His first patient after Abbott left was Helen Anderson.
Helen and Herb Anderson were old family friends, had been for many years. Herb owned a men’s ready-to-wear store; he was one of the community’s most successful businessmen. Helen was president of the Flower and Garden Club and, for years, her roses had been blue ribbon winners at the State Fair.
She showed him her right hand. The skin across the knuckles was rough and red. When he rubbed his thumb over it, it felt dry and scaly.
“Looks like eczema,” he said. “We’ll try some ointment on it.”
“I worked in the garden after I noticed it,” she said. “I don’t suppose that did it any good.”
“Probably no harm, either. How’s the garden doing?”
“Couldn’t be better. You should see my peas, and I am trying a new kind of tomato. You and Harriet drop over some evening and have a look at it. It’s been a long time since the four of us have gotten together.”
“That’s part of being a doctor,” Benton said. “You think you have an evening and then something happens. You never can be sure.”
“You work too hard.”
“All of us do,” he told her. “We get involved. What we do assumes a great importance. Your garden, for example.”
She said, seriously, “My garden goes me a lot of good. As you know, I’m not a fancy gardener. I’m a dirt gardener. I don’t wear gloves. I get down in there with my hands. I like the feel of soil. It’s so warm and it has such a nice texture. It has the feel of life to it. It plays hell with my hands, of course; but there’s something so elemental in it that I can’t resist. Herb, of course, thinks that I’m crazy.”
Benton chuckled. “Herb’s no gardener.”
“He pokes gentle fun at me. He’s a golfer at heart. But I don’t make fun of his golf. I don’t think it’s fair.”
“How’s his golf this year? I remember he was bragging last year that he had improved.”
Helen Anderson frowned. “He isn’t playing as much this year. Not as much as he used to.”
“Maybe he’s busy. This is a bad year for business. Inflation and tight money and—”
“No, it isn’t that,” she said. “Doc, I’m worried about Herb. He seems to be tired all the time. He has to be really tired not to play golf. Does a lot of eating between meals. He’s gaining weight. Grumpy, too. Some days he’s so grumpy I’m glad to see him go to work. I’ve told him to come and see you.”
“I wouldn’t worry about him,” said Benton. “Maybe he’s working too hard. Why don’t you try to get him to take a couple of weeks off and the two of you go on vacation? A rest would do him good.”
“It’s more than just tiredness,” she continued. “I am sure of that. He’s tired, of course, but there’s something more than that. Doc, won’t you talk with him?”
“I can’t go out soliciting business. You know that.”
“But as a friend …”
“I can tell him you’re worried about him. I can lean on him a little.”
“If you would,” she suggested.
“Sure I will,” said Benton. “But don’t you go worrying yourself sick. It’s probably nothing.”
He wrote her a prescription and she left, extracting a promise he’d drop by soon to have a look at the garden.
The next patient was Ezra Pike. Ezra was a farmer south of town, seventy years old, still working his farm with only occasional help.
He had hand trouble, too. He had a nasty gash across the knuckles.
“The baler broke down,” he explained, “and I was fixing it. The wrench slipped.”
“We’ll get that hand cleaned up,” Benton said. “In a day or two it’ll be like new. Don’t see you often, Ezra. You or Mrs. Pike. I’d starve to death if everyone was like the two of you.”
“Never did get sick much. Neither one of us. The boys, neither. We are a healthy family.”
“How are the boys these days? I haven’t seen them for ages.”
“Dave, he’s down in Pittsburgh. Working in a bank. Investments. Ernie is a teacher over in Ohio. School’s out now, and he’s running a boy’s camp up in Michigan. We’re real proud of our boys, both of them.”
“How are the crops?” Benton asked.
“Good enough,” said Pike. “Some trouble with bugs. Never used to have that kind of trouble, but it’s different now. No DDT, you know. They up and banned the stuff. Was poisoning everything, they said. Maybe so, but it made farming easier.”
Benton finished with the bandaging. “There, that’s it,” he said. “Keep watch of that hand. If it hurts a lot or gets red and puffy, come in to see me.”
Pike got spryly from the chair. “Got a good crop of pheasants waiting for you. Soon as the season opens, we’ll be looking for you.”
“I’ll be out,” said Benton. “Always have, you know. It’s been a long time, Ezra, I’ve been hunting on your land.”
“You’re welcome any time,” Pike said. “But there ain’t no need to tell you. I take it that you know.”
Nurse Amy appeared as soon as Pike had left. “Mrs. Lewis is here,” she said. “She has Danny with her. Someone bounced a rock off him. She is frothing mad.”
Danny, who by all odds could be classified as the meanest kid in town, had a goose egg on his head. The rock had broken the skin and there was some blood, but an X-ray showed no fracture.
“Just wait,” his mother raged, “until I get my hands on the kid who threw that rock. Here Danny was doing nothing, just walking down the street …”
She went on and on, but Benton got her quieted down and the two of them finally left.
After that came Mary Hansen, with her arthritis; Ben Lindsay, in for a post-coronary check; Betty Davidson, with a sore throat; Joe Adams, with a lame back; Jenny Duncan, who was going to have twins and was twittery about it.
The last patient of the day was Burt Curtis, an insurance man.
“Goddamn it, Doc,” he said, “I feel all beat out. Sure, a man expects to be tired after a long day’s work, but I get tired in the middle of the morning. By ten o’clock, I am all pooped out.”
“It’s sitting at that desk,” said Benton, kidding him, “lifting all those heavy pencils.”
“I know, I know. You don’t have to rub it in. I’ve never done an honest day’s work in all my life. Selling insurance isn’t something you can classify as labor. The funny thing is that I feel as if I were building roads. Muscles get sore and achy.”
“Hungry, too?” Benton asked.
“Funny you should say that. I’m hungry all the time. Keep stuffing my gut. A lot of snacking. Never used to do that. Three squares were all I needed.”
“Even-tempered, I suppose.”
“What the hell, Doc! I come in to tell you I get tired and you ask about my temper.”
“Well, are you? Even-tempered, I mean.”
“Hell, no. I’m all out of sorts. No patience. Let one little thing go wrong and I start storming. No way for a businessman to act. Keep on like that, and you get a reputation. Adele says I get harder to live with every day.”
“How about your weight?”
“Seems to me I’m getting heavier.” Curtis patted his gut. “Had to let out my belt one notch.”
“We’ll get you on the scales and see,” said Benton. “I’ll tell you what I’d like to do: run some tests. Nothing fancy or expensive. We could do them here.”
“You got something in mind, Doc? Something wrong with me. Something really wrong.”
Benton shook his head. “Nothing at all. But I can’t even make a guess until I see some tests. Blood sugar. Things like that.”
“If you say so, Doc,” said Curtis.
“Don’t worry about it, Burt. But when a man comes in and says he’s all tired out and gaining weight and getting downright mean, I have to
look into it. That’s my job. That’s how I make my living and keep my patients well.”
“Nothing serious, then?”
“Probably nothing much. Just some little thing that once we know about it, we can get it straightened out. Now, about those tests. When can you come in?”
“Tuesday be all right? Monday I’ll be busy.”
“Tuesday is just fine,” Benton said. “Now get over on those scales.”
When Burt had gone, Benton walked out into the empty waiting room. “I guess that’s it for the day,” he said to Amy. “Why don’t you go home?”
Back in his office, he sat down at his desk and began filling in Burt Curtis’ record. Tiredness, intermittent and persistent hunger, gaining weight, sore muscles, irritability—all the symptoms Abbott had talked about that very afternoon. And then there was Herb Anderson as well. From what Helen had said, his condition seemed much the same as Burt’s. Both of them and Ted Brown, too.
What the hell, he wondered, could be going on? Abbott had said “epidemic.” But did three people in one little town add up to an epidemic? He knew, however, that once he had gone through his records, he would probably find others.
The office was quiet. Amy had left and he was quite alone.
From some distance off came the wild and frantic snarling of a racing motorcycle. Young Taylor, more than likely, he thought. Someday the damn fool kid would break his neck. Twice he’s needed patching up, and if he kept on there’d likely come a day when patching up would be superfluous—although, Benton told himself, that was no concern of his, or should be no concern of his. But the terrible thing about it was that he found himself concerned.
He was, he realized, concerned with everyone, too concerned with everyone in this silly little town. By what mysterious process, he wondered, did a man through the years manage to take an entire town to heart, shift its burdens to his back? Did the same thing happen to other aging doctors in other little towns?
He pushed Burt’s record to one side and laid the pen beside it.
He gazed about the room, shifting his glance from one object to another as if he were seeing them for the first time and trying to fix them in his memory. They had been there all the time, but for the first time he was noticing them, becoming acquainted with this environment in which he had lived and functioned through the years. Too busy, he thought, too busy and concerned to have ever looked at them before. The framed diploma, hung proudly on the wall so many years ago and now becoming fly-specked; the fading and worn carpeting (some day, by God, when he found the money, he’d have new carpeting put in!); the battered scales shoved against the wall; the sink and basin; the cabinet where he kept all the samples sent out by pharmaceutical houses to be given patients (and there were many of them) who could not afford prescription drugs. Not the kind of office, he thought, that a big-city doctor would have, but the kind he had—a combination of office, examination room, treatment room—the hallmark of the family doctor always strapped for funds, hesitant to send out bills that would embarrass patients he knew were short of cash, trying to treat people who should go to specialists but who could not afford their fees.
He was getting old, he told himself—not too old yet, but getting there. There were lines upon his face and gray showing in his hair. There would come a time, perhaps, when he would have to take in a younger doctor who, hopefully, could carry on the practice when he would have to retire. But he shrank from doing so. He was jealous, he knew, of his position as the town’s one doctor, even though he knew it was most unlikely the town would accept anyone that he brought in. Not for a long, long time would they accept anyone but him. Patients would refuse to see the new man, waiting for Old Doc. It would take years before he could shift any appreciable percentage of his patient load.
Over in Spring Valley, Dr. Herman Smith had a son who was in internship and who soon would join his father. Slowly, over the years, young Doc Smith would phase out old Doc Smith, father followed by the son, and there would be no hassle. Oh, some hassle, surely, but none that would be noticed. That, Benton told himself, was the ideal method of succession. But he and Harriet had never had a son—only the one daughter. He had hoped, for a time, he recalled, that April might want to be a doctor. But that would have posed problems, too, for it would be unlikely the town would accept a woman doctor. The problem, however, had never arisen, for April, it turned out, had been big on music and there was no stopping her. Not that he had ever wanted to. If music was what she wanted, then it would be music. She was in Vienna now. Christ, these kids! he thought. The world belongs to them. Off to London, Paris, Vienna, and God knows where else, with no thought that it was extraordinary. In his youth, he recalled, it had been a big adventure to get a hundred miles from home. And, come to think of it, even now he seldom got more than a hundred miles from town. He stuck close to his work.
I’m provincial, he thought, and what was wrong with that? A man could not encompass the world. If he tried, he would lose too much. Friends and familiarity of place, the warm sense of belonging … Since he had come to this town, many things had happened to him—good things—with quaint little privileges established. Like old Ezra Pike and his annual crop of pheasants reserved for good old Doc and a few others in the town, and for no one else.
He sat in the office and tried to peel the years away, back to the time when he had first come here; but the years refused to peel and the diploma still was fly-specked and the scales still battered and he remained an aging man who carried the town upon his back.
The phone rang and he picked it up. It was Harriet.
“When are you coming home?” she asked. “I have a leg of lamb and it will be ruined if you don’t get here fairly soon.”
“Right away,” he said.
2
The next day was Saturday and office hours were from eight till noon. But, as was usually the case, the last patient was not gone until after one.
Once the waiting room was cleared and Amy had gone home, Benton got to work on the files. He went through them carefully, making notes as he went along. He didn’t finish the work on Saturday, and came back Sunday morning.
Going back through ten years of records, he was able to isolate some trends. There had been, in those years, a substantial increase in the symptoms Abbott had outlined. The incidence of obesity had risen rapidly. In more instances that he had recalled, the high level of blood sugar had indicated diabetes, but further tests had inevitably failed to bear out his tentative diagnoses. There had been, increasingly, a spate of muscular soreness. There were an increasing number of patients who had complained of general malaise, with no apparent cause.
Most of the symptoms were found in townspeople. Among the farm families, only the members of one family, the Barrs, had experienced the symptoms. The Barrs, about three years before, had come from somewhere in Ohio, buying the farm of Abner Young, a recluse who finally had died of old age and general meanness. And not a single case with those symptoms showed up among the hill people.
Maybe, after all, Benton told himself, geography might be a factor in Abbott’s epidemic—if there were an epidemic. But if some of the townspeople had the symptoms, why not all of them? If farmers were immune, as seemed to be the case, what about the Barrs? What was different about the Barrs? Recently arrived, of course, but what could that have to do with it? And what was so magic about the hills that in all the hill folk no symptom had turned up? Although, he reminded himself, he should not assign too much weight to the negative data from the hills. The people there, a hardy tribe, would not deign to visit a doctor for such minor reasons as being unaccountably tired or putting on some weight.
He pulled the sheets of notes together and, searching in his desk drawers, found some graph paper. The graphs, when he had them drawn, showed nothing more than he already knew; but they had a pretty look to them and he found himself imagining how they would look printed on the slick paper of
a prestigious journal, illustrating a paper that might be entitled “The Epidemiology of Muscular Exhaustion” or “The Geographical Distribution of Obesity.”
He went over the notes again, asking himself if he might not be looking at what amounted to medical constants—conditions persisting through the years, with only minor fluctuations from year to year. This did not seem to be the case. Ten years ago, there had been few of the symptoms—or at least few of his patients had shown up complaining of them. But, beginning seven or eight years ago, they had started to show up; and on the graph the curves showing their distribution over time rose sharply. There was no doubt the symptoms were a recent phenomenon. If this were so, there must be a cause, or perhaps several causes. He searched for a cause, but the few he could think of were too silly to consider.
Benton looked at his watch and saw it was after two o’clock. He had wasted most of the day and Harriet would be furious at his not showing up for lunch. Angrily, he shuffled the notes and graphs together and thrust them in a desk drawer.
He had wasted most of the weekend at it, and now he would wash his hands of the whole thing. Here was something that more properly belonged in a research center than in the office of a country doctor. His job was to keep his people well, not to tackle the problems of the world. After all, this was Abbott’s baby and not his.
He wondered at the anger that he felt. It was not the wasted weekend, he was certain, for he had wasted many weekends. Rather, perhaps, it was anger at himself, at his own inadequacy at being able to recognize a problem, but be unable to do anything about it. It was no concern of his, he had insisted to himself. But now he had to admit, rather bitterly, that it was deeply important to him. Anything that affected the health and wellbeing of the town was his concern by automatic definition. He sat at the desk, his hands placed out before him, palms down on the wood. His concern, he thought. Most certainly. But nothing that for a time he should wrestle with. He had a job and that job came first. In the chinks of time left over, he could do some thinking on the problem. Perhaps by just letting it lie inside his mind an answer might be hatched, or at least the beginning of an answer. The thing to do, he decided, was forget it and give his subconscious a chance to work on it.