Juvenal Urbino’s first examination of Fermina Daza is triggered by a mistaken suspicion of cholera, yet its importance outlasts the medical case: the young physician enters Fermina’s home as a clinician and returns soon afterward without being summoned. The scene joins the public danger of epidemic disease to a private encounter whose significance neither person initially understands in the same way.

The suspected epidemic

A physician who was a friend of Juvenal Urbino asked him to examine an eighteen-year-old patient whose symptoms seemed to warn of cholera. Urbino came that afternoon, alarmed by the possibility that the disease had reached the old city. Until then, cases had appeared in poor neighborhoods and had largely affected the Black population, making the prospect of its arrival in a wealthier household a particular concern.

The visit also reflects the physician’s wider experience with the disease. After his father died in an earlier epidemic that killed a quarter of the city’s population in less than three months, Urbino studied cholera intensively in France under Professor Adrien Proust. When he later returned home, he recognized how the city’s unsanitary market and sewers threatened a recurrence. Within a year, when a patient arrived at the Misericordia Hospital with a strange blue discoloration, he identified cholera and helped arrange warnings and quarantine. The examination of Fermina therefore takes place against a real history of epidemic danger, not an imagined medical pretext invented for a courtship.

The house and the first examination

From outside, Fermina’s house appeared as neglected as other buildings in the colonial district. Inside, however, Urbino found a carefully ordered patio: whitewashed walls, orange trees, patterned tiles, running water, flowering plants, and cages of birds. The contrast between the exterior decline and the interior harmony unsettled his expectation of the home. He followed Gala Placidia through the house and past the sewing-room window where Florentino Ariza had first seen Fermina, but could not proceed to the patient’s room because Fermina said her father was absent.

Urbino returned at five, when Lorenzo Daza opened the door and led him to his daughter. The examination was constrained by the father’s presence and by the doctor and patient’s mutual reserve. Urbino asked his questions impersonally; Fermina answered in a tremulous voice. He examined her carefully, while both avoided looking directly at each other. His later account was that he felt no emotion on meeting the woman with whom he would share his life. He remembered her blue chemise, feverish eyes, and loose hair, but said his attention remained fixed on the possibility of cholera. Fermina, by contrast, had already formed an unflattering impression: the young doctor she had heard praised for his epidemic work seemed to her a pedant who could love no one but himself.

The diagnosis was not cholera but an intestinal infection of alimentary origin. Three days of treatment at home cured it, and the suspected epidemic case was closed. Relieved, Lorenzo accompanied Urbino to his carriage and paid him a gold peso, a fee he considered high even for a doctor serving the wealthy. Lorenzo’s gratitude was bound up with his awe of the Urbino family name, and he welcomed the possibility of seeing the physician again in less formal circumstances.

The unrequested return

The next visit changed the pattern. On the following Tuesday, Urbino returned at three in the afternoon without an appointment or prior warning, although he had said he would come back only if the family reported a change. Fermina was taking an oil-painting lesson in the sewing room with two friends. Dressed for painting at home, she appeared to him unusually formal; he signaled her to the window and examined her there, checking her pulse, tongue, throat, and eyelids with the instruments in his medical bag.

This time Urbino was less inhibited, while Fermina was more guarded. She could not understand why he had returned when there was no stated medical reason, and she did not want to see him again. The contrast between his professional procedures and the uninvited nature of the visit leaves the encounter unsettled: the clinical case had ended, but Urbino’s attention had not. The narrative does not make the first examination an instant mutual romance. Instead, the two remember it differently, and Fermina’s resistance remains clear even as the doctor crosses the boundary of an ordinary follow-up.

From clinical practice to public action

Urbino’s authority in the scene rests on more than his family status. After studying in France, he became known for methods that helped prevent the province’s later cholera epidemic from reaching the scale of the earlier disaster. He founded the Medical Society, serving as its lifetime president, and helped organize the first aqueduct, sewer system, and covered market. These reforms connected diagnosis to the conditions in which people lived: public health required infrastructure and coordinated action as well as a physician’s judgment.

His conduct in other suspected cases clarifies that practical approach. At the hospital he alerted colleagues and authorities, warned neighboring ports, and sought to quarantine a schooner from Curaçao after identifying cholera in a patient. He opposed a military commander’s proposal to fire cannons as a supposed treatment. Later, after reports of possible cases in the city, families and neighborhoods faced quarantine and medical supervision; the outbreak was contained, and officials adopted further sanitary measures. This record makes the first visit’s urgency legible, while the mistaken diagnosis marks the limit of that urgency: Fermina’s illness needed treatment, but it did not confirm the epidemic Urbino feared.

Narrative significance

The episode brings two kinds of interpretation into contact. Urbino approaches Fermina through observation, symptoms, and the possibility of contagion; he believes his attention is wholly clinical. The narrative gives the encounter a longer horizon, identifying Fermina as the woman with whom he will live until his death, while preserving his claim that he did not recognize that future in the moment. His later return, outside the terms he set for medical care, complicates that self-understanding without proving that he has consciously named his feelings.

Cholera also has a distinctive place in Urbino’s memory. Among the many suicides he can recall, he once remarks that a cyanide death was the first not caused by the sufferings of love; elsewhere, his medical experience gives him occasion to describe love in the language of disease. These echoes do not turn Fermina’s intestinal infection into cholera or make her first examination a love confession. They show how the novel repeatedly lets clinical categories and emotional experience approach one another while keeping their differences visible. In this first encounter, diagnosis is mistaken, the treatment succeeds, and the physician’s attention continues beyond the cure.