I’m provincial, he thought, and what was wrong with that? A man could not encompass the world. If he tried, he would lose too much. Friends and familiarity of place, the warm sense of belonging … Since he had come to this town, many things had happened to him—good things—with quaint little privileges established. Like old Ezra Pike and his annual crop of pheasants reserved for good old Doc and a few others in the town, and for no one else.
He sat in the office and tried to peel the years away, back to the time when he had first come here; but the years refused to peel and the diploma still was fly-specked and the scales still battered and he remained an aging man who carried the town upon his back.
The phone rang and he picked it up. It was Harriet.
“When are you coming home?” she asked. “I have a leg of lamb and it will be ruined if you don’t get here fairly soon.”
“Right away,” he said.
The next day was Saturday and office hours were from eight till noon. But, as was usually the case, the last patient was not gone until after one.
Once the waiting room was cleared and Amy had gone home, Benton got to work on the files. He went through them carefully, making notes as he went along. He didn’t finish the work on Saturday, and came back Sunday morning.
Going back through ten years of records, he was able to isolate some trends. There had been, in those years, a substantial increase in the symptoms Abbott had outlined. The incidence of obesity had risen rapidly. In more instances that he had recalled, the high level of blood sugar had indicated diabetes, but further tests had inevitably failed to bear out his tentative diagnoses. There had been, increasingly, a spate of muscular soreness. There were an increasing number of patients who had complained of general malaise, with no apparent cause.
Most of the symptoms were found in townspeople. Among the farm families, only the members of one family, the Barrs, had experienced the symptoms. The Barrs, about three years before, had come from somewhere in Ohio, buying the farm of Abner Young, a recluse who finally had died of old age and general meanness. And not a single case with those symptoms showed up among the hill people.
Maybe, after all, Benton told himself, geography might be a factor in Abbott’s epidemic—if there were an epidemic. But if some of the townspeople had the symptoms, why not all of them? If farmers were immune, as seemed to be the case, what about the Barrs? What was different about the Barrs? Recently arrived, of course, but what could that have to do with it? And what was so magic about the hills that in all the hill folk no symptom had turned up? Although, he reminded himself, he should not assign too much weight to the negative data from the hills. The people there, a hardy tribe, would not deign to visit a doctor for such minor reasons as being unaccountably tired or putting on some weight.
He pulled the sheets of notes together and, searching in his desk drawers, found some graph paper. The graphs, when he had them drawn, showed nothing more than he already knew; but they had a pretty look to them and he found himself imagining how they would look printed on the slick paper of a prestigious journal, illustrating a paper that might be entitled “The Epidemiology of Muscular Exhaustion” or “The Geographical Distribution of Obesity.”
He went over the notes again, asking himself if he might not be looking at what amounted to medical constants—conditions persisting through the years, with only minor fluctuations from year to year. This did not seem to be the case. Ten years ago, there had been few of the symptoms—or at least few of his patients had shown up complaining of them. But, beginning seven or eight years ago, they had started to show up; and on the graph the curves showing their distribution over time rose sharply. There was no doubt the symptoms were a recent phenomenon. If this were so, there must be a cause, or perhaps several causes. He searched for a cause, but the few he could think of were too silly to consider.
Benton looked at his watch and saw it was after two o’clock. He had wasted most of the day and Harriet would be furious at his not showing up for lunch. Angrily, he shuffled the notes and graphs together and thrust them in a desk drawer.
He had wasted most of the weekend at it, and now he would wash his hands of the whole thing. Here was something that more properly belonged in a research center than in the office of a country doctor. His job was to keep his people well, not to tackle the problems of the world. After all, this was Abbott’s baby and not his.
He wondered at the anger that he felt. It was not the wasted weekend, he was certain, for he had wasted many weekends. Rather, perhaps, it was anger at himself, at his own inadequacy at being able to recognize a problem, but be unable to do anything about it. It was no concern of his, he had insisted to himself. But now he had to admit, rather bitterly, that it was deeply important to him. Anything that affected the health and wellbeing of the town was his concern by automatic definition. He sat at the desk, his hands placed out before him, palms down on the wood. His concern, he thought. Most certainly. But nothing that for a time he should wrestle with. He had a job and that job came first. In the chinks of time left over, he could do some thinking on the problem. Perhaps by just letting it lie inside his mind an answer might be hatched, or at least the beginning of an answer. The thing to do, he decided, was forget it and give his subconscious a chance to work on it.
He tried to forget it, but over the weeks it nagged at him. Time and time again, he went back to the notes and graphs to convince himself that he was not imagining the evidence found in his records. Could it be, he wondered, a circumstance that prevailed only in this place? He wondered what the other physicians Abbott had talked with were doing about it—if they were doing anything; if, in fact, they had even looked at their records; and if they had, what they might have found …
He spent hours going back through old issues of The Journal of the American Medical Association and other journals, digging into the dusty stacks down in the basement, where they were stored. He could easily have missed something bearing on the matter in the medical magazines, for up till now he had not been too conscientious in his reading of them. A man, he told himself—making excuses for himself—had so little time to read; and there was so damn much to read, so many medical eager beavers intent on making points that there was a continuous flood of papers and reports.
But he found nothing. Could it be possible, he wondered, that despite Abbott’s work he, Benton, might be the only man who knew about the condition that he had come to characterize as the exhaustion syndrome?
A disease? he wondered. But he shied away from that. It was too selective to be a disease, its parameters too narrow. A metabolic disorder, more than likely. But for a metabolic disorder to come about, there must be an underlying cause.
Burt Curtis, it turned out, was no more diabetic than Ted Brown had been. His blood sugar was haywire, but he was not diabetic. After Helen had nagged at him for a time, Herb Anderson came in and his case was almost identical with Burt’s and Ted’s. An insurance salesman, a merchant, and a down-at-the-heels house painter—what in the name of God, he asked himself, could those three have in common? And then there was the Barr family! The Barr family bothered him a lot.
There were others now as well, not such classic examples as Burt and Ted and Herb; but each of them showed some of the symptoms of the exhaustion syndrome.
“You have to put it out of your mind,” Harriet said one day at the breakfast table. “It’s the ‘good old Doc’ complex again. You have allowed it to drive you all your life and here it’s driving you again. You can’t go on like this. You have other things to do, you have a full-time job. If this Abbott person had not shown up, you would not have noticed it.”