When he was sure this patient knew he had heard her suffering, he said, “Now, Sally—it is Sally, isn’t it? I saw you once before about—” He felt her body tighten under his fingers and stopped himself from saying “a case of gonorrhea” just in time. “About a year ago,” he finished. The woman gave him a grateful look. Josh knelt beside her pallet, still holding her hand. He felt her pulse beating against the thin skin of his hand. “Sally, listen carefully. You are very sick with malaria. That was the good news. The bad news is you’re going to be very sick for the rest of your life.”
Her hand clenched. He wanted to pull his away but forced himself not to. “The illness will come and go. You will have bad spells, like you did a couple of days ago: high fever, delirium, possibly bleeding, possibly jaundice. You’ll know you have jaundice if your urine gets very dark.” He wanted to sound different, to sound comforting, but that seemed like too much of a lie and he couldn’t force himself to do it. “After each of these spells, you will feel better, maybe even better than you do right now, for three weeks or five or maybe even eight. Then will come another bad spell. All you can do is ride it out. Keep yourself as cool as you can, eat plenty of good food between bouts, and make sure to drink as much good clean water as you can manage.”
“I’m never going to get better?” Sally said. “Isn’t there a chance?” She tried to smile. “You can lie, just to keep my spirits up.”
“No, I can’t. I’m sorry,” Josh said. “But you won’t get all the way better, no. Even between bad spells you may still feel tired and irritable. Try to rest.”
“Oh, sure,” she said with the tired smile of a player whose bluff has been called. Of course there would be no rest for her. She would have to work, harder than he ever would, providing for children that weren’t even her own, the orphans of some brother or sister she had lost to sickness or to the storm. Josh thought of Gina Tucker, grim-faced, bullying him to save her boy.
“Malaria is a parasite,” Josh said. “It resides in your liver. Periodically it breaks out into your red blood cells. It’s carried by mosquitoes. Sally, even when you are feeling better, you can still spread the disease if a mosquito bites you first and then bites anybody else. It’s important for you to try to rest and eat well, but it’s even more important for everyone else on the Island that you sleep under good, tight mosquito netting every single night. Every single night. Do you understand?”
Her mouth worked. “Dr. Cane, we’ve got nothing—”
“Not true: you have malaria. It isn’t fair.” He shrugged. “But rotten as they are, those are the cards you got dealt, and now you have to make your best hand. Even if you can’t win, you can help the odds of those around you. If you want to keep your niece and nephew from catching the disease, you will have to watch for mosquitoes for the rest of your life. Do you understand?”
Josh approved of the way she worked not to cry. “I’ll try,” she said.
WHEN Josh had finished making his rounds he withdrew with Sloane and Ham to the foyer at the top of the staircase. “Worse than I had hoped, better than I feared,” he said. “I’m not positive about the fellow in the bathroom, but I’m guessing salmonella. He’s got a fifty-fifty chance of making it. I think you have three cases of malaria, and three more enteric complaints, one complicated by dysentery. The malaria patients must be put under mosquito netting as much as possible; you should treat any mosquito as more dangerous than a rattlesnake. Sooner or later a case of yellow fever will crop up. It can be innocuous, or it can be even worse than malaria. It is also mosquito-driven. Keep everyone cool when you can, and make sure they have plenty of clean water to drink. Boil it first. If you run out of fresh water, Ham can show you how to make a salt-water still. Serve dandelion tea; it’s rich in iron and potassium, both crucial for patients with anemia or diarrhea. Last, the teenager with the scarred face has tetanus. I found a bad puncture wound in his shoulder, probably from a rusty nail embedded in a piece of debris. He’ll die within the next three days.”
Sloane paled. “Oh. My God.”
“Good golly, Josh,” Ham said irritably. “Try not to get all choked up about it.”
Josh flexed his white fingers. “If I felt everything, I’d never move again. I’ve got damiana and jimsonweed to treat these people. What do you want from me, Ham? Hope?”
“People need hope to get well.”
“You two supply it,” Josh said. “I’m afraid I only have medicine to offer. Are there any other patients?”
“In the master bedroom,” Sloane said. She hesitated. “I should warn you, these aren’t exactly people.”
“I beg your pardon?”
“They’re revellers.”
“Ah. On our way over here, one of Sheriff Denton’s men stopped us in the street. He made me swear an oath I wouldn’t treat any ‘monsters.’”
Sloane closed her small eyes. She was tired, too, Josh thought. Not as tired as he was—she hadn’t mutilated any ten-year-old boys today—but tired nonetheless. “You won’t see them?” she said.
“Don’t be ridiculous,” Josh said. “Lead on.”
Sloane laughed. “Whatever happened to a gentleman’s word being his bond?”
“I’m not a gentleman,” Josh said. “As the sheriff went to some pains to point out at my trial.”
AFTER Josh had seen the revellers—another case of malaria; two with the DTs; one with septicemia, a goner for sure; three more he couldn’t diagnose—he gave instructions to Sloane on how the patients should be handled, stressing once more the need for clean, boiled drinking water, then went down to the kitchen to grab a bite to eat and instruct the cook. For those suffering from diarrhea he told Mrs. Sherbourne to alternate chicken broth and dandelion tea sweetened with sugarcane: a basic formula for electrolyte replenishment, disguised as food they could understand. Then he sat at the dining room table and let the cook bring him some food, a fillet of sea trout pan-fried in garlic butter, with red beans and rice on the side. Ham inspected the generator shed outside, prospecting for materials to build a still, and then rejoined him for lunch.
Ham cut out a portion of his trout. “Damn this is good. Wonder why old George would think to eat us when he could fix this instead? Principle of the thing, I guess. Survival of the fittest.” He chewed, savoring. Josh still felt dry and used up inside and could not interest himself in food. “Josh, I got a hell of a lot of mosquito bites back on the Peninsula. So did you. What are the chances…?”
“Depends on if any of them were carrying.”
The cook handed Ham a glass of milk and he drank it gratefully. Josh noticed her making a little note on a ledger on the kitchen counter. Shopping list? “When will we know?” Ham said. He started to scratch his bumpy neck, then stopped himself. “About the malaria and all?”
“Soon. If another couple of days go by without serious signs, we’re probably okay. For now. But don’t get bitten anymore. Wear layers on layers, no matter how hot it is. Rub garlic on your skin if you think that helps. There’s going to be a real epidemic.”
“Damn.” Ham said the word with two syllables, da-yum. He shook his head and tucked into his lunch. “Nice digs,” he said. “The table’s so polished up I can see my own reflection.”
“A hardworking maid will do that for you.”
Ham ate and ate. At last he pushed back his plate, belched, and said, “So here you are, Josh. Back in high society again. Bossing around Randall Denton’s servants. Giving orders to the Grand Duchess’s daughter. Is it everything you thought it would be?”
Josh tinkered with his fish, dissecting the white flesh methodically away from its spine, remembering how he had cut through the meat of Joe Tucker’s leg, exposing the bone. “It all seems smaller,” he said at last.
AN urgent knock on the front door sounded just as Mrs. Sherbourne was clearing their plates away. Ham pushed himself up from the table and padded out into the front foyer. Josh came more slowly behind. Lindsey the housemaid was already at the door. “Another
patient,” she said, seeing him.
The patient was a gaunt man with white hair. He wore a patch over his left eye and his left ear had been cut off. His face was lobster red and filmed with sweat. His eye was red, too. “Get him up—Oh, my God,” Josh said. He pulled himself together. “Get him upstairs.” He looked around for the maid. “Wet some sheets, please. We need to bring down his fever.” Sloane Gardner appeared on the landing, with her little girl Scarlet beside her. Josh looked up at her. “I’m going to need a separate room for this patient. It doesn’t have to be big, but a bed with mosquito netting would be ideal.”
“There’s the children’s bedroom,” she said. “I’ll lead the way.”
“Excellent.” Josh found Ham staring narrowly at him. “It’s my father,” he said.
Ham picked up Samuel Cane, carried him gently upstairs, and laid him in the bed Randall Denton had slept in as a boy, a small four-poster with a canopy of mosquito netting. Josh and Sloane filed into the room behind him. “I saw him this morning,” Sloane murmured. “He looked sick then, but not like this.”
“I saw him, too,” Scarlet said, worming in between the bigger bodies to get a spot at the bedside. “Grandpa took his eye before I ever met you. Flicked it out like a marble.”
Josh laid the back of his hand on his father’s forehead. Sam Cane’s skin was fiercely hot and damp and red, as if he were being steamed alive. Josh could feel the exact temperature with his white fingers, the way sailors who got the magic were said to be able to predict the next day’s weather by sticking one finger in the ocean. His father was running 103.2 degrees. A terrible temperature for a man in his fifties. “Let’s get those wet sheets,” Josh said. “Turn on the ceiling fan, would you, Ms. Gardner?”
The sick man twitched and stared glassily at him. “Josh?” he whispered.
Josh leaned forward. “I can smell vomit on his breath.”
“He couldn’t eat this morning,” Sloane said.
“Josh? Is that you? I’m hearing your voice,” his father said. “I keep hearing voices.”
“Patient shows some signs of delirium.” Josh reached for his father’s wrist. Sam Cane’s forearm was very different than he remembered it. Those arms had always been so smooth, so tanned; he could still see the precise play of the muscles under his father’s skin as he took a deck and cut it with one hand, split it and poured it into a waterfall shuffle that sounded as smooth and regular as a fan turning in the next room.
Now where his father’s skin wasn’t red it was terribly pale, sallow and white, like something growing under the floorboards. Age spots had crept over it like fungus, and the skin was baggy and wrinkled, the bones too obvious, not enough meat surrounding them.
Ham shifted in the doorway. “Answer him, Josh.”
“Quiet, please.” Josh flipped open his borrowed pocket watch and found his father’s pulse easily, a sluggish throb under that hot pale skin. He counted only ten pulses in the first fifteen seconds, which seemed impossible. Scarlet bounced on the end of the bed until Sloane grabbed her and pulled her away. Josh frowned at the pocket watch and started over. His father’s heartbeats fell far behind the sweep of the second hand. Thirty-eight beats in a minute.
High fever and slow pulse—Faget’s sign. The phrase drifted into Joshua’s mind from some medical book he had read long ago.
“Fetch your mother for me. Josh.” Sam Cane said. His mutilated head rolled weakly on the pillow. “Mandy? My head hurts so bad.”
“Neck pain?”
“Josh?” Sam Cane’s red eye rolled toward him again, holding on to his face unsteadily, like a drunk grabbing the edge of a bar.
Lindsey the maid appeared with a damp sheet, gave it to Josh, and quickly left the room, holding her facecloth tightly across her mouth and nose. Josh laid the damp sheet over his father. “Stick out your tongue,” he said clearly. There was blood in Sam Cane’s mouth: bleeding gums. His tongue was bright red around the edges, white and fuzzy in the middle.
“This man has yellow fever,” Josh said.
“No.” Sloane shook her head. “He’s too lucky for that.”
“Wasn’t so lucky with Grandpa.” Scarlet said. “I even felt sorry for him.” she added.
“Josh?” Ace said. “Is that you?”
“He’ll need clean water.” Josh said. “If the fever comes down, we’ll try to get some of Mrs. Sherbourne’s dandelion tea into him. I’ll need a clove of garlic, too, to rub on his skin. Anything to keep the mosquitoes off him. I may need to go back to my house to get a catheter tube.”
Ham grabbed Josh by the shoulder. “For God’s sake, answer him!”
“He’s delirious,” Josh said.
“He’s your father!”
Josh removed Ham’s hand. “Keep your bawling and hugging to yourself, Ham. You got your whole brood back, sows and piglets safe from the trailer park. Be happy.”
Ham grabbed Josh’s collar and slammed him against the wall so hard the ceiling fan rattled. Stars fizzed and popped in front of Josh’s eyes like Mardi Gras sparklers, and the pain in his sunburned back made him gasp. “That’s it,” Josh hissed. He realized he was furious. “Outsmart me.”
“You little fuck,” Ham said. His sunburned face was peeling everywhere, curls of skin flaking off the tops of his ears and the tip of his nose. Even after a week of privation he barely noticed Joshua’s weight as he held him pinned against the wall a foot off the ground.
Sloane Gardner put one hand on Ham’s big bicep. “I’m running out of bedrolls for the wounded.”
Ham took a big, shaking breath. Then he let Josh drop, turned his back, and walked heavily out of the room.
Josh sat on the floor with his back against the wall, trying to catch his breath. Sloane Gardner turned to follow Ham. Lindsey the housemaid had already left, leaving Josh looking into the eyes of Scarlet, the little reveller girl. “Well,” she said contemptuously. “I guess you showed him.”
TWO hours later Josh was still in Randall Denton’s boyhood room. The ceiling fan was turned to its fastest setting, humming and whirring overhead. The room was full of collections: seashells and pocketknives and pebbles. Regiments of toy soldiers, whittled from driftwood or cast in lead, lined the window ledge, led by three prized specimens, GI Joes made from genuine pre-Flood plastic. An old corkboard with beetles and butterflies pinned to it was propped on top of the desk. The butterfly wings had moldered away in the humid Texas years, browning and crumbling off like scraps of newsprint, but the hard-shelled insects were more or less intact: a grasshopper and a June bug, a tiny purple doodlebug, an empty cicada husk, and a big old tree roach the length of Joshua’s thumb. There was a dragonfly, too; its wings had turned a blotchy caramel color with age. The wind from the ceiling fan made the dragonfly and the cicada husk rustle and scratch against the corkboard.
The mosquito netting over the four-poster bed fluttered, too. On the days when Josh had been sick as a boy, he had watched the same thing, grey mosquito netting rustling hour after hour. There was a smaller electric fan with blue plastic blades on top of the writing desk. They had turned that one on, too, letting its head swing slowly back and forth.
“Joshua?” Sam whispered.
“Yes,” Josh said.
“So that is you. I thought it was.” They had stripped off Samuel Cane’s clothes, leaving him on the bed with only a damp sheet around him. Through the shaking curtain Josh could see his dead white chest sticking out of the sheet. “I don’t feel very good, but I’m not so lost as I was.”
“Fever’s down.”
“I figured.” Brass rails and steel springs creaked as his father shifted in the bed. After a time Ace said, “Did I imagine some big fellow hitting you, or did that really happen?”
“That happened. Ham thought I wasn’t being nice enough to you.”
Joshua’s father gave a short, painful bark of laughter. “Didn’t know your momma, did he? Never got less sympathy from a woman in my life. ‘Lie down and stop complaining. You j
ust have the flu. I see sick people every day.’”
Josh remembered lying in bed, coughing and coughing, the stink of Vick’s Vapo-Rub on his chest, the sound of children playing in the street outside. He found a tight smile starting on his face. “‘Mrs. Robinson, she’s sick. Lost her whole left leg to a fiddleback bite since yesterday morning. That’s sick.’”
“‘Chuck Yang, he’s got a tumor the size of a grapefruit in his neck. That’s sick.’”
Josh shook his head. “It was like it made her mad, when I got sick. Like it was a personal insult.”
“Mandy always secretly believed you chose the cards you got dealt. Like bad luck was a person’s fault.”
“I suppose,” Joshua said. He remembered the sounds of his mother getting out of bed in the middle of the night to collect raw pancreas. The fist-sized welts on her leg. “Guess what, Sam. You’re sick now.” He walked to the window, which looked over the back grounds of the Palace. Wet wash flapped lazily on clotheslines in the Gulf breeze. The swimming pool was littered with debris, palm fronds and live-oak leaves and fragments of shingle, bits of paper and cloth. Three ragged children with sticks were lying on their stomachs at the edge of the pool and slapping down. Trying to smack water-skaters, probably, or maybe frogs. He could see no sign of anybody watching out for them.
“It’s yellow fever,” Josh said.
“Remind me what that means.”
“How long have you been sick?”
“Three days of fever, maybe.”
“Today’s a big day, then.” Josh wished some grownup would come out and tell those kids to get away from the edge of the swimming pool. “Either you go into ‘remission’ or ‘malignant phase.’ You seem to be lucid, but maybe that’s just the fever coming down for a spell.”
“If it’s remission, am I home free?”
“No. Just puts the malignant phase off.”
“Oh. So sooner or later you have to draw the whole hand.”
“Unless you fold,” Josh said.