Of Flesh and Blood (49 page)

More than twenty years after saving Olivia’s life, Evan would be present to repeat the feat for another Alfredson: this time, his good friend and partner, Marshall.

—
The Alfredson: The First Hundred Years by Gerald Fenton Naylor

Even when Virginia was at her most disabled and Marshall Alfredson was threatening to kill him, Evan had never felt the cumulative weight of so many troubles as he did in early October of 1918.

His eldest son had returned from the Great War maimed. Despite the vehemence with which George had thrown himself back into the medical training, Evan worried for the boy’s future. With only one arm, George would never be the surgeon his father had hoped. Evan told himself that George of all people would triumph over his injuries, but the memories of Virginia’s final years gnawed at him. He knew only too well how limiting physical disability could prove to an able-minded person.

Evan’s paternal worries were not confined to George. At seventeen, his youngest, Nicholas, showed no interest in following his father or brother into medicine. The boy, who had always been particularly sensitive and somewhat effete, had become obsessed with acting. He had even sought his father’s permission to travel to a place in Southern California called Hollywood. Nicholas enlisted his mother’s help to lobby his father. While Evan loved to indulge his children, he could see no future for his son in acting, especially in moving pictures. He was convinced the allure of those ridiculous films was merely a passing fad that would soon be replaced by something better. Believing he was looking out for Nicholas’s best interest, Evan forbade the boy to go. Nicholas sulked for the next two months and then, in early September, disappeared without a word of warning. His parents found out that he had gone to Hollywood only after they received a letter from him with a California postmark.

But of all Evan’s progeny, the one nearest to his heart was causing him the most dismay. Headstrong as ever, Liv was still hell-bent on becoming a doctor. Impressed by her determination and pioneering spirit, Evan intended to help her realize the goal any way he could. But Liv was never one to wait. Without her father’s consent, she had begun to shadow the consultants and volunteer with the nurses on the wards, creating her own informal medical apprenticeship. Evan was astonished by how quickly the girl had learned. Two months earlier, he had walked onto the ward to see her expertly applying a full-length plaster cast to a patient who had a shattered tibia. Though he pretended to disapprove, inside Evan was bursting with pride at his daughter’s aptitude. However, the next time Evan had
happened across Liv unawares, he was deeply troubled by what he witnessed.

Ten days earlier, Evan had been out on one of his daily walks that took him around the Alfredson complex and, time permitting, sometimes miles beyond. Approaching the back of the new building along a dirt path, he slowed when he saw two figures tucked away in the shadows under the second-floor balcony. From the alignment of their bodies, Evan appreciated the intimacy of their interaction. Intending to leave the couple to their privacy, he stepped off the path and ducked behind a nearby oak tree. He was about to slip away when the sound of the girl’s voice froze him. Though she spoke softly, the breeze carried it to him.

Liv!

Hugging the tree with his back, he peeked around its edge. Neither one of them looked in his direction, but Evan recognized Liv leaning against Junior Alfredson.

Marshall did not usually allow his son to come to the clinic unsupervised. However, Evan remembered that the old man had come to see a rheumatic specialist regarding his gout. Junior must have accompanied his father on the visit and slipped away with Liv during his father’s appointment.

Liv stood inches from Junior. They spoke in hushed tones. Evan could only make out snippets of their conversation, but from the laughter and their proximity, the nature of their encounter was unmistakable. After a few moments, Junior reached out and drew Liv into his embrace. They kissed for several long moments. Transfixed, Evan watched in dismay as Marshall’s threat to throw him and his family out of the Alfredson rang in his ears.

Now, as he sat at his desk and stared out at the same building where Junior and Liv had shared their illicit kiss, Evan’s heart sank at the vivid memory of it. Desperately conflicted and still undecided as to how best to respond, he had yet to confront Liv. Though his daughter was gambling with the future of the family business, Evan still believed she had a right to pursue her own happiness. His heartbreak at having been forcibly parted from Olivia had never fully healed. And he had learned from his difficult experience with his youngest, Nicholas, that it was better not to meddle in his children’s lives.

Besides, a worry far greater than any personal or family trouble had been amassing like storm clouds over the clinic. And it threatened not only the Alfredson, but everyone in the civilized world.

Evan’s apprehension had begun to rise in the summer after he first received a letter from a colleague in Philadelphia warning of an unusually virulent strain of influenza. Evan had heard rumors already, but it was his friend who first used the term “the Spanish flu.” All summer, Evan followed the reports with growing alarm as the Spanish flu jumped from its origins at military bases into the civilian population in cities such as Philadelphia, Boston, Chicago, and New York with a death toll previously unheard of for influenza. For months, Evan had expected the Spanish flu to find its way to the Pacific Northwest. He had worked diligently to prepare the Alfredson and its staff. He made them separate the beds on the wards, so all the patients were at least ten feet apart. He asked Moses Brown to construct makeshift partitions out of wooden poles and bedsheets. He instructed the nurses to sew stacks upon stacks of six-ply-thick masks. He mounted posters with simple instructions on infection control, including advice on hand-washing frequency and technique. He even set out draconian rules, banning such benign contact as handshaking.

After reading promising research papers on the benefits of oxygen for soldiers whose lungs had been decimated by poison gas, Evan stockpiled oxygen tanks for the Alfredson, hoping that it might help with the severe pneumonia known to be associated with the Spanish flu. Working with Moses, Evan fashioned rubber tubing and face masks for delivering oxygen to the patients.

The Spanish flu finally reached Seattle on a rainy fall day—October 2, 1918. People were panicked. They had heard the grisly stories and rumors of hundreds of dead in a single day in many cities. Tales abounded of people going to bed well and never waking up. Gymnasiums were piled to the ceiling with the bodies. Evan knew from colleagues across the country that these stories were not exaggerated. Unlike in previous influenza outbreaks, the ones dying were not the infirm or the old. The young and healthy were perishing at a catastrophic rate.

The Alfredson admitted its first case of Spanish flu three days after the virus reached Seattle. From the moment the young sailor, Harry Stone, was carried into the clinic by his family on a makeshift stretcher, his diagnosis was never in doubt. Evan immediately mobilized his staff. He oversaw the relocation of the black patients onto the wards in the other buildings with the white patients, clearing out the entire main-floor wards of the original
building exclusively for flu victims. Within forty-eight hours, forty-two more Spanish flu sufferers had joined Harry Stone at the Alfredson.

Nothing in the written accounts or the newspaper photographs prepared Evan for the deadliness of the epidemic. A day before, he had assessed a young victim, Philip Enders, who had presented with relatively mild symptoms typical of the grippe. The young man had protested, claiming he was too well to waste a hospital bed. Evan almost agreed. However, within two hours of admission, the head nurse urgently summoned Evan to the bedside where Enders was coughing up bright-red blood. He was bathed in sweat, and his complexion had turned navy. Enders was racked by ceaseless paroxysms of coughing, and the skin between his ribs puckered with each breath, his body desperate for better ventilation. Trousers soaked with urine, Enders was so delirious from the fever that he called out to imaginary visitors and dead relatives.

Evan had tried to treat the young man with everything at his disposal, including oxygen, morphine, digitalis, atropine, and camphor. None of the interventions helped. Enders died less than four hours after proclaiming his healthiness. In that moment, Evan realized there were no preparations sufficient for this monstrous disease.

Now, as he secured the mask tightly around his face and walked onto what had already been dubbed the “flu ward,” there were thirty-three patients inside. Stone, Enders, and seven others—all young and previously healthy—had already died. Moses’s partitions only separated the patients from one another, so from Evan’s vantage point in the center of the room, he could see most of the patients with a turn of his head.

A number of reasonably well-looking patients lay in bed reading, sleeping, or just staring back at him with varying degrees of wariness or fear. Almost an equal number of sufferers appeared to be in distress; some of their faces had turned as blue as Enders’s. No one spoke, but the room was filled with harsh sounds of coughing, retching, and hacking. Unintelligible moans rose intermittently. The smell of sweat and death hung heavily in the air.

Three masked nurses, wearing long white aprons over full-length dresses, scurried from bed to bed, carrying buckets of cold water. Evan watched a nurse stop by an ill patient and try to ladle water into his mouth. The same quantity dribbled right back out. Using the same bucket, she wet a cloth and applied it across the man’s brow in an attempt to lower his raging fever.

Outraged, Evan watched the nurses use the same ladles over and over on different patients. Sometimes, they even dipped the contaminated cloths back in the water bucket two or three times and then gave a drink to the next patient. These practices inflamed Evan; he had been so clear to the staff about attention to hygiene and infection control.

Evan suspected that the sloppy infection-control practices had already exacted a terrible toll. He had come to the flu ward specifically to see Cecilia McClellan, the first nurse to contract the Spanish flu. Evan had desperately hoped his precautionary measures would prevent such cross-contamination to the staff. He was devastated to find out that, within two days of the virus reaching the clinic, one of his nurses had already taken ill.

Evan spotted McClellan on the far side of the room where the six female patients were clustered. The waiflike girl was on a bed in the far corner with the blanket drawn up to her neck. She lay very still with her eyes wide open. From thirty feet away, Evan saw the ominous bluish tinge that suffused her cheeks.

Approaching her bed, he heard McClellan’s raspy breathing before he even reached her. McClellan looked up at Evan with a stoic grin. “I’m so sorry, Dr. McGrath,” she panted.

Evan touched his chest. “I am the one who is sorry, Miss McClellan.” He shook his head. “I feel responsible.”

“No . . . Dr. McGrath,” she gasped. “You have done . . . what you could . . . to prevent this.”

Evan reached for his stethoscope in his jacket pocket. He slipped the buds in his ears, leaned forward, and then applied the bell to the blanket over her chest. He moved the stethoscope around. In every zone he heard the same crackling wet sounds of overwhelming pneumonia. Disheartened, he pulled his stethoscope from his ears.

“How . . . do I . . . sound?”

Evan saw how hard the poor girl tried to mount a brave face, but he could almost smell her fear. It made his heart ache. He nodded as encouragingly as he could. “The air is moving well,” he lied. “You have a lot of mucus to expectorate. That will help. Meantime, we will start oxygen therapy.”

Evan looked over his shoulder and saw the head nurse, Gertrude Flanders, glide into the room from the hallway. He turned back to McClellan. “I will
go arrange it now.” He held her gaze for a brief moment. “You can still overcome this flu, Miss McClellan.”

“I believe I can, too.” But her voice bore little conviction.

“I must speak to Mrs. Flanders now, but I will be back to check on you soon.”

“Thank you.”

Evan hurried over to the newly installed sink on the near wall. He scrubbed his stethoscope with soap under the running water and then washed his own hands. After drying them, he hurried over to where Flanders stood talking to one of the younger nurses.

The head nurse was a tall heavyset woman of around his age, but she moved with an effortless grace that made her appear to almost float at times. He respected Flanders for her ability and her kind manner with the younger nurses, who uniformly looked up to her. But at this moment he was as upset with her as he had ever been. “Mrs. Flanders, may I have a word, please?” he said in a low voice.

“Of course, Dr. McGrath.”

Flanders led him out to the corridor. Neither of them removed their masks. From where they stood, they could see only the nearer half of the ward. “Miss McClellan is not well at all, is she?” Flanders said.