In the Valley of the Kings: Stories

Hippocrates reminds us to remember our teachers with gratitude, and I gladly thank them first. Mark Dintenfass, Alison Lurie, James McConkey, Dan McCall, Walter Slatoff, and Harold Brodkey all have a hand in whatever virtues these stories possess. Ellen Schwamm gave invaluable assistance when I was learning to edit; “Charybdis” would never have gotten off the ground without her aid.

The individuals and agencies who have provided material assistance include: the Djerassi Foundation, and Carl Djerassi in particular; the Fine Arts Work Center at Provincetown; the Pennsylvania State Council for the Arts; and finally, to Grace Paley, for her customary generosity, encouragement, and support: thank you.

Ron Sharp and Frederick Turner of
The Kenyon Review,
William Abrahams of Doubleday’s
O. Henry Prize Stories
series, Stanley Lindberg and Stephen Corey of
The Georgia Review,
Mary Kinzie and Reginald Gibbons of
TriQuarterly,
and Adrienne Brodeur and Samantha Schnee of
Zoetrope
all helped shape these pieces and sustain my career.

Robert Weil at Norton has been the
beau ideal
of an editor. His insight into these stories has been invaluable.

It is impossible to thank Nicole Aragi adequately. I can only say that it is through her that I have come to understand the doctrine of grace.

And to Junot Díaz, for rewarding my stumbling efforts on his behalf far more than they deserved: thank you, even though you persist in calling me “Professor.”

Constance Holt knows far better than I how much she helped this book into being, but let this serve as a reminder to both of us.

Toby and Theo entered these stories at different points in their development, and added new reasons for finishing them. Thank you for keeping me awake so much of the time.

Laurie’s contribution to these stories is difficult to explain. That’s why I wrote them. And why I needed her to make sense of them. Thank you.

T
he first case of which any record survives was reported in a small-town daily in upstate New York. Tabitha Van Order, the brief item reads, age five, was brought into the county hospital’s emergency room with “strange markings” on her face and hands. “She was playing with the newspaper,” her mother reported. “I thought it was just the ink rubbed off on her.” But the marks did not respond to soap or turpentine. At the hospital, initial examination determined that the marks were subcutaneous, and the child was admitted for observation. They looked, according to the triage nurse, as though someone had been striking the child with a large rubber stamp. “They look like bruises,” the emergency-room physician told the
Journal
reporter. The department of social services was looking into the case.

This alone might not have warranted even three inches on page eight of a sixteen-page paper. What attracted the attention of the editor at the county desk (whose sister, a nurse in the E.R., had phoned in the story), and earned Tabitha’s case even that scanty initial notice, was one peculiar feature of those bruises, one fact about the case that stood out from the face of an otherwise unremarkable, seemingly healthy little girl. It was not that, over the next several days, the marks did not fade, nor exhibit any of the changes of hue or outline usual in a bruise—although this was puzzling. Nor was it the child’s silence, which she maintained three days with a patient gravity that impressed the most casual of observers. What claimed the attention of everyone who saw the child over the three days of her illness was the unmistakable pattern in those marks. They formed a word.

A word, certainly: no one who saw doubted for an instant what they saw. And it was something more, as well. Everyone struck with the sight of that pale, silent face and that black sign reported the same response: each said that the shock of seeing it for the first time was almost physical. It was as if, the nurse on the day shift recalled, seeing it, you felt it on your own face—“like a blush.” And indeed, after the initial shock, something like embarrassment did set in: the nurses could never bring themselves to utter the word, either to the child or among themselves; the physicians during their morning rounds half averted their eyes even as they palpated the affected areas. And although
bruises
were discussed day and night across the desk at the nursing station; although
palpable purpura
were the subject of long discussions in the cafeteria; although everyone down to the orderlies hazarded a guess as to the nature of the marks, the word itself went euphemized, persistently elided.

After embarrassment there followed another response, something of which communicates itself even now in the tone of that first newspaper article, a kind of delicacy, a reticence over the details of the case: a hush. That respectful silence grows ambivalently louder in the two pieces that in as many days followed, lengthened, and moved forward toward page one. As for the child herself, she made no complaint, nor in fact did she utter any word at all until just before the end, when she was heard to pronounce, in tones audible as far as the nursing station, the word spelled out by the bruise across her hands, cheeks, jaw, and (most plainly) forehead. She spoke the word in a piercing falsetto three times, and then, before the nurse could reach the room, the child coded, as the physician’s assistant said, and died.

I LEARNED MUCH
of this, of course, later, by which time several of the principals—the nurses, the orderlies, the mother, and the physicians—were beyond the reach of my own inquiries. But I believe the editor told me as much of the truth as he knew before he died.

Which was more than he told his readers. Even in the third article, which appeared on the fourth day following Tabitha’s admission to the hospital, and where the headline type has grown to fifty-four points, the text is most significant for what it does not say. It does not tell the precise form of those bruises that darkened across the child’s features in her last twelve hours and then faded completely within minutes of her death—although the darkening and the fading both are faithfully set down. Nor does it transcribe the syllables the child voiced three times before she died—although the fact of her crying out is also given. It does not even mention that the bruises formed a word.

There was this aspect of the affair notable from the start: the embarrassment that overcame all who saw the word, as if the thing were shameful. Not, I believe, for what it said, but for being so patently, inscrutably significant: for being a sign. Few people could bring themselves, at first, even to acknowledge what they saw. It was as if an angel had planted one bare foot in Central Park, another on the Battery, and cast the shadow of a brazen horn over Newark. If such had happened, how many minutes might we suppose to have elapsed before anyone could have brought himself to turn to his neighbor and ask,—Do you see?—How could any of us discuss it without feeling implicated? So it was in the case of Tabitha’s word: it was too plainly part of a world we no longer knew how to address.

But there was more to this evasion, of course, than met the eye, and it is this that I find truly remarkable about the case. It is the function of that evasion, and the unmistakable conclusion it urges, that most impresses me: that everyone who saw the word, immediately, without understanding, without conscious thought or any evidence at all, knew that to see the word in print was a sentence of death.

No one, at the time, had any empirical reason for suspecting such, but in every account, even the first, I trace an instinctive recognition that it was the word itself that carried the contagion. It was several months, of course, before the means of transmission was identified, through the work of the Centers for Disease Control and Prevention in Atlanta and Lucerne, and ultimately the heroic sacrifice of the interdisciplinary team at the
École des Hautes Études en Sciènces Sociales
in Paris. So how do we find, in this first written record, the prudence that spared until a later date so many lives? And how do we balance that seeming prudence with the other inescapable fact about the word: that as the end approached, all seemed seized—as was Tabitha herself—with an impulse to speak. It was as if the word struggled to speak itself, as if in answer to some drive to propagate that would not be denied.

The elucidation of the mechanism was complicated by the discovery that mere speech was harmless, as was hearing: it was the eye through which the plague entered, and the eye alone. The hand that wrote, so long as the person behind it did not look, was spared (with the notorious exception of the blind, who took the illness in Braille, and broke out before they died in portentous boils). But to see the word in print (ink or video, it did not matter) was to sicken, and invariably to die.

Experimental studies were hampered, of course, by a number of complicating factors, not least of which was the obvious difficulty in conducting tests on other than human subjects. A late attempt was made, by some accounts, to incorporate the word into the ideogrammatic code taught to chimpanzees at the Yerkes National Primate Center; results were fragmentary, the experiment ending prematurely with the incapacitation of the staff. One significant datum did emerge from all studies, however: illiteracy was no defense. Even those incapable of deciphering the dialogue from comic strips were found to be susceptible. The only exceptions were those functioning, for whatever reason, below the mental age of thirty months.

But all of this knowledge came later. Although this most important aspect of the disease did ultimately receive full measure of publicity, in the case of Tabitha Van Order the initial reports were mute. Indeed, were it not owing to the early curiosity of one researcher in virology at a nearby university, the epidemiological particulars of this first case might have passed almost entirely unrecorded. This virologist, one Taylor Salomon, happened to have been a patient on the same floor as the child, incapacitated with a pneumonia contracted while at work in her laboratory. On the day that Tabitha gave up the ghost in a room four doors down from hers, Professor Salomon was sitting up in bed for the first time in two weeks, taking some clear broth and attempting to organize notes from her research.

The attempt was futile, owing to the extreme weakness that had kept her semiconscious for the previous two weeks, and was disrupted forever by the unearthly cry that heralded Tabitha’s demise. Professor Salomon was fortunate in this, however: her own illness had kept her from visiting the child’s room, or even glimpsing her mottled face through the open door before the marks had faded entirely away. And the research project that had hospitalized Professor Salomon soon faded from her thoughts as well, supplanted by a new question as soon as the nurse appeared, visibly shaken, in answer to the professor’s call.

The nurse could report the sequel of the child’s cry, but not its meaning; she could only echo, with the distracted air that had come to typify the medical staff in the last hours of Tabitha’s life, the helpless distress of her colleagues at finding their patient so unaccountably dead. To Salomon’s more pertinent questions about the disease’s course and etiology, the nurse could only wring her hands and look back over her shoulder, as if she harbored a guilty secret. Her curiosity piqued, Dr. Salomon managed to rise from her bed and stumble down the hall before the orderlies arrived to wheel the body away. The marks had apparently disappeared no more than five minutes before her arrival.

Luck was with her again, in that her appearance in the room was followed almost immediately by that of the medical examiner. The examiner, already irritated at the interruption of lunch, was inclined to order Salomon from the room, and her recitation of her credentials did nothing, at first, to soothe him. But being in no mood to take up the investigation himself, even in his irritation he was no match for Salomon’s persistence, and in the end he agreed to provide the samples she required. In an additional example of the good fortune that marked so much of Salomon’s involvement with the case, the M.E.’s cooperative attitude was not shared by the hospital staff, which refused to release the child’s chart to anyone but the M.E., citing doctor-patient confidentiality. But the samples, Salomon felt, would prove more valuable than any M.D.’s scribble, and she was content with the oral recitation of the child’s history she eventually wrung from the nurses. The samples, iced and isolated according to protocols, waited another two weeks before Salomon was able to return to her lab, where she found, of course, nothing. The blood, nerve tissue, and other fragments of Tabitha’s clay were apparently those of a healthy five-year-old girl, and nothing an extremely well-funded laboratory could bring to bear on them was able to add anything to the story.

Stymied in the laboratory, Salomon turned to a colleague in epidemiology, and, swearing him to secrecy initiated field studies of the child’s home, school, and other haunts. The season was late spring; the child’s back yard abutted on a swamp: insect traps were set and their prey examined (at this point the impromptu task force expanded to include an entomologist). Once again, nothing significant appeared.

Time was running out for Salomon and her hope of scoring a coup. Five weeks after Tabitha’s admission to the hospital, the child’s mother, the triage nurse, four orderlies, the emergency-room physician’s assistant, three floor nurses and two doctors were admitted with livid bruises on the palms of their hands, cheeks, jaws, and (most plainly) foreheads.

In this first wave of cases, the disease exhibited additional symptoms, not observed (or not reported) in the case of Tabitha Van Order. In the triage nurse, onset was marked by a vague dreaminess that overtook her at work one morning. By lunchtime, she was incapable of entering insurance information correctly on her forms, and by midafternoon she had wandered from her desk. She was found on one of the high floors of the hospital, staring out a window at the lake, where a sailboat regatta was in progress. It was only at this point that the marks on her face were noticed. At about this time (the precise time is unavailable, owing to the nurse’s absence from her desk), Julia Van Order arrived at the emergency room, brought in by a neighbor who had found her laughing uncontrollably in the street outside her home. The third symptom, glossolalia, was observed in two of the orderlies and one physician, who were admitted over the course of the evening. By midnight, there were twelve patients on the floor.

Recognizing an incipient epidemic, the chief of infectious disease imposed strict quarantine that evening. Staff on the floor were issued the customary isolation gear, and strict contact precautions were imposed. Who could blame the man for not issuing blindfolds? Such measures were in fact tried, much later, but by then, of course, it was much too late. He failed as well to confiscate pens.

Professor Salomon, on hearing of these new admissions, realized that her time was running out, and did the only thing left to her. After one visit to the hospital, during which she conducted interviews with those of the victims able to respond, she wrote up as full a description of the disease as she could, took her best guess (which turned out, in the end, to be wrong) as to its cause, sealed the four closely-printed pages in a dated envelope, and sent it, with a cover letter, to the
New England Journal of Medicine.
It was not at that time the policy of the
New England Journal
to accept so-called
plis cachetés,
the practice having fallen into disrepute over a generation earlier, and Salomon’s contribution might have been returned unopened had it not been for yet another fortuitous circumstance.

A reporter specializing in science and medicine for a national news magazine was visiting Salomon’s university that week, lecturing graduate students in journalism. On the day he was scheduled to return to New York, he happened to hear of the dozen deaths that had occurred the previous night at the county hospital. Sensing a career opportunity, he filed a story, complete with an interview with Salomon, and the item ran prominently in the
Health
section of the following week’s issue.