The next day was a visiting day and Sunday and bright with sunshine so the incident was forgotten and the ward was peaceful until Velma, the store girl, came after supper to take our orders. She said, as she pulled her mouth over to one side and massaged her upper gums with her tongue, “I heard through the grapevine that the Charge Nurse caught all you kids out of bed playing checkers.” This seemed to put the proper light on the whole silly episode and for a time, at least, we all harmonized and did not need sedatives.
My great sense of well-being returned but this time it was accompanied by a terrible restlessness and irritability. I felt perfectly well and it drove me insane to lie there hour after hour, day after day, doing nothing. Absolutely nothing. Kimi was restless also and had unwittingly extended her reading time from fifteen minutes to about twelve hours, but as she was not allowed to read books, only magazines and papers, even this palled after a time. Eileen, always tremendously active, and always cheerful, suddenly became quiet and surly. Minna slept.
She slept so soundly at night she had to be awakened by the washwater girls every morning. She had to be awakened by the nurses at breakfast time. She had to be awakened for nourishment, for dinner, for supper. It was certainly a harmless enough activity and highly recommended by the staff, but it became a major irritation to me.
Every single morning, seven days a week, when the washwater girls had finally roused her, she yawned and stretched and rubbed her thick white eyelids and said, “Oh, my, Ah’m so sleeeeeeeeeeepy.” Right after she had washed, she snuggled down again saying, “Uhm, mmmm, uhmmmmmm, Ah’m sleeeeeeepy,” and I wanted to scream. Every time I looked at her she was asleep, lying on her back, her pale pink mouth, moist and partly open, her white eyelids pulled down and rounded over the slightly bulging, pale blue eyes. I longed to shout and shoot a gun off just above her head. Her sleeping was as unnatural and nauseating to me as watching someone eat or drink themselves into a stupor. She was apparently about as complicated emotionally as a bowl of mashed potatoes. Quite naturally, she was the favorite of the Charge Nurse because by comparison she made anyone who wasn’t under ether seem like a lighted stick of dynamite, and caring for her required the same amount of initiative and thought as stuffing dirty clothes into a Bendix. At mealtimes watching her emerge from her cocoon, blink her heavy white fringed eyelids over her pale eyes, and raise her pale head, was like watching a sluggish white worm poke its head out of an apple.
Except for meals, Minna came to life and evinced enthusiasm only when she talked about tuberculosis. Minna loved tuberculosis and enjoyed discussing each small repulsive detail of her illness. She had none of the new patient’s optimism about getting out of The Pines in less than a year and she counted on being on complete bedrest for three years and, with possible and probable relapses and good luck, maybe five.
She read her lessons avidly and discussed her symptoms with anyone who would listen. She probed the nurses, flower girls (ambulant patients with six hours’ up, who came to the Bedrest Hospital twice a week to fix the flowers), washwater girls, cleanup men, store girl, store boy and Charlie, for gruesome details of operations, hemorrhages and deaths. In Charlie, of course, she found a bottomless pit of bad news and depressing rumors.
So far, no one in our ward had had any treatment other than rest and Eileen certainly hadn’t had much of that, but we all seemed to be progressing favorably. I didn’t cough at all, now; Kimi never had; Eileen coughed only in the morning and when she talked and laughed, and Minna only when she exerted herself unduly, discussing rumors or case histories. We all had voracious appetites and took any and all food that was offered and as much as they would give us. Our letters home were always pleas for more food, and on visiting days our ward looked like a delicatessen.
Then one day without warning, Minna was wheelchaired away during rest hours and given pneumothorax. We had heard of pneumothorax, always referred to as “gas,” from the ambulant patients but we weren’t sure what it was and we thought it was only for the very sick.
When Minna came back she told us that the Medical Director had explained to her that pneumothorax was to a tubercular lung what a splint was to a broken leg. That it was the introduction of clean air into the pleural cavity, which in turn forced the lung to collapse through its own elasticity. It was like forcing air between the covering and the bladder of a football so that the bladder couldn’t expand. She said that the Medical Director had told her that she was very lucky to be able to take artificial pneumothorax as it could not be given to many patients due to adhesions (places where the lung had grown to the pleura).
She said that while she lay on an operating table on her back with her right arm over her head, the doctor painted a small area under her right breast with mercurochrome, injected novocain and then forced a hollow needle, about as large as a big darning needle but much longer, in between the lung and the pleura. After it was in, he attached it to a contraption that forced the air in. She said it hadn’t hurt a bit and showed us the small bandaged place.
Then she told us that she didn’t want to alarm us unduly, but it was her impression from her lengthy and illuminating talk with the Medical Director, that patients who weren’t taking any form of treatment were so far gone that the institution didn’t dare risk it. With this cheering remark she closed her eyes and went to sleep.
By bedtime that night, however, she had changed her mind about who were the lucky ones, for Charlie had told her about spontaneous collapses. A spontaneous collapse, according to Charlie, was almost always fatal and happened very frequently. Minna said, “He told me that some patients’ lungs ah just full of holes, mine probably ah, and when pressuh is put on the lung through pneumothorax, the lung collapses like an old tiah with a blowout. Charlie says that patients are dyin’ like flies around heah with these spontaneous collapses.”
A tuberculosis sanatorium, like a boarding school, is rife with gossip and rumors. But the gossips and rumors at The Pines, instead of being about cheerful things like boys and parties, were always about poor little patients who were mistreated by the staff. The doctors out of pure cussedness were always forcing too much air into the patients’ lungs so that they collapsed, ripping out all their ribs for the joy of it, putting them on enteric diets for meanness, ignoring vital symptoms so they could watch them suffer, and giving them medicines which did no good.
We heard about poor old patients who had so many night sweats that there were puddles around their beds, yet the nurses wouldn’t even bring them clean pajamas or sheets. Just left them to drown in their own juice. We heard about ambulant patients who were kept on janitor duty while spouting blood from every pore. We heard about mothers and daughters in the same ward but not allowed to speak to each other so that they died of a broken heart. We heard of patients without teeth who were given nothing but tough steak to eat.
The rumors were all based on a little bit of truth but turned out like the whispering game we used to play as children where we sat in a circle and the starter whispered something to the person next to him and that person whispered it to the one next to him until it had gone all around the circle. The last one said out loud what had been whispered to him and the starter told what he had originally said and “Mary’s dress is pretty” would go around the circle and come out as “Garry’s lips are spitty,” or “Charlie’s scalp is gritty,” or “Harriet has a kitty.”
I asked Katy Morris about some of the rumors and she told me that the janitor supposedly forced to janitor while hemorrhaging was actually a very lazy patient who always had some excuse for not getting his supervised exercise. His hemorrhage was in reality a very slight nosebleed caused by blowing his nose too hard. The mother and daughter, who were separated and died of broken hearts, was actually a case of a very stupid mother and a very sick daughter. When they were in a room together the mother talked to her daughter constantly and gave her all kinds of forbidden food. When they were separated they sulked and complained. They both died eventually of advance
d tuberculosis and lack of cooperation.
Katy said that she knew of only two spontaneous collapse cases and that in both instances the patient was so far gone, it was a case of trying anything to save them. She said that, as far as surgery went, there were patients who were not ready for it, begging for surgery; and patients who were ready for it fighting against it. She said that the only reason that patients were put on an enteric diet was because they had t.b. of the intestines, because any fool knew that it was easier to feed everybody the same thing at the same time.
She said that she knew that old man without any teeth and that he was an old devil and in addition to not wearing his teeth, which he refused to do out of arbitrariness, he wouldn’t take any of his medicines because he was curing his t.b. by correspondence course. He belonged to some sort of New Thought group and they sent him his instructions every day in the mail. The Medical Director didn’t send him home because home was with his daughter and five small children.
Katy said, “There’s nothing as dumb as people with t.b. You tell them, ‘Now if you do this you’ll get well but if you do this you’ll die,’ and they always try. to do the thing that will kill them.” She looked over at Eileen, who was lying on her side, her red hair fanned out on the pillow, her deep blue bachelor-button eyes round and bright with interest. Under the covers she had her writing paper, her fountain pen and five movie magazines. Kimi said, “Katy, if the nurses were all like you, it would be much pleasanter for the patient.” Katy said, “Kimi, if the patients were all like you it would be much pleasanter for the nurses.”
Minna was given pneumothorax every other day and her lungs didn’t burst or blow up and she continued to sleep twenty-three hours out of the twenty-four, but when poor old Sweetie-Pie came bouncing in on visiting day, wreathed in smiles and loaded with packages, she entertained him for two hours with her operation, her suffering and the horrible things that had happened to other patients and that might and probably would happen to her. We watched him droop and sag like a melting snowman.
After he had gone, Minna sat up and ate every crumb of her supper including two helpings of the main dish. Kimi looked over at her, wearing a new pink angora bed jacket and happily eating soup, while the mournful steps of the deflated Sweetie-Pie dragged along the corridor, then said softly, “With what a vast feeling of relief he will close the lid on your coffin.” I choked on my soup and Eileen shouted with glee. Minna said only, “Next week he’s bringin’ me a pink hood to match this jacket.”
VIII
I’m Cold and So Is the Attitude of the Staff
The Pines was a very cold place and that included the attitude of the staff as well as the temperature of the rooms. We patients wore woolen socks, as many as three pairs at a time, outing flannel pajamas, two, three and four sweaters, bed jackets, mittens, woolen hoods and scarves until we looked like bundles of old clothes but we were all cold all of the time.
From the first of October on, it rained and rained and rained and rained. When it wasn’t raining it misted and fogged, and everything, including our hair and the bedclothes, was damp and clammy. There was heat in the building we knew, because we heard the radiators clank and hiss in the early mornings, but with every window opened wide and all the partitions beginning a foot off the floor, it was as useless to try and heat that place with radiators as to heat the tundra with lighted matches. The cold made us irritable and snappish and ice cold bedpans slipped under the covers at stated intervals did nothing to alleviate the tension.
We were the living proof that colds do not come from draughts, chills, or continual dampness and that the human body will not grow mold. Most of the patients froze passively but I was not a good sport about the cold because I couldn’t see any reason for it. The hospital had thousands and thousands of gallons of boiling water which they could put in our hot-water bottles. They had cupboards loaded with nice thick warm blankets which they could put on our beds.
I complained, begged, cajoled, whined, even bawled and at last my efforts were rewarded with a large wrinkly brown paper blanket. The Charge Nurse brought the paper blanket herself with an air of “I don’t know what you’ll want next in the way of pampering.” She handled it as carefully as though it were made of llama hair and charged with electricity. As this paper blanket signified that I had won the battle, I couldn’t go any further with my fight without appearing like a victor who shoots all the captives, so I shut up.
The paper blanket rustled and crackled cheerfully but actually made me colder because it was so stiff that it let in draughts and kept my own blankets from clinging to me. How I envied the lucky patient in the private room who, Charlie reported, was burning up with fever.
The food, at first cool in the morning and evening, but hot at noon, was finally as winter progressed, all cold. The food was brought from the kitchens via the tunnels and supposedly served from steam tables but judging from the sanatorium’s idea of steam, they were more likely lukewarm tables. Anyway, even if they had been steam tables and everything had started out boiling hot, wheeling it up and down those icy windswept corridors a few times produced the same result as setting it down in the Arctic Circle and having a hundred Eskimos blow on it.
I didn’t mind so much the food’s being cold because it was always well chosen, well seasoned and well cooked, but being luke-warm did nothing for the coffee, which even when hot, tasted as if it had been made out of burnt toast crumbs boiled well with ground-up rubber bands.
Lesson III began, “You are occupying a bed badly needed for someone else. The cure of tuberculosis is very, very expensive. . . . All the nurses are graduate nurses and they are being trained, while at The Pines, to give the best of nursing care to the bed patient, to teach the tuberculous patient the many things he should know about control of infection, rest and exercise, and self-control. . . . Patients must be grateful to the nurses, the doctors, and to the Sanatorium.” The lesson ended, “IF YOU THINK RIGHT, YOU WILL ACT RIGHT.”
Eileen read her lesson and said, “All this guff about being grateful all the time. Be grateful to the nurses—be grateful to the doctors—be grateful to the sanatorium. It’s a good idea but why run it into the ground?” It was unfortunate that Miss Muelbach should have come in just then.
Miss Muelbach’s thick, gray, hairy legs looked as if they had been driven into her shoes and when she walked she stamped and the stands and tables jumped around like tiddlywinks. Her skin was oily and swarthy. She was also big and strong and when she made beds with one of the smaller, weaker nurses, the covers would be tucked in four feet on her side and wouldn’t reach the edge on the weak nurse’s side.
When we entered The Pines the Charge Nurse instructed us never to pick up anything from the floor. If we dropped something we were to wait for a nurse, as it was part of her work to retrieve things from the floor, she told us. This came under the heading of an Ideal State or Utopian Dream, for few of the nurses would ever pick up anything for the patients and the Misses Muelbach and Murdock never.
This day Muelbach stamped over and opened the windows as wide as they would go. It was raining hard and the wind was blowing and immediately there were pools under the windows and spitty gusts on Kimi and me. We asked her please to close the two outside windows as the Charge Nurse had done in the morning, but she said, “Rule of the Sanatorium is that all windows must be open at all times.” She stamped out and our water glasses danced around on the stands. Eileen said, “See what I mean? Asking us to be grateful for that is just running things into the ground.”
Minna said, “I think this place would be much pleasantah if they would use ouah names. That Mrs. Walkeh stuff all the time is right depressin’.” Eileen said, “Oh, that’s because the joint’s free. You never get nothing for free with a smile. You should see how snooty they were to Gramma down at the Relief Office. They Mrs. Kelly’d her from one end of the dump to the other and then wouldn’t give her her false teeth for three months. That’s why I hate soup so much. We had nothin
g but soup for the whole three months. ‘Jesus, Gramma, I got my teeth,’ I used to tell her but soup’s all we got.”
Kimi said, “I think they use the Miss so much because they do not want to become too fond of the patient when so many of them die.” I said, “It is because of the discipline. They have to be impersonal in order to enforce the discipline and the discipline is what makes us get well.” Eileen said, “But they run things into the ground out here. There was an old dame down at the dentist’s who’s been in this joint seven years. Seven years and they’re still callin’ her Miss Ryan. Jesus, how long does it take to get acquainted?”
Adjusting to complete impersonality was difficult, not only for the patients, but for the new nurses who felt sorry for the patients and were afraid of the charge nurses. New nurses were at first sweet and friendly in a frightened sort of way but after a week or so under the training of the Charge Nurse, they changed and became cool, impersonal, and very efficient like the Charge Nurse and her assistants.
Eileen always referred to the Charge Nurse as “The Old Dame,” but this was not an accurate description of her as she was neither old nor a dame. She was probably thirty, tall, slender, beautiful, cool, controlled and fanatical in her devotion to duty. Under her supervision the Women’s Bedrest Hospital clicked off its hours and days like a card punch machine. She knew every pore of every patient and if they were open and why. She was the perfect nurse, the vision in every hospital superintendent’s dream.
She slipped up and down the halls without a sound and prevented the patients from, or caught them in the act of, laughing, talking, reaching, sitting up, looking out the window, reading, or writing when they were not supposed to, or exceeding their reading-and-writing time when they were supposed to, talking to the ambulant patients, coughing, curling hair, not eating “the egg,” or reading mail on an empty stomach.