Andrea Barrett - Ship Fever - Stories

Here is the rest of her story, or as much as I could scribble while she spoke:

“I helped my grandmother after my parents died. Ned and Denis helped too. When we could we took the sick from their houses and put them into huts— bracai, we called them — we made by thatching brambles and rushes over poles against a sheltered ditch. We kept those people separate from the healthy. My grandmother would go into the hut with the sick people, and we would wall up the door with turf and then pass food in through the window, on the blade of a long shovel. Never would we touch the empty vessels she passed back out through the window.

“My grandmother could see the sickness on someone, as good as any doctor could; she knew it was an droch-thinneas by the color of their urine. She did not give the sick a mouthful to eat, but she gave plenty to drink, as much as we could gather and pass through the window. Two-milk whey she gave, when we could get it — very light and sustaining. To make it we boiled new milk and then added skim milk to it. The sick would drink this and also eat the curd. Also she gave the juice of cress and wild garlic, and sheep’s blood if it could be found. When the color of the urine lightened, she would give a single toasted potato. We saved what few good potatoes there were for this use; ourselves, we were eating ferns and dandelion roots and pig-nuts and cresses. My grandmother did not come out of the fever-hut, nor let anyone in, until her patients were completely well.”

When I asked her how she and Ned and Denis avoided the sickness themselves, she said that before they first touched the patients and carried them to the fever-huts, and also before they burned the huts of the dead, they washed their hands and faces in their own urine, to protect them.

“Would you say, then,” I asked, “that you attribute your relative health in Ireland to the strict isolation procedures taught you by this grandmother?”

“Isolation,” she said. When she raised her hand to smooth her hair, it slipped off the shorn ends. “That means making someone to be alone?”

June 20, 1847. Rain, which does not alleviate the heat. Two nurses died yesterday. In hospital we have 1,935 sick, according to Dr. Douglas’s count. Several hundred more sick remain on board their ships, infecting the well.

No sleep at all last night. This morning I saw a dog by the wharf and thought it was a wolf. Why would anyone allow dogs on this island? I have brought blankets from Mrs. Caldwell’s and plan this night to make a pallet here on the floor. The patients cannot be noisier than my fellow medical officers. A number of those working here now have been recruited from the army, and their manner is disagreeably matter-of-fact and hearty.

Nora’s story continues to haunt me. Henle makes the distinction between miasma — the disease substance that invades an organism from the outside; and contagium — the disease substance believed to be generated in the sick organism, which spreads the disease by contact. He argues that the pathogenic matter must be animated, although he has as yet no proof for this. Southwood Smith, in his Treatise on Fever, discounts the theory of contagion in favor of noxious exhalations, or miasmas, given off by filth. Chadwick, Smith’s follower, says dirt is the nurse of disease, if not the mother.

It’s true that on the filthy ships the passengers sickened quickly. Here, the disease seems to spread somewhat slower in those places where the beds are less closely crowded, and the ventilation is better.

But Nora says fresh air has nothing to do with it; she spent all the time she could on the deck of the bark and still sickened. In one of the books Gerhard sent to me is a discussion of an old paper by Dr. Lind, physician to the Royal Navy. Lind contended that typhus is carried not only on the bodies of the sick, but upon their clothes and other materials they touch: beds, chairs, floors. In defense of his views, he cites the death of many men employed in the refitting of old tents in which typhus patients had been cared for. He advocates fumigation (camphorated vinegar, burning gunpowder, charcoal); also a thorough scouring of patient quarters and destruction of bedding and clothing. Additionally he recommends that physicians and attendants change their clothing when leaving the hospital.

This may be worth trying here. Now that we must quarantine passengers aboard their ships, Dr. Douglas has given orders that the passengers be removed to the island temporarily, and that the holds be thoroughly washed and aired before their return. Stern and bow ports are opened, allowing a stream of air to pass through the hold and flush out the miasma. On many of the more recently arrived ships, however, passengers are no longer required by the captains to discard all their bedding before inspection; word has spread that the ships will be detained here regardless, and no one wants to cause extra suffering. So the passengers return to the clean holds with their filthy clothes and blankets and belongings. Wood’s Practice of Medicine notes that the disease “appears even to be capable of being conveyed in clothing, to which the poison has been said to adhere for the space of three months…It is thought that the poison can act but a few feet from the point of emanation; and attendants upon the sick often escape, if great care is taken to ventilate the apartment, and observe perfect cleanliness.” Interesting advice, if true. But what use is it? Not one thing on this island is clean. Throughout the sheds and tents, as well as the hospital, we have an infestation of lice. This in itself seems like reason to divest the passengers of their rags and provide them with new.

Nora appears to be making a full recovery. Tonight she asked me again about her brothers and this time I told her the truth: that when last seen they appeared well, but they were carried off on a steamer bound for Quebec and Montreal on May 24 and may now be anywhere. Her face turned very pale. She went outside for a while, and when she returned she asked that she be allowed to work here as an attendant. As she cannot catch the fever again, I agreed. We are desperately short-handed.

Three of my fellow physicians have fallen sick; also two Catholic priests and the same Anglican clergymen who chided me early on. At least six of the attendants are also sick.

The remainder so fear contagion that we have caught them standing outside the tents or in the open doorways of the sheds, hurling the patients’ bread rations at their beds rather than approach them. Gray bread flying through gray air.

June 27, 1847. Unbearably hot. Seven out of fourteen physicians are now ill. Of the six Anglican clergymen recently arrived, four are sick: Forrest, Anderson, Morris, Lonsdell. Our death-register now shows deceased 487 persons whose names we cannot ascertain. 116 ships so far. The backs of my hands are completely covered with hives.

Last night I stole a brief hour of conversation with Dr. John Jameson. Over a glass of brandy, and without meaning to, I complained that Dr. Jaques never talks to me if he can avoid it. John, who continues good-humored despite the lack of sleep and the working conditions, said, “You must not take this so hard. This island is a government installation, under military supervision — of course everyone’s concerned with discipline, the chain of command, the appearance of propriety. Dr. Jaques perhaps a bit more than the others. This is a political situation, at least as much as it’s a medical emergency.”

Of course it’s politics, as he said; Arthur Adam has maintained all along that the famine in Ireland is political, not agricultural, and so by extension our situation here has at least as much to do with government policy as with fever. I have not, apparently, been behaving in a sufficiently ‘military’ manner. And it’s true that John gives an appearance of going along, not asking questions or making comments when one of the superintendents tells him to do something. He smiles and nods. Then as soon as they’re gone, he does what needs doing, the way he sees fit to do it.