Race for the Dying (7 page)

Chapter Twelve

What a marvelous occasion,” Dr. John Haines said. He stood at the end of the table, wineglass raised. “A toast to our young friend, now well on the road to recovery.” He raised the glass a little higher, and Thomas saw that the older man's balance was precarious. “That's a good thing, since very shortly we plan to work him to death.” Those around the table laughed.

Thomas felt more weary than recuperating, but he gamely lifted his own glass in thanks, fascinated by this assemblage of contrasting personalities. Dr. Zachary Riggs sat at the end of the table opposite Haines, with Alvi Haines on his right, and Gert James on his left. Gert's brother Horace took his place beside his sister, and Thomas wheeled his chair close to the table on Haines' left. Horace James smiled at everything, but kept his eyes deferentially averted, paying close attention to the business of eating.

Thomas found Zachary Riggs enormously likable and attractive. Stocky, powerfully built, Riggs exuded energy and enthusiasm, as well as an easy laugh that often swelled to a bellow. Rather than the huge, spade-shaped beard favored by Dr. Haines, Riggs sported a close-cropped beard and mustache that matched his ruddy complexion. A pair of gold half-glasses hung from a vest pocket, and a heavy gold chain circled his paunch. He had greeted Thomas with delight, making sure that the young man was comfortable at the table before taking his own seat. The physician was deferential toward both Gert and Horace, and Thomas noted that Gert attended both Riggs and Haines as if they were visiting royalty.

Exactly what the relationship was between Zachary Riggs and Alvina Haines was unclear, but Thomas noted that Riggs' right hand now and then would stray across to touch the back of Alvina's. Thomas was surprised that he noticed at all, and even more surprised that he felt a little stab of disappointment.

“Here you've been under our roof for nearly a week, and we haven't had a chance to exchange more than a word or two,” Riggs said. “But I see that you share something in common with most of John's patients…and that's a speedy, complication-free recovery. We're all thankful for that.” He raised his glass to Thomas.

“Hear, hear,” John Haines said, refilling his own. “I repeat my original toast.” He drained the glass, and rested his elbow on the table as he regarded Thomas. “So. Alvi tells me that she has inflicted the book on you.”

“And may I say,” Thomas replied, “it's an incredible accomplishment.”

“Well, authors other than myself deserve much of the credit.” Haines said off-handedly. “Were it left entirely up to me, I'm afraid I wouldn't have managed beyond page two.”

“This is a collaborative effort, then?”

“Indeed,” Haines replied. He pointed his fork down-table toward Riggs, and then swept it back and forth to include both his daughter and the physician. “These two have convinced me that such a publication was necessary,” he said. “Something that the patient can hold in his two hands and use to make sense of all the folderol and jargon that we physicians spout.” He cocked his head, regarding the almost-empty wine bottle. “And, you know, I think they're right. I've had a number of patients tell me the same thing.” As he poured the last of the wine, Gert rose, removed the empty bottle, and headed for the kitchen.

“As I see it,” Riggs added, “it's more an archival thing, Thomas.” He nodded toward Haines. “A way to record for posterity the amazing medical knowledge this good man enjoys.” He smiled affectionately at Haines.

“An incredible endeavor.”

“How far have you read, then?”

“Well, I only began the journey this afternoon, you understand,” Thomas said, “but at the moment, I'm about to embark on part four, I think it is. The section touching on diagnosis.”

“Good heavens, man. You've been busy.”

“A bit. I thought to devise a system of therapy and exercise for any injuries. I'm sure that your text is a good place to begin my studies.”

“Really.” Riggs' fork halted halfway to his mouth, his expression one of genuine interest. “I trust you're proceeding with care. I picked you up from the floor once, you may recall. You're a bit heavy to be lugging about.”

“I shall try my best not to do that again, sir. But I found that the porch was ideal for my needs.”

“Hmm,” Haines said, and accepted the fresh wine bottle from Gert.

“I managed some six feet today with the crutches.” Thomas laughed ruefully, “and back to the chair. So that's twelve, but it's a start.”

“I dare say it's a start,” Riggs said, impressed. “What are you taking for the pain?”

“Nothing is best,” Thomas said. “At this point, it's to my advantage, I think. Not masking the source of discomfort helps me understand the nature of the injuries.”

Riggs nodded, although a bit skeptically. “John tells me that you're a graduate of the University of Pennsylvania?”

“Yes. Just this past spring.”

“Then you've heard Lamchert's lectures,” Riggs said. Thomas frowned. “I'm afraid not. The name is not familiar,” he said.

Riggs frowned in puzzlement. “I thought Lamchert was at that institution. Perhaps I'm mistaken.” He stabbed a piece of beef, forked it to his mouth, and chewed thoughtfully. “Now that I think on it, I believe it was Johns Hopkins. Anyway, little matter. His point is well taken in your case. An injured joint must be exercised with care, but with regularity and persistence. Otherwise it will wither on the vine, so to speak. You concur?”

“I'm in complete agreement,” Thomas said, “and above all, what I see clearly now, if not before, is that the pain of an injury must be managed in such a way that recuperation isn't put in jeopardy. I confess, before last week, I hadn't considered that a factor.”

“You hadn't considered pain?” John Haines said, and covered his mouth with the back of his hand. “My God. man.”

“What I mean is, in a personal sense. As students, we're told that patients suffer discomfort, even excruciating pain. I suppose we witness that very thing in the wards. But we didn't feel it, and so we say wonderfully ridiculous things like, Bite the bullet, old man. That leg has to come off.'” Thomas saw Gert frown. “When it's over, if the patient lives, we say, ‘Strong man, that.'” He took a sip of wine. “I can imagine someone familiar with my case saying, ‘Well, my God, so he ripped a ligament in his hip. Why doesn't the lazy fellow get on with it? A little limp, and even that will disappear in a few days' time.' I found it not that simple. That's all I'm saying.”

“With a busted head, a broken rib or two, a broken thumb, lacerations and contusions by the potful, and who knows what damage to your hip joint, I can't imagine anyone gainsaying your progress, my young man,” Riggs said.

“Thank you. I didn't want you thinking I was uninterested.”

“Hardly.”

Thomas looked at Gert, and then Alvi. “I had the opportunity this afternoon to attempt a preliminary examination on a somewhat foul patient.”

Again, Riggs' gaze was riveted on the young man. “You don't say.”

“I hope you didn't let him in the house,” Alvi said, and she held her linen napkin up to her nose as answer to Thomas' startled expression. “I can smell him yet.”

“What's all this?” Riggs asked eagerly.

“Most remarkable in some ways,” Thomas explained. “I was reading in the study this afternoon, and turned to see Mr. Lindeman's dog standing in the doorway. What a truly disreputable, homely beast he is.”

“Oh, my soul,” Gert piped. “You didn't encourage him inside, I should hope.”

“No, indeed I did not. I rolled myself outside to the porch. Now what interests me is that he has an injury of some kind to his left hind leg. Perhaps the reason he prefers to sit with his hindquarters squelched in the mud is that the muck is somehow soothing. Anyway, a most remarkable thing happened. He was standing beside my chair, and 1 ran my right hand down his back, impressed with how little flesh there is on his ribs. As I ran my hand down his back leg, he turned with such deliberate speed that I had no chance to move.” Thomas held up his right hand like a jaw, and clamped it around the bandages of his left wrist. “He closed his jaws around my right wrist, like so.”

“My God, he bit you?”

“No, he held me. And let me be the first to say, that dog has a big mouth. His canines were on the far sides of my wrist.”

“It didn't break the skin, then,” Riggs said.

“No. indeed. As I said, he held me. And gently, now that I think about it in retrospect. I suppose he could have crushed my wrist as one snaps a twig.”

“So what did you do?”

“Well. I thought it best not to pull away. In a moment, he let go and allowed me to continue my examination as best I could. I found what appears to be an enormous abscess of some kind. On the inner thigh.”

“And he let you do that?”

“He did.”

Riggs threw back his head and roared with laughter, smacking the table with the flat of his fingers. “My word. Extraordinary.”

“The animal is literally caked in muck, and I didn't have the freedom to probe and poke.”

“What do you propose to do now?”

“Well, if I could manage it, I'd walk him down to the Sound and give him a thorough bathing in salt water. We're not going to be able to see much of anything through an inch of mud and a tangle of rank fur. Then I'd go from there.”

Riggs filled his glass as the wine bottle was passed to his end of the table. “Alvi tells me that injuries resulting from trauma are what interest you highly—but I had assumed human patients.” He smiled indulgently. “I jest, of course.”

“Yes, sir.”

“The logging country should provide you with plenty of opportunity,” Riggs said. “Although most of the cases that come in from the camps go on over to St. Mary's.”

“And that is?”

“St. Mary's Hospital,” Alvi offered. “Perhaps thirty miles south, in Pesqualmie. It's so much easier than the journey to Seattle. They have facilities to treat the more serious cases.”

“I would think little would compare with the treatment offered by the Haines Clinic,” Thomas said.

“Oh, we do fair enough,” Riggs said, “but we're short-staffed at the moment.” He smiled engagingly. “One of the reasons you're here.”

“So I'm to understand that you're looking to expand,” Thomas said.

“We're expanding everything,” Riggs said grandly. “That's the aim. Without income, there's little we can do. Eventually, this area will become a center for the training of physicians.”

“That's ambitious,” Thomas said. “You were at Johns Hopkins, then?”

Riggs shook his head and held up one hand as if he'd heard a base rumor. “No, no. A lecture or two, and a symposium last year. Nothing more than that.”

“You studied abroad?”

“Have you read Lucier's work?” Riggs asked.

“I confess I haven't.”

“Ah, well…Claude Lucier's studies have been revolutionary. More even than Tessier's in Austria, and I had thought that Tessier was the benchmark for the rest of us.”

“I…,” Thomas shrugged helplessly, feeling somehow provincial.

“Let me tell you,” Riggs said, saving Thomas from his discomfiture. “In these small, out-of-the way corners of the world, we're so removed from the advances and studies of Europe. I was fortunate enough to travel extensively recently, and spoke with a score of learned professionals.” He made a large globe-shaped figure in the air with both hands. “A world of ideas is out there.” He jabbed a thumb at Thomas. “You're most fortunate to have studied at a center such as Philadelphia. That's the pulse of things. We'll be eager to hear your thoughts on a variety of difficult cases.”

“Hear, hear,” John Haines said. He placed his empty glass carefully on the table, as if he wasn't sure of his target. “And I think I shall retire to the study for a cigar and brandy. You'll join Zachary and me?”

“I'm afraid if I do that, I shall have to spend the night there,” Thomas laughed.

“Of course. How stupid of me. We've exhausted you. Tomorrow's another day.” He stood unsteadily.

“Let me help,” Riggs said, rising quickly. He maneuvered the young man's wheelchair away from the table. Fatigue, alcohol, and too much rich food had numbed Thomas well beyond the desire to fend for himself. He allowed himself to be wheeled back to the room. With an assurance that Thomas could manage his clothing by himself and make his way from chair into bed, Riggs left him with a final, warm salutation.

Wheeling himself close to the bed, Thomas paused. He had no desire to face another struggle. He reached out and pulled two of the feather pillows into his lap. Hugging the pillows with both arms, he cradled his head in the softness and fell asleep.

Chapter Thirteen

What's this?” Dr. John Haines asked. Thomas had awakened just seconds before the physician appeared in the doorway of his bedroom and hadn't yet figured out how to relieve the kink in his neck. “You wouldn't prefer the bed?”

“I was too tired and sore,” Thomas said. He pulled the pillows away from his torso where they had molded themselves. He saw that Haines was dressed in robe and slippers, his eyes alert, redness of nose subsided. Gone was the mellow, tipsy host of the evening previous. Thomas turned and squinted at his watch on the nightstand. “My God…is it really?”

“I'm about to go to the clinic,” Haines said. “I like to be there by seven, or they think I'm slacking.”

“I slept the night through, then,” Thomas said.

“Indeed you did. We've been doing a good job of ignoring you these past days, but it seems you've been healing nicely. Let's have a look at you, then.” He patted the bed. “Let me give you a hand.”

Pushing himself to his right foot, Thomas gained the bed and sat shakily on the edge, leaning on his right arm. Haines stepped close, and Thomas could still smell the liquor on the physician's clothing and the heavy aroma of the cigars. With deft, practiced fingers, Haines peeled away the bandage around Thomas' head, humming to himself. “Well, well,” he said at one point. He arose, reached out, and turned up the gas lamp.

“Close your left eye now,” he instructed, and Thomas did so. “What do you see?”

“I can see the wall and the doorway, but I cannot distinguish the small details,” Thomas said. He reached up and pushed tentatively at his right eyelid, trying to move it upward out of his line of sight.

“Don't do that,” Haines said, and caught him by the wrist. “The swelling will subside day by day. Let nature take its course.” He pulled a small card out of his pocket. “Can you read this with your right eye alone?” The print was fine, and Thomas turned so that the light fell on the card.

“No. I can't make out the individual letters.”

“Do this,” and Haines held up his hand, curling his fingers to form a tube, then holding it to his own eye like a short spyglass. “Does that improve it?”

Concentrating on the tiny hole. Thomas eyed the card, opening and closing his fingers until the print appeared almost comprehensible. “It helps.”

“Ah. That's good, then,” Haines said. “I've no doubt that the eye is going to give you fits for a while, but with rest and care, I think it will straighten itself out. You're going to have a scar on your pate that will be a fascination for all the ladies.” He touched the young man's head lightly, turning him this way and that. “No disfigurement…just a touch of dash and swashbuckle. That's good.” He stood back and regarded Thomas' face critically. “That's good,” he repeated. “But I wasn't truly concerned about that.” He watched Thomas for a moment. “How's the breathing?”

“As long as I don't do it, fine.”

Haines ignored the jest. “You feel movement?”

“I'm not sure.”

“Well, Haines said, “I am. Let's have a look.” He managed the fine knot of the bandage under Thomas' right arm and unwound the linen. “Lie back now if you can.” A pad of gauze remained, and he tugged it gently, revealing a nasty wound over the fifth rib on Thomas' left side. The gouge was deep and ragged, surrounded by a spectacular field of color that extended down to the eighth rib and across to his breastbone.

“I think we have at least two fractures, maybe three,” Haines said. “I pulled pieces of the sea bottom out of that gouge for the better part of an hour. Rib healing is really problematical.” He smiled at Thomas. “Unless, as you say, we can just keep them perfectly motionless for a month or so.” He touched the field of black, blue, and yellow, a touch featherlight. Thomas still flinched. “You can feel the slight depression of a fracture of the fourth rib through the swelling here. The sixth and seventh here.” He sat back. “You can understand why we're a bit apprehensive about your adventures out of bed, Thomas. You've got a piece of bone essentially floating free there. If you were to fall on it…” He made a face. “Nothing would prevent a ragged end from skewering your insides.”

“I thought about that.”

“But not enough, apparently.” Haines made a circular motion. “Roll on your right hip if you can.”

Thomas gasped at the first attempt, free as he was of the tight bandaging that had supported his ribs. Haines made a series of puffing noises as he examined the left hip. “Spectacular,” he said. “Is there any portion of your left leg where you have lost feeling?”

“I almost wish so,” Thomas managed. “But no.”

“When your hip attempted to dislocate backward, you did significant damage to some of the suspension for the joint,” Haines said. “Right here?” He touched with forefinger and thumb the area over the front and back of the iliac crest. “There are any number of muscle attachments that might be torn from here down to the head of the femur,” he said. “Deep within the joint itself. I think the damage is significant, since you're deeply bruised. Really quite spectacular.” He took a deep breath. “But I don't think there is a fracture. Everything is in line, as it should be.”

“I've managed a bit more movement with it,” Thomas said.

“Good,” Haines said. “I can give you something for the pain if you prefer.”

“No. Although I admit I made considerable progress with your brandy yesterday afternoon.”

Haines laughed. “You just help yourself. Between this hip and the brandy, you might develop a quite entertaining stagger. Let's protect that gash now.” In a few moments, he had re-bandaged Thomas' ribs. With a somewhat lighter bandage around his head, Haines left the right eye exposed.

“I am curious about your pharmaceuticals,” Thomas said as Haines finished with the last closure.

“Oh? How so?”

“In particular, the Universal Tonic,” Thomas said. “I couldn't help but notice the abundant uses mentioned for it in your volume.”

“Ah,” Haines said. The corners of his eyes crinkled, and one eyebrow raised. “You've made good use of your time.”

“Indeed. I spent most of yesterday engrossed.”

“It's important to remember that the book's purpose is not for the physician,” Haines said. “It's a book intended for every household. As Zachary says, it is intended as an advisor, so to speak—for those who have no inkling as to which way to turn.” He stood away from the bed. “It still amazes me, after all these years, that the basic dictum of clean air, clean habitation, and plentiful, wholesome food escapes most of our population. If we could change only those habits, we would eradicate most disease.”

“I agree absolutely,” Thomas said. “I mention the tonic simply because I had not encountered a preparation with such manifold uses. You mentioned in the book an entire factory devoted to production of useful materia medica, and a knowledgeable chemist and pharmacist in your employ. Most impressive, I must say. I'm eager to visit your pharmacy, John.”

“Well.” Haines shrugged. “We do what we can. Zachary has been an astonishing help to me, I must say.” He looked upward toward the ceiling, closing his eyes. “I'm trying to recall his description of the very drug to which you refer.” He frowned with irritation. “But I cannot. Tonight at dinner, we must ask him. He has a way with words.”

“I liked him immediately,” Thomas said.

“Engaging gentleman, isn't he,” Haines agreed. “We're all fond of him.”

“Where did he study? I know that I asked him last night, but somehow missed his answer.”

“That man has toured the world,” Haines said with admiration. “I don't suppose I've ever met a man who has taken such advantage of opportunity. In fact, just last month, he returned after a week spent in San Francisco. So many new ideas about the import of Oriental medicines that my mind was completely flummoxed. Really quite remarkable.”

“He must have had the advantage of an enviable schooling,” Thomas said. “His original work was at a university here, or in Europe?”

Haines looked at the ceiling again. “Undergraduate at Yale University, I believe, medical school at Vanderheide Institute in Delaware. A considerable stint in Vienna, and again in Bonn.”

“How did you come to make his acquaintance?”

“A chance meeting. I had traveled to San Francisco myself, to visit an ailing sister—she has since passed, bless her soul. I don't believe that you ever knew her…considerably older than myself. Anyway, at the time I took the opportunity to attend a symposium and made his acquaintance there. He wired me shortly after that and suggested that he was now seeking a position of some permanence. I happened to be entertaining the idea of finding assistance with my practice, and as it so often happens, our ideas collided. I confess, I was astonished that he would even consider a tiny, out-of-the-way community like Port McKinney, but I guess we have our advantages. He's been with me now for the better part of five years, and I must say, to our mutual benefit.”

“Your practice appears to be thriving,” Thomas said.

“Indeed. And you shall be a part of it.” He touched the young man lightly on the shoulder. “In due time. Your first job is convalescence.”

“Still, I can't bear simply lying here,” Thomas said. “I was entertaining the idea of having Horace drive me to the clinic.”

Haines glowered. “Under no circumstances,” he said. “I absolutely forbid it. Good God, man, think of the consequences of one misstep. Fall against something with that broken rib, and it would be a spear through your heart. No helping you then.” He held up an admonishing finger. “Don't be foolish, Thomas. Don't let a little impatience ruin a good start on the journey to recovery.”

“I was merely considering,” Thomas said. “Once at the clinic, perhaps I could simply remain there. With this wonderful chair, I could wheel about the wards. I could talk with patients, and as I become stronger and more ambulatory, I could be of some real assistance.”

“Next you'll want to be driving out through the big timber,” Haines snorted. “We'll find you crushed under a pile of logs somewhere.”

“I need to earn my keep.”

“Hardly.” He pulled out his gold watch and snapped it open. “Make me this promise, Thomas. Give yourself another full two weeks. You know that's not enough time for the ribs to heal, but it's a start. By then the eye will be out of trouble, and you may have gained some flexion in the hip. You won't be quite the disaster you are currently. Right now, you have the balance of an infant.”

“I…”

“Let me confer a bit with Zachary. It may be that we have some work we can bring to the house. It may even be…” He paused, face thoughtful. “Let me talk with Zachary. We'll speak more about it at dinnertime this evening. You'll feel well enough to join us again, I hope.”

“Most certainly.”

Haines patted the bed. “Good. Be patient, Thomas. Be a good patient. You're otherwise comfortable?”

“More than that,” Thomas replied, “pampering into sloth.”

Haines laughed. “Perfect. Eat and rest your way to health. That's what we want you to do. A year from now, when you're lying in bed exhausted from working half a dozen eighteen-hour days, you'll look back on this time and wish for a bit more serenity and relaxation. Take advantage of it while you can.”

“I'll try.”

“Have you finished the book? What do you think?”

“I am nearing the end. I am most struck by the chapter you present on mechanical aids. I had never seen such a wide range of helpful devices.”

“Ah,” Haines said, “a direct result of one of Zachary's visits to Vienna.” He nodded enthusiastically. “We'll talk at dinner.”