“Because Memphis is a powder keg getting ready to blow. He is concerned for his family’s safety,” Michael answered. “The racial tensions are much like the tensions that exploded into our draft riot three years ago. I have heard terrible things about the police force in Memphis. They are convinced the blacks are the reason for all their troubles. The state is trying to bring things under control, but it might not happen in time. The Irish seem to be looking for an excuse to unleash their fury on the black populations.” He scowled. “We have all experienced what happens when things get out of control. I have a friend in Nashville who is trying to change things, but he fears violence is inevitable. He suspects they have plans to provoke a riot. Soon. He predicts it will be bad.”
Jasmine appeared at Carrie’s side with an envelope. “I’m sorry, Mrs. Borden. I forgot to give this to you earlier. A letter came for you today.”
