The Grantville Gazette - Vol 3 Part 24

"There isn't any just to pneumonia anymore and you know it." Beulah came in and set the small package she was carrying on Garnet's nightstand. Bringing flowers to someone with pneumonia was out so she had brought some of the lemon candy Garnet loved. It would help soothe her throat, too.

"I shouldn't even be in here. I can lie around in bed at home."

Beulah settled herself in a chair by Garnet's bed and said pleasantly. "You even try to get out of that bed and I'll personally put you in four-point leathers and abscond with the key."

"We don't have leather restraints here."

"There are plenty of people around here who could make up a set real quick. Besides, it'd do wonders for my reputation."

Garnet gave a choking laugh that started a coughing fit. Beulah helped her sit up and handed her a handkerchief. She poured Garnet a gla.s.s of water when the fit was over. "Don't make me laugh, okay?"

"Sorry. I'll be sober as a judge.Promise. I'm just glad Stoner's got some more antibiotics on hand. I've seen your micro report. What we've got will cover you so you should be able to go home within a few days and be back at a limited work schedule in a few weeks."

"We've got cla.s.ses going. I have to teach..."

"Cla.s.s material that you aren't teaching will either be taught by someone else if we can find them, or not get taught till you're better. The students won't mind a break, especially before the holidays. We'll think of something, maybe more clinical time. They can always use more of that. You just concentrate on getting better, okay?"

"Okay. But I could probably..." She broke off at Beulah's frown and firm head shake. "I thought it was just the flu."

"That's been going around. I've been working with our outbreak tracking team all week. Looks like the flu is all it is and we've got it pretty well contained so far. I don't think we're looking at a major outbreak.

Flu isn't anything to mess with, though. I'm going to be showing Kunz and some of the others how the tracking team works later and how we're responding to this. It should be a good small-scale object lesson." She switched the conversation briefly to the interest Georg and Kunz had shown in public health and then left after making sure Garnet had plenty of handkerchiefs and cold water. She didn't want to tire her out.

As she left, she was mentally trying to rearrange the teaching schedule. She needed to talk with Courtney or Marcia as soon as she could get in touch with them. There was going to have to be some shuffling but they'd work it out. The sooner Garnet had a definite solution, the sooner she'd be able to relax a little and focus on getting well again. Beulah would stop by again as soon as she had things worked out with the other teachers at the votech program. The EMT and LPN courses would be most affected. She'd have to contact Starr again today and talk about what that would do to staffing projections, especially with some of the staff being pulled as students atJena in two months.Starr is going to start running when she sees me coming after today .

9.

"Please come in and sit down, Mara." Beulah kept her voice even and pleasant with an effort. This was a professional conversation. She wasn't going to stoop to name calling, ranting or even incivility. Well, probably not.

"I wasn't exactly surprised to get a summons to your office at the end of the day. Don't you think using your authority to protect one of your pets is stretching it a bit?Especially since you aren't the DON anymore. Starr is."

Mara had evidently decided she didn't have much to lose and that there wasn't much Beulah could do about what had happened.Wrong move, Mara .The best defense isn't always a good offense. "I'm nottalking to you as the DON. I'm talking to you as the dean of theHealthSciencesSchool and the chair of the Health Education Committee. Of which, at the moment, you are a member."A brief pause to let that sink in; then, "I'm here to talk about your unprofessional behavior and the fallout from it. Mr. Holtz told me what you said to him in the lab this morning."

Mara crossed her arms over her chest and glared at Beulah. "And is what I said so wrong? Okay, calling them parasites went a little far but the truth is that they are parasites. They don't have what we need to do this and by the time they get it, we could have trained our own people to the level we need.

We give; they take. That's parasitism."

"And how many of our own people could we train, Mara? How many of us are there available for health care? How many of us have any significant time to teach the math and science that we need taught or the-"

"But they don't have what we need taught, so why do we want them teaching any of it? They don't understand the scientific method. They don't understand being skeptical and observing and testing what they see. For them, knowledge flows from the authority. They've just figured out that we're now the authority. You want that att.i.tude pa.s.sed on to students? And that doesn't even get into content. They don't know the basics of virtually anything."

"You're exaggerating. Just the experience of having to look at what has changed historically, how and why is already leading them to question their knowledge and how it was generated. They've made a lot of progress and we've got a plan in place to move them forward. The seeds of the scientific method are already present. Autopsies and other ways of observational learning are already going on and have been for a while. See one, do one, teach one has worked for a long time. We still use it in our time. They do have content we need and some of their knowledge is valid. They do have skills we need. Yes, some of what they know will have to be unlearned. Yes, they'll have to make changes in their world view. But they're smart and motivated and I think they can do it."

"In two more months?" sneered Mara."Yeah, right. Meanwhile, we'll be splitting our resources and wasting our time on them. Just splitting the campus so that some of us are here and some inJena is a waste of time and resources we don't have. You aren't the only one who knows what we're facing. I tried to tell youthis months ago, but you wouldn't listen. If I said it, it had to be wrong, didn't it?"

Beulah took a firm grip on her slipping temper. "Have you ever heard the old saying about putting all your eggs in one basket? Right now, all our eggs are in Grantville's basket. What happens if we have one nasty epidemic wipe out most of our medical staff? You and I both know that in epidemics and plagues, the healer death rate is sky high. If we have some of our people and knowledge inJena , they may be far enough away to have some of itsurvive . Not to mention that the time issue is really a wash. Yes, splitting the campus takes more time but it also means that we can have students, the students you don't think know anything, teaching basic anatomy lab and skills like how to dissect, how to suture. We don't have the people or the time to do everything that needs doing."

"Most of our people may lack those skills but they've still got more basic science knowledge and they've got the mentality, the world view that the Jenaites don't." Mara leaned forward, fists clenched on Beulah's desk. "Why won't you see that?"

"I do see it," Beulah returned angrily. "I just don't see it as an insurmountable barrier. These are smart people and they've very motivated. They can get it and they will."

"As fast as we need it? Have you thought about the fact that your little jaunt toJena has already meantthe word about our medical care is spreading even faster? Most people will think it's a fairy story and dismiss it but not everyone and not for long. We can't take care of our own people and now you're spreading this around. We've got more people coming in. What if one of us gets sick? They can't take care of us but we can take care of them. You can d.a.m.n well bet that if my kids or husband are ill, I'm not going to want the medicine or care my family needs going to someone else. And I'm not the only one who feels this way."

"The only way to change that is to train more people and make more resources. Does that mean there will be a bottleneck, for a while? Yes. Does that mean that we're vulnerable right now and will be for a while? I know that better than you ever will. That means we have to look beyond ourselves for both teachers and students. There.Are. Not.Enough.Up-timers. Why won'tyou see that? Or is it just that you don't want to hear anythingI have to say? You talk about content but do you know how to judge the potency of herbs from a particular place?And how to grow and collect and administer them safely and effectively? They do. They may not know all the whys and wherefores but together we can figure that part out. That's just one example. We can help each other and that's symbiosis not parasitism." Forget professionalism. She'd had enough of Mara and her att.i.tude.

"So what are we supposed to do? All turn into little Jenaites? You've been in those meetings. They're still trying to hang onto the quadrivium and the trivium even when it doesn't make sense. We need people who can think and practice nursing and medicine. We don't need nurses and doctors who can debate how many angels dance on the head of a pin because they've had years of theology as part of their basic education. That's bull and you know it. But you won't call them on it. They're fighting for things that aren't what we need, things that don't matter. That doesn't sound to me like they're getting it at all. They have their definition of knowledge and what makes a university andit isn't anything like ours and never will be ."

The truth of some of what she was saying stung Beulah.But she's skewing things, twisting them. How much of it does she really believe and how much is to fight me? Beulah suddenly felt exhausted.

Rage had given her a temporary burst of energy but she couldn't sustain it. "They're trying to hang onto what they, and others here, believe a university education to be. It's difficult but we're working it out."

Even to Beulah's ears, that sounded pretty lame. She was getting so mad that she couldn't think too clearly. This meeting had gone way far afield. Maybe Mara's strategy hadn't been so off target after all.

"Debating what is going on withJena isn't the reason you're here. I'm relieving you of your position on the education committee. Unless I see changes in your behavior, you won't act as preceptor for any students, whether from here or fromJena . Starr will talk with you about your behavior as a staff nurse tomorrow.

Dismissed."

10.

After Mara left, Beulah stood shaking in her office. She hadn't been this mad in a long time. Or this scared. Mara's comments went round and round in her head. They argued for a very different course of action. But there were other voices, too.The voices of the dead and of those who would die if they didn't succeed. She had worked in poor areas ofWest Virginia . She had a pretty realistic idea of what could happen if they didn't get modern public health and other methods in place. The specter of epidemic was real but not as visible as the other threat, war. She'd seen so many die inKorea . Now, war was taking children from her town, people she knew. And it was going to get worse, not better.At least for a time. No. They'd chosen the best path. None of the choices were without risk. Certainly none were ideal.

Mara was just being spiteful. Even as she tried to rationalize it, Beulah knew she couldn't just dismiss all that Mara had said.

The pain hit suddenly. Something with lots of dull teeth was trying to gnaw through her stomach from front to back. A cold sweat broke out on her skin as she lurched for the bathroom just down the hall. A few very unpleasant minutes later, she looked down into the toilet bowl.Blood.

There wasn't that much really.Probably only a few ounces. And it didn't look that bright a red. If the bleed was arterial, she'd be in a world of trouble already. She got shakily to her feet after flushing the toilet, thankful that most people were gone from the second floor for the day. The blood wasn't a big surprise, given her symptoms. After washing her face and rinsing her mouth, she wobbled down the hall to her office, sank down into a chair and reviewed the 1633 available options for a bleeding ulcer.

She'd already changed her diet although she'd have to add more greens and liver to up her iron intake and correct for the blood loss. She could starta baking soda slurry to help reduce the acid. Not too much, she didn't need metabolic alkalosis on top of everything else. Instead of cutting the willow bark dosage, she'd have to stop it entirely. She didn't have anything else for the pain. She wasn't going to try to deal with these problems stoned. She'd just have to tough it out.

They didn't have the equipment to do a scope and see what was down there and then cauterize any bleeders. Surgery for something that might not be so bad, just to see what was there, was too risky in this time. If it came to that, the surgery would be both exploratory and repair work. There wasn't time for surgery. Things were at a crucial juncture with theJena project. They were already behind where they needed to be and events like this morning didn't help.

She'd have to hide this from Mary Pat, which wouldn't be that hard as busy as they both were. She could tell her that she had had her tea before Mary Pat left on her run each morning. There would even be a hot tea kettle there. Getting the variety of calendula and licorice she needed wouldn't be hard. Ray wouldn't ask what she needed it for. He'd just a.s.sume she was helping out with a patient or working with theJena students. The calendula would help with the bleeding as well as the healing. She could possibly use some sucralfate but that was expensive and time-consuming to make. They didn't have much in stock and she couldn't get that without rousing some suspicions. If she had to, she'd get some but that would mean going to James. She'd set a little more time aside for the stress reduction exercises. Just a few minutes here and there could make a difference. The exercises would also help with the pain.

There were options. She'd take them. There wasn't any point in adding to anyone else's worry, especially Mary Pat so soon after the death of Hans and Larry. There really wasn't anything else anyone could do, either. She'd make the changes, take the meds and monitor her condition. If things got much worse, she'd talk to James.

Chapter Eight.

November, 1633

1.

The stress didn't abate over the next two weeks. If anything, it was getting worse. The meetings with the Jenaites weren't going as well as Beulah had hoped. Mara's words came back to nibble at her more often than she'd have liked. Garnet was back on light duty starting today. If Garnet had gotten ill just a week earlier, there wouldn't have been any antibiotics to treat her pneumonia. They'd sent them all to the siege areas. She might have survived the pneumonia but the odds were much worse without antibiotics. Garnet wasn't just a colleague. She was a friend. She knew her so well. Garnet the gun nut who loved to debate for hours on caliber and range and anything else gun or hunting related. Garnet who was positivelyphobic when it came to spiders and who loved the color yellow. They'd already lost so many people they couldn't treat. Beulah firmly believed in the moral stand they were taking and the pragmatic logic that also went with it. But there were consequences.Always consequences.

They were still arguing with theJena faculty about things like astronomy, for Pete's sake. Great, you've got an observatory. We're happy for you. What does being able to find Venus have to do with diagnosing and treating a patient? Beulah's patience wasn't endless and they were running out of time. It wasn't just the January start date she was thinking about. It was almost Thanksgiving. The Jenaites would be leaving the first part of December and they still hadn't been able to iron out some basics in the curriculum. Every time she thought they'd gotten ahead there was another stumbling block. She also wanted to get some more knowledge squeezed out of them. Just yesterday, Werner came up with a botanical treatment none of them had heard of for a patient that they'd been trying to treat without success for weeks.

She was able to hide the bleeding for those two weeks, even from Mary Pat although she was beginning to watch Beulah pretty closely. At first, the measures Beulah tried seemed to be helping enough. The bleeding stopped for a while but the pain was worsening over the last few days. She was debating whether or not to see James in the morning when the decision was taken out of her hands that night.

2.

"Beulah?"Mary Pat shrugged out of her coat and shook the rain drops off as she stood by the front door. She put the coat onto the coat rack and headed for the kitchen. Dinner preparations were partway made and the light was on, but no Beulah. Mary Pat had stepped out of the kitchen and headed down the short hall to the stairs when she heard the sound of vomiting. The flu was going around but it was morerespiratory this year than GI.

She quickly headed up the stairs and opened the door, calling Beulah's name. What she saw wasn't what she expected. She had caught a whiff of the blood as she approached the door but it hadn't had time to register. Beulah had almost made it to the toilet before she was sick. Despite all Mary Pat's experience, the sight of Beulah half lying amid reddish black blood, deathly pale and shaking hit her hard. For a heartbeat, then another, she couldn't move, couldn't think. Then training kicked in and her nursing skillscame flooding back. She touched Beulah gently on the shoulder, then the neck, doing an at a glance a.s.sessment. The feebleness of her pulse, her pallor and the moisture on her skin worried Mary Pat.

Beulah was going into shock.

"I'm here. I'm going to call an ambulance and be right back." She didn't remember later whether her feet even touched the steps on the way down the stairs. The phone was in her hand and she cursed under her breath. Why couldn't Beulah have a touch-tone phone instead of the slow black rotary phone?The second it took after dialing 9 in 911 would have been all the time she needed to punch in 911.

"EMS, Walter Allen. What is the nature of your emergency?"

"Walt,it's Mary Pat. I just got home and Beulah's throwing up a lot of blood." She gave him a concise a.s.sessment, not that there'd been time to gather more information. She didn't hear anything from upstairs.

Had Beulah pa.s.sed out?

"Chesterand I are on our way. Be there in a few minutes. I'll notify the ER staff on the way. They'll gear up for her."

Mary Pat was relieved that Walt andChester were on duty. Both were experienced EMTs in their fifties.

"I'll have the door open for you." She hung up and rushed back up the stairs, praying all the way.Please, please G.o.d, help her. And, more selfishly,don't take her from me yet.

3.

James sat on the edge of her hospital bed and glared at her. "Don't think we aren't going to have a long talk about you hidingthis the last few weeks just as soon as you're up to it."

"Mary Pat..."

"I'll see she's taken care of. Right now she looks like h.e.l.l. I'm going to send her home with something to help her sleep."

"She won't take it."

"Then I'll come up with another plan. You're going to rest if I have to hogtie you to that bed. I heard about you threatening Garnet with leathers. I'll have a pair made up for you."

"Haven't worn leather in years.Don't have the body for it anymore." As comebacks went, it was a little weak, but James' lips twitched just a little. She couldn't be that bad if she could still come up with a joke.

"We'll see about that. You can bet that everyone who walks into this room is going to be on your case if you overdo. And we all know you well enough to watch you like a hawk. In the meantime, I'm giving you four mg of morphine. It'll help with the pain and let you get some sleep."

He stayed with her for a few minutes waiting for the medicine to take effect and then got up. He had an idea of how to handle this before he faced the crowd outside. And he had no doubt there would be acrowd, even this late.

Mary Pat was at the desk talking with the nurse who'd be caring for Beulah tonight. James' gaze lit on Fritz and he relaxed a little. "Fritz, come over here a minute."

A very concerned Fritz walked out of the group of others hovering near the door. Hospital staff and EMTs, off duty or not, a couple of Jenaites even. Word had spread fast even though it was after ten at night. Garnet was there too. He'd have to see she got back to bed as well.Dammit, didn't anybody know how to get some rest around here?

"I'd like you to special Beulah tonight. It'll let Mary Pat get some rest and her bearings. Then she can help me deal with Beulah tomorrow. Can you do it?"

"Of course.I was planning to study for another few hours anyway. Now that Fraulein Garnet is back, we are catching up on our studies for the LPN courses. I was off tomorrow anyway. Just let me get my books." As Mary Pat approached, the crowd moved in a little closer. Fritz patted her on the shoulder a little awkwardly before moving off. "She's going to be well soon. She is very strong and we'll take good care of her."

"How is she?" asked Mary Pat anxiously.

"Sleeping.I gave her some MS for the pain. I've got a couple of patients I'm keeping a close eye on, so I'll stay here tonight. Fritz was going to be up studying anyway, so I've asked him to sit with her."

Antic.i.p.ating her protest, James continued firmly, "I'd like you to go home and get some sleep tonight, Mary Pat. You get some rest so you can help me sit on her tomorrow."

"I'd rather stay.Not that I don't appreciate Fritz being willing to stay."