The Great Trouble Read online

  “His sheets were wet, sir, as though he had … well, been sick,” I said, panting. Dr. Snow hadn’t let up his speed for a second. “There were white particles everywhere, and he was in horrible pain. It was like a wild animal had got hold of his insides and wouldn’t let go.”

  We turned the corner onto Broad Street. “Point out his house, Eel.”

  “There, sir. It’s Number Forty, just across from the Lion Brewery and in front of the pump. Other families share the house too,” I told him. “It’s not like your street, if you know what I mean.”

  “Indeed I do,” said Dr. Snow.

  “Is that what causes the cholera, Dr. Snow? Folks being crowded all together and breathing foul air?” I wanted to know. “Because that’s what I heard from … well, from everyone.”

  “It’s called the miasma theory—the notion that diseases like cholera are spread by contaminated air,” Dr. Snow said. “Miasma is a kind of poisonous vapor, or so people think. This air supposedly contains particles of bad-smelling decaying matter, the kind we find in neighborhoods such as this, where families are crowded together and there is poor sanitation.”

  I felt hopeful. I’d known Dr. Snow was an expert in chloroform, but it sounded like he might know about cholera too.

  “The miasma theory has been around for centuries,” Dr. Snow continued. “People, even educated men, have believed it for so long that most are afraid to think in a different way, or consider a new idea.”

  “But don’t you believe in miasma, Dr. Snow?” I asked. “Or do you have a new idea?”

  “I do,” he said with a sort of laugh. “I’ve been working on a theory of the spread of cholera for several years now. Although I must admit that no one has paid much attention to it.”

  “On account of it being new?”

  “That’s part of it. If people are told something for hundreds of years, it’s difficult to change their minds,” Dr. Snow explained. “It would help if we could see cholera.

  “So, although I have gathered a lot of evidence, I need a study that will convince people that my way of thinking is right. In other words, I need more proof,” he told me. “Perhaps this trouble here on Broad Street is one way to get it.”

  What was his theory? I wondered. What sort of proof did he need? And most of all, when would he go up to see Bernie and Mrs. Griggs?

  Suddenly Dr. Snow pointed to the Lion Brewery. “Eel, have any of the brewery workers gotten sick?”

  “Well, no, I don’t think so.”

  “I imagine they have another source,” he muttered to himself.

  I had no idea what he was talking about. I rocked back and forth on my heels, looking up at Bernie’s window. I’d managed to convince Dr. Snow to come to Broad Street, but so far all he’d done was talk about theories and ask me questions.

  “Dr. Snow, please,” I said urgently. “Can you—”

  Before I could finish, Rev. Whitehead emerged from the door in front of us. His head was bent, and he stopped and drew in a long breath, as if to steady himself.

  The reverend’s face was so drawn that for an instant I feared he might be the next victim. But then he wouldn’t be upright and walking around, I reminded myself.

  “Eel, I’m glad to see you’re well,” he said, his face lighting up a little.

  I glanced at the two men, standing beside one another awkwardly. It was up to me, I realized. I tried to remember the proper manners Mum had taught me long ago.

  “Uh … uh, Reverend, this is Dr. John Snow,” I began.

  He nodded his approval at my effort and reached out to shake the doctor’s hand. “I’m Henry Whitehead, assistant curate of St. Luke’s. I’ve heard your name, sir, and know of your experiments with chloroform.”

  Dr. Snow bowed. “My interest is indeed in using gases like chloroform to ease pain. But I’ve also been a student of cholera for some years, and am just now learning of this epidemic. How many victims have there been so far?”

  “By my count, Dr. Snow, more than seventy people have died since Friday afternoon, and there may be more,” the reverend replied with a heavy sigh. “I’ve visited rooms where entire families are suffering together, with no one to help. It is heartbreaking.”

  “The disease has spread beyond Broad Street, I presume,” Dr. Snow said.

  “Yes, it has, though it appears to be at its worst right here. I’ve just come from Peter Street, near Green’s Court, not far from where we stand,” he told us. “I went into four houses there, and found half the residents of each one struck down by the disease.”

  He drew a handkerchief from his pocket and wiped his forehead. “I fear there can be no doubt: this stench, this stifling bad air of summer, and the appalling sanitation in some of these houses—all these things are culprits here.”

  Dr. Snow looked the younger man in the eye. “I know that is what everyone believes. But I must tell you that my studies over the last several years suggest that the miasma theory is wrong. There is another cause of this epidemic.”

  “Oh?” Rev. Whitehead sounded skeptical.

  “I believe cholera results not from breathing bad air, but from ingesting by mouth some morbid material that causes the disease,” Dr. Snow replied.

  I guessed ingesting must mean eating or drinking. But what was “morbid material”?

  Rev. Whitehead said nothing. His kind face wore a doubtful expression—about as doubtful as I felt.

  “I believe there must be a period of incubation that is quite short, while the poison grows or multiplies in the infected person,” Dr. Snow went on, seemingly unaware that at least some of his audience (that is to say, me) was not understanding much of what he said.

  “Further, it seems clear to me, though apparently not to others, that since this disease affects the alimentary canal, the poison must enter the person through the mouth.”

  I frowned, wondering what that was. Canal made me think of the river.

  “The alimentary canal,” Dr. Snow explained. “It’s the pathway by which food enters the human body at one end and is expelled at the other.”

  “Oh,” I said. It felt odd to be standing with two gentlemen talking about such things. But if I was embarrassed, the doctor wasn’t bothered at all.

  “In short, my belief is that cholera is spread by water,” the doctor concluded at last. He pointed. “Quite possibly by this very pump.”

  “Dr. Snow, I doubt it could be from this pump, even if your basic idea could be proved,” Rev. Whitehead replied. “The water from the well under the Broad Street pump is known to have a good taste. And it is far less cloudy than that from nearby pumps. Surely it has fewer impurities. How can it be the cause?”

  “Sir, I understand why it’s easy to think that foul smells mean that miasma is the cause of disease. I also know it is difficult to grasp that water that looks and tastes clean could instead be the culprit,” said Dr. Snow. “And it’s true that, even if I test the water, I may find nothing.”

  “What will you do then, Dr. Snow?” Rev. Whitehead wanted to know. “How will you solve what appears to me to be a complete mystery?”

  “There are other ways to investigate. My hope is that this epidemic, raging so quickly in such a small neighborhood, will help me build a case that will convince you and others of my theory,” said Dr. Snow.

  He paused for breath. His next question surprised me. “Can you tell me, is there a local governance committee for this neighborhood?”

  “Why, yes. There is a board of governors for St. James Parish. I understand that the board has formed a special committee to respond to the emergency.” Rev. Whitehead added, “In fact, they are meeting on Thursday evening at seven to discuss the outbreak.”

  “Thursday evening …,” Dr. Snow repeated thoughtfully. “And does this committee have any power to take action to help stop this horrible epidemic?”

  “Yes indeed,” Rev. Whitehead replied. “Already lime has been put in the streets to try to clean the air. Signs have been posted warni
ng the general population of the outbreak. Undertakers have been contacted to bring coffins. What else can be done?”

  Dr. Snow stared at the pump before us. “I have an idea that might work, if I can convince the committee to act. And if I can muster enough evidence in time.”

  “Doctor, your intentions certainly seem honorable,” said Rev. Whitehead wearily. “But I fear that epidemics such as this are beyond our poor powers to understand.”

  “Give me a chance to convince you otherwise,” said Dr. Snow. “Like you, I do not want to watch more innocent people die.”

  “I wish you luck, sir. We all need it. And now good day,” said Rev. Whitehead. “I see Dr. Rogers up ahead and must ask him to check on some of my parishioners.”

  “But what about Bernie?” I put in. “And Mrs. Griggs? How are they?”

  “I’m sorry, lad,” he said, putting his hand on my shoulder. “I’m afraid Mrs. Griggs is gone. Nor is there much hope for the boy. Florrie Baker and Mrs. Lewis are with him now.”

  Dr. Snow bent down to open his black bag.

  “Can we please go up now, sir?” I asked.

  Dr. Snow glanced at me quizzically. “Go up?”

  “To see Bernie!” I exclaimed. “Aren’t you … here to visit patients?”

  “Oh, I see. No, I’m sorry. I cannot help your friend or anyone who has already contracted cholera. My patient is a different one,” said Dr. Snow. He pointed to the Broad Street pump.

  “The pump!” I gasped in disbelief. “This stupid pump isn’t going to help Bernie. He’s sick now!”

  “I can’t do anything for your friend,” said Dr. Snow softly. “Once someone has cholera, there is little we can do. We don’t yet know enough to stop the course of the disease. I can only hope to save those who have not fallen ill.”

  “But … but …,” I sputtered, pointing to his bag. “Why did you bring that? I thought you were going to do a test, or that you might have … medicine or something.”

  Dr. Snow unwrapped one of the glass vials. “I am going to test the water. As I told Reverend Whitehead, I’ve developed a theory about how cholera spreads, which I feel sure is sound. Now I need clear and definitive proof to convince others.

  “The Broad Street epidemic could provide the evidence I must have to make a case that is beyond doubt,” the doctor went on. “There is no time to waste. It is Sunday. We have only four days and much to do.”

  I’d thought Dr. Snow could help Bernie, but he didn’t care at all about him—or anyone else. I looked down at his bag and felt like kicking it.

  “So you don’t have special medicine in there? You’re supposed to be one of the best doctors in London, maybe the whole country.” I clenched my fists in frustration. “I thought you could make folks better.”

  “I know how you feel, lad,” said Dr. Snow. “I can never forget the first time I watched cholera devastate a community, sweeping through houses like a terrible windstorm.

  “The sad truth is that I have no medicine. No one does—yet. Do I believe that someday we will find a cure and that we can make progress against epidemics like this? Yes, I fervently hope so. But it will take time and work.”

  I turned away and started to stomp off. Dr. Snow called me back.

  “Eel, there is something we can—something we must—do,” he said. “This swift, fierce epidemic is a chance to show how the disease spreads.”

  Dr. Snow’s next words startled me. “And I could use your help.”

  “What can I do? I’m just a mudlark.” I was sure he was making fun of me.

  “If we can bring evidence to the committee on Thursday night, we might be able to prevent more people from getting sick. We might be able to save lives.”

  “But … but … that’s not good enough,” I cried. “Bernie is dying now.”

  Dr. Snow opened his mouth. I didn’t stop to listen.

  I scrambled up the stairs and pushed open the door of the room. Florrie had her arm around Betsy, who was sleeping. Bernie lay on a pallet in the corner.

  “Oh, Eel,” whispered Florrie when she saw me.

  Her eyes looked large and frightened, though she wasn’t crying. “He’s goin’, poor little thing. He’s calling for his papa. Sometimes he’s awake, and then he slips off a bit.”

  “Have you been all alone?”

  “Mrs. Lewis was just here. But she has her own troubles. She lost her baby yesterday,” Florrie said. “Fanny weren’t even six months old, poor dearie.”

  She looked behind me at the empty doorway. “You didn’t bring ’im, did you?”

  I shook my head. “Dr. Snow said there’s nothing he can do once someone has it.” I felt hot tears sting my eyes. “He’s out there, though, down at the pump.”

  “What’s the pump got to do with anything?”

  “Dr. Snow thinks the blue death spreads by some kind of invisible poison in the water, rather than by bad air,” I told her.

  Florrie stared at me. “Is the water from the Broad Street pump bad somehow?”

  “Dr. Snow’s not sure yet. He wants to test it,” I said. Then I stopped. What if he was right?

  “I never drink from there myself,” I said slowly, looking at the bucket and ladle in the corner. “But have you drunk from that pump in the last few days?”

  “A little.” Florrie swallowed hard. “A neighbor came by and brought a jug of milk. Bernie wouldn’t touch it, so I gave it to Betsy. But I drank some water.”

  “Dr. Snow could be wrong,” I said, trying to make her feel better. “But it might be best not to drink any more.”

  Just then Bernie whimpered.

  “Go over and talk to him, Eel,” Florrie whispered. “He looks up to you something fierce.”

  Bernie’s small hand felt dry as paper. His cracked lips looked sore. His skin had a bluish tint. You could see his ribs heaving up and down from the effort to breathe.

  “Don’t be scared, Bernie,” I said softly. “Your pa’s lookin’ after you.”

  Bernie opened his eyes and stared at me. He gave a hoarse gasp. Then his little body gave up fighting.

  CHAPTER FOURTEEN

  Four Days

  I stood in the hot, close room, looking down at Bernie’s still form. Anger surged through me. “It ain’t fair.”

  Florrie drew the sheet over Bernie’s face. She nodded toward the corner, where Betsy lay curled up with a napping Dilly. “I’m glad I didn’t wake ’er. It don’t seem right that in three days she’s lost her whole family. I hate that I can’t do anything. But maybe you can, Eel. Maybe you can help your Dr. Snow somehow.”

  We went into the hall. Florrie said she would fetch Mrs. Lewis and ask her to keep Betsy. “I think she has an aunt somewhere. I ’spect Mrs. Lewis will know how to reach her.” Like Rev. Whitehead, she had dark shadows under her eyes from lack of sleep. “I need to get home.”

  I cleared my throat. “Be careful how you go, Florrie.”

  “You too, Eel.”

  Dr. Snow was still standing before the pump, making notes in a small black book. He took one look at my face and said, “I’m sorry, lad.”

  I stared down at my feet and pushed at a cobblestone with my toe. I wouldn’t cry in front of Dr. Snow, not in front of any swell like him.

  “Sorry for running off …,” I mumbled.

  A few families passed by us, but the stream of refugees was a trickle compared to Friday afternoon. I figured most everyone who could leave had already gotten away. I looked into the dark, empty windows around us. Were there still children like Bernie lying inside, suffering, with no one left to help them?

  “Eel, I’ve been studying cholera in other parts of London, but this epidemic is different,” Dr. Snow said urgently. “It’s come on fast, and is confined to one neighborhood. That makes me suspect a direct link with a single water source.

  “I meant what I said. This might be the best chance I’ll ever have to prove my theory. And I do need your help.”

  “But … what could I do?”
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br />   “I can’t stop all my other work. So I need an assistant. You know these streets and the people who live here,” Dr. Snow explained. “More importantly, they know you. You’re not a strange fancy doctor they’ve never seen before.”

  “True enough. I’ll never be a swell like you,” I said. Then I shook my head. “But I can’t exactly make out what you want me to do.”

  “Well, for one thing, talk. I will need you to help me visit homes and talk to people.”

  “You mean, warn them about drinking the water?” I thought of Florrie, and how she had drunk water from the pump.

  “Warning will be part of it, yes. We will also need to ask questions to determine if the Broad Street pump really is to blame for the cholera.

  “Don’t worry. I’ll guide you and tell you what to ask,” Dr. Snow reassured me.

  Then he added, “And naturally, I’ll pay you.”

  Dr. Snow would pay me just to talk to people. I could use the money. But I wouldn’t help Dr. Snow for that reason. I would do it for Bernie’s sake.

  “What do you say, Eel?”

  “All right,” I agreed. “I’ll do it. Though I’m not sure how talking to people can prove anything.”

  “You’ll see,” Dr. Snow promised. “But we must start at the beginning. The first thing I want you to do is to close your eyes.”

  It must be, I thought, a sort of test. Of what, I couldn’t say. I didn’t know how to pass it either. So I just shut my eyes. What I saw was Bernie’s small face, etched with pain, which made me quiver. I had to take a great gulp of air to calm myself.

  As I did, Dr. Snow took me by the shoulders and moved me so I was facing a different direction. “All right, now open your eyes and tell me what you see.”

  What I saw was the Broad Street pump.

  “Now, Eel, I want you to pretend you are seeing this neighborhood for the first time,” Dr. Snow instructed. “What would you say about this pump? Just tell me everything that pops into your head.”

  “Well, a pump is one place that people in the neighborhood get their water, though some also get it piped into their houses these days,” I said slowly. “It pumps water up from a well, and folks use that water to cook with and, of course, to drink.”