The Plague and I

photo (1)When I read a book, I am an underliner.  When I am finished, I will go back and copy down the things that I need to follow-up on or that I really want to remember. A few weeks ago, I finished a book on the history of tuberculosis. One of that book’s notes: “get Betty MacDonald’s The Plague and I.” Unfortunately for the world, The Plague and I has been out of print since 2000. However, with the awesome online opportunities that we are now afforded, I found a 1948 hardback copy on ebay for a reasonable $7.99. Got it. Read it. So delightful!

Let’s start with the author. I knew of Betty MacDonald mostly from her Mrs. Piggle Wiggle series of books. Ali was a big fan of Mrs. Piggle Wiggle, a sweet old lady who lived in an upside down house in a neighborhood crowded with children. Mrs. Piggle Wiggle possessed a dresser that was full of cures for misbehaving children. The dearly departed Mr. Piggle Wiggle (who was a pirate!) bequeathed these cures to his widow. Among them were The Selfishness Cure, The Tattletale Cure, The Crybaby Cure… These stories were the bedtime tales that Betty entertained her children and other relatives with. Lucky them.

For adults, besides The Plague and I, Betty MacDonald also wrote three other autobiographical books: The Egg and I, Onions in the Stew, and Anybody Can Do Anything. All of her books were published between 1945 and 1957 as, sadly, in 1958 at the age of 49, she died of uterine cancer. betty macdonald collage

Back to The Plague and I. I didn’t know what to expect. I knew this was a first person account of being in a tuberculosis sanatorium in the 1940s. That was enough for me! From the start, however, the reader is clued in that there could be some humor here. In the book’s dedication, she thanks her doctors who “without whose generous hearts and helping hands, I would probably be just another name on a tombstone.”

The sanatorium cure was quite something. Patients first were placed in rooms where they laid flat for weeks. They could not speak, could not get out of bed, could not read. The cure theory was lung rest, and anything besides perfect stillness would tax the lung and delay the healing. It seemed quite awful, but Betty pushes that aside by showing how one can cope in such a situation. Her way involved covertly chatting with her roommates, breaking rules, and ascribing hilarious names and back stories to the staff.

The connections that she develops while in the sanatorium are strong. Her first roommate, Kimi, is a tall, intelligent, Japanese-American girl. Before tuberculosis made her an outcast, Kimi felt ostracized by her community because of her height. Kimi handles her situation with unnatural calm. This intrigues Betty. When Betty cannot believe how peacefully Kimi can conform to the bedrest, Kimi explains that she uses the time to visualize how she will torture the nurses. That is the start of a great friendship. Later in the book, after the reader is introduced to a series of wittily drawn characters, Betty reflects that after her stay was over, her litmus test for new acquaintances was “Would she be pleasant to have t.b.with?”

The book blends this humor with, what I think is, an accurate portrayal of what such a life experience would have been like. Eerily, at this sanitarium, there was a separate home for the children of some of the patients. In many case, two parents would be infected and there would be no place for the children to go. Sometimes, however, neither parent made it out.

She describes the noises of the staff and patients. She recounts the procedures that would be conducted to work the cure. This was a time before antibiotics, so healing meant fresh air, lots of food, and invasive procedures like pneumothorax. The pneumothorax involved air being forced into the chest in order to collapse the lung and allow it to rest and heal. This would have to be repeated regularly. Healing was monitored with regular chest x-rays.022_pneumothorax

Photo from: http://www.lung.ca/tb/images/

As progress was made, the patient had more freedoms. Each phase of Betty’s stay is riddled with ridiculous rules and people. The section of the book detailing occupational therapy – where patients receive instruction on how to make kitschy crafts that may be their source of income in the future – is hysterical. Betty ascribes the family name for these crafty items – “toecovers”: defined as a useless gift.

Betty was lucky as her time in the sanatorium lasted only nine months. She writes of her release, and the months spent trying to regain normalcy. It was not easy or completely possible. The new her was labeled with her disease and the prejudice that came with that.

But what saw her through was this:

“In addition to good health, my family possessed a great capacity for happiness. We managed to be happy eating Grammy’s dreadful food or Mother’s delicious cooking; in spite of cold baths and health programs; with Grammy’s awful forebodings about the future hanging over our heads; in private school or public; in very large or medium-sized houses; with dull bores or bright friends; with or without money; keeping warm by burning books (chiefly large thick collections of sermons, left us by  some of the many defunct religious members of the family) or anthracite coal in the furnace; in love or just thrown over; in or out of employment; being good sports or cheats; fat or thin; young or old; in the city or in the country; with our without lights; with or without husbands.”

Betty had the capacity for happiness even when the family’s gift of good health failed her.

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Emily Morgan and the Serum Run of 1925

emily

Just this year, Alaskans inducted Emily Morgan into their Women’s Hall of Fame for her achievement in the area of health and community service. This morning, I wanted to write a blog post about the Iditarod and the Serum Run of 1925. When I began, I did not know anything about Emily Morgan. A few hours later, I feel like I know enough about this woman share her story as my way to write about the Serum Run.

I built Emily’s backstory via Wikipedia, the Iditarod website, information that has been compiled by a major Emily fan, and Ancestry.com. Born in 1878 in what is now Leon, Kansas, Emily was second oldest of nine Morgan children. Her desire to be a nurse had to wait until she could earn the money to pay her own way to nursing school. She kept at it, and in 1905, twenty-seven year old Emily travelled to St. Joseph, Missouri and started to learn how to be a nurse. Three years later she began her nursing career in St. Joseph, but eventually went back to Kansas to be Wichita’s first public health nurse.

When World War I broke out, Emily was sent to care for soldiers in France. Emily loved traveling and learning about new places and when the war was over, she wanted to do missionary work. She could not, however, leave her widowed father. At his death in 1923, Emily took an offer to travel to Alaska.

Emily’s Alaskan assignment took her to Nome, a city about as north as you can go without being in the Arctic circle. Her patients were the 10,000 settlers and native Alaskans spread throughout the vastness. When she wasn’t working at the small community hospital in Nome, she travelled throughout the region to care for those who needed her.

Emily and four other public health nurses supported the one physician in the territory. In 1924, that physician ordered diphtheria antitoxin because his supply had expired. Unfortunately, before the supply could get there, the port froze.

When the first child got sick and died at the end of 1924, Dr. Welch thought it was due to tonsillitis. As more children got sick and died, it became clear that it was not tonsillitis, but the deadly diphtheria virus that was killing. Emily Morgan understood the disease well as she had had the disease herself years before. Because of her history, she was chosen to be the nurse to administer to the sick.

The story of the Serum Run is that Dr. Welch put in a desperate call for antitoxin. The only way to get it to Nome, though, was via a train to the furthest possible point and then dogsled. The other option was to  fly the antitoxin, but that choice was scrapped when all attempts to put something up in the brutal cold, failed.

Alaska’s governor ordered a dog relay set up that would include the best mushers of the postal service. They would travel day and night in the brutal cold to deliver the serum to Nome, 674 miles away. In blizzard conditions, hurricane strength winds, and little or no visible trail, they made the trip in an incredible 127 hours. Gunnar Kaasen and his lead dog, Balto pushed through the final leg. When the serum was handed off to Dr. Welch, Emily Morgan got to work traveling to administer the anti-toxin to the quarantined. Because of the work to get anti-toxin to the community, an epidemic that had the potential to kill up to 10,000 only was fatal to about 100.

Emily Morgan stayed in Nome for another thirteen years. Seventy-eight years after she helped to save the people of Nome, she was inducted into the state’s Hall of Fame.

 

Those Rotarians are Good and Fun Folk

I am not a member of Rotary, but I have occasion to be among Rotarians. Last night was such a night.

Until Dan joined Rotary several years ago, my impression of Rotary resided in the same place in my brain that housed memories of going to Kiwanis club meetings with my Grandpa. That meant heading to a stately hotel banquet room at noon, sitting over lunch for a couple hours with a lot of other grandpas, kicking back a few martinis (Shirley Temples for me), and going home. I am guessing that that is not a proper view of Kiwanis today, but it certainly has nothing to do with Rotary.

I don’t want to go into a big history lesson, but Rotary has been in existence for more than 100 years, has clubs in each continent, and does good everywhere. Rotarians are men and women, young and old, prosperous and not. The tie that binds every Rotarian is the desire to make the world a better place. They do that through projects and through travel. A Rotarian can go anywhere in the world, find a Rotary meeting, and know that they will have a place of welcome. Club meeting usually involve some kind of knowledge booster, whether it is a speaker or some other kind of demonstration. Some of the money clubs raise, sends non-Rotarians on international travels to help them understand the world and Rotary better. We have hosted visitors from India, Brazil and South Africa in our house – each chosen by their local Rotary club to come to the Midwest of the United States to learn about what life is like here and teach us what their life is like. We also feel that we had a part in getting our own Ancillary Adams being chosen to travel to South Africa to learn and teach.

The foci of Rotary’s services are many, but there are some touchstones that carry throughout the world. One of those is the eradication of polio. In 1985 Rotary decided that it would be the engine that could run down and eliminate the last case of polio. Millions of dollars have been spent to produce vaccine, educate populations, and vaccinate the unvaccinated. The Bill and Melinda Gates foundation joined Rotary in their cause, recognizing that the Rotary effort was working and nothing that they could do would improve upon the Rotary plan. Just recently, India was removed from the list of  four countries that continue to have endemic polio. Only three more. Think about that.

Yesterday, Dan picked me up from work and we headed over to the home of one of his Rotary club mates. We walked in the door and were greeted with offers of Mardi Gras beads – for a small donation and a chance to win a prize. (They rarely miss a chance to raise a few more dollars). There was wine, beer and some delicious food. Some items auctioned off – all donated by members. I did not win the mardi gras bead contest, nor any auction. Sister Linda from Cristo Rey High School explained and showed us how the money that was brought in that night would buy dorm room and college supplies for the seventy-five new graduates from the school. She also thanked the many members who spend time at the school mentoring the kids as they prepare to make college choices. Once again, it was clear that the support of Rotary is not just the dollars raised. Almost always, dollars come along with volunteer hours and real commitment.

With all of that to make you feel good about the night, you get the bonus that this is a fun group of people! No one there does not want to be there. No one there is not interested in what you may have to say. There is joking and laughter. It is what gathering for a common purpose should be. It was a wonderful way to end my work week.

Happy is Healthy

For something different, I created a Spotify playlist to go along with today’s post. The thing that these songs have in common, is that everytime that I hear them, I think, “man, that song makes me happy.” They are not necessarily the happiest songs that I like, but that isn’t the point. 

If you use Spotify, you can listen to it here.

Happy is Healthy

I saw an article this week reporting on a recent review of scientific literature that suggests that positive attitudes may be associated with better cardio-vascular health. Reading further, the researchers acknowledge the limitations of their paper, but they point out that this is a step. Future prospective research may be able to study this link and prove what I think we already know. Being happy is healthy.

It isn’t always easy to be happy. I am one of the lucky ones born in an affluent country, to parents who loved me. I am given all sorts of opportunities. Even with that, I have gone through my own periods when I wouldn’t have characterized myself as happy and positive. I know people who have had similar opportunities, who appear to have a hard time ever seeing the positive or being happy. I know people who, by all logic, have reason to be miserable, but who seem to find good and joy almost always.

That is the big picture, but I want to write from the smaller view. How about a day? We wake up and there is a destiny before us. Eighteen or so hours ahead of us to do with what we have to do and what we want to do. How is it approached?

For me, it can vary. I can wake up already dreading something happening that day. Dreams may disquiet my psyche into the day. A perfectly sweet day can turn around and be anything but. Whether it is me going into the day already with negative energy or developing it as the day goes on, I have realized something. There is a power that I have – and I do consider it a power – to reverse it.

It happens without me noticing it. Yesterday, I stayed at work too long. I left my weekly to-do list with many things not accomplished. I already had my mind on some things that I really had to do that I did not want to. I made up my mind that the trip I was going to make to the gym on the way home wasn’t going to be happening.

When I drove into my driveway, the sight of my house was so sweet. There was a package on the doorstep that I knew contained something for Dan’s birthday that I hope he will like. The sky looked like it was going to rain, but it had a bright darkness that made everything that is already so green, looked even more intense. Getting out of the car, I saw that more of the peonies along the back of the house had bloomed and I caught a whiff of their fragrance.

I went into the house and decided that I was going to risk the rain and go for a walk. I changed clothes, put my awesome new Templeton Rye hat on, got my Ipod and stepped out. Immediately, my neighbor called out a friendly “hi” to me.

Along my familiar route I saw:

    • the man with the dalmatian who always seems to be outside and who almost always sees me when I pass and gives me a big friendly wave
    • a couple pushing a baby stroller, chatting and smiling
    • a young woman carrying a bag that looked like she had taken a walk to the grocery story to pick up dinner
    • an old man standing patiently while his old dog took his time finding the exact right spot
    • two young boys standing in a front yard, holding their bikes and talking
    • a man getting off of the bus, in a suit, with his backpack, and heading home
    • a dad, out of his car, getting his recycling bin off of the curb, and walking toward a little girl waiting for him on the step

By the time I rounded my final corner and came upon another neighbor out to walk his dog, the transformation was complete. Maybe it was the walk and the endorphins and whatnot. I think that it was part of it. But I also think it was my brain capturing images of beauty and comfort. It was my nose bringing smells of spring. It was my ears that were listening to some great music.

I am happy that I have been lucky in life. I am lucky that I can find happiness even when I try to ignore it.

Lillian Wald is My Women’s History Month Go To

“That’s what I want to do!  Not just tinker at a lot of worn-out bodies but make a new world! … I’m going to get a real job – public health.”

Sinclair Lewis, Arrowsmith, 1924

In honor of Women’s History Month, I am going to tell you about a woman I got to know very well as I completed my Masters’ program. Towards the end of my program, I signed up for an independent course on public health history. I can’t remember why, but I decided to study and write about the formation of settlement houses in New York City. I particularly focused on a woman named Lillian Wald. Lillian was the mover and shaker of the movement, and I adored her! When it came time for me to pick my thesis topic, I used Lillian and her story as a springboard for my analysis of the public health nurse trajectory over time.

What is fascinating about people like Lillian Wald, is that it would have been so much easier for her to not do what she ended up doing. I think of the things I struggle with today to get what I want. For the most part, they really are pretty trivial. Who knows what I would or would not have committed to if things were really challenging, or if there wasn’t some prototype to follow?

For Lillian, there was little to guide her or pull her along. She was born a girl in 1867. That says something right there. Opportunities for her were limited from the get go. She did have the benefit of being born into an upper middle class family that was somewhat progressive. Other than that, her opportunities were few.

After being rejected at colleges when she was 16 because she was too young, Lillian traveled before enrolling in the New York Hospital’s School of Nursing. She loved medicine, and after she graduated, she decided to go to medical school. But, then she began to work in the city orphanages. She began to see the lives of the children and families around her. The experience moved her to do more than briefly touch the clients that she served. She dropped her plans to be a doctor. She moved to the Lower East Side of New York City. There, she was a part of the community that she knew needed care and was not getting it. She became what she called a Public Health Nurse.

By the time she was 27 years old, Lillian Wald opened the Henry Street Settlement. At the house, Lillian and her partner, Mary Brewster, organized a growing team of nurses that went to the surrounding tenements to teach and care for the residents. Wald’s philosophy was embedded in the power of preventative care. Providentially, she was also a genius at fund-raising. Soon after its founding, her mission began to be supported by large and small contributors across the country.

When Lillian died in 1940 at the age of 73, her list of achievements was stunning. She had initiated the school nurse program in New York City Schools. She was instrumental in the women’s suffrage movement, the action plan during the influenza epidemic, securing women’s financial benefits after divorce, birth control freedom, workplace safety, women and children’s labor laws, and the peace movement. Most all of what she did formed what would become an integral part of our current healthcare system – community healthcare.

When we celebrate women during March, I now start with this true hero. The books that Lillian wrote to tell her own story are still available. If you want to know more, I would highly recommend picking one up.

Morbidity and Mortality Weekly

A few years ago I got my Masters degree in Public Health. When I started my higher education many years prior, public health had not entered my mind. From my days of doctor’s kits with plastic stethoscopes and candy pills, I was focused on spending my career taking care of people and making them better. I was going to be a doctor. Even before I started to apply for college, I was reading books on how to get myself into medical school. I did not doubt my dream at all.

But somewhere in the middle of my freshman year of college, that plan dissolved. Being away from home and experiencing a whole new kind of life, changed many things. My priorities got shifted. My interests expanded. One day, I made a call to my parents and told them that I was switching from my pre-med major to something called Environmental Studies. It was a good day.

And then, almost twenty-five years later, I was sitting in a classroom learning about public health. That was a good day too.

For those of you not too familiar with public health, it is all about the big picture. People in public health work in all different kinds of areas – medicine, government, journalism, academia, ethics. They are the people who inspect restaurants and the responders to flu outbreaks. It is multi-faceted and ever interesting!

On my first day of my first class of my masters program, my professor instructed us that our first assignment was to go home and subscribe to something called the Morbidity and Mortality Weekly. He explained that this was a weekly report from the Centers for Disease Control in Atlanta. Its content; a summary of goings on in the public health arena. Good student that I am, I subscribed immediately. Oh man! What a treat my MMWR continues to be.

Each Thursday morning, an email pops into my inbox. Many weeks, the content is pretty basic stuff: number of smokers, a group of passengers who got sick on a cruise boat, celebration of Safe Drinking Week. But then, there are weeks when I will open the email and something will catch my eye. Sometimes, I will learn about a disease that I have never heard of before. This week, I learned about Nodding Disease – a cute name for a serious issue for some children in Africa. No one knows what causes this disease that shows up in previously healthy children. The symptoms start out as involuntary head nodding and moves into very serious neurological problems. Public health workers from the United States and all over the world are working to figure it out.

 

It was in the MMWR that the first cases of a strange immune system disease among gay men in Los Angeles first was published.

Content oftentimes reads as a detective story. A problem was reported and public health investigators went out to figure out what was going on. How cool is that?