Dr. and Mrs. Luce and Garth finished their breakfasts while they waited for the others to show up. The meals had been, well not good, but food – having them brought from the diner on paper plates hadn’t helped very much, no matter how Garth had hurried. The coffee sat well with all of them, though.

They had just finished up when Donna and Wayne Clark showed up for the meeting, followed a few seconds later by Dr. Brege, who was the medical director of the hospital, along with everything else. As soon as Donna walked in she saw Garth sitting back in a corner, and obviously wondered what he was doing there. She shot a scowl at him, and noticed that Garth did his best to avoid looking her and Wayne in the eye.

“Harold,” she said as much to exert her dominance as anything else, “Can you tell me what this is all about, and why I haven’t been kept informed?”

“I’m going to have to pass the buck on that one,” Brege said, clearly not wishing to tangle with Donna. “I don’t know much about this, and under the circumstances I decided that Dr. Luce is better prepared to deal with this. Have you met Dr. Luce?”

“No,” Donna replied icily.

“Well, Donna, this is Dr. Herman Luce, and his wife Penny. They’re both very experienced with polio, much more so than I am. Herman, Penny, this is Donna Clark; she’s the head of the local March of Dimes, and her husband, Wayne.”

“Pleased to meet you,” Luce replied perfunctorily, clearly not being impressed with Donna’s attitude. “Let’s dispense with the niceties and get down to business. I’m not going to mince words. We have an outbreak of polio here. The boy yesterday was from out of town, but the other two cases, one here less than an hour, are locals. I’d be willing to bet a great deal that they are not the last cases we’re going to see. I won’t even bet that they’re the last we’re going to see today. We have two questions we need to settle in the next few minutes. The first of them is that we have to decide whether to try to treat these cases here, or send them to a larger hospital.”

“Under normal circumstances I’d say to send them to Camden,” Dr. Brege replied. “They’re better equipped to handle such things than we are, but since you say we have to make a decision, I would guess that means that you have a second opinion.”

“Not really,” Dr. Luce said, “but I do have some concerns. The first of them is that while I don’t know Camden General at all, there’s not much that they can do for polio that we can’t do right here. So long as we’re dealing with non-bulbar polio, we’re probably just as well equipped. Mr. and Mrs. Clark, I’ve explained to everyone else that until the infection has run its course there’s not a lot we can do but try to help the patient ride it out. We can increase their immunity a little with gamma globulin, and it may help in some cases. It can’t hurt in any case. However, the availability of gamma globulin is also a problem. Charles, I’ve lost track. Where are we on that?”

“Not good, Dr. Luce,” the hospital administrator said. “What with everything else, we’re now down to nineteen doses or thereabouts.”

“Why can’t you get some more?” Donna snapped.

“We had eight units this time yesterday,” Fike explained. “We were able to borrow twenty units each from Camden General and St. Marks, but we’ve used up a lot of it. They are facing problems too, Mrs. Clark. It was only with difficulty that we were able to get that much. I don’t know where we’re going to get more. I have sent a telegram to the maker in Kansas City to try and get a large lot of it, but I haven’t heard back, yet.”

“Kansas City?” she frowned. “That’s a long way away. Isn’t there anything closer?”

“If there is we haven’t gotten a telegram back yet,” Fike said, a little irritated at Mrs. Clark snapping at him for not doing things he’d already done. But considering who she was – and who her husband was – he knew he had to keep calm. “Believe me, I’ve sent dozens of telegrams looking.”

“Gamma globulin is a blood product, and it’s expensive,” Dr. Luce pointed out, obviously in an effort to keep some of the heat off of Fike. “That’s part of the reason there isn’t much of it around.”

“Forgive me, doctor,” Donna said, still pretty sharply but realizing she was ruffling some feathers. “Why is this gamma globulin so important?”

“Simply, it raises the strength of the immune system, at least some of the time. We’ve given it to patients to help them fight off the infection, and it’s really the only weapon we have against the polio virus once a patient has been infected. We also give it to people who have been in close contact with the victims, like their families and to staff members here, for the same reason. It is not as effective in preventing infection as the Salk vaccine, but it gives some protection.”

“I see, doctor,” Donna replied, a little mollified. “Thank you.”

“What makes it worse is that if we’re down to only nineteen units and expect more patients to arrive, we need to cease giving gamma globulin to the people who have been in close contact and save what we can for the victims. They will need frequent boosters. That makes it even more imperative that we get some more. We really need to get the Salk vaccine here as soon as possible, and frankly, I was hoping you could put some pressure on the National Foundation, either by a direct telegram or through channels.”

“I can do that,” she said. “I understand that we’re pretty far down the list for getting the vaccine, but with an outbreak here now maybe they can get it to us more quickly.”

“That’s exactly my hope, and we need to move quickly. But that leads us back to the gamma globulin problem. If other places have it and we don’t, then they can probably do a little better at treating our patients than we can. If we have an adequate supply, we should be able to do just as well, if not better, for our patients than other places, for no other reason than being able to give them better attention than in a busy infectious diseases ward. If neither we nor they have it, we might be able to do a little better here only because with smaller numbers there might not be quite as much infection involved.”

“So that leads right back to the question of whether we try to treat them here,” Fike commented.

“Right, and that’s still a knotty question. Actually, two questions. Rehabilitation is one of them, and we may be able to do some of it here with some patients, at least with Penny’s and my expertise. It will depend on the patient. The other question I see is ventilators in case we get more bulbar patients. We had to hunt like the devil to find one for that boy yesterday, and the closest one we could come up with was in Madison. If we get another case of bulbar polio like him, we’re in trouble, and they’re in trouble. It’s as simple as that.”

Just at that moment, Peggy Erikson, the receptionist and switchboard operator came into the meeting and handed Fike a sheet of paper. “I took this down over the phone from Western Union,” she said.

Fike glanced at the paper, and said, “Good news for once. This is from the lab in Kansas City. They have up to a thousand units they can reserve for us today. It will have to be picked up today, and we’ll have to pay cash since we don’t have an account with them.”

“Good,” Dr. Luce smiled. “I can’t see us needing a thousand units in the short term, but two hundred, easily.”

“Dr. Luce,” Garth spoke up for the first time since the meeting started. “If we get more than we need, and there’s an epidemic, we have a number of possibilities for it. We could use it to vaccinate children who are most at risk.”

“It wouldn’t be enough,” Luce said flatly. “And its effects only last for a very short period of time. But you’re right, we might be able to break the back of an epidemic with it if we don’t have the Salk vaccine. If nothing else, we can supply other places with it if needed.”

“I have to point out a couple obvious problems,” Fike said. “The first is that Kansas City is six hundred miles away, or thereabouts.”

“It’s a problem that’s easily solved,” Garth smiled. “Peggy, go call the phone company and have them track down Phil Gravengood again. It’s still plenty early in the day, he ought to be able to make it to Kansas City in five or six hours or so.”

“I’ll get working on it,” she said as she turned to head for the door.

“Once again,” Fike said negatively, “I have to point out that the stuff is not cheap. We’re talking eighty dollars a unit, and I doubt they’re going to give us a volume discount. Just for the sake of talking, a thousand units would be eighty thousand dollars. Mrs. Clark, I feel sure the National Foundation would be willing to help us out with that, but it’s still a lot of money up front. Could the local chapter of the March of Dimes help out?”

“We have some money in a reserve account, but nothing like that much,” she said flatly. “I’m sure the National Foundation would be willing to reimburse most of it, but it would take time.”

“The last thing we have is time,” Fike said.

There was an obvious answer to the problem. Garth looked up and got Wayne’s eye. The two of them had never been friends, and they hadn’t even been friendly for many years. While they could be civil to each other, they were never cordial. “Wayne?” Garth said emotionlessly.

“Yeah,” Wayne replied.

Garth nodded back. It was a done deal with only the two words being said. He and Wayne would cover the local chapter.

“All right,” Garth said. “I’ll have the bank cut a cashier’s check just as soon as we know how much we need. We can either get the whole thousand units and farm it out later, or we can ask both St. Marks and Camden General if they want in on the deal since we’re going to have Phil fly down and get it.”

“I’ll get in touch with them and ask,” Fike agreed.

“Quickly, Charles,” Garth said. “We’re going to be pushing the clock as it is, and I think we want Phil in the air just as soon as we can get a check in his hands.”

“I’ll get right on it,” he said, getting up from the table and heading for his office.

Donna looked over at her ex-husband. “Thank you, Garth,” she said neutrally. “We need to work together on this.”

“I agree.” It was all that needed to be said. It was enough. Their war would be put aside for a while, at least until this emergency had passed.

“That makes things quite a bit different,” Dr. Luce said. “Unless we get a really major regional outbreak, that would solve a lot of problems for the foreseeable future. Garth, would you have any idea how long it will take to get the gamma globulin here?”

“Five hours down, five hours back, if I understand what Phil told me about his plane. Add to that fuel stops and time on the ground in Kansas City, and the time it takes to get him going, Twelve to fourteen hours, at a guess. We really ought to wait on Phil to get a better answer.”

“All right, let’s suspend discussion on that for a moment. Mrs. Clark, this probably would be a good opportunity to fill you in on what we’ve had to deal with so far.” He spent the next few minutes talking about the three polio patients, and the decision to fly the Rathburn boy down to Madison the day before.

In three or four minutes Fike walked back in. “St. Marks will reimburse us for two hundred units, less what we borrowed yesterday,” he announced. “Peggy is still trying to track down someone I can talk to at Camden. The phone company got hold of Gravengood, and he’s on the way here. He should be here any minute.”

“Let’s get the thousand units, then,” Dr. Luce said quickly. “If we can’t use all of it I wouldn’t be surprised if there’s someone else who can. Charles, send a return wire to Kansas City, accepting their offer.”

“As soon as I can use the phone, I’ll have the bank cut a cashier’s check,” Garth offered.

Phil Gravengood was busy working on the same junction box he’d had to abandon the day before to fly that kid to Madison. He wondered how the kid was getting along, since no one had heard anything back. Somehow, that didn’t sound good, but Phil felt he had done what he could for him.

What also didn’t sound good was that another kid had been brought into the hospital the night before. This was beginning to look serious. After he’d gotten to the colonel’s house last night he’d called Rose and talked with the kids. Since he couldn’t enforce it, he didn’t want to flat-out order Larry and Mark to stay home, but he thought it was a good idea and Rose did too.

While having to stay away from Rose and the kids was a pain in the neck at best, it was nice of Garth to offer space in his house so Phil could batch it with him. He had a very nice house, even though it had been a little stuffy from having been shut up for so long. Having the scouts there made life a little more interesting – they were good boys, not the kind of young punks Larry had a tendency to hang out with.

He and Garth hadn’t yet had time to make plans about how they would get through the next few days, but Phil had made up his mind that he was going to do some of the cooking. He knew that Helga was a strict vegetarian, and the colonel mostly just put up with it. If the two of them were going to batch it together, Phil thought, they ought to at least eat something proper, not alfalfa sprouts and jazz like that. It probably would be best to not do it while the scouts were there, but as soon as they were gone there was going to be steak on the menu.

While he worked on the junction box Phil was idly musing about the fit Helga would throw if she found out about it, when he heard a woman’s voice call to him, “Hey, Phil!”

He turned toward the voice, to see Sally Trevetheck standing on her porch. “Yeah?”

“Central just called, they want you to call in.”

“OK, thanks,” he said. He hadn’t had his tester hooked up yet, but now he clipped the wires into the junction box, as an awful feeling came over him. If Carla wanted him badly enough to call a neighbor near where he was working, it probably wasn’t a phone out somewhere. He rang Central, and Carla picked right up. “Hi, it’s Phil,” he said.

“Phil, drop what you’re doing and get over to the hospital. They need you badly again, but Peggy didn’t say why.”

“All right, Carla,” he replied, his sinking feeling hitting him right in the gut. Did they need him to fly another kid to an iron lung? The possibility was certainly there. “I’m on my way.”

Phil quickly tossed his tools into his toolbox – he hadn’t gotten many out since he had barely started working – and within a couple minutes was heading to Sanford Memorial Hospital again. He pulled right up to the front door and hustled inside, to find Peggy waiting for him. “Phil, they need you back in the administrator’s office, it’s the second door on the left down the hall.”

He hustled quickly down the hall to the office, to find a meeting going on. He knew all of the people there, of course, but it was strange to see Colonel Matson and Donna Clark in the same room without a fight going on between them. “Phil, glad to see you again,” Charles Fike said. “We need you to do another flight for us.”

“Not another kid going to an iron lung, I hope.”

“No, not this time, thank goodness. We have an order in for a large amount of a drug we need desperately. We have to pick it up this afternoon in Kansas City.”

“It’s only about five-fifty or six hundred miles,” Phil replied after only a moment’s calculation. “I can get down there in plenty of time.”

“Good, we need to get you moving. Garth will take you down to the bank. You have to take a large check with you. They don’t give that stuff away.”

“How large?”

“Eighty thousand dollars.”

“Wow,” Phil said, his eyes lighting up. “You could buy a whole lot of houses for that.”

“It’s a lot of money, but we need the drug,” Colonel Matson spoke up. “Let’s get going.”

“Just a minute,” Phil said. “Since you’re sending me I know you’re in a hurry. I can get down there in time easily enough, but getting back is going to be a problem. The airport here doesn’t have lights, and it’ll be after dark before I can get back.”

“Camden is lighted, isn’t it?”

“Oh, yeah, no problem with that.”

“We’ll have someone meet you there,” Colonel Matson said. “I’ll meet you down at the bank, so let’s get going.” He turned to the rest of the people there. “I’ll be back as soon as I can get Phil on his way.”

“Thank you, Phil,” Penny Luce grinned. “We need this badly, but I’m sure you’ll understand if I beg off taking this trip with you.”

“I don’t blame you. I’ll see you later.”

As soon as Matson and Gravengood left, the discussion got back under way in Fike’s office at the hospital. There was a definite lightening of the atmosphere in the room, and not just because everyone but the Luces knew that Garth Matson and the Clarks were bitter enemies – just enemies who had agreed to work together in this crisis.

“In essence, I guess that settles the other decision we had to make,” Dr. Luce said. “Whether to try to treat polio patients here or send them on.”

“Herman, I know you think we can handle it,” Dr. Brege said, “but I still wonder if it’s wise. In a bigger hospital, like Camden General, it’s possible to isolate contagious patients much more thoroughly than we can here. Let’s face it, this is a small hospital, and while we can try to keep them isolated, we just can’t do it as well.”

“I have to agree with you on that,” Dr. Luce conceded, “but the fact of the matter is that the hospital is already contaminated from the three patients we’ve had here already. Denise, how many other patients do we have here right now? I’ve been so busy that I haven’t even thought to ask.”

“We have four, all downstairs,” she replied. “Two of them are a mother and a baby getting set to be sent home. They could go at any time.”

“Let’s get them out of here even if we have to find someone to drive them home and stay with them for a while,” he suggested. “I know we don’t have much gamma globulin left, but I think we should give them both shots of it. The baby won’t need much, so that helps. How about the other two?”

“One is a man who’s recovering from a urinary tract infection. Dr. Brege, what do you think on him?”

“You’re talking about Dick Jahnke, right? He could go home, too. He’s not in as good a shape, but I was planning on sending him home this afternoon anyway. He’ll just have to be on that Foley catheter for a few more days, and he ought to be able to handle that at home. Let’s get him out of here, too. The last one must be Mabel LeDroit, isn’t it?”

“Yes, and she’s not getting any better.”

“Let’s get her down to Camden General,” he said. “In fact, unless she stabilizes she’s going to have to be operated on, and I’d just as soon someone down there did it anyway. Let’s find someone to take her there, someone who hasn’t been exposed here.”

“I’ll find someone to take her,” Denise said. “Maybe Willie Halford would do it. She’s got a Nash, she could lay the seat down a little. I really don’t think we want to send her there in a hearse.”

“Good enough,” Dr. Brege replied. “Charles, can you get a transfer set up with Camden General? Explain the situation to them, and tell them we may have to send more non-polio patients to them.”

“I’ll do that as soon as we’ve finished making decisions.”

“Herman,” Dr. Brege spoke up. “Do you have any more thoughts?”

“It’s good that we’re getting them out of here,” Dr. Luce replied. “Let’s get the two children upstairs as soon as possible and try to not contaminate the downstairs any more than necessary. In fact, let’s set up a room upstairs as an admitting room, and any further patients suspected of having polio should go right up there. As soon as possible we should scrub the contaminated downstairs rooms with something strong, just to be on the safe side.”

“Are you sure we can handle the active cases here?”

“Yes, we can, so long as it isn’t bulbar polio where a ventilator is needed. After our experience in trying to find one for that boy yesterday, I’m not sure how we’re going to handle cases like that if we get them. Charles, have you heard back from any of the other places we wired yesterday about availability of iron lungs?”

“I’ve had a couple of responses. There’s nothing closer than Chicago or St. Paul.”

“What are the chances of getting one here? Even if it takes a couple of days.”

“Slim to none at this time of the year. I know Emerson is backordered for months. About all I can do is send some more telegrams, including one to the National Foundation for Infantile Paralysis. They would know more about availability than anybody else would. Someone somewhere might have one they’re willing to sell us or lend us, but it could take days.”

“Do what you can, Charles,” Dr. Luce said. “I don’t know if we have days, and there’s no way of telling until it happens. Let’s face it. We’re getting set up here to handle an epidemic we’re not sure will even happen. I for one will be perfectly happy if it doesn’t happen, but I don’t see how we can take the risk of not being ready. There are two children out in back who tell me that just by being here.”

Wayne Clark spoke up; he’d mostly been silent through the meeting. “Doctors, Charles,” he said. “Do what you have to do. If it costs money, it costs money. We can find the money if it’s needed. I feel it’s my duty to take care of the community, since it’s taken good care of me. I’m sure Donna feels the same way. I normally wouldn’t want to speak for Garth Matson, but in this case I’m sure he feels the same way, too. Do the best you can for our people.”

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