We begin far away from New York with an origin story of sorts. A young John Thackery is leading a burro into an encampment in rural Nicaragua that is ravaged by smallpox when he comes across one Captain August Robinson, who is being held prisoner. The army commandant who summoned Thack explains that it was the blankets brought in on the Robertson ships that caused the deadly outbreak, hence Mr. Robertson’s imprisonment. Seems like Mr. Roberston has a nasty habit of starting plagues. Thack says he can stem the outbreak — despite the fact that he’s come prepared to treat yellow fever — but he will only do so on condition of the American’s release. Young Doctor Thackery already possesses his trademark medical wizardry. He whips up a vaccine using scabs taken from those who are already sick that he administers by blowing into a patient’s mouth, which allows for a quick close-up on his face — fresh, unlined, and as yet unravaged by addiction.
Not so of our current-day doctor who is most certainly on the decline since Abby’s death — both mentally and physically. He cannot muster the enthusiasm to appreciate his recent triumph — the successful separation the conjoined twins. He doesn’t even leave his office to wish them good-bye, nor does he bother to hide the phials of heroin in his trash from Dr. Edwards, who comes to check on him. If Thack’s debilitated emotional state wasn’t causing the doc enough trouble, his gut is a wreck, bringing him to his knees in front of the Knick.
I’m not surprised that Thack refuses exploratory surgery — after all, he knows the risks of going under the knife better than anyone. He does, however, allow Bertie and Algie to take him to Dr. Zinberg, who has devised a nifty little tool, like a reverse periscope, that allows him to have a look around Thack’s insides. Dr. Edwards sums up their findings best. Thack’s “bowel looks like the Badlands,” which is to say the doc’s intestines are necrotic. Zinberg insists on immediate surgery. But Thack has other ideas. What they are remain to be seen. And our last glimpse of him shows that he’s drunk (and whatever else) himself into a near catatonic state at the dance hall where Cleary and Harriet (who have made up despite Cleary’s continued feelings for the ex-nun) are peddling rubbers. If Thack’s going cure himself, he’s going to need to sober up, and in order to sober up he’s going to need to cure himself. And so it goes.
Thack might be tiptoeing toward oblivion, but he’s still better off than A.J. Elkins, whose paralytic stroke has left him only able to move his eyeballs. Yet he is conscious, or so Lucy hopes as she sits at his side and reminds him about a stubborn family mule he beat into submission until the creature was so used up he had to shoot it. Lucy will not be that mule for her father to beat anymore, but she will take a page out of his book — call it a family penchant for mercy killing. She injects something into her father’s vein to send him on “his journey,” and while she has him as a captive audience for a few more moments, fills him in on the dirty sexual details she left out of her confession during his prayer meeting. Drugs, sex, seduction, and now murder for Nurse Elkins — maybe her father was right to be worried about the influences of the big city on his daughter.
Well, should the medical board (or anyone at the Knick, for that matter) catch wind of exactly how Papa Elkins shuffled off this mortal coil, I’m sure Lucy would be sent to the pokey quick-smart. Perhaps she should have simply sterilized him against his will because the board clearly doesn’t have issues with that. Edwards brings Gallinger up on charges of medical malpractice, which are quickly dismissed for two reasons, one explicit — the chairman considers eugenics a valid and important field of medicine, and the other implied — the glaring racial contrast between the two doctors.
Edwards doesn’t do himself any favors by waiting for Gallinger outside the hearing with his shirtsleeves rolled and ready for a fight. “In the face of intellectual reason you resort to violence,” Gallinger says. Of course he’s not right, but he’s not entirely wrong (about the violence, not the reason). Which is a shame because poor Edwards has behaved with dignity until now, and the last person he needed to hand over more ammunition to is Gallinger.
Gallinger arrives home all ginned up from his “victory” over Algie and finds Deborah waiting for him, ready to get hot and heavy. This wouldn’t be worth mentioning save for the fact that Gallinger recently learned that Eleanor wasn’t responsible for Doctor Cotton’s death. (Perhaps she confessed to protect him?) But he chooses not to act on that information, not to spring his wife from the sanitarium where she’ll spend the rest of her life. It’s rather nice having her out of the way, isn’t it?
Not going as quietly as Eleanor Gallinger into her role of spurned woman is Effie Barrow. (Do we know exactly why Barrow is so mean to his wife? It’s one thing to get a divorce. It’s another to behave as he does.) Well, it’s time for Effie to get a little revenge. She shows up at the Knick with paperwork that proves all of Barrow’s financial misdeeds regarding the new hospital building. She demands half his salary and half of all the money he ferrets away on the side, plus a few more perks to restore her to her old manner of living. Between Effie and Tammany Hall, Barrow’s going to have to figure out a whole host of new scams to make the game worthwhile, especially now that that new Knick is almost complete.
Which is why he appeals to Henry. The new architect is progressing too quickly for Barrow’s taste (and spending too frugally). Surely he’s cutting corners and jeopardizing the safety of the building. But Henry won’t hear Barrow’s nonsense, especially because he has graver matters on his mind — his father’s apparent corruption.
There’s no doubt about it — Mr. Robertson is definitely engaging in some shady business and Henry and Cornelia decide that the decent thing to do is confront him about it before they take their findings to the police. Conveniently, Henry and Mr. Robertson are planning on meeting at the new Knick that evening. Henry invites his sister to come along. Doesn’t she know that nothing good happens at an empty building site after dark?
Well, from the moment Cornelia arrives the whole thing smells fishy. Mr. Robertson is waiting on the top floor, far from the relative safety of the street. And where is Henry? This seems like a setup. But whose?
Mr. Robertson is charming. He’s pleased as punch with his new hospital and the good it’s going to do. Which is ironic, because as Cornelia points out, he’s responsible for bubonic plague outbreaks in three cities, as well as Speight’s death. Mr. Robertson is taken aback. Surely, his daughter is joking. Right? And he’s so sincere it’s hard not to believe him. But Cornelia isn’t wrong, is she? Is she?
That’s when the fire breaks out — and by break out, I mean tears through the hospital like a freight train. (Barrow is going to be thrilled. Just think of all the new expenses!) It’s a little contrived, I have to admit, but it’s only possible for either Mr. Robertson or Cornelia to escape. Mr. Roberston urges his daughter to get to safety, telling her to save herself and run for help. By the time she’s outside it’s too late. And she and Henry, who has conveniently arrived right after the fire started, watch their father jump to his death.
There’s a chance — a very teeny, tiny one — that Mr. Robertson is guilty of all Cornelia uncovered. And there’s a chance that he saved his daughter because he only hurts those whom he can’t see. But I fear that now the real blame falls on the shoulders of dashing Henry, who has been looking to bolster the Robertsons’ fortunes since he turned up on the scene, for whom boring old shipping has never been enough, who lost all that money in the subway explosion, who seems to have spent freely on cars and fancy motion-picture cameras. I guess the signs have been there all along. I guess, like Nurse Elkins, I, too, was easily charmed.