1636: The Kremlin Games: Chapter Seventeen

    Spring was in the air and mud was on the ground as Bernie and a small troop of Natasha’s guards left the Dacha to travel to the Gorchakov family townhouse in Moscow. It was a pleasant ride on little Russian steppe ponies. The sun was shining and the temperature was in the mid-forties. The breeze was gentle, not the chilling wind of winter. Bernie and the guardsmen laughed and joked about the girls of the Dacha and the visit of the bureau man. Bernie got teased about what invention he ought to introduce and teased the guards back about what inventions they might have to try out.

    All in all, it was a wonderful morning right up until they reached the outskirts of Moscow. As they entered the city, they were met with a delegation.

    “The slow fever has broken out,” said a somewhat chubby fellow in the dress of a member of the service nobility, or perhaps a very wealthy member of the merchant class.

    “What’s slow fever?” Bernie asked.

    That took some explaining and while they were figuring out that it wasn’t anything Bernie knew anything about they had drawn a crowd.

    The guard captain said, “I know there’s probably nothing you can do, Bernie. But at least have a look.”

    And Bernie couldn’t see any way out of it. Moscow in the seventeenth century didn’t have much in the way of hospitals. So it was homes Bernie was taken to; homes of the rich homes of the poor. There weren’t a lot of common factors and for a while Bernie managed to be analytical trying to figure out what was causing the people to get sick. For a while. Then he couldn’t any more. These were people . . . men, women, children. The houses stank and the healers were doing the best they could. There was no way Bernie could think of these guys as doctors what with their talk of balancing humors. But he managed not to call them quacks because it was pretty obvious that they cared about their patients and, again, they were doing the best they could.

    But there was this little kid, a boy maybe four or five. He was running a high fever. Even Bernie could tell that much and his bed was shat in. The healer had just finished bleeding the kid when Bernie got there. He’d be a cute kid, Bernie thought, in other circumstances. It was clear the little boy didn’t know what was going on and that he was in pain. It was like one of those ads asking for money for starving kids in Africa or South America back up-time. Except for the smell. The smell of week-old shit and death. Bernie barely managed not to vomit. This little kid who hadn’t done anything to deserve it was dying because he didn’t have modern medicines, just like Bernie’s mom had died because she didn’t have medicines.

    Bernie stood outside the log house on a Moscow street, breathing in the spring air, knowing that the little boy was almost certainly going to die. God might be a bastard, but he wasn’t out after Bernie specifically. The Ring of Fire didn’t happen just to turn Bernie’s life upside-down. That little boy and all the other people would have gotten sick whether the Ring of Fire happened or not. He’d known that all along, really, but it hadn’t felt like it. It had felt like the whole Ring of Fire was just God messing with Bernie Zeppi. Now, suddenly, it didn’t feel that way. It was more than a little humbling that Bernie wasn’t the center of the universe. The little boy dying in his own waste had had his own life. A life cut short and the kid was going to die in a lot more pain than Bernie’s mom had.

    What was a whole lot worse than humbling was the thought that maybe if Bernie had known what he was doing he might have been able to save the kid and who knew how many others. Maybe he wouldn’t have, but he didn’t know enough even to figure out what the disease was. Maybe cholera? He thought he’d read somewhere that cholera had something to do with diarrhea and most everyone who had this had that.

    The street was muddy and there was a bit of a taint to the air. Not just from the house where the boy was. Suddenly Bernie remembered a cartoon he’d seen somewhere with this cowboy apologizing to his horse as he hammered a cork into the horse ass. Something about an EPA regulation. That’s what he was smelling. Not really a barnyard smell. Not quite. An outhouse smell, that was it. The whole city of Moscow smelled faintly of outhouse. The problem was that Bernie didn’t know if it meant anything. He just didn’t know.

    “Okay, asshole,” Bernie muttered to himself. “What do you know? You must know something that will help.”

    There was one thing that he was pretty sure of. Bleeding didn’t actually help any disease he’d ever heard of. Maybe gangrene or something like that, but not an illness. He waved at one of the guards. “Listen, Pavel, I don’t know all that much about medicine but this much I do know. In my time we’ve known for centuries that bleeding people who are sick doesn’t help. I’ll write Prince Vladimir for confirmation, but I’m not waiting for an answer. The next time I see one of these guys bleeding someone with this, I’m going to bleed them. Cut their throat from ear-to-ear and bleed them right out.” Bernie looked Pavel dead in the eye and Pavel went a little pale.

    Then Bernie continued. “I know it’s not their fault. Doctors were still bleeding people in the Revolutionary War and that’s like 1776. But it doesn’t work! And it makes the patient weaker, more likely to die. If I have to take down a few of these guys to make it stop, I’m still saving lives.”

    Well, Bernie was in it now. He’d made his first medical pronouncement and it was a doozie. He knew that he wasn’t going to be able to leave it at that. He was in it now, and knew that there was no way back.

    In all the doctor shows back up-time, the doctors wore masks when they were doing surgery and he knew that when there was fear of an epidemic in places like Japan sometimes people wore masks. He knew that that was because some diseases were transmitted by air, by people sneezing on each other or even breathing on each other. Was this disease like that? Bernie didn’t know. He knew that in hospitals and restaurants they were fussy about washing your hands. And he remembered something about childbed fever being carried by doctors who didn’t wash their hands. Besides, all the hospital shows always had doctors and nurses washing their hands and wearing rubber gloves before and after they treated anyone. If the masks didn’t help, washing hands might. Or the other way around. Maybe if he could get people to do both it might help keep this sickness from spreading.

    Bernie started improvising. He sent one of the guards back to the Dacha to get anything they had on diagnosing disease. And while they were there, pick up Anatoly Fedorov, the apothecary and Vitaly Alexseev, the barber-surgeon, who were staying at the Dacha.

    It turned out that there was almost nothing in the Dacha about diagnosing or treating disease. However, Anatoly and Vitaly had known Bernie for months by now and had talked to him before about up-time medical and sanitary practices. So while they weren’t entirely convinced of the importance of such things, they had at least been exposed to the germ theory of disease. They’d even seen a couple of pictures of cells. Not photographs, but drawings copied from up-time books.

    It was in their interest that the up-time techniques worked. It would give them an advantage over their competitors. This, it seemed, would make a decent test case. So they supported Bernie’s recommendations. For the next weeks Bernie, the guards, and the medical community, such as it was in seventeenth-century Moscow, fought a holding action against an enemy everyone except Bernie knew too well. Bernie worked as hard as anyone and in the process got up close and personal with the grinding poverty and squalor of seventeenth-century Russia.

    Were they successful? Who could say? The annual spring epidemic of typhoid fever was less severe in 1632 than it had been in 1631. Fewer people caught it and fewer of those who caught it died.

    The reason for fewer deaths could have been the washing of the hands. It could have been the masks. And it could have been the boiled water with a touch of salt and sugar that Bernie called Gatorade that they gave to the sick to try and stave off dehydration. It could be those things made a difference. It could also be the placebo effect of Bernie’s masks and his being an up-timer touched by God. Or it might have just been a mild year.

    The little boy died barely a day into the fight. But, though he would never know it, he left a legacy for Russia. What had been a job for Bernie Zeppi had become a calling. By the time Bernie returned to the Dacha he knew that his getting it right made a difference. That difference was the difference between life and death. Not just for little kids who might catch a disease but for thousands of other kids and adults. Kids who would go hungry without better plows, or better crops. Craftsmen who couldn’t get their goods to market without better roads.