The little book of rules began, “Everything that is not rest is exercise.” The writer elaborated. . . . “If you had a broken leg you would not walk on it. The same applies to your lung. In order to heal, your lung must have rest. Talking, laughing, singing are all exercise which can be avoided.” This all seemed very logical and easy to understand. The next part struck me as a trifle odd. “Please,” the writer of the little book begged, “do not steal out of other patients’ lockers and please do not spit on the floor.” Apparently sex and over-optimism weren’t the only characteristics of people with tuberculosis.
From twelve-thirty to two-thirty were rest hours. “The strictest rule of The Pines is observance of rest hours and any infraction of the rule for absolute rest during these two hours, means instant dismissal,” it had stated in the book of rules. It also stated: “Getting well depends on the patient. Rest, fresh air, good food, and later, regulated and supervised exercise, all help but if the patient doesn’t have the will power, honesty, and character to obey the rules, nothing will save him. . . . If you cannot pay the price and feel that you will not be a good influence on others, go home and give your bed to someone who will be of value.”
During the rest hours, I lay in my clammy bed and looked at the pale green walls and tried to think about will power and honesty and how grateful I was to be there; about the two hundred people on the waiting list, who they were and what they were doing. Marie and Sylvia and Kimi slept. Everyone else slept too, apparently. There was not a sound. Occasionally, with terrifying suddenness, a nurse would appear at the door to see if we were resting. One time it was a cheerful nurse. She winked at me and disappeared. Through the windows I could just see the tip of one of the poplars. Its yellow leaves were motionless, like paper leaves hung by threads to an imitation tree. The sky was a dirty white now, the air steel blue with fog.
It seemed so strange, this stillness. It was daytime and there should at least have been the tapping of a distant hammer, the bark of a dog, the slam of a door. It was as though we were all dead. I took a drink of water and it had the acrid, slightly warm taste of bathroom water. I wondered why kitchen water and bathroom water never tasted the same. I moved my feet around to try and find a warm place in the bed. It was as futile as feeling around on a cement floor to find a soft place to lie down. I looked at my watch. One o’clock: an hour and a half to go.
I closed my eyes and tried to relax, joint by joint, muscle by muscle, according to an article I had recently read on charm. This relaxing was supposed to have been done by the hostess just before a dinner party and while the capon was roasting, the wild rice was steaming and the pistachionut ice cream cake was hardening. My reaction at the time had been that she should have had cheaper food and more help, but now I was grateful for her suggestions on how to relax.
There had been a picture of her lying on her bed in a negligee, with witch-hazel pads on her eyes. Lounging in the doorway was a rather unsavory-looking man, presumably her husband, and I remember thinking that she couldn’t have been the nervous type if she could relax on a bed with pads over her eyes and him in the doorway. The article had said, “Think of your big toe. It is heavy. It is limp.” I thought of my big toe but it was cold and stiff and there seemed to be a short circuit between my brain and my lower extremities. I tried my fingers, arms and shoulders. I was no more successful.
A girl in the next room began to cough. Her cough was deep and resonant and was a welcome relief from the silence. It was like a signal, for immediately up and down the corridors there were more coughs. Small dry coughs, loose phlegmy coughs, short staccato coughs, long whooping coughs. The hospital began to seem peopled and cheerful.
A nurse flashed in the doorway. She said to me, the others being asleep, “Patients must control their coughs. A cough can be controlled.” I didn’t say anything because I hadn’t coughed and I knew if I spoke I would. She looked at me penetratingly for a minute and then flashed away again. I noticed that the coughing had ceased. Apparently she had stopped at each door and turned it off, like the radio.
I looked at the green ceiling again and tried to be honest and grateful. I thought of that terrible evening when the chest specialist had told me that I had tuberculosis; that if I wanted to get well I would have to go to a sanatorium; that sanatoriums cost $35 to $50 a week. I remembered how I had stood and looked at him, feeling like a mouse in an apple barrel—no way out. Around and around—no way out—no way out—no way out.
Now here I was in a hospital, being cared for, being fed, being watched over, being cured, I hoped. Yet the institution had to remind me to be grateful. I had to remind myself to be grateful because my instinct was to be resentful. Resentful of the rules, resentful of the nurses who enforced the rules. What was the matter with me? Was that what the Medical Director had meant when he said the cure would be hard for me, or were all tuberculosis patients the same way? I would ask Kimi when she woke up. When the rest hours were over. I looked at my watch. It was one-seven.
I looked back at the ceiling and tried to relax my fingers but my heart was pounding and I felt like a skyrocket about to explode into a million jagged stars. I turned my pillow over and took another drink of the tepid water. I closed my eyes and pressed my fingers against the eyeballs. Brilliant, blinding kaleidoscopic pictures appeared. It was infinitely more interesting than the green ceiling but according to the little book, not very honest or grateful.
I reached out and got my damp cold washcloth and put it over my eyes. That was better. I thought, “That is my big toe. It is heavy.” But all I could see was that pistachio ice cream cake. I’ll bet it was heavy. I took the washcloth off and turned over so I could see the poplar tree again. While I watched, one small leaf let go and dropped limply through the misty air. Compared to the hospital it seemed like an act of hysterical activity. I watched for a long time but no other leaves fell off the tree.
The girl in the next room began to cough again. It was muffled as though she were trying desperately not to cough but I heard the low murmur of the nurse and “Patients must control their coughs.” My heart began to pound again, senselessly, as though I were climbing a steep hill. I turned over and lay on it and could feel its thudding clear to the top of my head. Thump, thump, thump, thump. I turned back again and it pounded harder.
When the nurse looked in I motioned to her. She came quickly to the bed on soundless feet. I said, “My heart’s pounding.” She looked at my chest and held my wrist for a minute then said, “Palpitations. Very common with t.b. Go to sleep,” and left. I turned on the right side and my heart quieted a little. I closed my eyes but my thoughts, like a skidding car toward the railing of a bridge, immediately veered toward home and the children. I quickly opened them again.
Marie coughed and turned over. Her pale face blended into the sheet. Her black hair looked like an ink blot on the white bed. Her mouth was turned down petulantly even in sleep. Kimi slept gracefully, one flushed cheek on a slender palm. She was either very well adjusted or imbued with Oriental fatalism. Sylvia had her back to me. She snored faintly like a fly buzzing behind a curtain.
I drank some more water and thought, “I haven’t even been here a full twenty-four hours yet and I have at least a year yet to go.” Again my thoughts careered dangerously toward home. Keeping away from homesickness was like walking across a rock slide. Every step was insecure and the very next one might bring the whole mountain down on me. If only I had a hot-water bottle. How long could people stay dank and cold without mildewing? How long was two hours anyway? Was being cold all the time part of the cure or was it the easiest way to keep patients quiet and under the covers? Why weren’t frail little creatures like Sylvia cold? She said she was always warm. Maybe that was the fever.
I reached under the covers and tried massaging some warmth into my feet. It was as unproductive as trying to get sparks by rubbing two wet sponges together. I made up my mind that before that day ended I was going to have a talk with the Charge Nurse. I was go
ing to ask her if keeping the patients half frozen was part of the cure; what the term “taking the cure” meant; what tuberculosis was; what the germ looked like; what its effect on the lung was; what rest had to do with the cure; if t.b. was actually curable; why some people, like the man in my office, could have t.b. for twenty years and live normal lives while others, like me, in less than one year became completely incapacitated; why I couldn’t rest during rest hours; why I was so nervous; if, as time went on, I would become more restless or more well-adjusted. There were hundreds more questions I could ask but these would do for a start and would give me something to go on. Give me a basic understanding of the disease, The Pines and the cure. I was sure that I could be more intelligently cooperative if I knew what I was doing.
Trying to memorize the questions I wanted to ask took up the last long dragging minutes of the rest hours and at last there was a gentle clink-clank down the hall and in the door came a nurse with the nourishment cart. “Thank God,” I thought. “Hot cocoa!” But the choice was ice cold milk or ice cold buttermilk. “What, no fans?” I said bitterly under my breath, as I chose ice cold buttermilk. Kimi took plain milk, Sylvia and Marie nothing.
After nourishment a nurse filled our water glasses again, another nurse took orders for supplies, such as toilet paper, paper handkerchiefs, sputum cups, etc., and told me to order enough for a week, as supplies were only given out on Saturdays.
After she had gone a nurse came in and asked us questions and wrote the answers down on a chart. She asked us how we slept; how our appetites were; if our bowels were regular; if we coughed; if we raised; how much; color of sputum. The frequent detailed discussions of sputum, its amount and color, often made me wish for a more dainty ailment like diabetes or brain tumor. After she had gone the nurses brought wash water and in a little while Charlie put up the beds and it was time for supper.
Except for rest hours the day had gone by quickly. The long spaces of time had been well broken by small activities. For supper we had cold beef, scalloped potatoes, vegetable soup, banana salad, bread and butter, cookies, beautiful thoughts and hot tea.
I had just taken a large bite of meat and was reading my beautiful thought which said, “I have often regretted my speech, never my silence,” when Sylvia threw up. I don’t know whether she choked or was suddenly sick or had just read her beautiful thought, but she threw up all over her supper tray and down the side of the bed. It made me very sick. I quickly drank some tea and looked to see how Marie and Kimi were taking it. They weren’t taking it any way. They were eating their supper as though it hadn’t happened. I drank a little more of the tea.
Sylvia tapped with her spoon on the stand and eventually a nurse came in and cleaned her up. When she had finished, the nurse turned to me and said, “Eat your supper, Mrs. Bard. You must learn to ignore these things.” She brought Sylvia another tray and some more tea and she ate her supper and so did I.
When the Charge Nurse and the doctor made their rounds, they came only to the doorway and said, “Everybody fine?” and so I put off asking the questions about tuberculosis until the next day. Half an hour after dinner we took our temperatures, mine was 98.6°, Marie’s 102°, Sylvia’s 101°, Kimi’s 99°, and almost simultaneously the radio came on.
First there was a program of dinner music, then a play, then music, then a play. The radio flowed on until lights out at nine o’clock. The music was very nice but the plays and programs were very irritating because the volume was kept so low we could only hear occasional words. At seven o’clock we were given nourishment again, hot chocolate or cold milk. At seven-thirty the day staff went off duty and two evening nurses came on. Immediately there was a low distinct hum of talking from all over the hospital. It was a soft undercurrent noise like the hum of a refrigerator but it stood out in the absolute quiet.
We talked too. I asked Sylvia how she got tuberculosis. She said that she had had it since she was a child, that all her life had been lived in sanatoriums. She had been in Switzerland, New York, Arizona, Colorado, New Mexico and California. The medical director of the last sanatorium she had been in, one in Arizona, had given her up and sent her home to die. She said that, without any hope and only for her mother’s sake, she had gone to see the Medical Director of The Pines. He had told her that his ways were hard but that he might save her.
I asked her if The Pines was like any of the other sanatoriums. She said, “No. In all the other sanatoriums they have the rules but only in The Pines do they enforce them. The Medical Director here knows tuberculosis and people with tuberculosis and he is going to cure them in spite of themselves.” I asked her if being cold was part of the cure. She said that she didn’t think so. That she wasn’t cold.
I asked Marie and Kimi if they were cold. Marie said only part of the time, Kimi said that she was cold all of the time. She said, “I have instructed my family to bring heavy sock, many sweater and mitten.” I made a mental note to tell my family to bring sock, sweater and mitten too. Also a bed lamp and a stand bag.
The stand bags, made of bright chintzes, were like shoe bags with large pockets for writing paper, bedroom slippers and hand mirror and smaller ones for pens and pencils, combs and brushes and cosmetics. They were pinned to the towel bar on the stand by safety pins and their accessibility eliminated a lot of reaching.
At eight o’clock a nurse brought medicines. At eight-thirty we brushed our teeth with drinking water, spitting in our bedpans and Sylvia and Marie began to talk about bedsores. Sylvia told about bedsores in Europe, in New York, in California, in Colorado, in Arizona and New Mexico. Marie told about her grandmother’s bedsores and her own. At nine o’clock the lights were switched out.
I pulled the clammy sheet up around my neck, stuck my feet timidly down into the icy regions at the foot of the bed and thought longingly of delightful hot climate diseases like leprosy, cholera and jungle rot.
VI
Anybody Can Have Tuberculosis
The next morning I was awake with my eyes open and feet braced when the lights blared and the washwater girls came crashing into the ward. To my astonishment, one of the washwater “girls” was a small, white-haired, very old woman.
I wanted to say, “But, you’re too old to have tuberculosis.” Instead I asked her how long she had been at the sanatorium. She said, “Almost a year. In fact it will be a year next Thursday.” I said, “And I suppose you had been sick at home before you came out here?” She said, “My goodness no, I was never sick. Dad used to say, ‘There’s one thing about you, Nellie, you’re never sick. You’re thin as a picked chicken, but you’re never sick.’ I had a cough, of course, for years and years but we thought it was asthma. Dad used to say, ‘Everything but me gives Nellie asthma.’ When Dad passed over the doctor examined me and sent me out here. It was lucky for me in a way too because I missed Dad something awful. Dad used to say, ‘Nellie, you look like the wind will blow you away but I’ll bet you outlive me.’ Everybody’s just lovely to me out here. It’s just like a real home to me.” I thought grimly that if this was just like a real home to her she must have been raised in a reform school. She went on. “Dad used to say, ‘Nellie loves people and people love Nellie.’”
It was easy to see why people loved Nellie because, in addition to loving people, she filled the wash basins clear full of hot water. I asked her hopefully if she was going to be on washwater duty every day. She said much as she liked people and washwater duty, it was a rule down at the Ambulant Hospital that all eight-hour patients should take turns on washwater duty. She wouldn’t be on again until the next Sunday.
The other washwater girl, a large, boisterous young blonde, when admonished by Nellie for giving only the usual two cupfuls of washwater said, “My gosh, Nellie, you fill the basins clear up and we’ll have to make another trip for hot water.” Nellie said firmly, “Durdree Swanson, you act like you was never in Bedrest and tried to wash in a little bit of lukewarm water. Now go down to the bathroom and fill up another pitcher.” Du
rdree said very unenthusiastically, “O.K., Nellie,” and took the pitcher down to the bathroom.
When she had gone I said, “What did you say her name was?” I thought perhaps Durdree was some native Swedish name. But Nellie said, “Her name’s Durdree, D-e-i-r-d-r-e. Her mother got it out of a book. Sounds funny don’t it?”
Durdree had cheeks like camellias, deep blue eyes and ash blond hair. She was so pretty, so generously proportioned and so vital that I felt that The Pines should put one of her up in every ward to give the patients something to work toward. She was the last person in the world anyone would associate with tuberculosis. I said so. She laughed, showing many perfect white teeth and deep dimples, and said, “You wouldn’t have said that if you’d seen me when I came in. I only weighed eighty-five pounds and I had been coughin’ night and day for a year. Mama and the doc thought it was just a cold. Finally the school nurse sent me to The Pines Clinic.” (She pronounced it “Clink,” which considering its atmosphere wasn’t too far off.)
Durdree was eighteen. She had been at The Pines for two years and expected her discharge any day. She told us that her “boy friend” was in the Navy and that as soon as she got out of the sanatorium she and her “girl friend” were going to hitchhike to San Diego. I was quite certain that this would not come under the heading of “Accepted Forms of Occupational Therapy” but I was equally certain that Durdree would have no trouble getting a ride.
By breakfast time a very consumptive sun had begun to peer wanly out from under its hood of fog and we all said hopefully that there would probably be sunshine for visiting hours. I wondered sadly if anyone would come to see me. Kimi said, “I certainly hope my family received all my letter. My mother is so rattle-brained at times. Always writing poetry and forgetting my instruction.” I asked what her instructions were. She said, “The instruction were about the heavy sock and sweater and mitten. But it would be just like my mother to forget all about the warm clothing and bring me one of her beautiful poem about the spring.”