Preface.  These are my kindle notes from “The Plague and I” by Betty MacDonald.  Her great sense of humor, beautiful writing, and finding out what it would have been like to be in a Tuberculosis (TB) sanitarium in 1937 are quite interesting.

So if you’re having a hard time coping with covid-19, TB would have been worse before antibiotics, and may be again now that there are drug-resistant strains. No thanks, I’ll take Covid-19.

TB is found in every nation of the world and the leading cause of infectious death, even greater than HIV/AIDS.  Currently about a quarter of the world’s population is thought to be infected with TB, with 10 million active cases resulting in 1.5 million deaths a year. About 95% of deaths occur in developing countries such as India, China, Indonesia, Pakistan, and the Philippines.  But now that there are multidrug-resistant forms of TB, the threat lurks for us all.

TB is at least 5,000 years old and as always, the world’s poor were most likely to die of it.  Sanitoria to treat patients began in the late 1800s, but at least half who entered died within five years.  Antibiotic cures began appearing after WWII, but even before then the prevalence had been dropping due to better nutrition and hygiene.  Most who have TB have no symptoms, and only 10% of them will progress to the active disease with a chronic cough, fever, and weight loss when it can be spread it to others. 

We’ve come a long way baby. Between 1810 and 1815 more than 25% of deaths in New York City were from TB. In 1900, 194 out of every 100,000 died of TB in the US, declining to 46 in 1940. Back then, the three leading causes of death were pneumonia, tuberculosis (TB), and diarrhea and enteritis, which (together with diphtheria) caused one third of all deaths.   In the U.S. from 1900 to 1925 the number of beds in sanatoriums went from about 4,500 to 675,000, and for those who could afford them, kept them from spreading TB to others and perhaps even a cure. Now TB kills about 500 people a year in the U.S.

Alice Friedemann www.energyskeptic.com  author of “When Trucks Stop Running: Energy and the Future of Transportation”, 2015, Springer, Barriers to Making Algal Biofuels, and “Crunch! Whole Grain Artisan Chips and Crackers”. Podcasts: Collapse Chronicles, Derrick Jensen, Practical Prepping, KunstlerCast 253, KunstlerCast278, Peak Prosperity , XX2 report

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MacDonald, Betty. 1947. The Plague and I.   Harper Perennial.

Getting tuberculosis in the middle of your life is like starting downtown to do a lot of urgent errands and being hit by a bus. When you regain consciousness, you remember nothing about the urgent errands. You can’t even remember where you were going. The important things now are the pain in your leg; the soreness in your back; what you will have for dinner; who is in the next bed.

Being sent to an institution, be it penal, mental or tuberculous, is no game of Parchesi, and not knowing when, or if, you’ll get out doesn’t make it any easier. At least a criminal knows what his sentence is. I had been confidently counting on the chest specialist’s guess of one year, when I remembered the rider he had tacked on of “or longer.” “Or longer” could mean anything from one month to ten years. It was not comforting.

Instructions from the clinic were that new patients must arrive at The Pines between the hours of three and four-thirty in the afternoon, “after rest hours and before supper.

I awoke early to milky windows and foghorns. The hollow echoing footsteps of the paper boy followed by the thump of the paper on the porch. A streetcar clanging past, high-spirited and empty on its first trip. A window slamming shut across the street. The thud of the front door and several sharp joyful barks as Mother let the dogs out. The complaining groans of the starter on a car somewhere down the alley. The rumbling thunder of another streetcar crossing the bridge over the park ravine two blocks away.

Finally Anne asked bluntly, “Are you going to die, Betty?” I said of course not. How ridiculous. Joan said, “Bessie had tuberculosis and she died.” Bessie was a school friend of Alison’s, and until this moment her illness and death had been tactfully kept from me.

In spite of our good intentions, the children did stay home from school and everything was very abnormal but I managed somehow to tie up most of the odds and ends of my life, and to have a permanent wave and a very short haircut before two o’clock. Then the thin autumn sunshine and the rollicking dogs gave a picnicking air to the good-byes, but even so as I walked down the steps of the old brown shingled house I remarked morbidly to Dede that I felt like a barnacle that had been pried off its rock. Glancing briefly at my short, too-curly hair she remarked drily that I looked quite a lot like one too.

As we drove off I turned and waved and waved to the children. They stood on the sidewalk, squinting against the sun. Young, long-legged and defenseless. I loved them so that I felt my heart draining and wondered if I was leaving a trail behind me like the shiny mark of a snail.

I looked at gardens blazing with dahlias, zinnias, Michaelmas daisies and chrysanthemums. At lawns blatantly green from damp fall weather, lapping the edges of the sidewalks. At full-leaved Western trees hesitantly turning a little yellow on the edges, while imported Eastern trees blushed delicately as they dropped their leaves in the soft, warm autumn air.

A freight train, enveloped in its own smoke, racketed and panted along the shore. Occasional late-flowering dogwoods gleamed greenish white in the dark woods, like numbers on a luminous-dialed clock at night. The madroña trees, leaning down and twisting their trunks in an endeavor to see from under the suffocating firs, dripped with berries bright as blood. Their cinnamon brown bark curled back to show patches of chartreuse skin. Occasional pines stood alone, their branches stiff, their gray green skirts held high. The whole outdoors was fragrant and beautiful and grew more so as inexorably we drew closer and closer to The Pines and my incarceration

It might have been any small endowed college except that there were no laughing groups strolling under the trees. In fact, the only sign of life anywhere at all was a single nurse who flitted between two buildings like a white paper in the wind.

Like wax figures in a store window we sat motionless in unnatural attitudes on the unyielding furniture, all facing each other and the empty grate. The quality of the whole scene was so dreamlike that I looked at Mother and Mary, side by side on a mustard-colored love seat in front of the window, and expected to see large cobwebs attaching them to each other and to the casement back of them. I felt that we had all been there forever.

She acted as if she were reading them off the bottom of the soap, in my bathrobe sleeve, from the hem of the washcloth. “Patients must not read. Patients must not write. Patients must not talk. Patients must not laugh. Patients must not sing. Patients must lie still. Patients must not reach. Patients must relax.

When she came to my bottle of cough medicine and box of aspirin, she exploded. “Patients must never take medicines without the Doctor’s permission. No patient of the Sanatorium ever has medicine of any kind whatsoever in his possession. Patients are never allowed to choose own medicines. These,” she held up the cough medicine and aspirin as if they were Home Cure for Syphilis and Quick Aborto, “will have to be sent home or destroyed. These extra sweaters, these bed jackets, all your clothes, books, writing materials and handkerchiefs [her disdain of this last filthy habit-forming article was tremendous] will have to go through fumigation and be sent home.

At four o’clock we had supper. First an ambulant patient came around and propped up the beds so that we were sitting up; then nurses dealt out trays, set with silver, napkins, salad, bread and butter, dessert and little slips of paper with beautiful thoughts on them. Then the food carts were wheeled around, and we were served spaghetti, soup and tea by the Charge Nurse. The food was well seasoned and very good but cold. The beautiful thought on my tray said, “If you must be blue, be a bright blue.

At five o’clock the radio, which was controlled and set at the office, with a speaker in each ward, began drooling forth organ music. Organ music of any kind depresses me and added to that was the fact that I had no bed lamp. A bed lamp apparently was not considered a necessity and had not been on the list of requirements. My corner was dark. My thoughts gloomy.

It was hard to remember how anxious I had been to enter The Pines; how grateful I had been to the Medical Director for putting me ahead of the long waiting list; how wonderful it was that I was being cured and cared for for nothing. I was cold and lonely and I missed my children and my family. The ward was very quiet and little wisps of fog crept through the wide-open windows. If only I could read, or write, or talk or do anything but lie there and listen to that awful organ music.

At seven o’clock we had hot cocoa, hot milk or cold milk. At nine o’clock the lights were turned out by a main switch in the hall. The night nurse operated by flashlight. Up and down the halls she went with her flashlight like a firefly dancing over each bed, resting for a second on each face. When she left our room the darkness, silence and cold settled down again like a shroud.

The night went on and on and on and I grew progressively colder and sadder. “There’s one thing to be said in favor of life at The Pines,” I thought, as I tried futilely to warm a small new area at the bottom of the bed, “it’s going to make dying seem like a lot of fun.

All the news was depressing and the patients spoke of two, three and five years with a casualness usually associated with minutes. But as I was still having difficulty coming face to face with the bald fact that I would be away from the children and the family for a year,

I took out my lipstick and Sylvia said immediately, “No, no, Betty, patients are not allowed to wear makeup except on visiting day.

We had been lying perfectly still for about ten minutes when I opened my eyes a crack and saw the Charge Nurse materialize in the doorway. She walked without a sound and appeared in the doorway so suddenly it was as though she had been projected there by a machine from the main office. She looked us over quickly and moved on to appear in other doorways and maybe catch other patients talking or laughing or reaching or singing or scratching or twitching or any of the other things that did not come under the category of resting.

At twenty minutes past seven the same ambulant male patient who had come in the evening before, put up our beds for breakfast.

As he put up the back of my bed he said, “My name’s Charlie Johnson. You’re new here, ain’t you?” I said yes, so he said, “Well, I been here five years and I seen ’em come and I seen ’em go. Some go out on their feet but most of ’em go out in a box. How bad are you?” I said that I didn’t know but that I only expected to stay a year. “Ha, ha!” he laughed mirthlessly. “A year. That’s what they all say when they first come. Ha, ha!

I asked Kimi if all the male patients were old and sad like Bill and Charlie. She said, “No, most of the male patient are young but because of sex the young virile men are not allowed in the Women’s Bedrest Hospital and, vice versa, the young pretty nurse are not allowed in the Men’s Bedrest Hospital.” I asked her what the young men did and she explained that they worked in the greenhouse, laboratory, x-ray and shops

From 12:3 TO 2:30 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.

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.

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 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.

Was being cold all the time part of the cure or was it the easiest way to keep patients quiet and under the covers?

The frequent detailed discussions of sputum, its amount and color, often made me wish for a more dainty ailment like diabetes or brain tumor.

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.

There was a terrific clatter in the hallway and two nurses pushed in a large pair of scales, for in addition to its being Sunday and a visiting day, this was also the last day of the month and weigh day. As each of us was helped out of bed and onto the scales, the room was tight with hope, for gaining weight signified at least a foothold on the climb to health. Losing weight meant a sliding backward

Kimi solved the problem by saying, in her small sweet voice, “Eileen, all crying will do is to make your pillow and sheet wet and colder. When Katy, the evening nurse, comes on duty she will fill your hot-water bottle. Don’t be sad, we are your friend and are in sympathy with you.” Kimi’s speeches always sounded as though they should have been on parchment with a spray of cherry blossoms or a single iris painted across one corner.

The staff at The Pines did not discuss tuberculosis with the patients. If you asked the doctors or nurses about your progress or lack of progress you got a noncommittal stare and no information.

Lessons and were mailed to the patients every few days. My first lesson on tuberculosis began; “Tuberculosis is contagious: The germ is thrown off in spray or sputum from the nose and throat. Patients must ALWAYS cover the nose and mouth when sneezing and coughing. Handshaking and kissing are means of spreading the germ.

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.

The rumors were all based on a little bit of truth but turned out like the whispering game

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 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.

Once during my first week, I asked Kimi how she could lie in her bed so entirely immobile hour after hour. She said in her gentle way, “It is not difficult. In my mind, I am torturing the nurses.” She only meant Granite Eyes, Gravy Face, Mrs. Macklevenny and Miss Garnet, of course. The rest of the nurses were unfriendly but not unkind. A few were darlings

The darlings were Miss Hatfield; Katy Morris, of course; Ann Robinson, who came to The Pines the same day I did, was tall, dark, beautiful and gentle and after nursing us for seven months, contracted miliary tuberculosis and died in two months; and Molly Hastings, an English nurse, who had been at The Pines for two years but was still sweet and friendly to the patients and had a wonderful sense of humor.

Molly told us some of the trials of being a nurse at The Pines. She said that the discipline was not limited to the patients as the nurses were not allowed to smoke on the premises, had to be in every night by ten-thirty, were required to attend school three nights a week and were under twenty-four-hour surveillance to be sure that they obeyed these rules and many others, including no indulgence in SEX, thoughts of SEX, actions which might eventually lead up to SEX, discussions of SEX or literature concerned with SEX. She said that with the exception of the charge nurses, the nurses weren’t allowed to speak to the doctors,

Molly told us that only unattractive nurses were sent to the men’s hospital because of SEX. We asked her if many of the nurses married patients and she said that many of them did.

When you have tuberculosis, you have broken lungs with sores on them and the less you use them the quicker they will heal. How can you rest your lungs? By breathing less often and less deeply. A person resting quietly in bed, breathes two times less each minute than a person sitting up and of course much less than a person walking. Deep breathing, hurried breathing and excitement, cause both lungs and heart to work faster and to wash out more poisons from the tuberculous sore. This is what gives you that tired feeling, rapid pulse, fever, etc. Rest is the answer. Rest, rest and more rest.

The only way we could tell whether we were getting well or dying was by the privileges we were granted. If we were progressing satisfactorily at the end of one month, we were given the bathroom privilege and 15 minutes a day reading-and-writing time. At the end of two months, if we continued to progress our reading-and-writing time was increased to half an hour, we were allowed to read books and were given ten minutes a day occupational therapy time. At the end of three months we were given a chest examination, along with the other tests, and if all was still well we were given three hours’ time up, one hour occupational therapy time and could go to the movies (if chosen by the Charge Nurse).

The most common surgical methods:

• Artificial Pneumothorax—compression of the affected lung by the introduction of gas or filtered air into the pleural cavity (between the chest wall and the lung).
• Intrapleural Pneumolysis—cauterizing of adhesions between the chest wall and the lung.
• Thoracoplasty—removal of the ribs on one side of the thorax to accomplish a permanent collapse of the affected (diseased) part of that lung.
• Several more

A successful collapse of the lung, whether it was accomplished by pneumothorax, thoracoplasty, phrenicectomy or stripping, favored rest for the infected part of the lung and facilitated healing of the disease.

The treatment room had windows to the ceiling, pure white walls and strong overhead lights and I sat in my wheelchair, absolutely quiet but blinking and squinting in the strong light and feeling like a mole that had suddenly burrowed out into the sunshine.

I grew fascinated with the blonde’s tatting shuttle. It darted in and out of the shrimp pink like a dragonfly in a hollyhock. The pink thing was square and lacy and seemed to be some kind of a yoke. I had seen many such yokes displayed at county fairs and could easily picture it completed, its virulent color clutching the top of a too-short white cotton petticoat, cut on the bias and sucked in at the knees.

I felt the prick of the hypodermic needle, just under my left breast, then an odd sensation as though he were trying to push me off the table, then a crunchy feeling and a stab of pain of what looked like a steel knitting needle to a small rubber hose connected to two gallon fruit jars partially filled with a clear amber fluid.  By suppertime I had sharp knifelike pains in my chest and had spit up a little blood.

She explained calmly that the pains were adhesions tearing loose, the blood was probably from my nose, that I was most fortunate to be able to take pneumothorax.  it was difficult for me to see eye to eye with the Charge Nurse, especially as I had felt perfectly well without a single pain of any kind before I got so terribly lucky and was given pneumothorax.  For three days and nights, each time I moved I had severe tearing pains in my left lung.

It all happened so quickly I didn’t even have a chance to say good-bye to Kimi. I opened my eyes after rest hours and the next I knew I was in a cubicle by myself at the opposite end of the building. A few minutes later Kimi was wheeled past my door and a pathetic note from her that night informed me that she had been put in a room with the Japanese girl with no character.

“Why did the Charge Nurse separate us? How could she perform such an act of cruelty?” That’s what I wanted to know so I asked her. She said, “It is better for the patients to move every so often. To adjust to different personalities. It is better for you to be by yourself.” I loathed being by myself. It was dull and depressing and I found it impossible to adjust to my own personality.

Before coming to The Pines, death, if I thought of it at all, which was seldom, was something swift, awe inspiring, cataclysmic, dramatic and grand. Death was a lightning bolt, a flood, a fire, a hurricane, a train wreck, an airplane crash, a pistol shot, a leap from a high bridge. When I had told this to Kimi one evening, she had said, “Oh, that is not at all my idea of Death. To me Death is a lecherous, sly, deranged old man. His beard is sparse and stained. His eyes are coarse lidded, red rimmed, furtive and evil. His loose red lips are slimy and drooling. He pants with anticipation. His partially opened mouth shows brown shaggy thread of tooth. He shuffles up and down the corridor at night, his malodorous, black robe dragging behind him.

I was horrified and told Kimi that she was morbid. She had said, “I cannot help it. Each time Margaretta or any other very sick patient passes our door I fancy I see Death’s evil face peering around the corner. I think I see his black robe swirl through the doorway ahead of the wheelchair. I can see him hovering like a great bat over the emergency ward, the light room, the private room. I can hear him shuffling up and down the corridor at night.

From far down the hall a cough—dry and rattling like seed pods in the wind. Then another nearer—gurgling and strangling and leaving the cougher gasping for breath. Then from across the hall a harsh deep cough with a strange metallic ring. Then the girl in the private room, the girl with skin the color of old snow, the girl with arms and legs like knobby sticks, whose voice was gone, would begin to gasp dreadfully.

Because over it all I could hear the slow, sure shuffle of Death. Up and down the halls he went, never hurrying, knowing that we’d wait for him.

The days were all so exactly alike and followed each other with such monotonous regularity that I lost all interest in holidays as such. I knew them only as “gas” day, bath day, fluoroscope day, visiting day, supply day or store day. It was in part infiltration into sanatorium life, divorce from normal living. It was also in part the childish self-centered attitude of an invalid. What I was doing, how I felt, what was to happen to me became more and more important to me as time went on.

At first when my visitors told me of happenings in the outside world I was vitally interested and relived each incident vividly with the telling. Then gradually, insidiously, like night mist rising from the swamps, my invalidism obscured the real world from me and when the family told me tales of happenings at home, I found them interesting but without strength, like talk about people long dead. The only real things were connected with the sanatorium. The only real people, the other patients, the doctors, the nurses.

Three months was the gestation period at The Pines. We were conceived at the Administration Building, confirmed by a staff doctor, approved by a Charge Nurse and for the next three months existed as embryos carefully fed and cared for by the Mother Hospital, alive but not living. At the end of three months we emerged and were individuals to engage in occupational therapy, attend the movies, read books and, if strong enough, have time up.

“The way I understand it, pulmonary tuberculosis is caused by tubercle bacilli in the lungs and to date the only way found to render these tubercle bacilli inactive is to wall them off in the lungs with fibrosis. The fibrosis forms quickest when the lung is at rest. If your lung was put at rest with pneumothorax or other surgery I shouldn’t think it would matter whether you were in Alaska or South America, but if you had to depend on bedrest to build your fibrosis then I should think that a year-round cool climate at sea level would be the most pleasant.

As in the Bedrest Hospital, all the windows were open at all times.

Most wonderful of all was the freedom. No nurses patrolled the promenade, occasional voices or moderate little trills of laughter could be heard on either side of us, eight-hour patients walking past the door, arm in arm, stopped to smile and talk to us, and Sigrid and I exchanged pleasantries without first listening carefully for the soft rubber-soled steps of a nurse. I filled my hot-water bottle with fresh hot water about ten times during the next hour and each time my skin prickled with the delight in this small free act of comfort. In spite of the Charge Nurse’s hateful reception, I thought her Ambulant Hospital was pure heaven.

At 4:15 Sigrid told me to get up and get ready for supper. She said that I could wash my face and put on makeup; that I would be taken to the dining room in a wheelchair for the first week, then I could walk one way one day, two ways the next day and so on. In two weeks, I could walk back and forth to all meals.

The tables for the men were on one side, for the women on the other, a no man’s land in between. The men and women were not allowed to speak to each other in the dining room; in fact no communication of any kind, including winking, waving, smiling or note writing, was allowed between male and female patients,

The Charge Nurse said, “We do not encourage any friendships between the men and the women, Mrs. Bard. In tuberculosis, sex is the worst complication, Mrs. Bard. Infractions of the rules are punished by taking away visiting or show privileges, not granting requests for town leaves or sending you home,

Mother brought me a dozen cans of fruit juice and a large box of cookies, all of which Sigrid stuffed in my old stand bag and hung under the robes and sweaters in my locker. We were all starving all the time but were not allowed to keep any food in our rooms, which were searched regularly.

Reading of Katherine Mansfield’s tragic and lonely struggle against tuberculosis made me see The Pines as such a paradise that I could even place a small golden halo around the head of the Charge Nurse as she sidled in our door like a giant hermit crab to warn me that from that moment on anything I did, including breathing, would be cause for removing my town leave.

On the following Monday, at ten-thirty, Sigrid left for home. The moment she had gone a corps of nurses came in with scrub brushes and buckets of disinfectant to remove all trace of her. Her bedding and all her things were dumped into large cardboard cartons marked fumigation, and wheeled away. Everything she had touched or used was scrubbed.

Eileen’s roommate, Delores the nightclub singer, arrived at the Ambulant Hospital and I felt reasonably sure that the Charge Nurse would be too busy to bother with me anymore.

Delores had a large mouth, perfect, flashing white teeth and bold blue eyes. Her every movement had a purpose and increased weight had given her very delectable curves which she showed to advantage by pulling her flimsy purple kimono tightly around her. Her first entrance to the dining room was late and dramatic. Arranging herself in the doorway, slightly sideways so that what lay beneath the tightly pulled kimono was prominently displayed, Delores looked the dining room and the diners over slowly and carefully. Then, when it was pretty well established that every single eye in the room was riveted on her, she put everything she had into a great big dazzling smile and slowly undulated to a seat at the front table. One of the men was so carried away by the performance that he began to clap

flagging down every doctor who went by and saying in her husky, penetrating voice, “I have a little pain right here, Doctah. No, a little lower down, if you don’t mind, Doctah. No, a little lower down, Doctah! No, it doesn’t hurt very much, Doctah, but if I thought it would make you come to see me oftener I could make it hurt moah.” Pixie said that the doctors quite evidently enjoyed

she brought out a new rule. After I had been in the shop for about an hour I started to leave to go upstairs to the bathroom. Miss Gillespie came panting after me. “Where are you going?” she demanded. “To the bathroom,” I said. She said, “Now, Mrs. Bard, going to the toilet is merely a habit. Habits can be broken. Not necessary. Break it. Bad habit. Control the functions of the body. Everything can be controlled. Why there are days and days when I don’t go to the toilet from dawn till dark.” I continued up the ramp with Miss Gillespie clutching my arm and trying to dissuade me. She never forgave me.

It took me the whole summer to learn that you do not dispose of eight and a half months in a sanatorium just by leaving the grounds. I had had to struggle and bleed to adjust to sanatorium routine and I had to struggle and bleed to adjust back again to normal living.

Kimi and I clung together. She came to the house frequently and we walked in the park and talked about The Pines, Miss Toecover and the patients. Kimi said that she was very lonely and unhappy, that her former friends treated her as though she were violently contagious, and boys, who before had been merely too short for her, were now like “mites” in comparison.

I asked Kimi if she had had any such unpleasant experiences. She said, “Oh my, yes. Sometimes they do not wait until I am out of the house before producing the Flit Gun and vigorously spraying everything I have touched.