With relief, Bingaman responded. "Yes, Harrisburg, I read you." He had hoped to raise an operator in Albany or somewhere else in New York State, but the capital city of neighboring Pennsylvania was near enough, an acceptable substitute. He explained the reason he was calling, the situation in which Elmdale found itself, the information he needed, and he couldn't repress a groan when he received an unthinkable answer, far worse than anything he'd been dreading. "Forty thousand? No. I can't be receiving you correctly, Harrisburg. Please repeat. Over."
But when the operator in Harrisburg repeated what he had said, Bingaman still couldn't believe it. "Forty thousand?"
Marion gasped when, for only the third time in their marriage, she heard him blaspheme.
"Dear sweet Jesus, help us."
"Spanish influenza." Bingaman's tone was bleak, the words a death sentence.
Powell looked startled.
Talbot leaned tensely forward. "You're quite certain?"
"I confirmed it from two other sources on the wireless."
The hastily assembled group, which also consisted of Elmdale's other physician, Douglas Bennett, and the hospital's six-member nursing staff, looked devastated. They were in the largest nonpublic room in the hospital, the nurses' rest area, which was barely adequate to accomodate everyone, the combined body heat causing a film of perspiration to appear on brows.
"Spanish influenza," Powell murmured, as if testing the ominous words, trying to convince himself that he'd actually heard them.
"Spanish… I'd have to check my medical books," Bennett said, "but as I recall, the last outbreak of influenza was in – "
"Eighteen eighty-nine," Bingaman said. "I did some quick research before I came back to the hospital."
"Almost thirty years." Talbot shook his head. "Long enough to have hoped that the disease wouldn't be coming back."
"The outbreak before that was in the winter of 1847-48," Bingaman said.
"In that case, forty years apart."
"Resilient."
"Spanish influenza?" a pale nurse asked. "Why are they calling it… Did this outbreak come from Spain?"
"They don't know where it came from," Bingaman said. "But they're comparing it to an outbreak in 1647 that did come from Spain."
"Wherever it came from doesn't matter," Powell said, standing. "The question is, what are we going to do about it? Forty thousand?" Bewildered, he turned toward Bingaman. "The wireless operator you spoke to confirmed that? Forty thousand patients with influenza in Pennsylvania?"
"No, that isn't correct. You misunderstood me."
Powell relaxed. "I hoped so. That figure is almost impossible to believe."
"It's much worse than that."
"Worse?"
"Not forty thousand patients with influenza. Forty thousand deaths."
Someone inhaled sharply. The room became very still.
"Deaths," a nurse whispered.
"That's only in Pennsylvania. The figures for New York City aren't complete, but it's estimated that they're getting two thousand new cases a day. Of those, a hundred patients are dying."
"Per day?"
"A conservative estimate. As many as fifteen thousand patients may have died there by now."
"In New York State."
"No, in New York City."
"But this is beyond imagination!" Talbot said.
"And there's more." Bingaman felt the group staring at him. "The wireless operators I spoke to have been in touch with other parts of the country. Spanish influenza has also broken out in Philadelphia, Boston, Chicago, Denver, San Francisco, and – "
"A full-fledged epidemic," Kramer said.
"Why haven't we heard about it until now?" a nurse demanded.
"Exactly. Why weren't we warned?" Powell's cheeks were flushed. "Albany should have warned us! They left us alone out here, without protection! If we'd been alerted, we could have taken precautions. We could have stockpiled medical supplies. We could have…could have…" His words seemed to choke him.
"You want to know why we haven't heard about it until now?" Bingaman said. "Because the telephone and the telegraph aren't efficient. How many people in Elmdale have telephones? A third of the population. How many of those make long-distance calls? Very few, because of the expense. And who would they call? Most of their relatives live right here in town. Our newspaper isn't linked to Associated Press, so the news we get is local. Until there's a national radio network and news can travel instantly across the country, each city's more isolated than we like to think. But as for why the authorities in Albany didn't warn communities like Elmdale about the epidemic, well, the wireless operators I spoke to have a theory that the authorities didn't want to warn anyone about the disease."
"Didn't…?"
"To avoid panic. There weren't any public announcements. The newspapers printed almost nothing about the possibility of an influenza outbreak."
"But that's totally irresponsible."
"The idea seems to have been to stop everyone from losing control and fleeing into the countryside. Each day, the authorities evidently hoped that the number of new cases would dwindle, that the worst would be over. When things got back to normal, order would have been maintained."
" But things haven't gone back to normal, have they?" Talbot said. "Not at all."
Talbot's comment echoed ominously in Bingaman's mind as the meeting concluded and the doctors and nurses went out to the public part of the hospital. What the medical personnel faced as they went to their various duties was the beginning of Elmdale's own chaos. During the half hour of the meeting, twenty new patients had shown up with what the staff now recognized as the symptoms of influenza – high fever, aching muscles, severe headache, sensitive vision, dizziness, difficulty in breathing. The litany of coughing made Bingaman terribly self conscious about the air he breathed. He hurriedly reached for his gauze mask. He had a mental vision of germs, thousands and thousands of them, spewing across the emergency room. The mental image was so powerful that Bingaman feared he was hallucinating.
"Mrs. Brady," he told one of the untrained volunteer nurses who'd been watching the emergency room while the meeting was in progress. "Your mask. You forgot to put on your mask. And all these new patients need masks, also. We can't have them coughing over each other."
And over us, Bingaman thought in alarm.
The end of normalcy, the chaos that had burst upon them, wasn't signaled only by the welter of unaccustomed activity or by the dramatic increase in new patients. What gave Bingaman the sense of the potential scope of the unfolding nightmare was that Elmdale's hospital, which was intended to serve the medical needs of the entire county, now had more patients than its thirty-bed capacity.
"What are we going to do?" Powell asked urgently. "We can put patients on mattresses and cots in the corridors, but at this rate, we'll soon use up those spaces. The same applies to my office and the nurses' rest area."
The head nurse, Virginia Keel, a strawberry blonde with a notoriously humorless personality, turned from administering to a patient. "This won't do. We need to establish an emergency facility, a place big enough to accomodate so many patients."
"The high-school gymnasium," Bingaman said.
The head nurse and the chief of staff looked at him as if he'd lost his mind.
"With school about to start, you want to turn the gymnasium into a pest house?" Powell asked in amazement.
"Who said anything about school starting?"
Powell looked shocked, beginning to understand.
"A third of our patients are children," Bingaman said. "At the moment, I don't see any reason not to assume that we'll soon be receiving even more patients, and a great many of them will be children. It would be criminal to allow school to start. That would only spread infection faster. We need to speak to the school board. We need to ask them to postpone school for several weeks until we realize the scope of what we're dealing with. Maybe the epidemic will abate."