Warday

This influenza caused the most dramatic pneumonic infection we have observed. Infants and the elderly usually died within six hours. A strong, middle-aged adult might linger for three or four days. The mortality rate was about sixty percent in Cincinnati, and about three out of ten people contracted the disease. What that meant in human terms was that, during the six weeks that the virus was active, we lost nearly eighty thousand people. To give you an idea of the magnitude of the problem, about five thousand people died in Cincinnati in 1987, the year before the war. All of a sudden we were dealing with close to two thousand new cadavers a day, and they carried a highly contagious disease. To make matters worse, seven out of ten hospital personnel and half of all mortuary and graveyard workers contracted the disease. Eight out of ten doctors contracted it. We actually had to abandon the hospitals.

The real heroes of the flu were the people who went in there on their own to help out, and not only in Cincinnati, but all over the country. All over the world, I suppose.

I have always been sorry that the flu had to start in Cincinnati, I love that town. It was my home and it was where my children were born. I would have stayed there happily for the rest of my life, if it hadn’t been for the war.

But the flu’s come and gone. We still have NSD with us. I’ll turn to my work in this area unless you two have any more questions about the flu.

JIM: I was there during the worst of it. I remember the bodies in Eden Park.

DR. GAYLE: We were desperate. That wasn’t the only public park in the world where cadavers were stored. Look, this is tough for me. I’d really prefer to go on to NSD.

JIM: Sure. Thank you for sharing what you have with us. I know it’s hard.

DR. GAYLE: NSD is one of a cluster of postwar illnesses, previously unknown, which now affect the North American population.

The combination of the radical negative alteration of the environment and the extraordinary and ceaseless stress of postwar life is believed to have caused the appearance of these diseases, of which Nonspecific Sclerosing Disease is certainly the most serious. It is a central-nervous-system disorder and is apparently caused by unknown environmental factors. Current thinking is that contagion, if any, is limited to skin contact. NSD’s early symptoms are dry, rigid skin occurring in patches, most often across the chest or abdomen. The development of massive cells leads to the “lumpy” appearance that is the familiar presenting complaint. The progress of the disease is accompanied by generalized organic deterioration.

As it spreads throughout the body, the dense, massive cell tissue causes various types of problems, ranging from interruption of ducted flows to actual destruction of organs due to compression or constriction. Death occurs sometimes as a result of a particular functional problem, such as the interruption of the heart or irreversible trachial constriction, but more often is caused by general collapse and exhaustion. The fatality rate is at present one hundred percent.

At first the disease was approached by attempting surgical excision of the lesions. This was unsuccessful because of the broad-based nature of the disorder. A given patient at diagnosis will generally support two to three hundred lesions, most of them microscopic, spread throughout the body. Subsequently, chemotherapy and radiotherapy were tried, but the lesions were not responsive. Color therapy, utilizing so-called pink light, has tended to reduce speed of spread in early-diagnosed disease.

The permissible treatment group has recently been revised by the Centers for Disease Control to include only patients under thirty years of age, employed, and with dependent children. These patients will be treated with thrice-weekly exposures to pink light and hyperbaric oxygen therapy, which has proven effective in reducing itching in surface lesions. They will be allocated three hundred grains of aspirin per twenty-four hours. When they are declared in stage-three disease and unable to function, they will be offered the euthanasia option.

Euthanasia is mandatory for NSD-diagnosed children under twelve years of age. Responsible resource allocation prohibits treatment of children for this disease because there is no chance whatsoever of recovery. The extreme discomfort associated with the progress of the disease makes euthanasia the only humane alternative in childhood cases.

Patients over thirty are given the CDC publication Blessed Relief, which describes effective methods of euthanasia and explains how to stage the disease at home, so the patient can determine when further delay may lead to a non compos mentis situation developing, which would make it illegal to practice euthanasia and impossible for the patient to do it himself. There are many different types of health-care professionals capable of carrying out this type of care in a humane and dignified manner.