Out Of The Deep I Cry

by Julia Spencer-Fleming

  Mar. 7th. Rainy & cold. Newspaper this morning filled with tales of flooding along the Sacandaga & the Hudson. I have observed much the same in my travels. Garaged the automobile & took the buggy to-day. In surgery: Saw Thomas F. for stitches, clean & debrided. Mrs. James McC. for removal of goiter, 12 oz & v. complete. Ralph Y., ag’d 4 for trench foot, powdered w/ alum & instructed Mrs. Y. to keep him out of water 1 week. Called to H. McAlistair’s house, twins, ag’d 13. Inflammation of throat, croupal cough, fever & difficulty breathing. Dx croup, Rx tincture of Aconite 1 tX20 minutes.

  Mar. 8th. Clearing, cold. Called v. early to DeGroot house in the valley to see Jan DeG., ag’d 13. Sore throat & fever over the night, frequent urination & many bowel movements. Upon examination, white pseudomembrane. Dx diphtheria. Suggested hiring nurse, Rx gargle of potassium chlorate & saline drops. Lengthy talk w/ Mr. DeG., who resists idea of serum anti-toxin. V. disturbed to hear Mr. DeG. had several friends & neighbors to call Thursday, when his brother returned from Amsterdam. One family-McAlistairs. Strongly suggested he notify those attending the party of J’s Dx. Promised to return to-morrow. Called again on MacAs, advised that catarrh may be diphtheria. Mrs. McA. more forward in her thinking & most eager to obtain serum for her twins. Returned to surgery, brought serum to McA. twins. Home v. late.

  Mar. 9th. Clear & warming. Excellent sermon to-day by Dr. Lee on the evils of rum smuggling, which is much in the news for our area-compared those who “wink” the eye at it to the Citizens of Sodom who allowed vice to flourish. Dinner after w/ Mr. & Mrs. Collins, v. good crown roast & bread pudding. Called after on DeG. house, J. much worse, w/ foul-smelling white exudate & much coughing & sweating. Argued for using serum to Mr. DeG., who is much afraid of harming the boy w/ its use. Dx potassium chlorate as before, alternating w/ echinacea 1d/4 oz water. Called on McA. twins, breathing much better, throats continue v. inflamed. Rx gargle of potassium chlorate 1d, hydrastine 5 grains, water 4 oz.

  Mar. 10th. Clear & cool, brisk winds. Roads still muddy & waterways overfull, so continued w/ buggy to-day. Much more secure in bad conditions, but I miss the speed of my automobile, as to-day had many calls. To Beermans’ in the valley, neighbors of DeG., where Mrs. B. showing Sx of white diphtheria. Discussed use of serum. She was much concerned of vaccination-syphilis. I assured her all my anti-toxin was approved by the State & that each inoculation was sterile/ boiling needles, etc. After much debate she declined, feeling as an adult she was in less danger than a child. Rx potassium chlorate & echinacea gargle, w/ saline drops. Called on Jan DeG. Pseudomembrane sloughing off w/ much coughing, secretions. Throat v. sore, appetite nil. Rx steaming, nitrate of sanguinary 2x or 3x every hour, cold pack for throat. Called on McAs, twins showing much improvement. Rx continue palliative care for throats. Back to surgery, telephoned Dr. Whittinger in Ft. Henry, who confirmed four cases diphtheria under his care. We agreed to notify the State BOH & to request additional supplies of anti-toxin. Held surgery: McGeough boy sprained wrist. Mrs. S.H. (again!) whose many symptoms I trace to a lack of useful employment of her hours & an inattentive husband. Sent home w/ mild sedative. Mr. McFarland, with gastritis I suspect is inflamed by a habit of taking alcohol. Rx Aconite, 5 drops; Ipecac, 5 drops, into 4 oz water, 1t/hour. Advised on simple diet & no spirits. Home for supper-whitefish in sauce & sponge-cake.

  Despite the unattractive recitations of secretions and foul smells, Dr. Stillman’s ready list of meals and desserts set Clare’s stomach rumbling. She put the diary down and went into the kitchen for something sweet. Since, unlike the doctor, she didn’t have a wife at home cooking for her, all she could find was a tin of flaked coconut and a bag of chocolate chips. She ripped the bag open, tossed a handful into her mouth, and went back to the sofa.

  March 11th. Clear and cold. Called on Mrs. B, Jan DeG., McA. twins. The latter show the only improvement, although I suspect J. will pass through the disease unharmed after he expectorates all exudate & hardened membrane. Kept Rx unchanged. Home for dinner. Told Ellen I was sending her & the children to her mother’s house in Ft. Ann. While Charles & Elizabeth have been inoculated with the serum, I have no wish to put it to the test, & I fear there will be more cases of the diphtheria, not fewer. Put them on the 4:00 train. No surgical hours to-day. Telephoned Dr. Whittinger & Dr. McKernon to consult re: advising schools to close for the next few days. Dr. Whittinger volunteered to call the Superintendent with our concerns. At suppertime, was called to Mrs. Kenneth Clow’s for her labor. As this was her eighth child, I scarcely had time to deliver her. Healthy, well-formed girl, 7 lbs 1 oz. I warned Mr. C. of the diphtheria & explained the danger of the contagion in a large family such as his.

  March 12th. Clear & cold. Roads improved much so that I took out my automobile, which proved a mistake, as I was mistaken for a bootlegger traveling home from the Adamses, where I was called for at mid-night. Fearing the diphtheria I brought with me doses of the serum, & found two of the three girls ag’d 11 and 9 w/ poor color, imperfect respiration, occluded & throats & tonsils coated w/ brown exudate. Fever over 103 in both children. I explained the extreme gravity of their condition to the parents, & told them w/o the anti-toxin I would not expect the girls to live out the next 24 hrs. They consented. After inoculation, Rx aconite, 5 drops to 4 oz water and phytolacca, 15-20 drops to 4 oz Water. Also hydrochloric acid 20 to 2 oz simple syrup & 2 oz Water. Driving home I was much startled when confronted by armed men at Powell’s Corners and ordered to stand out of my car. Police officer Harry McN. who knew me well as I have delivered all of his children, apologized at once they recognized me. Bootlegger activity is v. high w/ police on road as a result. Continued home where I slept late this morning. Breakfast Poached eggs and bacon and oatmeal.

  Dr. Stillman’s entries for March 12 and 13 were the shortest ones Clare had seen. They simply listed the current diphtheria patients and added two more, Maud Williamson, aged fifteen, and Roland Henke, aged eight. She tried to imagine how much time the doctor must have spent, driving around the countryside at, what, twenty-five miles an hour? And that was when he could use his car. Snow or mud or rain, he evidently went by horse-drawn buggy. No X rays, no penicillin, no anticoagulants or insulin or reliable blood transfusions. Did they even have aspirin back then? It seemed like a different world. And yet there were plenty of people around who had been born into that world. Mrs. Marshall. Mr. Madsen. Mrs. Johnson. Her own grandmother Fergusson had been fifteen when George Stillman wrote these entries. The same age as Maud Williamson.

  March 14th. Light Rain & cold. Called on Mrs. B. Temp. above 102, breathing v. strained & sibilous. Dx bronchitis secondary to sloughing off of exudate into larynx. Rx Veratrum, 20-60 drops in 4 oz Water for fever; directed Mr. B. on use of steam and pounding her back to loosen secretions. Called on Jan DeG., improved, though v. weak. Impressed on Mrs. DeG. importance of complete rest as the toxin may have affected the muscles of his heart. Called on Adamses, where girls are much improved, temp. normal, throats v. sore but respiration eased. Mrs. A. v. emotional and wishing for some way to express gratitude; I asked her to tell her friends and neighbors the importance of timely inoculation. I have become convinced only a steady diet of personal testimony will lead many of my patients to accept the anti-toxin & other inoculants. Called on McA. twins, steady improvement, but warned mother of dangers of too early exertion. Called on Maud W. & Roland H., both unchanged, Rx unchanged. Spoke to Mr. W. and Mr. H. further on benefits of the serum. Mr. H. has heard stories that vaccination causes idiocy! It becomes hard to listen to such ignorance knowing science has the power to alleviate their children’s distress. I am grateful Ellen and the children are gone away. No surgical hours, home early for supper, cold meat pie and chocolate pudding.

  Mar. 15th. Clear and cold. Called around midnight by Jonathon Ketchem, of the valley, in great distress. Arriving before 2 am, to my great sorrow found two children had died. Sx as described by Mrs. K. diphtheria, in the boy the more malignant laryngeal form. Mary K. ag’d 2, gravely ill, lowered t
emp., palpitations, sibilous & inadequate respiration, extremities blue-tinged. Throat almost completely occluded by pseudomembrane. Mrs. K. reported the baby had been fighting hard for breath and seemed sleepy & eased now. It was my heavy duty to tell her the fatal termination was likely close. Peter K., ag’d 7, was post-acute stage, livid but clear throat, prostrate, weak & irregular pulse. I inoculated both children, though expect the baby will not survive the day. Explained the effects of the diphtheria toxin on the heart & warned Mr. & Mrs. K. of the dangers of exertion for Peter. Offered to reset Mr. K.’s fingers broken the day before in accident and set by himself. He refused tx. Not wishing me to sit for the death watch, I returned home & telephoned Mr. K.’s parents in Cossayuharie, who will join the Ks immediately. V. low in spirits & much discouraged by wastefulness since children might have been saved had I been called earlier this week. No appetite for breakfast and prayed the other households in my care will be Passed Over.

  Clare shut the diary at that point. She felt as tired right then as George Stillman must have felt, hunched over a rolltop desk, writing carefully in his neat Palmer penmanship. She stacked the leather-bound books one atop the other on the coffee table. She closed the fireplace’s glass screens and turned off each light one by one. On the stair landing, she paused for a moment, looking at the journals etched in the light of the dying fire. She went upstairs to bed. It took her a long time to fall asleep.

  Chapter 31

  NOW

  Friday, March 31

  Clare didn’t tell Debba exactly why she wanted to see her when she called after the seven o’clock Eucharist.

  “Can we get together and talk? Today? I had an idea about the custody case.”

  “Sure,” Debba said. In the background, Clare could hear the sounds of children shrieking and the watery grinding of a dishwasher. “Do you want me to call Karen Burns and see if she can come, too?”

  “No. Not yet.” If she could use Dr. Stillman’s journal to drive an emotional wedge between Debba and her antivaccination beliefs, maybe Karen’s cool logic could make the break clean by pointing out that vaccinating Whitley would meet one of the major arguments in the ex-husband’s claim. But Clare was flying by instinct now, and her instinct was telling her Karen would just get in the way. She flipped open her agenda. “I’ve got a counseling session coming up and then a meeting with the church musician. How about ten o’clock?”

  “Okeydokey. See you then.”

  Clare reflected, as she was hanging up, that Debba was pretty upbeat for a woman facing some serious questions by the police. But then again, that was Debba. Upbeat and peaceable. Except when she wasn’t.

  ***

  The purple buses were out. That was the first thing Clare saw as she shifted into neutral and began rolling down the hill toward the Clow house. Two figures-it looked like Debba and her mother, Lilly-were hosing the behemoths down, and the kids were dancing around the spray, leaping in and out of mud puddles. Clare coasted into the drive in front of the house, inspiring Whitley to dash across the road from the barn, and her mother, screeching, to run after her.

  “Don’t ever, ever run across the road!” Debba snatched the three-year-old up, squeezing her hard. “You didn’t even look! You’re going to get squashed flat as a pancake!”

  Whitley wiggled out of her mother’s grip and promptly lay down at Clare’s feet in the gravel drive. “I’m a pancake,” she announced.

  Debba made a strangled noise of amusement and frustration.

  “What’s up?” Clare looked across the road, where Lilly Clow had put down her hose and was attacking the side of one bus with a soapy sponge. Skylar was walking around and around the barnyard, picking up rocks and dropping them into little hills. From the size of the piles, it looked as if he had been at the task for a long time.

  “Those are for my mom’s business, Hudson River Rafting. We’re taking advantage of the nice weather to clean them off. They get dust and chaff and squirrel poop on ’em, wintering over in the barn.” Debba had a bandanna tied over her kinky hair. She tugged it where it had slipped over her forehead. “You want to go in the kitchen and talk? I was going to get a cup of tea.”

  “Flip me, Mommy, flip me,” Whitley said.

  Clare opened her passenger door. Her parka was turning out to be too heavy, with the sun pouring out of the sky and the wind warm and southerly for the first time in memory. She tossed her coat into the front and took out Dr. Stillman’s diary. “Tell you what.” She handed the leather-bound book to Debba. “I’ll flip the pancake here and take her back over to her grandmother. You read this.”

  Debba glanced at the imprint on the cover. “You want me to read a 1924 diary?”

  “Not all of it. I stuck a bookmark into the section I want you to see. Go on in and have a cup of tea and then when you’ve read it, if you want to, we can talk about it.”

  Debba continued to look warily at the book, as if it were a gift-wrapped bomb, one that might go off in her hand, but one she didn’t want to offend Clare by dropping.

  Clare suddenly got it. “It’s not a religious tract. I’m not trying to proselytize you.”

  Debba flushed. “It’s not that I’m not a spiritual person,” she said. “I’m just not into organized religion.”

  Clare bet Debba had several angel books and a copy of The Celestine Prophecy. “Don’t worry. My religion’s not all that organized itself.” She stuck her hands in her pockets and hitched up her ankle-length skirt so she could crouch beside Whitley. “So what should I do with you, pancake?”

  “Flip me!” Whitley stretched her arms wide. While Debba climbed the steps to the house, Clare rolled the child over on the gravel. Whitley made sizzling sounds.

  “I think you’re all cooked,” Clare said. “I’m going to put you on the plate.” She heaved the three-year-old off the drive and sat her on the hood of the Shelby. “Now I’m going to butter you.” She pretended to smear something over Whitley’s stomach. The girl giggled. “And pour syrup on you.” She remembered her brothers’ trick of lightly running their fingers through her hair, along her scalp, making it feel as if something slow and liquid was running down her head. She did it now to Whitley, who squealed and laughed and swatted at Clare’s hands. “And now, since you’re so big, I’m going to fold you up and see if your grandmother wants to share you with me.”

  She picked the girl up and crossed the road. Lilly Clow tossed her soapy sponge into a bucket. “Hey, Reverend Clare. Whatcha got there?”

  “A pancake.” Clare stood Whitley up on the muddy, hay-flecked ground. “Want some?”

  Lilly lunged toward the girl’s belly, making “yum-yum” noises. Whitley darted away, shrieking. “Grab your mom’s hose and rinse off these bubbles for me,” Lilly yelled after her.

  “So you run Hudson River Rafting,” Clare said. “I saw your buses go by last summer when I was visiting Margy Van Alstyne. She lives right by where Old Route 100 crosses the Hudson.”

  “I know Margy. She does good work for the environment.” Lilly flipped one of her long gray braids over her shoulder. “When you’re in the Adirondack tourism business, you owe a debt to folks like her. Too much development can wind up scaring visitors away.” She grinned, her teeth white and fine in her tanned, lined face. “Of course, if it hadn’t been for developers putting a bunch of dams on the wild waters in the first place, we wouldn’t have the rafting business we do today. So I guess I like development so long as it happened a good long time ago.”

  There was a splatter of water, and Clare and Lilly jumped aside. Whitley, heavy-duty black hose clutched in her hands, sprayed at the side of the bus, rinsing off the soap, the windows, the tires, and, occasionally, the top of the bus. Skylar ignored her, steadily piling small stones in one hand and then dropping them into puddles. “Isn’t it a little early to be getting your things ready?” Clare asked.

  Lilly shook her head. “The season starts in April. If it weren’t so damn cold, we could take the punters out on the rivers
next week. Even before the dams start releasing, there’s some amazing water out there.”

  “What happens when the dams release?”

  “Woo-he!” Lilly raised her hands and dropped them, raised and dropped them, like a person sketching a roller-coaster ride. “Class-four and-five rapids. Very challenging. There are places along the Sacandaga where I wouldn’t make a run in April with a raft full of expert guides.” She grinned. “I might have done it once, when I was younger, but now I gotta make sure I’m around to see my grand-kids grow up. Hey, baby, stay away from that road, or you’re going to have to have a time-out.”

  Whitley had dropped the hose and was inching toward the country road.

  “Look!” Her grandmother strode forward and picked her up. “Here comes a car now, silly girl. No going on the road without a grown-up.” She singsonged the last sentence, as if she had said it so many times it was mere rote by now.

  The car was slowing down, perhaps responding to the sight of the little girl headed for the road. The Clows’ front door banged, and Debba rattled down the porch stairs, the leather-bound diary in one hand. She crunched down the gravel drive. She looked at Clare, opened her mouth as if to say something, then addressed her mother, who was still holding Whitley in her arms. “Is she being unsafe again?” Debba paused at the edge of the road to let the car pass, but it slowed even further, then rolled to a stop between the house and the barn. Not pulling over, just stopped. In the road.

  The weirdness of it made the back of Clare’s neck prickle. Lilly glanced at her, glanced back at the car, shifted her granddaughter to her hip.

  The driver was a woman, but hard to make out from their side of the road, with the morning sun bouncing straight off the driver’s-side window. Then the door swung open and Renee Rouse stepped out, as impeccable as the last time Clare had seen her, her cashmere sweater and perfectly draped pants looking so out of place compared to the Clows’ water-stained jeans and Wellies that for a moment, the gun she had in her hand seemed just another discrepancy, like the gold bangle and the leather pumps.