Thursday, March 30
They had said the prayers together, and she had read Lauraine Johnson the Gospel and heard her confession. Now Clare spread the small linen square over the elderly woman’s rolling bedside tray and arranged the round silver container and stoppered silver bottle on top. She unscrewed the pyx and removed the wafer, holding it up to Mrs. Johnson with both hands. “The body of our Lord Jesus Christ, which was given for thee, preserve thy body and soul unto everlasting life.” On one of their first meetings, Mrs. Johnson had told her, a little embarrassed, that she was most comfortable with the old language from the 1928 prayer book. And why not? She had been in her sixties when the new prayer book became official. She tried to cup her hands to receive the host, but her body betrayed her, as it usually did these days, and she couldn’t get them high enough.
“Let me.” Clare leaned forward and placed the wafer on her tongue. “Take and eat this,” she said, “in remembrance that Christ died for thee, and feed on him in thy heart by faith, with thanksgiving.”
She said the offertory for the consecrated wine and held the bottle to Mrs. Johnson’s lips. The old woman sank back onto her pillow, her eyes closed, while Clare folded the pyx and bottle into clean linen and replaced them in their small leather carrying case.
She laid a hand on Mrs. Johnson’s forehead, pushing a weightless strand of silver hair back into place. “I don’t think I need to tell you to go in peace, to love and serve the Lord.”
Mrs. Johnson smiled, but did not open her eyes. “I’m going to do that soon enough, whether you tell me to or not.”
“I need to do a shorter bedside service for you. This tires you all out. Last week your nurse chewed me out.”
Mrs. Johnson looked at her. Her eyes were pale, as if too many days living had washed all their color away. “No. I love your visits.” She lolled her head to one side. “You know what pleases me?” Clare shook her head. “That the last priest to tend to me on this earth is a woman.” She let her eyes drift closed, and she smiled. “For most of my life, women couldn’t serve on the vestry. Couldn’t be in holy orders, couldn’t sit in convention and vote with the men. I was in Philadelphia, you know, when the first eleven defied the bishops to be ordained. I was fifty-six years old.” She opened her eyes again. “How old were you?”
“In 1974?” Clare smiled. “Nine.”
“You’re just a child yet.” She managed to move her hand so that it fell on Clare’s arm. Clare hadn’t taken her alb off yet, and they both looked at the contrast between the ancient, ropy-veined hand and the fine white cloth. “I knew this,” Mrs. Johnson breathed. Her eyes closed. “I knew we were good for more than ironing the altar cloths and holding bake sales.”
When Clare slipped out of the room a few minutes later, the old woman was asleep. She had pulled her alb off and rolled it into a ball. It would mean wrinkles later, but she couldn’t go flapping through the hospital corridors looking like a dean in a cathedral close. She didn’t need to wear the long white gown when delivering the Eucharist, but the more things looked like a regular service, the more Mrs. Johnson liked it. The dying woman had precious few pleasures left in life. If it had been within Clare’s power, she would have lined the walls with cut stone and set up a stained-glass window.
She stopped at the nurses’ station. It was quiet in the early afternoon. Only the charge nurse, furiously typing her records into the computer, and a doctor buried in a file. “She’s asleep,” Clare told the charge nurse.
“Good,” the nurse said. She looked up at Clare, her fingers still keystroking, as if they were more a part of the machine than of her body. “She needs to rest up for visiting hour tonight.”
“I’ll see you next week,” Clare said. “Please call me if she wants me for anything.”
The doctor straightened. “I thought I recognized your voice.” He stepped forward. It took her a moment to place him; nondescript brown hair, a pleasant face, and the ubiquitous white jacket went a long way toward making him anonymous.
Then she remembered. “Dr. Stillman.” She shifted her bundle under her arm and shook his hand. “How are you? What are you doing up here?”
“One of my older patients had a bad fall,” he said. “Broke her hip.” He gestured toward Clare’s clericals. “Look at you. You can sure tell you’re a minister now. You were a lot more casual when you brought your friend in. How’s he doing?”
“I haven’t seen him since then,” she said. “He’s been keeping pretty busy investigating Dr. Rouse’s disappearance.”
Dr. Stillman shook his head. “Bad business. You just don’t expect something like that to happen in this area. Especially to a man as well respected as Allan Rouse. Lord only knows how they’re going to staff the clinic with him gone.”
“Not to sound like a Monty Python sketch, but he’s not dead yet.”
Dr. Stillman looked at her. “When people go missing in the Adirondacks for two weeks in winter, they don’t walk out again.” He gestured toward the elevator in the middle of the hall. “You headed out? I’ll walk with you.” He came around the work counter and fell into step beside her. “I’ve heard that there was a woman with him who was involved in his disappearance.”
“There was a woman with him, but it’s not what it sounds like. She was a former patient of his. Or rather, her children were. She’d been picketing the clinic. She thinks the preservative in their vaccinations caused her son’s autism.”
George Stillman’s whole face opened up in understanding. “That woman. Oh, Lord, yes, she was over here at the hospital, too. Total nut job. What did she do, drag him out there to kill him?”
Clare looked at him, surprised. “I doubt it. He’s the one who asked her to meet him. He wanted her to see the graves of some children who died of diphtheria in 1924.”
Dr. Stillman stopped in front of the elevator and mashed the button. “Really? And the graves were around here? I wonder if they might have been my grandfather’s patients. He lost quite a few to diphtheria in the early twenties. Couldn’t persuade people to take the serum. They used to think gargling and nose sprays would get rid of it.” He rolled his eyes.
“How do you know about it?”
He looked at her as if she were soft in the head. “Diphtheria? I studied it in med school.”
“No, I mean about your grandfather. And his patients. Did he used to talk about them?”
Dr. Stillman shook his head. “He died in ’48, before I was born. But he was a lifelong diarist. My dad kept every volume and passed them on to me.” The elevator doors whooshed open and they stepped inside. “I’ve read them all at least twice. Incredible insight into life in the early years of the twentieth century and what it was like to be a country doctor. Someday I’m going to work them into a publishable form.” He grinned. “Like when I’m retired.”
Clare rested her balled-up alb and leather case against her hip. She tamped down the electrical surge that had flashed through her at the mention of the diaries. “Do you think I could take a look at them? The ones from 1924?”
The doors chimed and opened. Dr. Stillman gave her the soft-in-the-head look again. “Why?”
“It’s complicated. Have you got a half hour?” They stepped out of the elevator into the first-floor admissions area. Before he could answer, she went on, “Short version is, the surviving child of that family is one of my congregation. And a hefty sum of her mother’s money—the mother who lost the other four children to diphtheria—used to go to support the clinic and now is going to go to St. Alban’s. I’ve been digging out bits and pieces of the Ketchems’ family story ever since I learned we were going to be recipients of their money. If he was their physician, your grandfather’s journals might be the only contemporary eyewitness account of what happened.”
“That’s the short version?”
“I told you it was complicated.” She pressed her hand against her chest, not so subtly highlighting her clerical collar. “I promise I’ll be very careful with them. I know how to work with old and valuable books.” She had researched original sources occasionally in the seminary. Of course, that had been under the direct supervision of the rare-collections librarian, a man who had been known to turn the pages for seminarians whose skin-oil level he found fault with.
Dr. Stillman was waving his hand, demurring. “It’s not that they’re really old and valuable,” he said.
“They are to you.”
He looked at her. “Okay.”
“Okay?”
“Okay, you can borrow them. The volumes you need.” He glanced at his watch. “I’ve got another half hour before I’m done with rounds. How ’bout I meet you at my office after that? It’s right next door, in Medical Building A.”
“You keep them in your office?”
“I’ve got two teenagers and a back-to-the-nester in my house,” he said, looking pained. “I keep everything I don’t want torn apart in my office.”
“Clare had time to swing over to St. Alban’s, collect her messages, and get back to a few people before heading out to Dr. Stillman’s office, Lois’s admonition to “return that man’s phone call!” ringing in her ears. Hugh Parteger had called again. Clare couldn’t help but think that if he phoned her in the evening, from his apartment, instead of using the company line at his office, he’d be more likely to reach her.
Medical Buildings A, B, and C were as unique and graceful as their names promised. Large concrete shoeboxes two stories high, they housed most of the specialists who practiced at the Washington County Hospital. Stillman shared a receptionist and waiting room with three other doctors, and when Clare gave her name to the woman behind the glass divider, she was told to go right on in.
“You found me,” Dr. Stillman said, rising from his desk.
“Well, you know. Medical Building A stands out. I hear it’s the status address in town.”
He laughed. “These places went up in the early sixties. I think it was one of those projects designed to wow the public with the creative uses of concrete.” He stepped over to one of the bookcases lining three walls and ran his hand along a shelf of identical leather-bound books, untitled. “According to my grandfather, the land we’re sitting on was the hospital farm in the thirties and forties. It supplied milk and fresh produce for the kitchens.” He grinned. “The cafeteria would probably be a long sight better if they had kept it going.”
“Are these the diaries?”
He pulled one off the shelf and handed it to her. AMSTERDAM STATIONERY SUPPLIES DIARY 1939 was stamped on the cover in gold. “They were freebies,” Stillman said. “Grandfather got all his writing paper and ledgers and whatnot from them, and they threw in the diary every year as a thank-you.”
“Like the old advertising calendars.”
“Yes.” He looked at the shelf again. “What years were you interested in?”
“Nineteen twenty-four. Probably ought to include 1923 as well.” He removed two volumes and she swapped them for the 1939 diary. “And could I also look at 1930, too?” Maybe old Dr. Stillman had had something to say about Jonathon Ketchem’s disappearance.
Stillman handed her a third book. “You know,” she said, tucking them into the crook of her arm, “you should make some provision to leave these to the historical society. In case you don’t get a chance to publish them.”
“You’re right,” he said. “I shudder to think what might happen to them if my kids get their hands on them. My oldest is a so-called artist. She’d probably tear the pages out to use in one of her collages.”
Clare thanked him and promised again to take good care of his grandfather’s work. On her way back to St. Alban’s for the five o’clock evening prayer, she dropped the three volumes at her house. She resisted the temptation to take a quick peek, knowing that if she did so, she’d wind up reading and probably be late for the service.
Evening prayer had a whopping seven attendees, but they were evidently as eager to get home as Clare, and after she concluded the service with a verse from Ephesians, they all scattered, and she was back in the rectory by dinnertime.
She figured that the rare-collections librarian would never have approved reading the diaries while scarfing down pasta, so she plunked her plate in front of the tube and ate with Jim Lehrer, who was never put off from discussing the day’s events by the sight of her chewing rigatoni.
After she had washed up, she started a fire, stretched out on the sofa, and began reading.
Mar. 6th. V. Rainy & cold. Called to Mrs. B.G.’s house for delivery, got stuck in the mud as their creek had risen & had to walk the last mile. Mr. G. took his team & rescued my automobile. Mrs. G delivered of a boy, 6 lbs 5 oz at 6:00 pm, good color & sound lungs. Home early for supper—Hard rolls & sausages, chocolate cake.
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 temp., 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.