From January on I noticed also that I had stars in front of my eyes when I bent over. Reaching down to get a file from a low drawer I would straighten up to a blinding kaleidoscope of stars, whirls, flashes and round black dots. Biliousness, I thought, and took calomel and tried not to bend over any oftener than I could help. I thought also that it was probably a combination of my tiredness, my job and the calomel that gave me the indigestion. People who are very nervous and eat so fast they rarely taste what they eat have indigestion but only big bores talk about it, so I ignored mine.
By the time I had gone through my sixth cold, I noticed that I seemed much more nervous, that I slept badly and that I had a heavy feeling over my heart and occasional sharp pains in my lungs. I attributed the heavy feeling and the pains to my indigestion and my indigestion to my nervousness and my nervousness to my job.
This sounds, I know, as though in addition to many symptoms of tuberculosis, I had also all the symptoms of a very retarded mentality. I hadn’t. It was just that I was operating under the impression that I was healthy and I thought that everybody who worked felt as I did. It never occurred to me that my complaints were symptoms of tuberculosis. (Actually they all were.) From Gammy’s training, the movies I had seen and the books I had read, I thought that the only real symptoms of tuberculosis were a dry hacking cough and a clean white linen handkerchief delicately touched to pale lips and coming away blood-flecked.
I was almost thirty years old, had been married and divorced, had two children, had raised chickens and seemed to have normal intelligence but what I knew about tuberculosis, its symptoms, its cause and its cure, could have been written on the head of a pin. It was just that nobody in our family had ever had tuberculosis. None of my friends had ever had tuberculosis, and it is not something that you read up on just for the pure joy of the thing.
The ironic thing is that, although I knew nothing about tuberculosis and never entertained the thought that I might have the disease, for two years I had been very concerned about a co-worker of mine in the Government service, who looked like a cadaver and coughed constantly, with a dry little hacking cough, much of the time in my face. “I think that man has tuberculosis,” I finally told my boss excitedly. “Who don’t?” was his laconic reply.
When I entered the sanatorium and filed a compensation claim against the Government, naming the cadaverous coworker as a possible source of infection, he was sent through the t.b. clinic and found to have had active, communicable tuberculosis for nineteen years. He knew he had it and apparently liked it, for it was much against his will that he was finally sent to a sanatorium.
Four or five of us, who had worked with him, went to sanatoriums with t.b. but the Government paid none of the compensation claims. Whoever it was in charge of compensation claims in Washington had the same attitude as my boss. “All these girls have tuberculosis,” read our claims. “Who don’t?” came back the reply from Washington.
In March I still had January’s cold so I surreptiously consulted an eye, ear, nose and throat specialist. Having had little to do with doctors and having been convinced since infancy that I was healthy, I was ashamed to tell him all the little things that seemed wrong with me so I limited my symptoms to his field and told him about the cold and the chest pains. He examined my eyes, my nose, and my throat and said that there was nothing wrong with me. He patted my shoulder and told me to try infra-red on my back. Sometime later the cold went away.
In May the attacks of indigestion became so frequent and so severe that I went to an internal medicine specialist. I gave him the symptoms which fitted his field. I told him about the indigestion and stars in front of my eyes. He examined my stomach and abdomen and said that there was nothing wrong with me. He patted my shoulder and told me to drink less coffee.
By July I coughed a lot. Also in July I had a complete physical examination for $5000-worth of life insurance. I told the examining physician about my cough and he said, “Cigarettes, haha, I have one too.” I told him about the tiredness and he said, “You should have this job.” I answered truthfully all the questions about who died of what and “has anyone in your family ever had tuberculosis, syphilis, Buerger’s disease, large swelling of the spleen, a steady job, etc.,” was considered a good risk and given the life insurance.
In spite of my increasing debility, there seemed to be nothing wrong with me. I was like the frail creatures in the olden days who for no apparent reason wasted away and died. I continued to take aspirin for the colds and chest pains; calomel for the stars and bismuth for the indigestion, and to attribute the other discomforts to my job, which was arduous in itself and, like all Government jobs, made more so by politics and conflicting personalities (chiefly my own).
In September I became afflicted with hemorrhoids (according to the dictionary you can have but one hemorrhoid—more than one are piles, which I consider an indelicate word). Hemorrhoids should not be glossed over or ignored, so I called my sister Mary, and she sent me at once to her husband, a pathologist. Inasmuch as the study of pathology seemed to embrace the entire human body, I told him all of my symptoms, even the nervousness and the insomnia. He listened gravely, examined my back and chest; tested my sputum, had my lungs x-rayed and sent me to a chest specialist.
I was at the chest specialist’s all afternoon. He listened to my breathing and coughing, tested my sputum, examined my throat and fluoroscoped and x-rayed my lungs. He was showing me the x-rays when he gave me the diagnosis. He said, “This shadow is the tuberculous area in the left lung. You have pulmonary tuberculosis.” I didn’t know that pulmonary tuberculosis meant tuberculosis of the lungs. I thought it was some strange quick-dying type. He concluded, “You will have to go to a sanatorium.”
Sanatorium, I knew what that meant. I had seen Margaret Sullavan in Three Comrades and I had read The Magic Mountain. Sanatoriums were places in the Swiss Alps where people went to die. Not only that but everyone I’d ever heard of who had had tuberculosis had died. I was undoubtedly going to be in excellent company but I didn’t want to die.
For one who had just pronounced a death sentence the chest specialist seemed singularly untouched. He was whistling “There’s a Small Hotel” and looking up a number in the telephone directory. He found his number and began to dial. I got up and went over to the window. It was nearly five o’clock and the September evening fog had begun to drift up from the waterfront. A car tooted its horn irritably in the street below. In the lighted windows of an office across the court I watched the girls jam things quickly into drawers, slam files closed and hurry into their coats and hats.
I said to the doctor, “What about my job?” He had hung up the phone and was leaning back in his chair. He was well tanned and very handsome. He said briskly, “Oh, you won’t be able to work for a long time. Complete bedrest is what you must have. You’re contagious too,” he added comfortingly. I began to cough and he automatically reached down into the drawer of his desk and handed me a Kleenex. I covered my mouth as he had told me to do, and as I had not done for the four or five months I had been coughing, and felt neat and very sad. I said, “How much does a sanatorium cost?” He said, “Thirty-five to fifty dollars a week.” My salary had just been raised to $115 a month. I said, “How long will I have to be in a sanatorium?” He said, “At least a year—probably longer.” I picked up my purse and gloves and said goodnight. As I went through the waiting room I could hear him whistling “There’s a Small Hotel.”
Mary’s husband was waiting for me in his office. In a shaky voice and close to tears I told him about the diagnosis, the sanatorium and the $35 to $50 a week. He said, “The Pines, one of the finest sanatoriums in the world, is an endowed institution and free to anyone who needs care and cannot pay. There is a waiting list of over two hundred but mothers with small children are usually taken right in. I’ll write a letter to the Medical Director.” He took a sheet of paper and began to write. His writing was scratchy and entirely illegible, but he seemed very satisfied with
it and anyway it was going to another doctor. He folded the letter and handed it to me. He said, “Be at the clinic at eight-thirty tomorrow morning. Here is the address. Give them this letter and tell the doctor to call me. As soon as Mary gets here I’ll drive you home.” He also was very handsome but, more important, he was interested and he was kind.
Mary came in then and in five minutes told me so many big lies about tuberculosis, who had it, where they got it, and so forth, that I was immediately cheered up. She said that practically everyone on the street had tuberculosis, that she couldn’t go to a party without seeing at least four far-gone cases, that actually it had gotten to a point where she was ashamed to admit she hadn’t t.b. because everyone who was anyone—look at Robert Louis Stevenson and Chopin—had had t.b. Anyway with or without t.b. she wished someone would order her to go on complete bedrest—she hadn’t had any sleep for so long that the muscles of her eyelids had atrophied. She thought a slight case of t.b. should be the aftermath of every pregnancy so that the poor mother could get a little sleep. She thought a lot of things and she thought them out loud, which was soothing and made it unnecessary for me to talk and so I didn’t cough all the way home.
Instead I worried about how to tell the family and if I should tell the children. I toyed with dramatic little scenes in which I went quietly into the house as though nothing had happened, smiling often and bravely, and then Mary told them. I entertained the idea of telling just Mother and when I had gone upstairs, smiling often and bravely, she would gather them all together, preferably around her knee, and tell them about my “trouble.”
I needn’t have wasted the effort. When we stopped in front of the house the entire family, including the children and the dogs, came bursting out. They already knew. Mary had called them while I was at the chest specialist’s office. I was to go right to bed in Mother’s bed, the fourposter in which we had all been born, and had had all of our illnesses.
There was a fire in the fireplace. There was fresh hot coffee. There were infinite love and abundant sympathy. There may have been too much sympathy because after a while I became almost overcome with my own bravery, selflessness and power of mind over body. To think that for the whole past year I had been going my way, working, playing and laughing, while all the time I was seriously, perhaps fatally, ill. I wallowed in self-pity. Instead of admitting to myself that it was a great relief to know what was wrong with me and that I was really sick instead of ambitionless and indolent, I dripped tears on Mother’s blue down quilt as I created doleful mental pictures of little Anne and Joan putting flowers on “Mommy’s” fresh grave. I was a big, no-sense-of-humor saddo. I coughed all night long and enjoyed doing it.
III
“Good-bye, Good-bye to Everything!”
Crack goes the whip, and off we go;
The trees and houses smaller grow;
Last, round the woody turn we swing;
Good-bye, good-bye to everything!
—Robert Louis Stevenson
THE NEXT MORNING I was awakened by Anne and Joan who, instead of arising early to gather the flowers for my grave, came boiling into the room to involve me in one of their senseless quarrels. They demanded that I get right out of bed and go into their room and peer into the eaves trough outside their windows to determine by the number of pits, which were not supposed to be there, who had eaten the most of a large box of cherries sent them early in the summer.
My sister Dede coming in with my breakfast tray in the middle of the story said that she thought the best and fairest way to handle the thing would be to hold them out the window by their heels while they counted the pits one by one. Everyone in our family knows that Dede always means what she says so the children left, flashing us several withering looks over their shoulders and fighting all the way downstairs about who had the thickest arithmetic book. Dede called down that the one with the thickest book had the thickest head and we were rewarded with a stony silence.
“At least Anne and Joan are making themselves awfully easy to say good-bye to,” Dede said cheerfully sitting on the bed and lighting a cigarette. Then she offered to stay home from work and go to the clinic with me and I accepted eagerly for Dede has a very direct approach to life and has often been described as “having her feet on the ground.” Sometimes her feet are so firmly planted that you can hardly see her ankles but this is most comforting in times of stress.
Dede is the only one of us who is small and quiet and hasn’t red hair. She has dark curly hair, large gray eyes and a low voice. In one so slight and wistful-looking, great strength of character and immutability are unexpected qualities. Dede describes herself as merely being a person who faces facts. “The trouble with you,” she used to tell Mary, Madge, Alison and me, “is that if you have a date with a short, dull man you pretend to yourself that his growth was stunted in early childhood and that he’s not dull, he’s tired. I face the fact that I’m going to spend the evening with a little bore and I plan to go some place where there will be other people and we can sit down.”
We learned on arrival that The Pines Clinic shared a building with the police station, city jail, emergency hospital and venereal disease clinic. The dark, ancient elevator seemed to have caught some virulent ailment from its patrons for, when it was loaded, it coughed and wheezed, lost its breath entirely, dropped back a foot or two, bounced uncertainly for a while and finally by summoning every ounce of its strength managed to struggle up to the second floor. Because of the location and bad light, Dede and I were certain that all the other occupants of the elevator were crooks and prostitutes and were very disappointed when most of them filed out of the elevator and entered the t.b. clinic with us. In the strong daylight of the clinic they turned out to be just average people. A few better than average. All sad.
The clinic was a depressing place filled with golden oak benches, stale air and the other people with t.b. The nurse at the desk took my letter, read it and asked me suspiciously who had sent me down “there.” She pointed with her pencil to the paragraph in the letter mentioning the name of the chest specialist. I told her, but I couldn’t see what difference it made. It made a lot of difference apparently because it seemed that the chest specialist had his own sanatorium and the nurse gave me to understand that if I had been over there learning their methods there was no place for me on one of her benches. She also gave me to understand that tuberculosis was something just a little special and she wasn’t sure she was going to let me have it.
Her tight-lipped, unsmiling, unfriendly attitude was a shock to me. I had thought, from my meagre previous experience in hospitals when Anne and Joan were born, that all nurses were unusually kind, gentle and friendly little ladies. That girls were originally chosen to be nurses because of these qualities and that their training enhanced them. I tried smiling at the desk nurse. She gave me a stony stare and motioned me to one of the benches. Apparently she hated people with tuberculosis the way some people hate liver. I slunk over to the bench and sat down beside Dede.
Immediately another unsmiling, hard-eyed nurse rustled over and stuck a thermometer in my mouth. She tried also to put one in Dede’s mouth but Dede clenched her teeth and said that she wasn’t sick. Either the nurse didn’t hear her or didn’t believe her because she made three attempts. After the last one Dede said quietly, “If you try that again I’ll bite your hand off.” The nurse looked startled and backed into the scales. Another nurse came by. She was a fat, motherly-looking woman but she was about as friendly as a halibut. She handed me two blue sputum specimen bottles. I started to say, “Thank you,” but she held up her hand for silence. “Don’t talk with the thermometer in your mouth,” she said coldly and went away.
In about half an hour the rustling nurse removed the thermometer, took my pulse and weighed me. Then a very deaf old nurse gave me the Mantoux test, which is an injection of tuberculin serum in the forearm. She shouted questions at me and I shouted replies, which was very embarrassing owing to the nature of some of the quest
ions. As each operation was completed we were moved forward a bench like playing Rock School. The benches were as hard as tombstones so the long intervals between each operation were not only dull but painful due to my hemorrhoids.
The next step was a Wassermann test, given in another part of the building. The man who took the blood out of my arm was very pleasant and very kind. As we left his department and walked down the hall toward the t.b. clinic, Dede said, “I’d choose syphilis.”
After another longer wait I was given a throat and chest examination by a cheerful, red-haired young doctor. At last we reached the front bench and had only to wait for the Medical Director. While we waited we looked at the other patients and they looked at us. Some of the patients seemed to be old-timers and knew all the nurses and most of the other patients. Everyone but me was either very young or very old. Also I seemed to be the only one who coughed and each time I coughed three nurses and all the patients looked at me accusingly to see if I covered my mouth.
On the wall were several framed mottos. One said, “If you have nothing to do, Don’t do it here.” Another said “All that is not rest is exercise.” Another, “Don’t stand up if you can sit down. Don’t sit down if you can lie down.” After the third hour I felt as if the mottos were etched on one end of me and the grain of the wooden benches on the other.
The windows, very tall, very narrow and uncurtained, framed a bail bond office, an old rotting hotel with orangecrate coolers tacked on the windowsills, and the station clock. The hands of the clock slowly moved from 8:30 to 12:25. Dede discovered that by changing to the outside seats we could see into the little room where they showed the x-rays but when we got up to move we found that the benches had grown sticky from the long sitting and we had to peel ourselves off like adhesive tape.
Watching the x-rays was a tiny bit more interesting than the mottos or the station clock. The doctor slid the x-ray film into a little frame, turned on a light under the frame and pointed out to the patient the tuberculous area in his lung. The x-ray pictures were milky and the doctors, instead of saying, “This muddy area here is t.b.,” said things like “exudative infiltrate in the middle of the left lung representing a bronchogenic extension from the cavity” or “infiltration of mixed exudative and productive character in the upper third of the right lung.”