Warm Springs

by Susan Richards Shreve

  I’d stand at the back of the dark church, thick with the scent of incense. At the altar was a screen of thin cloth through which the congregants could see the bearded priest—the very mental picture I had of God, large, cloaked, with a heavy gray beard down to his chest and hair to his shoulders—carrying out the Sunday service. We saw him as a shadow through the screen.

  The people at the Greek Orthodox church were very warm and physical with one another and with me, their visiting penitent, in a way I’d never experienced. It was altogether satisfactory. If I had been asked, when I met Father James at Warm Springs, whether I believed in God, I would have said yes, in spite of my parents’ feelings about religion. And the God I’d have had in mind would have been some combination of the shadowed priest and the flea who lived in the ear of the principal of Sidwell Friends.

  I was ready for Father James’s invitation to join the Catholics.

  That morning after Father James left, I was sitting on my bed looking at the tiny book from Florence he had given me when the orthopedic medical team, two doctors and an orderly carrying what looked to be a toolbox, entered our room. I thought they were coming to do something with me, since I was scheduled for surgery in the morning. But they had come for Caroline.

  They pulled the curtains around her bed and shut the door to the room, but I could see through a space in the curtain what they were doing. They turned Caroline on her back. I hadn’t seen her on her back before and it looked painful, the way her legs hung over the side of the bed, bent under, and her head hung over the other side, so that she was contorted in a belly-upward curve. They checked her cast, one doctor running his hands between it and her chest, pushing his arm down to her stomach. The orderly and the other doctor stood with the tools on the side of her bed where her legs dangled.

  From where I was sitting I could see Caroline’s face, with no expression except the flat one I had been watching all day.

  “We’re going to tighten the screws here, Caroline,” the first doctor said, indicating the metal contraption attached to her legs at either end of the pole. “It’s going to hurt.”

  The doctor began working the plaster with his wrench.

  “Tell me when,” he said, turning. “Now?” he asked.

  Caroline shook her head.

  “Now?” He had turned the wrench a little more. “Caroline?”

  Her face suddenly hardened as if she’d locked her jaw.

  “There,” the doctor said. “High pain tolerance, Caroline. It takes a lot of self-control not to scream.”

  He patted her head.

  Then they turned her over on her stomach, spread the sheet over her back, and opened the curtains.

  “We’ll be seeing you tomorrow morning,” the doctor said to me. “I’m Dr. Irwin.”

  And they were gone.

  “That must’ve really hurt,” I said, breathless with admiration.

  “No,” Caroline replied, her face bone-white. “It didn’t hurt.”

  When I was eighteen, I wrote a novel, never published, called Wooden and Wicker, about a girl with mild paralysis who goes to Warm Springs hoping to be accepted as the cripple she is considered in her ordinary world, only to find she’s not crippled enough. The book’s title refers to the old-fashioned wheelchairs that were in occasional use at Warm Springs during my time there. When I started to write this book, I went in search of the manuscript, hoping to stir my recollections for the place and the people I knew there. I discovered the book among the files of an old friend, and reading it again after almost forty years, which I did before I began this memoir, I was surprised to see that my present memory of what happened and my youthful invention of events were so different. I initially wanted to write this book to make sense of what had happened in the years I lived at Warm Springs, but it’s difficult to connect the strings of truth.

  So the truth of this story is in the way I see it now.

  For example, the novel is of course autobiographical. My memory of how I portrayed the protagonist, before I reread the novel, is as a brave, spirited young girl, idealized to be sure, but realistically portrayed from the point of view of autobiography as a girl responsible for causing a lot of trouble. I didn’t expect that I had understood that girl at eighteen, when I was writing the novel, in the way that I understand her now, but the sappy, sentimentalized Victoria of Wooden and Wicker is nobody I remember in either fiction or fact. She’s a little piece of victimized misery, and I was glad to see her go when I finished reading. Which made me question the character of Caroline Slover, my roommate during the first four months I lived at Warm Springs. The Caroline in Wooden and Wicker is a whiner, so I assume that at eighteen I invented these characters out of whole cloth or else my perspective on them, and certainly on myself, has changed. I have never seen or corresponded with any of these people as an adult, except for the Caroline I write about here, and she’s a strong and independent woman.

  A reason, maybe the real reason, I never made an effort to be in touch with these people, who were so central to me for an important period of my growing up, is part of the reason I wanted to write this book in the first place. Not so much to discover anyone I’d lost, but to understand why I had wanted to lose them.

  Patient Number Three

  WHEN THE NURSE pushed the stretcher into our room to take me down to surgery, I was wearing the Alabama baseball cap that Joey Buckley had given me. She took off the cap and covered me with a sheet.

  “What’s going to happen now?” I asked as she pushed the stretcher toward the door.

  I looked over at Caroline, who was painting with watercolors in a sketchpad on the metal table by her bed. She had her eye on me with that flat expression she sometimes had.

  “Am I going straight to the operating room?” I asked.

  “No,” Caroline said. “You’ll have to wait. We always have to wait.”

  “You’re number three,” the nurse said, angling my stretcher through the door. “Number two is in the OR now.”

  “So where are you taking me?”

  My mother had already told me what to expect, but I was hoping to engage this nurse in charge of my immediate future. I wanted eye contact and conversation. I had become expert at achieving both with doctors and nurses and orderlies in the various hospitals I’d been in. I had learned to soften the expression in my eyes so the pupils didn’t dilate, to chat in an easygoing way, to ask a nurse about her family, to say I liked her hair or her necklace, her summer tan, something personal and disarming so that she’d devote herself to me for however long we were to be together. I had learned to be winning and funny, to fix a listener in my gaze so he was captured by the intensity of my attention. My life depended on a certain charm.

  “Where are your parents?” the nurse asked. “Most parents come with me to the holding room.”

  There was judgment in her voice, and I didn’t want it to fall in my parents’ direction.

  “I asked them not to see me before surgery,” I said.

  I had told my parents that I wanted to be alone the morning of my operation weeks before we left Washington for Warm Springs. I knew what I required of myself to rise to the occasion of my parents’ fear and sadness.

  “Whatever suits you,” the nurse said, pushing my stretcher into the elevator, pressing the button for the lower level. “But I feel sorry for them.

  Later, waiting in the holding room, I wondered about what the operating room nurse had said, wondered whether it was selfish for me to keep my parents at a distance during a time like this, whether I was being self-protective at their expense. I knew above all that I wanted their admiration, and that seemed difficult to earn as a sick child with a reputation for causing trouble.

  I had a habit of playing out scenes in advance, a whole scene on the stage set of my brain, and in this particular scene, as I imagined it, I’d be lying on the stretcher, my parents standing on either side, looking down at me with such sorrowful expressions I couldn’t take on the responsibility
for them.

  We had a small family—two children, one dog, one grandmother, two parents—and we lived far away from the town where my parents had grown up. We were a typical postwar nuclear family, sufficient unto itself and in retrospect very lonely. My parents had traded the narrow life of a midwestern town for the independent isolation of the urban East Coast, and there was about us a kind of pride in that. But I think, especially on my father’s part, there was shame as well. He had escaped from the provinces to forge his own life and had been punished for this breach with a damaged child. Whether he believed this or not, I can only guess. God knows we never spoke of it. But I had overheard or been told stories that led me to a certain kind of thinking about the sacrifices my parents had made. I knew, for example, that my father had given up a job in Europe during the war because I was ill. I knew this because my mother told me that she worried over the short shrift she gave to my compliant little brother in favor of me. I knew my father missed my mother’s company.

  The elevator doors opened on the first-floor corridor in front of the waiting room. At one end of the corridor was the operating room, and we turned in that direction, passing the waiting room. As the nurse wheeled my stretcher down the corridor, I caught sight of my parents looking out the window toward the courtyard. My father’s hands were behind his back, holding one of my mother’s hands in his. My mother was in a dusty-rose linen dress, looking young and strong in that fleeting image. I turned my head away.

  The nurse took me into the small, windowless room where patients were taken to wait their turn for surgery. The room was empty except for a hard-backed chair and an iron lung, and she pushed my stretcher alongside it, so close I could touch the metal cylinder.

  “Who else is having surgery today?” I asked.

  “Four of you. I don’t remember the names.”

  I gave her my name so she’d remember it and told her I was from Washington, D.C. I added that I had a boyfriend named Harold Ickes, whose father had worked in the White House with President Roosevelt. It was my effort to establish a personal connection to Roosevelt, but she didn’t show an interest.

  “Did I tell you I was going to give you something to make you sleepy?” she asked.

  There must have been something like valium in the enema she gave me, and it felt as if bubbly water in the colors of the rainbow or shooting stars were flying through my blood.

  “That’s it,” she said. “You’re done. When I come back you’ll be asleep, and when I take you to the operating room, you’ll get put out completely so you won’t feel a thing.”

  “And then what?” I called to her.

  But she had gone out the door.

  The iron lung was a long green coffin, and in my fuzzy-minded, drugged state I was drawn to look at it, at the pillow on the end of the bed inside it, where the patient’s head would be, his body immobilized in the metal contraption. I’d seen a little girl in an iron lung at the Cleveland Clinic, her curly yellow hair spread on the pillow, and I’d been fascinated by the whoosh whoosh of the machine as the air went in and out.

  I’d said hello as I passed her, and she’d smiled at me with her glazed eyes.

  Her name was Sally, the doctor said while he examined me, and she had died the day after I saw her, he told me later.

  “Did she die because of the iron lung?” I asked him.

  “She died of polio,” he said.

  She was perhaps the first person I had seen who was actually sick with the poliomyelitis virus, and for years I couldn’t get rid of the image of her flushed cherubic face and yellow curls and the grip of her eyes as she tried to engage me.

  I didn’t remember anything about my own polio, although I was told that I had been paralyzed, that the paralysis had lasted a few weeks, and that I had screamed in pain whenever someone got close. But to me it was as though I’d been born with a crippled leg. I didn’t know how it felt to walk normally, so the trauma of paralysis was not a conscious memory. In absolute terms, I didn’t know what it was like to have paralytic polio, although I knew what it meant to be trapped in bed.

  Polio is an old virus. We have evidence from the ancient world of polio-like deformities, and later, in the Middle Ages, there are references to paralyzed children. Clusters of epidemics were reported by physicians in the nineteenth century. A rural community in Louisiana, for example, had a number of serious cases that occurred over a period of time suggesting an epidemic. The first recorded outbreak in the United States happened in 1894, near Rutland, Vermont, where a young country doctor interested in public health kept a record that revealed that the majority of cases were male and under six years of age, and that the symptoms were headache, nausea, fever, fatigue, and stiff neck.

  A public record indicating, as this did, that polio was contagious suggested the possibility of widespread epidemics.

  In June 1916 there was an epidemic in a part of Brooklyn known as Pigtown, populated by recent Italian immigrants, and the rapid spread of polio there was attributed to filthy conditions. The new immigrants were blamed as the carriers of infectious disease. As a result, Pigtown was isolated and cleaned up by the New York City Board of Health with the usual methods of disease control: quarantine and sanitation. But the epidemic had spread, continuing for months, eventually resulting in twenty-seven thousand deaths across America.

  Those who studied the outbreak were concerned that the measures taken had not controlled the spread of the disease. Wealthy neighborhoods and rural areas were as affected as squalid urban centers. In fact, it appeared that a child living in poverty might even be protected from the virus by frequent exposure and a more developed immune system.

  In the twentieth century, Americans became obsessed with cleanliness. Protection against viral-borne diseases like polio consisted of soap and water, frequent baths and hand washing, clean sheets and clothes, clean toilets and kitchens and public facilities.

  In the case of polio, however, the result of the anti-germ revolution was, ironically, more frequent outbreaks of the disease.

  In 1941, when I had polio, it was generally known that the disease was not associated with filth, but myths persisted about swimming in public pools, playing in sandboxes in public playgrounds, and summer heat as breeders of the disease. Mothers like mine still associated polio with scummy conditions and poverty. For years, my mother would defend the protective measures she took against germs.

  “I even sterilized the orange before I made your orange juice,” she’d say.

  In the early 1950s, the National Foundation for Infantile Paralysis, established by President Roosevelt and headed by his law partner Basil O’Connor, was funding the research of several scientists, including Jonas Salk at the University of Pittsburgh, whose lab was developing a vaccine for polio. Salk grew all three of the identified viruses, testing them on tissue from the kidneys of monkeys. He then fed the viruses with a solution called Mixture 1999 so they multiplied. Finally he killed the viruses with a formaldehyde solution and created the vaccine by combining the three strains of dead viruses. At the same time, another scientist, Albert Sabin, believed that the only vaccine that would succeed in developing immunity was one made from live polio viruses. There was a competitive “race for the cure” between Salk and Sabin, which was the background music for the two years I was living at Warm Springs.

  The iron lung in the holding room in which I waited operated like a bellows. Once a patient was enclosed in the machine, a perfect seal was created. A patient with bulbar polio couldn’t use his breathing muscles to inflate the lungs, so air was pumped out of the casing, causing a reduction in pressure that forced the patient’s chest to rise, filling the lungs with air flowing through the nose and mouth. When the air was allowed back in, the pressure increased, forcing the lungs to empty. Thus the operating principle of bellows.

  An active iron lung is frightening—the body concealed, the head exposed, air whooshing in and out. But at least the living patient is present.

  An empty iro
n lung looks like death.

  I was in a coma for a couple of weeks when I had spinal meningitis. I still have recollections of hearing voices during that time I spent in isolation. I heard them as if at a great distance, and I couldn’t take hold of them beyond the background din of sound, so I couldn’t make out what it was they were saying. Dr. Nicholson was at the hospital with me and stayed, off and on, for those weeks, sometimes through the night, so I wouldn’t be afraid if I regained consciousness.

  My mother was told she couldn’t come into the isolation ward. Instead, she wandered the streets of downtown Washington, filling the tin cups of the beggars who sat with their monkeys and their boxes of change, their harmonicas and their foul language. And then, as she later told me, she would go home to her new baby and wait for Dr. Nicholson’s report.

  I remember thinking that one of the voices I heard in the distance was my mother’s and wondering whether I was dead. I asked her later, after I recovered, if that was what death sounded like. I knew death was possible. Children in the meningitis isolation ward had died when I was there.

  As a child, I thought a lot about death. The key, as I saw it, was not to fall asleep.

  At the farm where we lived after I got out of the hospital, where my parents had moved in order to protect us from the city, from disease and other dangers, I could not sleep at night.

  I had a puppy called Trixie, one of the farm dogs, given to me when I got home from the hospital, who slept on my bed, and outside my window I could see the barn and the chicken coop and the pig shed. Jeffrey slept in the bedroom next to mine in his bassinet, and next to that was my parents’ room. I loved the sounds of the farm and the brightness of the stars at night, yet with all that company in close and safe proximity I couldn’t fall asleep.