The Art of Breathing

by Janie DeVos

  “Maybe.” He was thinking all of this through. “Daddy’ll come here to see me?”

  “Of course he will! He’s gonna miss you a lot! And in the fall, you’ll go home again and start school. Gee, you’re getting to be such a big boy and much too fast for my liking!” I tried to shift the conversation away from my illness and all of the changes that it was causing in his little life. “Aren’t you excited about starting first grade?” I knew that he was.

  “Uh-huh.” His answer was soft and distracted. He was confused and frightened, and I needed to acknowledge it.

  “Donnie, I know my going away is real scary and sad for you. It is for Daddy and me, too. But I’m going to tell those doctors that they have to fix me up real good so that I can walk you to your class on the first day of school. I bet they have little boys and girls themselves, and will understand how important that is to you and me. And I know they’ll do everything they can to make sure I’m as good as new so I can take you to school, just like we planned. In the meantime, though, is it all right with you to stay here for the summer?”

  “Yeah, I guess,” he said.

  “Okay. Good. You’re a good boy.” I hugged him hard. I didn’t want to let him go, ever. Not wanting him to see the tears in my eyes, I turned away from him and started putting away our snacks. “Here, you want another cracker before I put them away?”

  “Naw.” He shook his head. “Can we go? I’m kinda cold.”

  “Sure,” I said. I could see he was trying his hardest not to cry. Though I knew he didn’t understand the magnitude of what was happening, and that he had no real concept of time at his age, he knew I was going away, and he understood enough to make him cry. As he turned to walk away, I caught him by the arm and knelt down in front of him. Not worrying whether he saw the emotion on my own face, I looked directly into his. “I promise you, son, I’m going to be all right. Do you understand?” He nodded his head but his lips were trembling as he fought to be brave. “I’m going to be fine. I promise you! I’ve never made a promise to you that I haven’t kept, right? And I’m not going to start now.” But I knew I just had, for there was no way of knowing what the future would hold. I knew I had no business making that promise to him, but he needed hope. We all needed hope. All of a sudden, I was kinda cold, too.

  CHAPTER 10

  The Threshold

  “You ready?” My aunt looked from the window to me as the train came to a stop at the East Asheville station.

  “As I’ll ever be,” I said, forcing a smile as I stood up and ran my hands down the front of my navy suit in an effort to smooth out some of the wrinkles, as well as to wipe some of the moisture off my clammy hands. I was exhausted, petrified, and heartsick, and those emotions had escalated to the point of making me numb.

  My aunt took one of my hands firmly in hers. “It’s going to be okay, Kate. You’ll get the help you need. You’ll be in very good hands.” She emphasized her statement by squeezing my hand tightly.

  “I know I will be, Aunt Harriet. Thanks. Okay,” I said, taking a deep breath as I started down the train aisle. The deep inhalation started my coughing again. I sidestepped into an empty row of seats to let other passengers by. Aunt Harriet stepped aside to wait for me, and once the coughing passed, I nodded my head, indicating that we could go.

  When we exited the train, my aunt’s head swiveled around, looking for the car from Pelham. Any newly arriving patients were picked up at the train station or airport by a car from the hospital. It was just a courtesy that was offered, but the thought crossed my mind that it might also be a way of keeping any would-be patients from deciding at the last minute that they would not be patients, and buying a return ticket instead.

  “There he is!” Aunt Harriet was waving to a man in a black sedan that was just pulling up to the depot. The man drove over to us and immediately jumped out.

  “Nurse Pierce! I didn’t realize I was picking you up today, too. I was told your niece was arriving but had no idea that you’d be accompanying her.” Turning to me, he bowed slightly. “Good afternoon, Mrs. Cavanaugh. I trust your trip was uneventful.”

  “It was fine, thank you.” He spoke as if he were taking me to meet the lord of the manor.

  “Harold, don’t they ever let you have a day off?” My aunt smiled. “We appreciate your coming to get us. We have luggage, of course. Kate, let’s get you in the car. It’s starting to drizzle. We’ll get the bags.” Harold opened the back door for me, and once I was inside, the two of them walked over to where the porter was unloading the luggage. I laid my head back, closing my eyes. The car smelled of disinfectant. They must sanitize this car after picking up new arrivals who might be contagious, I thought. I pitied the next passenger after me. Undoubtedly, his or her nose would be assaulted. I felt the luggage being stowed in the trunk as the car gave a small bounce under the weight of the heavy suitcases. Then the trunk was slammed shut and Aunt Harriet joined me on the backseat.

  “You holding up okay?” My aunt looked concerned and I wondered if she was more worried about me physically, or mentally. In truth, I was beginning to wonder if the fact that I was going to a state hospital, where a good percentage of those being treated were psychiatric patients, was most appropriate after all. There were small moments when I wondered if I was going to crack under the pressure. Dying didn’t frighten me as much as losing the life I’d planned with those I loved so dearly, and missing so many precious moments—like watching Donnie grow up, or seeing Geoffrey reach his lofty goals, and watching my parents’ orchard grow, watching them grow old gracefully with it. I wanted to be witness to it all. I wanted to be with them all.

  “Aunt Harriet, is there a phone in my room?” I asked. It would make things so much easier if I could communicate with my family and friends whenever I needed to.

  “You’ll be in the TB ward, honey. There’s no phone in there, but there’s one in the hallway in front of the nurses’ station, which is just outside your ward. They want the patients to stay as quiet as possible, especially those who are extremely ill. The staff tries to keep the noise level down and by having fewer phones, there’s less noise. So, to answer your question, there’s just the one phone for the two wards to share.

  “Who is housed in each of the wards?”

  “The tubercular patients are on the second floor, but they’re separated by gender; women on one side and men on the other. The first floor houses a few of the administration offices. The third floor of the building you’ll be in, which is building three, by the way, is restricted to psychiatric TB patients. But you’re rarely around each other, with the exception of the outdoor areas, and then there are always staff members in attendance. It goes without saying, our psychiatric patients are kept under lock and key most of the time. Everyone else has the freedom to move around, with the doctors’ approval, of course. Tubercular patients, however, are required to remain separate from non-tubercular patients inside the buildings, but they’re free to be in the company of each other outdoors, as long as they remain a safe distance apart to prevent spreading the disease. I know all of this probably makes you feel you’ll be treated like some common criminal for having tuberculosis, but it’s really not like that. You’ll learn the rules in no time and understand the reasons for them. I promise you, Kate, it’ll be okay. It isn’t a dreadful place.” But I knew she was looking at it through the eyes of someone who could come and go as she pleased, and I wondered if she’d feel the same way if she saw the place through the eyes of a patient.

  “I’m sure it’ll be fine, Aunt Harriet,” I said, laying my head back against the seat again and closing my eyes to shut out the world. I was beginning to understand what lepers had been dealing with for centuries. The isolation and the stigma were shared by those suffering from tuberculosis. Quickly brushing a tear away with my beige-gloved hand before my aunt could see, I turned to look out the window and saw the raindrops leaving trails as they slid down the frosted glass, as if mocking me.

  “About tw
enty minutes to go,” she said. “It’s quite a ways out of town. The hospital sits in the middle of sixty-two acres. There are wonderful open spaces, flower and vegetable gardens, even a greenhouse. Patients are encouraged to spend time outdoors. It’s believed to be a curative thing, especially for TB patients. Fresh air, especially cold fresh air, is good for tubercular lungs. The doctors say it inhibits the progress of more cavities and lesions from forming, and it helps to heal the ones that are there.”

  “It’d be nice to work in the gardens and greenhouse. Do y’all grow the food you’re eating?”

  “Most all of it. Let’s get you halfway back on your feet, then see if we can’t get you out growing vegetables, all right?”

  “Yes, that’d be good.” It was one of the only things that had sounded good in the last few days.

  “I’m sure your activity will be restricted for a time,” she continued, “but before too long, I bet you’ll be out digging in the dirt.”

  “How ‘restricted’?” The word struck a chord deep within me; I had grown up freely roaming the mountains.

  “Kate, you’ve got to understand that you’re dealing with a progressive, deadly disease. If you don’t get plenty of bed rest and confine your daily activities for a while, you’ll never get better. You’re going to be told over and over again to be patient with your recovery. But, honey, Pelham is a good place with excellent doctors. They’re not there to make your life miserable. They’re there to save it. Let’s just wait and see what they prescribe for you, okay? Just rest a little bit now. It won’t be much longer till we’re there.” She patted my hand as a sign of support and comfort, but I was beginning to feel like a child about the same age as my son.

  I realized that for the first time since I’d become a woman, doing exactly what I wanted to do, in a life of my own choosing, I was faced with the unpleasant fact that many choices would be made for me by others, others who didn’t know a thing about me. They wouldn’t know my likes and dislikes, my fears, passions, or the many things that brought me joy or sadness. To them, I would just be another patient with an ID number, and yet, they’d be orchestrating all of my days and nights—my life—at least for a time. And because I wanted to get well and pick up the pieces of my life again, I knew I would go along with those choices, like them or not.

  Suddenly, we turned off the highway onto a private drive. Leaning forward in my seat so that I could see exactly where we were going, I realized we’d arrived at Pelham. The entrance was fronted by two large brick pillars that were connected by an iron arch with the words “Pelham State Hospital” welded in place across the archway. The entire complex was fenced, though just the main entryway had the dramatic brick and iron façade. Though the high brick wall continued off to the right and left for a short distance, beyond that, a simple wire fence enclosed the entire property. Topping the wire fencing was barbed wire which would deter even the most ambitious would-be escapees from attempting to climb it.

  Just before the gated entrance was a small brick guard house with windows on all sides of it. As we pulled up, a man in a security uniform stepped out. “Back already?” he asked Harold, then turning to look at the passengers in the back and recognizing my aunt, he continued, “Oh, hey, Nurse Pierce! I didn’t know you’d be back today. How was your trip?”

  “Real good, Leo, thanks. Leo, this is my niece, Kathryn Cavanaugh.” Then, “Kathryn, this is Leo Sacks. He keeps a good eye on this place.”

  “Good to meet you, Miz Cavanaugh,” he said, tipping his police of-ficer–style cap. “Welcome to Pelham.” Then, reaching inside the gatehouse, he maneuvered something that caused the massive right half of the gate to swing open, allowing us through.

  The driveway was long and curved in places, and evenly lined with tall white pines. In the distance, I could make out a large, imposing brick building that was gothic in style and several stories high, with wings that jutted off to each side of it. Behind the building was some kind of giant tower. My aunt told me that it was the complex’s power house and laundry building. The facility generated its own electricity, so even in the event that the rest of the world was plunged into total darkness, Pelham State Hospital would remain up and running, with staff and patients alike going about their business in clean clothing, all while lights burned brightly and machinery continued its mechanical humming.

  As we pulled into the circular driveway in front of the main building, Harold put the car in park and his chauffeur’s cap back on. “Here we are, ladies,” he announced, opening my door and holding an umbrella over me as I got out. Aunt Harriet scooted out the opposite door and hurried up the steps to the deep covered porch. The drizzle hadn’t let up since we’d left the train station. If anything, it was coming down a bit harder. Making small talk about the weather not being very cooperative, he walked me up the steps and joined my aunt.

  “Harold, would you please bring Kathryn’s luggage in and leave mine in the trunk. If you don’t mind, I’ll have you drop me off at home when I’m done getting Kathryn settled in. It shouldn’t be too long. They’ll want to take her right from admittance to the shower and then to her room. I’d say maybe an hour. If you have somewhere else you need to go, though, just leave my—”

  “No, no.” Harold interrupted her. “I’ll stay right here and wait for you. If another driver is needed, Carl is around today. I saw him pulling in as I was going out to pick you up. You go ahead and get Mrs. Cavanaugh taken care of.”

  As they spoke, I looked around, taking in my surroundings. I noticed that there were many chaise lounge–style chairs neatly lined up to either side of us. I assumed they were there for the patients so that they could be out in the fresh air even when the weather was bad. The imposing column that Harold stood next to dwarfed him in both height and width, and the front porch was lined with six of them. The roof that the columns supported came to an apex, and following the angle of the roofline were beautifully painted tiles and medallions, some with religious symbols and some that were purely decorative.

  “Ready, honey? Kathryn?” My aunt gently touched my arm to get my attention.

  “What? Oh, yes.” She’d startled me. “I’m sorry. I was a million miles away.” And wouldn’t I give anything to be exactly that, I thought.

  “C’mon. Let’s get admissions behind you so that you can settle in. I know you’re worn out.”

  She was correct. I was worn out—well beyond it. Physically, I felt my body wasting away. In just the last two days I’d dropped more weight, so that the traveling suit I’d worn on the train to Howling Cut was a size too big now. It seemed as though my body was being eaten away. And my coughing had gotten much worse in just a short time, too. I felt like I was coughing up my insides and breaking ribs as I did so. The amount of blood that I’d been expectorating had increased as my weight had decreased. It seemed as though the weight I’d lost had been in blood alone. I was awake coughing for the better part of the night, and I was running a fever. I had dark circles under my eyes, and my skin had grown paler. I was looking more and more like the perfect model for a Christmas Seals poster. The sale of the seals had come about in order to fund yearly examinations to detect the early onset of tuberculosis in school children. If the posters were intended to scare them into getting their X-rays taken, then I would soon be the perfect candidate. I was a tubercular, both inside and out now. I looked like one, and felt like one.

  As Aunt Harriet held the door to the admissions office open for me, I stood frozen in place, unable to move. I literally stood at the threshold of a strange and frightening new life, in a strange and frightening new place. But in order to return to the life that was so familiar and so loved, I had to experience this. As terrifying as it was, I realized that this, too, was a chapter of my story, and I could choose to live it with dignity and determination, or bemoan my lot in life by cowering in bed and doing nothing to help advance my recovery. And with that clear understanding, along with exhausted resignation, I stepped over the threshold and throu
gh the door, unsure if I would ever cross back over again.

  PART TWO

  CHAPTER 11

  Rules and Rebels

  The high ceilings and long hallway gave the room a cold, sterile feeling. Gone were the warm bricks that made up the building’s façade, and in their place were stark white walls that were interrupted by heavy dark oak doors spaced several yards apart. I realized that there wasn’t one admission office, but many. At some point, there must have been an enormous influx of people to have needed so many offices to check people in and, I hoped, check them out, as well.

  Aunt Harriet told me to wait where I was, then she walked into an open office door several yards down the hallway on our left. After a moment of muffled conversation, she stepped back into the hallway and waved me in. I was quickly introduced to the admissions nurse, who immediately handed me a rule book that was nearly as thick as an encyclopedia, along with a form to sign stating that I’d read the book. When I was shown where to put my signature, I looked up at the nurse with a look of confusion. Laughingly, she told me that the first rule was that the patient must sign the form. No one actually reads the book, not at first anyway, she’d explained.

  “Then why have it?” I asked, incredulous.

  “Dunno,” she’d flippantly answered. “We just do, and everyone does—sign the form, I mean.” When I told her that I wanted to read about what would be expected of me, she said she hoped I’d brought food along to keep me going because only after I signed the form could the hospital legally feed me.

  Aunt Harriet rolled her eyes at me and whispered, “Just sign the damn thing. No one follows what’s in that stupid book anyway. It’s just protocol.” And so I signed it.