Die Once Live Twice Read online

  DIE ONCE

  LIVE TWICE

  a novel by

  Lawrence Dorr, M.D.

  Silverado Books

  Napa, CA 94558

  www.SilveradoBooks.com

  Copyright ©2011 by Lawrence Dorr, M.D.

  ALL RIGHTS RESERVED

  ISBN 978-0-9817425-6-4

  Library of Congress Control Number: 2011932181

  This is a work of fiction. Names, characters, places and incidents are either products of the author’s imagination or, when based on historical figures and events, used fictitiously.

  Cover photograph: © Geoffrey Clements/CORBIS

  Painting: The Agnew Clinic by Thomas Eakins

  First edition.

  To my wife Marilyn, and my kids,

  Michael, Kristy, Randy, and Hunter.

  A family worth living twice for.

  I would like to pay tribute to the following physicians who helped bring Die Once Live Twice to life. These medical pioneers live again in the pages of my novel, and when you see their names know that they made real life contributions to the world of medicine and we are all indebted to them.

  D. Hayes Agnew

  Joe Megis

  Herman Biggs

  William Osler

  John Shaw Billings

  William Park

  Ernest Chain

  Louis Pasteur

  Marie Curie

  Walter Reed

  Harvey Cushing

  Peyton Rous

  Alexander Fleming

  Albert Sabin

  Simon Flexner

  Wilbur Sawyer

  Howard Florey

  Arthur Steindler

  William Gorgas

  Max Theiler

  William Halsted

  Emil von Behring

  Danny Heatley

  Warren Weaver

  Hunter McGuire

  William Welch

  Cover Illustration: The Agnew Clinic, the clinic of surgeon David Hayes Agnew at the University of Pennsylvania, painted by Thomas Eakins, 1889.

  — TABLE OF CONTENTS —

  PART I: THE DREAM 1853–1893

  1. Cancer’s Child

  2. Death’s Love

  3. Stolen Kiss

  4. Fox Chase

  5. War and Love

  6. The General and the Captain

  7. Temptation

  8. Renewal of Love

  9. Betrayal

  10. Surprise

  11. Disaster

  12. No Second Chance

  13. The Phoenix

  14. Crusade

  15. Promise Kept

  PART II: THE AWAKENING 1895–1922

  16. Legacy

  17. Cures

  18. Jonathan the Lion

  19. Vaccine Fever

  20. Resurrection

  21. Evolution

  22. Eureka!

  23. Revolution

  24. Spinal Fusion

  25. Fractured Faith

  26. Dream Denied

  27. Illusive Truth

  28. Sugar Time

  PART III: YELLOW GRAIL 1934–1942

  29. Tip of the Iceberg

  30. Devil’s Blood

  31. Of Mice and Men

  32. Two Wars

  33. Fly to Glory

  34. Penicillin’s Promise

  35. The Grail

  ACKNOWLEDGMENTS

  PART I

  THE DREAM

  1853–1893

  Chapter One

  CANCER’S CHILD

  —1853—

  As the evening sunlight of a long summer day cast a streak through the window of the Pennsylvania farmhouse, Katherine Lovington sat in a straight-backed wooden chair with her hands pressed together as if in prayer. I wonder if Mother will eat supper with us tonight. Please, God, let her get up and come help me. Please.

  Her silent prayer was answered by a cry like a wounded animal. “Aaah! Dear Lord, isn’t that enough?” Katherine leaped to her feet, but before she could run to her mother’s bedroom, another agonized wail made her cringe. “Aah! Kather—aah!—Katherine.”

  Katherine moved briskly to help her mother. Maybe God was not answering prayers today.

  Katherine could not believe a person could change so much. For all her thirteen years she had wanted to be just like her mother. Look like her. Dress like her. Act like her. Now her mother had lost so much weight her face was nothing but bone and shadow. Her hair, what was left of it, had turned completely gray. “Katherine, please, can you give me...” Lillian’s hand fell toward the night table, and Katherine knew she wanted more laudanum. The sweat that drenched Lillian’s gown told Katherine that the pain was raging in her body.

  Katherine carefully measured out the drops and then lifted the spoon to her mother’s mouth. “My sweet daughter,” Lillian said. “I am sorry to cause you so much trouble.”

  “Oh, Mama, hush,” Katherine said, fluffing her mother’s pillow and tucking the blanket up under her chin. The laudanum would quickly quiet her mother’s pain. She wished her own pain and anger could be assuaged so easily. She was tempted to try this medicine, but the smell was so foul that she could not bring herself to do it. She was agonized by her mother’s illness and enraged that the doctor could do so little. Her grandfather was the richest man in Philadelphia. His shipping and textile business employed more people than any other business. He entertained the President of the United States. She knew he had hired the best doctor in Philadelphia. But still she had to witness the horror of her mother’s suffering.

  Katherine sat with her mother until she fell into a restless sleep. With this temporary peace, Katherine’s anger calmed. What makes Mother feel better makes me feel better.

  Rising quietly, Katherine returned to the kitchen to help Emma cook supper, but her mind would not leave her mother’s condition. What exactly was wrong? Why had they moved from Philadelphia to their farm near Lancaster? She wished her parents would tell her more.

  “Cancer,” her mother had said. The word kept playing over and over again in her brain. She had no idea what cancer was. None of her friends had it. No one she knew had had it. She knew it was powerful, though—she could tell from the fear in her mother’s eyes. Never before had she thought her mother would be afraid of anything. Lillian Donovan Lovington was the strongest person Katherine knew, her Queen Victoria, the president of every women’s organization in Philadelphia. She raised all the money for the church, entertained the president now that her own mother had passed. Katherine truly believed her mother ran Philadelphia.

  All that changed the night Lillian came home from the doctor. Though a visit to the doctor was unusual even for people with the wealth of the Lovingtons, Lillian had confidently expected Doctor Agnew to prescribe a salve that would heal. After supper, her mother had said to her, “Katherine. I went to see Doctor Agnew today at Pennsylvania Hospital. You see, I had a sore here.” She nodded her head toward her right breast. “It was draining pus.” Her mother hesitated for a second and looked at her father, who nodded. Then she continued, “You should know about this. You may have to face the same situation.” Katherine could see the fear come into her mother’s eyes. “Doctor Agnew asked for permission to feel in my armpit. When he touched me, it was quite painful.” She shuddered. “Then he said, ‘Please forgive me, Lillian,’ and that I should dress while he brought in your father.”

  “Why did he need to speak to Father?” Katherine was confused. “How could he help?”

  “It was not a matter of help. Sometimes doctors need to talk to both the mother and the father at the same time. When it is serious. He told me that I have cancer.”

  Katherine’s head jerked back as if she’d been slapped. Then she turned back to her mother. �
��You’re going to heaven, aren’t you.” It was a statement, not a question.

  Her father started to intercede with an optimistic tone in his voice, but Lillian stopped him. “Give the girl credit,” she said quietly. Then she turned back to Katherine. “It may turn out that way, but I don’t believe it yet.” Lillian looked into Katherine’s deep blue eyes as they misted with tears. “We will pray each night for as much time together as the Lord will allow.” Then she tried to smile. “Maybe God wants me closer to him to help him run Heaven.”

  Katherine shook her head furiously. “No! I want you to be close to us. God doesn’t need you right now.”

  “Well, maybe He does. God’s will is His will.” Lillian stood up. “Off to bed. We will talk more about this tomorrow if you like.”

  They never did.

  When Lillian woke, the sweet smell of fresh rain was in the air. She lay awake listening to the soft beat of the rain on the rich soil outside her bedroom. When she heard waves of rolling thunder in the distance, a slight smile gave new life to her weakened body. The fields need the rain. What a blessing this storm is to the crop. She wondered if Katherine was in the house safe and sound or had gone out to help her father with the horses. William, who had grown up on a farm himself, had always made sure that Katherine learned the value of honest labor. In truth, she enjoyed working with her father. Lillian felt badly that Katherine had to spend so much time nursing her. The cancer is slowly eating me up. Why can it not take one big gulp and be done with it?

  She had never had to live with fear. It had begun that day in Doctor Agnew’s office, with his demeanor. Her fear was confirmed when he brought William in. The doctor sat facing them, he behind his desk and they sitting in chairs across from him, awaiting his diagnosis. “Lillian, there is no easy way to say this. There are painful lumps in the axilla under your arm, and combined with the sore, I can only conclude that you have cancer in your right breast.”

  She was speechless. The word bored into her brain. William, not quite sure what the diagnosis meant, asked, “What will be the course of this disease?”

  “William, there is no remedy. We do not know what causes this disease and we have no treatment. With a draining tumor, cutting it away is not an option. A deadly infection would instantly set in.” He turned to Lillian. “I am afraid the disease will spread throughout your body, Lillian.”

  “There is no cure?” Lillian’s eyes felt heavy with grief already.

  “I will give you strong medicine, Lillian. It is all I can do.” Doctor Agnew folded his hands and looked down. Then he raised his head again. “I’m afraid it is inevitable. Perhaps three months.”

  The doctor waited. The only sound in the room was Lillian’s muted crying. William sat stunned. He wrapped his arm around Lillian and drew her to him. Doctor Agnew slowly rose and came around the desk to put his hand on William’s shoulder. “Don’t you have a small farm near Lancaster? Take your wife there. Even among the educated, there is great fear this is contagious and sometimes people can be, involuntarily or not, offensive in their reactions.”

  Lillian wiped the corners of her eyes. She straightened her hat and settled it on the top of her head. She stood and smoothed her dress. “Doctor Agnew, thank you for your concern. I will take the medicine you recommend. This coming Saturday I will be having a dinner party at our home for our close friends. Please come. Next week we will move to the farm. I will send Pollard to you if I need more medicine.”

  They shook hands with Doctor Agnew, and Lillian, as she had all her life, squared her shoulders and strode out of the office, her head high. She would face whatever came next. She just didn’t know what it was, and that was the wellspring of her fear.

  She forced herself to listen to the patter of the raindrops on their roof. Closing her eyes tightly, she concentrated on the sound of each drop as if they were creating a melody. Her frail body began to relax and the twinge in her chest subsided. Doctor Agnew had warned her that as the time got closer her body would become fragile. Lillian was astonished at the idea. She had never let fatigue or hunger or sickness keep her from her duties. Now her body had become as the doctor predicted: an insidious enemy of her mind and her will.

  The rain started to come down harder and Lillian began to worry. Where could they be? Just then she heard the clank of the stove door swing open and she relaxed once again. The storm had darkened the day and now she saw rays of light in the hallway as someone lit the kerosene lamps. Soon she heard Katherine adding logs to the fireplaces in the dining room and den to warm their small country home. She gave a small sigh of relief as she listened to the comforting sounds of life around her.

  Quiet footsteps approached Lillian’s door and it gently opened, allowing just room for Katherine’s head. Then Katherine herself eased into the room and gently replaced the quilt over her mother. Lillian smiled. “Thank you, sweetie. I pulled it off earlier when I got warm but just noticed a chill in the room. Did you help your father with the horses in all this muck?”

  “I did.” She sat next to her mother and lifted her foot to show the mud on the cuffs of her pantaloons. “I wore a woolen bonnet so my hair did not get much wet.” Her hair was parted in the middle, like all women and girls in their circle, and it was turned up on the sides, held by netting. Her dress hung short of her ankles, as girls were allowed to do. Her sleeves cuffed at the wrist and her dress collar hugged her neck. “The mares got spooked with the first bolts of lightning and galloped off to the back fences again. Papa says we just need to blindfold them for the whole of spring.” Katherine laughed. “I don’t think he would mind it if we really could. They were a handful to get back.”

  Lillian grimaced, trying to hide the searing pain that shot through her back as she struggled to raise her head. Katherine’s shoulders sagged at her mother’s grimace and Lillian saw it. She had always gone to great lengths never to let Katherine see her sick. She knew all too well that life was tough and in order to survive you could not cower at adversity. Now she realized that her strength had prevented her family from preparing for what was happening.

  Katherine turned towards the kitchen at the sound of her father stomping the wetness from his boots on the door grate. She looked back to her mother. “Papa’s going to want his coffee. I made some tea for you. Are you ready? Do you want to get up for a while?” she asked hopefully.

  “You have grown up so fast. I am so proud of you.” Lillian smiled.

  “Actually, I’m still a little tired. Let me join you for supper. Have your father wake me before you sit down. I’m eager to try your latest dish.”

  Katherine looked at her mother and smiled sheepishly. “Mama, I have a special surprise tonight.”

  “Wonderful, Katherine. I can’t wait!”

  Katherine beamed. Cooking for her mother gave her a chance to feel she was contributing to her care. Emma patiently supported her, dressing up the meal even when Katherine’s skills fell a little short.

  As Katherine slipped from the room, Lillian sank into the down mattress and prepared herself for the pain that was coming throughout her body. She drew in a slow deep breath to try to relax. The air that tried to fill her lungs met with resistance and spasms consumed her. She quickly grabbed the cloth she kept at her bedside and covered her mouth to stifle the sounds and to catch the blood she coughed up.

  Panic started to set in as she gasped for air. Shaking, she clutched the cloth tightly over her mouth, as she felt the blood rise from her throat. Her heart pounding and her chest tightening, she rolled onto her side to bring her knees to her chest to reduce the pain. Mind racing, and suddenly seeing the room all too clearly, Lillian instinctively prayed. “My refuge,” she gasped, “my fortress.” She attempted to breathe again, this time finding some relief. Slowly she focused on each word. “My God...” Slower now. “...in whom...” Quieter still. “...I trust.” Finally, the pain eased and her body quieted. She removed the blood-soaked cloth and placed it in the bin she kept hidden under the bed. She wou
ld find a way to wash it out in the morning when the house was empty. Exhausted, she closed her eyes to hold in the tears. The room swayed gently as she drifted off.

  Chapter Two

  DEATH’S LOVE

  William Lovington shook off the dampness from his afternoon’s work rounding up the horses. He swung his hat up on the hook in the wall and laid his cape over the back of a chair. As he ducked his six-foot three-inch frame through the door from the porch to the kitchen, Katherine said, “Momma wants to have dinner with us tonight.”

  He dropped his bony body into a chair by the kitchen table and answered, “Well, that will be wonderful.” William felt Katherine still looking at him as he unbuckled his wet boots. He was exhausted and needed just a few minutes. “She’ll need some more rest first,” he said without looking up.

  Katherine leaned against the kitchen sink and wondered why they had not brought more of the household help down from Philadelphia. Besides Emma, there was only their butler Pollard, and he was useless in helping with Lillian. Katherine knew her father couldn’t keep from worrying about her mother, who had always been the one to pick up everyone when they were blue. As she watched her father fiddle with his boots she wished she knew his thoughts. Was he planning what they would do for her mother—after? Would she be able to go back to school? Or—Katherine had not thought of this before—would he marry again? That was too much for her.

  Katherine watched her father’s shoulders sag forward after he took a deep breath. She could sense the helplessness in him and it unnerved her to see him so lost. She felt the anger rising in her again and tried to push it back down. “Why don’t you go check on Mother? She wanted you to wake her and I know she needs help getting dressed for dinner.”