He followed her up the grand staircase and down the second-floor hall. “Here’s where we’ve put in a ladies’ room,” she said, pointing to the first door on the left. “Ran the piping up from the kitchen belowstairs. Men’s room is the old second-floor toilet. I figured they didn’t need the space the women did. This one’s taken, this one.” She pointed to the closed doors as they walked past. “Here,” she said, entering through the last door in the corridor. It was an examining room. Plain, but with everything he’d expect to see. The wooden floor had been replaced with linoleum. She saw him looking at it. “The doctors said you can’t keep wood sterile. This stuff can be scrubbed down with hospital-strength disinfectant.”
For a moment he wondered if the clinic’s doctor would be responsible for that job, too.
Mrs. Ketchem crossed her arms and looked out one of the room’s two windows. “This house belonged to my husband’s grandparents before it came to my in-laws and then to me. Grandmother Ketchem was some house proud. Sometimes I can’t help but imagine those old folks rolling in their graves at some of the things I’ve done to this place.”
“Why?” Allan couldn’t restrain the question that had been swelling inside him since he had first seen her dumpy house on Ferry Street. “I mean, I know it’s great to give away money and all, but most folks who do it are rich. Didn’t you want to keep this house for yourself? Live, you know, in style?”
She didn’t answer him right away, and he wondered if he had just blown it, by showing that he was not the sort of person who would give away riches as soon as they fell into his hands. “I gave birth to my first child in this room,” she finally said. She let her gaze roam over the walls and windows, as if she were looking through time, to the way it used to be. “We had a farm out in the Sacandaga River valley, a good half day’s ride by horse and cart, which was all we had. So when my time came near, my husband brought me here, into town, to stay with his grandparents. It was in here I had my son Peter.” Her voice had gone all thin, as if it were coming from a long way away.
She looked straight at Allan. “I’m going to tell you something I don’t speak of, because I want you to understand what this clinic means. What it’s for.”
He nodded, desperately curious and afraid of what he might hear, both together.
“I had four children once, in that farm. It’s all gone now, children, farm, everything. But back then, it was my life. I never thought it wouldn’t all go on like it had, each day following the one before.”
He nodded again, feeling that he ought to make some acknowledgment.
“It was March, in ’24. It had been a cold March, like this one, after a cold winter. Jonathon had taken our two oldest to a party, one of our neighbors who lived upriver. I figured they must have gotten it there. Some of the older kids came down with it, but they recovered after a bad croup. It works that way, you know. Once they’re eight, nine, ten, it mostly sickens them. But younger, it kills. My Lucy and Peter were the youngest there that day.”
Allan wanted to sit down, but his legs seemed nailed to that spot on the linoleum floor.
“About two days later, they both came down sick. It could have been most anything. They were feeling poorly, with a cough and a fever. Their coughs got worse and worse, and I could see how bad their throats looked, all white and red, and them pulling for breath and spitting out nasty mucus. I stayed up all night for two nights running with both of them, steaming ’em, making potash gargle, giving them saltwater drops to keep their noses clear. Then the next day, they seemed to be on the mend. Both of them terrible weak, but their throats clearing up and their breath coming easier. I had kept the two younger ones away…” She looked out the window again. “Three days after Peter and Lucy got over the worst of the coughing, Mary and Jack came down with it. But it was worse, so much worse. It went through them like wildfire. High fevers, and their little throats all swollen and choked. They couldn’t hardly breathe. It was when I saw their throats and tongues all dark that I couldn’t deny anymore that they had the black diphtheria. You know what they used to call the diphtheria, don’t you?”
Allan tried to nod. “The Strangler,” he said.
“That’s right. Jack died by the next morning, died hard, fighting it with everything in him. And then that evening, my little Lucy. Her heart stopped. That’s what it does, you know. If it doesn’t choke off the breath and blood, it paralyzes the heart.”
Allan felt as if his throat were closing up. At that moment, he would have promised Mrs. Ketchem another seven years’ service if she would only stop talking about it.
“That night, Jonathon went for the doctor. Mary…” She sighed. “I rocked her and rocked her all night. When Dr. Stillman came back with Jonathon in the small hours, he gave Peter the serum. He told us Mary was… She died just before the sun came up. I remember praying, praying harder than I ever did, that the angel of death would pass us by, and leave us our firstborn. But the poison had gotten too far, and Peter’s heart and kidneys were damaged too bad. He died three days later.”
Allan stood there. What could he say? His experience with sorrow was losing a grandparent. The death of a pet. He shifted from foot to foot, intensely uncomfortable and ashamed of himself for feeling that way.
“I had worried plenty, over the years, about the German measles, and mumps, and scarlet fever. But I never thought about the diphtheria. It had always seemed a faraway thing to me. Something you read about in the papers, happening in the cities. Places where folks lived all crowded together and didn’t know how to be clean. Whooping cough and influenza, that was something you had to worry about, living on a farm. Not the Strangler.” She moved then, stepping toward Allan, making him start backward as he had on her front steps. “That’s what this clinic is for. I want you to understand it, not like book understanding, but living-it understanding. You’re hardly more than a boy yet, but someday you’ll have children, and when you do, you’ll think of my children, and you’ll picture in your heart what it feels like to lay all four of your babies into the ground. You’ll know what it is to spend the rest of your life wishing you had done different things.”
Allan backed into a cabinet by the examination table, jarred it hard, and lurched forward as a glass container filled with cotton swabs tipped over. His hands closed on empty air and the container smashed against the floor, spraying glass shards and swabs across the linoleum, over his shoes, into the cuffs of his pants.
“Hold still,” Mrs. Ketchem said, in an entirely different voice than the one she had used when recounting her spooky history. “There’s a closet over this way.” He stood stock-still as she retrieved a broom and swept up the mess in short, efficient strokes. “Shake off your pants,” she directed, and he did as he was told. She bent over and squinted at his shoes. “You’re fine,” she said. “Go fetch me the dustpan.” He picked his way over to the closet and found it. He held it to the floor while she swept the glass and wood into a sparkling pile, and then he carried it, at her direction, to the waste bin.
“I sure hope you won’t be as careless as that when you’re working here.” She stepped out into the hall and beckoned him to follow. “We don’t have much of a budget and we have to stretch the supplies as far as we can.”
“Yes,” he said, trailing after her. “I mean, no, I’m usually not that clumsy. I was-”
“Jane?” On the stairs below the landing, he could see the old lady who had been working the reception desk. “Are you ready?” She was untying her striped apron. “I’d stay longer, but I promised my daughter I’d watch her girls this afternoon.”
“Sorry, Ruth,” Mrs. Ketchem said. The other woman passed her the apron, and Mrs. Ketchem tied it on over her dress. The starched sweetness of the blue and white stripes seemed to cast Mrs. Ketchem in a deeper darkness, like a witch wearing an angel’s robe. “I didn’t mean to keep you over,” she was saying as they all three descended the stairs.
Allan looked with longing at the door as the morning’s volunteer receptionist let herself out, but Mrs. Ketchem had cast a spell over his shoes-or perhaps they, more than his head, knew how much he wanted to become a doctor-and he found himself following her into the parlor turned office.
“It’ll be up to you to see you get accepted into medical school and that you keep your grades up. If you drop out or flunk out, I’ll be after you to repay the money I’ve spent. You or some other, I’m going to find someone to help me establish this clinic so that it can’t get knocked down.” Mrs. Ketchem enthroned herself on the desk chair and swiveled toward him. Across the desk, he could see the patients waiting for their turn with today’s doctor. These people would become his responsibility. This clinic would become his responsibility. For seven
