No one got much sleep at Sanford Memorial Hospital that night, especially after Pat Burling drove in with the six hundred units of gamma globulin. Dr. Luce had been very conservative with it the past day and more, which was the only reason it had stretched to last this long. The deputy had been right: they had been down to one single unit of the drug for use in some unforeseen circumstance, the one Garth Matson had brought back from the airport the day before.

Now he had the option of increasing doses in active patients, trying to pump up the immune system to possibly hold back the attack of the invader. It might possibly help some damage from being done. There was no telling if it would work, but he had sometimes seen increased dosages have a positive effect when he’d been down at Baptist.

The good news was that there were no further patients, at least at the moment, but the three of them still at the hospital overnight knew full well that more could arrive at any time.

Both Dr. Luce and Penny were asleep in one of the empty patient rooms downstairs during the early hours of the morning, while Denise was keeping a rotating watch on the four upstairs. All four of them seemed to be resting quietly, although the Toivo girl and the Bell girl only occasionally showed signs of consciousness. The boy who had arrived in the evening, Martin Holliday, was asleep, with the help of some morphine; he didn’t seem quite as serious as the other three.

The patient Denise was most worried about was Gail Saunders. She was still in considerable pain, and Dr. Luce had decided to try some morphine to ease her distress despite the fact that her breathing problems were slowly getting worse. It was a touchy balancing act, and Denise had to check her vital signs every few minutes. As the long night eased toward morning, she noticed that her breathing was less and less active, even though the last shot of morphine had to have been wearing off by now.

Should she call Dr. Luce? He was tired, and he needed his rest; he was the main hope of helping all the patients they had now and the ones they expected in. As the sun was starting to come up, she knew she couldn’t hold off calling him any longer.

Despite the fact that it was one of the largest houses in Spearfish Lake, there was only one telephone; extension telephones weren’t terribly practical in the days of party lines and having to use a central operator. At that hour of the morning Garth Matson was sound asleep, and didn’t notice the periodic ringing of the phone.

However, repeated poundings on the street-side door did wake him up. He stumbled downstairs in a bathrobe and answered it, to find deputy Pat Burling waiting for him. “Hi, Pat,” he said. “What’s up?”

“They want you to call the hospital, as soon as possible. There’s trouble.”

“Oh, OK,” Garth replied sleepily, heading to the front hall where the telephone was located. He spun the crank a few turns to give it a long ring to get Central’s attention.

Normally the operator on duty would ask, “Number, please?” Not this time – “Mr. Matson, is that you?” she said.

“Yeah,” he stifled a yawn.

“I’ve been trying to get you for some time. I’ll put you right through to the hospital.”

In only a few seconds Garth was talking to Penny Luce. “Garth, what’s with that respirator you had someone building?”

“I don’t know. I haven’t talked to them since last night.”

“We need it badly and as quickly as possible. We have a little girl here who’s quit breathing. We’re giving her manual artificial respiration and we can’t keep it up for long.”

“I’ll go see what I can do,” he replied. “Do you need extra hands? I could help.”

“Yes, please. Both. But we need that respirator badly.”

That woke Garth up better than half the coffee at Woody’s Café. He ran upstairs, pulled on his pants, grabbed his car keys, and tore out to the Buick still wearing his bathrobe. In only two or three minutes he was halfway across town, beating on Brent Clark’s door.

Brent wasn’t much easier to wake up than Garth had been, but the house was smaller. When he came to the door, he was wearing a robe, too. “What is it?” he asked.

“The wooden lung,” Garth said. “Is it done?”

“Not yet,” Brent said, yawning. “It still needs several hours work yet. We knocked off about midnight when Joe was getting to the point he couldn’t weld straight.”

“They need it now,” Garth explained. “They’re keeping a five-year-old girl alive by artificial respiration.”

“I knew we should have kept at it and finished it,” Brent shook his head. “I’ll go give Dan and Joe a call. Maybe they can rush things.”

“Do that.”

By now Ursula was awake, and had heard the exchange. “Garth, I’ll make you some coffee,” she said.

“Do it quickly if you can. I’ll even take instant, but I need to get over to the hospital. I promised them I’d help with the artificial respiration on the kid.”

“All right, Garth,” she replied. “I’ll be as quick as I can.”

Brent had the receiver of the phone to his ear, listening to Central. “She’s ringing Dan,” he said. “If I can get him and Joe going maybe we can rush it.”

“How far are they from being done?”

“The box part of it is done, that was easy. There are a few tricks to be done on the mechanical side, I can’t tell you how long. A couple of hours minimum after they get here, maybe noon. I just don’t know.

“Brent, I don’t know if that kid can make it till noon. Look, when I was talking with Dr. Luce yesterday, he said that the first iron lungs used a vacuum cleaner for power. Is there some way you could hook up a vacuum cleaner to what you have?”

“Yes, but from what I understand, it wouldn’t work right. The one we’re building uses a motor powered diaphragm to move air in and out. You could move air out all right with a vacuum cleaner, but to let it back in you’d have to shut the thing off. It would take time for the pressure to let down, and then build back up again when you started it. And I wouldn’t be surprised if you could burn a vacuum cleaner motor out in short order if you started and stopped it all the time.”

A new voice joined the conversation: Ryan Clark, Brent and Ursula’s nine-year-old son. “That’s easy, Dad. Build a valve so that the vacuum cleaner would pull from inside the box, then from outside. It wouldn’t have to be anything more than a small door that opens and closes.”

Brent thought about it for a moment. “Yeah, that might work,” he said. “In fact, it ought to work. Glad you thought of it, Ryan.”

Garth looked them; Brent in his robe and Ryan in his pajamas. “Can you build it? I mean, real quickly?”

“Probably pretty fast,” Brent said, “but it would be a cobbled-up mess.”

“I don’t care how cobbled-up it is, just so long as it works. Get something together as quick as you can. I really should get over to the hospital and help them keep that kid alive.”

“We’ll get something to you as quickly as we can get it built,” Brent promised. “Ryan, go get your clothes on. I’m going to need your hands on this. Ursula, come handle the phone while I get dressed. We need to get Dan and Joe here as quick as we can.”

“Don’t you want breakfast?” Ursula asked.

“Not now, honey. We can eat after we get this thing done.”

In only two or three minutes Brent was carrying Ursula’s vacuum cleaner out into the garage, to find Ryan already there, still in his pajamas. Ryan had helped work on the wooden lung the previous night, taping the seams to cut down on air leakage, and doing small chores like that. He was a sharp kid, with a good mind for mechanical engineering for a nine-year-old, and he wasn’t shy about asking questions about things he didn’t understand – questions that Brent sometimes couldn’t answer. He was standing there looking at the thing, and now he asked one of those questions: “Dad, is the vacuum cleaner going to be strong enough?”

“I don’t know,” Brent admitted. “All I know is what you heard Mr. Matson say, that the first one of these things used a vacuum cleaner to power it.”

“Yeah, but it’s an awful big box,” Ryan frowned. “Can it move enough air to make the difference?”

Brent looked at the box, and looked at the vacuum cleaner in his hand. “Darn good question,” he admitted. “And I don’t know the answer. What’s more, I don’t know how to find out.”

Ryan looked at the box again. “Dad, Mr. Matson said that the kid who needs it is only five. Does the box have to be that big? The vacuum could suck air out of a smaller one quicker than this box.”

Brent looked at the box again. “You’re right, son. That would give it a better chance of working. Let’s grab a sheet of plywood and build a smaller box. We can probably do it about as fast as we can modify this one.”

That was bad news, but maybe they can get it working in a hurry, Garth thought as he went back out to his Buick. He was wishing that he’d told Brent last night to hurry up and get it done, but he just hadn’t done it, what with the scouts being at the house, and the general depressed feeling that had hung over the evening.

Oh well, it was water over the dam, and that was that. He knew they were shorthanded at the hospital, and that it would take one or two people almost continually to give artificial respiration, and that would really stress them. He knew how to do it; at least maybe he could spell someone.

It was still too early for Peggy to be on the front desk, so he just went inside, and up the stairs to the second floor where he knew the polio patients were being kept. It didn’t take much to find the room where the little girl was – both Denise and Penny were there, trading off in giving the unconscious little girl chest-pressure, arm-lift manual artificial respiration. “Can I help?” he asked.

“Sure,” Penny said. “We need the help, but go get a mask, gown, and gloves on. You shouldn’t be up here without them.”

“I can do that. Where are they?”

“Downstairs, in the supply room off the admitting room, there’s a box of gowns. There should be boxes of gloves and masks open.”

Garth dashed back down the stairs, into the admitting room, and found what he was looking for. He pulled them on, then went back up the stairs. He’d failed this girl by not pushing hard enough on Brent to get the wooden lung done. Now he was going to have to pay the price.

Brent snaked a sheet of half-inch plywood out of a stack at the back of the garage, and onto sawhorses. There wasn’t much time to draw anything, except in his mind’s eye. He really wasn’t a full-out carpenter, but in the nine years he’d owned Clark Construction he’d learned a fair amount about it, and he had a pretty good collection of tools in his garage.

Cutting crosswise across the sheets, he cut four pieces four feet long by eighteen inches wide, which left a fifth piece that was a little bit wider. Since he hadn’t even thought about the actual dimensions, it took a bit of work with a tape measure to figure out how big to cut the ends of the box, but that didn’t take long, either. He and Ryan were starting to nail the box together when Dan Evachevski showed up.

“Hi, Brent, Ryan,” Dan yawned. “What’s this?”

“You know what’s going on? That kid needs help in a hurry, and we figured we could cobble up a real simple rig and run it off a vacuum cleaner. Ryan was the one who figured out how. Now help me nail this thing together while I figure out how to build the valve system Ryan dreamed up.”

“All right, I can do that.”

“Dad,” Ryan spoke up. “I’ve been thinking about that valve. We don’t need to build a separate valve at all.”

“You’re faster than I am this morning,” Brent shook his head. “Tell me what you mean.”

“It’s simple, Dad. The box is the valve. All we have to do is to cut a door into it somewhere, like a trap door that opens outward. Open the door and the vacuum cleaner can’t suck air out of the box. Close the door, and it can.”

“It sounds good, but you realize someone is going to have to stand there and open and close the door.”

“Sure, but that’s easier than artificial respiration, isn’t it?”

Dan looked at the box for a moment, then replied. “The kid is right, Brent. Let’s do it.”

A fast and furious forty-five minutes followed. Dan and Brent had to do most of the work, but Ryan helped where he could, doing such things as taping the seams. With a hole saw, Brent cut a hole for the vacuum cleaner hose, and then took a circular saw and cut a larger hole for what they started to call the pressure relief door. A small piece of plywood went over the hole, and was hinged with a couple of cabinet hinges.

The other end of the box wasn’t nailed in; a hole for the little girl’s head was cut in it down low, and cabinet fasteners would keep the end of the box in place. In less time than had seemed possible, they plugged in the vacuum cleaner, and standing at the head hole they could feel air being pulled through – enough that when Ryan put a small piece of plywood over the hole, the vacuum was enough to keep the plywood in place.

That was enough. “I can think of other things we could do to it,” Dan said as he stood there watching it. “But right now, I think this cob job will either work on the kid or it won’t. I think it’s time to go see.”

“I’ll run it over there in the pickup,” Brent offered. “Dan, get back to work on the Popular Mechanics unit. That’ll work automatically. They’ll probably want to get the kid into it as soon as we can get it done, but if this works it’ll hold them for now.”

“Can I go with you, Dad?”

“No, better not,” Brent told him. “Polio is dangerous, and it’s more dangerous for kids than it is for adults. I’m going to try to not get very close myself. Help Dan with getting the other one done till I get back.”

The three of them carried the smaller wooden box out to the pickup truck. Even with the vacuum cleaner, it wasn’t heavy, and it was hard to believe that such a simple thing could save a life, but if they understood how it worked then it stood a good chance of doing just that.

Out on the south side of Spearfish Lake, Sarah Perkins went to wake her eleven-year-old son Thomas. Even though it was Saturday, it was time for him to get up and get dressed, since she had a lot she had to do that day. It was going to be even more difficult, since Sarah had heard the stories about polio going around town, and she’d made up her mind to keep the kids home today.

Thomas was usually pretty good about getting up, but this morning he didn’t want to. “Mom,” I don’t feel so good,” he protested, and from the way he acted, Sarah felt he might be right. She put her hand on his forehead, and he was right. He was running a fever, and considering the stories going around town, that wasn’t good news. “Honey, is there anything else wrong?” she asked gently.

“I feel kind of achy, Mom. My neck is real sore.”

Sarah felt like she’d just swallowed a cannonball. It could be . . . maybe it wasn’t, but it could be. “Honey, I think I’d better take you to the doctor.”

Oh, please, no. Not Tommy, please!

Brent didn’t waste any time rushing across town in the pickup. In only a few minutes he was at the back door of the hospital. There didn’t seem to be anyone around, but the back door was open, so he went inside, to run into a nurse he didn’t know, wearing a mask and gown, along with surgical gloves. “Do you have another patient?” she asked wearily.

“No, but I have a real cobbled-up emergency respirator we just threw together.”

“Oh, you must be Brent Clark. I’m Penny Luce. Garth said he thought you’d be here quickly with that emergency respirator.”

“We still don’t have that done, but we should in a couple hours. We threw this one together in hopes it will hold you in the interim. It’s a real cob job but we think it’ll work.”

“Good, the little girl won’t take much more artificial respiration by hand, it’s stressing her too much. Can you get it upstairs by yourself or will you need help?”

“I could get it by myself but help would be nice.”

“Good. Let me get you a mask, gloves, and a gown. You need some protection if you’re going upstairs, and we’ll give you a gamma globulin shot before you leave just to be on the safe side.”

Although it was awkward, the “cob job” was light enough for Brent to carry easily, while Penny carried the vacuum cleaner and the hose. Upstairs, Brent found Garth giving manual artificial respiration to a little girl, while another gowned figure checked her vital signs. “Get it done?” he asked.

“No, but this ought to work until we do.”

There wasn’t much to setting the thing up. It just involved setting the box on a vacant bed, plugging in the vacuum cleaner, taping the hose end into place with some fabric backed tape, and getting some towels and pieces of foam ready to pack around the little girl’s neck after they put her in the box.

“All right,” Dr. Luce said. “We need to do this quickly. We’ll only have a minute or so after we stop the manual respiration, so let’s all be sure of what we’re going to do.”

After a little discussion and planning some moves, they were ready. Garth gave her a final chest compression and arm lift, then reached under her, picked her up, and slid her into the box as Brent stood waiting with the box end in his hand. He guided it into place as Penny held the little girl’s head, and just held it there – if it didn’t work, freeing the catches that kept the box end on would waste seconds. As soon as he had it in place, Penny was packing foam rubber pieces around the girl’s neck.

“OK, turn it on,” Penny said as the three men looked on anxiously. Brent reached down and hit the pushbutton switch on the vacuum cleaner and it roared to life. From the sound of the motor lugging they could hear it pulling air out of the box. He reached up and opened the pressure relief valve trapdoor, and they heard the motor speed up, not working as hard. After a couple of seconds, he closed the valve, and they could hear the motor work harder.

“It looks like it’s working,” Dr. Luce said. “There’s no point in taking a stethoscope to her, I’d never hear anything over that vacuum cleaner.”

“I’ve got an idea,” Penny said, and rushed out the door. She was back in seconds with a chilled glass bottle from a refrigerator in a room at the end of the hall. She held it in front of the little girl’s face, and they could see her breath exhalations cloud the glass as it condensed.

No one needed to be told what that meant, as the little girl’s face had already started getting some color in it to tell them it was definitely more effective than the manual respiration Garth had been performing on her. The box may have been an extremely crude cob job; it was noisy, it was awkward, and someone would have to stand there and open and close the valve door every few seconds.

But it worked.

At least for the moment, Gail Saunders would live.

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