Originally published in 1976 in the anthology Stellar Science Fiction Stories 2, which was edited by Judy-Lynn del Rey, this is one of only two published stories in which Clifford Simak worked with a coauthor. This time, his coauthor was his son, a chemist who at one time worked for the U.S. government. The title of the story is, of course, a reference to Silent Spring, Rachel Carson’s well-known book that controversially warned about environmental pollution and disinformation campaigns allegedly spread by certain industries, and ultimately led to the banning of the pesticide known as DDT (although Carson never actually called for that action), and the creation of the U.S. Environmental Protection Agency.
Robert Abbott was a well-known man, so Dr. Arthur Benton had saved two hours for him in the middle of an afternoon of an ordinarily busy day. When Abbott had phoned ten days before, he had insisted that his visit was important.
Benton, watching the clock as the hour approached and trying to hurry Abby Clawson, who regarded a visit to a doctor’s office as a social occasion, wondered once again what could be so important as to bring Abbott to this little Pennsylvania town. Abbott was a medical writer with two best sellers to his credit, one a book on cancer and the other an expose of faddy dieting. The doctors he consulted were important people, eminent medical researchers or lofty specialists; and Benton knew, with a twinge of honest envy, he was neither eminent nor lofty. He was just an old fuddy-duddy country doctor—a pusher of pills, a dispenser of liniments and salves, a setter of broken legs and arms, a wrapper-on of bandages, a deliverer of babies—who never had written a learned paper, conducted a research program, or been involved in medical studies, and who never would. He had not, in more than thirty years, done a single thing or uttered a single word that could be of the slightest interest to a man like Robert Abbott.
He had been wondering ever since the phone call why in the world Abbott should want to talk with him; and over the past few days he had evolved an elaborate theory that there were two Dr. Arthur Bentons and Abbott had confused him with the other Benton. He had been so haunted by the idea that he had looked through a medical directory in search of the other Arthur Benton. Although he had not found him, the idea still clung to his mind, for it seemed the only explanation.
He found himself glad that the hour of Abbott’s visit had arrived, for once he knew what it was all about—if indeed Abbott really wanted him—he could quit his worrying and get down to business. The worry and the wonderment, he knew, had interfered with business—like that matter of Ted Brown’s symptoms that had shouted diabetes but had turned out finally not to be diabetes. That had been damned embarrassing, even though Ted, an old and valued friend, had been nice about it. Nice, perhaps, because he was so relieved he was not diabetic.
That was the trouble, he told himself, sitting behind his desk and listening with only half an ear to Abby’s departing chatter: all his patients were old and valued friends. He could no longer be objective; he bled for all of them. They came in, sick to death, and looked at him with trusting eyes because they knew in their secret hearts that good old Doc could help them. And when he couldn’t help them, when there was no one on God’s green earth who could help them, they died, forgiving him with the trust still in their eyes. That was the hell of family practice, that was the torture of being a country doctor in a little town—holding the trust of people who had no reason to trust you.
“I’ll be coming in again,” Abby said. “I been coming here for years and you always help me. I tell all my friends that I am lucky in my doctor.”
“That’s kind of you to say.”
If they were all like Abby, it wouldn’t be so bad. For with her, there was nothing wrong at all. She was a tough old woman who would outlive them all. The only thing wrong with her was a tendency to secrete an enormous amount of ear wax which required occasional irrigation. But the evident fact of sound, good health did not in the least deter the imaginary ills which brought her regularly to the office.
Rising to open the door for her, Benton wondered what she got from her regular visits, and thought he knew: fuel for conversation with her friends at the bridge table or with her neighbors across the backyard fence.
“Now you take care of yourself,” he told her, putting into his voice a medical concern for which there was no need.
“I always do,” she chirped in her bird-like old woman’s voice. “If there’s anything wrong, I’ll come straight to you.”
“Doctor,” said Nurse Amy, hastening to guide Abby out, “Mr. Abbott has been waiting for you.”
“Please send him in,” said Benton.
Abbott was younger than Benton had expected him to be and not half as handsome. He was, in fact, a rather ugly-looking man—which explained, Benton thought, why the dust jackets of his books had not flaunted his photograph.
“I’ve looked forward to meeting you,” Benton said, “and I don’t mind telling you I’ve done some wondering at what brought you here. Surely there are other men.”
“Very few,” said Abbott, “like Dr. Arthur Benton. Surely you are aware that you are one of a dying breed. Not many medical men today are willing to devote their lives to a small community such as this.”
“I’ve not regretted it,” Benton replied. “The folks are good to me.”
He waved Abbott to a chair and pulled another for himself from against the wall, not going back behind his desk.
“When I phoned you,” Abbott said, “I couldn’t very well explain. This is something that calls for face-to-face talk. Over the phone what I have to say would have made no sense at all. And I’m anxious that you understand what I am getting at because I’ll be seeking your cooperation.”
“Certainly. If I can help, I will.”
“I came here for several reasons,” Abbott explained. “You’re in family practice and must work with a broad spectrum of the population. You must deal with a variety of illnesses and disabilities, unlike the specialist, who sees only certain cases and usually only those patients who can afford his fees. One other matter—at one time you were in epidemiology. And then there is a matter of geography, as well.”
Benton smiled. “You have done a good workup on me. For several years, early on, I was an epidemiologist with the National Health people. But I came to realize the field was all too theoretical for me. I wanted to work with individuals.”
“You came to the right place to do it,” said Abbott.
“What’s this business about geography?” Benton asked. “What’s geography got to do with it?”
“I’m trying to track down an epidemic,” Abbott said. “There may be a lot of factors involved.”
“You can’t be serious. There’s no epidemic here or anywhere else I know of. Not even in India or the underdeveloped countries. Hunger, of course, but …”
“I’m fresh from months of burrowing through statistics,” said Abbott, “and I can assure you there is an epidemic. A hidden epidemic. You’ve seen it yourself. I am sure you have. But it’s been coming on so gradually and so undramatically that it has made no impression on you. A lot of little things that slipped by unnoticed. More people gaining weight—in some cases, very rapidly. That, by the way, may explain some of the faddish diets that are popping up. Wide variance in blood sugar levels—”
“Wait a minute,” said Benton. “I had a patient just last week, and would have sworn he had diabetes.”
Abbott nodded. “That’s part of what I’m talking about. If you go back in your records, you’ll probably find similar instances, perhaps not so dramatic as to suggest diabetes. But you’ll find minor symptoms. I can tell you what else you’ll find: More people feeling groggy, irritable, looking bleary-eyed. An increase in obesity. A lot of complaints about sore and aching muscles. People not feeling well—nothing specifically wrong with them, nothing you can put your finger on, but just not feeling well. A lot of people with no pep, a general tiredness, a loss of interest. Fifty years ago, you would have been prescribing tonic or sulfur and molasses to clear up the blood—thinning out the blood, I believe, was how they put it.”
“Well, I don’t know … the symptoms somehow sound familiar. But an epidemic?”
“If you’d seen the statistics I have seen,” Abbott said, “you’d agree it’s an epidemic. It’s happening all over the country, perhaps all over the world.”
“Okay, granting you are right—which I don’t—why did you come here? You said you wanted my cooperation. How could I possibly help?”
“By keeping your eyes open. By thinking about what I’ve just told you. You’re not the only one I’m seeing. I am talking to a number of other doctors, most of them in family practice. I will be asking them to do the same thing as I am asking you—observe, think about it, perhaps pick up a clue here and there.”
“But why us? There are specialists.”
“Look, Doctor,” said Abbott, “how many people go to a specialist because they’re feeling all beat out or have aching muscles or for most of the other things we have been talking about?”
“Not many, I would suppose.”
“That’s right. But they come running to good old Doc, bellyaching because they aren’t up to par, figuring he’ll pull a miracle out of his hat and fix them up.”
“How about the disease-prevention people in Atlanta?” Benton asked.
“That’s where I got some of my statistics,” Abbott told him. “Some of the people there agree with me that there may be an epidemic, although I don’t think any of them take it too seriously. Most of them think I’m trying to cook up another sensational book. Not that any of my books were sensational, but there are some doctors who think they are. The trouble with Atlanta is that they deal solely with data. What this job takes is field work. I need people like you, aware of the situation, looking at their patients and asking themselves questions, trying to see patterns. Not spending a lot of time at it, of course, for none of you will have the time, but keeping the problem there in the back of the mind. What I should like some months from now, if you are willing, are your impressions. Maybe then, with some input from a number of family doctors who see a lot of people representing a broad socio-economic range, it will be possible to pull together some sort of general picture of what is happening.”
“I am afraid,” said Benton, “that you contacted me because of my work in epidemiology. It is only fair to tell you I’ve forgotten most of what I ever knew in that particular field.”
“Well, if it doesn’t help, it certainly won’t hurt. I might have come here anyhow. You may remember I said something about geography. Geography often is an epidemiological factor. Here you are located in a broad, fertile valley, while on either side of the valley lie rugged hills, an almost primitive area. I would assume that you have patients among both hill and valley people.”
“That is true,” Benton answered. “I guess most of the hill people figure I’m their doctor, although I don’t see them often. Either they don’t get sick as often as the valley people, or when they do they manage to tough it out. Some of them may have an ingrained reluctance to submit to doctoring. A lot of them, I suspect, use folk medicine, old-time recipes handed down through the years. That is not to say there is anything wrong with that. Much as we may hate to admit it, some of those old cures work.”
“Geography may have nothing to do with it,” said Abbott, “but it’s a factor we can’t cancel out until we’ve had a look at it.”
“And there’s a possibility you are wrong. There may be nothing to look for.”
Abbott shook his head. “I don’t think so. Doctor, you will go along with me? You’ll walk that extra mile?”
“Yes, of course,” said Benton. “I’ll keep it all in mind. I’ll be seeing you again, you said, or hearing from you, a few months from now.”
“I can’t tell you exactly when. I have a lot of ground to cover. But I promise I’ll be in touch again.”
They talked a while longer, then Abbott left.
Benton followed him out to his car, thinking as he walked along with him that it had been a long time since he had met a man he liked so instinctively. Here was a man whose name in the last few years had become a household word and, yet, there was about him none of the self-importance that so many eminent men wore as a cloak wrapped about themselves. He found himself looking forward to that day, some months from now, when they would be in touch again. Here was a sincere man you did not brush off automatically, even if his ideas seemed a bit offbeat. Thinking of it, Benton had to admit that Abbott’s idea did seem a bit offbeat.
His first patient after Abbott left was Helen Anderson.
Helen and Herb Anderson were old family friends, had been for many years. Herb owned a men’s ready-to-wear store; he was one of the community’s most successful businessmen. Helen was president of the Flower and Garden Club and, for years, her roses had been blue ribbon winners at the State Fair.
She showed him her right hand. The skin across the knuckles was rough and red. When he rubbed his thumb over it, it felt dry and scaly.
“Looks like eczema,” he said. “We’ll try some ointment on it.”
“I worked in the garden after I noticed it,” she said. “I don’t suppose that did it any good.”
“Probably no harm, either. How’s the garden doing?”
“Couldn’t be better. You should see my peas, and I am trying a new kind of tomato. You and Harriet drop over some evening and have a look at it. It’s been a long time since the four of us have gotten together.”
“That’s part of being a doctor,” Benton said. “You think you have an evening and then something happens. You never can be sure.”
“You work too hard.”
“All of us do,” he told her. “We get involved. What we do assumes a great importance. Your garden, for example.”
She said, seriously, “My garden goes me a lot of good. As you know, I’m not a fancy gardener. I’m a dirt gardener. I don’t wear gloves. I get down in there with my hands. I like the feel of soil. It’s so warm and it has such a nice texture. It has the feel of life to it. It plays hell with my hands, of course; but there’s something so elemental in it that I can’t resist. Herb, of course, thinks that I’m crazy.”
Benton chuckled. “Herb’s no gardener.”
“He pokes gentle fun at me. He’s a golfer at heart. But I don’t make fun of his golf. I don’t think it’s fair.”
“How’s his golf this year? I remember he was bragging last year that he had improved.”
Helen Anderson frowned. “He isn’t playing as much this year. Not as much as he used to.”
“Maybe he’s busy. This is a bad year for business. Inflation and tight money and—”
“No, it isn’t that,” she said. “Doc, I’m worried about Herb. He seems to be tired all the time. He has to be really tired not to play golf. Does a lot of eating between meals. He’s gaining weight. Grumpy, too. Some days he’s so grumpy I’m glad to see him go to work. I’ve told him to come and see you.”
“I wouldn’t worry about him,” said Benton. “Maybe he’s working too hard. Why don’t you try to get him to take a couple of weeks off and the two of you go on vacation? A rest would do him good.”
“It’s more than just tiredness,” she continued. “I am sure of that. He’s tired, of course, but there’s something more than that. Doc, won’t you talk with him?”
“I can’t go out soliciting business. You know that.”
“But as a friend …”
“I can tell him you’re worried about him. I can lean on him a little.”
“If you would,” she suggested.
“Sure I will,” said Benton. “But don’t you go worrying yourself sick. It’s probably nothing.”
He wrote her a prescription and she left, extracting a promise he’d drop by soon to have a look at the garden.
The next patient was Ezra Pike. Ezra was a farmer south of town, seventy years old, still working his farm with only occasional help.
He had hand trouble, too. He had a nasty gash across the knuckles.
“The baler broke down,” he explained, “and I was fixing it. The wrench slipped.”
“We’ll get that hand cleaned up,” Benton said. “In a day or two it’ll be like new. Don’t see you often, Ezra. You or Mrs. Pike. I’d starve to death if everyone was like the two of you.”
“Never did get sick much. Neither one of us. The boys, neither. We are a healthy family.”
“How are the boys these days? I haven’t seen them for ages.”
“Dave, he’s down in Pittsburgh. Working in a bank. Investments. Ernie is a teacher over in Ohio. School’s out now, and he’s running a boy’s camp up in Michigan. We’re real proud of our boys, both of them.”
“How are the crops?” Benton asked.
“Good enough,” said Pike. “Some trouble with bugs. Never used to have that kind of trouble, but it’s different now. No DDT, you know. They up and banned the stuff. Was poisoning everything, they said. Maybe so, but it made farming easier.”
Benton finished with the bandaging. “There, that’s it,” he said. “Keep watch of that hand. If it hurts a lot or gets red and puffy, come in to see me.”
Pike got spryly from the chair. “Got a good crop of pheasants waiting for you. Soon as the season opens, we’ll be looking for you.”
“I’ll be out,” said Benton. “Always have, you know. It’s been a long time, Ezra, I’ve been hunting on your land.”
“You’re welcome any time,” Pike said. “But there ain’t no need to tell you. I take it that you know.”
Nurse Amy appeared as soon as Pike had left. “Mrs. Lewis is here,” she said. “She has Danny with her. Someone bounced a rock off him. She is frothing mad.”
Danny, who by all odds could be classified as the meanest kid in town, had a goose egg on his head. The rock had broken the skin and there was some blood, but an X-ray showed no fracture.
“Just wait,” his mother raged, “until I get my hands on the kid who threw that rock. Here Danny was doing nothing, just walking down the street …”
She went on and on, but Benton got her quieted down and the two of them finally left.
After that came Mary Hansen, with her arthritis; Ben Lindsay, in for a post-coronary check; Betty Davidson, with a sore throat; Joe Adams, with a lame back; Jenny Duncan, who was going to have twins and was twittery about it.
The last patient of the day was Burt Curtis, an insurance man.
“Goddamn it, Doc,” he said, “I feel all beat out. Sure, a man expects to be tired after a long day’s work, but I get tired in the middle of the morning. By ten o’clock, I am all pooped out.”
“It’s sitting at that desk,” said Benton, kidding him, “lifting all those heavy pencils.”
“I know, I know. You don’t have to rub it in. I’ve never done an honest day’s work in all my life. Selling insurance isn’t something you can classify as labor. The funny thing is that I feel as if I were building roads. Muscles get sore and achy.”
“Hungry, too?” Benton asked.
“Funny you should say that. I’m hungry all the time. Keep stuffing my gut. A lot of snacking. Never used to do that. Three squares were all I needed.”
“Even-tempered, I suppose.”
“What the hell, Doc! I come in to tell you I get tired and you ask about my temper.”
“Well, are you? Even-tempered, I mean.”
“Hell, no. I’m all out of sorts. No patience. Let one little thing go wrong and I start storming. No way for a businessman to act. Keep on like that, and you get a reputation. Adele says I get harder to live with every day.”
“How about your weight?”
“Seems to me I’m getting heavier.” Curtis patted his gut. “Had to let out my belt one notch.”
“We’ll get you on the scales and see,” said Benton. “I’ll tell you what I’d like to do: run some tests. Nothing fancy or expensive. We could do them here.”
“You got something in mind, Doc? Something wrong with me. Something really wrong.”
Benton shook his head. “Nothing at all. But I can’t even make a guess until I see some tests. Blood sugar. Things like that.”
“If you say so, Doc,” said Curtis.
“Don’t worry about it, Burt. But when a man comes in and says he’s all tired out and gaining weight and getting downright mean, I have to look into it. That’s my job. That’s how I make my living and keep my patients well.”
“Nothing serious, then?”
“Probably nothing much. Just some little thing that once we know about it, we can get it straightened out. Now, about those tests. When can you come in?”
“Tuesday be all right? Monday I’ll be busy.”
“Tuesday is just fine,” Benton said. “Now get over on those scales.”
When Burt had gone, Benton walked out into the empty waiting room. “I guess that’s it for the day,” he said to Amy. “Why don’t you go home?”
Back in his office, he sat down at his desk and began filling in Burt Curtis’ record. Tiredness, intermittent and persistent hunger, gaining weight, sore muscles, irritability—all the symptoms Abbott had talked about that very afternoon. And then there was Herb Anderson as well. From what Helen had said, his condition seemed much the same as Burt’s. Both of them and Ted Brown, too.
What the hell, he wondered, could be going on? Abbott had said “epidemic.” But did three people in one little town add up to an epidemic? He knew, however, that once he had gone through his records, he would probably find others.
The office was quiet. Amy had left and he was quite alone.
From some distance off came the wild and frantic snarling of a racing motorcycle. Young Taylor, more than likely, he thought. Someday the damn fool kid would break his neck. Twice he’s needed patching up, and if he kept on there’d likely come a day when patching up would be superfluous—although, Benton told himself, that was no concern of his, or should be no concern of his. But the terrible thing about it was that he found himself concerned.
He was, he realized, concerned with everyone, too concerned with everyone in this silly little town. By what mysterious process, he wondered, did a man through the years manage to take an entire town to heart, shift its burdens to his back? Did the same thing happen to other aging doctors in other little towns?
He pushed Burt’s record to one side and laid the pen beside it.
He gazed about the room, shifting his glance from one object to another as if he were seeing them for the first time and trying to fix them in his memory. They had been there all the time, but for the first time he was noticing them, becoming acquainted with this environment in which he had lived and functioned through the years. Too busy, he thought, too busy and concerned to have ever looked at them before. The framed diploma, hung proudly on the wall so many years ago and now becoming fly-specked; the fading and worn carpeting (some day, by God, when he found the money, he’d have new carpeting put in!); the battered scales shoved against the wall; the sink and basin; the cabinet where he kept all the samples sent out by pharmaceutical houses to be given patients (and there were many of them) who could not afford prescription drugs. Not the kind of office, he thought, that a big-city doctor would have, but the kind he had—a combination of office, examination room, treatment room—the hallmark of the family doctor always strapped for funds, hesitant to send out bills that would embarrass patients he knew were short of cash, trying to treat people who should go to specialists but who could not afford their fees.
He was getting old, he told himself—not too old yet, but getting there. There were lines upon his face and gray showing in his hair. There would come a time, perhaps, when he would have to take in a younger doctor who, hopefully, could carry on the practice when he would have to retire. But he shrank from doing so. He was jealous, he knew, of his position as the town’s one doctor, even though he knew it was most unlikely the town would accept anyone that he brought in. Not for a long, long time would they accept anyone but him. Patients would refuse to see the new man, waiting for Old Doc. It would take years before he could shift any appreciable percentage of his patient load.
Over in Spring Valley, Dr. Herman Smith had a son who was in internship and who soon would join his father. Slowly, over the years, young Doc Smith would phase out old Doc Smith, father followed by the son, and there would be no hassle. Oh, some hassle, surely, but none that would be noticed. That, Benton told himself, was the ideal method of succession. But he and Harriet had never had a son—only the one daughter. He had hoped, for a time, he recalled, that April might want to be a doctor. But that would have posed problems, too, for it would be unlikely the town would accept a woman doctor. The problem, however, had never arisen, for April, it turned out, had been big on music and there was no stopping her. Not that he had ever wanted to. If music was what she wanted, then it would be music. She was in Vienna now. Christ, these kids! he thought. The world belongs to them. Off to London, Paris, Vienna, and God knows where else, with no thought that it was extraordinary. In his youth, he recalled, it had been a big adventure to get a hundred miles from home. And, come to think of it, even now he seldom got more than a hundred miles from town. He stuck close to his work.
I’m provincial, he thought, and what was wrong with that? A man could not encompass the world. If he tried, he would lose too much. Friends and familiarity of place, the warm sense of belonging … Since he had come to this town, many things had happened to him—good things—with quaint little privileges established. Like old Ezra Pike and his annual crop of pheasants reserved for good old Doc and a few others in the town, and for no one else.
He sat in the office and tried to peel the years away, back to the time when he had first come here; but the years refused to peel and the diploma still was fly-specked and the scales still battered and he remained an aging man who carried the town upon his back.
The phone rang and he picked it up. It was Harriet.
“When are you coming home?” she asked. “I have a leg of lamb and it will be ruined if you don’t get here fairly soon.”
“Right away,” he said.
The next day was Saturday and office hours were from eight till noon. But, as was usually the case, the last patient was not gone until after one.
Once the waiting room was cleared and Amy had gone home, Benton got to work on the files. He went through them carefully, making notes as he went along. He didn’t finish the work on Saturday, and came back Sunday morning.
Going back through ten years of records, he was able to isolate some trends. There had been, in those years, a substantial increase in the symptoms Abbott had outlined. The incidence of obesity had risen rapidly. In more instances that he had recalled, the high level of blood sugar had indicated diabetes, but further tests had inevitably failed to bear out his tentative diagnoses. There had been, increasingly, a spate of muscular soreness. There were an increasing number of patients who had complained of general malaise, with no apparent cause.
Most of the symptoms were found in townspeople. Among the farm families, only the members of one family, the Barrs, had experienced the symptoms. The Barrs, about three years before, had come from somewhere in Ohio, buying the farm of Abner Young, a recluse who finally had died of old age and general meanness. And not a single case with those symptoms showed up among the hill people.
Maybe, after all, Benton told himself, geography might be a factor in Abbott’s epidemic—if there were an epidemic. But if some of the townspeople had the symptoms, why not all of them? If farmers were immune, as seemed to be the case, what about the Barrs? What was different about the Barrs? Recently arrived, of course, but what could that have to do with it? And what was so magic about the hills that in all the hill folk no symptom had turned up? Although, he reminded himself, he should not assign too much weight to the negative data from the hills. The people there, a hardy tribe, would not deign to visit a doctor for such minor reasons as being unaccountably tired or putting on some weight.
He pulled the sheets of notes together and, searching in his desk drawers, found some graph paper. The graphs, when he had them drawn, showed nothing more than he already knew; but they had a pretty look to them and he found himself imagining how they would look printed on the slick paper of a prestigious journal, illustrating a paper that might be entitled “The Epidemiology of Muscular Exhaustion” or “The Geographical Distribution of Obesity.”
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.
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.
Benton had no need to take his own graphs out of the desk; he knew them now by heart. Staring at Smith’s graphs laid out on the desk top, he knew immediately they were almost identical with his own.
He sat down weakly in his chair, grasping the arms so tightly that his fingers ached.
“I was right,” he told himself. “God help us, I was right!”
When bird season opened, Benton drove out to the Ezra Pike farm for an afternoon of pheasant shooting, jotting down a mental note that before the day was over he would ask about the Barrs, who were Pike’s next-door neighbors. But he never got around to it.
Pike had a lot to show him: the pen of shoats that were becoming sleek and plump for the late-fall market; the high-quality wheat from the little patch he had grown as a hobby and which he was intending to take in to Millville to an old-time water mill to be ground into flour by a genial, half-mad hermit who was unconvinced that he lived in the twentieth century; the ritual sampling of some cider Pike had run off, using the fruit from an ancient, withered tree, the only one remaining in the country that bore the famed snow apples of another day. There was politics to talk about and the rising prices of food; the gasoline-wasting propensities of the anti-pollution equipment which had been installed on cars; the latest, rather mild scandal of the neighborhood, involving a boy barely out of his teens and a widow who was old enough to be the lad’s grandmother. They shot some pheasants, ate fresh apple pie—washing it down with milk—and talked of many things, the time passing pleasantly.
It was not until he was halfway home that Benton remembered he had not asked about the Barrs.
The following Saturday he skipped his morning office hours, loaded his gun into the car trunk, and took off for the hills, ostensibly to shoot quail. He made the quail trip several times each autumn, but when he thought about it he realized that it was not the quail he was looking for now, but the time that he could spend with the hill people.
If one had asked them what they were, they would have said that they were farmers; but precious few of them did any actual farming. Their acreages mostly stood on end, with only here and there a creek bottom or a hillside bench that was level enough for a plow to turn the soil. They planted some corn to fatten up the scrawny hogs that mostly ranged the woods for acorns, a field of potatoes at times larger than the corn patch, and a slightly smaller garden. They might at times plant other crops as well, but mostly it was corn, potatoes, and the plants in the garden. The women canned a lot of vegetables, for there was no electricity to freeze them, and even if there had been, few of the hill people could have scraped together the money for a freezer. There were strawberry beds for eating and for canning as well as wild fruits such as blackberries and raspberries. By the end of autumn, the cellars of the hill farm homes were well stocked with canned vegetables and fruits, with potatoes and “winter keeper” apples from the scraggly trees of their haphazard orchards.
As he drove, Benton fell to wondering, as he had many times before, just how the hill folk managed to live from year to year. Each family ordinarily had a cow or two, as well as a few hogs and a bedraggled flock of chickens. Most of the hogs were butchered for meat rather than sold on market, and many of the farms had smokehouses out in back in which hams and bacon were cured. Game such as rabbits, squirrels, coons, and an occasional deer—usually taken in a fine disregard of game laws—helped round out their diet. Fish from the many streams, as well as ruffed grouse and quail, were often on the table. Somehow or other they managed to eat rather well all the year round.
But they had little money. They were largely self-sufficient and they had to be, raising and gathering most of their food. They bought little at the grocery store: flour, sugar, coffee, salt … Living that way, Benton told himself, they didn’t need much money. What little they had they earned at odd jobs here and there. A few of them worked at small industrial plants in the valley, but not very many of them. He suspected that few had any taste for such work. Occasionally some of them peddled firewood to the townspeople.
But, despite all the hardships which they probably did not regard as such, they were a relatively happy, reliable, proud, and independent people, filled with dignity and inborn courtesy.
Benton had a good day, dropping in at the homes of several families that he knew. He did a little hunting, but not a great deal, getting, in all, three quail. But he did a lot of talking, sitting on the steps of the sagging verandahs of houses so old that moss grew upon the clapboard and the brick—houses there so long that they were accepted even by the environment in which they sat as a part of that environment—or as he roosted on a split-rail fence that might have been erected a hundred years before or stood in the coolness of a springhouse after he had drunk a dipper full of ice-cold buttermilk.
They talked of many things, he and these scarecrow men with carefully sewn patches on their pants, their hair grown long not because long hair was in style but because no one in the family had as yet gotten around to cutting it. They talked of the weather, which bore heavily on their minds and was worthy of lengthy conversation; of someone having seen a panther, although wildlife biologists were agreed there had been no panthers in these hills for almost forty years; of times long gone and tales told by forebears now only dimly remembered.
In the course of these conversations Benton always got around to mentioning the exhaustion syndrome—although he did not use that term—explaining how patients for no apparent reason were gaining weight, were feeling all tired out in the middle of the morning, and had a seemingly never-satisfied longing for sweets. He didn’t know what caused it, he told them; and he was somewhat upset about it and was wondering if there might be any such condition in the neighborhood.
They looked at him with ill-concealed laughter in their eyes and said, no, unless that was what might be wrong with Grandpa Wilson or Gabby Whiteside or any one of another dozen people. They regaled him with stories of fabulously lazy men who, all their lives, had worked much harder to avoid work than the work would have been itself. But their tales all had the ring of folklore to them, so Benton accepted them as such. Most of the shiftless men who peopled the stories, he realized, did not exist and never had existed.
He came home convinced that no signs of Abbott’s epidemic existed in the hills.
It could be body chemistry, he told himself—something in the hills, the way of life, the things they ate, the conveniences they could not afford—that made all the difference. Although maybe, he admitted, he had that turned around; not something that kept the syndrome from the hills, but something that afflicted the townspeople with the syndrome.
Nonetheless, Benton thought, this business of body chemistry might be the best bet yet. Figure what the townspeople had or did not have, did or did not do, and the answer might be there. But, he warned himself, the elusive factor that he sought must be unique to town life.
That evening he went to the office, pleading paperwork, and wrestled with himself. Sitting at the desk, doing nothing except sitting at the desk, with a single gooseneck lamp making a splash of light upon the desk top, he tried to think it through.
He had tried to forget all the silly business, but he could not forget it. Perhaps he was unable to forget it because it was not a silly business, because he knew all the time, deep down within that hidden core of medical awareness, that it was a greater threat than he had allowed himself to believe—and knew as well that if he were to keep faith with his community he must not go on ignoring it, or attempting to ignore it. Although, he asked himself, how, for my own peace of mind, can I do other than ignore it? I do not have the training … He was not a research man. For too long he had been a plodding country doctor, exerting all his energy and knowledge to fight disease and death in this tiny corner of the land. He had no tools for research; he did not have the brain for research; he did not have the time—and, he thought, he might as well admit it, he did not have the devoted objectivity and the narrowness of purpose to do a research job.
But, ill-equipped as he might be, he owed it to the town to have a go at it at least. That was the hell of it—he owed it to the town! All his life he had owed everything he was and ever hoped to be to the people of this little town in payment for the trust that they had in him. He had placed them in his debt, but they had placed him in even greater debt. Just walking in and talking with him cured half of what was wrong with them, and how did a man respond to a faith like that? They thought he had all the answers, so he could not tell them how few answers he did have. Their faith in his infallibility often was the one last resort they had going for them. They put their faith and trust in him, and in doing that they made him feel guilty when he was forced, through inadequacy, to betray that faith and trust. How, he wondered, was a man trapped? How had he allowed himself to be trapped into such a situation?
He dug into the desk drawer and brought out his notes and those of Dr. Smith. Carefully, he went through them, hoping that further study might give him a clue. But there seemed none.
Hormones? he wondered. Some sort of hormonal imbalance? If that were true, however, there would have to be something to have brought about such an imbalance. This was not the first time he had thought of hormones, for an imbalance of insulin would explain the diabetic symptoms; but the hell of it, he reminded himself, was that it had not been diabetes. Glucogen, perhaps? But the trouble there was that no one knew for certain what glucogen really did, although it was suspected that by elevating the glucose blood level it might kill appetite. The hypothalamus? he asked himself. Or the steroid hormones? No, it could be none of these.
Personality disturbances? Fine as far as obesity and irritability might be concerned, but certainly not for any of the other symptoms. And, anyhow, personality disturbances were slimy things to work with and psychiatric training was required to cope with them.
Enzymes? Vitamins? Trace elements?
He was going at it wrong, Benton told himself. He was going at it backward. The way to work out the syndrome was to find a common factor that might be the cause and then try to cipher out what effect the factor had. Although, still thinking of it backward, the enzymes might hold more promise than any of the others. Enzymes basically were catalysts that sped up biochemical reactions. Not that biochemical reactions could not occur without the enzymatic catalytic action, but the reactions would be so slow that the body could not function.
He sat quietly and ran through his mind what he could recall about enzymes. He was surprised to find that after all the years he had scarcely thought of enzymes, he could remember so much about them. The reason that he could recall so much was that instead of thinking directly about enzymes he found himself recalling Professor Walter Cox—old Stony Cox, eccentric and beloved in a rather ragged way—who had paced up and down when he lectured, bobbing like a ball, his head hunched forward between skinny lifted shoulders, punching the air with one clenched fist to emphasize his words. He wondered where Stony Cox might be this night. More than likely dead, he thought, for that had been more than thirty years ago and he had been an old man then.
Thirty years and all, the words came clearly to mind. “The enzymes,” Cox had said, jabbing wildly at the air, “are made up of apoenzymes and coenzymes, the two forming a loose bond to make up an enzyme. The coenzyme normally is a vitamin plus another organic molecule, bonded together. And now, gentlemen, today I ask that you focus your attention on a single coenzyme, the coenzyme A, which is directly involved in two biochemical cycles, the fatty-acid cycle and the citric-acid cycle …”
Benton sat limp in his chair, shaken by what his mind had conjured up, dredging out of a past that measured more than thirty years an instant of almost complete recall—not of the man alone but of the words he had spoken, the slanted shine of sunlight through the slatted blinds, the smell of chalk dust in the air—hearing the words perhaps more distinctly than he had heard them at the time.
Was it a sign? he wondered. Had his subconscious mind reached back and laid a bony finger on this isolated incident to tell him what his conscious reasoning could not tell him?
The phone rang and it was not until the third ring that he realized what it was. Almost as if in a dream, he reached out for it.
“Hello,” he said. “Dr. Benton here.”
“Are you all right?” Harriet asked.
“Sure, I am all right.”
“Do you know what time it is?”
“No. No, I hadn’t noticed.”
“It’s two o’clock,” Harriet said. “I became concerned about you.”
“I’m sorry, dear,” he said. “I’ll be right home.”
Late in the fall, Ezra Pike stopped by the office, not because he was sick, but because he had butchered one of his hogs and was bringing Benton a sack of sausages, Mrs. Pike being known throughout the valley as an expert sausage maker. Regularly, each fall at butchering time, Pike came by with a sack of sausages for old Doc.
It was one of the regional eccentricities that Benton had finally become accustomed to, although it had taken him a while. Over the course of any year, a lot of people would come by with something for old Doc—a bag of black walnuts, a basket of tomatoes, a clutch of fancy baking potatoes, a comb of honey fresh from the hive—free-will offerings that Benton had learned to accept with considerable grace.
Although patients were waiting, Benton had Pike step into his office and settled down for a chat with him. Toward the end of their talk he asked the question he had wanted to ask.
“What do you know about the Barr family?”
“You mean the ones that bought Abner Young’s place?”
“Those are the ones,” said Benton.
“Not really much,” Pike answered. “They come from Ohio, I think. Were farmers there. Don’t know why they moved here. I know Barr pretty well and have talked with him, but he never told me and I never asked. Maybe because they got Abner’s place dirt cheap. When Abner died, the farm went to some shirttail relatives out in California—nephews, I gather. They didn’t want to be bothered with it. They never came for the funeral or to settle the estate. They told Abner’s lawyer to sell it for what he could get as soon as he could, and he offered it cheap.”
“So that was the way of it. I never really got to know Abner. He was in a couple of times. A crusty old customer. Once he had a foot infection. Stepped on a nail, the way I remember it. The other time he was on the verge of pneumonia. I tried to get him to let me send him to a hospital, but he wouldn’t do it. Wound up that I gave him some drugs and he went home and managed to live through it. Didn’t see him after that, didn’t really hear much about him until I heard he died. Found dead by one of the neighbors, wasn’t he? Probably he got sick and figured he wanted no more to do with me. Afraid I might send him to a hospital. Likely neither myself nor a hospital could have helped him much. He was one of those characters who fought a doctor tooth and nail.”
Pike chuckled, remembering his neighbor. “I know people said he was a mean man, and in some ways I suppose he was. Ran people off his place with a shotgun. The pheasants were knee-deep in his fields and he would allow no hunting. Wouldn’t even shoot them himself. Never had much to do with his neighbors. Kept to himself. He’d gone sour on humanity. But he loved other things. He let his fence rows grow up to brush so that rabbits and woodchucks and birds would have a place to live. He always fed the birds in winter, and if English sparrows or blue jays came to feed he never tried to drive them off, or was put out about it the way a lot of people are. Said they got hungry, too.”
“You sound as if you knew him fairly well, Ezra.”
“Oh,” said Pike, “we had our differences. He was a hard man to get along with. Unreasonable and had a bad temper. Had some funny ideas, too. He was an organic farmer. Never put a pound of commercial fertilizer on his land, refused to use pesticides. Said they were poison. Long before that lady wrote her book about a ‘silent spring,’ he said that they were poison.”
Benton sat straight up. “You mean he never used any pesticides? No DDT at all?”
“That’s what I mean,” said Pike. “And the funny thing about it was that he grew as good a crop as any of the rest of us—that is, as long as he grew any crops. As he grew older, he farmed less and less. A good part of his land was idle. But what little he farmed, he farmed well. Abner was a first-class farmer.”
Pike stayed a while longer and they talked of other things, but Benton scarcely heard him. His mind was buzzing with what Pike had said about Abner Young never using pesticides.
DDT! Benton thought. For the love of Christ, could it be DDT?
Here was the Barr family, farmers out of Ohio, where they probably had used DDT, then moving to a farm where not a grain of the chemical ever had been used. And among all the farmers in the valley, they were the only ones who had suffered from the exhaustion syndrome. Could it be that they had gotten used to DDT or something else in the pesticides, and now were sick because of the lack of it?
The other farmers were okay, he figured, because there still were traces of DDT in their soil, and by working in the soil they were picking up enough of it not to yet experience any ill effects from the lack of it.
And the folks out in the hills? That was simple enough, he told himself. They had never been exposed to it, had never developed whatever need for it the others had acquired. They had never been exposed to it because they were so bone poor they could not afford to buy it. Raising their own food, consuming what they grew, never eating commercially canned foods or buying foods that might have been grown on DDT-drenched land, they had never been exposed.
The next day was Saturday, and in the afternoon, after office hours were over, Benton went through his files once again and found what he had expected to find: that, with only two exceptions, townspeople who had gardens and who actually worked in them had never mentioned any of the symptoms of the exhaustion syndrome.
He phoned Helen Anderson. When she came on the line, he said, “This is your friendly family physician and I’m going to ask you a silly question. Please don’t laugh at me, for maybe it’s important.”
“Ask away. You know I wouldn’t laugh at you.”
“All right, then. When DDT was still available, before it was banned, did you use it in your garden?”
“Sure I did,” she said. “I think most gardeners did. I used it for years and years, and I tell you I miss it. This new stuff, the bugs positively like it. They lap it up and settle down to wait for more. It doesn’t even faze them. Herb used to fuss at me for using DDT. He said he didn’t want his vegetables salted with chemicals.”
“And Herb? Herb never works in the garden, does he?”
“Doc, you know damn well he doesn’t. He makes fun of me and my gardening. You have heard him do it.”
“But he eats stuff from the garden?” Benton asked.
“Are you kidding? Of course he does.”
“Fine,” he said. “Thank you for not laughing.”
“Doc, what is going on? Has this got something to do with Herb—with the way he feels?”
“Maybe. I don’t know yet. Maybe I’ll never know. I’m just scrabbling around.”
“All right,” she said. “I won’t ask. When you know, you’ll tell me?”
“You can count on that.”
He made several other phone calls to people who had gardens and to those who didn’t. The two exceptions said they had never used DDT because they didn’t want to mess around with it. It was too much work, they said. No, they said, their gardens didn’t do as well without it and through the summer they had always bought some garden stuff from others and, like most people, had always used a fair amount of canned goods.
All of them wanted to know why the doctor asked, and some of them laughed at him; but that was all right, he thought, it didn’t mean a thing. Everyone knew that old Doc had some strange ideas, like the time when he had raised so much hell about the water from the old municipal well that a new one had to be drilled, or the time of his strict insistence, as the town’s health officer, that all garbage cans must be covered. Old Doc, everyone agreed, was a fuddy-duddy; but they loved the man and went along with his craziness.
He hung up the phone after his last call and stared at the pad on which he had made notes as he made the calls.
This could be it, he thought; enzymes and DDT. Was it possible that a coenzyme, by forming a bond with a molecule of DDT, had become a super-catalyst? And now that DDT was no longer available, the super-catalytic action was no longer possible. That, he told himself, could account for the symptoms of the exhaustion syndrome.
Take coenzyme A, the one so intimately tied up with two biochemical cycles—the fatty-acid cycle, for example, which operates to oxidize lipids. Deprived of the super-catalyst on which the people had come to depend, fewer lipids would be oxidized and more would be stored as fat. Thus, an increasing incidence of obesity. With fewer lipids being broken down, the body would have to depend almost totally on carbohydrates for energy. Thus, the need for between-meal snacks.
Carbohydrates are transformed into useful body energy by means of the citric-acid cycle and the glycolysis process. The citric-acid cycle also involved coenzyme A, while the glycolysis process did not. if the two processes should become irregular, a seesawing effect, where one effect took over when the other faltered, and vice versa, could have far-reaching consequences. The blood sugar level would become erratic, a great deal produced at one time, very little at another. Lactic acid production would rise when the citric-acid cycle slowed down, since one of the functions of the cycle was to break down lactic acid. One result of a rise in lactic acid would be sore and aching muscles. And, in addition to the variation in blood sugar levels, the production of insulin also would be erratic. As a result of both conditions, there would be times when the brain would starve for lack of glucose in the blood. The symptoms would vary from fainting spells, convulsions, and shock to grogginess, irritability, and bleary vision.
It fit! he realized. It all fit, perhaps too perfectly.
He felt a moment of panic and distrust. He was going at it wrong, he knew. He was working with deduction. There should be extensive laboratory testing. But he was not qualified for laboratory work of the caliber required. He was going on a hunch alone, with no real evidence. His conclusions were unscientific and medically unacceptable. But the pattern was there, all logically laid out.
It was logical, he told himself, not only physiologically, but in other ways as well. It made sense evolutionally. Under the pressure of modern living, man was burning up more energy than he ever had before. Perhaps it was possible he had outrun the biochemical functioning of his body. Under such a circumstance, the body, as an evolutionary life system, would use anything available to permit it to function more efficiently. If DDT were something that would help it to do a better job, if DDT made the enzymes or even one enzyme into a super-catalyst that would do a better job, the body unhesitantly would latch onto DDT.
But now that the DDT was gone, the human body had gone back to where it was before. Among those people to whom DDT had not been available, the hill people for example, the old non-DDT system was still functioning, perhaps not as efficiently as if DDT had been available, but at least not disturbed by having become a new system which had operated successfully for a time but now was lost. Those whose bodies had become accustomed to the DDT system now were suffering a reaction—the old non-DDT system was sluggish in recovering, if it ever could recover, its old efficiency.
Someone other than himself, he knew, should look into the situation. But to look into it would take staff and money. Perhaps it was time that he got in touch with Abbott, not waiting for Abbott to get back to him. Then he realized he did not know how to get in touch with Abbott. The writer had left no address or phone number, probably because he had expected to be traveling and for a time would have no permanent base of operation.
The best approach, Benton decided, was to phone Abbott’s publisher. Someone at the publishing house undoubtedly would know how to go about reaching him. But it was Saturday and publishing houses, he suspected, would be closed. He would do it the first thing Monday morning, recognizing even as he thought, that his urgency was motivated by his wish to shift the problem of the exhaustion syndrome off his back. He had done the thinking and had gone as far as he could go; now it was time for someone other than himself to take over.
Maybe research would prove that his deductions were wrong. Right or wrong, however, some effort, he was convinced, should be made to find the truth.
He phoned first thing Monday morning.
He identified himself and said, “I was hoping someone on your staff could tell me how to get in touch with Robert Abbott. He came to see me several months ago and it’s rather important that I speak with him.”
The woman who had answered hesitated for a moment; when she spoke, she sounded slightly flustered. “Just a moment, sir,” she said.
A man came on the line. “You were asking about Abbott.”
“Yes. It’s important that I reach him.”
“Doctor,” the man asked, “don’t you ever see a paper?”
“I’m ordinarily too busy,” said Benton. “I simply glance at headlines. At times not even that.”
“Then you don’t know that Abbott’s dead.”
“Dead!”
“Yes, a couple of weeks ago. A highway crash somewhere in Colorado.”
Benton said nothing.
“It was a shock to all of us,” said the man in New York. “You say you knew him.”
“I didn’t really know him. He visited me a few months ago. We talked an hour or so. I assume you know what he was working on.”
“No, we don’t. We’ve often wondered. We knew he was onto something, but he was closemouthed about it. You may know a great deal more than we do.”
“Not a great deal,” Benton said. “Thank you very much. I hope I did not disturb you.”
“Not at all. Thanks for calling. I’m sorry I had such bad news for you.”
Benton hung up and stared blankly at the office wall, not seeing the fly-specked diploma that had hung there so long. What do I do now? he asked himself. Just what in hell do I do now?
The first hard frost had come the night before and there was a sharp chill in the air the day Lem Jackson came into the office. Jackson was one of the hill people, a tall, gangling man who appeared to be forty years or so of age. Benton knew who he was, but could not recall that he had ever been a patient.
Jackson sat down in a chair opposite the desk and dropped his shapeless, battered hat upon the carpeting.
“Maybe, Doc,” he said, “I’ve done wrong in coming and taking up your time. But I feel all dragged out. I ain’t worth a hoot. I am not myself. Seems like I’m tired all the time, and my muscles are sore. Most days I’m so ornery and feel so mean that I’m ashamed of myself, the way I treat the wife and kids.”
“How about your appetite?” Benton asked. “You been eating well?”
“All the time. Can’t seem to get filled up. I’m hungry all the time.”
There it went, Benton thought—all the carefully worked out deductions, the elaborately constructed theory of the exhaustion syndrome. For Jackson was a hill man, and under Benton’s theory the people of the hills had to be immune.
“What the trouble, Doc?” Jackson asked. “Did I say something I shouldn’t?”
Benton shook himself mentally. “Not at all. I was just wondering. What have you been doing, Lem?”
“To tell the truth,” said Jackson, “not much of anything. A little farming, that’s all. An odd job now and then. I feel so beat out I’m not up to a day of honest work. I guess I’d have to say I don’t do much of nothing.”
Then he went on, “Some while ago I had a good job down in West Virginia, but I lost the job. If I could’ve stayed on, I’d be sitting pretty now. Short hours, work not too hard, and the pay was good. But they up and fired me. The foreman had it in for me. I tell you, Doc, there simply ain’t no justice. I was as good on the job as any of the other men.”
“What kind of work?” Benton asked, not really caring what kind of job it was, but just making conversation.
“Well, I suppose that even if I hadn’t been fired the job wouldn’t have lasted. They closed down after I left. It was a small chemical plant. They were making DDT, and I hear they banned the stuff.”
Benton felt himself go limp as relief flowed through him. His theory still stood up, he thought triumphantly. Lem Jackson was the exception to the rule his theory had set up that helped to cinch that theory. But even as he felt elated at this evidence that his deductions had been right, he told himself that his reaction was wrong. He should have been glad, it seemed to him, when he first had thought Jackson’s symptoms shot his theory down—for, come to think of it, this business of DDT and the human body was a ghastly thing. But, in a perverse way, he had become fond of his theory. After all the work and thought he had put into it, no one, not even the most humane person in the world, would have wanted to be proved wrong.
“Lem,” he said, “I’m sorry, but there’s not a thing I can do for you. Not yet. There are others like you. Perhaps there are a lot of others like you. It’s a condition that has just come to be noticed and there is work being done on it. In time, there may be a cure. I am sorry I have to be this honest with you, but I think you’re the kind of man who would want that kind of honesty.”
“You mean,” Jackson said, “that I’m going to die?”
“No, I don’t mean that. I mean I can’t make you feel any better. You probably won’t get any worse. There’ll be a time, I’m sure, when there’ll be drugs or medicine.”
And all that would be needed, he told himself rather bitterly, was a pill or a capsule with a requisite dosage of DDT incorporated with carrier ingredients.
Jackson picked up his battered hat and got slowly to his feet. “Doc, all the people in the hills say you’re a square shooter. ‘He don’t feed you no crap,’ they told me. ‘He is a doctor it’s safe to go to.’ You say probably I won’t get any worse.”
“Probably not,” said Benton.
“And maybe someday there’ll be a medicine that’ll do some good.”
“I am hopeful.”
Watching Jackson leave, he wondered why he had told him what he had. Why the brutal honesty? Why the giving of some hope? “There is work being done on it,” he had said; but that had been a lie. Or had it? There was one person working on it and that one person, he grimly told himself, had better buckle down to business.
That evening he drafted a careful letter, setting forth in precise detail what he suspected. Then, as he found the time, working in the evening after office hours were over, he typed the letters and mailed them out. Then he sat back and waited.
The first reply came, in two weeks’ time, from JAMA. His letter, it said, could not be considered for publication since it lacked research evidence. JAMA was kind enough, but final. It did not even suggest he institute further research. But that was only fair, he admitted to himself, since there had been no research to start with.
The second reply, from the National Institutes of Health, was barely civil in its officialese.
The third, from the Association for Biochemical Research, was curt.
On a Saturday afternoon, when the last patient had left, he sat at his desk with the three letters spread out before him. It had been unrealistic, he admitted, to think that any one of the three would have paid attention to his letter. After all, who was he? An unknown family physician in a town that was equally unknown, advancing a theory unsupported by any kind of research, relying only on observation and deduction. The reactions to what he had written could have been expected. Yet there was no question in his mind that he should have written the letters. If no more than a gesture, it was something that had needed to be done.
So now what did he do? Work through the medical association, starting with the county, going to the state? He knew that it was useless. Smith, he was certain, might give him support; but the others would laugh him off the floor. And even if this were not so, it would take years before there was any action.
A chemical company, perhaps. There would be millions of dollars’ worth of business for a DDT capsule once what he now knew became general knowledge. But a chemical company, knowing the hassle of getting approval from the Food and Drug Administration, might shy away from it. Before a chemical company would even touch it, there would have to be years of laboratory work to provide supporting evidence to place before the FDA. On an idea so “far-out,” he knew, no drug or chemical firm would put up the money that was necessary.
So he was licked. He had been licked before he even started. If Abbott had not died, there might have been an even chance. Abbott, writing about the syndrome, would have found a publisher, for he would have produced the kind of book publishers dream about—sensational, controversial, attention-grabbing. Published, the book would have created enough furor that someone would have worked on the theory, if for no other reason than to prove Abbott wrong.
But there was no use thinking about it. Abbott would not write the book. No one would write it. So this was the end of it, he thought. All the years he had left, he would carry the knowledge that he had found a truth the world would not accept.
The world! he thought. To hell with the world! The world was not his concern. His concern was for the people of this community, for Lem and Ted, for Burt and Herb, and for all the others. Maybe he couldn’t help the world, but there might be a way, by God, he could help his people!
Lem Jackson lived on Coonskin Ridge, and Benton had to stop a couple of times to ask his way. But he finally found the farm, with its tilted acres and the little, falling-down house crouched against the wind that whipped across the ridges.
When he knocked, Jackson let him in.
“Come and sit by the fire. It’s a nippy day and a fire feels good. Mary, how about pouring Doc a cup of coffee. What brings you out here, Doc?”
“A small matter of business,” Benton said. “I thought maybe you’d be willing to do a job for me.”
“If I can,” Jackson answered. “If I’m up to it. I told you, remember, I’m not good for much.”
“You have a truck outside. This would be a hauling job.”
“I can manage a hauling job.”
Mrs. Jackson brought the cup of coffee. She was a small, wispy woman with hair straggling down across her face, wearing a bedraggled dress. From a far corner of the room, faces of children, quiet as mice, stared intently out.
“Thank you, Mrs. Jackson,” said Benton. “This will go good after the long drive out.”
“I have a bottle of brandy with some left in it,” said Jackson, “if you would like a splash in that there coffee.”
“That would be splendid, if there’s enough for both of us. I never drink good liquor by myself.”
“There’s plenty,” said Jackson. “I always keep a little in the house.”
Mrs. Jackson said, “Lem told me you would let him know if medicine ever came along that would do him good. I hope that’s why you’re here.”
“Well, I’m not absolutely sure,” Benton said, “but that’s what I have in mind.”
Jackson came back with the brandy and a cup of coffee for himself. He poured generous splashes and set the bottle on the floor.
“Now about this hauling job …” he said.
“When you were in to see me, you said you worked at a plant down in West Virginia, making DDT.”
“That’s right,” said Jackson. “They fired me off the job, but the plant was closed not long after.”
“It’s abandoned now?”
“I suppose so. It was just a little plant. It only made DDT. No reason to keep it open.”
“Would you be willing to drive down there and try to get into the plant?” Benton asked.
“Shouldn’t be no trouble. They might have fenced it in, but there shouldn’t be no guards. There’s nothing there to guard. Probably just sitting empty there. I could get through a fence. Doc, what are you getting at?”
“I need some DDT.”
Jackson shook his head. “There mightn’t be any left. They might’ve destroyed any they had left.”
“DDT would be nice to have,” said Benton, “but I’d settle for some dirt that had DDT mixed in it. Would there be that kind of dirt?”
“Sure there’d be! I know a dozen places where I could find that kind of dirt. Is it dirt you want? I could bring back a truckload. Even have a pal who would help—owes me a favor. Would a truckload be enough?”
“Plenty,” Benton said. “I take it you will do it. There might be some danger.”
“I don’t think so,” Jackson replied. “It’s sort of isolated. No one nearby. If I picked the right time of day, there’d be no one to see me. But what do you want the dirt for, Doc? The damn stuff’s poisonous.”
“It also might be the drug I was telling you about. The drug that we don’t have.”
“You’re spoofing me.”
“No, I’m not.”
“Well, I’ll be damned!” said Jackson.
“You’ll do it, then?”
“I’ll start at sunup.”
Late Monday afternoon, Nurse Amy stuck her head in the office door. “Lem Jackson’s here to see you,” she said. “He has a truck heaped full of dirt parked out in front.”
“Fine. Please show him in.”
Jackson was grinning when he came in. “I got the dirt,” he said, “and better than that, I found three bags of DDT, tucked away in an old shed where someone had forgot them. Where do you want that dirt, Doc?”
“We’ll put the bags of DDT down in the basement,” said Benton. “Dump the dirt over in the northwest corner of my parking lot. And I wonder if you’d be willing to do something else for me?”
“Anything at all,” said Jackson. “You just name it, Doc.”
“Tomorrow I’d like you to come back and build a tight board fence around the dirt so no one can get at it. Then down in the basement I want a box built, a sort of sandbox, like the sandboxes kids play in.”
Jackson scratched his head. “You sure do want the damnedest things. Maybe someday you’ll tell me what it’s all about.”
“I’ll tell you now,” said Benton. “Old Doc’s Dirt Box—that’s the whole idea. After you get that box built, we’ll fill it with some of the dirt you hauled and we’ll seed it with a little extra DDT. Then I want you to sit down alongside that box and play in the dirt, just like a kid would play in sand. Make a dirt castle, build dirt roads, dig dirt wells—things like that, you know. You need DDT. Don’t ask me to explain. Just do like I tell you.”
Jackson grinned lopsidedly. “I’d feel like a goddamn fool,” he said.
“Look,” said Benton, “if I knew how much was safe, I’d put that DDT in capsules and you could swallow them. But I don’t, and if I guessed wrong I could kill you off. But I do know that people like Helen Anderson, who works in a garden where there’s still some DDT, are healthy as a hog—while Helen’s husband, Herb, who won’t dirty his hands in the garden, feels just the same way you do. All beat out, good for nothing, tired.”
“Well,” Jackson said reluctantly, “if I could do what you say by myself. If there was no one to see me …”
“I promise you no one will see you. I won’t tell a soul.”
Watching Jackson’s retreating back, Benton stood for a time trying to figure out how he would convince Herb and Ted and Burt and all the others of them.
It might be a chore, he knew; but he would get it done. He would have them all down there in the basement, playing at that dirt box like a bunch of kids. After all, he was good old Doc and his people trusted him.