Race for the Dying (14 page)

Chapter Twenty-four

A tiny woman was busily engaged dusting bookshelves in the clinic's waiting room when Thomas arrived. She stopped and watched as Horace James and Alvi lifted the wheelchair over the last step, and then as Thomas followed on crutches.

“Good morning, all,” she said. Thomas sank back into the chair.

“Thomas, this is Miss Bertha Auerbach,” Alvi said. “Dr. Thomas Parks.”

Bertha Auerbach folded the damp dust cloth neatly and placed it in a metal basin that rested on the windowsill. Folding her arms across her thin chest, she regarded Thomas critically.

“So…here you are,” she said. “I've heard much about you, Doctor.”

“Some of it good, I hope,” Thomas said. “And I am in your debt, Miss Auerbach. Thank you for tending to the wreckage of my medical bag. You certainly didn't have to do that.”

“My pleasure. We don't know when you might need it.” The light of the window illuminated her face, and Thomas saw that Bertha Auerbach was actually younger than the stern voice made her out. A collection of flat planes with high cheekbones and full lips, her face was the sort that badly needed a smile. Were it not for the voluminous folds of her dress, her figure would have appeared childlike. Barely topping five feet, she wore the same style white dress and apron that Alvi had adopted, but with a small white cap that sought to capture the abundant black hair pinned high on her skull. Her large, deep blue eyes fixed on Thomas' face. He felt like a bacterium trapped on a microscope slide. “You're going to be staying here at the clinic as well?”

“Apparently not,” Thomas replied. The nurse had made it sound as if he'd need her permission to do so. “I thought that I might, but now it appears that I'll be lodging at one-oh-one for awhile.”

“Just as well, I suppose. The elevator was never installed in this building, more's the pity. Now that you're here, how do you propose to reach the second floor?”

“I—”

“He's not,” Alvi interrupted. “He'll be working with Father tending to patients. At least until he's completely recuperated.”

“I see.” Bertha's gaze roamed down Thomas' figure. “And how's that progressing, Doctor? I'm to understand you nearly killed yourself.”

“A bit of a bang,” Thomas replied. “But I'm mending.”

She nodded once. “I've worked for Dr. Haines for eight years.” Thomas wasn't sure how he was expected to respond to the announcement, but she added, “Perhaps you'll instruct me on your preferences.” She tucked a strand of hair back over one shapely ear. “When you're ready, of course.”

“Yes. Where to start,” Thomas said. He turned his chair in a circle, regarding the waiting room. All the medical offices he'd seen as a boy, especially the ones in rural Connecticut and even what private practices he had seen in Philadelphia, combined all activities in a single room. Patients waited their turn, their business with the physician as public as a town meeting. Here, Dr. John Haines had provided a waiting area with benches and even a comfortable chair or two, examinations and treatments remaining discreetly behind closed doors.

“I'm impressed with this, I must say,” Thomas said, although he couldn't help comparing the reality of the clinic with the imaginary presentation in the new
Advisor
. “I could become spoiled very quickly.”

“Where was your practice before this?” Bertha asked, and Thomas felt that cursed blush rise up his neck and touch his cheeks. Surely Dr. Haines had mentioned Thomas' circumstances to nurse Auerbach—fresh out of school, with no clinical or practical experience of his own.

“I assisted Professor Wilhelm in his work in Philadelphia,” Thomas said. “During my last two years in school there.”

“I see,” she said, and Thomas saw that figuring out just what Bertha Auerbach was thinking was going to be a challenge. “Well,” she said and turned away, “we shan't be ready for anything, standing about yakkety-yakking. If you have instructions for me?”

Her retreat to the examining room required that Thomas follow along if he wanted to converse with her, and he glanced at Alvi, who smiled sweetly.

“I've work to do upstairs,” she said. “I'll be in and out, if you have questions.”

“I shall have an unending list,” Thomas said.

“In most things, Berti will guide you,” Alvi said. “She's most efficient. And Father will be here by ten o'clock, regardless of his promises.”

Thomas glanced at the clock and saw that it was seven-thirty. He felt as if he had already wasted half the day. Wheeling into the examining room, he arrived in time to see Bertha empty the contents of a steaming kettle into one of the washstand's reservoir bottles.

“I did have one concern,” Thomas said. “I wanted to discuss the gas clave system with you. Yesterday, I noticed that it wasn't operative.”

“Of course not, Doctor. Yesterday was the Sabbath. Normally, no one is here at that time. House calls, perhaps. But not here.”

“Well, you see the problem is,” and Thomas pushed himself more upright in the chair, leaning on his good right arm, “we don't know when we're going to need sterile instruments, Miss Auerbach.”

“I don't understand what you're asking of me,” Bertha said flatly, and her tone cut through Thomas' efforts to be tactful.

“What I'm asking,” he said, “is that at any time, day, night, Sabbath or not, I may have sterile instruments in my hand for the, asking. Without delay. Without confusion.”

“How will I know what you require?”

“A commonsense selection,” Thomas said. “Nothing unusual. I shall draw up a list for you if that's necessary. But it's the notion of everything at the ready that's important, Miss Auerbach. Ready and sterile.”

“Sometimes we make do with what we have,” she said, and she might have added
and that's that.
Her tone softened a bit. “I heard about young Charlie,” she said. “Such a shame.”

“Yes, but more than a shame. A crime, in fact. And that's my point. Before we leave the clinic for the day, I'll have such a kit in the pan, already claved, simply left inside the machine where it will remain sterile,” Thomas said. “I'd like you to see to that each day. It's easy to become busy, I imagine. But that needs to be done.”

“I see.”

He smiled at her. “Do we have such a selection at hand at the moment, Miss Auerbach? That's sterile, I mean?”

“Indeed not. No.”

“Then perhaps that can be your first chore,” he said. “A scalpel or two, forceps large and small, sutures of varying sizes, probes, the hypodermics. Whoever arrives first in the morning will resterilize the kit as a double precaution.” He pivoted the chair so that he could survey the examination room again. “If there's one thing that the War between the States taught us, it is that prompt medical attention, coupled with aseptic conditions, contributes to effective care.”

“The war was forty years ago,” the nurse replied.

“Indeed. Before either of us was born. I don't mean to be pedantic, but it is also my observation that the lessons from that war are slow in taking root. Please don't misunderstand me, Miss Auerbach. I mean in no way to be critical of what is done here. My particular interests have led me to believe that nearly any injury may be satisfactorily repaired by prompt treatment, including aseptic instruments, gentle surgery, and intelligent therapy afterward.” He realized that he had launched himself on a sermon, and cut himself off abruptly. “That's all I'm saying,” he said. “Where did you complete your training, if I might ask?”

“At St. Vincent's in Portland,” she replied. “I went there directly from Macy Normal.”

Thomas had heard of neither, but nodded as if he had. “May I ask what prompted you to move to Port McKinney?”

“An ill relative across the bay,” she said tersely. “Since passed on.”

“Ah, I see. I'm sorry. Other family here?”

“I have a brother who works for Mr. Schmidt.”

“Really,” Thomas said. “As does Mr. Tate, whom I've met already. He led the charge into the surf to rescue my carcass.”

“Jake Tate is a good man,” Bertha said. “You'll find that many of Mr. Schmidt's workers pass through here for one reason or another.”

“I would expect so. It surprises me that the ward is empty today. Is that the usual state of affairs?”

“We transfer any patient who will need extended care to St. Mary's, Doctor.”

Although he had been told that by both John and Alvina Haines, Thomas still found the notion incredible. “We do? All?”

“Yes.”

And that's a trip of some thirty miles?”

“Yes.”

“My God, Miss Auerbach, whatever for? Thirty miles there and thirty back?”

“Yes.”

“While we have a ward with eight beds? Good heavens. You have assistants? Am I understanding that correctly?”

The nurse looked sideways at Thomas. “I have no assistants, Doctor. There are six girls who work upstairs with Mr. Riggs and Miss Haines.” She glanced at the clock. “They will arrive shortly, although most often, they use the back stairway. I don't want them clumping through the waiting room, you see. Down here, it is Dr. Haines and myself. And often, just myself.”

Thomas gazed at her thoughtfully, interested to hear her version of Zachary Riggs' endeavors. “There are patients upstairs?”

“My heavens, no.”

“Then I'm confused. What do eight people do all day long on the second floor, while you and Dr. Haines struggle with the community's medical needs here?”

“There is much correspondence,” the young woman said, and Thomas heard the discomfort in her voice.

“There must be,” he replied. “With whom are we corresponding at such a pace?”

“I was under the impression you would know about that aspect of the practice.”

“Apparently I hadn't appreciated the magnitude of book sales,” he said.

Bertha Auerbach's lips compressed a bit, and she raised an eyebrow as she stared at the floor. “I think it best that you discuss that affair with Mr. Riggs,” she said after a moment. “Or with Miss Haines. Or with the good doctor.” The
mister
, rather than a physician's title, was not lost on Thomas.

“I shall. But tell me…when you transfer a patient to St. Mary's, who drives the ambulance?”

“Normally, Mr. Winchell will do that.”

Thomas laughed. “Having the coroner and undertaker at the reins must inspire the patient's confidence, I'm sure.”

“Mr. Winchell uses his white team for ambulance duties,” Miss Auerbach said. “The blacks are reserved for the hearse.”

Thomas caught himself when he saw that she was serious. “We have no ambulance routinely at hand. That's what you're telling me?”

“Mr. Winchell has one. Or hearse, depending on its need.”

And when Mr. Winchell is transferring a patient, we are left with no ambulance at our disposal for at least two days?”

“We are a small village.”

Thomas leaned back in the chair, resting his chin on his right fist. “That puts us at a serious disadvantage.” he said. “Earlier you asked my preferences. Well, one of them is an ambulance at hand here at the clinic, fully prepared with a driver of our employ. If we must purchase an ambulance or two, we'll do just that. I'll speak with Dr. Haines about it today. This isn't a matter for next year, Miss Auerbach.”

“That's a considerable expense.”

“Indeed,” Thomas said. “I'm sure he is as eager as I am to make progress here. I hope you'll join with me in this.”

“Of course,” she said. A ghost of a smile touched the nurse's face, and Thomas saw that she was really quite pretty.

“This morning I'd like to examine the daily journals,” Thomas said. “Dr. Haines said that he keeps a narrative?”

“Of course. They're shelved in his office. It is his habit to make notations after each patient he sees. There are times, certainly, when he is much pressed, and I'm sure some time passes before he makes an entry. But he's really very organized in that regard.” She paused. “Would you like to see them now?”

“If you please.”

He wheeled after her to enter the quiet sanctum of Haines' office. Bertha Auerbach opened the glass doors of one of the cabinets and slid out a heavy, leather-bound volume. Opening it, she turned to the last page of writing, and as Thomas wheeled behind the desk, she rested the book in front of him.

The doctor's hand was fine and angular, the entries in black ink as easy to read as a printer's copy. No scratch-outs marred the page.

“You'll see that he makes an entry for each date,” she said. “A diary, more or less.”

“I see that,” Thomas said, reading down the page. “He assigns a case number for each visit, or for each patient?” He leafed back through two pages.

“That would depend,” Bertha replied.

“On what?”

“It is my understanding that each separate incident or illness receives a fresh case number,” she said.

“Ah, here I am.” Thomas said. He grinned. “I'm Case Number 43,731, entered September 12, 1891.” He turned the book slightly so that light fell more clearly on the page. “‘Thomas Brian Parks,'” he read aloud, “‘age 27, the victim of a riding accident, brought to this office via Schmidt's freight wagon, found to be in a semiconscious state, suffering from multiple injuries.'” He looked up at Bertha.

“I have read that entry,” she said.

“Really?” He skimmed the lengthy list of injuries that the physician had enumerated. “He's most complete.”

“I would imagine so.”

As the dates progressed down the pages, Thomas saw himself mentioned several times, interspersed with other patients. In the course of the past week. Dr. Haines had seen thirty-seven different cases, with complaints ranging from slivers to abscessed teeth to fractures, lacerations, and other interesting wounds, to cases of debility, dyspepsia, tuberculosis, and influenza. One patient had eaten raw fish and nearly died, while number 43,760 had tried to shoot himself in the head, changed his mind at the last moment, and managed to blow off only a portion of his left ear.