“Almost exclusively.” He smiles. “Though I’ve been known to treat a sore throat when indicated. Through the work done here, we’ve identified some genetic disorders that are almost unheard of elsewhere in the world.” That he uses “we” instead of “I” tells me he’s a modest person, content to share his achievements with his colleagues, the mark of a man who loves his work and whose mind enables him to see not only the big picture, but the end goal.
“The Amish are unique in that the gene pool is relatively small,” he adds, leaning forward and gesturing. “Most of our patients are special-needs children. We’re talking quality of life disorders. Cohen Syndrome. Ellis-van Creveld syndrome. Dwarfism. Founder effect inheritable diseases mostly.”
“Founder effect?”
“Disorders that can be attributed to a limited gene pool,” he replies. “We’re working with community leaders on a way to broaden the scope of that pool, and I think we’ve had some success. My colleagues have been in touch with the bishops of church districts in other states. Colorado and upstate New York, mainly. To a lesser degree, Indiana and Illinois. We’re trying to get a relocation-and-exchange program up and running, which is difficult because the Amish are so family oriented. And, of course, the church districts have different rules.” He leans closer to me. “But, if we can overcome those things, if we can get young men and women of marrying age to emigrate to out-of-state Amish communities, marry, and have children in their new locale, we could broaden the gene pool and, in effect, eliminate some of these genetic disorders. Of course, only time will tell if—” He stops himself short. “Sorry. Once I start talking about my work here, it’s hard to shut me up. Used to bore my wife to tears.”
“Sounds fascinating.”
“Or maybe you’re just too polite to tell me I’m boring you to death.”
I smile, find myself liking him. “It’s good to be passionate about your work.”
“Some might argue that I’m a little too passionate.”
It’s obvious he’s married to his career—and that his soon-to-be ex-wife had had to compete. I see him as a hopeless workaholic, always coming home late, working weekends, sequestered behind his computer when he’s home at all. Hence the pending divorce. “How long have you been in Painters Mill?”
“Going on eight months now. I came down from Cleveland. Different world up there. I needed a change after my wife filed. I’ll never go back to the big city. This area, this clinic, has been my salvation, so to speak. It’s exciting work, and I couldn’t ask for a better group of people to work with.”
“The Borntrager children were patients here?”
“They were.” His lips twist as if he’s bitten into something rotten. “I couldn’t believe it when I heard what happened to them. I still can’t. Those poor kids. And Paul. My God, I can’t imagine what Mattie must be going through.” He gives me a direct look, and I see a layer of thinly veiled outrage in his eyes. “I heard it was a hit-and-run.”
“It was.”
“Any leads?”
“We’re working on it.”
“I meant to get up to the hospital to see David, but I’ve been putting in long hours here and never made it. How’s he doing?”
“He’s going to be fine.”
“Great. I hear they’ve got an excellent trauma team at Pomerene.”
“I’m wondering, Dr. Armitage—”
“Call me Mike, please.”
“Mike,” I say. “Can you tell me what the children were being treated for?”
“All three were afflicted with Cohen syndrome, to differing degrees.”
“What is Cohen syndrome, exactly?”
“Like most of the disorders we treat here, it’s genetic in nature. Rare, but not so much among the Amish. It causes a delay in mental and physical development. Neutropenia, or low white blood cell count. Hypotonia, which basically means low muscle tone. A whole array of symptoms that can impact a kid’s life in a negative way.” He shakes his head. “Mattie and Paul were good with those kids. It never seemed to bother them that they were special-needs. Hell, they barely noticed. Never complained or felt sorry for themselves or their children. Paul and Mattie loved those kids and raised them the best they could.”
“How well did you know them? Paul and Mattie, I mean.”
“Well, they’d been coming to the clinic since I arrived. It was a professional relationship, you know, just to talk about the kids enough for me to ascertain how they’re doing and gauge improvements or changes, if any.” Looking inward, he smiles. “First month or so we pretty much talked about the weather. Mattie and Paul were wary of me. You know, the whole outsider thing. Until I began working here in Painters Mill, I hadn’t had much contact with the Amish or their culture, so I was clueless. All of us had to open our minds, so to speak. Once that happened, they began to trust me. I think they realized I care, and they knew I’d do my utmost to help their children. They’re good people, Chief Burkholder. Nice family. Kids are well behaved and sweet. I hope to God you get justice for them.”