Ship Fever

by Andrea Barrett

  June 19, 1847. Still hot; thunderstorms. Today, after finally obtaining Dr. Douglas’s grudging permission, I moved my books and supplies to this closet at the front of the church we’ve converted into one of the hospitals. I will continue to sleep at Mrs. Caldwell’s, and have left most of my clothes there. But now I have one small space where I may read and write in relative silence, without the snores and sighs and throat-clearings of Mrs. Caldwell’s.

  A number of my patients are arrayed in rows in the main chapel. Nora Kynd lies among them; she continues to improve. Last night she felt well enough to walk about, and as she begged for some fresh air I escorted her out to the porch, bringing two chairs from inside. She regrets the loss of her hair, which had to be cut during the worst of her sickness.

  She is from a rural area in the west of Ireland, not far from where Arthur Adam traveled. In the years just before the murrain struck, when the potato crops were so abundant that no one knew what to do with the surplus, potatoes were stacked in heaps in ditches and fields, buried in huge pits and never used, fed to animals, plowed back into the fields. The famine is a punishment, she believes, a scourge come from God to punish her people for waste. I was not able to convince her that this was a superstitious view, that the blight is a biological phenomenon and unrelated to the earlier surplus.

  Most of her family is dead now; only she and the two brothers I saw on the bark survive. Her account of their passage differs in detail but not in substance from the stories I’ve heard again and again this month. Later she backtracked and spoke of fever in her village. She sometimes refers to the fever as an droch-thinneas, which she tells me means “the bad sickness”; sometimes she refers to it by the name Arthur Adam used, fiabhras dubh. Of course it’s difficult for me to be sure, but based on her description of symptoms I would guess that in most cases her neighbors suffered from typhus, as defined by Gerhard and Wood. Some clearly had famine dysentery as well—she described the ground outside the huts of the sick being marked by clots of blood. Her grandmother was an Irish nurse—“nurse Gaelacha,” Nora called her; a local woman with some knowledge of traditional remedies. She seems to have practiced something very close to the quarantine procedures we’ve tried and failed to employ here.

  At first I tried to stop Nora from speaking of this time, but she wouldn’t stop and I came to believe it was of some help to let her talk. I found it interesting to hear how the disease process manifests itself elsewhere.

  “There were houses in the district next to us in which first one person died and then another and another, and all were so weak and sick that none could do anything until the last person died,” she said. “The bodies lay in the houses and the dogs came. When the fever passed by, those neighbors who had come to themselves a bit would go to the houses where everyone had died and find nothing but bones lying there on the floor. The neighbors would gather the bones and bury them and then burn the houses to the ground, so as to burn the sickness out.”

  She wept quietly for a while; I went inside and returned with a note pad, a handkerchief, and a small glass of brandy, which choked her when she sipped it but brought a little color to her face. Her skin is remarkably white; I still can’t tell whether this is the result of her illness, or her natural color. Around the irises of her eyes is a fine line which appears bronze in some lights, dark brown in others—normal?

  “In my village half the people died, including my parents, two brothers and a sister, my mother’s brother and sister, and many of my cousins. My grandparents, too. But others were spared, because my grandmother on my mother’s side helped them before she got sick herself.”

  This is what I drew as she spoke. Lines of writing, little arrows and crosses; as she watched me draw she said it looked like a misshapen tree hung with apples:

  The circles with the small crosses beneath indicate the women in her family; those with the arrows are the men. Each generation on a separate line. Those darkened represent the dead—grandparents, parents, her aunt and uncle on her mother’s side, her brothers. When I had explained the figure to her, she took the pen from my hand and added to the bottom row an apple I’d missed; then she darkened it. Robbie, the youngest. She found it hard to say his name.

  Here is the rest of her story, or as much as I could scribble while she spoke:

  “I helped my grandmother after my parents died. Ned and Denis helped too. When we could we took the sick from their houses and put them into huts—bracai, we called them—we made by thatching brambles and rushes over poles against a sheltered ditch. We kept those people separate from the healthy. My grandmother would go into the hut with the sick people, and we would wall up the door with turf and then pass food in through the window, on the blade of a long shovel. Never would we touch the empty vessels she passed back out through the window.

  “My grandmother could see the sickness on someone, as good as any doctor could; she knew it was an droch-thinneas by the color of their urine. She did not give the sick a mouthful to eat, but she gave plenty to drink, as much as we could gather and pass through the window. Two-milk whey she gave, when we could get it—very light and sustaining. To make it we boiled new milk and then added skim milk to it. The sick would drink this and also eat the curd. Also she gave the juice of cress and wild garlic, and sheep’s blood if it could be found. When the color of the urine lightened, she would give a single toasted potato. We saved what few good potatoes there were for this use; ourselves, we were eating ferns and dandelion roots and pig-nuts and cresses. My grandmother did not come out of the fever-hut, nor let anyone in, until her patients were completely well.”

  When I asked her how she and Ned and Denis avoided the sickness themselves, she said that before they first touched the patients and carried them to the fever-huts, and also before they burned the huts of the dead, they washed their hands and faces in their own urine, to protect them.

  “Would you say, then,” I asked, “that you attribute your relative health in Ireland to the strict isolation procedures taught you by this grandmother?”

  “Isolation,” she said. When she raised her hand to smooth her hair, it slipped off the shorn ends. “That means making someone to be alone?”

  June 20, 1847. Rain, which does not alleviate the heat. Two nurses died yesterday. In hospital we have 1,935 sick, according to Dr. Douglas’s count. Several hundred more sick remain on board their ships, infecting the well.

  No sleep at all last night. This morning I saw a dog by the wharf and thought it was a wolf. Why would anyone allow dogs on this island? I have brought blankets from Mrs. Caldwell’s and plan this night to make a pallet here on the floor. The patients cannot be noisier than my fellow medical officers. A number of those working here now have been recruited from the army, and their manner is disagreeably matter-of-fact and hearty.

  Nora’s story continues to haunt me. Henle makes the distinction between miasma—the disease substance that invades an organism from the outside; and contagium—the disease substance believed to be generated in the sick organism, which spreads the disease by contact. He argues that the pathogenic matter must be animated, although he has as yet no proof for this. Southwood Smith, in his Treatise on Fever, discounts the theory of contagion in favor of noxious exhalations, or miasmas, given off by filth. Chadwick, Smith’s follower, says dirt is the nurse of disease, if not the mother.

  It’s true that on the filthy ships the passengers sickened quickly. Here, the disease seems to spread somewhat slower in those places where the beds are less closely crowded, and the ventilation is better.

  But Nora says fresh air has nothing to do with it; she spent all the time she could on the deck of the bark and still sickened. In one of the books Gerhard sent to me is a discussion of an old paper by Dr. Lind, physician to the Royal Navy. Lind contended that typhus is carried not only on the bodies of the sick, but upon their clothes and other materials they touch: beds, chairs, floors. In defense of his views, he cites the death of many men employed in the refitting
of old tents in which typhus patients had been cared for. He advocates fumigation (camphorated vinegar, burning gunpowder, charcoal); also a thorough scouring of patient quarters and destruction of bedding and clothing. Additionally he recommends that physicians and attendants change their clothing when leaving the hospital.

  This may be worth trying here. Now that we must quarantine passengers aboard their ships, Dr. Douglas has given orders that the passengers be removed to the island temporarily, and that the holds be thoroughly washed and aired before their return. Stern and bow ports are opened, allowing a stream of air to pass through the hold and flush out the miasma. On many of the more recently arrived ships, however, passengers are no longer required by the captains to discard all their bedding before inspection; word has spread that the ships will be detained here regardless, and no one wants to cause extra suffering. So the passengers return to the clean holds with their filthy clothes and blankets and belongings. Wood’s Practice of Medicine notes that the disease “appears even to be capable of being conveyed in clothing, to which the poison has been said to adhere for the space of three months…It is thought that the poison can act but a few feet from the point of emanation; and attendants upon the sick often escape, if great care is taken to ventilate the apartment, and observe perfect cleanliness.” Interesting advice, if true. But what use is it? Not one thing on this island is clean. Throughout the sheds and tents, as well as the hospital, we have an infestation of lice. This in itself seems like reason to divest the passengers of their rags and provide them with new.

  Nora appears to be making a full recovery. Tonight she asked me again about her brothers and this time I told her the truth: that when last seen they appeared well, but they were carried off on a steamer bound for Quebec and Montreal on May 24 and may now be anywhere. Her face turned very pale. She went outside for a while, and when she returned she asked that she be allowed to work here as an attendant. As she cannot catch the fever again, I agreed. We are desperately short-handed.

  Three of my fellow physicians have fallen sick; also two Catholic priests and the same Anglican clergymen who chided me early on. At least six of the attendants are also sick.

  The remainder so fear contagion that we have caught them standing outside the tents or in the open doorways of the sheds, hurling the patients’ bread rations at their beds rather than approach them. Gray bread flying through gray air.

  June 27, 1847. Unbearably hot. Seven out of fourteen physicians are now ill. Of the six Anglican clergymen recently arrived, four are sick: Forrest, Anderson, Morris, Lonsdell. Our death-register now shows deceased 487 persons whose names we cannot ascertain. 116 ships so far. The backs of my hands are completely covered with hives.

  Last night I stole a brief hour of conversation with Dr. John Jameson. Over a glass of brandy, and without meaning to, I complained that Dr. Jaques never talks to me if he can avoid it. John, who continues good-humored despite the lack of sleep and the working conditions, said, “You must not take this so hard. This island is a government installation, under military supervision—of course everyone’s concerned with discipline, the chain of command, the appearance of propriety. Dr. Jaques perhaps a bit more than the others. This is a political situation, at least as much as it’s a medical emergency.”

  Of course it’s politics, as he said; Arthur Adam has maintained all along that the famine in Ireland is political, not agricultural, and so by extension our situation here has at least as much to do with government policy as with fever. I have not, apparently, been behaving in a sufficiently ‘military’ manner. And it’s true that John gives an appearance of going along, not asking questions or making comments when one of the superintendents tells him to do something. He smiles and nods. Then as soon as they’re gone, he does what needs doing, the way he sees fit to do it.

  Am I such a troublemaker?

  John said, “In the staff meetings, you ask quite a few questions. Sometimes you want to know why you can’t be reassigned here or there, why you can’t try this or that, why they can’t get better food for the patients, why the servants don’t behave better—this isn’t a situation where questions are welcomed. And then this place”—he waved his hand around my makeshift office and sleeping quarters, touching two of the walls as he did so—“What do you think it looks like, you unwilling to sleep at Mrs. Caldwell’s with the rest of us? You hardly talk at dinner, you bolt your food and run back here…some of the staff say you think you’re better than the rest of us.”

  Me—who worries all the time that I’m not holding up my end. Then he brought up Nora and her work with the patients. I have given her too much responsibility, he says. I talk with her too freely.

  “It’s a question of maintaining our positions here,” he said. “Where would we be if the emigrants started questioning the authority of the administration? Tens of thousands of them. And on our side a few hundred of us, an old fort, a handful of guns, a small detachment of troops—not much to keep them from ignoring us altogether and continuing upriver in any fashion they want.”

  Suddenly I could not like him so much anymore. “You see this as a war?” I asked sharply. “These poor sick people as our enemies?”

  “I see that we have a responsibility to our own citizens.”

  We parted stiffly and I wonder if we will share our precious leisure time again. Now he will be against me as well—but I too have sometimes seen this not as a war against fever but as a war against the emigrants who carry it. Doesn’t it come down to the same thing, the way we’re forced to run this island? Susannah was right: hidden in myself was the capacity to view the poor as the enemy.

  June 29, 1847. I saw four dogs yesterday, slinking along the streets; there can no longer be any doubt of what goes on in the burial ground. The graves are not sufficiently deep; the coffins are laid one above the other, with no more than a foot of earth to cover them. Although we do not speak of it among ourselves, we are all aware of the army of rats come ashore from the fever ships and swarming through the trenches. Six men are now employed full time, digging fresh graves and reburying those disturbed.

  Another letter from Arthur Adam, dated April 14th. The usual woe to report, with one bit of good news: the U.S. sloop-of-war Jamestown, loaded with food contributed by charitable Americans, landed in Cork earlier that week. He reports that every inch below the gun decks, including water tanks, storehouses, and the ward room, was filled with provisions. The food vanished into the gathered crowd like water spilled on dry ground; yet it was something, he says. Very much something, and more help than those people get from Parliament.

  This day the husband of a woman recently deceased on a brig from Limerick set off to bury her in a small boat granted him for that purpose by the brig’s captain. Two sailors attended him and rowed. As they were unable to find the burial ground, they dug a grave among the trees at that tip of the island which is cut off from the rest at high tide. In this act they were discovered, and forced to leave. Rowing back to the brig, they came upon the usual line of boats making their grim journey to the burial ground and, joining this line, finally arrived at the right place. The grave was dug without incident, but after it was filled the grieving husband seized one of the shovels and struck the nearest sailor a blow with it. The sailor remains unconscious and we fear for his life. The husband disappeared into the woods and has not been found.

  July 3, 1847. Too busy to attend to this, although every night I mean to. Prisoners from the city jail arrived two days ago, to act as gravediggers, carters, and attendants. More than 2,500 sick now on the island; more physicians have arrived but two have fled in disgust and nine are themselves sick. Father O’Reilly, who visits the tents at the eastern end of the island where the “healthy” are quarantined, claims that he has in two weeks given last rites to fifty who were dying. When I return I mean to go with him, if there are by then any other medical officers well enough to cover here. Dr. Malhiot is pale and weak but swears it is only exhaustion.

  Tomorrow
I go to Quebec, at Dr. Douglas’s request: he cannot spare me, he says, he cannot spare anyone, but someone must go on this errand and he claims that I am “persuasive” and thus will be of much use. We need food, medicine, tents, bedding, everything; he begs me to report in person to members of the Board of Health and press our case. Secretly I wonder if by “persuasive” Dr. Douglas does not mean “pushing” or “argumentative” or both. But I am trying to follow John Jameson’s advice and accept my orders without question.

  I hope to see Susannah. And Arthur Adam as well, who must surely have returned home by now.

  I carry also a message from Nora, which she begs me to run as an advertisement in both the Mercury and the Montreal Transcript:

  “Information wanted of Ned Kynd, aged 12 years, and Denis Kynd, aged 17 years, from county Clare, Ireland, who arrived in Quebec or Montreal about five weeks ago, aboard the steamer Queen—their sister having been detained at Grosse Isle. Any information respecting them will be thankfully received at this office.”