“Come on upstairs. If they aren’t all in use, you can see some of the examining rooms.”
He followed her up the grand staircase and down the second-floor hall. “Here’s where we’ve put in a ladies’ room,” she said, pointing to the first door on the left. “Ran the piping up from the kitchen belowstairs. Men’s room is the old second-floor toilet. I figured they didn’t need the space the women did. This one’s taken, this one.” She pointed to the closed doors as they walked past. “Here,” she said, entering through the last door in the corridor. It was an examining room. Plain, but with everything he’d expect to see. The wooden floor had been replaced with linoleum. She saw him looking at it. “The doctors said you can’t keep wood sterile. This stuff can be scrubbed down with hospital-strength disinfectant.”
For a moment he wondered if the clinic’s doctor would be responsible for that job, too.
Mrs. Ketchem crossed her arms and looked out one of the room’s two windows. “This house belonged to my husband’s grandparents before it came to my in-laws and then to me. Grandmother Ketchem was some house proud. Sometimes I can’t help but imagine those old folks rolling in their graves at some of the things I’ve done to this place.”
“Why?” Allan couldn’t restrain the question that had been swelling inside him since he had first seen her dumpy house on Ferry Street. “I mean, I know it’s great to give away money and all, but most folks who do it are rich. Didn’t you want to keep this house for yourself? Live, you know, in style?”
She didn’t answer him right away, and he wondered if he had just blown it, by showing that he was not the sort of person who would give away riches as soon as they fell into his hands. “I gave birth to my first child in this room,” she finally said. She let her gaze roam over the walls and windows, as if she were looking through time, to the way it used to be. “We had a farm out in the Sacandaga River valley, a good half day’s ride by horse and cart, which was all we had. So when my time came near, my husband brought me here, into town, to stay with his grandparents. It was in here I had my son Peter.” Her voice had gone all thin, as if it were coming from a long way away.
She looked straight at Allan. “I’m going to tell you something I don’t speak of, because I want you to understand what this clinic means. What it’s for.”
He nodded, desperately curious and afraid of what he might hear, both together.
“I had four children once, in that farm. It’s all gone now, children, farm, everything. But back then, it was my life. I never thought it wouldn’t all go on like it had, each day following the one before.”
He nodded again, feeling that he ought to make some acknowledgment.
“It was March, in ’24. It had been a cold March, like this one, after a cold winter. Jonathon had taken our two oldest to a party, one of our neighbors who lived upriver. I figured they must have gotten it there. Some of the older kids came down with it, but they recovered after a bad croup. It works that way, you know. Once they’re eight, nine, ten, it mostly sickens them. But younger, it kills. My Lucy and Peter were the youngest there that day.”
Allan wanted to sit down, but his legs seemed nailed to that spot on the linoleum floor.
“About two days later, they both came down sick. It could have been most anything. They were feeling poorly, with a cough and a fever. Their coughs got worse and worse, and I could see how bad their throats looked, all white and red, and them pulling for breath and spitting out nasty mucus. I stayed up all night for two nights running with both of them, steaming ’em, making potash gargle, giving them saltwater drops to keep their noses clear. Then the next day, they seemed to be on the mend. Both of them terrible weak, but their throats clearing up and their breath coming easier. I had kept the two younger ones away…” She looked out the window again. “Three days after Peter and Lucy got over the worst of the coughing, Mary and Jack came down with it. But it was worse, so much worse. It went through them like wildfire. High fevers, and their little throats all swollen and choked. They couldn’t hardly breathe. It was when I saw their throats and tongues all dark that I couldn’t deny anymore that they had the black diphtheria. You know what they used to call the diphtheria, don’t you?”
Allan tried to nod. “The Strangler,” he said.
“That’s right. Jack died by the next morning, died hard, fighting it with everything in him. And then that evening, my little Lucy. Her heart stopped. That’s what it does, you know. If it doesn’t choke off the breath and blood, it paralyzes the heart.”
Allan felt as if his throat were closing up. At that moment, he would have promised Mrs. Ketchem another seven years’ service if she would only stop talking about it.
“That night, Jonathon went for the doctor. Mary…” She sighed. “I rocked her and rocked her all night. When Dr. Stillman came back with Jonathon in the small hours, he gave Peter the serum. He told us Mary was… She died just before the sun came up. I remember praying, praying harder than I ever did, that the angel of death would pass us by, and leave us our firstborn. But the poison had gotten too far, and Peter’s heart and kidneys were damaged too bad. He died three days later.”
Allan stood there. What could he say? His experience with sorrow was losing a grandparent. The death of a pet. He shifted from foot to foot, intensely uncomfortable and ashamed of himself for feeling that way.
“I had worried plenty, over the years, about the German measles, and mumps, and scarlet fever. But I never thought about the diphtheria. It had always seemed a faraway thing to me. Something you read about in the papers, happening in the cities. Places where folks lived all crowded together and didn’t know how to be clean. Whooping cough and influenza, that was something you had to worry about, living on a farm. Not the Strangler.” She moved then, stepping toward Allan, making him start backward as he had on her front steps. “That’s what this clinic is for. I want you to understand it, not like book understanding, but living-it understanding. You’re hardly more than a boy yet, but someday you’ll have children, and when you do, you’ll think of my children, and you’ll picture in your heart what it feels like to lay all four of your babies into the ground. You’ll know what it is to spend the rest of your life wishing you had done different things.”
Allan backed into a cabinet by the examination table, jarred it hard, and lurched forward as a glass container filled with cotton swabs tipped over. His hands closed on empty air and the container smashed against the floor, spraying glass shards and swabs across the linoleum, over his shoes, into the cuffs of his pants.
“Hold still,” Mrs. Ketchem said, in an entirely different voice than the one she had used when recounting her spooky history. “There’s a closet over this way.” He stood stock-still as she retrieved a broom and swept up the mess in short, efficient strokes. “Shake off your pants,” she directed, and he did as he was told. She bent over and squinted at his shoes. “You’re fine,” she said. “Go fetch me the dustpan.” He picked his way over to the closet and found it. He held it to the floor while she swept the glass and wood into a sparkling pile, and then he carried it, at her direction, to the waste bin.
“I sure hope you won’t be as careless as that when you’re working here.” She stepped out into the hall and beckoned him to follow. “We don’t have much of a budget and we have to stretch the supplies as far as we can.”
“Yes,” he said, trailing after her. “I mean, no, I’m usually not that clumsy. I was-” Scared.
“Jane?” On the stairs below the landing, he could see the old lady who had been working the reception desk. “Are you ready?” She was untying her striped apron. “I’d stay longer, but I promised my daughter I’d watch her girls this afternoon.”
“Sorry, Ruth,” Mrs. Ketchem said. The other woman passed her the apron, and Mrs. Ketchem tied it on over her dress. The starched sweetness of the blue and white stripes seemed to cast Mrs. Ketchem in a deeper darkness, like a witch wearing an angel’s robe. “I didn’t mean to keep you over,” she was sa
ying as they all three descended the stairs.
Allan looked with longing at the door as the morning’s volunteer receptionist let herself out, but Mrs. Ketchem had cast a spell over his shoes-or perhaps they, more than his head, knew how much he wanted to become a doctor-and he found himself following her into the parlor turned office.
“It’ll be up to you to see you get accepted into medical school and that you keep your grades up. If you drop out or flunk out, I’ll be after you to repay the money I’ve spent. You or some other, I’m going to find someone to help me establish this clinic so that it can’t get knocked down.” Mrs. Ketchem enthroned herself on the desk chair and swiveled toward him. Across the desk, he could see the patients waiting for their turn with today’s doctor. These people would become his responsibility. This clinic would become his responsibility. For seven years. “I don’t mind telling you, I’m hoping that if you take the job on, you’ll want to stay even after your term is over.” A hint of the woman upstairs, the woman of the terrible story, rose in her eyes. “I need someone who believes in this place like I do. To keep it going in perpetuity after I’ve died. That’s the word my lawyer used when I gave over my in-laws’ dairy farm to the town. ‘To be used in perpetuity for the benefit of the clinic.’ I like that.”
The language reminded Allan of the way Roman Catholics paid to have masses sung for the souls of the dead. In perpetuity.
“Well?”
“What?” he asked, feeling that she had caught out his secret thoughts again. “Do we have a deal?”
He thought of the upstairs room, the glass shattering, the rising and falling of her voice. He thought of his dad’s face when he came home and told them the mill was closing down. For good. He thought of his own name, Allan G. Rouse. M.D. Then the bratty boy in the waiting room coughed, hard, whining his misery, and he thought suddenly of four small coffins.
“Yes,” he said. “We have a deal.”
Chapter 28
NOW
Tuesday, March 28
Russ couldn’t settle on the worst part of having a broken leg. Was it being driven around town like a kid too young for a permit? Or struggling along sidewalks slick with muddy water and the last remnants of crumbling ice, praying he wasn’t going to fall on his ass? He had plenty of time to contemplate both while humping himself up the South Street sidewalk toward the free clinic.
He hadn’t started out the day in the best of moods, and the rapidly falling barometer didn’t help. His leg registered every change in the pressure with a new ache or twinge. The search at Debba Clow’s home yesterday had turned up a big fat nothing, and he was getting that feeling, the one he hated, of chasing his own tail.
“Isn’t this a great day, Chief?” Officer Kevin Flynn feinted side to side across the walk and up and down the stairs, dribbling and shooting an imaginary basketball. He had been detached to squire Russ around, on the grounds that shadowing the chief might be considered advancing his education in law enforcement. “I heard it’s gonna get over fifty!”
Russ paused for a moment to flex his aching hands. He looked up at the gray clouds coursing across the sky, the shafts of sunlight sweeping down the mountains and away to the east. “Forty-five degrees tops,” he said. “And it’s going to rain.” If there was one thing worse than hobbling around on crutches, it was hobbling around on crutches in the rain. He creaked his way up the walk and squared the crutches’ rubber tips on the lowest step.
“Hey, Chief, don’t you want to use the wheelchair ramp?” Kevin paused in front of the door, the imaginary basketball still held between his hands.
“No, I do not want to use the wheelchair ramp.” Russ gritted his teeth and teetered his way to the clinic entrance, where he was forced to let Kevin open the door for him.
The noise, even in the tiny foyer, was confounding. They pushed through the inner doors to a waiting room overflowing with kids, moms, babies, old folks-everyone except the family pet. “What the hell’s going on?” Russ asked.
“Maybe these are all the people who didn’t like to see Dr. Rouse,” Kevin said. “I think he could be kind of intimidating.”
A kid of maybe four broke from the room and dashed across the hall, nearly knocking into Russ. “You come right here this minute, Max!” his harried mother hissed.
Russ beckoned to Kevin with his head. “C’mon, let’s see if we can find Laura Rayfield.”
A strained-looking volunteer behind the reception desk let out a weak “Ha” when Russ told her he wanted to speak to Ms. Rayfield. “Sign the list,” she said. “But I warn you, your wait will likely be well over an hour and a half at this point.”
Of course. He looked like a civilian in his Dockers slit up to the knee and his bomber jacket zipped up over his uniform blouse. “I don’t think you understand,” Russ said. “This is official police business. I’m Chief Van Alstyne…” He forgot he couldn’t just unzip his jacket pocket and haul out his ID. One crutch clattered to the ground. He swore under his breath. “Kevin-,” he started, but the officer had already scooped it up and was holding it out to Russ, beaming like a Boy Scout.
“Thank. You.” Russ lifted his elbow and allowed Kevin to slide the crutch back home. He had retrieved his ID, but it was moot now that the receptionist had seen Kevin’s uniform.
“Oh!” She glanced back and forth between Russ and Kevin. “Is this about”-her voice dropped to a barely audible whisper-“Dr. Rouse’s disappearance?”
“That’s right,” Russ said.
“Oh. Well. That’s a different story, isn’t it?”
Russ allowed as how it was, and let her escort him and Kevin into the conference room, a square space whose elegant moldings and central chandelier gave evidence of its past as a dining room. “You wait right here, and I’ll send Laura to you as soon as she’s done with her current patient,” the receptionist said.
Kevin obediently sat down at the conference table and stared out the windows. Russ stumped around, examining the space. The door opposite the hallway turned out to be the old house’s kitchen, modernized with a cast-off green refrigerator, a microwave, and a coffeemaker. The door between the kitchen and the hallway opened onto the doctor’s office.
It was the size of a roomy closet, but comfortable, with a leather desk chair and a desk that would have been handsome if it hadn’t been covered with heaps and piles of papers. Interspersed among the medical books lining the walls were framed photos of Rouse and his family. There was one of the five of them in what looked like Cape Cod, and another, with the children much younger, taken in Disney World. There was one of a tanner and slimmer Allan with his arm around his tanner and happier wife. They were on the deck of a cruise ship, and the silver frame was engraved with the words OUR 30TH ANNIVERSARY.
“I’m sorry about the mess.” Laura Rayfield stood in the doorway, clipboard in hand, sections of her red hair escaping from her braid. “Your officer was searching for something that might provide a lead to what happened to Al, and I haven’t had time to put everything back to rights.”
“I apologize,” Russ said. “Officer Entwhistle should have done that for you.”
“No, no, I’d rather handle it myself. Doesn’t matter, really, unless and until Allan reemerges or we get a new doctor in here.” She tilted her head toward the conference room. “Mind if we sit down while we talk? I’m beat.”
She eyed him as he crutched out of the narrow office and lowered himself into a chair. “Your officer said you’d broken your leg. What happened?”
“Slipped on the ice. Greenstick fracture.”
“Any pins?”
“Two. I’m supposed to be out of this in another five weeks.”
“Who was your orthopedic surgeon?”
“Dr. Stillman.”
She collapsed into the chair opposite him. “He’s good.” She tossed the clipboard on the table. “What can I tell you, Chief? I already gave a statement to Officer Entwhistle last week.”
“I know. I read his report.” He
matched up the crutches and laid them on the floor. “It looks like you’ve got half the population of Millers Kill back there in the waiting room. Are we in the middle of an epidemic I haven’t heard about?”
Her mouth twisted. “Yeah. It’s called the no-health-insurance epidemic. These folks are here because the volunteers and I have been calling all our current patients and letting them know we’re about to close up shop. Everyone’s coming out of the woodwork to get their prescriptions or to take care of problems they’ve been putting off. As of April first, their only recourse is going to be the ER.”
“Wow,” Kevin Flynn said. “That really sucks.”
“How come?” Russ asked.
“I’m a nurse practitioner. Do you know anything about nurse practitioners?”
“I know you can examine and treat patients. And write prescriptions.”
“That’s right.” She tucked a loose strand of red hair behind one ear. “We practice in collaboration with a physician. Every NP works under a particular practice agreement that’s filed with the state board. Mine states that I will practice under the direct supervision of Dr. Allan Rouse or such physicians as he may appoint-that’s in case we hand off one of our patients to a specialist-with Dr. Rouse reviewing my patient records no less than every fifteenth day. That covers his two-week vacations.”
“Okay,” Russ said.
“Don’t you see? Without Al here, I’m effectively barred from practicing fifteen days after his disappearance.”
“Can’t you call up whoever is in charge of these things and explain the situation? Get an extension or something?”
“No. In order to resume practicing here at the clinic, I’m going to need to find another M.D. willing to serve as my collaborating physician. Then we’ll have to draw up a practice agreement and a practice protocol and file it with the office of Professions at the Education Department. Then we have to wait until the agreement and protocol are approved.”
Out Of The Deep I Cry Page 25
