This book tells how plague--not COVID-19--threatened Astoria, Oregon. The plague scare from 1899 to 1900 defined the work environment of the first United States Public Health Service assistant surgeon Dr. Hill Hastings after he was sent to the mouth of the Columbia River to transform a mothballed cannery building into the first unit of a yet-to-be-built larger federal quarantine complex. Of course, this story is also about the difference a doctor's leadership makes when quarantine work moves from thinking and talking about health to action among people. The cannery's transformation was realized during the West Coast's most serious public health crisis before the 1918 Spanish Flu epidemic. Dr. Hastings mastered it as the first of many unique, noteworthy doctors of the USPHS out of his office on Commercial Street, Astoria, and the new fumigation buildings and hospital at Knappton Cove, WA.