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For as long as she could remember, her mother had never complained about not feeling well, not even after having the twins, when Mrs. Schmidt instructed her to spend two weeks in bed. Not even when she had a horrible headache that seemed to last for weeks, or when she broke her big toe. Mutti always kept quiet and kept going as best she could. She never gave up or gave in. To hear her say she didn’t feel well sent a flood of terror through Pia’s bones. Mutti sat on the edge of the bed and Pia knelt down, unbuttoned her boots, and pulled them off.

      “Danke,” Mutti said, lying back on the pillow. Pia covered her with a blanket, wondering what else she should do.

      Out in the other room, Ollie and Max started crying.

      “Bitte, feed the boys and let me rest,” Mutti said, shooing her away with one hand. “I will be much better when I wake up.”

      “Will you promise to call me if you need anything?”

      “Ja, now go.”

      Pia started out of the room, then stopped at the door and turned. “And tell me if you start feeling worse?”

      “Ja, ja,” Mutti said. She laid her forearm across her forehead, her pale wrist turned up, and closed her eyes.

      “Promise?” Pia said.

      “Ja, Pia.”

      With growing dread, Pia left the room and closed the door. Hopefully Mutti was right; she was only overworked and exhausted. It made sense, with the twins waking up several times a night to nurse, then barely sleeping during the day. Still, Pia couldn’t help fearing the worst. She prayed she was wrong.

      After feeding Max and Ollie mashed potatoes softened with broth, she put them on a blanket in the middle of the floor with their rattles, then filled a bowl with soup and slowly opened the bedroom door, trying not to make any noise. A slice of weak light fell across Mutti’s pale face. She was sound asleep again, her mouth agape.

      “Mutti?” Pia said in a quiet voice. “I brought you some soup.” She went over to the bed and looked down at her. “Mutti?”

      Mutti didn’t blink or move. Pia thought about waking her, but decided to let her rest. The few minutes she’d gotten earlier probably weren’t enough. She needed an entire night of uninterrupted sleep, then maybe she’d be back to her old self by morning. Pia left the bedroom, quietly closed the door, took the soup over to the table, and sat down. From the blanket on the floor, the boys watched her eat, grinning and gurgling, and reaching for each other’s hands and faces. She would take care of them tonight. She would mix a jar of Mellin’s Infant Food with water and feed them that so Mutti wouldn’t have to wake up and nurse. They weren’t used to drinking from bottles, but if they were hungry enough, they’d figure it out.

      When she was done with her soup, she got up, knelt on her bed, opened the window, and, working fast, pulled the clothes off the line and piled them beside her. The undershirts and nightdresses were still damp from the fall air, but she’d hang them up again inside, when she had time. When everything was off the line, she closed the window and stacked the laundry on the kitchen chairs, then took her math book out from beneath her bed and tore out the first page, which was blank, except for the title and copyright. Damaging a schoolbook would likely get her in trouble, but there was no other paper in the house, and this was an emergency. She found a pencil, sat down at the table again, and wrote to Finn.

      Are you all right? What’s wrong with your brother? Mutti might be getting sick and I don’t know what to do. I have no medicine or whiskey. She says I shouldn’t leave the house to find a doctor, and I don’t really want to, anyway. Please help. I’m scared.

      She folded the paper, crawled up on her bed again, opened the window partway, fastened the note to the line with a clothespin, and sent it across the alley. The pulley squeaked while the clothesline lurched and paused, lurched and paused, until finally the note reached the ledge outside Finn’s window. Afraid to blink, she watched to see if he would reach out and take it, but no one came to the open window, or looked out. She glanced over her shoulder at her brothers, content and playing on the blanket, then pushed the window open all the way and leaned out as far as she dared. Praying Mutti wouldn’t hear, she called out, “Finn!”

      No answer.

      “Hey, Finn! Are you over there? It’s me, Pia!”

      Still no answer.

      She pulled the sash down and watched for a few more minutes, but no one came to the window. Looking out over the eerily silent Fifth Ward, a cold eddy of loneliness began to swirl inside her chest. The sun blazed on the distant horizon, casting a yellow glow over the cool fall evening, the perfect weather for a brisk walk or a rousing game of stickball. But no children played in the alley below. No delivery wagons rattled along the cobblestones. No women gossiped on the front stoops or called their children in from open windows. A hollow draft of fear swept through her. It felt like the end of the world.

      * * *

      While Mutti slept and Pia took care of her brothers, panic gripped the city. The director of the Philadelphia General Hospital pleaded for volunteers to relieve nurses who had collapsed from overwork. Doctors and nurses started dying, three one day, two another, four the next. Undertakers ran out of embalming fluid and coffins, and masked policemen guarded what coffins were left. Gravediggers were either ill, overcharging people, or refusing to bury influenza victims. The director of the city jail offered prisoners to help dig graves, but withdrew the offer when he realized there were no healthy guards to watch them. Thirty-three policemen had already died. The citizens of Philadelphia began whispering the word plague.

      Meanwhile, The Philadelphia Inquirer scorned the closing of public places:

      What are the authorities trying to do? Scare everyone to death? What is to be gained by shutting up well-ventilated churches and theaters and letting people press into trolley cars? What then should a man do to prevent panic and fear? Live a calm life. Do not discuss influenza. Worry is useless. Talk of cheerful things instead of disease.

      For Pia, getting the twins to drink formula out of bottles proved to be more difficult than she thought. By the time the first feeding was over, all three of them were exhausted. When her brothers finally collapsed into a restless sleep on her bed, it was after midnight. She edged off the mattress, moving slowly and quietly, and peeked into the dark bedroom, surprised her mother hadn’t heard the boys’ frustrated cries. Mutti was still sound asleep, her breath like sandpaper against wood. Pia tiptoed into the room, stood by the bed, and, with trembling fingers, reached out to feel her mother’s forehead. As soon as her hand touched Mutti’s clammy skin, heat lit up her face and neck, and an invisible weight pressed against her chest. She yanked her hand away and the frightening sensations disappeared. Tears filled Pia’s eyes. No. Mutti can’t be sick. She just can’t be.

      Turning toward the dresser, she quietly opened the bottom drawer, took out a sweater, and laid it over her mother’s chest and shoulders, pulling it and the blanket up beneath her chin. She didn’t know what else to do.

      Queasy with fear, she crept out of the room and closed the door. The thought of leaving the safety of their apartment, going out into the city in the middle of the night to search for a doctor, not knowing if anyone would even help, terrified her. And who would take care of the babies while she was gone? Mutti might be too sick to watch them. And the boys probably shouldn’t be near her, anyway.

      Paralyzed by indecision, she turned down the lantern and lay in her bed, the boys’ small bodies snuggled between her and the wall. She needed to organize her thoughts and gather her courage. The sun would be up in a few hours. Then she could ask a neighbor to watch the twins. Mutti always said everything looked less frightening in the light. She hoped so, because right now she was scared to death. Knowing she couldn’t sleep, she tried to come up with a plan.

      When her frantic dreams ended, she opened her eyes, confused and trying to remember what day it was. An eerie, grayish glow filtered in under the flour-sack drapes. She turned her head and looked up. A jagged water stain colored the gray ceiling paper like a small yellow lake, making her think of the spring runoff near

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