Soon Joe dozed off again and this time Ben dozed off too, lulled by the steady hum of the train, the meal, and lack of sleep the night before.  Ben jolted awake when they pulled into the station in San Francisco. Alarmed that he had slept so long, he quickly glanced at Joe to check on him.  Joe was still asleep, his face leaning against the window.  The light from the window made his face look even more ashen, almost translucent.  Ben’s felt his heart constrict when he saw how fragile and still he looked---so unlike him.

**********

“Joe.  Wake up, Joe.” Ben gently shook Joe’s shoulder and aroused him. Joe looked around, temporarily startled.  Realizing they had arrived in San Francisco, he frowned. He was petrified of what lay ahead of him.  Joe didn’t even like having to be seen by Paul Martin, he was very anxious about seeing some strange doctor.

As they waited to depart the train, Joe asked “So what time do I have to go see this doctor tomorrow Pa?”

Ben sighed and said, “Not tomorrow Joe.  Now.  Dr. Toland was going to have someone meet us at the station and take you to the clinic tonight. “ Joe was totally shocked by this statement. He had thought he would have at least one night to prepare for the meeting with this strange doctor.  Joe let out a deep sigh and his face tightened, but he said nothing.  He knew it would have done no good.

When they stepped off the train, the first thing Ben saw was a wagon with a medical insignia on it.  Looking around, he saw two men standing beside a wheel chair.  He walked toward them, guiding Joe in that direction.  As he neared them, one of the men, a tall, dark-haired man spoke, “Ben Cartwright?”

Ben said “Yes, I’m Ben Cartwright and this is my son, Joseph.”  He extended his hand and the man shook it briefly, his eyes on Joseph as he did so.  “I’m Dr. Toland.  Let’s get Joseph to the hospital.”  Ben winced when he said “hospital”; he had avoided telling Joe that he would be admitted to Dr. Toland’s hospital for his examination.  Joe glared at Ben but said nothing.

“Here Joseph sit in the wheelchair and let’s get going.”  Dr. Toland motioned towards the chair.  Joe’s reaction was immediate and volatile.  “I am not getting in that wheelchair. I can walk.”

“Nonsense, you’re much too weak to walk.” Dr. Toland said and looked at the other man who had come with him.  “Jerry would you assist Joseph into the wheelchair? Come along Mr. Cartwright, I want to discuss Joe’s illness with you and explain the diagnostic process.”

Dr. Toland pulled Ben along, without another look at Joe.  Joe was standing there, with his fists clenched at his sides and a defiant expression on his face.  Ben started to go over to persuade him to get in the chair, but Dr. Toland, glanced back and then looked back at Ben and said, “Come along Mr. Cartwright, Jerry is quite capable.”  He continued walking and began questioning Ben about Joe's symptoms and pulled him helplessly along.  Ben was trying to monitor the interaction between Joe and “Jerry” but Dr. Toland was striding briskly along and he had to hurry to keep up with him.  Soon Jerry caught up with them, pushing a sullen, very angry Little Joe in the wheelchair.  Ben could tell by a glance at his son’s face that he was very upset, but Dr. Toland paid no heed to him or to his expression.  “I see what Paul was talking about” he thought to himself. His heart went out to Joe, but there was nothing to be done about it. 

They reached the medical wagon and Joe got out of the wheelchair as soon as it was stopped in front of the wagon.  He climbed aboard by himself quickly, afraid that Jerry might help him if he didn’t.  Joe had not said a word since they got off the train and Ben was feeling very uneasy about his state of mind, but Dr. Toland continued to ask questions of Ben and appeared to be oblivious to Joe’s mood.

**********

The ride to the hospital took about 15 minutes, during which Ben tried to give Joe reassurance by eye contact and by putting his arm around his shoulders; and though he didn’t say anything, Joe didn’t shrink away from his father’s touch.  Ben could tell that Joe was trembling and knew that his son was terrified of what was awaiting him.  In Virginia City, there was no real hospital and patients were cared for at home or at Dr. Martin’s office if necessary.  The idea of a hospital was terrifying to both Ben and Joe.

Upon reaching the hospital, Jerry quickly removed the wheelchair from the back of the wagon and moved it to the side of the wagon where Joe was sitting.  Joe got out of the wagon and after only a moment’s hesitation sat down in the wheelchair.  Ben wondered just how Jerry had gotten Joe in the chair in the first place, but wasn’t sure he wanted to know.  He had a knot of fear in his insides that he was sure equaled the one that must be in Joe’s.

**********

"Jerry, you and Mrs. Cramer get Joseph settled in his room and I will take Mr. Cartwright to get him admitted.  Come along, Mr. Cartwright."  Dr. Toland took hold of Ben's arm, attempting to pull him in the opposite direction than Jerry was taking Joe. 

"Just a minute, Doctor" Ben said firmly.

"Joseph, I'll go get the paperwork done and then I'll be right along." Ben put his hand on his son's shoulder and patted it gently.  He caught Joe's eye and then said, "I'll be there soon, Son."

"Come along Mr. Cartwright, Joseph's in good hands.  He'll be fine. Right Joseph?"

Although Joe wasn't so sure about that, he saw the conflict in his father's face, so he said, "Go ahead, Pa.  I'll be fine."

Ben hesitated momentarily, but when Dr. Toland tugged his arm again, he reluctantly let himself be led away from his son.

Dr. Toland took Ben to a desk where he was presented with a sheet of paper that he had to fill out to get Joe admitted.  Dr. Toland waited impatiently, and as soon as he was finished, he led Ben to his office, where he asked him more detailed questions about Joe's symptoms, severity, and health history.  Upon being satisfied that Ben had told him every possible bit of information that might be helpful, he said they would then go to Joseph's room.

When they arrived at the hospital room, Ben was alarmed at the sight of his youngest son, wearing a hospital night shirt lying in  bed. He looked pale and tired, but more than anything he looked scared.  Ben walked to the bedside and placed his hand on Joe's arm and smiled at him in an attempt to reassure him.  Joe was relieved to see his father return and gave him a half-smile.

Dr. Toland, never one to waste time on small talk, said, "Joseph, I'm going to order up a meal for you and then I want you to get some sleep.  I'll be running some tests tomorrow so you need to rest tonight.  Mr. Cartwright did you make arrangements for your stay?"

"Yes, I have a room at the Derringer about a block away."

"Well you can visit with Joe while he has dinner, but then I suggest you go on over to the hotel and get some rest yourself.  I'll talk to you again as soon as I know something."

"Don't you think I should stay with him tonight?" Ben asked, not comfortable with leaving his son alone.

"Certainly not.  We don't allow that sort of thing.  You can go on over to the hotel.  If you feel better about it, leave the name with the nurse and if they need you, they'll send someone for you. "  With that, he said a brisk "Good night" and was gone.

When he was out of the room, Ben looked at Joe and said, "Now I know what Paul was talking about."

He was rewarded with a half smile from Joe.  He noticed how tired Joe was and realized that he would soon be asleep, regardless of his anxiety.

Soon a nurse brought Joe a dinner tray.  As she readied the tray, Ben caught Joe looking at it with displeasure.  When she had left the room, Ben said, "I guess Hop Sing has nothing to worry about from here, huh?"

Joe picked at the food, playing with it, moving it around, while his father watched him.  Ben noticed that Joe could barely keep his eyes open and was just thinking of leaving when a nurse came into the room and said "Visiting hours are over, Mr. Cartwright and I need to get that young man settled down for the night. "

Ben sighed and stood up and went to stand directly by Joe's bed.  "Joe, you don't worry about anything and just get some sleep.  I'll be here by the time you wake up in the morning."  He took one of Joe's hands in both of his and squeezed tightly.

The nurse, sensing that Ben was anxious about leaving tried to reassure him, "Don't worry Mr. Cartwright, I know where the Derringer is and if I need you, I'll send Jerry to get you.  From the looks of him, Joseph is tuckered out and he should sleep well tonight."

Feeling reassured, Ben nodded his head and said, "Thanks, Mrs. Sanders," reading the name tag on her uniform.  Reluctantly he left the room, stopping in the doorway for just a moment for a last look at his son.  Joe's eyes were closing, even as he stood there, so Ben headed for the Derringer Hotel.

As he made the short walk to the hotel, he recalled the last trip that he had made to San Francisco, only a month ago.  It had been under quite different circumstances.  Joe had been with him and they had stayed at the Cattleman's Club, an exclusive hotel that catered to cattlemen.  He and Joe had shared a two-bedroom suite.  He and Joe had been tied up with business dealings all day and after a quick dinner, he had gone to bed.  Joseph, on the other hand, had been out every night, with several different daughters who had accompanied their fathers to the cattlemen's meeting.  Ben smiled as he recalled how excited Joe had been, claiming every night that the girl he had a date with that night was prettier than the one he'd had a date with the night before.  Joseph had stayed out very late and in fact, he hadn't known exactly when he came in.  He was always in by breakfast time and ready for the full day of meetings, though he did seem to require a lot of coffee to get going, but then Joe had never been a "morning person" Ben thought.

The next morning, Ben had a quick breakfast in the hotel dining room, then hurried to see Little Joe.  When he arrived, he found that Joe was not in his room.  He finally found a nurse who told him that Dr. Toland was examining him in the treatment room.  "He doesn't waste any time" Ben thought, since it was only 7:00 am.  He wondered how Joseph had slept and how Dr. Toland had managed to wake him up, if he did sleep.  The nurse brought Ben coffee and a newspaper and he sat and waited for Joe's return in his room.

Two hours later, the ever-present Jerry returned Joe to his room.  Joe was pale, tired-looking, and very cranky, Ben could tell.  He also had a bandage on the inside of his arms, evidence that Dr. Toland had already drawn some blood for testing.

"Hey Joe, how'd you sleep last night?"

"Hmmp.  Sleep my eye.  How can you sleep with all the noise around here.  Every time I did get to sleep, someone would come in here and shine the lamp in my eyes.  And then that Doctor came and got me before daylight this morning."

Ben knew that Joe would have continued, but he was too tired to get the words out.

"Well here, Son, you just lie back down and rest now.  Have you had breakfast?"

"No and I don't want any, Pa.  I'm not hungry."

Ben didn't see the doctor until late that afternoon.  Joe slept most of the rest of the day, interrupted regularly by a nurse in to take his vital signs or to encourage him to eat.  Ben knew that the fact that Joe just accepted any demands put on him by the nurses was a testament to how tired he was and how bad he felt. 

When Dr. Toland came to the room, he joined him outside in the hallway to ask what he had found.  "Well I found the same things that your Dr. Martin found; he did a very thorough job of describing his findings."

"So do you know what is causing this?  Is it serious?"  Ben couldn't bring himself to ask about specific diseases, afraid to say them out loud.

"Well Mr. Cartwright, to be honest, I'm pretty stumped myself. I am hoping the blood tests will show us something. I will have the results of those in two or three days."

"What are you going to do in the meantime?" Ben asked, frustrated that after coming all this way, this Doctor had nothing definitive to offer him as the cause.

"Well all we can do is treat him supportively."

"Supportively?  What do you mean by that?"

"Well we'll treat the symptoms.  We'll give him something for the fever, keep him in bed, let him rest, try to get him to eat and drink more, and watch him closely for any new symptoms.  That's all we can do until we know more."

"I see." Ben said, still not completely satisfied that this Doctor was doing what needed to be done.  He wanted the Doctor to tell him exactly what the problem was and how to cure it.  He would accept nothing less than a cure.

The next several days passed slowly for Ben.  For one of the few times in his life, Joe was a model patient.  Mostly because he was too tired and feeling too ill to be resistant.  Everyday the Doctor would carefully examine him and then finding no new symptoms, would continue to prescribe bed-rest and nutrition.  Joe's lack of appetite and aversion to food posed a problem, but Joe managed to eat enough to keep them from becoming too alarmed about it.

On the 5^th day of their stay, Joseph's fever was down some and he said he felt better.  The test results came back that day; however, they did not provide a definitive diagnosis either.  Dr. Toland was very puzzled when he came to talk to Ben; but he was also relieved.

"Well Mr. Cartwright, I can't give you a diagnosis, but I can give you a prognosis."

"How can you give us a prognosis when you don't know what it is?"

"Well the blood tests are very similar to the results in a little outbreak of something we had here about a month ago.  His symptoms are the same and his blood tests are the same.  The fatigue, fever, enlarged glands, stiffness, soreness, nausea, anorexia, sore throat, and increased heart and pulmonary rates are all consistent with whatever this illness was. In addition to that, his blood tests show the same elevation of one particular line of white blood cells."

"But you don't know what causes it?"

"No, Mr. Cartwright, but about  3-4 weeks ago, we had almost an epidemic of it---oddly enough, it was among young people too.  Girls and boys about Joe's age, as a matter of fact.  We just don't know what causes it though.  I mean the elevation of the white blood cells seems to suggest an infection of some kind, but I didn't detect the cause if that is what it is.   It's a mystery still."

"Can you treat it?" Ben asked.

"Well yes, the main treatment is bedrest.  After a few weeks, the blood tests return to normal and the patient begins to feel better.  The main thing is to make sure that they get plenty of rest and good nutrition and don't overdo it."

"Well that's a relief.  I was afraid he had leukemia or something like that."

"Yes, Mr. Cartwright so was I. If he had been living here in San Francisco, I might have thought of this---we called it glandular fever, for want of a better name---but not from someone in Nevada."

"Dr. Toland, we were in San Francisco, about four weeks ago.  Could that have had anything to do with it?"

"Hmm that does sound like there could be a connection, but we just don't know."

Over the next few days, Joseph began to feel much better and the better he felt, the more determined he was to go home. He was very difficult to keep in bed.  Every time someone would leave the room, he'd get out of bed and go to the window or try to sneak down the hallway to look for something to do. Ben noticed too that Joe's color and appetite was improving, at least he was complaining more about the awful hospital food. Although he was still pale and thinner, he was beginning to look more like his old self.  His eyes had lost that dull, tired look and were beginning to sparkle again.   Finally, after another week of them trying to keep him in bed, Ben broached the subject of taking him home to continue his convalescence with the doctor.

"Hmmm....well I guess he could rest there just as well as he does here.  Do you think you can keep him in bed on this Ponderosa?"

Ben laughed and said, "I'll have reinforcements there.  It'll be much easier, in fact."

"Well, his repeat blood tests, actually show that the anemia and the elevated white blood cells are normalizing.   If you can get him to eat and keep him in bed.  I guess he'll be okay.  You can have your Doctor Martin monitor his progress."

"Home, Pa?  Really?  That's great!  Let's leave right now." Joe said when Ben told him that the doctor had agreed to let him go home.  He jumped up and began to dress.  Ben assisted him and forced him to slow down some.  "We have plenty of time before the train."

"But you know what I was thinking, Pa?  If we hurry, we could go down to the Barbary Coast for just a little while…….."

Ben didn't even allow him to finish, instead he put his arm around Joe's neck and pretended to squeeze his head.

"Not likely, Son.  And remember, you aren't well yet.  You have to follow Doctor Toland's orders and then Paul's when we get home.  You aren't cleared from treatment yet, Son."

"If you'll just get me outta here, I promise not to complain Pa.  Not one complaint." 

Ben laughed, knowing that was a promise that Joe was incapable of keeping.

After paying the hospital bill and thanking Dr. Toland and the nursing staff, Ben Cartwright took his son back to the train station.  Although he wasn't sure Dr. Toland would approve, he allowed Joe to walk to the buggy he had hired to take them to the train.  He noticed that Joe still got winded easily, but could tell he was improving rapidly.  In fact, Joe had really begun improving just a few days after they arrived, meaning that the worst of his illness had already passed when they got to San Francisco. 

Upon returning to the Ponderosa, Ben and his brothers and Dr. Martin tried to enforce the recommended 6 weeks of bed-rest.  They tried, but after two weeks, they gave up.  Within 3 weeks of returning home, Joe was completely recovered from his illness and back to his usual activities.  He made a point to remind everyone that he had told them he wasn't sick in the first place and that if they'd just left him alone, everything would have been just fine.

Ben didn't know what had been wrong with his Son, but he was thankful that whatever it was, it had seemed to go away on its own.  He hoped all future illnesses would do the same.  Hearing his son's giggle, he walked from the kitchen to see Hoss and Joe engaged in a game of checkers. Adam was watching the progress of the game from the easy chair.  Obviously, Little Joe was winning because of that infectious giggle.   As Ben passed by on his way to his desk, he said, "Joseph."

"Yeah, Pa?"  Joe replied, hoping that his father wasn't going to remind him not to overdo it, for the thousandth time.

"Get your feet off the furniture!"  Ben said. 

Joe quickly moved his feet and looked sheepishly at his father, as Hoss, Adam, and Ben laughed heartily.  Joe was quick to join the laughter.

*****End*****

Okay, you medical sleuths---what ailment did Joe have? E-mail me for the answer.

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