Ship Fever

[I.]

January 27, 1847

Skibbereen, County Cork

Dear Lauchlin:

Does this find you well, my friend? For myself I am well enough in body but sick at heart: small excuse for not writing sooner. All has been confusion since our arrival. I have been traveling from county to county with two Quaker relief workers, an American philanthropist, a journalist from London, and various local authorities. Matters are worse than I expected.

At Arranmore, in County Donegal, the streets swarm with famished men begging for work on the roads. At Louisburgh, in County Mayo, the local newspaper reports between ten and twenty deaths a day, and I myself saw bodies lying unburied, for want of anyone to dig a grave. In a hut that had been quiet for many days we found on the mud floor four frozen corpses, partly eaten by rats. That same day, a dispensary doctor told me he’d seen a woman drag from her hovel the corpse of her naked daughter. She tried to cover the body with stones.

Does this give you some idea? Here at Skibbereen, I saw in one cabin a man, his wife, and two of their children, all emaciated beyond belief, sitting around a tiny fire and mourning a young child dead in her cradle, for whom they had no way to provide a coffin. In some places, men have constructed coffins with movable bottoms, in which the dead may be conveyed to the churchyard and there unceremoniously dropped. Those lucky enough to be buried at all have no mourners, often no more than a handful of straw for a shroud.

I see no hope of this situation changing; the British Government continue their benighted policies and say they’ve spent vast sums. Yet we hear reports that the people, having eaten their seed potatoes and cattle and horses, are reduced to eating frogs and foxes and the leaves and bark of trees. Dysentery rages among those who eat the unground Indian corn passed out so grudgingly by the Relief Commission. To the complaints of Parliament, that the land lies unworked and that the lazy Irish refuse to fend for themselves, I would only ask that they visit here and see with their own eyes the terrible apathy brought on by starvation and despair. Or let them hear the horrifying silence lying over this land. We travel for miles and never hear a pig’s squeal, a dog’s bark, a chicken’s cluck, or a crow’s caw.

As you might imagine, I’ve been writing articles, the first of which I am sending to the Mercury by this same post. The American with whom I travel has also undertaken to arrange publication of some of these in the New York papers. Anything to counteract the London papers, which are enough to drive one mad. Yesterday I read a column stating that the cause of the “potato murrain” is a sort of dropsy. Others contend that the rot arises from static electricity generated in the air by the puffs of smoke from locomotives, or from miasmas rising from blind volcanoes in the interior of the earth. Always the potatoes; not a word about the ships that sail daily for England with Ireland’s produce, which might have been used to feed the starving.

I wonder what you would make of all this? You are busy, I imagine. But I know you are keeping an eye on Susannah, as promised. Do try to visit when you can, and keep her in good spirits; I expect she is lonely but I cannot be both here and there and I know you will help her understand this. With luck I will leave here in April, but it is possible I may go to London and do what I can to influence matters there. There will be a vast emigration this spring, for which you should prepare yourselves. Forgive my haste and this scattered letter.

AA

Dr. Lauchlin Grant paused, after reading most of this letter out loud to Susannah Rowley. They were in the Rowleys’ handsome house on Palace Street, in the city of Quebec, behind a door carved with a pair of As intertwined with an S. Susannah’s husband, Arthur Adam Rowley, had built the house and arranged for the decoration of that door. So confident was he of his place in the world that he signed everything, even his newspaper articles, solely with those initials.

But even Arthur Adam could not control the weather, and his sitting-room, with its windows still sealed against the Quebec winter, was overheated on this unexpectedly warm day. It was April already; winter had delayed the mail even longer than usual. The letter increased Lauchlin’s discomfort, and he removed his jacket as he finished reading.

He had not read the lines about watching over Susannah, because they would have infuriated her. Nor had he read the part about the corpses devoured by rats. Now, as he draped his jacket on the chair, he spoke two lines that did not exist: Please ask Susannah to forgive me for writing so infrequently to her. She is in my mind always, but I cannot bear to subject her to all I’ve seen.

Susannah made no response, but Lauchlin felt the sweet, easy mood in which she’d welcomed him disappear. Annie Taggert, the Rowleys’ parlormaid, set the tea-tray down on the claw-footed table by the fireplace, and still Susannah said nothing more than, “Thank you.” Only after Annie’s departure did she turn to Lauchlin to ask, “Do you suppose Annie heard you reading that?”

“Annie?” Lauchlin said. “How could she?”

Susannah shrugged. “She hovers, you know. She stands outside and pretends to dust that cabinet in the hall. She’s been with Arthur Adam a long time—I’m still new to her, and she doesn’t entirely trust me.”

“With…me, you mean?” His face grew so hot that he moved toward the sealed window. “Can’t we get this open?” he said, pushing irritably at the latch. At night he dreamed of women he’d glimpsed during the day, and in his dreams their garments fell away, revealing milky skin. But his dreams were no one’s business.

“With anyone, I suppose. She thinks my manners are appalling. She thinks I’ll say something that will prove I’m not a lady.”

That was all she meant, then. He leaned his forehead against the window, but the glass was hardly cool. Then he said, “I’m sorry about the letter—I shouldn’t have read it to you.”

“Why not?” she said. “How else would I know what’s going on? Maybe he’s on his way home already.”

As she paced the room, the sun cast the folds of her blue gown into deep shadow and struck silver highlights on her breast and shoulders and back. These glimmers were her only jewels, other than her wedding and engagement rings—although not born a Quaker, she’d been raised by her Quaker aunt and uncle after her parents’ deaths, and she still dressed simply. And yet, Lauchlin thought, part of her seemed to miss the glitter of her childhood. When he’d entered this sitting-room earlier, he’d found her kneeling before the tea-table, turning over the contents of her mother’s jewel box. The sight of that mahogany box, with its chased silver hinges and rose velvet lining, had frozen his greeting in his mouth. When they were very young, and had lived next door to each other, Susannah’s mother had sometimes let them play with the box on rainy days. The string of pearls Susannah held, and the hatpins—one tipped with cloisonné flowers, the second with an onyx knob—were as familiar to him as his own mother’s earrings and brooches.

“Do you want to put it on?” he’d asked, bending over to touch the necklace.

As he did so he’d remembered her, at age seven or eight, parading around her mother’s dim dressing room while the rain streamed down the windows. Her parents had gone out and the nursemaid who was supposed to be watching them had fallen asleep. Susannah had stuck the hatpins in her pinafore and, because neither she nor Lauchlin could open the clasp, draped the necklace over one shoulder and around the heads of the pins. She’d smiled broadly and tilted her chin, imitating her mother. Later she’d been given some modest jewelry of her own: a ring with a small ruby, which Lauchlin had watched her unwrap at her tenth birthday party; a dainty gold bracelet. And he had chosen, with his mother’s help, a pretty enameled hair-clasp for a Christmas present. Where had those things gone?

“I don’t like to wear them,” she said, dropping the strand back in the box. “But they’re so pretty to look at…remember these?” She held up a dangling pair of coral earrings.

“Of course I do,” he said. “Surely you could wear those? They’re very plain.” Her earlobes were just visible below the wings of her dark hair, which was parted in the center and drawn up in a simple knot. The coral drops would look lovely against her hair and skin, he thought.

She shook her head, but did not object when he crouched across from her and peered into the box. “Your mother dressed so beautifully,” he said. “And that whole house looked like her, somehow—those violet drapes, remember those? I used to think she must have picked them to match her eyes.”

“She might have,” Susannah said. Her own eyes were closer to gray than violet, and were set unusually far apart. They’d made her look oddly adult when she was a girl. Now they made her look girlish. “I wish I could picture her more clearly. Do you ever have times when you can see all the things around your mother, her clothes and jewelry and furniture—but you can’t see her face?”

“Sometimes,” he said.

Then he’d risen hastily, turned his back on her and the mahogany box, and produced the letter that seemed, suddenly, to have soured the afternoon. All because he couldn’t bear to think of the year when Susannah’s parents had died within a week of each other, and his own mother’s life had been extinguished like a lamp within a room he was not permitted to enter. Afterwards he and Susannah had been separated. She’d gone to her aunt and uncle’s house, in the suburb of St. Roch; he’d been shipped off to cousins in Montreal. Throughout those years, and then through his medical training and his postgraduate studies in Paris, he hadn’t seen her.

On his return to the city of Quebec two years ago, he had rediscovered her: grown and married to Arthur Adam Rowley. How had this happened? But the answer was obvious. She was intelligent and beautiful; Arthur Adam was tall and wealthy and clever. And although she had no more dowry than her mother’s jewel-box, her upbringing set her apart from many of the more frivolous young women in the city. Her seriousness fitted well with Arthur Adam’s ambitions. Already he’d made a name for himself as a journalist, despite the fact that he had no need to earn a living. He liked to make crusades in print, and to outrage his peers by taking up the causes dear to Susannah’s adoptive family. Older men predicted for him a career in politics.

Lauchlin had grown fond of him, despite twinges of envy. All that energy and enthusiasm, his warm hospitality and vibrant conversation—no, it was impossible that Lauchlin should resist him. And their growing friendship had meant he could see Susannah easily. He could knock on the initialed door, as he had today, and be sure of a welcome. Just now, though, he felt confused. Was it the information contained in the letter that had upset her? Or the fact that the letter had not been written to her?

“His news made me miserable,” Lauchlin said: both stating a fact and searching for the source of Susannah’s unhappiness. “It’s unbearable, what’s going on over there. And me here, doing nothing—I should be there.” He pressed his forehead against the glass, as if he could push through it to the air.

“It’s not as though Arthur Adam is actually doing anything,” Susannah said. “He’s watching. He’s writing. That’s what he does. Why does he write in such detail to you, and not to me?”

“He’s writing articles that move people,” he said, evading her question. “Move them to send clothes, money, food—that’s hardly nothing.”

“Anyone could do as much…oh, I don’t mean that, I know what he’s doing, how important it is—but I miss him. All the time.” She continued to pace, swishing her skirts against the heavy furniture. “Does he think I wouldn’t be interested? Why can’t I be there?”

“It’s no place for a woman.”

She spoke as if she hadn’t heard him. “Stuck here, sorting old clothes and running bazaars…and feeling you watching me all the time. He asked you, didn’t he? To keep an eye on me.”

“Only the way a friend would ask another friend—to ease his mind, you know. And perhaps to make sure we each have some company in his absence.”

“That’s how you see yourself? As company?”

Was she mocking him? The room was stifling. He had taken great pains, he thought, not to let her know the depth of his feelings for her. He had been friendly but no more than that; well-mannered, discreet. Although it was true he fussed over his clothes when coming to see her. Now he sneaked a glance at the oval mirror hanging from a cord on the wall. Bushy red hair as neat as a pair of brushes could make it in this weather; a flush spreading from his cheekbones across his freckled, blocky nose. His new shirt was handsome enough, but for all it had cost it still bunched at the collar as if made for a smaller, daintier man. He sat and extracted a fat, prickly cushion from under his elbow. Then he flushed more darkly as he caught Susannah’s gaze.

“Vain boy,” she said. She settled herself in a low chair and poured the tea.

“I am not.” But even as he protested he found himself oddly comforted by her tone, which brought back the bickering of their childhood. Once, in the garden behind his family’s house, they had argued for hours over a passage in a book.

She shrugged, spilling tea into her saucer. “I was only teasing.” Then she let out a small, exasperated sigh. “But here I am. And here you are. Both of us wanting to be over there. I wish you’d stuck with your work at the hospital.”

“But the director wouldn’t let me do anything…bleed, bleed, bleed; that’s all he does, and all he wanted me to do.” He reached for more sugar. “You know that.”

They’d argued before about Lauchlin’s unwillingness to continue working at the immigrant hospital supported by Susannah’s aunt and uncle. “You’re as prejudiced as your father,” Susannah had said. In Findlay Grant’s eyes, the cholera that had killed his wife in 1832 had come from the Irish immigrants, and since then he’d never had a kind word for anyone or anything Irish. But Lauchlin’s defection had nothing to do with his father, only with the limits his own research placed on his time. He studied the nature and uses of alkaloids, those active principles isolated from plants. A substance as useful as atropine or quinine might reveal itself to him, if he were diligent. He’d thought Susannah understood the importance of this. She’d seemed to agree when he explained, after his second hospital visit, how he wasn’t really needed there, and how the work disrupted his research.

Now she offered him a biscuit and said, “Of course your own practice keeps you so busy—how is your practice?”

“The same,” he said bitterly. “As you know.” Why was she being so hard on him? His practice was the least part of his professional life, and the part in which he’d most obviously failed. “Hypochondriacs, asthmatics, rheumatics. And few enough of those. If Dr. Perrault had ever told me that a man with my training would have such a hard time finding patients…”

“Perhaps you ought to pay attention to that,” she said. “Perhaps you ought to think about other ways to employ your talents.”

Why were they arguing? All the warmth of their moment over the jewel-box had dissolved into this disagreement, which had surfaced several times since Arthur Adam’s departure. Where Lauchlin had always believed that his dedication to science would serve the world in large ways, Susannah believed in more immediate good works, embracing the recent flood of immigrants as if by doing so she might bring her parents back. During their honeymoon, she and Arthur Adam had investigated the slums of Paris and Edinburgh, and Arthur Adam claimed she’d contributed to his articles. Since he’d left for Ireland, she’d been helping her aunt and uncle gather food and bedding for the sick. But it was not as if Lauchlin had been idle.

“You’ve made your point,” Lauchlin said. “I notice you don’t seem to mind living in this fine house, though. Even if you’re too good to wear a necklace.”

Immediately he was ashamed of himself; she had lost both parents, where he had lost only one. And the oil portraits in their gilt frames, the piano, and the table with the claw-feet grasping marble spheres were not her choice. Once, when the three of them had been playing whist with another of Arthur Adam’s friends, the friend had complimented Susannah on the new Turkey carpet and she had said, “Arthur Adam picks out everything—congratulate him.” A silence had fallen across the card-table, but later she and Arthur Adam had stood arm in arm at the front door, waving good-bye to the two single men.

“I’m sorry,” Lauchlin said. “I know you wish I was more like your admirable husband.”

He’d meant to be sarcastic, but to his horror she didn’t disagree. “So do something,” she said. Her handsome hand, flicking the air in a furious gesture, knocked her cup to the floor.

And at that, so discouraged and disheartened was he by both her attitude and Arthur Adam’s letter—Arthur Adam, brave and noble, off doing all that he ought to be doing himself—that he set down his own cup and left, his jacket tossed over his arm and the afternoon completely spoiled.

Annie Taggert watched Lauchlin leave. She had overheard most of this conversation; she had also, as Susannah suspected, listened to him read Arthur Adam’s letter. But the letter didn’t keep her from wishing the emigrants arriving here would all stay home. They were like Sissy, she thought. She bustled back into the sitting room and swept up the fragments of broken china while her mistress stared out the window. Too pathetic to help themselves, more and more of them flooding this country: like Sissy, whom Mrs. Heagerty had hired last fall in a moment of weakness. Filthy and stupid and good for nothing. Making a mockery of the people already here.

Down the stairs she went to the kitchen, balancing the heavy tray and already anticipating all that Sissy would have done wrong in her absence. Annie had left Ireland almost twenty years ago; she remembered her fellow passengers as poor but respectable. Men who found work immediately, on the docks or in the forest, cutting timber. Women like her, who went into service with a knowledge of what it meant to do their part in keeping up a household. Nothing like the new arrivals. She noted a small puff of slut’s wool on the stairs; Sissy, again. And in the kitchen she found Sissy crying as she peeled parsnips.

“What’s with her?” Annie asked Mrs. Heagerty, the cook. “What’s the girl sniffing about now?”

Mrs. Heagerty was filling and trimming the lamps, which marched across the table in tidy rows. The room was fragrant with the pies cooling on the range. “I went across to see Mrs. Mullaney,” Mrs. Heagerty said. “Just for a minute, you understand. And what do I find when I come back? Our lazy girl here, sleeping under the table like a dog.”

“What can you expect?” Annie said. She and Mrs. Heagerty had an old and firm bond; they had both worked for Arthur Adam’s parents for years, in one of the finest houses in the city, before coming here to set up this new household. They knew how things should be done. “The stairs are a horror, you know. You saw the filth she left in the corners?”

“No,” Mrs. Heagerty said. “Really?” They turned to weeping Sissy and shook their heads. Annie piled the crockery near the sink. “Don’t you be smashing these when you wash them,” she warned Sissy. “Mrs. Rowley’s already done enough damage for one afternoon—and the good china, too.” She turned to Mrs. Heagerty. “Swept a cup right to the floor, she did. She was that angry at the doctor.”

“What was he wanting?” Mrs. Heagerty asked.

“He had a letter,” Annie said. “From Mr. Rowley. I heard him read part of it. Terrible goings-on over there. If you could hear the things he writes—a stone would cry.”

“He’ll cry,” Mrs. Heagerty said darkly. “When he gets home. If someone doesn’t have a word with that wife of his.”

“They had a fight,” Annie said. “I think that’ll be the end of our doctor—you should have heard the tone in her voice.”

“He’s a useless creature, isn’t he? I heard from Mrs. Mullaney that whole days go by when he isn’t called to a decent house.”

Annie agreed, although she was not sure what it was she wanted the doctor to do. No one could emulate Arthur Adam Rowley, and the idea of the doctor joining in Mrs. Rowley’s dogooding was hardly better. Annie disapproved of her mistress’s actions almost entirely. Exposing herself to filth like that, walking through low parts of town with only a Quaker woman for a chaperone—no, it was not appropriate. Although it was just what you might expect from a woman brought up so irregularly. Mr. Rowley’s mother would never have done such a thing.

Sissy sniffed. “I heard,” she said, in a quavery voice just audible to Annie.

“You heard what?” Annie said sharply. “Speak up.”

“I heard,” Sissy repeated, “from Margaret—you know, at the Richardsons’—that a patient of his died because of something he did. Mrs. Sewell, it was. She had the dropsy. And Dr. Grant wouldn’t bleed her, Margaret says. She says Mrs. Sewell swolled up like a great pig and died, because Dr. Grant wouldn’t bleed her.”

“You heard,” Annie said angrily. “You heard. You know better than to repeat that sort of gossip.” But to Mrs. Heagerty she said, “What can you expect of a man like that? Learning here isn’t good enough for him, he has to go to Paris, France. Then he’s surprised when he comes back here with his fancy theories and finds no one to welcome him but our generous Mr. Rowley.”

Mrs. Heagerty made a sour face and picked up the first pair of lamps. “And his generous wife.”

On an evening two weeks later, the only lamps lit at Lauchlin’s house were in the kitchen, where he had no place, and in his crowded office. He shared this house with his father in theory, but in fact his father was not around for more than a few weeks a year. In his absence, Lauchlin had let go all the servants but one housemaid and the housekeeper and the housekeeper’s nephew, who slept in the stables and did part-time duty as gardener and groom. Lauchlin could hear them laughing downstairs, by the warm range.

His room was cold. He sat on the floor, in front of the fire, with a glass of Bordeaux beside him and a plate of food congealing on the arm of his chair. Slowly, meticulously, he pried the top from a large crate and began to unpack the shipment of books he’d been awaiting all winter. Henle’s General Anatomy, which he handled reverently and then set on the shelf beside his earlier work, On Miasmata and Contagion. Chadwick’s Sanitary Report, which he placed next to Southwood Smith’s Treatise on Fever. Thick books bound in smooth calfskin, containing knowledge he’d begun to think he would never use.

In Paris, where he’d studied with the famous Dr. Pierre Louis, he had learned to be suspicious of excessive blood-letting and over-zealous purgation and to seek scientific explanations for disease. He had learned percussion and auscultation and how to use a watch with a second hand for the counting of the pulse. In Paris human dissection was legal; he had not had to rely on demonstrations but had explored scores of bodies himself. Here, though—here the doctors were old-fashioned, even ignorant. Although they’d admitted him to the Quebec Medical Society, no one agreed with his methods and no one sent patients his way. His research had yielded nothing so far and his practice was dead. He might be better employed doing almost anything.

Susannah’s right, he thought. I’m useless. Still stinging from her sharp tongue, he’d called a few days after their argument on his father’s old friend, Dr. Perrault, and mentioned his desire to find some way of combining his interests in research and preventive medicine with patient care. To his surprise Dr. Perrault had responded enthusiastically, although he hadn’t had an immediate solution.

“Public health,” Dr. Perrault had said. “It’s the emerging field—think about Mathew Carey’s study of yellow fever in Philadelphia. Or Dr. Panum’s handling of the measles epidemic last year in the Faroe Islands. In his report he proved beyond doubt the efficacy of quarantine and the fact that measles is not miasmatic but purely contagious in character. The most rigorous, mathematical epidemiology and investigation of underlying cause, combined with patient care and social policy—good science combined with good medicine. Or so it seems to me. You might keep your eyes open to opportunities here for similar work. It’s a shame to waste your kind of training.”

The conversation had sent him back to his books and, even more than Susannah’s apparent scorn, had made him think perhaps he should reconsider his direction. He had not gone to see Susannah these past two weeks; no more evenings playing cribbage, no long talks over tea. Since their argument he had felt himself to be a scuttling little creature: a rodent, say. Or a louse. His desk was piled with unpaid bills and he’d have to draw on his father’s account again. The house needed repairs, after this long harsh winter. Gutters needed patching, stonework repointing, the shrubberies were a mess; workmen had to be organized and plans drawn up. He had more than enough time to attend to all this, but the idea filled him with an overwhelming boredom. Surely, surely, this was not how he was meant to spend his life.

He finished shelving his new books and then methodically broke the crate into kindling and stacked the pieces beside the fire. Nothing to do now but face the mail. Bills, a heap of medical journals, some of them from the States; a letter from Bill Gerhard in Philadelphia and one from a Dr. Douglas.

He opened the letter from Gerhard first: the usual list of triumphs and enthusiasms. In Paris, Gerhard had already been established as Dr. Louis’s prize student when Lauchlin arrived, and they’d overlapped just long enough to establish a friendship. Since his return to the States, Gerhard seemed to have done everything that Lauchlin wished he’d done himself. An appointment at the prestigious Pennsylvania Hospital; an enormous practice; an investigation into epidemic fevers that resulted in a series of brilliant papers in which he differentiated typhus and typhoid in terms of their distinctive lesions.

Increasingly I lean toward the theories of Henle, Gerhard wrote, after giving the news of his family. These fevers must be due to some sort of pathogenic microbes; and not, as the miasmatists contend, to noxious exhalations given off by filth. But I have to admit I have had no success in finding these microorganisms.

Lauchlin skimmed the rest of the letter and then put it down, feeling very tired. His twenty-eighth birthday had passed without anyone noticing it but him; perhaps, as Gerhard had once suggested, he should have settled in New York or Philadelphia upon his return from Paris, instead of coming here. He almost burned the other letter unread. A request for money from one of the newly founded medical schools, or an invitation to a dinner honoring a colleague he did not respect; he could not bear one more reminder of his failure to make his mark in this city.

But it was just possible that the letter was a referral, and so he slit the envelope.

May 2, 1847

Grosse Isle Quarantine Station

Dear Dr. Grant:

Dr. Perrault has been in touch with me, about your recent inquiry into the possibility of entering the field of public health. I am writing to ask if you might consider assisting me here at the Quarantine Station for the summer months. Every evidence suggests that the coming migration from Ireland will be extraordinarily large this year. We have news that vast numbers of emigrants began leaving Ireland in February, and I believe we may expect them here within a few weeks, now that the ice has finally cleared from the St. Lawrence.

No doubt you have read in the newspapers the various expressions of alarm by the citizens of Quebec and Montreal. Their alarm is justified, I believe. And likely you are also aware of the recent harsh legislation in the United States, which will almost surely have the effect of turning the bulk of the emigration toward us. However, I have not so far succeeded in convincing Buchanan of the probable seriousness of the situation. I have been granted hardly a tenth of the money I requested for preparations. Nonetheless, I have been empowered to hire several physicians to assist me.

Dr. Perrault has recommended you most warmly, and I pray, if your own business is not too pressing, that you consider joining this important effort. If you can see your way to doing this, I could use you at your earliest convenience. Our small steamer, the St. George, arrives at the King’s wharf on Fridays for supplies, departing Saturday, and is available to convey you. Please let me know your decision as soon as possible.

Yours sincerely,

Dr. George Douglas

[II.]

The island looked like this at first: low and verdant and beautiful, covered with turf and trees. The shrubs growing down to the water’s edge were mirrored in the St. Lawrence, so calm that day that the island seemed to hang suspended above a shadowy version of itself. A huge white porpoise rose, disturbing the silver surface, and gulls dove and then emerged with fish writhing in their beaks. As the St. George steamed past the coast, Lauchlin saw a series of miniature bays, craggy and appealing. Toward the island’s center, where the ground rose, were stands of large trees and a white steepled church. None of these conventional beauties eased the knot in his chest.

He had not called on Susannah to say farewell. Instead he’d sent her a brief, businesslike note, wishing her well in her efforts and telling her his destination. He’d asked that she welcome Arthur Adam home for him, thinking Arthur Adam would be sailing up to the King’s wharf any day, but he had not said, though he often thought: “What if I can’t do what’s asked of me? What if all my training isn’t enough?” She believed he was vain, and she might be right. He could not conquer his fierce desire to be recognized as intelligent and competent.

How tired he was of himself! He thought of Arthur Adam across the ocean, wielding his pen on behalf of the people he met, and he tried to set his self-absorption aside and concentrate on what he was seeing. Something that looked like a fort, something else that might have been the hospital—these disappeared in the trees as the St. George moved on. The island could not be more than three miles long, and was very much narrower than that. So green, so seductively rural. Brown cows grazed, all of them facing him. Parts of the countryside outside Paris had looked like this, offering the same relief from the sights of the crowded city. The view changed as the steamer rounded a point; a small village, and low white buildings near the water that might be the quarantine station. Beyond the wharf jutting into the river at the foot of the village, eight or ten large ships lay at anchor. A number of small rowing boats bustled among them, but Lauchlin could not determine what they were doing.

As the St. George eased alongside the wharf, a slight man in a straw hat came trotting down the planks and prepared to board a boat in which four rowers sat ready. He paused to watch the St. George tie up, and to exchange a few words with its pilot. In their conversation, Lauchlin thought he heard his own name. He smoothed his clothes and hair and took several deep breaths, aware that his hands were trembling. A few seconds later, the man cupped his hands to his mouth and shouted, “Dr. Grant! Dr. Lauchlin Grant!”

“Here,” Lauchlin said quietly; the man was no more than ten feet away.

“Wonderful!” the man said. “Come, come, come! I’m late already for the afternoon rounds, you’d better come with me and see what we’ve got. Three more ships came in at noon.” As he talked he guided Lauchlin off the steamer, down the wharf, and toward the boat where the rowers waited.

“But my luggage…” Lauchlin said. He was tired and hungry and a little queasy, as well as worried about his trunk. In it was everything important to him: his medical books, his lancet and lancet-case, a thermometer, some bandages, and some drugs. Morphine, calomel, ipecacuanha, sulfate of zinc, copper salts, sodium bicarbonate, sweet spirit of nitre, Dover’s powder. Some Madeira and brandy, of course, and a few sets of clothing. The man brushed his hesitations aside.

“Leave your trunk here, someone will take it up—Dr. Douglas arranged a room for you in the village. We’re delighted you’ve come. Just sit here, fit yourself in this corner if you can.”

If this wasn’t Dr. Douglas, who was it? The boat pushed off before Lauchlin had settled himself, and he banged his knees against the seat in front of him. He looked up to find a small, creased hand thrust at his waist. “Dr. Jaques,” the man said. “Inspecting physician. Pardon my manners. All this rush—but you’ll understand when you see. No one expected this. We’re very glad you’re here.”

“Glad to be here,” Lauchlin said.

And for the moment, despite the odd flurry of landing, he was. His last patient, before he closed the office, had been a wealthy neighbor who complained that his liver pained him when he drank more than a bottle of wine at dinner. Clutching the bulging flesh below his ribs, he’d whined like an old man but declined to modify his diet. But here were people, Lauchlin thought, among whom his skills might be useful. Almost surely there’d be dysentery, and perhaps a few cases of ship fever; also all the effects of the long starvation about which Arthur Adam had warned him. He braced himself; this was what he was trained for. Meanwhile he took care to sit with his back straight and his chin set, looking over the shoulders of the men who rowed.

It was several minutes before he noticed the water. No longer clear and blue, it was now streaked with dirty straw in which larger objects were suspended. Something floated past him that looked remarkably like a pillow; then several barrels, a blackened cooking pot afloat like a tiny boat, a mass of rags, and some broken planks. There were corked bottles half-filled with clear yellow fluid the color of urine, and baskets lined with scraps of maggoty food. A soggy bed-tick, still kept afloat by pockets of air in its stuffing, elicited a curse from one of the rowers. Two high-crowned hats spun on the water behind it.

“What are these?” Lauchlin asked Dr. Jaques. “These…things?”

Dr. Jaques was impatiently directing the rowers; they were nearing one of the ships. On the rigging white banners fluttered. It took Lauchlin a minute to realize the banners were tattered clothes, hanging out to dry.

“That’s the way they clean,” Dr. Jaques said shortly. “The captains aren’t idiots, even though the British ones run their ships like slavers. Before they signal that they’re ready for us to come, they tell the passengers that we won’t keep them in quarantine if the steerage looks clean. They bully the passengers into throwing all their filthy bedding overboard, all their cooking utensils, the nasty straw: it gets foul down there—have you seen one of these holds? There are no…facilities, and the floors fill up with excrement and filth. They shovel the worst of it into buckets and heave it into the river before we arrive.” He pushed his hat back on his forehead and rubbed at the damp line there. “Sometimes they knock out the berths and toss the planks as well. If they’re healthy enough, they’ll scrub out the place with sand and water, maybe throw on a coat of whitewash. If you didn’t know better, you might think they’d sailed over under reasonable conditions. But you’ll see for yourself—although if this ship is anything like the ones that came in last week, you won’t find much cleaning’s been done.”

Lauchlin nodded, as if this were no less than what he’d expected. He stared at the floating filth and fought down the bile in his throat.

The next half-hour passed in a flurry that left him dumbfounded. On the deck, and then to the captain’s cabin; Dr. Jaques barking out orders and questions. Was there sickness on board? What kind? How many passengers dead and buried at sea? Any dead as yet unburied? How many patients now? The captain, Lauchlin saw, looked as confused as himself. Dr. Jaques had a tablet of paper, on which he scribbled the captain’s answers to his questions. He passed the captain a small book: “Directions,” he barked. “This will explain our procedures. But you must not expect everything to go as stated here. We have room for 150 patients in the hospital, and already we’ve 220 there. No beds. No beds, you understand—we’re building a shed, but we’re dangerously overcrowded already. We’ll do what we can. We’ll take some, the worst cases. The rest will have to be cared for on board until we make other arrangements. The hold, please.”

And then he was trotting back along the deck and down the hatch into the hold, Lauchlin at his heels. The smell was staggering. A single oil-lamp hung from the ceiling, and in the dim light Lauchlin saw the stalls and the narrow passages between them. Within the stalls were rows of bare berths stripped of their bedding and hardly more than shelves. In an open area, scores of unshaven men and emaciated women huddled together, some weeping. Children lay motionless. An old man sat on the floor, leaning his back against a cask and gasping for breath.

Dr. Jaques stopped beside the first berth in which a passenger was lying. “There is sickness here,” he said to Lauchlin.

Lauchlin gaped; did the man think him a fool? Dr. Jaques felt the young man’s pulse and examined his tongue, then gestured for Lauchlin to do the same. Lauchlin shook his head and stepped back, now seeing as his eyes adjusted to the light all the other people collapsed on the bare boards. They shook with chills, their muscles twitched, some of them muttered deliriously. Others were sunk in a stupor so deep it resembled death. On the chest of a man who had torn off his shirt, Lauchlin could see the characteristic rash; on another, farther along, the dusky coloring of his skin.

“Ship fever,” Dr. Jaques said, and headed quickly back up the ladder.

“Typhus,” Lauchlin said, behind him. “We’ll have to find beds for them at once…”

But Dr. Jaques was thrusting more papers into the hands of the mate, with instructions to have the captain fill them out by the following day. “We’ll send a steamer for the healthy,” he said. “As soon as we can. I’ll be back to inspect them before we load. I’ll write an order to admit ten of the patients to the hospital, but the rest will have to stay here for another few days.”

Before the mate was finished protesting, Dr. Jaques had returned to his boat, with Lauchlin reluctantly following. “Nothing else to do,” Dr. Jaques told Lauchlin. “Nothing. You’ll see why when we get back to the island.”

The second ship they boarded, a brig, was not quite so bad as the first; the passengers well enough to stand had cleaned and dressed themselves and were waiting on deck to be reviewed. They were very disappointed to learn that they were not to be carried immediately to Quebec or Montreal.

“Tomorrow,” Dr. Jaques told the captain. “Or the next day. We’re very short-handed just now.”

Meanwhile Lauchlin could see that the water-barrels were nearly empty, and the pig-pens and chicken-coops silent. The passengers’ beds had been thrown in the river. He said, “But…” and clutched the papers Dr. Jaques had asked him to hold. He said, “I’m sorry,” to the sputtering captain; then he said nothing. It was impossible to guess the right things to say or do.

The third ship they visited, a bark, was very much worse. The captain had died four days before reaching Grosse Isle, and the mate who’d brought the bark the rest of the way was sick himself, only capable of responding in broken phrases to Dr. Jaques’s questions. They had buried a hundred and seven at sea, he said. Or perhaps it was a hundred and seventy. When they ran out of old sails to use as shrouds they’d slipped the bodies into weighted meal-sacks and tipped them over the bulwarks on hatch-battens. There were many sick below. Along the rails a crowd stood pale and thin, some propped up by their companions but pretending desperately to be well. Two boys caught Lauchlin’s eye—still in their teens, dark-haired and gaunt, leaning against each other’s shoulders for support. Perhaps they were brothers. When they saw Lauchlin looking at them, they looked at the deck.

He said nothing to them, nor to Dr. Jaques; by now his silence seemed unbreakable. There was no way to make sense of this situation. From the deck he saw the green island, the sun glinting on whitecaps, the hills lolloping gently toward the horizon from the river’s edge. And for a moment he thought longingly of his clean, empty office at home.

Into the hold: again, again. Already Lauchlin felt as though he knew that place by heart. The darkness, of course; and the rotting food, and the filth sloshing underfoot. The fetid bedding alive with vermin and everywhere the sick. But a last surprise awaited him here. He inched up to a berth in which two people lay mashed side by side. He leaned over to separate them, for comfort, and found that both were dead.

He vomited into a corner, a place already so filthy he couldn’t make it worse. Then he scrambled up the ladder and hung breathing heavily over the rail. It was too much, it was impossible. He would go home at once, on the next steamer out, and when Susannah chided him he would tell her that this was not what he had bargained for: this was madness, he could be of no help. All the instruments he’d learned to use, all his theories and knowledge were worth nothing here. These people needed orderlies and gravediggers and maids and cooks; not physicians, not science. They needed food, sleep, baths, housing, priests.

Dr. Jaques came to fetch him. “Feel better?” he asked, offering a clean handkerchief. “Don’t be embarrassed—I did the same thing when I started. Everyone does. Dr. Moorhead fainted six times his first day out on the ships. Up and down like a Jack-in-the-box, you never saw a face that color in your life. You’ll be all right. Are you ready?”

He turned and backed down the companionway again, looking expectantly over his shoulder at Lauchlin. Lauchlin spat into the handkerchief one last time and steadied himself. Of course he had to follow Dr. Jaques. He was young, strong, healthy. “You’ll get used to it,” Dr. Jaques said, as the darkness folded over their heads. “They’re not all this bad. This is among the worst we’ve seen.”

Among the worst? What could be worse? Lauchlin turned his eyes from one impossible sight to the next, determined to follow Dr. Jaques’s lead. Dr. Jaques gave orders to some sailors behind him, sending one up on deck to recruit more hands and another back to his boat, with instructions to have him gather up whatever other boats were available.

“You men,” he said to the sailors who’d reluctantly come to join them. “You’ll have to help here—we have to get these bodies off the ship. There’s a sovereign in it for each of you who’ll do a good hour’s work.”

Even with that vast sum, there were not so many volunteers; he checked the passengers up on deck, but among them not one was strong enough to help. The remainder hunched in corners or lay on the planks, shivering and dull-eyed. Lauchlin shed his coat and rolled up his shirt sleeves and did as Dr. Jaques directed. He and Dr. Jaques and the sailors formed a chain, as they might to pass buckets of water for a fire. Down the length of the hold, up the ladder, across the deck to the rail.

There were boathooks involved at the ladder, where the bodies had to make a transition from one level to the next, but Lauchlin could not bear to look at them or even admit their existence. No thinking, he told himself. Follow orders, do what’s needed. He would not, until this task was done, see the ropes binding bodies into bundles and then lowering them, heads and limbs dangling, down the side of the ship to the boats waiting below. Had he seen that journey’s last stage, he might not have been able to move, as he did, from berth to berth, gently turning bodies and closing eyes and lifting shoulders as Dr. Jaques lifted legs.

The eighteenth body he lifted and passed was a young woman, hardly more than a girl, who’d been dead for several days. Her feet were black and twice their normal size. The nineteenth body, almost crushed beneath the eighteenth, was another young woman, perhaps twenty-two or three. Her hair was very long, matted around her face and neck. Lauchlin had to move the hank aside before he could grasp her shoulders. His mother had had hair like this, black and heavy and perfectly straight; for an instant, as he touched it, he could see her face. It took him a second to realize that this woman’s flesh was still warm. As his fingers tightened reflexively on her arms, she groaned.

The woman, whose name was Nora Kynd, heard Lauchlin’s voice without at first understanding his words. In her delirious half-sleep, she was reliving the last week of her passage.

She had fallen sick before they reached the Gaspé Peninsula and Anticosti Island, and although she had not taken to her bed at first—there being no bed for her to go to—she had spent the days after they entered the St. Lawrence reeling between the deck and the hold. On deck she’d stared at a cabin passenger, neat and clean and well-fed, sketching the sights on a pad. An impossible figure, a gentleman. From the corner where she huddled, he’d looked like someone who might save her, had he cared to. But he was occupied with other interests.

Whales! she heard him exclaim to the mate. She’d seen them too, a great swirl of water near the side of the ship breaking to show a glossy flank. Beluga whales, the gentlemen said; his pencil moved on his pad. A shark followed in their wake with great constancy, and the gentleman mocked the ship’s carpenter who said it was a certain harbinger of death. He pointed out sturgeon, green with white bellies—she saw them too, or thought she did, and that was the name he gave them. Eavesdropping on his conversations, she learned the names for porpoises and eels in the water and the white birds overhead. She needed no help to appreciate the green hills and stony cliffs and farms along the water. They’d been right to come, this was paradise. It was curious, though, that the gentleman never noticed her.

She stayed on deck when the weather allowed, even though she was very ill; anything was better than the crowding and smells below. One of her brothers brought her water, the other what food he could. She knew the younger, Ned, had already been caught once begging extra water from the sailors’ scuttlebutt. She worried about them, distantly, and prayed they’d stay healthy. But a deadly calm had come over her, a calm she knew came from her illness. Shivering that swept her body in waves, scarlet spots on her shoulders—she had fiabhras dubh, the black fever, like all the people dying below. At home she’d taken care of fever patients, using the tricks she’d learned from her grandmother. But now her tongue had gone quiet in her mouth, she could no longer groan, she could not resist. She was filled with a gentle resignation that, during her brief lucid moments, she recognized as fatal.

Where was it she’d finally collapsed? Near the galley, she thought. Somewhere in that crowded space around the range of cooking fires, hemmed in by the cow-house and the poultry pens and the pigsty and the heap of spare spars. Down she’d gone, with the sky overhead rushing down to greet her. Afterwards came a long stretch of darkness and a tormenting thirst. A weight arrived, pressing and crushing as the ship heaved in what must have been a storm. Feebly, during brief waking moments, she had tried to push the weight aside. The weight was first warm and then cool and then cold and very heavy. She woke when the hatches were open, letting in a pale streak of light, and found herself staring into the open eyes of Julia McCullough. They were filmy, like the eyes of a fish.

She’d tried to push Julia’s body away but she had no strength. Her brothers were up on deck where she’d ordered them, knowing her death crouched beyond the bulkhead and unwilling for them to witness it. How they had wailed when she’d said goodbye to them!

But here were sounds, and a sense of the boat motionless beneath her in a way she’d never thought she would feel again. A man spoke above her and then lifted Julia’s body away. He touched her hair, gentle hands. She wanted to thank him but was unable. He touched her shoulders, released them suddenly, made a strangled noise she could not interpret, and then brought his face down so close she could feel his breath.

“You’re alive!” he said.

With a great effort she opened her eyes. Red hair, blue eyes, a nose like a chunk of granite. Almost like someone from home. “Don’t worry,” he said. “Don’t worry—I’m taking you to the hospital.”

Another man appeared behind the first man’s shoulder; then both straightened out of sight. She heard the sounds of argument, then nothing. And so when Lauchlin carried her up the ladder himself, she was not aware of Dr. Jaques’s angry objections, nor of her brothers who broke into sobs as they saw what they assumed was her body draped across a stranger’s arms. She did not hear their joy when they rushed to her and found her miraculously alive, nor their anguish when one of the doctors, red-faced and truculent, pushed them aside and denied them entry to the island.

The two boys who’d staggered over to Lauchlin were the pair who’d first caught his eye upon boarding; they were brothers, Ned and Denis Kynd, and this woman he was carrying was their sister Nora, whom they’d believed dead.

“Let us come with her,” Denis begged. “We’ll do anything—carpentry, cleaning, tending the animals. You wouldn’t have to pay us. We could help take care of her.”

Lauchlin started to say, “Of course,” but Dr. Jaques stopped him. He looked straight at Lauchlin, ignoring the boys.

“I’ll admit her to the hospital,” he said. “Even though there’s no room—let it be on your head, you can find a place for her. I said ten patients from this ship, and I meant it. There are others sicker than her. But I absolutely refuse to let these two on the island. They’re almost healthy, except for the dysentery, and they’re going on the steamer that leaves for Montreal tomorrow. If they stay here they’ll die. If they land on the island, there’s no telling what will happen to them.”

“How can you separate them?” Lauchlin said. It seemed to him, just then, that he had never met a more callous man. But all his pleas were no use; in the end Dr. Jaques simply pulled rank. “You’re the junior doctor here,” he said. “Have you managed an epidemic before? Have you ever seen more than an isolated case of typhus? Do you have any idea what’s going on?”

“No,” Lauchlin said. “But…”

“I didn’t think so.”

The last thing Lauchlin saw of the bark was the Kynd brothers hanging over the rail and wailing, not at all comforted by the thought that they, almost alone among the bark’s passengers, would be on a steamer headed upriver tomorrow. Why hadn’t he thought to give them some money? He could not imagine what would happen to them after their journey—although they didn’t have fever they were half starved, penniless, hardly more than children and deprived of their sister. He could not imagine what would become of any of these people. Already, despite his fury and confusion, he’d begun to doubt the wisdom of singling out a single patient to save among the hundreds needing help. By now he’d figured out the mission of the other boats plying between the ships and the island.

Some carried the patients lucky enough to be admitted to the hospital by Dr. Jaques’s orders. From his own boat, with Nora Kynd unconscious in the bow, Lauchlin could see sailors lifting the helpless patients from other boats, dragging and carrying them over the rocks in the direction of the hospital he still hadn’t seen. The remaining boats carried the dead.

The dead from the bark, where there’d been no supplies, were dropped on the nearest beach and corded like firewood to await the men who’d build their coffins. Others, from ships where a few healthy passengers remained, were wrapped in canvas or rudely coffined in boards torn from their berths. The boats carrying those bodies formed a long line, moving around the projecting tip of the island to the burial ground. In some a mourner accompanied the corpses, but in most only the rowers were alive. A lone boat moved in the opposite direction, carrying four priests with their black bags, ready to don their vestments and visit the holds.

They would be more welcome aboard the ships than him, Lauchlin thought; perhaps more use as well. And yet despite his despair, and his first sight of the hospital surrounded by piles of coffins, the tents lurching upright as the sound of hammering filled the air; despite the glimpses he could hardly bear to register of a panic equaling that on the ships; still he could see that the island was as beautiful as his first glimpse had promised. Above the beach a mass of wild roses bloomed furiously.

Nora was taken from him, to the hospital he glimpsed in the distance. A man whose name he didn’t know led him, on Dr. Jaques’s order, to the place where Dr. Douglas lived. The road from the village wound through a beech grove in full leaf, casting a solid shade that cooled him. Bewildered, exhausted, Lauchlin followed his guide to a green lawn stretching before a cottage perched at the water’s edge. A dog rushed from the rhododendrons, barking and barking as if prepared to bite, veering off only when Lauchlin’s companion seized a stone and threw it. Lauchlin brushed his clothes off as best as he could while his companion knocked on the cottage door. A small man, tidy despite his shirtsleeves, opened it. His hands were full of papers and more littered the table behind him and towered in stacks on the chairs.

“Dr. Douglas,” said the nameless guide. “I’ve brought you Dr. Grant.”

Dr. Douglas said, “Where have you been?”

[III.]

June 2, 1847. The weather continues terrible; today it rained again. The men finished building the first of the new sheds but the hammering continues: coffins, sheds, more coffins. I have not been sleeping well. Already the hives that occasionally plagued me in Paris, when I was overworked, have broken out along my upper arms. Another letter from Arthur Adam arrived, dated March 4 and forwarded from the city—he includes this news, which I suppose he meant as a warning:

There is a great deal of fever here now. We see two types: the so-called yellow fever, which the natives call fiabhras buidhe and some of the doctors call relapsing fever; and black fever—fiabhras dubh—which you will know as typhus. You might warn your colleagues who see this class of patient that they should expect to see some cases among the emigrants headed your way. Yesterday I heard a story, which I could not confirm, that the emigrant ship ‘Ceylon,’ sailing with 257 steerage passengers, lost 117 to fever on the voyage. Have you any evidence yet of this?

One of his articles appeared in the Mercury a few days ago. Lots of details, very elegantly written.

Three days after my arrival, another seventeen ships anchored. All of them had fever. By May 26 there were thirty ships, and by the twenty-ninth, thirty-six: a total of some 13,000 emigrants, many of them sick. Yesterday I stood on the wharf and counted forty vessels stretching down a St. Lawrence so befouled I could hardly see the water. We have in excess of a thousand fever patients on the island: more than 300 jammed in the hospital, the rest in sheds normally used to detain passengers during their quarantine, in tents, and even in rows in our little church. More than this number lie sick in their ships, waiting for help we are helpless to provide. At the far end of the island, the quarantine camp for the “healthy” is in fact also full of the sick. Yesterday a boy died there, without ever having seen one of us. First name Sean, last name Porlack? Pallrick?

June 8, 1847. Muggy and hot. Dr. Douglas is a good man, but nothing he does makes more than a dent in this situation. There are more than 12,000 people on this island now, many without shelter and almost all short of food. Dr. Douglas has applied to the government for a detachment of troops to be stationed here, to preserve order. Buchanan, the chief emigration officer, has obtained some tents from the army. These are not much comfort during the rain and hot weather. My feet are swollen and the skin is peeling between my toes.

This day Dr. Douglas sent an official notice to the authorities in Quebec and Montreal, warning that an epidemic is bound to occur in both cities. Any reasonable quarantine procedures, as the medical profession would recognize them, have become impossible to enforce.

We now allow the ‘healthy’ to perform their quarantine on board, as there is no room for them on the island. They are detained aboard for fifteen days, after which they are shipped upriver. We released over 4,000 last Sunday—truthfully, many were already sick, and many more carry the seeds of contagion. We received word yesterday that three ships loaded with emigrants and bound for this port were wrecked in a late snowstorm along the Cape des Rosiers. All aboard were lost.

Some eighty vessels have now made their way to us. Several among them fly their ensigns at half-mast: captain, chief mate, or other officer having succumbed to fever. Deaths among the passengers are almost past counting. I see I have not yet mentioned the death of Dr. Benson. Arrived here from Dublin on May 21, just before me, he volunteered his services in hospital. After contracting typhus, he died May 28: a kindly, thoughtful man. We are fourteen now, on the medical staff. Twice our number would hardly be enough.

I have hardly seen Dr. Jaques since my arrival. He spends every minute shuttling among the ships. The sick he can do little for—many lie for days without any medical attention. The ships’ captains, crew, and passengers despise him for his failures, but I can no longer do so. He—we, I—separate the sick from the healthy without regard for family ties; we have no choice. Yesterday a young Anglican clergyman, newly arrived, chided me for dismissing a fully recovered young man from the hospital while detaining his still fevered wife. “Where is that man to go?” he said indignantly. “You know they’re sleeping on the beaches now, without any covering. Do you expect him to go upriver without his wife?”

“Where would you have me put him?” I asked. “He’s well, and the ships are full of sick who need the beds here.” Of course I heard the echo of Dr. Jaques’s rebuke to me in my words. And on the clergyman’s face I saw an expression that must have once been on my own.

Why, then, does Dr. Jaques continue so unfriendly toward me? Three young doctors from Montreal assist him at his task, but I am not allowed to join them and he never looks at me squarely. Dr. Douglas says I am needed here on the island more than on the ships; he is courteous to me, but not much warmer than Dr. Jaques, and I cannot help believing that I am under some sort of suspicion because of my behavior that first day. Not because I vomited or fled the hold: Dr. Jaques told the truth there, every new doctor responds this way. But because I argued with Dr. Jaques about the disposition of the Kynd brothers, because I insisted on bringing Nora here…was it what I said? Or only that I raised my voice to say it, that I shouted and showed myself to be excited?

I have not once since then left a patient’s side when I was needed. I have not once raised my voice in anger. Mrs. Caldwell burned the cuff of my last good shirt, and I said nothing.

The days pass swiftly, each worse than the one before. Already those here to help the patients begin to turn into patients themselves. More Catholic priests have arrived, from Quebec and Montreal. They travel among the ships with Dr. Jaques, giving what comfort they can. Mostly they administer last rites. One, who returned to the village this evening for dinner, looks to be on the verge of fever himself. The miasma arising from the holds of the ships is so dense that he swears it is visible as a stream of tainted air flowing from the hatches like a fog.

June 14, 1847. The weather continues extremely hot. Nora Kynd is recovering—a miracle that anyone should get better under these conditions.

We have almost no equipment. The hospital was overcrowded even before my arrival; we were given, to meet the influx of thousands, exactly fifty new bedsteads and double the quantity of straw used in former years. The new sheds are no more than shacks and what bedding there is has been placed directly on the ground, as there are no planks on which to lay it. Within days it becomes soaked and foul. The old passenger sheds are the worst of all. Here the berths are arranged in two tiers; several patients are jammed in each berth and invariably it seems to happen that the top berths are given to patients with dysentery. The filth and stench are indescribable.

We have very few nurses—how could this surprise anyone? For three shillings a day they are obliged to sleep amongst the sick and have no private rooms where they may rest or change their clothes. They receive the same food as the emigrants, and are granted no time in which to consume it; I see them crowded outside the sheds at mealtime, gobbling on their feet. It will be a wonder if they do not all succumb to fever. Dr. Douglas asked one of the priests to try to persuade some of the healthy passengers to volunteer their services. Even with the enticement of high wages, very few came forward.

Buchanan has issued an order compelling all the servants at present on the island to remain, until and unless they can provide substitutes for themselves. They are surly, nearly useless, retained as they are against their will; they taunt us, trying by outright misbehavior to provoke us into dismissing them. The woman whose job it is to bring afternoon tea to me and my assistants yesterday spilled it deliberately. She looked me right in the eye as she let the tray tip, the teapot slide forward and crash to the ground. Her name is Millie. If I dismiss her, there will be no replacement. There is talk of freeing prisoners from the city jail and bringing them here to care for the sick. Meanwhile the police appointed to maintain order wander the streets drunkenly.

On occasion I have longed to join them. I long for many things. Privacy, quiet, sleep, decent food. Susannah. I wonder how she is. If it were not for her and my own fear of appearing weak, I might run away.

Nora is in the little church, which has turned out to be the best of our makeshift hospitals—the bedding stays dry because of the floor, and the large windows allow for good ventilation. Last night, when I stopped by to see her, her skin was cool, her pulse almost normal. She asked me where her brothers were and I told her they were fine. What use would there be in telling her that they have already been carried against their will at least as far away as Montreal? In fact they may be much farther, as we hear that the residents of that city are in an uproar about the condition of the emigrants, and have insisted on pushing many on to Kingston and Toronto.

When I woke this morning, I could not at first remember where I was. I heard hammering—a sound one never escapes from here—and the sounds of carts rattling down the streets, and for a moment I was back at home during the season my mother died. Then I heard the bustle of Mrs. Caldwell below, fixing breakfast for the crowd of us. Besides Dr. Stephenson and Dr. Holmes and Dr. Black, with whom I have been working and who share the second floor with me, we were joined two days ago by Dr. Pinet of Varennes, Dr. Malhiot of Vercheres, and Dr. Jameson of Montreal—a quiet, well-bred man with a passion for bees and some real understanding of physiology. Mrs. Caldwell has arranged makeshift beds for them in the attic above me. Rapidly, this is coming less to resemble a boarding house and more one of the sheds where our patients lie. The other physicians are similarly lodged, the attendants and servants lodged much worse. Food is becoming a problem for us, as it is for the passengers. The beef and mutton Mrs. Caldwell can obtain are sometimes inedible. She bakes, and so we usually have bread except on the days when the local storekeeper runs out of flour. We hear that the bread his wife turns out in large batches is purchased at exorbitant prices by the ships’ crews, who are running low on provisions.

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.”

[IV.]

Lauchlin was so tired on his second journey aboard the St. George that the landscape passed before him in a kaleidoscopic blur. He dozed and woke and dozed again, each time opening his eyes to sights that no longer seemed familiar. Cape Tourmente and Mount St. Anne, then the orchards and vineyards of Orléans Island, and Montmorency Falls tumbling white and foamy between the firs—how was it these places could look so untouched?

The steamer arrived at the mouth of the St. Charles in the middle of the afternoon. Canoes and pilot boats bustled around the large ships anchored in the harbor. Men streamed along the wharves and timber ponds, carrying out the work by which Lauchlin’s father had made his fortune. Before his mother’s death, before his father grew so fierce and distant, Lauchlin had often accompanied him here. Then, as now, a fleet of bateaux with great white sails had carried lumber from Findlay Grant’s sawmill at Montmorency Falls to the ships lined up along the coves.

Amazing, how the roar and bustle of riverside commerce continued in the midst of this crisis. The confusion in the yards and wharves had alternately bored and frightened Lauchlin when he was a boy, and he’d found the London Coffee House, where his father liked to gossip with the Ottawa lumbermen and ship captains, hot and squalid. His father’s disappointment with him had been evident here, as elsewhere. That he did not like to hunt plover and partridge in the Bijou swamp, that he did not much care to shoot caribou near Cape Tourmente, or join the snowshoe races across the ice in winter—all these things had widened the rift between them.

But this summer Findlay Grant was doing business out west, alone but for his crews among the pines and basswoods and maples, and of no more use to Lauchlin than he had ever been. Lauchlin turned his back on the forest of masts and made his way through the Lower Town and then up to the city crowning the cliff. The long sets of stairs swarmed with people. A woman hurrying down cracked his elbow with a basket and one of the hens inside opened her beak so wide in protest that Lauchlin could see down her gullet. The woman pressed on, leaving Lauchlin with a painful bruise.

In his pocket he had Nora’s advertisement, and although he had other duties he went directly to the office of the Mercury. The street outside was crowded with emigrants, most of them pale and in tattered clothes, and for a moment as he pushed his way through it was as if he were back on the island. Inside, he had to fight his way to the counter. A boy whirled to speak to someone behind him, banging his bony wrist against Lauchlin’s bruised elbow. “Excuse me,” Lauchlin said, with growing exasperation. “Excuse me.” A woman in the corner was wailing, collapsed on the floor with another woman bending over her. A clerk leaned over the counter and beckoned to Lauchlin, ignoring the men who were shouting at him from both sides.

“May I help you, sir?” the clerk said. He had a large mole near the corner of his eye, which moved as he spoke.

The men grumbled but stepped back. “I have an advertisement I’d like to place,” Lauchlin said. He handed over the page on which he’d written Nora’s message. “I’d also like to arrange for a copy to run in the Montreal paper. Can you take care of that for me?”

The clerk read the message, his face expressionless. “Certainly,” he said. “Certainly, if that’s what you wish. You’ll be picking up any responses here?”

“Yes,” Lauchlin said. “Or I’ll arrange to have them forwarded to me.”

The clerk calculated the charges and Lauchlin paid his bill. “You know the responses to these have been small?” the clerk said, handing him his change.

“These?”

The clerk gestured at the room. “All these people,” he said. “All placing the same sort of advertisement, looking for family they’ve misplaced. I wish you good luck in your search.”

As Lauchlin turned to leave, an elderly man bumbled into him and then pulled himself upright, clutching a fistful of Lauchlin’s coat. “Your pardon,” the man said. “Would a fine gentleman like yourself have a minute to help?”

Lauchlin gently detached himself. The man’s fingers had left marks on his coat. “What’s the problem?”

“I’m searching for my daughter,” the man said. “If you could just spare a minute, to help me write out an advertisement…”

Lauchlin penned the man’s message, and then he fled. Throughout the cities along the great waterway he imagined this scene repeated: those left behind here searching for those shipped to Montreal; those left in Montreal searching for those shipped farther inland. Nora’s brothers were gone.

One fruitless call after another ate up the afternoon; the members of the Board of Health were more angry than sympathetic, and more concerned with the outbreak of fever in the city than with conditions on Grosse Isle. Sewell was furious and blamed Dr. Douglas; Henderson and Phillips could spare only minutes for him. At Phillips’s office he learned that the clothing and provisions gathered by the Quebec Ladies’ Protestant Relief Society, and meant for the sick on Grosse Isle, had been diverted to the sick here in the city. But here, in the heart of the city’s best neighborhood, the sick were not evident. The clerks bustling around with their papers were remarkably sleek and plump. The physicians’ coats were clean and brushed, the servants were well turned-out, the horses stood calmly before their carriages, occasionally twitching away the flies, and the stone steps he trudged up and down were freshly scrubbed.

In and out of offices, through and back out pairs of weighty doors. Grave faces, cups of tea, hurried half-hearted promises, or outright refusals; yes on a little extra bedding, yes on some extra funds, but not now; no on an emergency shipment of flour and milk, there were already shortages in the city. The fever here was already serious, he heard again and again. A tall official said, “The only good news is that so far most of the victims are emigrants—there are upwards of 800 of them at the Marine and Emigrant Hospital and the newly erected fever sheds nearby. We have no medicine to spare at present.” Lauchlin stared at this man’s shoes as he spoke; they were expensive, and very well shined. Two doors down and a cup of tea later, Jackson told him that the residents of St. Roch, near the emigrant hospital, had torn down the first set of fever sheds in a fury of opposition. “We have had to post guards over the second set at night.”

He called at Dr. Perrault’s office, but Dr. Perrault, whom he had particularly wanted to see, could not be found. Later a young physician told him that a hundred beds had been equipped for the sick in the cavalry barracks on the Plains of Abraham, and that Dr. Perrault was thought to be out there. Someone promised some corn and barley; another official promised a donation of blankets from the army. No more physicians could be spared, he was told. And nurses were not to be found for any wage.

Defeated, and obscurely ashamed, Lauchlin went to Susannah’s house when he finished his rounds, rather than to his own. It was almost dusk and he could not bear to face what he knew awaited him at home. Mail and repairs and the complaints of his servants; what could he do about any of that? In the back of his mind he was hoping, too, that Arthur Adam and Susannah might invite him to dinner. He’d forgotten what real food tasted like, away from the smell of death.

He stood outside the Rowleys’ door, thin and exhausted and out of breath. It was Annie Taggert who greeted him, as he’d expected. But he did not expected her news.

“I’m sorry,” she said. “Mr. Rowley is still abroad.”

“I didn’t know,” he said. Even Annie looked plump to him. Her apron and cap were starched, so clean. “Is he all right?”

“Of course. He’s in London now. We expect him back next month.”

Susannah had been alone, then. All this time. He had written her only twice from Grosse Isle: the most perfunctory of notes, not wanting to worry her in the happiness of her reunion. He had written simply to say that he continued well. He said, “Might I see Mrs. Rowley, then?”

Still Annie did not open the door. “Mrs. Rowley is out,” she said, her voice harsh with disapproval. “Mrs. Rowley is where she always is these days, trotting between the hospital and the fever sheds in St. Roch. It’s a horror, it is. What she’s doing, the places she goes with no more escort than her friend Mrs. Martin—does she think the sickness will just keep passing her by?”

“I don’t know, Annie,” Lauchlin said wearily. Who was Mrs. Martin? “But may I come in? It’s late, she’ll surely be back soon from wherever she is.”

Annie looked him up and down. “You look terrible,” she said. “If you don’t mind my saying so. Have you been home yet?”

It didn’t occur to him to lie to her. “No. I came straight from the island.”

“Straight from working with the sick, I’ll bet.”

He thought she would praise him for his good works among her countrymen. “Yes,” he said.

“And why would you be thinking I’d let you into this house, still carrying the sickness on you? Not me, not through this door.” She stepped forward and closed the door behind her, carefully avoiding any contact with him. “You follow me,” she said. “You want to wait for the mistress, you’ll do what I make her do every night, when she comes home from those filthy places.”

Lauchlin was too weary to argue. Around the house she led him, past the hedges and flower beds and the kitchen garden. “Don’t you touch a thing,” she said, as she led him through the kitchen door. A dirty scullery maid looked up as he passed; Annie said to her, “Dr. Grant’s come from tending the sick. Don’t you go near him.” In an unused storeroom off the kitchen she stopped.

“You go in there,” she said. “That’s where I make Mrs. Rowley clean herself every night. You take off every stitch of those clothes and push them out through the back window. I’ll bring some hot water and a sponge.”

He stood, numb and confused, after she closed the door behind her. What was going on in this house, where the servants now gave orders? What was Susannah doing, and why was Arthur Adam still absent? The room was clean and bare and smelled faintly of nutmeg and flour. There was not even a chair where he might sit.

He was still standing when Annie knocked at the door. “Yes?”

“Here’s your hot water,” she said. “And some soap and a sponge, and a blanket to cover you when you’re done. Get those clothes off you, now.”

He looked down at his filthy pants and his stained, worn shirt and coat, unable to argue with Annie’s caution. “I will,” he said. “I’ll do that right now. Thank you. But could you bring me something of Mr. Rowley’s to put on when I’m done? Even a dressing gown would be fine.”

Annie drew herself up. “That would not be possible,” she said. “We have put all his clothes in storage, against the moth.”

“But Annie—I can’t see Mrs. Rowley wrapped in a blanket, now can I?”

Annie sighed. “You tell me what you’d like from your house,” she said. “I’ll go over there and get what clothes you’d like from your housekeeper.”

“That seems foolish. All I need are a few things.”

He started to argue that Arthur Adam surely wouldn’t mind the loan, but Annie cut him off. “Mr. Rowley’s things are not available,” she said stiffly. “But it would be no trouble for me to fetch something from your house.”

Lauchlin looked down at the cooling water. “Fine,” he said. He gave her instructions and then, as soon as she’d gone, tore off his clothes and tossed them out the window to the ground below. Then he began to bathe. Against his skin, the warm water felt heavenly. The storeroom was almost dark, except for the rectangle of dusky sky let into the rear wall; in the kitchen the scullery maid hummed to herself as if she’d forgotten about him.

Annie set off for Lauchlin’s house but turned back a few yards down the street. The doctor would be wanting supper, she knew. Mrs. Rowley would come home late, as always, and would bathe and change her clothes in the storeroom, the way Annie had trained her: then she’d discover her waiting doctor friend and offer to feed him, with no thought as to where that food might come from. It was Mrs. Heagerty’s day off. Annie, knowing Mrs. Rowley would only pick at some little scrap on her return, had not fixed anything more than a chicken pie, which she’d expected would be more than enough for her and Sissy and the other servants after Mrs. Rowley had taken her two bites.

She ducked back into the kitchen and seized a basket. Sissy cringed. “It’s nothing to do with you,” Annie snapped. “You finish cleaning that silver before I’m back.” Then she was off again; first the market and then the doctor’s house.

At the market, in the square facing the Basilica, she looked through the butchers’ stalls. Chickens were shockingly high, and none looked as fresh as she would have liked; geese were even higher and the mutton she examined was distinctly off. She bought some oysters, which were cheap and fresh, and a pair of lively lobsters—an oyster stew, she thought, warm and sustaining; then the lobsters split and broiled. She and Sissy would eat the leftovers tomorrow in a salad. The wild raspberries had a wonderful smell and she bought a large pail, undecided yet as to whether she’d serve them plain with cream, or in a tart. Lettuce, radishes, green onions; cream and butter of course. Because Mrs. Heagerty wasn’t around to bake, and because she knew she’d be pressed for time, she allowed herself the luxury of a dozen hot rolls.

Then she set off for the doctor’s house. She knew where it was, having carried gifts of preserves and extra produce from the Rowleys’ garden there on occasion; Mrs. Rowley was overly generous with the bounty of Mr. Rowley’s household. Annie walked past the convent, the courthouse, the livery stable, and two hotels. The hotels appeared to be almost empty, which was no surprise; who would visit this city if they could avoid it, now that the fever had come? Behind her she heard the rattle of a pair of carts, and although she averted her eyes she could not help seeing the coffins they carried.

At Lauchlin’s house, she registered the disrepair with surprise. Nasty weeds poking up through the flagstone walk; tall saplings waving arrogantly from the places they’d stolen in the hedge; a stain creeping down the wall where rain had poured through a broken gutter. Ashamed of himself, Annie thought. That’s what the doctor should be. She blamed him for letting things fall apart. If he’d been here where he belonged, and not off at that horrid island, his house would look at least partly respectable.

Annie knocked at the door. The Rowleys’ house might look like this, were it not for the unceasing efforts of herself and Mrs. Heagerty and the others, all joined to keep the place intact for Mr. Rowley, so that he might not be ashamed when he returned. At night sometimes, lying alone in her small attic room counting Mrs. Rowley’s faults, she’d been tempted to let the house crumble in just the way Mrs. Rowley’s inattention deserved. But who could bear it? She touched the grimy doorknob with distaste. Still no one came to the door. Then she heard voices, just a few feet away, too ignorant to realize she could hear them.

“You get it,” a girl said. “It’s not my place, it never was.”

“Well it’s not mine either,” a boy said. “I wouldn’t be in here at all, if it weren’t that I’d come in to eat. You want I should open the door with stable-muck all over my breeches?”

“Don’t care. You open that.”

“Won’t.”

Annie rapped sharply on the door. “Whatever are the pair of you doing in there?” she called. It was shocking, how far this household had fallen. “You open this door right now—I’ve a message from Dr. Grant.”

A terrified silence, and then a boy, as dirty as promised and with a wild head of blond hair, pulled the door inward.

“Fetch the housekeeper for me,” Annie said to the girl. Tall and poorly dressed, the girl was nearly as sluttish as Sissy but looked to be German or Norwegian. She vanished and returned with a middle-aged woman in tow.

“I’m Mrs. Carlson,” the woman said. Portly, suddenly filled with dignity, she drew herself up. “And you would be?”

Annie also stood very tall and identified herself. “Dr. Grant has come to call on us,” she continued. “On Mrs. Rowley, that is—Mr. Rowley being still in England, on very important business. Dr. Grant has had a small accident with his clothes, and he requires that you gather a new set for him, from the skin out. I am to bring the items back to him at the Rowleys’.”

“Indeed,” Mrs. Carlson said. “And how am I to know . you’re telling the truth? What could the doctor have done to himself, to need everything from linens to a coat?”

Annie swallowed the implied insult in silence; this woman was too far beneath her to argue with. “It’s the sickness that’s on him,” she said, lowering her voice dramatically. “From that island. It’s on his clothes, and he doesn’t want to bring it into the Rowleys’. When he leaves there tonight he’ll be coming here. Perhaps he’ll give those old clothes to you then, to have washed.”

Mrs. Carlson stared silently for a long minute. Then she indicated a chair where Annie might wait, and vanished up the stairs in the direction of what Annie could only assume was the doctor’s dressing room.

In Annie’s absence, the other servants at the Rowleys’ seemed to forget that Lauchlin was in the house. When he let himself out of the storeroom, he found the kitchen empty. The front hall was empty as well and finally, feeling very embarrassed to be wandering the rooms in a blanket, he slipped into the library and closed the door behind him. The windows were closed and the room was stuffy, smelling faintly of leather and cut flowers left to stand too long. He opened two windows and then gingerly set himself down in one of Arthur Adam’s magnificent armchairs and arranged the folds of his blanket for maximum modesty. Warm, soft, clean; all these things were delightful but he was very hungry. When he placed his bare feet on the hassock before him, he saw that his toenails were as broken and ridged as those of an old man. His diet, perhaps. Or simply an utter lack of care. On the elbow poking out of the blanket the skin was loose and dry around his fresh bruise. Briefly he let himself wonder what he’d look like by the end of the shipping season, should he survive that long. Eight physicians had already died on the island; he put the thought out of his mind.

Annie would be back any minute, he thought, as he closed his eyes. The breeze that blew through the windows was balmy and carried the scent of roses. A cardinal perched in a pyracantha whistled his four-note summons again and again.

When he woke, it was almost dark. The door to the library opened behind him, and he lifted his head with a start. “Annie? Could I have my clothes?”

The figure behind him caught her breath. “Lauchlin?” he heard Susannah say. At first he thought he’d dreamed her voice. “Lauchlin? Is that you? Whatever are you doing here?”

He rose without thinking, his blanket swirling about him like a cloak. There she was before him, a book in her hand, clad almost as lightly as him in a maroon dressing gown. In the instant before he blushed and turned, he registered how little she had on beneath the glossy silk.

“I’m so sorry,” he said to the fireplace. “Can you pardon me? When I got here you were out, and Annie took all my clothes and made me wait downstairs while she went to fetch others from my house, and I got so tired of waiting for her that I came up here. I must have fallen asleep…what happened to Annie? Why didn’t anyone tell you I was here?”

His voice stumbled, caught between his apologies and all he wanted to say and couldn’t. That she was beautiful in this dusky light, that he had not seen her hair loose in years and loved it; that he had dreamed of her, again and again, during his weeks at Grosse Isle. If only he hadn’t been wrapped in this wretched blanket, he might have allowed himself to turn and gain another glimpse of her. But that would be wrong; she was surely just as embarrassed by her own relative state of undress as by his.

He could hear her backing out of the room, but she was laughing and didn’t seem offended. “Poor Lauchlin! So you ran afoul of Annie’s obsession with dirt,” she said. “I just got in myself—Annie wasn’t in the kitchen when I got home, but I didn’t dare skip my ritual wash. I’m the one who should apologize: my servants mistreating you and then me showing up like this. Just give me a minute to get into some proper clothes. Then I’ll find Annie and see what’s happened to yours.”

He turned around again only when he heard the door close. His skin was burning beneath the blanket—never, not even as children, had they shared such an intimate moment. He tried not to imagine how it might be to have her appear like this before him willingly; he tried, and failed, and then sank down in the chair with a groan, more jealous of Arthur Adam than he could stand to admit. When the door opened behind him again, he didn’t dare rise or turn.

This time it was truly Annie, who was vexed. “Your clothes,” she said. She set the pile on the library table and stood with her hands on her hips. “This whole time I thought you’d disappeared—how was I to know you’d let yourself up here? And then Mrs. Rowley creeping in, without even a word to let me know she was back—an hour I’ve been back myself, after running all over town, and when I return there’s not a sign of you.”

Lauchlin sighed and rested his chin in his hands. “Annie,” he said. She had grown very forward these past months, but he did not feel it was up to him to correct her. Arthur Adam would straighten her out quickly enough, when he came home. “If you knew what I’d been doing these last weeks, or how tired I was—I just came in here to wait for a bit. Where did you think I’d gone, with only this bit of blanket to cover me?”

“I’m sure I don’t know,” Annie said. “I’m sure, after seeing the state of your household, that I wouldn’t have the least idea what a gentlemen like yourself would be up to. Your Mrs. Carlson sends her apologies about the darned shirt, and says to tell you she couldn’t find another clean, she’d packed everything away against your return. Mrs. Rowley will be down directly.” But then, as if she’d understood for the first time that he was naked beneath his blanket, she relaxed a bit. “You’re looking foolish in that get-up,” she said. “Go on—get dressed.”

Was that a smile? She shut the door behind her and Lauchlin dressed quickly. By the time Susannah returned, with her hair piled up and her frock demurely buttoned over her shoulders and neck, he was almost respectable himself. “Forgive me for barging in like this,” he said.

She swept across the room and seized his hands. “Don’t be ridiculous,” she said. “I’m so glad to see you—you’re well? No trouble, I hope.”

He squeezed her hands gently and then pulled away. “No more than what’s become a matter of everyday. Dr. Douglas sent me back on some business—I return to the island tomorrow. I was just hoping to see you and Arthur Adam briefly. I had no idea he was still away.”

For a minute Susannah occupied herself with the lamps. “Couldn’t Annie do that?” he said gently.

“I hate to trouble her.”

In the warm glow of the lamplight, she looked almost as lovely as she had in the dusk. Perhaps a little cooler, a little harder, as if her clothes had armored her. Just for a moment he found himself thinking of Nora, whose appearance and manner toward him were always the same. Whose eyes had that mysterious ring around their irises…

“I asked her to bring us some supper, and she’s annoyed enough over that. Arthur Adam will be so sorry to have missed you—you know he’s in London? Still?”

He didn’t want to talk about Arthur Adam. What he wanted was to build a fire and lie down on the rug before it, his head in her lap, and tell her all he’d seen and felt in her absence. He wanted to pull a strand of her hair over her shoulder, against his cheek, but as long as she bustled about like this, and chattered as if this were a social call, all he could do was respond in kind. “Annie said something about that.”

Susannah gestured toward one of the armchairs and then seized a folder of papers before settling in a matching chair across from him. “This is what he’s been doing,” she said, ruffling through the folder and pulling out newspaper clippings. “Quebec, Montreal, Boston, London—there’s hardly a first-rate paper he hasn’t written for, about the famine and the emigration problem. Now he’s calling for wholesale reform of the shipping laws. Look at this.”

She pulled out a long column from a London paper. “‘The entire system of conveying these unfortunate Irish emigrants stands in need of revision. Who, if not the Government, will assist and protect these poor people banished by hunger from their native land? We are bound to regulate matters so as to see that too many are not crowded upon one ship, and that their accommodations are decent. We are bound to see that they have sufficient provisions to endure the voyage in good health, and that medical attendants be on board to see to their needs. We are bound’… well, you get the idea.”

“I do,” Lauchlin said. He grasped both Arthur Adam’s efforts and the way this evening was to go, at least until supper had arrived and been eaten and then cleared away. Annie or one of the other servants might pop in here at any moment, and it was surely their looming presence that made Susannah so circumspect. “I couldn’t agree with him more, after all I’ve seen this month. You have to admire him, for setting this all down on paper.” He could not help feeling a twinge, as he compared that thick file of articles with his own private scribbles.

“Well, of course,” Susannah said. “Now tell me about Grosse Isle. Your letters have been so brief.”

He was reluctant at first, but she pressed him and he found himself telling her some of the details he’d otherwise confided only to his diary. “The worst thing,” he added, “the worst is sending passengers upriver from the island, knowing—knowing—that they’ll be sick within a few days, that they’ll bring the sickness here.”

“It’s true,” Susannah said simply. “I see it every day at the hospital. Some of the doctors here are very bitter about what’s going on at the quarantine station.”

“You think we’re not?” Lauchlin said, indignant. “You think any of us would choose to practice this way? If we had even the slightest support from the government, if we had anything like adequate space and provisions and an adequate staff—you ought to see what it’s like, you’d never blame me.”

“I don’t blame you,” Susannah said. “It’s only the ignorant who do, and even those who blame anyone blame Dr. Douglas. The worst is this fellow called Dr. Racey—he’s set up a private hospital at Beauport, for treating the wealthy unfortunate enough to come down with this pauper’s fever. I went there the other day, with my aunt and uncle. It made me so angry. Dr. Racey has two beautiful clean buildings with excellent ventilation and an armload of good nurses, all for less than a hundred patients. Each of them waited on hand and foot, given tepid baths daily, helped to special drinks and food—he trumpets all over town that he’s only had two deaths. What he doesn’t say is how much he charges.”

“No doubt,” Lauchlin said. Somehow, despite all Susannah’s good will and interest, he was growing very melancholy. His spirits picked up when supper arrived; nothing could counteract the aroma of oysters swimming in hot milk and butter, or of lobsters swelling above their bisected shells.

“You’re very kind,” he said to Susannah. “I haven’t had a good meal in weeks.” During the time he was eating, he forgave her for the fact that she didn’t love him and never had. It wasn’t her fault, he told himself. He had not had the sense to find her before he went to Paris; he had not understood how deeply he was bound to her until she’d reappeared married to someone else.

He finished the oysters, he finished the lobster, he ate three rolls and then Annie reappeared with a beautiful tart. His mood improved and he tried to get Susannah to tell him about her work at the Marine and Emigrant Hospital. She was becomingly, infuriatingly modest. “I just help out where I can,” she said. “Whatever the doctors find useful for me to do.” When he pressed her, she said, “You know what I see, and what I do. Just think of what your own nurses do.” He did, and blushed.

“You know,” he said, “As a physician I’m very grateful for all the ways you are helping out. But as your friend, and particularly as Arthur Adam’s friend, I have to wonder if he would approve. You put yourself at real risk.”

Susannah pushed away her plate of raspberry tart. “Oh, risk,” she said. “If Arthur Adam had his way, I’d never leave this house. Too much risk, he says, when I begged to join him in Ireland, or when I beg now to join him in London. Everything I want to do is too much risk. Meanwhile he leaves me here alone for eight months—what does he expect me to do? Shall I tell you something?”

“If you wish,” Lauchlin said uneasily.

“I hope he doesn’t come home for a few more months. If he were to arrive tomorrow, he’d lock me in here and keep me from going to the hospital—anywhere—and I tell you, I couldn’t bear it.” She held her hands in front of her, staring into her palms. “He’s not like you—you’d let me come to Grosse Isle and help out if I wanted to, wouldn’t you?”

“I wouldn’t,” Lauchlin said quietly. “I never would.”

Susannah rose and stood by the window. “You wouldn’t,” she said. “So you’re like him, that way. Even though you’ll put yourself in the thick of things, you’d still keep me out.”

“Arthur Adam loves you. He only wants to keep you safe.”

Annie came in, cleared the plates, and vanished, gazing at Susannah as she closed the door. And now Lauchlin was as miserable as he’d ever been. All evening he and Susannah had been at cross-purposes; every opportunity for a real conversation lost, every real feeling subverted. He could think of nothing to do but to rise and stand beside her and then hesitantly, hesitantly, touch her shoulder.

She did not pull away from him. Rather she leaned into him slightly, so that their hips touched, and their shoulders and their upper arms. They stood there for a long time, gazing out at the garden as a current of warmth flowed between those few connections. How starved he’d been for the slightest human touch! “I’m sorry,” he said simply. “I spoke badly. But if you knew how much you mean to me…”

“I know,” she said.

Did she? But whether she did or not, his heart lightened. After a few more minutes, already far longer than any touch could be justified, they separated by common consent and moved back to the armchairs. They talked lightly then, of other things; Susannah poured glass after glass of brandy for him and then left him—briefly, she said—to take care of a few details with the servants. Eventually, as he had earlier in the evening, he fell asleep. Who covered him with a crocheted throw he never knew; nor who blew out the lamps or closed the windows. Annie, probably, although just possibly it was Susannah herself. But when he woke at dawn, with the sky pinkening through the windows, it was with an extraordinary sense of well-being despite the slight stiffness in his neck and the fact that he’d made no proper farewell to Susannah.

He crept out of the house as carefully, and as full of elation, as if he’d spent the night doing something illicit. Behind the kitchen he found his old clothes, lying where they’d fallen from the storeroom window but now covered with dew: proof that Annie was not entirely efficient after all. He gathered them in a loose bundle and set off through the empty streets for his own house.

To his surprise he found his housekeeper waiting for him, slumped on a davenport in the front hall. “Mrs. Carlson?” he said, shaking her gently by the shoulder. “Mrs. Carlson? What are you doing out here?”

She rose with a start. “Don’t touch me,” she shrieked. “Don’t come near me with those clothes.”

He’d forgotten about the bundle under his arm. She’d been dreaming, he thought. “It’s me, Mrs. Carlson. Back from the island. I didn’t mean to startle you.”

She backed away from him. “I know it’s you,” she said. “I know all about you. Annie Taggert from the Rowleys’ was here yesterday, and she said you were back and that your clothes were full of sickness and you needed clean, which of course I sent although there’s hardly a scrap in the house that isn’t packed away—those very clothes you’re wearing. She said you had brought fever with you, in your clothes—and then you bring that bundle to me, without the slightest consideration…”

He stepped backward, opened his own front door, and threw his clothes in the bushes. Had all the servants in this city gone mad? “Fine,” he said. “No more clothes, and you have my apologies. Must you believe everything that Annie Taggert says?”

“I believe this,” Mrs. Carlson said. “That you have no consideration for this household. You don’t even let us know when you’re expecting to be back—how can I arrange things here? We’d no food in the house for you last night, and then I rushed out to shop and cooked a meal and then you never came at all—how can you expect me to work in such an ill-regulated house? If your father was here he would never permit it.”

Was it reasonable that he should have to explain his actions to his housekeeper? But there was no one else available, and he had to return to the island; he sighed and set himself to the task of mollifying Mrs. Carlson.

Later that morning he boiled his old clothes in the kitchen himself, as he could get no one else to do it, and after he hung them out to dry and gathered a few more things he settled down with pen and paper. First a quick note to his father: Please return at your earliest convenience, he wrote. Or make arrangements by post for someone to take care of the house in your absence. I must return to Grosse Isle today, and I can no longer be responsible for matters here. By now you are most likely aware of conditions at the quarantine station; they require my full attention.

Then, after much thought, he wrote a letter to Arthur Adam as well. He praised Arthur Adam’s articles; he confirmed Arthur Adam’s suspicions that there would be sickness on the emigrant ships; he described conditions at the quarantine station briefly. He would not say outright what Susannah was doing, but finally he added this paragraph:

Of course by now you have heard that there is fever here in the city as well. I am worried about this; I fear very much for Susannah’s safety, exposed as she is to contagion. There is much going on here worth writing about, and no one better than you to do it. Perhaps you would consider heading home?

Lastly he wrote to Susannah: the simplest, shortest note of all. Thank you, he wrote. You cannot know what last evening meant to me, nor how it helps to have the memory of you to carry back to Grosse Isle. I will write from there, when I can.

[V.]

Nora hardly recognized Lauchlin when he returned from his trip to the city. When he’d left the island, his thatch of reddish hair, uncut for weeks, had been matted and dry, while his skin had had a greenish tinge. Everything about him had faded: even his eyes, even his beard. The mouse-colored patches beneath his eyes had looked permanent.

But here he was ruddy and smiling, almost sleek, after such a brief stay away. Perhaps he had slept. He fairly ran up to her, where she was bent over a patient. “Nora!” he said. “Nora!”

The way he said her name made her catch her breath, but still she finished dipping her rag in water and wiping the woman’s face. Dirty bedclothes, dirty skin, foul breath: Margaret O’Connell. One of the people whom, since she’d been well enough, she’d applied herself to helping. Mostly her help amounted to doing battle with the filth that coated everything. At least Margaret’s face was clean. She put down her rag and led Lauchlin away from the pallet. Was it possible he had news of her brothers?

But he said nothing about them. “Nora!” he said yet again.

“What is it? What’s happened?” There could be no news yet of Denis and Ned—unless, perhaps, they had made inquiries themselves, and Lauchlin had seen them…but he would have said. Perhaps he brought some other good news: more doctors, some nursing nuns, better food.

“Nothing,” he said. “Only…”

He wanted to tell her something; he was as eager as Ned had once been, on discovering a beetle he wanted to show her. Then his face changed, and she watched him decide to keep whatever it was to himself. He said, “It was so strange there, Nora. In the city. The fever’s there too. And I couldn’t get anything Dr. Douglas wanted, and then the steamer was so slow coming back, and I saw how many more ships were anchored, and the two big steamers headed upriver: somehow I thought you were on one of them. I thought you’d gone to Montreal. I’m glad you’re still here.”

He worried about her? Surely he was the kindest man she had ever known; and yet after all he understood so little. “How would I go?” she said. “When my only chance of finding Ned and Denis is to stay right here, and hope they find me. You didn’t hear any news of them?”

“Nothing,” he said. “But I put in the advertisements, as you asked. There were so many people at the newspaper office, though. So many people looking.” He touched her gently on the shoulder.

It was as she’d dreaded, then. Her brothers were adrift in this gigantic, unknowable country, along with a flood of their countrymen. She stood frozen for a moment, trying to absorb what he’d said. And why hadn’t he told her this calamitous news before anything else? Other things must be weighing on his mind. He had on different clothes, she saw; a worn, darned shirt with a low collar and a jacket that seemed slightly too large.

“You brought new clothes from home,” she said. “A good thing, too. You needed them.”

He looked down at his shirt front absently. “Annie made me. Annie has ideas about clothes and sickness, she made me strip and wash and put on clean things. I boiled the others, they’re in my grip.”

Nora nodded. She’d been very careful with her own clothes, sponging them off each night with a solution of vinegar and warm water and then hanging them outside her window while she slept. No substitute for a full change, but she had nothing more than the dress and undergarments in which she’d been taken from the ship. Her trunk was gone; she liked to think that Ned and Denis had it. Around her the chapel was filled with groaning people, who needed her attention. Margaret seemed slightly better today. Somewhere else, perhaps someone was bending over her brothers. “Who’s Annie?” she asked.

“One of Mrs. Rowley’s servants, back home.” Who was Mrs. Rowley? “She’s…you don’t know her, what am I talking about?” He walked as he talked, moving quickly among the patients and checking a pulse here, a damp forehead there. George Maloney, Catherine Conran, Matthew Kennedy, Eliza Regan.

Nora could hardly keep up with him. “I don’t know,” she said uneasily. “What are you talking about?”

“Fever,” he said, as if to himself. He turned back blankets, lifted shirts. Francis O’Rourke, Martin Mulrooney. “Thready pulse, shallow respirations; this one’s dehydrated, abdominal rash…” He was not himself; he was changed. What had happened to him?

That day she saw for the first time the wild energy and obsession that overtook him. He’d worked long hours before, but now he seemed to work all the time. He was with his patients when she arrived in the morning and still with them, or bent over his books, when she left late at night for the small room he’d found for her in one of the village boarding houses. When he was not in the chapel he was at one of the other hospitals, or one of the sheds; when he wasn’t there he was down at the tents or out making rounds of the ships or at the shoreline helping land the sick. He was at the cemetery, directing the sanitary arrangements; he was in the kitchens giving the cooks and their helpers instructions about food preparation; he was at Dr. Douglas’s cottage, writing up reports.

The ships continued to arrive, the numbers of patients and quarantined passengers continued to rise beyond all reasonable bounds, and she saw Lauchlin—“You must call me Lauchlin,” he said at some point. “What’s the point of standing on ceremony?”—lose his brief, false flush of health and grow pale and gaunt again. His flesh fell off him as if it belonged to someone else, and had only been borrowed. She believed he had ceased to sleep at all.

During those weeks she and Lauchlin flew past each other like birds, both so busy that they paused only to exchange the most important information. And yet they grew curiously intimate, so that in her mind she carried on long conversations with him. She imagined that he knew just how worried she was about Denis and Ned, and about him. She imagined that she rested her hand on his sleeve and said, “Lauchlin. You must slow down. You must rest. What is it that’s driving you so?”

She could not imagine his answer to this question, but she understood, after a week or so, that his utter lack of care for himself was not purely a wish to heal everyone but rather a symptom of a kind of insanity: He believed himself to be invulnerable. She had seen this at home, in Ireland; she had even felt it herself. She knew what it meant. When she couldn’t bear to think about Ned and Denis she thought of her father, who had lost his mind before he lost his life.

Last summer, when the blight came, her father had at first reacted like everyone else. One afternoon a chill had come, after days of peculiar sultriness, and then a fog that rolled down the mountains. A great silence followed, in which no birds called; nor was there any other sound. When the wind lifted the fog from the ground, it left a dusting like snow on the leaves and stalks of the potatoes. The dust turned brown and spread. And then the smell came, a stench that filled the valley and made the dogs slink into the ditches and howl. The leaves and stalks of the potatoes turned black; the potatoes, when dug, were slimy and corrupted. Her father had bent his head and wailed like his neighbors.

It had frightened her to see him that way but it was normal: tragedy had come among them, and it was right to mourn. What was wrong and from the devil was the strangeness that came on her father that winter, after her mother and sister and brothers had died. He rose one day from the floor, laughing, cursing, and he drove her and Denis and Ned to the river, searching for cress where every living thing had long since been stripped. “We’ll not lie down in this cottage and starve like cattle,” he said. Nor would he let them join the crowds around the huge iron boilers where the stirabout was cooked and served by the government relief workers. “The feeding of dogs in a kennel is more orderly,” he said bitterly. “They treat us as though we were creatures not made in the image of God.”

Up the hill he drove them instead, looking for fiddleheads and dock leaves; down the hill, looking for carrion. He found a dead dog and dove on it exultantly, roasting it over a fire he made right there. For days he was like that, full of a frenetic, useless bustle; then he set off for town, where a crowd had gathered demanding work on the roads. When he was denied he threw a rock at the head of one of the members of the relief committee. He was shot, she heard from the men who carried his body home. Shot dead there in the street, still cursing and demanding.

She’d seen others go the same way, men and women both, though more often men. Pretending courage and strength could save them, when salvation was clearly only a matter of luck. The passive waited for death, which came; the active fought and cursed and railed and death came anyway. It was fate, which could not be defeated. Fate was starvation and fever back home, and humiliation and fever here, and in neither case could fate be fought but only tricked a bit.

That was what she’d learned from her grandmother, during the days they’d cared for the sick together. You ought not lie down and let your fate roll over you, her grandmother taught her; neither ought you stand unbending, as her father had, and wait for fate to lop off your head. There was a bending, weaving, cunning way, in which you appeared to give in but rolled aside just slightly, evading the blow at the last minute. The way of eating whenever there was food to eat, sleeping whenever a stray minute came; never angering anyone stronger nor harming anyone weaker. “Make your mind like a pond,” her grandmother had said, when she found Nora weeping at night. “Push away longing and fury and make your mind still, like water.”

That’s what she’d done when Lauchlin had first brought her to Dr. Douglas and said he wanted her hired as an attendant. That first minute, when Dr. Douglas had looked her up and down—she’d begun to tremble. And when he’d said, as if she didn’t have ears to hear, “Can she follow instructions?” she might have struck him had she not remembered her grandmother’s training and stilled her mind until it resembled the lake near her lost home. While Lauchlin had argued on her behalf and reminded Dr. Douglas of their desperate shortage of help, she’d stood calm and quiet, waiting. She had even been able to bob a small curtsy when Dr. Douglas agreed.

Here there was water wherever she looked—and Lauchlin, humming like a sail under too much wind. Frenetic, like her father, though surely not useless. She feared for him. One day, crossing paths on the porch, he seized her arm and said, “Nora. Are you all right? Are you taking care of yourself? I’m so tired I don’t know what I’m doing half the time, I forget to ask how you are.” His hands were dry and cracked and his knuckles were dotted with blood where the skin had split.

“I’m fine,” she told him, although in the last few days her bowels had loosened and she feared she had a mild case of the flux.

He patted her arm and then disappeared. He was admirable, if mad. Dr. Douglas called on Lauchlin one evening, and the two of them holed up in Lauchlin’s converted closet. As she bathed the patients and tidied bedclothes she overheard them drafting indignant letters to someone named Buchanan, to someone else named Lord Elgin: Canadian officials, she understood, powerful people who might have sent more help but refused. “A petition,” she heard Lauchlin say to Dr. Douglas. “To Earl Grey, Secretary of State for the Colonies—we’ll demand he take action to stem the flood of immigration.”

“These half-naked, famished paupers,” she heard Dr. Douglas dictate. “Sick or aged or too young to work—are you writing this down, Lauchlin?—shipped off to our young country with promises of clothes and food and money on their arrival, when in fact there is no one here to greet them, and no prospect but further starvation or private charity: Where is the humanity in this? Where is our common decency?”

It was her and her kind they were talking about; Nora shivered. Of course she was grateful to them, to everyone working on this island. Yet it was horrible to hear herself described this way: a “pauper,” a “half-naked pauper.” Before the blight fell on the potatoes, her family had been hard-working and decent; if they had no savings it was only because the landlord took everything in rent. What kind of new world was this, where the rich blamed the poor for their poverty?

But still, the physicians were admirable, even Dr. Douglas; despite his brusqueness he worked very hard, and was fair with her and the other attendants. No one worked like Lauchlin, though. She watched him draw up a list of healthy orphaned children and then sit down with a group of six priests and convince them to divide the orphans among their parishes for adoption. She saw him bathe patients with his own hands, when the attendants were too busy. She saw him carry out armfuls of filthy straw he had no business touching, and make new beds from fresh straw he’d gotten who knew where. And at night she saw him reading and writing, reading and writing, as if in his papers he might find an answer to this nightmare afflicting them all.

July 28, 1847. A break in the weather; three days of blessed coolness and light breezes. No word from Susannah, although I have written her twice. No word from Arthur Adam. Perhaps this is because he’s already on his way back.

We have been forced to abandon quarantine entirely. Dr. Jaques is down with fever; his replacement now simply calls at the ships and instructs the passengers to file past him while he looks at their tongues. Those in fever are carried here; those appearing even remotely well are given clean bills of health and transferred immediately to steamers headed for Montreal. The steamers move from ship to ship, collecting their cargo. In the prow of these steamers, fiddlers scrape away with a horrible gaiety.

In this month of July we have entered 941 persons in the death-register under the description of “unknown.” Dr. Alfred Malhiot died July 22, of fever. Dr. Alex Pinet died July 24, also of fever. Twelve other physicians are sick, including Dr. Jaques.

At night I write letters to officials of our government; it is as if I’ve turned into Arthur Adam, but without his skills of persuasion. At night I lie on the pallet in this room for a few hours and listen to the sighs and cries and moans around me, and I wonder how it is I spent my whole life with so little understanding. In Paris, I thought of medicine as a science. I thought that by understanding how the body worked, I might cure it when diseased. What’s going on here has nothing to do with science, and everything to do with politics—just what John Jameson tried to tell me. Jameson has the fever now. I look out at the harbor and all I can think is: Stop the ships. Stop the ships. This although I know, from talking to Nora, that to forbid further emigration from Ireland would be to condemn those people absolutely.

I met Nora today by accident, just around suppertime. We stole half an hour and walked to the top of Telegraph Hill, where we shared some bread and cheese. She sang me a song about a woman standing on a cliff in Ireland, waiting for a fishing boat to return. Untrained, uneducated, she has been of more use and shown more dedication than anyone except the Sisters who came this month from Quebec. Two of them have already died. Still no news of Nora’s brothers. Four dogs were shot today, found scavenging in the cemetery.

August 3, 1847. Hot again; 98 degrees where I measured in the tent. New sheds are under construction at the eastern end of the island: I have requested that boilers be built between two of the old sheds; if they can be completed I plan to order the attendants and other visitors to the sheds to remove their clothes immediately upon leaving and soak them in the hot water. Nora is in favor of this; I do not tell her the idea comes partly from Annie and partly from her own stories about her grandmother. But why would I scorn their ideas, when everything I have tried on my own has failed?

I believe I can convince the other physicians to adopt this plan as well: there is precedent in the writings of Lind, whom many respect; also in Wood’s new text. Of course we will need tents in which to change—I wonder how many of us have a spare set of clothes? I am down to three changes myself; the remainder are in tatters from the constant scrubbing. I will worry about the details later. The important thing is to take action, to do something to stem this flood of deaths among the staff.

Nothing from Susannah. Nothing from Arthur Adam. None of the promised supplies have arrived. Dr. John Jameson died yesterday. Two of the carters engaged to transport the sick and dying and dead are dead themselves. In the woods delirious patients wander, finding the forest less fearful than our hospitals. When they die they are buried where they fall, as their finders are afraid to transport them elsewhere.

August 6, 1847. Still hot; this weather is insufferable. The river surrounding us looks like soup. A man separated from his wife threw himself over the rail of his ship and sank in this turgid filth. On the beach the sick and dying taken from the ships are dumped without ceremony. As there are no longer enough carts to transport them promptly to the hospitals, nor enough healthy carters, they flop like fish among the mud and rocks as they try to haul themselves to higher ground.

I carried a woman up to some grass beneath a tree, where she might have shade until we could get her to one of the sheds. I carried two boys and a younger girl, aged perhaps five or six, and a man my age reduced to half my weight. Then one of Dr. Douglas’s clerks spotted me and came running, irritated and anxious; I was needed at the hospital, I was needed at one of the sheds. And what was I doing down here by the water, lifting bodies like a servant?

I am being torn to pieces. Wherever I am, whatever I do, means only the neglect of someplace else I need to be and something else I ought to be doing. I have given up sleeping almost entirely and no longer miss it.

The new hospital is almost completed. No doubt it will be ready for use just as the emigrants cease to come. Will they ever cease?

Bishop Mountain of Montreal has descended upon us. He demonstrates his concern by making speeches and wrinkling up his fat face. In Dr. Douglas’s quarters, where the few of us healthy enough to be presentable had been ordered to gather for a welcoming dinner, we listened to the Bishop wax indignant. He is corpulent; his hands are plump and small-boned. With a wineglass in his hand, with his voice trembling in anger or surprise or both, he told us about the scenes he’d witnessed his first day on the island. Sick people newly brought from the ships, lying outside the church and screaming for water: “They were lying on the ground,” he said. “It is a sin, what’s happening here.”

Does he suppose we haven’t noticed?

When he calmed down, after several glasses of wine from the last case Dr. Douglas had set aside, he spoke at length of the situation in Montreal. Until just a few days ago, he told us, steamers from this island had been landing emigrants at the old stone wharves there. Absolutely as predicted, many were already in fever on arrival. No one was there to receive them, no arrangements had been made. “They lay on the wharves,” the Bishop said. “In the open air, like here. Some of them crawled into an old passenger shed.”

I could not help thinking of Nora’s poor brothers: can this be what has happened to them? Some of the sick, the Bishop said, were carted off to the hospital. Those apparently healthy but destitute were crowded into the old sheds near the Wellington Bridge, there to await transport further upriver by barge. Many sickened, and despite the ministrations of the Grey Sisters upwards of thirty a day died.

Earlier this week they were transferred to a new site, above the Lachine Canal at Point St. Charles, on a low piece of ground where the Indians once encamped each summer. A better place: and yet, the Bishop says, it is still very bad. Fifteen or twenty die each day, and the crowding is appalling. The barge firms, who promised a wait of only a few hours before the next stage of the journey to Kingston or Toronto, must often leave prospective passengers waiting for days. During that time, many sicken.

Of the Catholic priests from Montreal who have been tending to these emigrants, eight have already died. Some twenty of the Grey Sisters are sick, as is the Vicar-General. It is Bishop Mountain’s considered opinion that the sick in Montreal number many thousands. How many sick have we here? he asks.

No one could tell him for sure. Our last count was two days ago; more ships have since arrived, and among the fleet still awaiting transport of the sick to the island is the bark Larch, of Sligo, with 150 sick out of 440 embarked; 108 dead during the passage. Also the Ganges, from Liverpool, with upwards of 80 sick. And more and more: the Naparima from Dublin, the Trinity from Limerick, the Brittania from Greenock among them.

We know that near 80,000 emigrants have arrived here since May; of these some 2,500 have died in hospital or in the quarantine sheds, and we will without a doubt lose another two or three thousand. Among the nearly 200 attendants and nurses and cooks, almost half have sickened and 22 are dead. Eight policemen have sickened, two have died; all of the 21 stewards have sickened and two so far have died. Six Catholic priests have died here: Fathers Robson, Roy, Paisley, Power, Bardy, and Montminy. Also two Anglican clergymen: Anderson and Morris.

Among us physicians, I said—for it was I who told the Bishop these things; I rose from the table, spilling my wine; I shouted, I could not help myself—he had only to look at the haggard faces around our small table: where at our peak we were twenty-six, four are already dead and eighteen down with fever. There were four of us, only four, at that table. Count us, I said to him. Count us.

Dr. Douglas led me outside; although he might have rebuked me he did not. Nora is nowhere to be found. My hand is shaking so that I can hardly write. What is to become of us?

One minute Lauchlin was rushing between two sheds and the next he was flat on his back, in a room he didn’t recognize. Like one of his father’s trees he’d been felled, thrown in the river, chained into a raft with the others to begin the long journey downstream.

In fact he was in his converted closet, on a pallet surrounded by his books. Dr. Douglas came by when he could, but by then only he and two other physicians were well enough to work. So it was Nora who tended to Lauchlin, sponging him down with lukewarm water, dripping water into his mouth from a cloth, massaging his legs and feet and hands. She did for him all she wished had been done for her during her illness on the ship. All her brothers had wanted to do but been unable. There had not been enough fresh water on the ship for drinking, never mind for washing; there had been so little food, and no brandy of course, no milk, no clean linen, no space nor privacy. Unlike her brothers, she had access to these things. As soon as Dr. Douglas heard of Lauchlin’s illness, he gave Nora everything she asked for. He had a private stock of supplies, she learned, for treating his sick staff.

She did not resent this; the medical staff on the island were not to blame for what had happened to her and the others on the ships. Perhaps the authorities in Quebec were at fault, for not making better arrangements. Certainly the landlords back home had acted badly, and the passage brokers, the ships’ captains, the government in England that had encouraged emigration and then closed its eyes to conditions on the ships.

But these people here, the few remaining physicians and nurses and attendants still well enough to work—weren’t they all doing what they could? And if they gathered outside in knots sometimes, smoking and talking bitterly about the filth and poverty of her fellow travelers, their ignorance of the most elementary principles of hygiene and the way their habits contaminated the entire province, certainly they didn’t mean for her to overhear them. They were exhausted, she knew. They had no understanding of what the people they treated had been through, no ability to imagine the hardships that still lay before those who survived and tried to make a life in this new country. She overheard one attendant say, both puzzled and outraged, that he had yesterday seen a woman land whose only piece of clothing was made from a scrap of a biscuit bag. And how, he said, could a woman let herself come to that?

But they meant well, and they risked their own lives, and whenever she felt bitter she reminded herself of this. Thirty-six people died on the island the first two days Lauchlin was sick, among them another attendant and three emigrants she’d tended herself in the chapel: Jane Quinn, Peter Hogan, Caspar Fitzpatrick. She grieved for them, as she grieved for everyone. But Lauchlin had raised her from the dead, and while she did not neglect her other duties she bent herself to returning the favor.

Her hands cradled Lauchlin’s head, but although he was vaguely aware of her touch his mind slipped and turned like a sturgeon in the river. He was in Paris, peering into a microscope and examining the infusoria he’d scraped from his own tongue. He turned and he was deep in his first cadaver, dissecting the muscles and nerves of the upper arm; he turned again and saw a famous physician demonstrating mediate auscultation with a stethoscope. Dum-DUM…swooosh; dum-DUM…swooosh: the sounds of disease in the heart. In his chest something raced and leapt like a heart gone wild, but it didn’t belong to him. Someone said, in French, a sentence that in English defined nephritis associated with dropsy and albuminuria as Bright’s disease. As a girl Susannah’s face had been severe to the point of plainness, but he had loved her forehead even then. Dilatation of the aortic arch was named after Hodgson; transposition of the great vessels was rare but possible. In a café not far from the university, he and Gerhard had toasted each other with rough red wine and eaten omelettes and fried potatoes. Morphine, strychnine, and quinine were among the first alkaloids isolated; in Ireland, just a few years ago, a doctor had successfully given morphine by hypodermic needle. Why was it he had never gone to Ireland? Nora said he looked Irish. He saw the fingers of his left hand plucking at the sheet that lay over him; he gathered a fold between two fingers and saw in it a map.

Nora, watching his fingers twitch, was filled with fear. His fever was very high; although she sponged him again and again his skin still burned and the words that burst from his mouth now and then were not in English, except for a woman’s name: Susannah, he cried. She had boiled some milk, which she’d obtained only at frightful expense, using money Dr. Douglas gave her himself. She trickled a spoonful of the cooled liquid into Lauchlin’s mouth.

And he thought, I have done something wrong. I have come here out of envy and wounded vanity and have acted without understanding. And so of course I am to be punished. Something ran down the back of his throat; he tried to swallow and gagged. Then he saw a woman’s face recede from his, as if she’d been lying beneath him, passed through him and risen, and he said to himself: But everything’s fine. Somewhere, not far from here, Susannah sits in a chair before an open window, basking in the smell of roses as she bends her head over some sewing. He sighed and turned his head until his right cheek was buried in his pillow. The cloth was cool and clean. In his own bedroom, when he was a child, he had pressed his face all the way into his pillow, folding it up over both cheeks with just a small cleft for his nose and mouth. In that cleft he had hidden the evidence of his grief for his mother. That cloth had felt like this cloth; that sun, which came through his window in a low dusty beam, was like this sun. But this sun burned his eyes and brought tears to them and he had a pain in his head, such a terrible pain, and he was extraordinarily cold. A hand came up before his eyes: his hand? The skin was gray and mottled and damp. Whoever owned this hand had typhus; tuphos, a mist. Very clouded was the mental state of such a patient. Once he’d had no patients, and then Susannah had chided him and he had been childish and had gone to a place where he had too many patients. Now all the patients were gone. The face appeared again: Susannah? The features could not be distinguished; he saw a pale oval, dark hair, teeth. Something moist and horrid pressed against his mouth and he pushed his lips out and spluttered and blew, trying to push the object away with his breath.

“Patience,” Nora said. “Just a little patience, my dear. I beg you. Take a few drops.” Had she ever been so tired? Lauchlin’s lips were so dry that they cracked when he pursed them and tried to roll the lower one outward. The faintest stream of air came from between them, no more than a sigh. Was he trying to speak? She held the moistened sponge to his lips again, but he would have none of it. She stripped his shirt, kicked it away from her, and eased his arms into a clean one; she had found his spare clothes, and each night she rinsed out a set for him and hung them to dry in the wind, so that he might have fresh things to sweat through the next day. While the clothing dried she stood at Lauchlin’s makeshift desk and piled his books into towers that she then dismantled and built again, moving the books from hand to hand and place to place as if, through handling them, the knowledge contained in the words she couldn’t read might be absorbed into her blood.

Very early on the sixth day of Lauchlin’s illness, with the sun just up and no one watching, she walked into the forest and gathered herbs resembling those her grandmother had taught her to recognize in Ireland. She steeped them in brandy she begged from Dr. Douglas and hid the bottle behind the books; twice daily she dripped the infusion into Lauchlin’s parched mouth. All this time, she believed that Lauchlin recognized her and was grateful for her care.

On the eighth day, Dr. Douglas came by for his morning visit and examined Lauchlin briefly. When he stood his face was grave. “Worse, I’m afraid,” he said to Nora. “He has a friend in the city who has been inquiring after him. I must write her.”

“Annie?” Nora said, remembering a conversation with Lauchlin that might have taken place a year ago. Somewhere, in the city she had not yet seen and might never reach, he had a life she knew nothing about.

“No,” Dr. Douglas said. “Susannah, it was.” Nora recognized the name Lauchlin had cried. “Although perhaps that’s a nickname for the same person. You’ve been sponging him?”

“Every hour.”

“Good.” He gave her a small bottle containing solution of ammonia and cayenne pepper, with instructions to rub it along Lauchlin’s legs and spine. “Hot bricks, too,” he said. “To help stimulate diaphoresis. If you can find them, if you can find the time…I’m so sorry, I have to go.”

Outside birds were speaking. Lauchlin was aware that he could no longer move his legs, that his spirit and his body were coming unglued from the feet up, like a pair of black-paper silhouettes separating. But it’s all right, he thought. The people moving around him would glue his two parts back together; no harm would come to him because what mattered was not his legs or the lack of feeling in them but all he knew and thought and felt. Of course nothing could happen to him, he loved Susannah and had told her so and she had acknowledged it. That she had never loved him, and never would, mattered not at all. What mattered was that he had understood that he loved her, and also his life and the world; what could happen to him now?

His memory turned and burrowed through the places he had loved. First it brought him the foothills of the Pyrenees, through which he’d tramped with Nicholas Benin one July, during a break in his studies. Then the upper reaches of the Ottawa—oh, he had hated being with his father, hated the business and the noise, but after all the place had been beautiful, the massive rapids and the unclouded sky and the smell, overwhelming and everywhere, of the trees. The white sails in the St. Lawrence, fluttering below the cliffs. His mother’s hair, the fragrance of the stables, the lobsters Annie had split and broiled, the market at the height of harvest, the weight and smoothness and promise of books—the cadavers, even, cool and preserved on a slab, slowly yielding the secrets beneath the skin.

What had he been doing these past years? What had he been so worried about? Fussing and struggling to build a practice, continue his research, establish himself—if he died now his life would have been only that, almost nothing, a chain of meaningless accomplishments and struggles. Why had he wasted so much time? When he was a boy, before his mother’s death, he had understood the beauty of daily life. Somehow this had slipped his mind, and if he died now—but of course he would not die now, he was very sick but it was all right, he was young and strong and outside the sun shone on the meadows and gulls plunged into the river, emerging with fish in their beaks—if he died now it would be ridiculous, because all these years he had not been living but readying himself to live, stuffing himself with knowledge that would help him live later. All this time he’d been learning to live, and now he was ready to start his life.

He opened his eyes. The room was dusky and no sun streamed through the window; he understood for the first time that these people he’d been caring for were, if not exactly him, extensions of him, as he was an extension of them. It was life, simply life, that they had in common, and if he could have his life back he could be happy with anything. That was Nora bending over him, sweet Nora who had shared a berth with death, and in his imagination he said to her: Isn’t it lovely, this life? Didn’t you love being on that ship, despite the horrors you endured? Didn’t you love the clouds and the sun and the rain, the smooth rolling waves and the leaping dolphins and the sight of the moon at night? From Telegraph Hill, he reminded her, we saw groves of silky white birch.

What was this shadow that lay over him now, if not the shadow that had lain over her and all the others? He smelled his own body, he had a slight erection, he remembered a young woman in Montreal, the grey wall next to him loomed. He became aware of a large, echoing space beyond the small space confining him. That space was filled with other beings, turning, murmuring, plucking their blankets as he plucked his; he knew his hands were doing this, but he could not control them. Those beings dreamed, like him. Count me, he thought, remembering a phrase he had once said in anger to someone he could no longer remember. Count me, count them, count us.

[VI.]

Nora meant to leave the island, but she couldn’t seem to find the right moment. Early in September the flood of ships began to slow, and the number of patients to drop, but the staff well enough to care for them diminished correspondingly. There was a flurry of work in mid-September, when the new sheds at the eastern end of the island finally opened—twelve hundred patients to transfer, and so few people to help. For days she traced the muddy streets in carts, struggling to keep a few flaps of blanket over the sick and to cushion their heads against the jolting ride. Then the tents had to be struck, and the old sheds and the church had to be fumigated. Numb and exhausted, she did whatever Dr. Douglas asked.

All through October the number of patients decreased daily, but still there always seemed to be more work than people able to do it. One of the hospitals was closed, and then another; two of the physicians were discharged and with them their staffs. She might have left the island then, but there were children to comfort and old bedding to burn and floors to be scrubbed. The weather grew cold very rapidly; she did what she could to distribute the blankets and cast-off clothes sent by relief committees in the city. Slowly the island emptied. There were 500 patients the first week of October, and only three ships waiting at anchor. By the third week of October, all the convalescents had been sent upriver to Point St. Charles and only 60 patients remained.

The first snow had fallen by then. Dr. Douglas found some extra stockings for her, and a discarded coat, but at night a skim of ice began to form on the St. Lawrence and she was still cold much of the time. In a warehouse near the wharf were hundreds of boxes and trunks left behind by dead emigrants, along with a vast heap of their clothes, but she would not go into that room, she would rather freeze to death than touch those things. It was not fineness of feeling that stopped her, but fear of carrying the contagion. Along with the nurses and other attendants, she guiltlessly appropriated the money she found on the bodies of those who died without relatives. But she swept those shillings and occasional sovereigns into a leather purse with a stick, and before she touched them she boiled them in a saucepan of water.

She got a proper set of warm clothes only on October 30, the day the quarantine station was formally closed. That day a last, late ship limped into anchor; the Lord Ashburton, from Sligo, carrying tenants from the estates of Lord Palmerston. She thought she had seen everything by then, but this ship was the worst of all. Dr. Douglas was in a fury over it. Under a stunted pine on shore he stood shouting and waving his hands, arguing with another official she didn’t recognize; he had aged terribly in the few months she’d known him and his voice was hoarse and cracked. She had no way to comfort him. He was nothing like Lauchlin and kept her at a distance, although he seemed grateful for her hard work.

Dr. Jaques, who’d finally recovered, returned from his tour of the Lord Ashburton to report that over a hundred passengers had died on the voyage. Sixty were sick with fever and the crew was so debilitated that five passengers had worked the ship up the river to Grosse Isle. Had she not kept her grandmother’s training firmly in mind, she might have expired with rage and grief over the medical staff’s inability to help her fellow travelers. Their supplies were gone and the authorities declared that this last shipload was to be sent directly to Montreal. Among the surviving passengers, all were destitute and half were nearly naked. They could not disembark in any decency until clothes were provided for them.

Dr. Douglas asked Nora to help distribute among them the last shipment of cast-off garments rounded up by the Catholic women of Quebec, and in one of those relief parcels she found a blue woolen dress in surprisingly good shape, which she set aside for herself. Boots turned up as well, and a cloak and a kerchief. On the morning after the long day during which the Lord Ashburton’s passengers were clothed and sent upriver, Dr. Douglas called her into his office and dismissed her.

“It’s time for you to leave,” he said. “Where will you go?” Not a word to acknowledge the days they’d spent working side by side. She could almost hear his brain whirring, ticking off all he had yet to do. On his desk, next to the money box, was a long list of what looked like names—attendants and other staff, she guessed, to be paid off and sent on their way. After he counted out her wages he made a small mark by the line that represented her. He was very tired, she knew.

“I can’t say yet,” she told him. “I’ll try to find my brothers, first.”

“I wanted to give you something,” he said. He reached under his desk. “It’s a satchel, for your things.”

It was made of heavy carpeting and was quite clean, although not new. Perhaps it had belonged to one of the physicians, or one of the priests. “Thank you,” she said.

“Thank you.”

And so November 2 found her aboard the St. George and headed up the freezing river. Along the banks she could see the ice extending further every hour. The breeze was icy as well, and low grey clouds scudded across the horizon. A few flakes of snow fell and she burrowed deeper into her cloak. Someone’s cast-off, true. And yet the cloak was warm and whole and clean, the fabric wonderfully thick, the buttonholes frayed only slightly and the torn satin binding nicely mended. The boots she’d found were too big, but the newspaper she’d stuffed into their toes acted as insulation. Her feet were remarkably warm.

The sheer cliffs of Cape Diamond were a surprise; the bustling harbor, as busy as Liverpool, another. No one had told her the city was walled, or that the two addresses she’d asked Dr. Douglas to write out for her on a scrap of paper were not in the Lower Town, near the wharf where she disembarked, but high on the cliff and within the walls. Three times she asked strangers for directions to her first address; she got lost among the narrow cobbled streets and again emerging from the stairs at the top of the cliff. The strangers who looked at her scrap of paper and directed her on were distant but not rude. The dress, she thought, and blessed it. The cloak and the satchel and her boots. Later, when she would go in search of a boarding-house where she might spend a few nights, these clothes might keep her from unpleasant treatment.

Caleches passed her on the snow-covered streets, the horses pulling the runnered sleighs as cheerfully as if they pulled carriages. She had prepared herself for disappointment at the newspaper office, but still the clerk’s flat words almost flattened her as well. No word of Ned and Denis, from either advertisement. In her mind’s eye she saw the river, malignant and frozen, stretching for hundreds of miles through a country she could never penetrate, to cities that were only names. Kingston, Toronto—what were the chances of her finding her brothers in either place? What were the chances that Ned and Denis had not been pushed from those unreachable cities, looking for work as loggers or farmhands? What were the chances that they were still alive?

Two boys, out of the hundred thousand Irish emigrants who’d made the voyage to the Canadian provinces this season; two among all those who’d died on the passage over, or at Grosse Isle, or in Quebec and Montreal and further inland. But the numbers dead on the ships and the island meant nothing here in the city; the faces behind them could not be seen. As she walked toward her second address and came upon the market, she thought how the prosperous folk here forgot the numbers as soon as they sat down to breakfast or dinner, surrounded by this beautiful food—oh, the food in this market was astonishing!

She inched toward a tower of hot mutton pies, drawn by the smell and disguised by her blue dress. In her pocket was more money than she’d ever had before, and when the roundfaced farmwoman told her the price of a pie she drew out a coin and ate her purchase right there. Flaky crust, hot spiced mutton, savory gravy that oozed with every bite; she closed her eyes as she chewed and thought how easy it would be to forget death in a place like this.

There was a cathedral just in front of her, where surely services had been held for the dead. But right here, within arm’s reach, were muffins and large fried cakes and fresh butter and eggs. On the island food had been scarce and bad, cooked all at once in giant kitchens and distributed by the authorities: enough to keep them all alive, enough to make her give thanks every day, but by no means appetizing. Even back home, when there was still any food at all, a woman might have sat before a board on which were two or three eggs, a single ball of butter, perhaps a chicken or a goose. Here the eggs stretched like sand on a beach, the geese hung in rows by their beautiful feet, potatoes spilled from bags and oysters came not singly, nor even by the dozen, but by the barrel. As she watched, women with baskets over their arms made their purchases as if there were nothing unusual about the plenitude surrounding them. Haggling seemed like a sport for them; they bickered cheerfully. Some, having filled baskets with more food than Nora could comprehend, still had enough money left to buy odds and ends for sheer pleasure. Cedar boughs, balsam, candles.

She bought a heavy golden muffin and ate that too; her mouth watered and her head spun. She touched potatoes and onions and cabbages, apples and squashes and leeks, and then she pulled herself together and moved on, to the address on Palace Street.

The neat flagstone walk had been swept clear, and someone had knocked most of the snow from the shrubberies. For a minute she thought of going round to the servants’ entrance, but this was no servant’s errand she was on. She walked up to the handsome front door and knocked firmly on the center panel, below a carved decoration. Some kind of writing, she thought, staring at the intertwined shapes. Someone’s name, perhaps? Annie Taggert opened the door.

The two women gazed at each other, each assessing the other’s probable origins and position. Nora took note of Annie’s worn shoes and reddened hands and coppery hair, but she also saw the care with which that hair was braided and pinned, the good-quality cloth of the simple dress, and the clean white apron, well-pressed and starched. Another Irishwoman, clearly, but one who had been here for some time and who was respected in this prosperous house. Annie, very busy this day, still registered the disparity between Nora’s dress and boots, nicer than her own, and the worn, thin, absolutely Irish face. A new one, Annie thought. Another like Sissy. Who did this girl think she was, aping her betters in those clothes?

“There’s no work here,” Annie said frostily. “And you oughtn’t be coming to this door—you go around back if you’re looking for food, perhaps cook will have something for you.”

Nora flushed. “It’s not work I’m needing,” she said, although soon enough she would. “Nor food.”

Before she could finish speaking, Annie tried to slam the door on her. Nora wedged her satchel between the door and its frame and said, “I have a message for Mrs. Rowley. It’s important. Would you fetch her for me, please?”

It was too much, Annie thought. Everything that had happened these past six months; it was simply too much. She owed this girl no explanations, but she did open the door a little wider. Perhaps she had not taken sufficient account of the quality of that blue dress. Perhaps this girl had important friends? “Mrs. Rowley is not available,” she said. “You may leave the message with me.”

“Is Mr. Rowley available, then?”

“He’s busy,” Annie said. “But you can be sure whatever you leave with me will reach him.”

Nora shook her head and refused to move. “It’s important. And I have a parcel as well. I will wait.”

For a minute Annie considered making her wait downstairs, but Mr. Rowley was so changed these days, and so distraught, that she dared not risk offending him. Suppose the girl was a friend of someone he’d met on his travels? Grudgingly, she said, “You can wait here in the hall, I suppose. But it may be some time.” She opened the door wider and led Nora in, pointing out a stiff brocaded chair. “Your name?”

“Nora Kynd. Please tell him I have a message from a friend.” Just as Annie was about to say, “Don’t you go touching anything here,” Nora said, “From his friend Dr. Lauchlin Grant.”

Annie drew back at the mention of Dr. Grant’s name. “You haven’t come from that island?”

“I have,” Nora said proudly. “I worked there all summer. I was one of Dr. Grant’s assistants.”

“Are you…sick?” Annie whispered. “Have you brought the fever back to this house?”

“Of course not,” Nora said. “I had the fever back in the spring, and recovered—you know you can’t get it twice.” She brushed her arm over her cloak and dress. “These are all newly boiled, completely cleaned. I touched nothing on the island after I changed.”

“I’ll tell Mr. Rowley you’re here,” Annie said. She opened another door, into a nearby room.

Nora could hear the sounds of men arguing in there, a constant rumble that broke only for a second when Annie interrupted them. Annie returned, said, “Mr. Rowley will be a while,” and disappeared again. She forgot to close the door to the library behind her, and so left Nora inadvertently eavesdropping.

No faces, only voices; fragments of statements from which she might try to deduce an attitude, a person. One of those voices, she supposed, belonged to Mr. Rowley. She waited on her stiff chair, wondering where Mrs. Rowley was. Wondering if Mr. Rowley had any idea of the relationship between his wife and Lauchlin; wondering what she would do with the things in her satchel if Mrs. Rowley did not appear and Mr. Rowley asked leave to pass them on to his wife. Was he the sort of man who’d consider his wife’s belongings private? Or the sort who’d think his wife’s possessions were his, as his wife was his possession?

As she studied the cut glass and the gleaming furniture, the knot of voices began to unravel and isolated phrases floated free. The men were forming some committee, or had already formed it and now were drawing up resolutions. Someone mentioned the Lord Ashburton; someone mentioned an article yet another someone had written about the terrible conditions aboard that ship. Someone reminded someone else of the recent deaths of both the mayor of Montreal and the Catholic bishop of Toronto. A man with a harsh, carrying voice said, “The stringent measures adopted by the Government of the United States have driven the poorer classes in Ireland to the more tedious but less expensive route up the St. Lawrence, with the result that a large mass of indolence, pauperism, destitution and disease has been thrown upon us.”

“Fine,” another man said. “That’s fine, we’ll end the summary with that. Now for the measures we recommend, to prevent a recurrence of the catastrophe next year—”

“Point number one,” said a man with a fresh, light voice. “The emigration tax must be increased.”

“No, no, no,” said the harsh-voiced man. “We will list that second, even third. Most important is that we demand regulation of accommodations aboard the ships. No more than two tiers of berths six feet in length by eighteen inches in width, in the orlop deck no more than—”

Still other voices broke in. “A medical attendant must be present for every one hundred passengers—”

“Effective means for ventilation and cleanliness between decks must be assured—”

On and on the men went, throwing out numbers and rules and restrictions, suggestions, demands, and pleas. Nora balanced on her straight-backed chair, gazing at the blue-and-white glazed vases and the framed arrangements of flowers made from shells while the men began to argue about money. A great deal had been expended by the province in caring for the sick and destitute emigrants, she heard. A much smaller amount had been received in emigration tax receipts. Who had paid, was paying, would pay?

“Water, twenty-one quarts per week per passenger,” someone said. “Specifications must be laid down for all provisions. Biscuits, two and a half pounds; oatmeal, five pounds; two pounds molasses…”

“Rice,” someone added. “Don’t forget an allotment of rice.”

Would she have sickened, if she’d been given all that food on the bark? Would Ned and Denis have been stronger? She wished she had bought another muffin in the market and had the sense to stow it in her pocket. Had her father been here, she thought, he would have skipped the muffins and pocketed some of the expensive trinkets littering the tables. His right, he would have thought. They had it, he needed it. He would not have seen, as he had not back home, that the rich believed he had a right to nothing.

A voice she hadn’t heard before, clear and yet somehow tired, said, “We have to keep in mind that the point isn’t to discourage emigration of these poor people—what else are they supposed to do? Where else can they go, so long as this famine lasts? The point is to make their voyage more humane, and to make better arrangements for them once they’re here.”

The harsh-voiced man disagreed. “That you of all people should say that…no, we want to reduce the numbers as well as ameliorate the emigrants’ passage.”

“You’ll excuse me for a minute. I have someone waiting to see me.” And then Nora heard footsteps coming her way and a man wearing a beautiful fawn-colored coat suddenly stood before her.

“Miss Kynd?” he said. His features were youthful, but his face was pale and drawn. “I’m sorry to keep you waiting. I’m Arthur Adam Rowley. How may I help you?”

He was shockingly young, hardly older than herself although his poise and grace were those of an older generation. Perfectly groomed, and somehow very sad. She rose from her chair. “I’m sorry to interrupt you,” she said. “I have a message for your wife.”

His face, already pale, blanched further. But his voice continued courteous and controlled. “My wife is very ill,” he said. “Of this fever that’s come in the ships. Perhaps you could give the message to me.”

Nora silently cursed both her clumsiness and Annie’s secretive nature. “I’m sorry,” she said. “Would you have known Dr. Lauchlin Grant?” Still, surprisingly, it gave her a horrible pain to speak his name.

“Of course. We were good friends. How did you know him?”

Briefly, Nora told him the story of how Lauchlin had found her and saved her, and how she’d gone to work for him on Grosse Isle and then cared for him during his illness. “Dr. Douglas has packed up his books and most of his belongings for his father,” Nora said. “They’ll be shipped to the house soon. But he had a few small personal things with him, and he told me he wanted Mrs. Rowley—and you, too, of course—to have them if he died.”

She lied here: he had told her no such thing. She had made this up on her own when she cleaned his office the day after his death. During the worst of his fever he had several times called out Susannah’s name, and she had linked this to the woman Dr. Douglas had mentioned, and then to the “Mrs. Rowley” Lauchlin had spoken of when he returned from his one brief leave. Although she was unable to read Lauchlin’s journal, she had seen him write in it so often that she believed it to be both important and personal. And surely the woman he thought of above all others during his last days deserved to have it.

But now this woman was too sick to read it, and there might be something in the closely written pages that would bring her husband sorrow. Quickly Nora made a decision; she reached into her satchel and took out the small parcel containing Lauchlin’s good shirt and waistcoat, and his watchchain and his watch. She pushed the journal down deeper and then held out her gift.

“It’s so little,” she said. “But I know he would have wanted you to have it.”

Arthur Adam unfolded the wrapping paper with his long white hands, pushed aside the folds of the shirt, and lifted a loop of the chain. “Thank you,” he said. “You’re very thoughtful, to bring these here. My wife would have—will—cherish them. I’ll cherish them.”

They were silent for a minute. Then Arthur Adam said, “They were very close, you know. Lauchlin and Susannah—they were childhood friends. It seems impossible that he’s gone, and her so sick—over and over this month I’ve kept thinking that if he were here he could help her.”

“He was a fine doctor,” Nora said. “If you’d seen him with his patients…” For a moment she almost thought of shouldering what she could of the burden Lauchlin had dropped, as she’d done on the island. She might say to Mr. Rowley, Perhaps you need some help? I’m very good with fever patients. She might walk up those wide and curving stairs, find her way down the hall to a room where a sick woman lay in a soft, clean bed, near a shining window. To that woman she might say, Lauchlin called your name when he was dying. Over and over again. Let me bathe your face, let me smooth your hair, let me bring you a cool drink. All those things she might do, in memory of Lauchlin. And then be caught here, in a web of obligation and sorrow…She picked up her satchel.

“You look rather like my wife,” said Mr. Rowley.

“Me?”

“In a certain way. Your hair, the shape of your mouth and forehead. Where will you go when you leave here? What will you do?”

“I’m not sure,” she said, startled by his words. That she should look like Susannah, whom Lauchlin had cried out for—she knew then she was right in keeping the journal, and not just because she was protecting the Rowleys by doing so. That was her family tree in there, with its dead branches and withered fruit. She would find a teacher, a school, deciphering what Lauchlin had left behind and all he’d had access to: newspapers, books, the advertisements she’d place for her brothers and the ones that they, if they knew someone as kind as Lauchlin, might place looking for her.

Annie appeared in the hall just then, irritable and faintly ashamed. Downstairs, while Nora had been waiting, Annie had been cursing Sissy with more than her usual violence. It was Mrs. Rowley who had brought her to this; she had no love for her mistress, but she pitied her and also everyone in this house. No one deserved to suffer as Mrs. Rowley had. Six weeks she’d been wasting away, and Arthur Adam could not take much more strain. Nor could she herself: she was exhausted shuttling trays back and forth, running errands for the doctor, putting up with the whims of the high-handed nurse. And then the sight of Nora, and the recognition of where she’d been, had brought her own early years in this strange land back to her. That awful time, when so few people had been kind to her; at the thought of it she’d yelled at Sissy and then felt abashed and wondered what possessed her to be so mean. She had been mean to this stranger as well, or at least unwelcoming. She cleared her throat and said, “Won’t you come downstairs for a cup of tea before you go?” Nora, grateful to be released from Arthur Adam’s gaze, followed Annie willingly.

In the kitchen, Nora sat in silence while Annie prepared the tea. “I’m sorry,” she said finally. “I’m sorry about Mrs. Rowley. I didn’t know. You should have said.”

“I should have,” Annie said. “I don’t know what got into me.” She thought about the vomiting and the delirium, the inability of the doctor to ease Mrs. Rowley’s pain, her own fear and terror during the two weeks before Arthur Adam’s arrival, when Mrs. Rowley had cried out in the night and there was no one to help but her. About Arthur Adam, who for all the good he might have done with his articles, had not arrived home in time. Now his wife didn’t recognize him. “It’s a hard sickness. You know. What was it like, on that island?”

Nora told Annie a little about Grosse Isle. “My brothers were taken from me,” she said. “They were well, and I wasn’t, and the doctors took them away and wouldn’t let them join me on the island.” She told Annie about her days in the church, what little she could remember; and about how Lauchlin Grant had saved her and become, almost, a friend. She spoke briefly about the work she’d done when she’d recovered, and about all she’d seen, but she didn’t dwell on this; she could tell from Annie’s face that the news was unwelcome. Finally she described Lauchlin’s last days. “He was such a gentle man,” she said. “He worked so hard, right up until the last. Even when he was dying, you could tell he tried not to be any trouble.”

“I hardly knew him,” Annie said. “But the Rowleys were very fond of him.” Neither of them said anything about the attachment of Lauchlin and Susannah, but the fact hung in the air between them. And when Annie told Nora about Susannah’s work among the emigrants at the hospital, and the way she’d fallen sick despite Annie’s best efforts, Nora shook her head and said, “It’s one thing I am thankful for, that Dr. Grant never knew she was sick.”

The afternoon lengthened as they spoke. “What are your brothers’ names?” Annie asked, and Nora found herself telling tales about Ned and his love for beetles, Denis snatching fish from the stream with his hands. Annie served tea and seed-cake. On the boat, Nora said, the boys had conspired to steal extra water for her. Her description of their passage over led Annie to talk about her own, which had been marked by the same crowding and insufficient supplies but was much easier to bear, as the weather had been fine and all her companions had been in good health. “But I’ve seen sickness,” she said. “As bad as anything this time around. In ’32, when the cholera came, I was in service down in Lower Town when I was taken with it…”

She’d been a girl then, she told Nora; just turned twenty-one and only a few years off the boat from Leitrim. One day she’d felt hot and peculiar and then had fallen unconscious down the stairs she was scrubbing. She had only the haziest memory of being carried out of the city on a sick cart. When she’d woken she’d found herself in a tent on the Plains of Abraham, surrounded by the dying.

“It was a miracle I survived,” she said, and she told Nora how the cholera burying-ground had swallowed her friend Mary MacLean, and with Mary their shared dream of making their way to the States together. Around them the shadows gathered in the kitchen. And in a corner, occupied with a bushel of beets, Sissy listened open-mouthed to their tales.

“Where will you go?” Annie said finally, echoing Arthur Adam. “What will you do?” She had changed her mind about Nora, and thought that after all there might be a way to find her a position in the Rowleys’ house.

But somewhere in the course of this long day, Nora had reached a decision. “If I can’t find my brothers,” she said. She stopped and swallowed and started again. “If I can’t find them, and I probably can’t, I’m going to the United States. It’s beautiful here. A beautiful city. But I could never live here after all that’s happened.”

“You could,” Annie said. “You could stay. It gets better.”

“There’s a place called Detroit,” Nora said. “I heard about it on the island; it’s off one of the huge lakes that this river runs into.”

Sissy, unnoticed until then by Nora, set down the beets and her knife and crept closer to the table. “I’ve heard about that place too,” she said.

Because she had company, and because she was abashed by her earlier outburst, Annie restrained herself from snapping at the girl and only motioned her back to the corner with her chin. Nora, thinking of Denis and Ned, registered Sissy’s shining, curious face before she turned. This one had lived, like her, somehow escaping the trail of bodies littered across the ocean. And like her was all alone. She said, now speaking to Sissy as well as to Annie, “A man who has some family there told me it’s easy to sneak over the border, and that the city is lively, and there’s lots of work. I’d like to be in a new place,” she said. “Start fresh.”

“Wouldn’t we all,” Annie said. “Didn’t we all of us think that was what we were doing, leaving our homes for here?” She put down her saucer as Nora rose and grasped her satchel. “You’re leaving already?”

“I am,” Nora said.