Chapter 25

Enchiridion Chirurgicum

Amberg, Upper Palatinate

Breakfast at the inn was usually when the men talked over what they had read in the newspapers-the war in the north, what Wallenstein was doing in Bohemia, anything that had been heard from Venice or Rome. Supper at the inn was when they compared notes on the day's work. What each of them learned separately was of far more use after it had been combined with the information that the others had collected. The reluctance of the mine owners to invest, for example, which they had made very clear, made a lot more sense in the light of what the Cavrianis had learned about cost/profit ratios and what Keith had found out about Bavaria's nationalization of the mines and the resulting uncertain legal status.

"But," Keith summed up, "I think it can be done. Not as fast or as easily as we were hoping. Duke Ernst is going to have to cut some knots. And hit some kind of a balance between total control and letting the entrepreneurs run wild with no supervision at all. It's not as if our-the SoTF's, I mean-laws are in effect here, covering labor relations and pollution and such. He's going to have to think about that, and some of it may have to go all the way up to the king, ah, emperor, for approval. I just hope that won't drag out too long. Otherwise, new technology will help a lot-stationary steam pumps for the big operations. Capital will help a lot, too-low cost loans for the smaller operations to buy the traditional pumps."

Marc started to open his mouth; then closed it again.

Keith waved at him. "Go ahead, kid. If you've got something to say, then say it."

Marc looked at his father. "I'm, ah, here to watch. To observe. To learn. Not to say things."

"Say it, and I'll decide whether it was worth saying." Keith wasn't entirely joking.

"Well, sir, I don't think you're going to get younger men for the rebuilding of the metals trades once you have the ore. Not skilled workers, I mean. Oh, you can get plenty of unskilled workers. Ex-soldiers. Servants, even, from farms and towns, if they're strong enough for the work. Especially if they want to get married. The mines and mills and smelters never tried to limit their men's marriages, the way towns and farmers do. Oh, they had barracks for the unmarried guys. But there's no need for miners to "live in" the way servants do. And it's out in the country, not short on space the way walled towns always are. So the men can marry, build cottages; their wives can garden, keep chickens, cook for the unmarried men, do laundry. It works fine for them, as a system. They'll find that kind of worker. But skilled? I don't think so."

"Why not?" Keith was listening a little harder now.

"The whole Montanbereich has not really been working for fifteen years. That's… well, it's almost as long as I've been alive. The conditions described in the 1609 survey-that's several years longer than I've been alive. That's too long for a man to wait for a new job. They've left, if they could. I bet, if you look, you'll find them in mines and forges all over Germany, all the way to Silesia and Lusatia. In Austria and Bohemia. In northern Italy. Which means that they haven't been training apprentices here in the Upper Palatinate for that long, almost. So you're not going to find many younger masters and hardly any trained journeymen. Not even apprentices about to become journeymen-not except for just a few places, like the one Papa and I found out in the country. Plus, Duke Maximilian forced out a bunch more of the skilled workers who were Protestant, mostly grown men who naturally took their sons with them. Some have come back, but not many to stay. They've just come to get what they can and cut their losses. Then, of the ones who stayed in the 1620s, others have died of the plague and other epidemics since then. No, Herr Pilcher. I think, I really think-for the processing and finishing, it will be old men and untrained boys, at least to start with. That will slow things down. People may start to come back when things get going, but not… not right away."

Keith pursed his lips. "I'll file that away to think about. And mention it to Ollie."

Leopold Cavriani smiled to himself. His son had noticed this, thought about it, presented it clearly. Ahhhh! He would have to compliment Jacob Durre.

The waiter appeared with food. Quite a lot of it. They dropped business for eating. Especially Marc. His capacity for food astonished the rest of them.

Toby Snell was with them, for a change. Like Mary and Veronica, he was living in the Schloss. Not, by any means, in such luxurious quarters. He was sleeping in a cot in a small room on the top floor, next to the array of large blue bottles and annexed wires and stuff that constituted a down-time radio room.

He started talking about his girlfriend, back home. Dawn. Not, he pointed out, his fiancee. Half-seriously, he lamented that even if she did agree to marry him, he was never going to be able to live up to the images on the romance novels that she read by the jillion.

"You'd think," he finished, "that fate would have done us guys a favor. That eventually, after the Ring of Fire, the things would have worn out. But no. What do the down-timers do? Reprint them! Complete with woodcuts of all the hunks on the covers."

"If you get her to say 'yes'," Keith answered, "the rest of it is easy. If, that is, she's romantic enough."

Toby was inclined to listen. Keith's wife was a member of the same book club that Dawn had joined a while back.

"The hard part is having a wife who sees you the way you are. Hey, having one of those and keeping her in love with you is something of a challenge. If she notices that your hair is sort of thin on top" -he pointed to his own head- "and you're sort of sloppy about pruning the weigela bushes and sometimes you don't get around to taking out the garbage when she asks you to, how do you explain it? If she compares the waist size on your last set of briefs with the waist size on your new set of briefs, how are you supposed to persuade her that things aren't settling, so to speak? A realistic wife-that would be a problem."

Marc was listening with fascination.

"But a member of the Romance Readers book club. Hey, Toby, it's a cinch, if you do the husband business at a sort of minimum level. Basically, I mean, don't get hauled home sodden drunk very often. Usually get there for supper on time and call when you can't. Remember her birthday and anniversary with flowers. Which isn't that hard, in spite of all the jokes. I keep Max's birthday and our anniversary written on a note card on my machine. So, you see, just do that much. Your wife's imagination will take care of all the rest. You see, she really wants to have a romantic, hunky, husband. So she'll festoon you with all sorts of desired heroic qualities that you… ummn… may not actually have, like tinsel on a Christmas tree, and cheerfully ignore the fact that middle age is not just creeping up on you but has already arrived and taken up squatters' rights on your midsection."

Marc would have been happy to listen all evening, this being completely beyond anything he had thus far encountered in his rather sheltered Calvinist existence.

"You mean?" Toby was asking.

"Yup. Just don't deliberately disillusion the little thing, and she'll do all the rest of the work that needs to be done so she can have a Great Romance. Happily ever after. Guaranteed recipe, the old 'Pilcher special.'"

Toby pulled a little spray bottle and soft cloth out of his breast pocket and started to polish his glasses.

"Where did you get the cleaning fluid," Keith asked.

"Just vinegar. Like everything else. Some vinegar manufacturer in Badenburg must be making a fortune out of Grantville, the amount of the stuff that we use. That's where the crocks full of it come from. McNally says it won't hurt the lenses and these little spray bottles last and last." Toby cocked his head. "Speaking of lasting, how long have you and Max been together, anyway?"

Keith thought about it. "Well, Mom brought Lyman and me back from Detroit the summer after she and Dad divorced. That would have been, um, '83. I started high school in Grantville as a sophomore. And I took Max to the Halloween dance that year. That was our first date. We got married the summer of '89. So it sort of depends on how you figure it, I guess."

"You really never dated anyone else?"

Keith shook his head. "We pretty much figured out that we'd be getting married some day on the second date. But Max was a year behind me in school and we didn't want to frazzle her folks. Old man Maddox was an okay guy, but Max's mom could be a real PITA sometimes. Plus, I knew that when I turned eighteen, Dad would stop the child support, just as soon as he legally could. So I graduated and moved over to Fairmont, got a factory job and started on my A.A. in night classes. Kept right on, summers and all, so it only took me three years. Max graduated the next year and commuted to State; we got married between her sophomore and junior years."

Keith grinned. "Want some advice from a wise old man, Toby? Ninety percent of marriages that go on the rocks land there because of that 'first you say you do and then you don't' business like the song says. Pretty soon it's 'gloom, despair, and agony on me.' He's down at Tip's having one too many and she's at the county seat talking to a divorce lawyer. If you want to be married to Dawn, just make up your mind that you're married to her, and then stick to it. And if you don't really want to be married to her for good, don't marry her in the first place."

Toby thought that this sounded altogether too simple. Leopold Cavriani, though, was nodding in approval; Marc was watching his father.

The conversation meandered on. Eventually, Lambert Felser asked if anyone else had heard mention that there was a lot of sickness going around.

"Not a lot," Keith answered. "But Tanzflecker didn't show for the meeting today. Nadelmann said that one of his children died last night."

"One of the radio techs is sick," Toby contributed. "He didn't feel well enough to get up this morning. I mentioned it to Mrs. Simpson and she came upstairs. Then she went and talked to Jake Ebeling and hauled Bill Hudson upstairs to look at him."

Jake was the military liaison from the up-time contingent in the USE military to Duke Ernst. Here to teach and to learn. Spent most of his time with Hand, the Swede. Bill was Willie Ray Hudson's grandson, trained since the Ring of Fire as an emergency medical technician. He was teaching and learning, too. Those two, with Dane Kitt and Mark Ellis, made up the whole body of up-time military assigned to Duke Ernst. The trade delegation had scarcely seen them since they'd been here. Kitt and Ellis weren't even in town. They had gone to Ingolstadt with Baner. Plus three "civilian advisors," one of whom, Bozarth, the UMWA man, was down in Regensburg schmoozing the city council, while the other two, Glazer and Fisher, were someplace out of sight doing something that no one had bothered to tell the trade delegation about. Probably something that no one was going to tell a trade delegation about.

"Plague?" Leopold Cavriani asked. It was the first thing that always came to mind. There had been plague in the entire Upper Palatinate since February 1632, when a passing army unit left a couple hundred infected soldiers behind; Amberg had been particularly hard-hit the previous winter.

Keith shook his head. "The local doctors say that it isn't. And, honestly, they ought to know. They can't cure plague, but they sure see enough of it to recognize it when it comes along."


****

Mary Simpson made the diagnosis first, long before Bill Hudson had finished leafing through his manuals. Through the admiral's old friendships in the Netherlands, she knew people at the World Health Organization who had worked for the international center for vaccination when the disease made its way through the former Soviet republics in the early 1990s.

Diphtheria.

The down-time physicians concurred. It was the "strangling angel of children." They had, all of them, seen it before. All too often.


****

"It's a kid's disease," Toby said, when Bill told him. "You get your DPT shots and that's that."

"They don't have DPT shots here," Bill pointed out. "And we don't have any magic bullet to cure it. Oh, yes, it's bacterial rather than viral. My little pamphlet says that it can be treated with penicillin. Or with erythromycin. Neither of which I happen to have available."

"Oh."

"Try to get through to Grantville tonight, will you, Toby? I know that reception in these hills has been driving you guys, crazy, but please try. If not tonight, then tomorrow morning. Keep trying. Get me one of the doctors. What I have is chloramphenicol, and not much of that. Ask them if it works on diphtheria. If it doesn't, there's no point in wasting what we have; I'll save it for something it does work on. If it does work, well… ask them if they can send some more. Please."

"People don't really die of it, do they?"

"According to what I have here, it was a major killer, right up through the end of the nineteenth century. There aren't going to be DPT shots for a long, long, time. I've put your tech into quarantine. Let's hope that it doesn't spread too fast. What about you. Are your shots up to date? When did you get your last DT shot?"

Toby didn't have the slightest idea. "Last time that I had to get one, I suppose. That would have been, uh, when I started high school, maybe?"

"And you're twenty-five now? So, about ten years. Well, let's hope that you still have antibodies." Bill stomped off, looking glum.

He was feeling frightened. That's about how old his shots were, too. He was just a year younger than Toby. Of all the up-timers in Amberg, only two had their immunizations up to date when the Ring of Fire hit. Keith Pilcher was one of them, because of the nature of his job He had to have tetanus shots, being a machinist, and diphtheria vaccine came with it. Mrs. Simpson was the other one, partly because she traveled so much; and partly because she was just naturally one of those super-picky people who kept everything up to date. Jake's last shot was before his and Toby's.

And there were a lot of down-timers who had never had diphtheria. Including, he found out, Mrs. Dreeson. She'd had a lot of stuff, but no diphtheria. Duke Ernst, yes; Bocler, no; Zincgref, yes; Hand, no; Brechbuhl, yes; Leopold Cavriani, no; Lambert Felser, no; Marc Cavriani, no. The "no" list went on and on. Not a virgin field, but bad enough.

Like the out-of-date immunizations, he hoped that the immunity gained from childhood exposure would last for the ones who had already had it. Diphtheria was one of those things you could get again, once the antibodies wore off. Strangling on the swollen membranes in your own throat wasn't a pretty way to die. Not that there were very many pretty ways. It hit children hardest, mainly because their windpipes were smaller, more quickly closed off by the membranes.

The pamphlet talked about complications, too. Severe heart and nervous system complications which develop after two to six weeks and can lead to collapse, paralysis, coma and death in about five percent of the cases. He guessed that real doctors found that sort of information fascinating. And stuff about possible long-term complications for people who survived. He'd worry about those later.

And how was he supposed to identify carriers? Not! At least, he could tell the down-timers that there were carriers and ask them to look for patterns. If person X's visit to a household is regularly followed by an outbreak, quarantine him, too. And tell them what the incubation period was. If he could convince them that it was contagious and that's how it was spread.

Oh, damn.

If he ever got out of the army, he was going back to Grantville. And going to work for Tom Stone. Let the other guys go to med school. He was going to make the medicines. Somebody else could deliver the doses.


****

Caspar Hell's voice was steady. "I have closed the school because of the epidemic. Too many children are quarantined, or their parents are afraid to let them come, for us even to try to hold classes."

None of the other Jesuits disputed that.

"We will offer the collegium to the city as a quarantine hospital. It is the largest suitable building. Those diagnosed can be brought here and we will nurse them. That may offer some hope, at least, that uninfected members of their families will escape exposure. Otherwise, the young medic, as they call him, tells us that whole families will die, one after another."

None of the other Jesuits disputed that, either. Most of them had seen it happen, when families, the sick and the well alike, were quarantined together in their own houses.

Duke Ernst accepted the offer of a lazarette with gratitude.

Hand crossed "espionage centered at the collegium " off his list of things to worry about for the time being.


****

Bill Hudson's hopes sank. He had kept wishing for a magic bullet. That someone could dispatch a 4x4 from Grantville with a batch of a lifesaving drug. Instead… as best the medical personnel in Grantville knew, chloramphenicol would not work on diphtheria. They didn't know just why. Diphtheria was a gram positive bacilli, which chloramphenicol was effective against as a class. In short, it did work on the class of bacteria but they couldn't find anything in their searching that specifically said that it would work on C. diphtheria -on this specific organism. It probably wouldn't hurt someone, if he tried it on them as an experiment, Doc Adams had radioed. But they didn't have any evidence that it would help.


****

Jakob Balde found it odd, having so many strangers inside the private portions of the collegium. There were usually students, of course. The few boarding students, however, had now been confined to their own quarters on the other side of the building, where the infection had not entered yet, and to the care of one of the cooks.

The Jesuits were not the only ones who volunteered to nurse. The older up-time man had been here, almost from the start. He wasn't squeamish, either. An up-time woman had volunteered to come, but Father Hell had drawn the line at having that. So she worked in the city, with the young medic, who insisted that he was not a full-fledged physician. Doing something that she called triage. The arriving patients were marked: those who, God willing, would benefit from nursing; those who, barring a miracle of God, probably would not.


****

The other men who assisted the Jesuits in caring for the sick had only one thing in common. Chosen by Duke Ernst and the up-timers, they had all had the disease before and survived it. And, of course, a second thing: they were willing to come. Duke Ernst had not forced them, other than some of his own direct subordinates and some of the city employees. A few Catholics-there were not many Catholics in Amberg any more. Several Lutherans, several Calvinists. A Jew, just a peddler passing through the city. Two Swiss men who listed no religion when they arrived, which probably meant that they deserved burning for heresy. Jakob Balde, now in charge of the hospital, had chosen not to ask them for details.

Duke Ernst had not closed off the city; which was the reason the Jew and the two Swiss were here. One could not quarantine a city for every little disease that came along. For plague, yes, but not for diphtheria. Life had to go on.

Three deaths; five deaths; nine deaths. The count went up every day.

Father Hell among them. Also Oswald Kaiser, one of the lay brothers, a cabinetmaker who had been working on finishing the interiors of some of the rooms.

Balde, in the company of the regent, continued his tour of the sickbeds. And pulled the sheet over the face of another child.


****

None of the rest of them would have believed that Keith Pilcher could stand up to Veronica Dreeson until he did it. Over his dead body, he announced, was Veronica going to be involved in the care of the sick.

"Because," he said, "you never had diphtheria and if you die on us here, everybody back home will blame it on Maxine's not liking you. They'll say that because the two of you don't agree about whether four-year-olds ought to learn conversational Latin, I didn't take care of the old woman. And I'm not going to put Max through that. You've got Henry waiting, you've got Annalise to send to school, you've got a dozen of Gretchen's kids who depend on you. So you're not going to go out and die of something on my watch. Like it or lump it."

He might not have made it stick by himself, but Mary Simpson agreed with him. As did Bill Hudson, Duke Ernst, and just about everybody else. Hand volunteered to keep an eye on her.

They couldn't precisely lock her up. She continued to investigate the situation with the Grafenwohr properties. Elias couldn't help her; he was one of those at the hospital, caring for the sick. She continued to meet occasionally with Rastetter, her lawyer. Until his family became ill and he closed his office temporarily.


****

"Hey, Toby," one of the down-time radio techs asked. "Why aren't you eating."

"I don't really feel like it, Franz. I'm getting a sore throat."


****

"Where's Lambert Felser?" Marc Cavriani asked. "I don't think that I've seen him the last couple of days. Is he taking time off because Keith is busy at the hospital?"

"I'm not sure," Eric Haakansson Hand answered. "I don't think that I've seen him around, either."

"I'd better," Marc said, "check his room."

Felser wasn't there. The chambermaid at the inn said that, the morning before, she had come to clean and found him sick. So, according to the instructions that had been given to all the innkeepers, she told Hans from the stables to take him to the quarantine hospital. Had she told anybody? Well, no. She hadn't known whom to tell. Herr Pilcher, his master, was, like the others who cared for the sick, sleeping at the hospital.


****

Balde made his rounds. More than seven hundred people were lying ill in the collegium, today. They were calling for more volunteers to care for them. For more people who had already survived the disease.

Three more of the Jesuits were among the ill.

There had been only about seventy deaths, though, so far. Most of them children.

A recurrence of the plague would have been far worse.


****

By the end of the week, the tide seemed to be turning. The patient count was under five hundred. Not, of course, all the same people who had been there the week before. The acute period of the disease did not last long; many of those still in the hospital were clearly recovering. Those who had family to care for them had already returned to their homes for convalescence.

Balde completed the day's entries in his ledger. The death toll stood at ninety-three, including one of the sick Jesuits. However, no more of the brothers had sickened. So far.

During the plague epidemic the previous year, there had been nearly five hundred deaths in Amberg. God had been very merciful this time.


****

Franz looked at his friend Toby. Then, had one of the stablemen load him into a cart and take him to the hospital.

Toby was likely to recover, though, Franz thought. He was a strong young man.

Franz, like the chambermaid at the inn, wasn't sure whom he should tell. Toby had been more or less the boss of the other radio techs. Franz wasn't really sure who Toby's boss was.

It wasn't as if he could just drop into the regent's office, even though he was living in the Schloss. Nor could he leave the radio room for a long time to go running around town looking for someone to tell. Finally, he just left a note on Bocler's desk and returned to the top floor. Someone had to watch the radio, now that Toby was no longer there to do it.

He looked at the familiar, comforting, scene with its blue Leyden jars. Tiptoeing across the room so as not to jar them, he lay down on his cot.


****

Keith Pilcher was the first of the up-timers to learn that Toby was in the hospital, when he came to bathe him. Of the radio techs who had come with them from Grantville, this left how many on duty? Keith racked his brain. One of the down-timers, the first one who had become ill, was dead. Three more had been here and recovered enough to be sent over to the convalescent ward, because there wasn't anyone to take care of them at the Schloss. Now Toby. That left one more. What was his name? Oh, yes. Franz. He ought to remind somebody that they were down to one functional radio tech.


****

Bill Hudson climbed up to the top floor of the Schloss and started to cuss a blue streak. It was one thing to say that the geeks were married to their work, but that didn't mean that all six of them had needed to have their cots crowded into one little room next to the array of Leyden jars. Not eight inches between them; they must have walked sideways to get into bed. Plus they worked together and ate together. No wonder they had infected one another.

He asked Franz whether he had diphtheria before. Franz went on the "no" list.


****

Two days later, Bill ordered Franz to the hospital. Until one of the recovering techs was well enough to come back to work, Amberg would be on a radio blackout. No one else had the vaguest idea how to work the thing.

He notified Jake Ebeling. And Duke Ernst.

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