Die Once Live Twice (17 page)

1895–1922

Chapter Sixteen

J
onathan shivered, and not only with the cold and damp of the tenement. A dozen angry women stood in a circle around them, but were keeping their distance, as if the doctor himself was the source of the contagion that was killing their children. Coughing and wheezing children, victims of the diphtheria epidemic sweeping the city, provided an ominous chorus to their drama. Doctor William Park stood poised, a syringe in his right hand, pinching a small boy’s arm with his left thumb and forefinger. The boy’s mother sat in front of him, holding her child in her lap. Jonathan knelt beside them, keeping a hand under the boy’s arm in case the frightened and nervous child tried to pull his arm away when the needle pricked his skin. Though few others would have been able to tell, Jonathan knew the doctor was both exhilarated and deeply worried.

It was January 1895, and Park was attempting to inject the first dose of diphtheria vaccine ever administered in the United States. He and Jonathan were in a tenement on East 44th Street and First Avenue in New York City, where forty Italian families lived in an overcrowded five-story building. Over time Jonathan had become accustomed to the stench, but the filth made his skin itch, as if diphtheria bacteria were crawling all over it. The tenement was a house of death, filled with youngsters who were febrile and wheezing. In many cases a toxic membrane formed over the trachea, literally strangling the victim to death from the inside. That it occurred in children in waves of winter epidemics added to the urgency as the cold weather settled in. If nothing was done, most of them would die.

Yet the very people who were most concerned for their health – their families – had for two days prevented the doctors from administering this new cure. When Park had asked that he be allowed to inoculate their children, the mothers had ignored him or backed away as if he were the Devil, muttering, “This punishment was sent by God and only God can call it off.” “We have prayed to St. Jude. It is all we can do.” “Father Padraig assures us God will have mercy.”

Others attacked the doctor directly. “What has the government done for us but step on us? Who shut down the shops so that we cannot earn a living and buy bread?” Never mind that the “shops” were little more than dank holes where children and adults worked together for two nickels a day. In this ghetto, Italian or Russian depending on which street you walked, the Italians had been immovable. As the diphtheria epidemic gained momentum, Park had begged the mothers who surrounded him in the tenement to allow him to inject their children with the new antitoxin against diphtheria. They steadfastly refused, out of fear and distrust.

“What is your name, child?” Doctor Park asked in a whisper. As the boy looked up at his mother for help, the doctor asked again, “
Come se dice
?”

The mother nodded and the boy, pale and weak, whispered, “Angelo.”

Doctor Park smiled. “
Bene
, you will be a guardian angel for your people.” The boy did his best to return the smile, but he was obviously worried. As the doctor cleared the syringe and brought it toward the boy’s arm, a woman in the room shrieked and fainted. For all they knew, the doctor was about to turn the child into a zombie. When their sick children were taken to Willard Park Hospital, so far from their families and home, they rarely came home again. Surely the needles this doctor showed them must contain some new poison, some drug that would allow doctors to control their children and enslave them.

Finally, after Jonathan and Doctor Park had exhausted all the arguments of their limited Italian vocabulary, one woman had stepped forward from among the crowd staring distrustfully at them. Her six-year-old Angelo was limp in her arms, struggling for air. “Lucia, non!” one of her neighbors shouted, but the woman had continued forward, staring at the doctor as if that would tell her everything she needed to know. Jonathan felt that if Doctor Park smiled, if he tried to seem at all ingratiating, too eager, the woman would bolt. The doctor stood still, looking back at the woman with concern and something else Jonathan couldn’t quite place. Understanding, perhaps. At last she had nodded, grimly satisfied. She took a chair that was sitting behind Park, her son in her arms. She would let the doctor inject him, but not hold him. Doctor Park knelt down to prepare his syringe.

After he looked one more time at the mother, at Angelo, and at Jonathan, Doctor Park slid the needle into Angelo’s skin and injected the liquid into the muscle. The boy started, but Jonathan gently held his arm still. As he withdrew the needle, Doctor Park looked at Jonathan with the smallest smile. He knew the consequences if the boy died, but if he lived it would be the first cure ever of a disease in the United States. Jonathan suddenly realized that he was present at what could be a monumental change in the course of medical history—
hell
, he thought,
in all of history
!

Jonathan couldn’t believe his luck to be here today to watch medicine take this giant leap. After earning his medical degree from Harvard he went to Hopkins and worked in Welch’s laboratory for one year. His focus was isolating bacteria and studying chemicals to kill them. Welch sent him to New York. “Jonathan, you need to learn all you can about bacteriology. Bacteria are our greatest foe. One of bacteriology’s shrewdest warriors is Doctor Herman Biggs, chief of the Health Department for New York City.”

Jonathan soon learned that Biggs was the most decisive man with whom he had ever worked. When a cholera epidemic threatened New York City in 1892, Biggs had the ghetto streets and lots cleaned, scoured thirty-nine thousand tenement buildings and flushed out their water pipes with disinfectant. Circulars were distributed about prevention and treatment in English, German, French, Spanish, Italian, and Yiddish. The epidemic was stopped dead in its tracks. Now Biggs was at war with diphtheria, the winter-time murderer of children. It started with a sore throat and low fever, but progressed to nausea, vomiting, chills, and often, finally, the lethal membrane in the throat or nose. Biggs hired Park to set up a bacteriology laboratory specifically for diphtheria cases, the first in the United States.

Diphtheria was cured first in Europe. Emil von Behring had inoculated a boy on Christmas Eve, 1891, saving his life. At a medical meeting in Budapest in May 1894, Biggs heard Emile Roux present data that fifty-six percent of sick children given the diphtheria antitoxin lived, while seventy-five percent of those without the antitoxin died. Biggs joined other doctors as they threw hats in the air and stood on chairs and clapped. Finally. Finally doctors could really make a difference. Biggs rushed from the hall, telegraphed the news to Park, and ordered him to initiate the process to inoculate the children of New York City. Jonathan was right where he wanted to be—in the middle of finding a cure for infection.

Park and Jonathan were quiet as they walked back to the office in the basement of the building at 42nd and Bleecker. As they entered, Biggs was waiting anxiously. He grabbed Park by the arm. “Well,” he blurted. “How many are inoculated?”

“One.”

“Only one? My God, we rolled all the dice on one patient?” Biggs sat down and stared at the floor. Park explained the difficulty, which was not entirely news to Biggs, but he had hoped for at least ten children to give them a sure chance of success. “You know the percentages are not one hundred, William. If that boy dies...”

“If he dies, we will keep trying,” Park said firmly. “You’re right, Herman, I do know the percentages, and I know that they are in our favor. The antitoxin works. Not every time, but most of the time. Medicine has joined forces with experimental science now. We’re not just hoping.”

Biggs sighed. “You’re right, of course, William. But sometimes I wish we had a magic wand. If we can just replicate the results of von Behring and Roux, we will be... we’ll save a lot of lives.”

Jonathan went home for the night to his apartment in the Bowery. Tomorrow would be a momentous day, he felt sure. His hard work was coming to fruition. He only wished his mother were here to share his exhilaration. She had died in the fall of 1894, soon after she visited him in New York City. Her strength was on the wane and her weight was falling, but her spirit was strong. She visited the laboratory with Jonathan and watched every step of the antitoxin process. They had converted the clean laboratory out of a horse stable.

“Why horses?” asked Katherine.

“Because the blood serum of horses doesn’t provoke a violent reaction in children—it is tolerated well. I complained at first, Mother. I didn’t want to be a stable boy. I didn’t know how we would buy horses or where would we house them. I knew there was little money in the budget. Well, Parks laughed at me and said, ‘There’s no money for wealthy medical students, but when it comes to horses—your job is to answer your own question. I’ll give you $500 to buy the first five horses. You find a clean stable to house them.’ That was the beginning of this strenuous summer.”

Jonathan found a veterinary college on East 72nd Street where he could house the horses. When Biggs returned, he loaned them his own money to start buying more animals and then cajoled the
New York Herald
newspaper into raising $8,000 dollars for sixty horses. Jonathan named the stable the Royal Palace for Horses, because Park insisted that it remain absolutely clean and as sterile as possible. Any infection in the horses’ serum would be passed to the children, so the walls and floors were scrubbed twice a day, manure was immediately removed, and flies and rats were eradicated. The horses were given only clean, filtered water, free of cholera or typhoid bacteria, and feed that was free of dirt and debris. “I have to inspect their meals like I’m the king’s taster,” Jonathan complained good-naturedly. Jonathan dressed neck to toe in a long sterile gown and wore a hood that covered his head entirely, exposing only his face, which was covered with a mask. The room used was thoroughly washed, floor to ceiling, ten minutes before the procedure. “Dust will not fly around in a wet room,” Park explained. “The particles will stick to the walls for the time it should take you to remove the serum from the flasks.”

Jonathan quickly learned how to expose a horse’s jugular and insert a large open-ended needle in the vein, which drained blood into flasks through a sterile rubber tube. Each horse could safely fill nearly twenty flasks, and horses were rotated as donors to allow them to replenish their blood. Within minutes of being collected the blood began to clot, attaching itself to the walls of the flasks that were stored on their sides. The serum separated from the clotted blood, creating a yellow, liquid layer that was transferred into glass vials to be used for injection.

Katherine was fascinated. When Jonathan explained the high costs, she ran a personal fundraising campaign for this project while in New York. She hosted a dinner at the Waldorf-Astoria for Teddy Roosevelt, General William Waring, and John D. Rockefeller. Roosevelt was reforming the police and raided corrupt police stations and bars wielding his own pistol; Waring was manager of New York’s sanitation and treated the city’s filth as a wartime enemy. Waring’s White Angels swept away refuse and manure, both sources of disease. By evening’s end, all three pledged their support to the project’s success. As they left, Jonathan saw Rockefeller leave his legendary dime for a tip.
It’s not worth what it used to be,
he thought. Katherine left the dinner secure that Biggs would have the support of the power in New York City.

Katherine never knew whether Jonathan’s project succeeded, but she died at peace with herself. She was grateful for the gift of time she’d received, for she knew no one else had lived six years with breast cancer. She had been consumed by her passion to leave the earth a better place, pressuring medical research to improve and find treatments to prolong life. Life expectancy of less than fifty years was just too short. A way to prolong life had been found for patients with breast cancer. Her sons, and future heirs, would build on her legacy and be responsible for the discoveries that would eliminate disease as man’s scourge.

Chapter Seventeen

J
onathan had butterflies as he walked with Park to Angelo’s house the next morning. He had felt this nervous excitement before football games, but those were games for entertainment. This was life and death. If they lost, there wasn’t another chance the following Saturday. All the months of work now came down to the health of one small child.

He walked with fear in his heart—the fear of failure compounded by the fear of retribution. Park asked the neighborhood constable to accompany them and stand outside the tenement house. As they knocked on the tenement door in the strangely quiet hallway, Park looked at Jonathan and took a deep breath. “No one has assailed us yet,” Jonathan said encouragingly. Park nodded and knocked again. When it opened, Angelo’s mother Lucia immediately began crying and Jonathan’s heart sank. Then she startled both of them by grabbing Doctor Park’s hand and kissing it. Park looked at Jonathan, his eyebrows raised, as the woman pulled him into the room by his arm to see Angelo. The boy was lying on a thin mattress on the floor, breathing normally, and when he looked up at them, he smiled.

Jonathan had heard of seminal moments in life.
This must be one,
he thought. No football game, no date, not graduation from medical school—nothing had given him the surge of emotion he felt throughout his body.

Park leaned forward and laid a hand on the boy’s forehead. His smile broadened as he straightened up. “His fever has broken. It worked, my boy, it worked.” He clapped Jonathan on the back.

“Cured!” Jonathan grabbed the doctor’s hand and shook it vigorously. “A new age in medicine. Hell, a new age for society!”

Lucia gestured at Park’s medical kit. “How...?” she asked, then stopped, not having the words. Park and Jonathan combined their meager knowledge of Italian with the woman’s equally meager knowledge of English in an effort to explain. Park held up a vial of the serum. “In this, there are antibodies”—Lucia frowned—“like soldiers,
soldati,
to fight the disease. We put the soldiers in Angelo’s blood—”