By Brian Sutton
The doctor knocks on the door. Immediately the door opens and a woman’s voice says, “Come in, doctor.”
But the doctor pauses at the threshold, savoring the moment. After all, it’s his first house call, the start of his career. He arrived in town only a few days earlier, having been sent for after the previous doctor died of heart failure. He only recently graduated from medical college. The year is 1852.
The home is just a cabin, so even from the doorway the doctor can see the patient lying in bed at the far end of the room. Family members hover nearby, seemingly focused on the patient but stealing furtive glances at the doctor, their faces revealing hope and apprehension.
The patient seems to be about the same age as the doctor, and resembles him in body type and general features as well. But his skin is almost bluish-grey, and his hands seem shriveled—washer-woman’s hands. Near the bed lie pot after pot, all filled with a liquid that resembles broth, with a few white flecks, about the size of rice grains, floating near the top. Although the town is a thousand miles inland, the doctor can detect a strong fishy smell.
Without even entering the cabin, the doctor has his diagnosis.
Cholera.
But while he can diagnose the disease at a glance and a sniff, the doctor can’t effectively treat it or prevent its spreading. In 1852 the miasma theory, holding that contagious diseases are caused by “bad air,” is still dominant. It will be another three years before John Snow publishes a treatise linking an outbreak of cholera to a contaminated water supply, longer still before the research of Louis Pasteur leads medical science to begin recognizing the link between microorganisms and disease. And until that link is recognized, there can be no life-saving vaccines.
So the doctor literally doesn’t know what to do. But he knows what will happen.
Although this town has been spared until now, the doctor knows about the epidemic’s ferocious and lightning-fast progress elsewhere. From appearances, the patient seems likely to die within forty-eight hours. Most of the other family members, huddled around the patient, will probably join him within a week, even though they look healthy enough now.
So as the doctor stares with numb recognition, he can hear a voice within him, crying out, “Get away while you can!”
These are not his people, not yet. He doesn’t know a single person in town by name. Not one of them would recognize him on the street.
And the town has no hospital, nor is there any other doctor for miles around. If he stays he will be called on, again and again, to enter the contagion-ridden homes of strangers, and then to re-enter those homes repeatedly, even after he himself has put them under quarantine. He will be expected to battle a foe against which medical science has not yet armed him with effective weapons, a foe which he cannot kill but which can easily kill him.
So his first response is one of self-preservation. He could turn and sprint to his horse, speed back to the rooming house where he is staying, pack his bags (they’re not fully unpacked yet anyway), and be miles away by this time tomorrow. He even makes the case to himself that this would be the right thing to do. He became a doctor to save people’s lives, didn’t he? How can he save lives if he’s not alive himself? The longer he lives, the more lives he can save.
He hasn’t yet entered the cabin. It’s not too late. If he stays, he will almost certainly die. If he leaves, he will almost certainly live.
And live with the knowledge of what he has done and not done, and what he has left behind.
Somewhere in his medical training, somewhere in his very essence, a line was drawn, a line he cannot cross.
The doctor looks across the room to where the family members, doubtless weary from bearing their burden alone, have begun gesturing toward him to enter the cabin and join them. He takes a deep breath—a dangerous act in itself according to the miasma theory, although research will later establish that cholera, unlike the causes of some later pandemics, is not an airborne disease.
Then he crosses into the cabin. The family members smile, welcoming him to the group. Each step brings him closer to the dying man ahead.
Brian Sutton’s work has appeared in or is forthcoming in The Journal, Oyster River Pages, Flash Fiction Magazine, Seventeen, and other periodicals. Four of his plays have been produced, including a musical comedy which won the Stage Rights / NYMF Publishing Award after a successful run on 42nd Street in New York, was published by Stage Rights Press, and has now been performed at the high school, college, community-theatre, and professional levels. As a student at The University of Michigan he won three Hopwood Awards for Creative Writing, two for collections of short stories and one for a collection of one-act plays.
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