BETTY: The Story of Betty MacDonald, Author of The Egg and I

by Anne Wellman

  In Plague Betty describes her first few weeks at Firland in moving but comic detail. To start with, her thoughts are gloomy and she has problems remembering how eager she had been to enter Firland, how grateful to the Medical Director for allowing her to jump the queue, how wonderful it was to receive completely free treatment. She is cold and lonely and misses Anne and Joan, who are being looked after by her mother and the rest of the family. She is not allowed to read, or write, or talk. She takes us through the long, tedious process of each day: the explosive awakening at six each morning as the wash-water girls snap on the lights and jerk the patients out of sleep with the crash of their jugs and basins; the tiny amount of water given out for washing and teeth-cleaning; the disgusting coughing and spitting all over the hospital in accordance with prescribed procedure (presumably to produce their sputum samples); the temperature-taking, the bed-pan rounds, the meals, which are good, if often cold, and the two hours each day of strictly observed rest which Betty initially finds extremely difficult. There is also, of course, the complete lack of privacy twenty-four hours a day. Betty likens this to adjusting to a planned marriage but without the curiosity or the sex.

  The routine is enlivened only by visiting day on Sundays, bath days once a week, a hair-wash every four to six weeks and weigh-ins on the last day of each month. For her visitors Betty puts on lots of make-up, which she suspects makes her look like an old sick Madam but raises her spirits. On bath days, disappointingly, Betty learns that bedrest patients are taken to a bathroom and washed on a bed by a nurse: tub baths are not allowed. On weighing days the nurses push a large pair of scales into each ward and the patients are helped up from bed to be weighed, each holding their breath in case they have lost rather than gained. Losing weight signified a backward slide but gaining weight meant at least a foothold on the climb back to health. The despair in the ward felt by those who had lost weight is palpable.

  Writing about the nine months she spent at the sanatorium Betty achieves a nice balance between extracting the maximum humor from the situation – the other patients, the nurses (‘Granite Eyes’ and ‘Gravy Face’), the routine, the boredom of lying there doing nothing, the cold and discomfort in the drafty wards – and the genuine terror she experienced as the victim of a then potentially fatal disease. There was no guarantee at the time that she would ever emerge from Firland alive, let alone cracking jokes. However, others have attested to the fact that her sense of humor really did sustain her and that her unfailing ability to see the funny side was a surprise, and mostly a delight, to her fellow sufferers. One of these was ‘Kimi’, a young Japanese girl who in reality was Monica Sone, the Seattle-born daughter of Japanese immigrants. Monica later wrote about her months at Firland in her own autobiography. She described Betty’s fluff of copper-bright hair, her easy laugh and the crisp humor which relieved the drabness of their highly regimented existence. Monica was devastated to have tuberculosis and couldn’t understand how Betty could seem so cheerful. When the two eventually shared a small room together, Monica had at first planned not to intrude on Betty’s privacy beyond the necessary minimum, but found trying to remain distant from Betty was like trying to ignore a blaze of fireworks. She could not remain untouched by Betty’s brilliant wit and her irresistible zest for living, and felt as if Betty was bodily dragging her up into bright sunlight from a pit of self-pity. Every morning Betty would burst through Monica’s groggy sleep with a ‘Good morning’ in Japanese (learned from Monica), and a funny comment to get the day going. For Monica, Betty made the long, long hours at Firland bearable. For Betty, her friend’s wit and resignation were a vital support in her worst hours. One of Betty’s acid tests for friendship became whether someone would be pleasant to have TB with.

  Another witness to Betty’s constant good cheer was her faithful school friend Blanche, who came to visit about a month after Betty entered the sanatorium. As she approached the ward she could hear laughing and talking. The nurse showing her in started to smile too. ‘Listen to Betty,’ she said. ‘She keeps us all laughing. Most of her room-mates love her – although one sensitive girl had to be moved because she couldn’t take Betty’s sense of humor’ (an incident not mentioned in The Plague and I). Betty introduced Blanche to her fellow sufferers and everyone started to talk at once. They had many little in-jokes and favorite characters at the institution to laugh about, and anecdotes that made life at the deadly serious Firland seem one long riot.

  However, laughter was actually taboo at Firland because of what it could do to healing lungs. It’s obvious from Betty’s own writing that her jokey behavior was disapproved of by the staff and, while it might have kept her and those around her sane, the reality was that she was jeopardizing her health. In any case, beneath the wisecracks Betty makes clear in Plague that, certainly at first, she is always grimly aware of where she is and how it could end; she is outwardly cheerful but inwardly often thinking the worst. Betty’s children were totally dependent on her and much of her internal brooding inevitably revolved around their future and what would happen if she died. She had lost her own father at about their age. The Plague and I, although funny and immensely enjoyable, is the most somber of Betty’s books.

  Fortunately, she began to recover almost immediately. In Plague, after only two weeks of complete bed rest, she has gained weight and begun to feel better. The resting has grown easier and through the long quiet days she has been able to relax more and more. There comes a night when she sleeps the whole night through and the next morning doesn’t cough at all when she wakes up. She has a new sense of well-being and a feeling of energy, feels perfectly well and has lost some of the depression and terrible foreboding. Betty begins to think about the future with some hope of actually getting well. Naturally it then drives her insane to lie hour after hour, day after day doing nothing, but she has to continue following the prescribed program. Inevitably this produces a dreadful restlessness and irritability. And, in line with Firland policy, Betty is told nothing about her good progress, which might have helped her state of mind. Resting in bed made everyone gain weight and stop coughing and although there were regular x-rays and tests, nothing was ever revealed to the patient.

  From October onwards it begins to rain and rain and when it isn’t raining there is mist and fog; because of the open windows, everything, including hair and bedclothes, becomes damp and clammy. The sanatorium, always cold, becomes colder still. The patients each wear several pairs of woolen socks and are so wrapped up in sweaters and scarves and hoods and mittens that they look like bundles of old clothes, but they are all still cold all the time. The heating is now on in the building but with the constantly open windows it goes nowhere. The cold makes the patients irritable and snappish, especially Betty (in her own estimation). The food, which at first had been hot at least at lunchtime, becomes progressively colder as the winter advances. Meals are brought from the kitchens via long icy tunnels and any heat can’t survive the journey, although the food itself continues to be excellent.

  Because a shadow on her right lung clears very quickly it becomes possible for Betty to be given an artificial pneumothorax, a common surgical method used at Firland to arrest tuberculosis. This was based on the theory that a flattened lung would heal more quickly. Compression was effected by the introduction of gas or filtered air into the pleural cavity between the chest wall and the lung, and refills of the air were given at regular and then increasingly spaced intervals, and could be continued for a number of years.

  In Plague Betty is told nothing about what is going to happen to her and as she waits in a side room she is so scared she is practically in a coma. It proves to be an unpleasant experience. In fact artificial pneumothorax was not without its dangers, although it is reported to have helped cure or extend the lives of many at the time. Having survived the ordeal Betty climbs back into bed with a terrific, overwhelming desire for a cigarette (which, of course, she had had to give up on entering Firland).

  In mid November Betty is
moved to a room by herself, possibly because there has been too much laughing and talking with her former room-mate ‘Kimi’, and she loses her feeling of high spirits and growing good health and spends much of her time longing for the children and thinking about dying. She appears not to have had any consolation from religion at this critical point in her life. She had been brought up as Episcopalian, and used to take the girls to church when they were young but may not have had any deep religious feeling, at least as far as is revealed in her books. Elsewhere in Plague she does describe hearing the soft murmurs of the ‘sweet-faced, gentle Catholic Fathers’ going from room to room blessing the patients, and wishing that they would stop at her bed: only the Catholic Church appeared to her to have the true feeling of religion, she wrote. Nevertheless she appears to have been without the comfort of strongly held belief that other patients may well have called upon. When asked by a nurse if something is troubling her, Betty answers truthfully that she hates being alone, longs for her children and thinks about death. The nurse is horrified and orders Betty to have pleasant cheerful thoughts. She gathers herself together and from then on, as she lies there through the long sad days, cold and lonely, Betty consciously tries to assemble cheery thoughts to keep her going when she is wakeful in the night.

  At Firland, once a patient’s daily sputum samples indicated that he or she was no longer contagious, the sanatorium gradually began testing the patient’s strength. Those who showed signs of recovery through weight gain, improved chest x-ray, negative sputum samples, and normal temperature and pulse were given ‘time up’, which meant they could sit up in bed for a given number of minutes, and then gradually a number of hours each day. If a patient showed no sign of relapse, additional privileges such as reading and writing time and, eventually, permission to walk down the hall to the bathroom followed. By December 1937 Betty in Plague has at last been moved back to a two-bed cubicle (perhaps for her good behavior all on her own) and has graduated to one hour’s reading-time a day and is taking pneumothorax only once a week. She is also colder than she has ever been. The patients’ bedpans and water glasses freeze solid each night and they all wear woolen mittens and woolen hoods even at meal-times.

  After all these months Betty has become institutionalized: she knows the hospital routine by heart, what’s going to happen hour by hour and minute by minute. No longer thrilled even by a big holiday like Thanksgiving, she knows each day only as bath day, ‘gas’ day, fluoroscope (a type of x-ray) day, visiting day, supply day or store day, when patients received items such as toiletries and the like ordered from Firland’s store. She is aware that this is down to a combination of the divorce from normal living and the self-centeredness of the invalid. Although at first vitally interested in her visitors’ stories of life on the outside, gradually these tales became less and less real. The only reality is the sanatorium – its patients, staff and happenings. This makes time move unbelievably slowly and Betty becomes ever more irritable as she lies there just waiting for the hours to pass. Her room-mate at this point is a very obedient, inspirational patient who is so annoying that Betty lies awake in the long dark nights listening hopefully for her breathing to stop.

  The period for bedrest patients to start engaging in occupational therapy, go to one of Firland’s movie showings, read books, and have time up – if they were judged well enough after a chest examination – was three months. In Plague Betty reaches this milestone at the end of December, and she is wheeled away to be examined just as she is telling herself that she will be in the sanatorium for the rest of her life but that at least she will go through menopause under medical supervision. After a thorough appraisal she is told she can have three hours’ time up and one hour of occupational therapy time a day, leaving her almost hysterical with joy. However, she is dismayed, to the point of tears, by the occupational therapy activities on offer: knitting, crocheting, tatting, or embroidery. She had thought that the therapy would be useful work, something she could do to support herself and Anne and Joan if she wasn’t strong enough to return to regular work after her release. None of the sorry objects she is shown as samples of what she could do would ever bring in money but she is told that the idea is more to add interest to the patients’ days, to keep them occupied and release tension. Morosely, Betty chooses tatting, a form of lacemaking with a shuttle. It makes listening to the radio and time up more pleasant and so she gets on with it. When her time up, which is increased by five minutes a day, reaches one hour, she is wheeled to the porch morning and evening to join the other time-uppers. Bundled in everything they own they sit in reclining chairs and in the mornings do their knitting or tatting with frozen fingers. The evenings are too dark so they just sit and shiver. Betty’s mother is delighted about Betty’s time up and occupational therapy and brings her in a thick book of tatting instructions. Betty looks at the attractive illustrations of collars and cuffs and tablecloths, reads the instructions and works hard, but for a long time can only produce small ‘pustules’ of grayish white thread.

  Occupational therapy also allowed the medical staff to keep observing patients’ strength. Firland offered leatherwork, photography classes, a woodshop, a machine shop, a print shop, a beauty parlor, a full domestic arts department and even a volunteer fire department, all staffed by recovering patients. Patients engaged on these activities were continually monitored to guard against relapse, and if temperature or pulse increased they were put back to bed. Those with ‘eight hours up’, the maximum time allowed, were still expected to spend the remaining sixteen of the twenty four hours at rest.

  Those with the requisite skills – like Betty, who could type – could also help produce Firland’s inhouse magazine Pep (later called Firland Magazine), which sold subscriptions to help towards the costs of occupational therapy. The aim of the magazine was to educate and inform patients and to raise morale. There were columns on famous tuberculosis sufferers, a joke column called ‘Your Sputum’, and news of former patients. There was frequent urging to STOP and REST. Birthdays, admissions, and discharges were listed; those who had died were listed as discharged, which at times was as many as one-third of the list. Patients back in the community often continued to subscribe to the magazine in order to keep up with their old friends.

  Recovering patients also delivered mail or library books round the wards, pushed wheelchairs or worked in the dining hall. They carried out practical and useful tasks such as sewing surgical gowns and linens and rolling bandages, or delivering items to patients’ beds from the Firland Exchange Store. Outdoors they could work on the Firland Farm, which provided the institution with vegetables and fruit, eggs, poultry, and pork; the farm even raised guinea pigs for use in Firland laboratory experiments. There were the beautiful grounds to walk in and a miniature golf course. Coincidentally, some of the land had been cleared by men put to work by the Works Progress Administration, the job creation agency Betty had done work for while at the Treasury. In Plague Betty’s eventual job during this recovery period is to work as one of the dreaded wash-water girls who crash the bed-rest patients so hideously awake each morning with their jugs and basins. For Betty it’s a point of honor to make damned sure every patient gets enough water to wash and clean their teeth with. Some of her old friends in the Bedrest Hospital are so much worse it makes her cry.

  Betty is getting better and taking the first steps towards normality, but there is more treatment to come: having her ‘bands’ cut. This was pneumolysis, the snipping of large adhesions between the lung and the pleural membrane. If a patient had received artificial pneumothorax, strong adhesions like this could hamper a proper collapse of the lung and therefore delay healing. Not surprisingly the procedure was another unpleasant experience, again carried out with only local anesthetic, although Betty does have an injection of morphine. Unfortunately she is allergic to it (her warning is ignored) and instead of dulling the pain the drug makes her highly alert and nervous. In Plague she also makes the mistake of wearing mascara and the discomfo
rt from the stinging, running mascara in the hot operating theater proves far greater torture than the procedure itself. Betty was in any case fortunate to have closed pneumolysis, meaning a less invasive puncture in the chest wall through which to do the cutting, instead of an open pneumolysis, which was a removal of portions of the ribs to get at more extensive adhesions. Even so, there was a variety of mishaps possible during the closed pneumolysis, including cardiac arrest due to stimulation of the vagus nerve or even death from hemorrhage following the accidental cutting of a vein. There were many accidents and poor results from this procedure during that era. Eventually, from the 1940s onwards, the procedure was totally replaced by drug therapy. Betty, luckily, survived. As it was, that evening she experiences a peculiar scrunchy feeling in her wrist – air in the veins from the hypodermic of morphine, which had apparently been badly administered. She is given a sedative and the air in the veins dissipates before the bubble, or embolism, reaches her heart with potentially fatal consequences.

  A Firland inmate making good progress would finally be moved into a ward for ambulant patients, where he or she enjoyed greater freedom and could take meals in the dining room rather than on trays in bed. As always, staff were instructed never to discuss a patient’s case with them directly, so they never knew exactly where they were in their recovery and when additional privileges might be granted. Each new privilege gave rise to growing hope and elation. Betty’s condition continued to improve and in March 1938, at six hours up and having gained twenty pounds in weight since she entered, a chest examination showed that she was ready to become an ambulant patient. In Plague her bed is moved and to her delight her new accommodation, which she shares with one other room-mate, has its own warm dressing-room and a private toilet. They can fill up their own hot water bottles to their hearts’ content and have real baths in a tub instead of blanket baths. Betty is ecstatic at the change of location and the chance to go to something so normal as a movie – and in the company of those now strange animals, men, from whom she has been segregated for so many months.