by Lauren Small

from Baltimore Divide, a novel in progress 


Margaret Marshall is gone. In the end Nell could do nothing but sit by her side as she gasped for breath, her lungs full of fluid, her skin dusky with cyanosis. The blue death: making a mockery of Nell’s medical degree, making a mockery of everything she’s ever worked for. Whats the good of being a doctor when your beloved assistant is dying and there’s nothing you can do? By the time Margaret succumbs, drawing her last breath at the break of dawn, Nell is glad to see it. At least her suffering is over. But then the wailing starts from Margaret’s mother while her father turns his face to the wall, and Nell realizes for this family the suffering is only just beginning. 

 Influenza. Never has Nell seen anything hurtle so powerfully across the color divide that separates her city into streets and alleyways, black and white. Race determines everything in Baltimore, where you sit and where you stand, where you sleep and where you shop, the streetcar you ride in, the school you attend, the church you belong to. If you are sent to war it determines the regiment you serve in, and if you are unlucky enough to die, it determines where you are buried when your body is returned. The Baltimore she loves is also the Baltimore she despairs of, filled with people who live intensely close to one another but also infinitely apart, knowing of each other without really knowing. How much, if she is to be honest, does she really know of Margaret’s life? How can she properly mourn her when she’s never even set foot in the church where her father serves as pastor? The thought gives her grief a painful cutting edge. 

The Marshall family resides on Hamiltonone of the more prosperous of the alleyways criss-crossing West Baltimore where the colored people live. But prosperity is no protection against the flu—nor is prayer. Nell sees it in the pastor’s eyes, a kind of vacancy as defeat sets inhis mind growing numb, shutting downIt’s the same look she’s seen over and over again in faces of the bereaved ever since the flu epidemic took hold, adding another layer of misery to what already felt like the bottomless misery of the Great War. The dying happens too fast, leaving people no time to adjustIf Nell could, she would go numb herself. But shutting down is a luxury she can’t afford. Too many people depend on her. Each morning they fill her waiting room, line up on the stepsspill out onto the sidewalk. Now that the sun is up, they will be gathering again. She needs to get home. 

 “I will send someone for her,” she promises Margaret’s mother as she slips out the door, even though she knows it’s a promise she may not be able to keep. The epidemic is only two weeks old, and already well over ten thousand people in the city are ill, nearly a thousand dead. At first the horse-drawn hearses were a familiar sight, wending their way to Greenmount and Baltimore Cemeteries where the bells on the gates tolled their mournful arrival. But lately the hearses have disappeared, the funeral parlors closing one after another, their directors felled with flu. The entire city is beset with shortages of caskets and gravediggers. Nell has heard rumors of bodies piling up, unburied. 

Only please, she thinks to herself as she heads westward through the alleyways for home, please not Margaret.  

With dawn has come a soft blue sky, a fresh tang to the air. It’s a lovely day in mid-October, or rather would be if any day could be called lovely at a time like this. The city has a ghostlike feel. A masked woman walks by, her shoulders hunched, keeping her distance. A lone man drives an empty cart like a specter. A pig roots forlornly in the gutter. There isn’t even any garbage to eat.  

“Miss. Please.” 

The voice comes from a doorway on her left. Don’t stop, Nell thinks. You need to get home. You need to see to Margaret’s burial. And your patients. They’ll be waiting.  Don’t stop, and above all, don’t look. You can’t treat them all. You can’t possibly— 

“Please. Miss.” 

She stops, turns, looks. “Yes?” 

The man sways slightly, barely able to stay upright. He’s tall and thin, would probably have been thin even under the best of circumstances, but from illness has become skeletal. His eyes are bloodshothis lips dry and cracked. If nothing else, he needs water. Nell knows how hard it will be to get it into him. It’s one of the worst symptoms of the influenza, people refusing to eat or drink. Then she realizes—it’s in his face—he’s not asking for himself. He’s asking for someone else. 

“Please. Miss.” He leans towards her, holds out his hand. 

Yes.” She takes a deep breath. “Of course.” 

She follows him into the house, no, not house, a storage room tacked on to the end of a long row of alleyway houses. He must have been kicked out of the place where he was living when he got ill and took refuge here. The room still smells faintly of earth; bales of straw are stacked against the walls. The floor is dirt, the walls nothing more than wooden boards with light leaking through the seams. In the center lies a woman stretched on a blanket. Dead. A few hours most likely. The flies are only now finding their way to her; she hasn’t yet started to smell. Nell feels a surge of hopelessness and frustration and finally anger at the man who has brought her here. He must be mad from shock. “I can’t help you,” she says. “She’s gone.”  

 “No,” he whispers. Then she realizes: it’s not the woman. It’s someone else. “Miss. Please.” 

But there is no one else. Or is there? He is leaning towards a pile of rags in the corner. She draws closer. An infant. Three months old or so. The baby looks up at her, bright-eyed, the mouth working, the fingers clasping and unclasping. How strange to see such happiness in the midst of so much sorrowThe baby coos, wriggling joyfully, offering her a crooked smile.  

“Please,” the man says again.  

Nell knows what he wantsknows what she must say. She can’t possibly take this child. “Isn’t there anyone else?” she asks, already knowing what the answer will be. If there were, they would have come and taken the baby away.   

 “Please.” He mouths the word. 

Milk, she thinks. I would need milk, and where am I to find it? Most of the stores are closed. Supplies are low, the shelves bare, milk gone along with everything else, and no one left to bring more. How quickly the world has come to a halt! The carters and drivers are ill just like the gravediggers and firemen and streetcar conductors and teachers. The city has simply shut down. 

She rummages in her bag for a pen and her prescription pad. Not for a prescription—there’s no point in writing one. Medicines are in short supply too, aspirin and Epsom salts and epinephrine all scarcer than dragon’s teeth. “It’s a girl, isn’t it?” she says. On the baby’s dress is a bit of lace. 

He nods. 

“When you are better, come and get her.” Nell writes her name and address on the page, rips it off, and hands it to him. Then she pulls a packet of aspirin from her bag. “Take this. With water. Lots of water. Do you understand?” 

He shakes his head. He won’t take it. He wants her to save the medicine for the ones who might get better. 

She presses the packet into his hand. “Take this. Do you hear me? With water.  Plenty of water. And when you are better, come and get your baby.” 

She bends over, picks up the baby. She is surprisingly lighttoo young to have a fear of strangers. She gives herself over easily to Nell’s arms 

Thula,” he says. 

“Her name is Thula.” He glances towards the corpse on the floor. “Like her mother. Tell her that.” 

“You will tell her yourself,” Nell says firmly. But she knows he won’t. As she leaves the house with the baby in her arms, she looks back and sees the man—Thula’s father, his great responsibility discharged, his body quivering with relief—lie down next to his wife and close his eyes. 


Nell hurries home, the baby tucked securely in her arms. She will see to Margaret’s burial. But first she will see to Thula. She will need milk. And where is she to find it? 

She emerges from the alleyways onto Eutaw Place, the grandest of the west side avenues. In the center runs a broad, grassy median, studded with walkways and fountains. Normally Eutaw would be stirring by this time of the morning, elegant horse-drawn carriages and chauffeur-driven automobiles passing by, nannies pushing prams, gloved ladies in veils and hats strolling arm in arm. Today the street is all but deserted. Only the children are out. They’ve been gathering on the avenue for days now, ever since the schools closed, the girls skipping rope, the boys hunched over games of marbles. They have been sent from their homes where their relatives are sick or dying. Better, Nell thinks, for them to be in the fresh air.  

A my name is Alice, my husband’s name is Albert, we live in Annapolis where we sell apples . . . . 

The girls sing as they skip rope. The sound is rhythmic, hypnotic. Nell stops for a moment to listen. All at once she realizes how tired she is. She has hardly slept for days. Three is it, or four? She sinks onto a bench by a fountain, the water plashing with a light, chiming sound. The water pleases Thula, who gives it an echoing coo. Like Thula, the children on the avenue look healthy, startling so, the girls with ruddy cheeks, the boys with plump faces. It’s one of the aspects of this flu that puzzles Nell the most: the people it strikes. Normally epidemics take the most vulnerable, the young and the old. But the Spanish influenza is perverse, felling the strongest and the healthiest, like Margaret, and Thula’s parents, and Theo Rivers, a soldier recently returned from the warwho was the first influenza patient Nell delivered to Johns Hopkins, and who died only hours afterwards. 

There will be no more patients brought to Hopkins. The hospital closed over a week ago. More than anything else in this epidemic, the thought of the hospital turning its back on the people it is meant to serve, worries Nell. Part of her understands why. The wards were overflowing, and with so many doctors and nurses ill and dying, they simply couldn’t keep up. But part of her can’t help seeing the closure as a massive betrayal—especially for the people of the alleyways. With Hopkins closed, Presbyteria became the only hospital left still taking people of color, and just yesterday it closed its doors too. Meanwhile the flu rages through their neighborhoods like unchecked fire, spurred by the overcrowded conditions, the lack of clean water and fresh air 

Thula cares little for such things. She frowns; her face screws up. She must be getting hungry. “Yes,” Nell says. “I know. Milk. You need milk. We will go home and find it.” 

As she stands up, the world turns. She feels lightheaded; a wave of nausea courses through her. She must be more tired than she thought. The sun is so bright now, hurting her eyes. She tightens her grip on the baby. By the time she gets home, Thula is wailing. Nell slips in the back door, avoiding the line of patients at the front. Esme, her housekeeper, is in the kitchen waiting for her. She looks at Nell, then at the baby, then at Nell again, opens her mouth, shuts it, opens it again.  

“We need milk,” Nell says. She doesn’t have the energy to explain. She will have to tell Esme about Margaret, but can’t even begin to think about that now. She holds the baby out to Esme“Her name is Thula. Please—” Please tell me we have milk, she wants to say, but can’t. The world is turning again, and this time it doesn’t stop.