“What do you know about the Barr family?”
“You mean the ones that bought Abner Young’s place?”
“Those are the ones,” said Benton.
“Not really much,” Pike answered. “They come from Ohio, I think. Were farmers there. Don’t know why they moved here. I know Barr pretty well and have talked with him, but he never told me and I never asked. Maybe because they got Abner’s place dirt cheap. When Abner died, the farm went to some shirttail relatives out in California—nephews, I gather. They didn’t want to be bothered with it. They never came for the funeral or to settle the estate. They told Abner’s lawyer to sell it for what he could get as soon as he could, and he offered it cheap.”
“So that was the way of it. I never really got to know Abner. He was in a couple of times. A crusty old customer. Once he had a foot infection. Stepped on a nail, the way I remember it. The other time he was on the verge of pneumonia. I tried to get him to let me send him to a hospital, but he wouldn’t do it. Wound up that I gave him some drugs and he went home and managed to live through it. Didn’t see him after that, didn’t really hear much about him until I heard he died. Found dead by one of the neighbors, wasn’t he? Probably he got sick and figured he wanted no more to do with me. Afraid I might send him to a hospital. Likely neither myself nor a hospital could have helped him much. He was one of those characters who fought a doctor tooth and nail.”
Pike chuckled, remembering his neighbor. “I know people said he was a mean man, and in some ways I suppose he was. Ran people off his place with a shotgun. The pheasants were knee-deep in his fields and he would allow no hunting. Wouldn’t even shoot them himself. Never had much to do with his neighbors. Kept to himself. He’d gone sour on humanity. But he loved other things. He let his fence rows grow up to brush so that rabbits and woodchucks and birds would have a place to live. He always fed the birds in winter, and if English sparrows or blue jays came to feed he never tried to drive them off, or was put out about it the way a lot of people are. Said they got hungry, too.”
“You sound as if you knew him fairly well, Ezra.”
“Oh,” said Pike, “we had our differences. He was a hard man to get along with. Unreasonable and had a bad temper. Had some funny ideas, too. He was an organic farmer. Never put a pound of commercial fertilizer on his land, refused to use pesticides. Said they were poison. Long before that lady wrote her book about a ‘silent spring,’ he said that they were poison.”
Benton sat straight up. “You mean he never used any pesticides? No DDT at all?”
“That’s what I mean,” said Pike. “And the funny thing about it was that he grew as good a crop as any of the rest of us—that is, as long as he grew any crops. As he grew older, he farmed less and less. A good part of his land was idle. But what little he farmed, he farmed well. Abner was a first-class farmer.”
Pike stayed a while longer and they talked of other things, but Benton scarcely heard him. His mind was buzzing with what Pike had said about Abner Young never using pesticides.
DDT! Benton thought. For the love of Christ, could it be DDT?
Here was the Barr family, farmers out of Ohio, where they probably had used DDT, then moving to a farm where not a grain of the chemical ever had been used. And among all the farmers in the valley, they were the only ones who had suffered from the exhaustion syndrome. Could it be that they had gotten used to DDT or something else in the pesticides, and now were sick because of the lack of it?
The other farmers were okay, he figured, because there still were traces of DDT in their soil, and by working in the soil they were picking up enough of it not to yet experience any ill effects from the lack of it.
And the folks out in the hills? That was simple enough, he told himself. They had never been exposed to it, had never developed whatever need for it the others had acquired. They had never been exposed to it because they were so bone poor they could not afford to buy it. Raising their own food, consuming what they grew, never eating commercially canned foods or buying foods that might have been grown on DDT-drenched land, they had never been exposed.
The next day was Saturday, and in the afternoon, after office hours were over, Benton went through his files once again and found what he had expected to find: that, with only two exceptions, townspeople who had gardens and who actually worked in them had never mentioned any of the symptoms of the exhaustion syndrome.
He phoned Helen Anderson. When she came on the line, he said, “This is your friendly family physician and I’m going to ask you a silly question. Please don’t laugh at me, for maybe it’s important.”
“Ask away. You know I wouldn’t laugh at you.”
“All right, then. When DDT was still available, before it was banned, did you use it in your garden?”
“Sure I did,” she said. “I think most gardeners did. I used it for years and years, and I tell you I miss it. This new stuff, the bugs positively like it. They lap it up and settle down to wait for more. It doesn’t even faze them. Herb used to fuss at me for using DDT. He said he didn’t want his vegetables salted with chemicals.”
“And Herb? Herb never works in the garden, does he?”
“Doc, you know damn well he doesn’t. He makes fun of me and my gardening. You have heard him do it.”
“But he eats stuff from the garden?” Benton asked.
“Are you kidding? Of course he does.”
“Fine,” he said. “Thank you for not laughing.”
“Doc, what is going on? Has this got something to do with Herb—with the way he feels?”
“Maybe. I don’t know yet. Maybe I’ll never know. I’m just scrabbling around.”
“All right,” she said. “I won’t ask. When you know, you’ll tell me?”
“You can count on that.”
He made several other phone calls to people who had gardens and to those who didn’t. The two exceptions said they had never used DDT because they didn’t want to mess around with it. It was too much work, they said. No, they said, their gardens didn’t do as well without it and through the summer they had always bought some garden stuff from others and, like most people, had always used a fair amount of canned goods.
All of them wanted to know why the doctor asked, and some of them laughed at him; but that was all right, he thought, it didn’t mean a thing. Everyone knew that old Doc had some strange ideas, like the time when he had raised so much hell about the water from the old municipal well that a new one had to be drilled, or the time of his strict insistence, as the town’s health officer, that all garbage cans must be covered. Old Doc, everyone agreed, was a fuddy-duddy; but they loved the man and went along with his craziness.
He hung up the phone after his last call and stared at the pad on which he had made notes as he made the calls.
This could be it, he thought; enzymes and DDT. Was it possible that a coenzyme, by forming a bond with a molecule of DDT, had become a super-catalyst? And now that DDT was no longer available, the super-catalytic action was no longer possible. That, he told himself, could account for the symptoms of the exhaustion syndrome.
Take coenzyme A, the one so intimately tied up with two biochemical cycles—the fatty-acid cycle, for example, which operates to oxidize lipids. Deprived of the super-catalyst on which the people had come to depend, fewer lipids would be oxidized and more would be stored as fat. Thus, an increasing incidence of obesity. With fewer lipids being broken down, the body would have to depend almost totally on carbohydrates for energy. Thus, the need for between-meal snacks.
Carbohydrates are transformed into useful body energy by means of the citric-acid cycle and the glycolysis process. The citric-acid cycle also involved coenzyme A, while the glycolysis process did not. if the two processes should become irregular, a seesawing effect, where one effect took over when the other faltered, and vice versa, could have far-reaching consequences. The blood sugar
level would become erratic, a great deal produced at one time, very little at another. Lactic acid production would rise when the citric-acid cycle slowed down, since one of the functions of the cycle was to break down lactic acid. One result of a rise in lactic acid would be sore and aching muscles. And, in addition to the variation in blood sugar levels, the production of insulin also would be erratic. As a result of both conditions, there would be times when the brain would starve for lack of glucose in the blood. The symptoms would vary from fainting spells, convulsions, and shock to grogginess, irritability, and bleary vision.
It fit! he realized. It all fit, perhaps too perfectly.
He felt a moment of panic and distrust. He was going at it wrong, he knew. He was working with deduction. There should be extensive laboratory testing. But he was not qualified for laboratory work of the caliber required. He was going on a hunch alone, with no real evidence. His conclusions were unscientific and medically unacceptable. But the pattern was there, all logically laid out.
It was logical, he told himself, not only physiologically, but in other ways as well. It made sense evolutionally. Under the pressure of modern living, man was burning up more energy than he ever had before. Perhaps it was possible he had outrun the biochemical functioning of his body. Under such a circumstance, the body, as an evolutionary life system, would use anything available to permit it to function more efficiently. If DDT were something that would help it to do a better job, if DDT made the enzymes or even one enzyme into a super-catalyst that would do a better job, the body unhesitantly would latch onto DDT.
But now that the DDT was gone, the human body had gone back to where it was before. Among those people to whom DDT had not been available, the hill people for example, the old non-DDT system was still functioning, perhaps not as efficiently as if DDT had been available, but at least not disturbed by having become a new system which had operated successfully for a time but now was lost. Those whose bodies had become accustomed to the DDT system now were suffering a reaction—the old non-DDT system was sluggish in recovering, if it ever could recover, its old efficiency.
Someone other than himself, he knew, should look into the situation. But to look into it would take staff and money. Perhaps it was time that he got in touch with Abbott, not waiting for Abbott to get back to him. Then he realized he did not know how to get in touch with Abbott. The writer had left no address or phone number, probably because he had expected to be traveling and for a time would have no permanent base of operation.
The best approach, Benton decided, was to phone Abbott’s publisher. Someone at the publishing house undoubtedly would know how to go about reaching him. But it was Saturday and publishing houses, he suspected, would be closed. He would do it the first thing Monday morning, recognizing even as he thought, that his urgency was motivated by his wish to shift the problem of the exhaustion syndrome off his back. He had done the thinking and had gone as far as he could go; now it was time for someone other than himself to take over.
Maybe research would prove that his deductions were wrong. Right or wrong, however, some effort, he was convinced, should be made to find the truth.
He phoned first thing Monday morning.
He identified himself and said, “I was hoping someone on your staff could tell me how to get in touch with Robert Abbott. He came to see me several months ago and it’s rather important that I speak with him.”
The woman who had answered hesitated for a moment; when she spoke, she sounded slightly flustered. “Just a moment, sir,” she said.
A man came on the line. “You were asking about Abbott.”
“Yes. It’s important that I reach him.”
“Doctor,” the man asked, “don’t you ever see a paper?”
“I’m ordinarily too busy,” said Benton. “I simply glance at headlines. At times not even that.”
“Then you don’t know that Abbott’s dead.”
“Dead!”
“Yes, a couple of weeks ago. A highway crash somewhere in Colorado.”
Benton said nothing.
“It was a shock to all of us,” said the man in New York. “You say you knew him.”
“I didn’t really know him. He visited me a few months ago. We talked an hour or so. I assume you know what he was working on.”
“No, we don’t. We’ve often wondered. We knew he was onto something, but he was closemouthed about it. You may know a great deal more than we do.”
“Not a great deal,” Benton said. “Thank you very much. I hope I did not disturb you.”
“Not at all. Thanks for calling. I’m sorry I had such bad news for you.”
Benton hung up and stared blankly at the office wall, not seeing the fly-specked diploma that had hung there so long. What do I do now? he asked himself. Just what in hell do I do now?
6
The first hard frost had come the night before and there was a sharp chill in the air the day Lem Jackson came into the office. Jackson was one of the hill people, a tall, gangling man who appeared to be forty years or so of age. Benton knew who he was, but could not recall that he had ever been a patient.
Jackson sat down in a chair opposite the desk and dropped his shapeless, battered hat upon the carpeting.
“Maybe, Doc,” he said, “I’ve done wrong in coming and taking up your time. But I feel all dragged out. I ain’t worth a hoot. I am not myself. Seems like I’m tired all the time, and my muscles are sore. Most days I’m so ornery and feel so mean that I’m ashamed of myself, the way I treat the wife and kids.”
“How about your appetite?” Benton asked. “You been eating well?”
“All the time. Can’t seem to get filled up. I’m hungry all the time.”
There it went, Benton thought—all the carefully worked out deductions, the elaborately constructed theory of the exhaustion syndrome. For Jackson was a hill man, and under Benton’s theory the people of the hills had to be immune.
“What the trouble, Doc?” Jackson asked. “Did I say something I shouldn’t?”
Benton shook himself mentally. “Not at all. I was just wondering. What have you been doing, Lem?”
“To tell the truth,” said Jackson, “not much of anything. A little farming, that’s all. An odd job now and then. I feel so beat out I’m not up to a day of honest work. I guess I’d have to say I don’t do much of nothing.”
Then he went on, “Some while ago I had a good job down in West Virginia, but I lost the job. If I could’ve stayed on, I’d be sitting pretty now. Short hours, work not too hard, and the pay was good. But they up and fired me. The foreman had it in for me. I tell you, Doc, there simply ain’t no justice. I was as good on the job as any of the other men.”
“What kind of work?” Benton asked, not really caring what kind of job it was, but just making conversation.
“Well, I suppose that even if I hadn’t been fired the job wouldn’t have lasted. They closed down after I left. It was a small chemical plant. They were making DDT, and I hear they banned the stuff.”
Benton felt himself go limp as relief flowed through him. His theory still stood up, he thought triumphantly. Lem Jackson was the exception to the rule his theory had set up that helped to cinch that theory. But even as he felt elated at this evidence that his deductions had been right, he told himself that his reaction was wrong. He should have been glad, it seemed to him, when he first had thought Jackson’s symptoms shot his theory down—for, come to think of it, this business of DDT and the human body was a ghastly thing. But, in a perverse way, he had become fond of his theory. After all the work and thought he had put into it, no one, not even the most humane person in the world, would have wanted to be proved wrong.
“Lem,” he said, “I’m sorry, but there’s not a thing I can do for you. Not yet. There are others like you. Perhaps there are a lot of others like you. It’s a condition that has just come to be noticed
and there is work being done on it. In time, there may be a cure. I am sorry I have to be this honest with you, but I think you’re the kind of man who would want that kind of honesty.”
“You mean,” Jackson said, “that I’m going to die?”
“No, I don’t mean that. I mean I can’t make you feel any better. You probably won’t get any worse. There’ll be a time, I’m sure, when there’ll be drugs or medicine.”
And all that would be needed, he told himself rather bitterly, was a pill or a capsule with a requisite dosage of DDT incorporated with carrier ingredients.
Jackson picked up his battered hat and got slowly to his feet. “Doc, all the people in the hills say you’re a square shooter. ‘He don’t feed you no crap,’ they told me. ‘He is a doctor it’s safe to go to.’ You say probably I won’t get any worse.”
“Probably not,” said Benton.
“And maybe someday there’ll be a medicine that’ll do some good.”
“I am hopeful.”
Watching Jackson leave, he wondered why he had told him what he had. Why the brutal honesty? Why the giving of some hope? “There is work being done on it,” he had said; but that had been a lie. Or had it? There was one person working on it and that one person, he grimly told himself, had better buckle down to business.
That evening he drafted a careful letter, setting forth in precise detail what he suspected. Then, as he found the time, working in the evening after office hours were over, he typed the letters and mailed them out. Then he sat back and waited.
The first reply came, in two weeks’ time, from JAMA. His letter, it said, could not be considered for publication since it lacked research evidence. JAMA was kind enough, but final. It did not even suggest he institute further research. But that was only fair, he admitted to himself, since there had been no research to start with.
The second reply, from the National Institutes of Health, was barely civil in its officialese.
The third, from the Association for Biochemical Research, was curt.
On a Saturday afternoon, when the last patient had left, he sat at his desk with the three letters spread out before him. It had been unrealistic, he admitted, to think that any one of the three would have paid attention to his letter. After all, who was he? An unknown family physician in a town that was equally unknown, advancing a theory unsupported by any kind of research, relying only on observation and deduction. The reactions to what he had written could have been expected. Yet there was no question in his mind that he should have written the letters. If no more than a gesture, it was something that had needed to be done.