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.
3
He tried to forget it, but over the weeks it nagged at him. Time and time again, he went back to the notes and graphs to convince himself that he was not imagining the evidence found in his records. Could it be, he wondered, a circumstance that prevailed only in this place? He wondered what the other physicians Abbott had talked with were doing about it—if they were doing anything; if, in fact, they had even looked at their records; and if they had, what they might have found …
He spent hours going back through old issues of The Journal of the American Medical Association and other journals, digging into the dusty stacks down in the basement, where they were stored. He could easily have missed something bearing on the matter in the medical magazines, for up till now he had not been too conscientious in his reading of them. A man, he told himself—making excuses for himself—had so little time to read; and there was so damn much to read, so many medical eager beavers intent on making points that there was a continuous flood of papers and reports.
But he found nothing. Could it be possible, he wondered, that despite Abbott’s work he, Benton, might be the only man who knew about the condition that he had come to characterize as the exhaustion syndrome?
A disease? he wondered. But he shied away from that. It was too selective to be a disease, its parameters too narrow. A metabolic disorder, more than likely. But for a metabolic disorder to come about, there must be an underlying cause.
Burt Curtis, it turned out, was no more diabetic than Ted Brown had been. His blood sugar was haywire, but he was not diabetic. After Helen had nagged at him for a time, Herb Anderson came in and his case was almost identical with Burt’s and Ted’s. An insurance salesman, a merchant, and a down-at-the-heels house painter—what in the name of God, he asked himself, could those three have in common? And then there was the Barr family! The Barr family bothered him a lot.
There were others now as well, not such classic examples as Burt and Ted and Herb; but each of them showed some of the symptoms of the exhaustion syndrome.
“You have to put it out of your mind,” Harriet said one day at the breakfast table. “It’s the ‘good old Doc’ complex again. You have allowed it to drive you all your life and here it’s driving you again. You can’t go on like this. You have other things to do, you have a full-time job. If this Abbott person had not shown up, you would not have noticed it.”
He agreed with her. “No, I don’t suppose I would have. Even if I had, I would not have paid too much attention to it. But when he talked to me, he made an uncommon lot of sense. As you’ve heard me say, I suppose far too often, medicine is not an exact science. There’s an awful lot of it a man can’t understand. A lot of problems he can’t begin to understand.”
“You’ve encountered those kind of problems before,” Harriet pointed out, just a shade too sharply. “And you have always said—I have heard you say it often—that someday a researcher will come up with an answer. You didn’t spend days fretting over those problems. Why can’t you stop this fretting now?”
“Because, damn it,” he told her, “here it is, right underneath my nose! There’s Ted and Herb and Burt, and a lot of others—more of them every day. There is nothing I can do about it. It’s nothing that I recognize; I’m completely in the dark. I’m tied hand and foot and I don’t like the feeling.”
“The trouble is, you are feeling guilty. You’ve got to cut that out.”
“All right,” he said. “I will cut it out.”
But he didn’t.
He did what, at the time, seemed rather silly things. He stopped at the Fanny Farmer candy shop and learned that in the last three years sales had increased by almost twenty-five percent. He phoned the two small factories at the edge of town and was told that sick leave and absenteeism had risen by almost ten percent in the last few months. At the drug store, he talked with his old friend the pharmacist, who told him that over-the-counter sales of analgesics were higher than at any time within memory.
That afternoon he phoned Dr. Herman Smith at Spring Valley. “You have a minute to talk with a competitor?” he asked.
Smith snorted. “You’re no competition,” he said. “We got that worked out years ago, remember? You work your side of the street and I work mine. We have our territories all laid out and fenced, and we have a gentleman’s agreement to do no trespassing. But I won’t let you in on any of my trade secrets, if that’s what you’re calling about.”
“Nothing like that,” said Benton. “I’ve been noticing some strange things. I’ve been wondering if you are noticing them as well.”
Smith’s voice became serious. “You sound worried, Art.”
“Not worried. Puzzled, that’s all.” He went ahead and told Smith what he had been noticing, making no mention of Abbott.
“You think it’s important?”
“I don’t know about its importance, but it’s a funny business. There seems to be no reason for it, no underlying cause. I’ve been wondering if it’s only happening here or if—”
“If you want me to, I could have a look at my records.”
“If you would,” Benton said.
“No sweat. I’ll let you know in a week or so. I’ll even draw you up some graphs to match with yours. If I find anything, that is.”
Dr. Smith didn’t take his week. In four days’ time there was a fat envelope. Opening it, Benton found not only the graphs, but statistical tables and a sheet of Xeroxed notes.
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