Die Once Live Twice (18 page)

“Sangue,” Jonathan said helpfully, and Lucia nodded.

“—and the soldiers kill the disease.”

Lucia smiled and nodded again. “Sono forte, questi soldati,” she said, making a fist.

Doctor Park laughed. “Yes, very strong.”

There was a knock at the door, and Jonathan turned to see a crowd of women holding children. It was clear that they now wanted the vaccination, too, and Doctor Park had brought it with him hoping for just such an outcome. Before they left, word spread around the neighborhood and more women came for what they called magic. With each injection he gave that afternoon, Doctor Park thanked God, the European doctors who discovered the antitoxin, and Biggs, for being in Budapest.

For Jonathan, it was the moment he came to know who he would be
. Each person must learn their purpose, must have an epiphany like this, to understand the meaning of their life
, he thought. He now knew his work was to learn the secrets of germs so he could destroy them. God, could it be possible that this glory was to be his? Was he indeed a Richard the Lionheart whose crusade was infection? His mother had believed it, and now so did he.

Jeffrey had his moment of enlightenment when Welch convinced him that medical education was his career. In 1897 he was within months of becoming a doctor of medicine in the first graduating class of Johns Hopkins. His favorite teacher was Doctor Harvey Cushing, who arrived in 1896 from Harvard as a first-year resident studying with Halsted. Jeffrey was the first medical student to work with him.

In their first surgery with Halsted, Cushing was fidgety. “Why can’t you stand still?” Jeffrey whispered.

“This patient will die. He takes forever to operate.” Halsted’s meticulous method of ligating every bleeder minimized blood loss and shock, so he sometimes operated five hours. “At Harvard the skill of the surgeon was judged on the speed of his operation,” Cushing continued.

“Didn’t you have anesthesia?” Jeffrey whispered back.

“Yes, but that hasn’t changed the surgeon’s habits.”

“You have a lot to learn, Harvey. At Hopkins the doctors make decisions and act based on research and knowledge, not past tradition. This is a very different place.”

Jeffrey and Cushing studied and learned together. Cushing had a deep interest in the brain and neurological system. Roentgen’s x-ray had been available for two years, and both young men were fascinated by what they could learn by seeing inside the body. One evening in 1897 they were studying the x-ray of a gunshot wound to the neck, marveling at how the bullet had shattered the structure of the third and fourth cervical vertebrae. Cushing suddenly pushed back his chair and ran doubled over out of the x-ray room. Jeffrey followed him to the restroom, where he watched him kneel over the sink and vomit.

“What’s the matter?”

“I’m not sure. I’ve had a pain in my lower abdomen all day. Now I have trouble standing up straight.”

“Lie down on the floor,” Jeffrey commanded. The lower right side of Cushing’s abdomen felt tense and he yelped when Jeffrey pushed on it. When Jeffrey quickly released his push, Cushing screamed.

“That’s rebound tenderness,” Jeffrey said. “You have appendicitis, Harvey. Rebound tenderness is the classic sign of this infection.”

“Appendicitis?”

“In Boston you may have called it peri-typhlitis. Doctor John Murphy in Chicago presented fifty cases, operated on the patient’s kitchen table no less, to his medical society. They booed him out of the building. But Halsted believed him. He operates for these symptoms you have.” Jeffrey helped Cushing to a bed in the hospital and ran to find Halsted. If the appendix burst, the bacteria would spread through Cushing’s body and then there was no treatment. He would die.

Halsted confirmed the diagnosis, and within the hour Cushing was on an operating table, his abdomen prepared with carbolic acid and permanganate while he was anesthetized with chloroform. Halsted worked steadily, clamping and tying each bleeder, until he could see the appendix. “It is that fingerlike appendage from the colon,” he said to Jeffrey. “Not quite as big as your little finger usually, but today it is, being so swollen.” Halsted ligated the root of the appendix and then amputated it and sewed the defect in the bowel.

He lifted up the clamp that held the appendix and all in the room stared at it. “Cured!” was all he said.

Jeffrey was witness to the first surgical operation that cured a disease—the removal of an infected appendix—and experienced a transcendent moment, as had Jonathan with the medical cure. It fueled his passion for medicine, which he had tolerated until now for his mother’s sake. Now he had witnessed what he’d always said doctors couldn’t perform—a cure. Medicine became his profession. He wrote to Jonathan:

Dear Jonathan,

You are no longer the only doctor who has witnessed a cure. Today I watched a surgical cure, by removal of an infected appendix. Because you are a Harvard man you probably know it by that uneducated name of peri-typhlitis! It can be done! Medical cures are by chemicals and surgical cures are by cutting out disease. Wouldn’t Mother be excited! We are on the road to Jerusalem, and I will serve the cause by educating your soldiers as you search for Medicine’s Holy Grail.

Your brother,

Jeffrey

Chapter Eighteen

A
maroon and tan Great Arrow motorcar, latest 1907 model, stopped in front of the Fifth Avenue entrance of the new Plaza Hotel in New York City. A tall blonde woman with large shoulders and chest, her hair fashionably twirled into a bun, stood up in the seven-foot-tall car. She took the doorman’s offered hand and stepped down from the passenger side. Jonathan Sullivan exited from the driver’s seat. As he removed his Borsalino fedora and took the woman’s hand, the doorman asked, “Mrs. Sullivan, isn’t it rather cool to ride in an open touring car in November?” “Ask cockle-brained Jonathan. I bundled up in this fur coat and fur hat to go six blocks. Now you know how much I must love him!” she said, taking Jonathan’s arm and snuggling up to him.

Jonathan and Marion lived in one of the mansions on Fifth Avenue just above 65th Street, joining the Vanderbilts, Astors, and Andrew Carnegie, among others. Jonathan enjoyed his wealth. Their house staff of twenty cost him $25,000 a year. The two Great Arrow cars were over $8,000. Though far beyond what his $1,000 yearly salary as a doctor could buy, they were readily affordable on the $5 million income from investments of his $50 million inheritance.

Jonathan marched her up the stairs into the warmth of the lobby, nodding to those they knew. Marion Kramer Sullivan, a Broadway actress, was five foot seven and had Scandinavian blonde hair and blue eyes. Her cheek bones were high and her figure voluptuous, two characteristics that attracted Jonathan. Jonathan had met her in his private clinic at Rockefeller Hospital, the clinical arm of Rockefeller Institute.

Jonathan’s appointment at the Rockefeller Institute when it opened in 1902 was a boost for his career, despite his initial reluctance. Welch had ordered Jonathan to move to Rockefeller to do research. “Rockefeller will become the leading center for study of infection in the world,” Welch had insisted. After the death of his three year-old son from scarlet fever, John D. Rockefeller had funded the Rockefeller Institute for Medical Research. When Jonathan objected that he didn’t want to leave his research with Park, Welch grudgingly said, “Well, you can keep your weekly clinic in the tenements with Doctor Park, but I warn you, Simon Flexner and Park are not friends.” Welch had selected Simon Flexner, his protégé and an outstanding pathologist, to head the research laboratories at the Rockefeller.”Jonathan, the money for research is at Rockefeller. Your self-proclaimed destiny can be achieved there, not working for the city of New York.”

Marion came to Jonathan’s clinic because she wanted a smallpox vaccination. “I grew up in Des Moines, Iowa, and no one gets vaccinated back there. When I went to Philadelphia to perform in a week-long music festival, all I read were stories about a smallpox epidemic there.”

“Yes,” Jonathan agreed. “Philadelphia is my hometown, but it has a disgracefully high rate of smallpox, and has since 1901. The river is full of filth, and until the new mayor came in and cleaned house last year, even the hospital was a source of infection.”

“That’s why I came to Rockefeller,” said Marion. “Everyone told me not to get vaccinated in Philadelphia. Some people got tetanus from the vaccine.”

Jonathan found the young woman not only beautiful but alluring. “The oversight on the farms where the smallpox vaccine is produced from infected cows is criminal. We control our vaccine here and it is not contaminated. However, I should check on the vaccination daily for the next week to make sure that no complications arise.” Her only complication, Jonathan’s friends said, was that he got her into bed and then to the altar in 1905.

Jonathan and Marion strolled into the Oak Room bar, the newest watering hole of the rich and famous. The Plaza Hotel had opened October 1, so it still smelled brand new. Jonathan stopped just inside the entrance, looking for his friend Phillip Spanezzi, a surgeon at the Hospital for the Ruptured and Crippled on 42nd Street. Spanezzi and Jonathan had spent a year together at Hopkins, and remained friends. Spanezzi’s reputation was stellar in the city for treating fractures and injuries, and Jonathan knew him to be a skilled surgeon for all operations.

Spanezzi waved from his booth next to the large windows looking across 59th Street at Central Park.

“Jonathan, my friend,” Spanezzi gushed as he clapped him on the back and then turned to introduce his companions. “This is Maude Adams, whom you may have seen play Peter Pan, and this is Colonel William Gorgas, a doctor and the chief of sanitation on the Panama Canal project.”

“Hello, Maude,” Marion shook hands with her across the booth. “Lovely to see you again.”

“Maude, you know Marion the Librarian?” Spanezzi asked.

“We’ve met from time to time in the theater.” Maude looked quizzically at Marion. “Are you a librarian now?”

“Oh no, Maude. Phil just always teases me with that name. I call him Spanezzi the Deezi!”

“What’s a Deezi?”

“Just a word that I made up. It means—” She glanced sideways at the stranger in the booth. “I’ll tell you later.” She turned to Gorgas and said, “I’m very pleased to meet the head of the Panama Canal project.”

“Well, I’m not the chief engineer...” Gorgas protested, obviously pleased.

Spanezzi saved Gorgas from having to finish his sentence. “Bill, this lovely young woman is Marion Sullivan, the wife of Jonathan Sullivan, who is with the Rockefeller Institute.” There were handshakes all around.

“Doctor Gorgas, it’s an honor to meet you,” Jonathan said. “So is construction actually proceeding on the canal, now that you’ve annihilated those mosquitoes?” he asked.

“Call me Bill,” Gorgas offered genially. “We’re finally making some progress, thanks to the chief engineer, Stevens, who is the real man in charge, Mrs. Sullivan. If he hadn’t accepted the mosquito theory about yellow fever and malaria, we’d still be stuck where the French were. And believe me, that’s no place you’d want to be.”

“What brings you to New York?”

Spanezzi volunteered, “Doctor Gorgas is the guest speaker at the New York Academy of Science. Everyone’s eager to hear how he did it.”

Gorgas huffed through his mustache. “Sanitation, really. Proper housing, sanitation, clearing the standing water. Major offensive against the larvae, that’s for sure.”

“Bill,” Jonathan said, his tone more serious, “my field is infection, too. I so admire your discovery, with Walter Reed, of mosquitoes carrying this germ, and your discipline in controlling the environment to eradicate mosquitoes. But I want to find a chemical we can give people to protect them while they form antibodies against diseases. To help their host defense defeat the infection. That’s my obsession.”

Gorgas almost scoffed. “Of course, Jonathan. Who doesn’t want that? But you aren’t close to that cure yet, and neither am I, nor any other bacteriologist. So now I do what I can to help build the canal.”

“I know.” Jonathan’s voice was no longer bombastic. “I know there is a great deal of work to be done, but for me—for me the glass is half full. But you’re the right man for the job and I’m glad you’re there.” Jonathan turned to Maude Adams, the most famous actress on Broadway. “Miss Adams, your Peter Pan is a marvel. How is it that we are honored by your presence tonight?”

“Doctor Spanezzi is my doctor,” she said in a quiet voice, as Jonathan did his best to hide his surprise. “He told me that I could meet Colonel Gorgas so I came along tonight. I will be unable to attend his speech, but I too wanted to hear his descriptions of Panama. I’m quite fascinated, Bill, as to how you came to find that mosquitoes were the carriers of yellow fever.”

“It was in our research lab in Cuba,” Gorgas responded. “Carlos Finlay, a Cuban doctor, had told Walter Reed he believed mosquitoes carried the disease, but he’d never been able to prove it. Reed’s research training at Hopkins was the key to confirming it. The proof, however, came at the price of the deaths of Doctor Jesse Lazear and nurse Clara Maass, who allowed themselves to be bitten to prove the theory. No one has yet been able to develop a vaccine, so our only protection is mosquito control.”