Imagine a hill shaped like a dog’s head, its nose pointed south and resting on crossed front paws. The main buildings of Tamarack State Sanatorium for the Treatment of Tuberculosis, including the two long brick wings where we used to cure, are set where the eyes would be. There’s a siding at the base of the hill—four posts, a metal roof, space for a cart and the portable steps—where the train makes a special stop and where, on arrival day, we had each looked up to see the sanatorium windows staring back at us. We all remember looking down for the first time, after getting settled in one of those wings, to see the new arrivals sagging down the train steps or being passed on stretchers through the windows of the train.
Back then we lay on our porches in orderly rows, the two chairs assigned to each room still separated by shoulder-high panels and sheltered by canvas awnings. Fields surrounded us—they still do—and also a river, three ponds, and the road curving down toward the village. After the cities from which we’d come, this looked to us like wilderness. Rivers, mountains, wild geese honking. The air meant to cure us pouring antiseptically through the woods. The Adirondacks were new to us, and we were shocked to learn that Canada was so near. The snow shocked us too, along with the dark winter days and the heavy mist that sometimes blanketed the fields. A fox, hunting, would brush his tail through the surface, leaving a track we followed with our eyes. Ducks escaping the fox would burst into the air as if they’d been shot. The sight made us think that our own lives, hidden similarly, might still be launched on their proper paths.
We weren’t a big group even then—60 women and 60 men, if every spot was taken—and a single arrival shifted scores of relationships, as did a single discharge or a death. On the porches we gossiped as eagerly as we drew breath. Twice each week, if the mist didn’t block our view, the train pulled up to our unmarked siding, and we inspected who might join us next.
In late July of 1916, the train from New York City brought us Leo Marburg. Tall, thin, with black hair worn too long and big hands with spatulate fingertips, he paused on the boarding steps until a porter passed him like a sack of wheat to the driver of our cart. The driver, without asking, draped Leo over the pallet in the back. Leo forced himself back up.
“I’m not that sick,” he said. Up on the hill, our windows blinked at him. “Let me sit beside you.”
He eased himself down and around until, with the driver’s grudging help, he was on the bench and looking out over the horses. The cart climbed from the siding and up the track, the buildings dotting the lower slope wavering slightly in the suffocating haze. Staff cottages, laundry, incinerator, power plant; he recognized only the stables, the others he’d learn later. The mountains were cool, he’d been told in the city, the air crisp and restorative. So what was this steamy batting wrapped around him?
Inside the door of our central building, Leo found it hotter still. The linoleum floor felt sticky; the hands of the nurse to whom the driver delivered him were hot and moist and she treated him, Leo thought, like a bag of raw sugar being taken off a ship. Plop into a wheelchair, plop went his carpetbag into his lap; plop on top of the carpetbag went a pamphlet bound in olive paper: Rule Book, this said helpfully.
“Read it,” said the nurse.
Before he had time to glimpse more than a few of what seemed like hundreds of rules, she pointed out his patient number, inscribed in white ink on the booklet’s cover, and then a page where he was meant to sign his name. Above it was a statement saying he’d read the rules and agreed to abide by them. I understand that I am occupying a bed badly needed for someone else, that I am fortunate to be here, and that only by obeying the rules conscientiously can I show my value to the community.
“Sign,” she said. We’d all been through this and all, like Leo, had felt uniquely prosecuted.
She pushed a pen at him, prodded his hand, said “Good,” when his hand obeyed her request, and then rolled him briskly down the corridor and into the lift that rose to the infirmary. What had he signed? As if to make up for his slowness, she recited rules as they whisked along. No talking during his initial period of total bed rest. No smoking, no laughing, no singing, no reading, no writing. Do not get out of bed for any reason, bathroom privileges come later. Do not think gloomy thoughts. Eat what’s put in front of you. Rest. Think only of resting.
How was this better than Brooklyn? When the lift opened he saw metal beds, in which lay long lumps not talking, not moving, not singing. Then he was inside a bathroom with a dark red floor. Toilets to one side, washbasins on the other. An adjoining room held a huge white tub, in which the nurse proceeded to boil him. That he’d had a bath before getting on the train meant nothing to her: All new patients must be bathed on admission, she said firmly. This was a rule. So too were the astonishing temperature of the water, the disinfectant she poured in a copious stream, the harsh green soap with which she washed his hair. He tried not to wince as she scrubbed at his arms and back. Not to choke as she rested the heel of her hand on his head and gently, but quite firmly, pushed his head under the water.
“Take a breath,” she said, and then he was under, panic rising in him so swiftly that he could see, before it happened, his body bursting from the water, leaping upright, shaking off droplets like a dog. He stood there, naked and breathing heavily.
“That’s not going to do us much good,” she said calmly. “I still have to rinse you off. But I can use a pitcher if you’d prefer.”
He squatted back down, squeezing shut his eyes while she poured water over his head. Count, he thought, as the acrid water streamed. Onetwothreefourfivesixseven . . . He had always hated being under water, but how could she have known that? When she was done, she draped him in towels and inspected his carpetbag, first pulling on white cotton gloves. Piece by piece she pincered out and laid on a metal table two pairs of flannel pajamas, a shabby woolen robe, a sweater, pants, a few shirts, underwear, books.
“Why didn’t you bring warmer clothes?”
“I packed exactly what the tuberculosis nurse in Brooklyn told me to,” Leo said.
She shook her head and made a note on her clipboard. “We keep telling them—these are completely insufficient. Put on those pajamas for now.” While he dressed she bundled up his belongings. “No books, you won’t be reading for quite a while. We’ll issue you appropriate clothes from the storeroom. The other things we’ll fumigate and put away. I need the address of your next of kin, so we know who to contact if that becomes necessary.” She stood with her pencil poised.
“I have no family in this country,” he finally said. “Why else would I be here?”
“If you don’t appreciate how lucky you are to be given this chance to cure,” she said, “and to be supported by the state while your health improves, there are plenty who’d be glad to change places with you.” How many times have we heard that? “You have no family?”
“None,” he said.
She shook her head. “Another one. Where do you all come from?”
If he’d had a place to go, he might have walked away. “I’m grateful to be here,” he said instead. He was 26 years old, and the nurse had just touched everything he owned. On a machinist’s hand he could count the friends—Vincenzo, from the sugar refinery; Meyer, from the boat—who knew or cared where he was.
She stowed him in an empty ward, the top sheets of the beds around him pulled so taut that the edges hovered above the blankets. All of us, he later learned, started out here, wedged between those cotton sheets in one of the white enameled beds, each separated from its neighbor by a small white cupboard. He learned to eat, propped up very slightly, from a white tray on a wheeled stand that swung over his chest. He learned to use a bedpan, to brush his teeth and wash his face in bed, to cough always into a paper handkerchief and expectorate into a waxed-paper sputum cup, casting cups and handkerchiefs into a paper bag pinned to his stand. He learned that his meals, which came on trays, would almost always be cold but would be garnished by a bit of folded colored paper, a Daily Thought: Resting is done with the mind as well as the body. Getting well depends on YOU.
On Thursday, his weekly bath day, he squinted with fear when an orderly came, heaved him from his bed onto a stretcher, and rolled the stretcher into the bathroom. The tub was now off limits to him; instead he was sponged gingerly and then patted dry, covered with blankets, and inserted back into bed. Food came endlessly, more than he’d seen since childhood. The nurse followed the food cart, taking his temperature and his pulse, and the minute she left—“Coughing can be controlled,” she scolded—he hacked and heaved and rattled in ways that he couldn’t before have imagined. In the early evening a resident doctor made rounds, peering briefly at him and then making notes on his chart. If all went well, the doctor said, and he rested thoroughly and ate everything, he might be allowed in a few weeks to walk once a day to the bathroom, to sit in a chair for 15 minutes, to read or write for another 15.
During his confinement to the infirmary, weeks spent staring out the window while time clotted like blood in a bowl, Leo thought often about the Lithuanian forest of his earliest summers, dark and leafy and crowded with men who cut down trees and lashed them into rafts that they sent hurtling down the river. Because he’d been a Russian citizen, people he met in this country usually thought he was Russian. But in fact his father’s people were Baltic Germans and his mother’s were Polish, and divided; her parents were converts. When he was small, and his mother was still alive, he’d lived near her parents, in Grodno. Every summer, though, he’d spent six weeks in a forest called Bialowieza, near the rest of his mother’s family, who were Jews. In Grodno he learned to speak as his mother did: Polish to her parents and her parents’ friends; Russian to his father, who worked for the government, and his father’s friends. His mother’s other language, which she spoke in the forest, he lost when she died.
The forest, which he lost as well, remained in his dreams. When his father sold the house and started moving them from village to town to marshy plain, always south until they finally settled in the outskirts of Odessa, Leo retreated in his sleep to the woods where his cousins had taught him to use an axe. His father married a plump Ukrainian with bright yellow hair and narrow eyes, and then he had brothers and sisters who looked like buttercups. He shot up, gangly and dark, amazed at the black hairs sprouting from his knuckles. The year he was 13, soldiers murdered Jews in nearby Kishinev and his father stormed around the house until the new wife seized Leo by the shoulders, thrust him in front of his father, and said, “This one makes you feel like that. The son of that Yid.”
“She was Catholic,” his father said. “My wife.”
“Pfff,” the new wife said. “Once a Jew . . .”
So he was Jewish, then? Yes to his stepmother, no to his father, yes in Odessa, no in New York. His father hadn’t defended him, and everything that happened in the years just after Kishinev, after he’d run away from home, was jumbled. In Odessa, a stray boy knowing several languages hadn’t been unusual; the city was filled with strangers born in Italy and Germany and Turkey and Sweden, all busily trading and making money. He’d found work in a cooperage run by a Greek; later with a French wine merchant who offered him room and board. He was clever, the merchant said approvingly. And had clever hands. With the merchant’s help, he studied chemistry at the polytechnic institute, learning along the way about fermentation and the making of wine. For a while he worked at a winery, but later, as the strikes and the riots continued and his friends fled one by one, the balance had tipped for him as well. At 20 he felt like a middle-aged man; what was there to keep him at home? His mother was dead, and his father was dead to him. He left for America, convinced that there he might be anyone.
Instead, somewhere between his first days on the Lower East Side and his move to Williamsburg and the sugar refinery, between the job in the char house, which he’d hated, and the one he’d made for himself as the head chemist’s assistant, his lungs had rotted, and all his prospects had disappeared. Working one day at the refinery, he’d walked from the room upstairs, where he’d been testing effluent from the melter, down four flights and past the hall that led to the char house, across the floor where the graders were working, and into the corner laboratory next to the dock, where the head chemist was analyzing a sample from the ship. He’d given Karl his results, said good night, and stepped outside. Near the door was a bin of raw sugar, the last load left to be tested. He’d leaned over to look at the color and rubbed a pinch between his fingers. Then he’d coughed—the same cough he’d had all spring, no more—and watched, astonished, as blood sprayed over the pale crystals.
Everything after that had also caught him by surprise, and that itself had been surprising. Despite his six years in New York, despite all his jobs and the people he’d met and the evening classes leading up to his citizenship hearing, he still hadn’t expected the way that, once the government was involved, one step led to the next and the next, until he was cornered and forced up here. A nurse came to the flat where he’d boarded in Brooklyn. Someone who had seen what happened at the refinery had told someone else, who’d told someone who worked at the clinic. What a fool he’d been, not to spit over the side of the dock, not to hide his cough! A mouthful of blood on a mountain of sugar and then this.
In that nurse’s hurry to fill out her forms, she’d dropped Leo’s diagnosis into the conversation as casually as if he already knew it and then walked from one end of the flat to the other, winding between the boarders’ trunks and beds, examining the clothes hung on nails on the walls and the wash on the line in the courtyard. In the kitchen, saying nothing, she counted the plates and the cups. Back at Leo’s side again, she started with the questions: How many people live here, what do they do, where do they sleep? When he explained about Tobias and Rachel and their two children, the four other boarders and the sleeping arrangements, she said, “Children, and you contagious.” From a pamphlet she handed him—Circular #2: Advice for Patients Suffering from Pulmonary Tuberculosis (Consumption)—he numbly read a paragraph:
Be hopeful and cheerful, for your disease can be cured, although it will take some time. In the treatment of your disease, fresh air, good food, and a proper mode of life are more important than medicines. Take no medicine that is not ordered by your physician. Don’t waste time or money on patent medicines or advertised cures for your disease: they are worthless. If you are offered admission to a sanatorium, accept at once. Until then, stay in the open air as much as you can; if possible in the parks, woods, or fields. Never sleep or stay in a hot or close room; keep at least one window open in your bedroom at night. Have a room to yourself, if possible.
As if a person like him would have a bedroom or a window. As if his part of Williamsburg had a park. The nurse made him spit in a cup, ordered Rachel to keep his clothes and dishes separate, and referred him to a floating day camp for consumptives. There, during the hours he used to spend at work, he lay on a reclining chair on the rear deck of a ferryboat that had once crossed the East River between Brooklyn and lower Manhattan. The breeze blew through the open decks; meals appeared on a long table built in the center, where once there’d been engines and boilers; doctors examined them in rooms along the sides. Men on the lower deck, women on the upper; all of them immigrants, all of them poor. On and off the boat stepped officials from the Board of Health, visiting nurses, social workers, all trying to find placements for the patients. Prying into their backgrounds, investigating their living situations, checking their clothes for lice. After a month he chose not to remember, a woman with lopsided lips had handed him a train ticket and told him to pack his bags.
The nurse who’d admitted him to Tamarack State was right: he needed more clothes, and he came to miss the heat he’d so hated when he arrived. The leaves turned color, far earlier than he expected; the rain and wind poured through the long windows, kept open day and night; he was constantly cold, he was freezing. Some of us had relatives who arrived on visiting days with extra clothes or treats, but he had no one, and nothing he’d brought was right. He learned to be grateful for the worn but heavy garments grudgingly doled out to the indigent patients—which, he learned, included him. What he couldn’t learn, despite being chided again and again, was to stay still. He spoke to anyone near him, tossed, turned, sneaked out of bed to pick up a magazine he saw on a table at the end of the ward and then read it, surreptitiously, beneath the covers. The nurses barked at him, and Dr. Petrie came to speak to him.
“Why can’t you behave?” our assistant director said. “Don’t you understand how sick you are?”
“I hate this,” Leo said passionately, glaring at the doctor’s small figure. With his crisp dark hair and pointed beard and small oval spectacles, Dr. Petrie resembled the inventor Charles Steinmetz, minus the hunchback. Not quite five feet tall, Leo guessed. No doubt with problems of his own. He yielded his left wrist to Dr. Petrie’s thumb and first two fingers.
“Your lungs,” Dr. Petrie said, his gaze averted while he counted the beats of Leo’s heart, “have little pockets of infection scattered through them, which your body is trying to wall off. Right now the scar tissue around each pocket of germs is fragile, like a spider’s web.” He dropped Leo’s hand. “If you move suddenly, or take a deep breath or stretch your arm—like you just did, when you reached for your pillow: don’t do that—you break the scar tissue and let the germs escape. And then they make new spots of disease, and we have to start all over again. You seem like an intelligent man. Can’t you understand that?”
“Of course I can,” Leo said. “But until now no one’s bothered to explain the point of lying here like a corpse.”
With half a smile, Dr. Petrie said, “We’ll try to keep you better informed.”
By mid-September his temperature was down, his cough had improved, he’d gained six pounds, and the nurses let him walk to the bathroom. He could sit for a little longer each day on a cure chair on the infirmary’s porch. Not since first running away from home had he been so alone, for so long. One day an orderly took him in a wheelchair down the lift, through a tunnel, and into the X-ray facility beneath the dining hall. In the gloom he stood stripped to the waist, bending and turning as the technician instructed, holding his breath and then exhaling, perfectly aware of what an X-ray was from his studies in Odessa but unfamiliar with this particular apparatus. That the technician was a woman struck him as odd, as did the purple glove on her left hand and the angry sores on her right.
His radiographs, Dr. Petrie told him later, showed a small cavity near the top of his left lung.
“Am I going to die?” Leo asked.
“Much of what happens now depends on you,” the doctor answered. Always, they pretend it’s up to us. “Curing is a full-time job. But you’ve made good progress, and there are signs that the cavity is already beginning to shrink. We’re going to transfer you to the men’s annex next week. You’ll be allowed a little more movement once you’re there. But you’ll still have to be very careful.”
On a Wednesday morning in October, an orderly took Leo down in the lift from the fourth floor of Central, wheeled him through the corridors and across the covered walkway, and deposited him on a porch off his new room, on the second floor of the men’s annex. Two cure chairs nearly filled the sliver of open space—one of them waiting for him. Company, Leo thought, as eager to meet the figure lying in the other chair as he’d once been to meet a woman. His heart raced as he introduced himself.
“Ephraim Kotov,” the man responded, waiting patiently as Leo arranged himself and struggled with his blankets. Beyond his toes and the wooden railing, Leo saw forest stretching to Canada, ranks of trees marching up hills and down, nearly black where they were shadowed by clouds and the color of his childhood in between.
“In Minsk I was Kotovachevsky,” his new roommate continued, “but here I am cut-off. Kot-ov.” He held out his hand. “A little joke. Welcome.”
“Thank you,” Leo said, reaching across for Ephraim’s palm.
Ephraim, who like the rest of us had been speculating about Leo during his weeks of isolation, said, “That was Hiram’s chair. Yours now, though; he passed last week. Do you play chess?”
“Not well,” Leo admitted.
“Too bad. Hiram was good at it.”
Leo stretched his legs, wondering what else Hiram had been good at. What he’d liked and disliked, how he’d died. Should he apologize for taking Hiram’s place? He looked back at the forest, seamed here and there with a birch. Below, a train pulled into the siding and tiny figures moved across the platform. For them, he must be a speck in the dog’s right eye. “I came here from New York,” he said. “You too?”
“From an apple farm near Ovid,” Ephraim answered. In response to Leo’s puzzled gaze, he added, “One of those little towns in central New York, near the Finger Lakes, named after classical places and writers. Troy, Ithaca, Homer, Virgil . . .”
“A Jew from Minsk, in the middle of farm country,” Leo said with a smile. “How did that happen?”
Quietly—conversation has always been forbidden during rest hours—the two men leaned toward each other and, breaking the first of many rules, settled in to talk.
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