In Europe, physicians and civil servants have been tracking disease outbreaks for decades, beginning with the cholera epidemics in London. Records compiled by doctors, clergymen, postmen, and others have proven invaluable to the study of how sickness spreads, and my own interest in the subject had prompted me to collect such day-to-day details and write them down. I’d begun perhaps five years before, recording basic information and keeping it in files after reading about the efforts of a Dublin doctor to do the same in the slums of that city. I had no slums for the studying, but I had Fall River and I knew its population.

I didn’t honestly believe that any of my short notations would ever be as important as London’s Ghost Map. No, certainly not. But I liked to think that one day my notes might benefit some researcher, somewhere.

My drawers and files had fallen into disarray, relative to how neatly they were kept when my wife was alive. Such is the way of things, all order passing into chaos, given time enough. But even so, I soon found what I was looking for: a few sheets of paper stuffed into a folder, labeled “Ab. Bord.”—to distinguish her from Andrew but to preserve some measure of anonymity for the families whose well-being I observed.

•   •   •

(Privately, I assumed that any serious researcher would have no difficulty teasing out the particulars of my patients; but I liked to think that my little abbreviations would at least give me some protection, if any of those patients were to learn of my notes and take objection to them.)

•   •   •

My notes frustrated me. They were incomplete, and woefully so—through no one’s fault but my own.

Upon my first visits with Abigail Borden, I had recorded everything from her temperature to her breathing rate, but as her condition deteriorated . . . it’s as I said before. I was paying less and less attention, for I was distracted by the family drama that played out across the street.

I was deeply annoyed because the notes revealed that I’d become complacent and lazy, and that I have not always performed my job to the best of my ability.

When did that begin? When did I go from the ideals and optimism, and the intent engagement of youth, to the apathy of age?

I’m not so old yet as to be feeble or infirm. I’m scarcely in my sixties, and though my hair goes whiter by the year, I still feel like a healthy man with a sturdy constitution.

Granted, men with sturdy constitutions and feelings of health drop dead every day, and this should sober me. But it sobers me less than the awareness that I’m slipping, in my way. Maybe not my strength of body, but strength of character—or professional responsibility.