They sat in a wide, ornate chamber filled with the various trappings of luxury, at least it would be if Vanderbilt neglected to forcefully remove some of the less tasteful pieces. As it stood all the council chamber had were various paintings, some unalcoholic beverages, and comfortable chairs surrounding a round table. Even these small luxuries served to make some of the less fortunate members uncomfortable, but there was little that could be done about it with the membership being as varied as it is, creating a somewhat awkward atmosphere. Which was summarily interrupted by Vanderbilt rapping his knuckles on the table.

"Now gentlemen, we have gathered today to discuss my first wave of orders, which will be focused on the improvement of hospital mortality rate and curbing, hopefully eradicating, the continuous Polio epidemics." He started, keeping a watchful eyebon the moods of the few dozen people around him. "You may begin your discussion."

"Before we do that," interrupts a well-dressed man, a professor if memory served, "I believe I speak for all of my peers when I ask why janitorial staff, surgeons, and nurses are present at such a meeting?" It seems he thought of it as a valud questionas he looked rather confident and had the apparant approval of several other people around the table. And why not? Those other professions aren't as extensively trained in modern medicine as a doctor is after all.

But Vanderbilt had an objection to this line of reasoning, "There's one thing you forget, professor, nobody knows the state of a hospital or a patient as well as a janitor or nurse does, and surgeons are directly involved with a patient's wellbeing. Any one of them could be holding some miscellaneous clue that could prevent a tragedy in the future." Vanderbilt's expression started to turn stern and he stared deeply at the professor. "If you desire, you may leave this meeting and organize another one with your peers, knowing that whatever you come up with will have little chance of ministry approval. Or you could just play along."

With that arguement out of the way, and a thoroughly embarrased professor in tow, the discussion began in earnest. One of the first questions they had to answer was, what actually caused Polio and hospital mortality? There were several camps in this debate. People who believed in germ theory, mainly the younger folk, believed terrible sanitary conditions, especially in cases like blood-caked medical instruments,  caused disease and ultimately mortality. This theory was disputed by the sanitation workers of old Winstam, who can attest for the lack of any such conditions in their part of the city. There was also the old miasma theory, but that was also refuted as the sanitation workers keep careful note of how pleasant an area smells. Old Winstam was, expectedly, the first stumbling block of the discussion.

"How can you be sure that you get everything? How could you possibly know?!" Nurse Eleanor, one of the biggest supporters for germ theory, shouted out in frustration.

"Because we're professionals who managed to make a living in possibly the most filth paranoid place in the world. How could we not know for sure when that is exactly what the cleints demand of us!" Rebutted Mr. Clein, disgusted by the thought that he could leave anything behind.

The arguement was, unfortunately, going nowhere, so Vanderbilt rapped his knuckles on the table yet again, calling order. "I think it's time we changed perspective, instead of arguing the merits of one theory over another, let us compare new and old Winstam. We know that old Winstam has significantly fewer disease and treatment mortality rates than new Winstam, so answer the question, why is old Winstam better at preventing disease than new Winstam?"

One of the few persons in the room of a nonmedical profession, namely a city bureaucrat, spoke up, "Well, there are several differences between the two, most notably a sewer system that only exists in old Winstam. Other differences include more stringent cleaning, less densely travelled streets, clearer air, private rather than public medical practices, and better food to name a few."

"What are the conditions in a private practice?" Nurse Eleanor asked, "I know that in our hospital practices we take little care for hygiene except for the clearing of miasma."

"We do our work in our patient's home, so naturally we have the most stringent sanitation measures possible. They don't even allow us to have stains on ourselves, being too paranoid over it." A private doctor replied.

"But doing work in a patient's home also reduces risk of miasma as homeowners don't tolerate bad gas." Another private physician rebutts. 

"Regardless," began a council member, putting up both hands as if to placate the two. "making conditions in our hospital healthcare more similar to our private healthcare is bound to provide benefits."

This conclusion reached wide support amongst the gathered people. And the discussion branches out to cover the other differences in the Winstams, but most reached the conclusion that there was little that could be done in these cases. Extending the benefits experience by a relatively few wealthy elite to an entire industeial city's worth of people was impractical, at least in this day and age. But, there was still a heated debate over the sewer system. 

Despite widespread support for a sewer system in new Winstam from all the medical professionals, there was a severe pushback from the bureaucrats on the council. "The city simply cannot afford the expense of such a sewer, no matter the theoretical health benefits it might bring. We cannot waste taxpayer money on such a gamble."

"But it's not a gamble, it has recieved-"

"Enough," interrupted Vanderbilt, "A competent administrator would not accept such an arguement without hard proof. Let's call the topic of hospital mortality over for this meeting, I will implement the ideas presented. Polio is the only remaining topic of debate now."

"Ah, yes" said the professor who was embarrased at the beginning of the meeting, "I was investigating the case files for the various outbreaks and I noticed a peculiar fact. Patient Zero seemed to have always been somebody who left old Winstam, for any reason, and then came back. Needless to say, it looks like the epidemics did not start in old Winstam itself, but was transferred over from elsewhere."

"Where, by chance, were most of these patient zeroes when they were out of old Winstam?"

"It seems to have been new Winstam, overseering various businesses or visiting gamily in most cases."

This news was, concerning, enough people need to move between the two daily that a strict quarantine of every traveler would be impossible.

Vanderbilt however, was pleased by such news. "Then the answer to Polio is clear gentlemen, kill it along with every other disease inhabiting new Winstam, and we smother epidemic in old Winstam. Well, at least when it concerns intracity transport. I believe that is all we will get from this meeting, you all are dismissed."

As everyone else filed out of the room, Dr. Bertold Vanderbilt steeped his fingers in satisfaction and smiled the ferocious grin of a beast who had its prey within reach.