The American People: Volume 1: Search for My Heart

by Larry Kramer

  THE NITS ARE COMING

  Different “historians” have differing versions of the history of NITS. Well, as the English say, “horses for courses.” And here follows YRH’s.

  After Philadelphia, Ontuit, Sagg, and the debacle at Fruit Island, the official Pox, Pus & Sores business takes a detour during the Civil War, then reroutes itself to return to New York City, which, because of its own great growth, has a festering problem that makes Philadelphia look like an out-of-town tryout. It is thus leaping for the opportunity of government payments, regardless of whether the government wants to pay. Is not health a federal problem? New York is now the undisputed power center of our country. Washington may think it is, but it thinks a lot of things about itself that aren’t accurate: for instance, they think they know what they’re doing, always a big mistake for governments and politicians. There seems to be a lot of foreign involvement with places such as Spain and Cuba and the Philippines … well, who even knows where the Philippines are? Teddy Roosevelt, when he shows up, might look like a teddy bear, but he also looks like he should go on a diet and lose a lot of weight. But let’s stay with McKinley for a while, before he, too, gets knocked off.

  It seems as if everyone wants to live in New York. The city is chockablock, on its way to what it is today. There are many people, and many sick people, especially in Manhattan, where people in all neighborhoods and income classes are not shy about participating in all of life’s manifold destinies. A Rose McPherson, who works for the New York City Health Department (a primitive place where as a woman and hence new to the workforce her opinions are disregarded), manages somehow to prepare a map of the city which shows that from lower Broadway to the Bronx there’s not a single block that hasn’t forwarded to her attention a “representative public health problem” “and, quite frankly, I am swamped.” She is unable to release her thoughts of why this is so, that people are fucking everywhere and the syphilis etc. that had almost toppled Philly has just moved farther north. (It isn’t that fucking is no longer happening in Philadelphia, but it’s a tired city now, trying unsuccessfully to live on past glories as the first home of this and that, and tired people don’t fuck as much. Even its Liberty Bell gets cracked.) Rose is also worried about a lot of other things: rampant childhood diseases, whooping cough (pertussis, often fatal), measles (ditto), hemorrhagic bleedings (ditto), mumps, even various paralyses of limbs, though polio as such is not known yet. New York is definitely not a healthy place.

  But let us stick with syphilis. Rose doesn’t know why more people aren’t dying from it since so many have it and she knows it’s certainly thought to be fatal. She figures everybody’s body’s not the same. Believe it or not, this is a relatively new thought and relatively unknown reasoning—that some people get sick and in varying degrees and others don’t, from the same fatal thing. She writes a quite impressive report on her thoughts for Newbold Harold Sypress, who she guesses is her superior at a department so muted in its voices of authority. He doesn’t answer her, so she decides to write to the president, who doesn’t answer her either. She does get a letter from Theodore Roosevelt, who is assistant secretary of the Navy in McKinley’s administration. “I know what it means to be unhealthy. I was an unhealthy child. I was called ‘sickly and delicate’ by my father and told to remake myself, which I did. ‘I’ll make my body,’ I declared to him, and so I did. I have sympathy and sadness for those, particularly the sailors under my department’s jurisdiction, who have allowed themselves to decline in health. I suggest that they take up a rigorous program of hunting, fishing, swimming, hiking, and boxing. I shall issue an official order suggesting same. My program certainly did wonders for my asthma, which had plagued me.”

  Comes to lower Manhattan what is initially called the Clinic for Hygiene, which is built from scratch on a lovely street overlooking the harbor by, yet again, a group of sailors not enjoying the best of health. For some reason sailors as a group appear to be more adept at organizing for their welfare. You never hear of soldiers fighting for their health care. Because, once again, so many sailors use the facilities, it comes to be called the Sailors’ Clinic. By 1900, business is so good that a “concerned” local government (i.e., New York City) determines it is time to move this House of Sores farther out. Better yet, as its infected population has grown mightily, it’s someone’s bright idea to kill syphilis off once and for all. A Captain Martin Reddicher of the U.S. Army Medical Corps, put in charge of preparing a report, “The Disciplinary Problems of Today’s Illnesses,” determines that enough syphilis is enough syphilis. There are 76 million of The American People now. Enough is enough with them, too. We’ve been here before, too. The captain is friendly with President William McKinley.

  McKinley, thought much less of at the time, has been resuscitated somewhat by biographers who praise his leadership. He took a country in deep depression and turned it into an international powerhouse. Why, United States Steel became the world’s first billion-dollar corporation. While he is assassinated by another crazy man, homosexuality does not appear to be woven into this particular murder. He dies before Captain Reddicher can press his case.

  Staten Island beckons. Though in sight of the booming metropolis across the harbor, it has been up until now a vast and lonely place, and mostly populated by the stunted, the twisted, the genetically malformed, including an exceptionally large family of Rattlefields. Huge portions of Staten Island thus become home to the wandering, abandoned, senseless, and demented, much as the middle of America has been the home of wandering war-wounded youngsters. Land on Staten Island, so near and yet so far, is cheap and about as easy to acquire as the syphilis most of the inhabitants are running around with. Staten Island is in desperate need of a population change. Rose McPherson knows that Captain Reddicher is talking about stuff she wants to know more about. She is chosen to be in charge of a “new” Sailors’ Institute, as a reward for a job well done in New York City.

  There is a suitable building already here, called the Great State Hospital for the Destitute and the Wretched. Apparently there were quite a few such edifices around our country, built by nineteenth-century do-gooders to hide their country’s unhealthy secrets. Once again, as on Fruit Island, no description can do justice to the horror of its innards—endless smelly hallways and windowless fetid cells. Once again we witness another awful place to hide the sick. How is anyone ever going to get better? The answer, of course, is that no one is, nor is anyone expected to. But who is saying this? What faces and/or forces and/or powers are saying this? All of these are late-twentieth-century questions, fostered by a current plague. People didn’t think like this then. People didn’t know yet that other people could perpetrate outcomes like this.

  To this particular hospital on Staten Island some trace the real beginnings of the NITS we know today. In case you’ve forgotten, NITS stands for the National Institute of Tumor Science, which has been authorized by Congress and given an annual budget of a very small, tiny, paltry, minuscule, puny amount. Some sticklers trace the birth of NITS, more correctly, to Fruit Island. Neither is a proud place to claim ancestry, which is why neither is ever claimed, certainly not in any “official” history of NITS, when it should be.

  This predecessor of today’s mammoth, behemoth, gargantuan NITS, under which these hideous Great Hospitals of the D&W fell, is opened here on Staten Island and called the “New Sailors’ Clinic,” out of someone’s misguided desire to do homage to the first Sailors’ Clinics we visited earlier in Sagg and on Fruit Island. Has someone in Washington actually heard Rose McPherson’s cry for help? There is no such thing as mandatory reporting, of anything, so it is unclear exactly who is meant to do, on one end, the reporting, and on the other end, the recording, or in between, the caregiving. Oh, a few odd doctors here and there write to their senators if anything interesting or dangerous is seen in their neck of the woods, so it may have been determined, vaguely, by someone or other, somewhere, that by 1901 the cases of syphilis etc. are spreading every w
hich way across, well, every which way. Sorry for the impreciseness of the mechanisms but that’s how this country’s been run from our get-go. Not all doctors can recognize syphilis, so you can imagine how bad things truly must have been. But this is a country that has already learned to coexist with its sick selves without really knowing what they are doing or how they are doing it. If ignorance is bliss and even if it isn’t we’re living in it anyway. All population centers just go on infecting all they can.

  The “true” story of what happened at this “New” Sailors’ Clinic on Staten Island will probably never be known. That big old hospital for the Wretched etc. was burned to the ground in 1858 by a posse of the few residents living in the vicinity. As we have seen time and again, fires are ubiquitous in attempting to change a status quo or to end it. A few matches and a few crazy people to strike them are easy to come by. Indeed, where would this country be without its conflagrations? Or its crazy people? Or their matches? It’s time for a commemorative postage stamp for Fire.

  This particular fire was set by one Anushkus Rattlefield. We know this because he had so many relatives and they watched him set the buildings on fire and they watched him set his wife on fire and they watched him set his children on fire and they watched him set himself on fire and they watched them all burn to death. And then, all now suitably roasted, the remaining onlookers all ate them. Shades of green-and-goldmonkey days. The American People do seem to have eaten each other a good deal more than has ever been recorded. Mostly in out-of-the-way places. Off the beaten track. We do remember the monkeys, don’t we? Anushkus had said, simply, “I tire of living,” and struck the match. It was an ugly building anyway. And the Rattlefields were pretty ugly themselves.

  Several employees of that same Department of Illness and Disease (DID) (which by the time of The Underlying Condition will be renamed the Department of Disease [DOD]) that sent the Furstwasser brothers to Fruit Island are in fact in attendance at this bonfire. They express to the reporters “by chance” in attendance their “heartfelt” concern for the wretchedness of the destitute, who weren’t using the place anyway. Each promises to petition Theodore Roosevelt, who is now vice president and after whom the teddy bear will shortly be named, for a “serious” place where diseases can be studied “once and for all.” The New York Truth reporter writes all this down. A Dr. Quirky told him his appearance here was “strictly coincidental. DID is making site visits of all its outposts. We must finally establish a new one here to house the poxed.” “There is no Dr. Quirky found in any of our records,” according to an official NITS historian, Ethel Vance. “We were barely getting off the ground. It’s true that Staten Island was to be our launching pad. The hospital standing there was to be generously remodeled as our first exterior flagship.”

  Miraculously, on the heels of this fire Congress authorizes the purchase of one hundred acres of farmland in the outlying Maryland countryside “for a permanent institution devoted solely to the eradication of diseases most harmful.” The bill’s sponsor, Congressman Eddie Troeblight (Rep., West Virginia), tells the Monument, “it is time to get the heck out of Staten Island and back to a mainland where the disposable are not so free to wander hither and yon and be burned up. Let’s bring sickness and disease back to Washington, where it belongs!” So onward to Maryland we go.

  This does not mean that the Sailors’ Clinic is not built on Staten Island. It is, and it is still there. And the Sailors’ Rest Home is indeed most “generous,” with comfortable rooms and excellent board. There is a waiting list of the poxed anxious to move in. Captain Reddicher and Rose McPherson move there to run it and indeed become man and wife. He insists on putting a plaque at the entrance, “The birthplace of the National Institute of Tumor Science.” Over the years it will become enormously rich from all those “voluntary” contributions withheld from sailors’ paychecks that Alex Hamilton set in motion, buying up with these funds huge portions of New York City real estate, which it still owns. The Reddichers retire in great splendor to Park Avenue. Congressional investigations will not transpire for quite some time. Sailors’ Cozy Nest still remains an organization with an awful lot of money and more and more real estate but it has little other reason for being and is naturally run by mysterious personages who come and go.

  On that land in Maryland (one hesitates to name it “suburban Washington” yet, although that’s what it will become) are built quite primitive bungalows to house this nation’s first true, real, official medical facility. Research, damn it, is still not a term or activity in general use.

  One does not have to be terribly intelligent or observant to notice that more and more people are getting sick. Everywhere. In every state of the union. From tons of things. Not just social diseases. Although many diseases are in fact contagious, which means they should be classified as “social diseases.” Or else this stupid, discriminatory moniker should be ditched, which it is not. It is too useful, particularly, already, for legislators. It is a scary term used profusely when trying to scare people into voting for or against something that would be for their own good if they’d just shut up. Same thing today. Scare the shit out of people by inferring they are going to “get” something.

  It is doubtful that there’s a healthy population center anywhere under the sun. Growing populations tend to be like that. Oh, people died in plenitude from hideous illnesses before, but the one symptom separating those earlier centuries from the new one is the mighty one of Hope. Hope is coming into fashion. And when people are hopeful they tend to be, well, more social.

  More and more, doctors begin to believe that illness can be cured, the sick made well, the lame less halt. Hope does have a way of disguising, if not downright obliterating, the realities of the moment. Hope also says that contagion can be rendered less ripe and rife. And Hope, for many, is just another word for Truth. Why, if we can only ferret out the Truth, truths will come tumbling out of test tubes in torrents! Yes, NITS timidly begins to use the word research. It even employs a few doctors who won’t ever have to see patients and can spend all their time in new laboratories built especially for this new research thing.

  NITS will be The American People’s new Home for Hope. It will be our Lourdes. Its first director is Dr. Robert Grant Mellow. “Our land and people must be made pure and clean, as clean as that land the Puritans found and landed on and tilled and turned over to us,” are among the first words in Dr. Mellow’s fine speech at the official NITS opening. “This Tumor Institute,” the now President Theodore Roosevelt announces ceremoniously when officially opening NITS in 1903, “will rid our great land of pestilence and vice.” Was he meant to say “lice”? But then, he had sight only in one eye. He lost the other in a boxing match. What a fighter! “How can America fail to be greater still without illness, without sickness, without disease?” Good questions, if not usually posed so publicly by presidents. “We shall be as clean and pure as God decreed.” Well, we have heard talk like this before. He polishes his oratory off with a bit of the Bard, shaking his fist at the crowd: “Out, out, damned spot!” Well, we lived through Harrison and Cleveland, we will live through Teddy Roosevelt, a bully, but better a bully than a wuss. So many wusses. My goodness, how we pick them. McKinley, to polish him off, was a wuss: the wife he adored so absolutely suffered from a hideous list of serious ailments, “repeated convulsions, seizures, blackouts, possible epilepsy, certainly depression” (two daughters dead, remember, one from typhoid fever); no wonder the poor woman was always so “sickly, sullen, and withdrawn” (Brinkley et al., The American Presidency). Her Billy would sit with her endless hours and through many a night to comfort her. But when Dr. Robert Grant Mellow appealed to him for support for the new NITS, the president summarily dismissed him. “It was a harsh lesson for me to learn so early on,” Mellow was to write, “that my President did not care for health. And to be so rude about it!”

  The wooden NITS bungalows out there in still-distant Maryland multiply and are joined by larger verandahed hospit
als patterned—for is this not a southern state?—on gracious southern models. As new diseases proceed, like the march of history itself, to parade themselves more identifiably, more new buildings sprout over the acreage, which is becoming more manicured and landscaped, a handsome place to dream of Hope. Why, searching for cures may soon become more fashionable than doing the Charleston. One by one the buildings will come to represent differing (and increasingly competitive) interests: eyes, hearts, livers, lungs, blood, children, teeth, aging, and that mighty wild stallion, cancer, and yes, infectious diseases, among them The Underlying Condition. It will not be long before the unanimity envisaged in a congressional charter that heralded “a united crusade in a united land, against disease, all disease, irregardless of color, creed, race, religion” crumbles as each body part comes to fight like a tiger for the same congressional buck. But we are once again getting ahead of ourselves. But know it won’t be long before America’s lifesavers are at each other’s throats rather than looking down them. Saintly harmonies in no time at all become discordant. Competition among the lifesavers comes into being, and remains. This, too, is the American way. So very many unhealthy things are “the American way.”

  But by now it is official. Since the Civil War it’s no longer American for brother to get along with brother.

  And we have NITS. NITS will be home to The Underlying Condition.

  Happy New Year! Happy Twentieth Century!

  DAME LADY HERMIA: Fredchen, I must tip my hat to you. You become more and more a true historian. Are you learning how to do this all from me?