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FIELD WORK AND FIELD CLINICS

By MISS BLANCHE WEBB, FIELD NURSE, VIRGINIA ANTI-TUBERCULOSIS ASSOCIATION

At present we are an organization with a force of five workers, but for the last year we were not so prosperous, and the work has been done by "The Big Chief" and her right hand assistant "Me." In all organizations of two, one finds "Brains and the Worker" and so it is with us. She plans and I carry out her

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ideas.

In the Spring, the fancy of my commanding officer turns seriously to thoughts of "Field Clinics."

The work is done county by county. If we have affiliations in a place the preliminary work is easy. To walk in, to be properly introduced and then to work. If not, when a locality is decided upon, we go there and first ask permission to appear before the Council or Board of Supervisors, state the nature of our work, and ask to be allowed to make certain investigations, saying that no obligation is attached to same, but when we finish, certain reports and resolutions will be made which can be acted upon at the discretion of the governing bodies. I remember once the executive secretary gave a more or less impromptu talk before a group of men, explaining the work, telling something about T. B., the germ prevention, etc. When she finished I heard a man whisper to his neighbor: "That was a corking good story, but of course nobody believes a word of it."

The Chief then calls on a few interested people, properly introduces the Field Nurse and departs, leaving with the nurse the death certificates of the past five years, for that county. The Nurse must then try and get in touch with the families of these people looking for contact cases. She must see all doctors in community, ask for names of their cases, offering her services for instructive care and bedside nursing when necessary. Very

SUKEY SHADES DOWN, NO AIR, NO LIGHT, MANY FLIES

few cases are found through the doctors, as we find among the colored people where most of our cases are, a decided disinclination to see a doctor or go to bed until they are in too bad shape for us to do much with them. The nurse must get as many cases as possible under supervision, giving instructive care, watching suspicious cases, persuading those who should, to take the cure at home, whenever possible, sending a patient to some sanatorium, and giving careful oversight to advanced and hopeless cases to prevent infection of other members of the family.

As soon as possible clinics are arranged and then everybody on the force is happy. We

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THE OVERWORKED DOCTOR AND THE

VICTIM

love clinics. Possibly the overworked doctor isn't as happy as the rest of us, because he usually remarks in a sad tone when urged for an extra day, "Well, I'm in the hands of the Philistines anyway, so do with me as you will."

We reach our people through the churches and schools. On a certain Sunday we arrange

to talk in just as many churches as we can reach, sometimes driving ten or twenty miles between speeches. Once I arranged eight appointments in one day. My superior officer did the work, but it almost killed her.

Sometimes we get lost in the woods, for it is no uncommon thing to find a church way beyond a winding path, in the middle of a primeval forest. But we are philosophic; when this happens my boss settles down on pine needles for a nap. She won't talk much then because she is a wee bit peeved, my business being to get her there, and even if the road is winding and queer, one should know one's business. Once we waited an hour for a funeral service to be over, and got a big crowd. Another time everybody was down at the river at a baptizing so I peeked in. Two sisters were on the front bench; I meekly sat on the back seat to wait for the minister, and introduce my Chief, when I heard a voice say, "White Sister back there, are you a Christian?" I said I thought I was, so she said, "Come on up front." My Chief preaches on health, gives plain stories on how to live, tells of the disease, it's cause and prevention, makes them cry, and then proceeds to tell a funny story. Everybody laughs, the tension is relieved, we hear cries of, "Ain't that so? I tell you dat's de truf, yas-suh." We are friends with our audience, they trust us and believe us. And so when we compare the human body to a machine and say that all machines need looking over once in a while, and then invite the audience to come out on one of the following days for a freechest examination, we know our applicants will be many.

A specialist from one of the state sanatoria comes to help and makes the examinations. On a given day at a given time we arrive at a church or school and stay for three hours, in which time as many people are examined as possible.

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HOUSE THAT JACK BUILT

the doctor says we do, for he has the work to do. We take the histories, and from these learn much. The "Head" is a very persuasive person, and she gets much information. It was at one of these clinics we learned the story of "Pinkie" of "The House that Jack Built" and many others. Pinkie is an old woman of seventy, who came just to see what was going on, "Never had no Con-sumption, no suh, never been exposed to it, no suh, seed somebody with it, yes suh. Come to think about it 'member jus' as well 'ole marster, way back yonder, 'foh the Wah, had a bad cough all the time, used to send me up to fan him, yas suh he did die with Con-sumption, yas suh, yas suh." Pinkie has lost six children and two grand-children with tuberculosis. One living grand-child is a suspicious case and Pinkie is an old chronic case, good, but a little too old to learn much.

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PINKIE'S HOUSE

In August, 1917, a woman and her daughter came to be examined, Betty, the mother, a prospective case, Lessie the daughter, suspicious. Family history shows that twenty years ago Betty's father, John, built a house in which the family lived. His first wife died there with "pneumonia." Her brother died

PATIENTS WAITING FOR EXAMINATION

with T. B. in 1896 in same house. John married again, his second wife died with T. B., also her sister and brother.

John's mother, Jane, married three times, she died with T. B.; three sons also died with same disease, and a daughter Josie. John's sister Mollie has tubercular hip-joint_disease. Her daughter Hopesina died with T. B. Both developed it in same house. John's daughter, Rocky, and a son died with it. His first wife's sister is an old chronic case. Sukey, a child of friends, who spent much time with Betty, developed T. B., and died in 1917. Betty cooked for the family. While there the young son developed trouble. Ten years ago John moved out of the house and Georgianna, her husband and nine children moved in,-all well and strong with no history of tuberculosis. Six of the children died with T. B. in same house. The family then moved away, and two others have died since then, but from other causes.

SOME

Of all the drinks and beverages
In harmless and fermented stages,
Of all concoctions ever brewed,
Or liquids plain or mixed or stewed,
Of all that gurgled down my throat
There is but one that gets my goat;
That takes the cake, that makes me shake,
It's very thought now makes me shiver,
Sends spasms through my bowels and liver.
'Tisn't sweet and isn't sour,

Has never seen sweet grapes or malts,
I gag and curse that fateful hour
When I must drink those "Epsom Salts."

It's well to snigger, be laconic,
I wish I didn't need that tonic.
You well may smile and feel at ease
Who need no salts your bow'ls to tease.
The nurses smile with sympathy,
The patients grin with dev'lish glee,
I shiver, shake and faces make
And hold my breath and think of Sherman,
And wish the salts on every German,
Then take with trembling hands the glass,—
I see some stars that shoot and waltz,-
I gulp-how brave-the ugly mess,
The vile, pestiferous "Epsom Salts."

Georgianna now has "night-sweats," coughs in the morning, much sputum, but refuses to be examined. John, realizing that the house was causing trouble, tore down the plaster, fumigated, painted and re-plastered. Another family has been in the house five years and no new cases have developed.

The cases found through the clinics, are visited by the Field-Nurse. "Lizzie-Ford" is always ready and can go anywhere. She has an intuitive, inquisitive nose that can poke anywhere through the woods, through the mire. "Lizzie" doesn't care, and so we find the people.

When our people need hospital care and there is no money in the family, when they need sleeping-porches and have no money to build them, we find understanding and goodness everywhere. We ask of organizations, we ask of individuals, and we get what we ask for.

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I will not speak of consequences,
Of hurry calls with num'rous chances;
Sufficient is the evil taste

To make me wish for "gas" in haste.
If ever by some clever trick
We'll get the Kaiser and his clique,
I'd advocate to dedicate

A stein for daily consummation,
A schooner tall as prison ration
Filled to the brim with-Oh, I say-
Nix on champagne or Munich malts!
We'll let them toast their rotten "Day"
With luke-warm double "Epsom Salts."
The poor old grouch who's constipated
Is never happy, sometimes hated;
He always some queer pain can feel,
His troubles grow with every meal.
He has no pep and all his dough
To drugs and dope and docs does go.
That is too bad, it makes me mad,
Because there is one good prescription
And quite effective, that's no fiction.
Screw up your courage; way up high
And save your life before it halts,
And from some drug store quickly buy
A good supply of "Epsom Salts."
FRED W. HEYER.

Dear Sid:

DINNER FOR THREE

By R. HAL MACPHERSON

101 Lake Ave., Saranac.

I would like extremely much if you would be so kind as too empart to me in youre next epissle what is the mater with that there wife of yourn. Has she bin strickn all off a sudden with paralis of the right hand? I allways had a very high esteam for Gert but it don't seam like she was wearin' out no fountin pens nor nothin' off her correspondence with yourn truly. Now does it? Sid? She aint in no danger of gettin' the writers cramps on my account judjin' by the no. off times the male man has stopped hear lately. Honest, old man, if all folks was like her, the post office dept. would go broke in before you could shake a lams tale, as the sayin' is. I have been lookin' out for them doenuts what she was goin' to send me for a monthe an' I aint seen or even had a smell off them all the time I been hear. Tell her I aint bin made sick at my stumoch on acct. them nor none of her cookin' for that mater, yet. A fellaw wouldnt mind bein' not wrote to so much, but them promises is maid too be kep. Aint they, Sid?

Well, I am getting to know peopel prety good a round this hear little berg an I must tell you about where I was at last Sunday for diner an it was not no slouch of a diner neither, Sid, but a banged up feed with ice cream an chicken and etc. etc. I aint had as good spread since I been hear an that's sayin' a good eel as the meales hear is usualy O. K. an why wouldnt they be for what I'm payin' hear because 17 dolars is not no pin money to be threw about like it was water, specialy for a man like I, an that's what I'm held up for every weak, Sid. Anyways, last Saterday Joe Barker (he's the guy what I was tellin' you about that's allways springin' them bum jokes) he says, "Are you goin to have anything on for to morrow afternoon, Kelly?"

"I should say I am,” I says, “Do you think I aint decent? Besides this aint no fig-leaf weather."

"I mean have you got any engagement for to-morrow P. M.?" says he, "Because if you ain't, there is a lady what is a friend of mine has asked me to diner to morrow an she said I was to bring a friend a long."

"Well," I says, "I did have a date with Woodrow, him wantin' me to take a run down to Washinton for the weak end, but if this here dame is hard up for some one to eat diner with her, I don't mind takin' youre place. I wasn't never one to disapoint a lady."

"Oh," he says, "I aint askin' you too take my place nor nothin', but to come a long with me. She wants me too."

"She does, does she," I says, "She must be hard up then, an that aint no idle dream."

"Never you mind," he says, "I've knowed her or a long time and her and me is good friends."

"They must be treatin' her for a brain lesion," I says, "What's her name?"

"Mrs. Hall," says Barker. "She's one of the oldest residents of Saranac, and she comes from one of the very best families. Her folks come over in the Mayflower and the Halls has always been one of the most respectable families in New England."

"And yet she's a friend off yourn," I says, "Well, I won't call you a liar cause they say truth is stranger than fiction, and they aint far wrong in this here case.'

"She's a great old bird on this here literary stuff," says he, "Always readin' them classy novels wrote by Thackery, Hugenot, Boneporte and all them old timers and she can recite poetry by the yard. Every time I go to call on her she gets off some of this here stuff like Longfellow's "Evangelist" and "Highwater" and all such like."

"She must be a corker," I says, "but if she hands us out a decent line of eats, she can recite the whole outfit for all I care. I can stand most anything on a full stumoch." "Did you ever do any recitin'?" he says. "If you could speak a pome for her you'd make a hit right a way."

"Well," I says, "I aint no Henry Irving nor nothin', but I have wrote one or two little pomes off and on. You aint got no idea that she'll ask me to recite, have you?"

"Well," he says, "It aint likely she'll ask you to do nothin' like that, but if you could write a few verses of youre own and would be willin' to do a little recitin' stunt when she begins talkin' literary, you'd get in good right away."

"I guess I could dope out something' pretty good," I says, "I aint so bad at writin' poetry and I have wrote a lot at different times though none of it aint never been published in no magazine. Them editors is hard to suit though."

You know Sid, I ain't given to boastin' but I have wrote lots of stuff that I haven't seen no better stuff than it in lots of the magazines. Do you remember that there pome what I wrote about you and Gert when you was gettin' married? I guess that was prety good, eh Sid? and I have wrote lots of more pomes that you aint never seen. So I figgered out that I could maybe write somethin' pretty good and put it over at this here diner party and I would get in strong with the old lady right away, her bein' of a literary turn of mind herself. And maybe she might help me to get somethin' printed if I made a hit and she seen I had got some good stuff. So I maid up my mind to do somethin' real good, and that night I set up til 1 P. M. dopin' out some verses to spring the next day.

Well Sid, Sunday A. M., I gets all toged out in my good close, and me an Barker starts

out about twelve thirty for this here Mrs. Hall's house like she said we was to come early, diner bein' at 1 oclock. We was early all right, and the made what let us in the front door showed us into the parlor and said we was to set down and she would tell Mrs. H. that we had arrove. We was about a quarter of a hour early, Sid, as it turned out and I guess the old dame was still punishin' the paint pot and wrasslin' with her spangled duds when we blew in. Anyway we had about twenty minutes of settin' in that there parlor and gettin' a line on the swell trappin's and the fancy paintin's. Oh them paintin's, Sid! I wisht you could of seen them. Honest, old man, it makes me blush just thinkin' off them. They was one what was a picture of a swell lookin' dame runnin' like the divel down a country road in broad day lighte, Sid, and all the cloths she had on, wouldn't of give you enough cloth to make a babies undershirt. Honest, old man, if gauze was sellin' for a hundred dolars a yard, that dame wouldn't of had to pay a cent for her whole outfit.

"Aint that some picture?" says Barker, lookin' like he had just lit his pipe with a hundred dolar bill by mistake.

"Yes," I says, "But what is she doin' out in a place like that without no cloth nor northin' on ?"

"Beats me," he says "Maybe its a new way of takin' the fresh air cure. It wouldn't do in winter though, not in Saranac."

"No," I says, "Nor not in summer, neither. I bet she aint no friend of Willie Jennings Bryan."

Well, Sid, we was sittin' there tryin' to figger out why she had took her duds off, and what was the idea, now that she had got them off, when in come Mrs. Hall beamin' and smilin' like we was ambasadors from the King hisself. Barker done the introductions between me and the missus and she starts tryin' to make me feel at home right away.

"It was so good of you to come, Mr. Kelly," she says "I have heard such a lot about you from Mr. Barker, that I almost feel as if I had known you for a long time. I hear you are quite a literary person."

"Oh," I says, "I only come to oblige Barker and anyways, you don't never see me turnin' down a free meal."

"Well," she says, "I think dinner is ready, so if you don't mind I think we might as well go right in."

"Lead on MacDuff," I says, "The quicker, the sooner."

"Ah," she says, "I see you are familiar with Shakespeare. Do you read very much Mr. Kelly?"

"Well," I says, "I aint no book worm, but I don't get nothin' much else to do up here. I take Snappy Stories regular."

So we goes in to dinner, Sid, and believe me, I didn't loose much time gettin' out side off some of them articles of diet. And the old lady didn't just seam to take to yourn truly, Sid, for she kep talkin' to Barker and lettin' me prety well alone. Maybe she seen I

was to enrapped up in the process of feedin' and thought she'd leave me have a clear field, but it aint long before she begins to think as maybe she'd ought to include me in the conversation if only as a safeguard to my digestion.

"I am afraid that chicken is a trifle tough," she says to me, "It is so hard to get anything satisfactory from the market these days unless one is right on the spot to pick for one's self."

"Youre lettin' the butcher off easy," I says, "This aint no chicken, this here's a rooster an I bet he's got severial grandsons of military age. You should ought to of made the butcher run him up and down the street a few times before he kiled him."

"Oh," she says, "I'm sorry it is so tough. I must have given you the neck. It isn't very tender, is it."

"Wringin' them usually makes them tender," I says, "but this here bird must of had a goiter."

And it wasn't no cinch, Sid, tryin' to slash that there old boy's neck up. However, I tells the old dame not to apologise. It aint for me to tell nobody how to buy there vittals, and I wouldn't of said nothin' only she seemed like she wouldn't get sore at bein' gave a hint where she had fell down. And at that, old man, the ice creme was all to the good and as I says to Mrs. H. it more than made up for where she had fell down with the chicken.

Well, after we had done eatin' we went into the parlor again and set an talked-that is, Barker an the old girl done most of the talkin' -about literature an art and all them things. Then old Barker puts his foot in it as usual.

"Mr. Kelly was admirin' that paintin'," he says pointin' to the dame with the undress costume on.

"Ah, is it not beautiful?" she says to me, "That is a true work of art."

"Yes," I says, "she looks artful, all right. Maybe she was in swimmin' and some one stole her cloths. She does look kinda chilly, don't she."

The old girl smiles kind of frosty like.

"I am afraid you do not appreciate the true touch of artistic genius," says she, "You do not grasp the beautiful interpretation of such a wonderful work of art."

"No," I says, "I'm a sick man and T. B. and that there kind of art don't mix good. Besides, I'm a married man. Clara wouldn't never stand for nothin' like that around the flat."

She changed the subject then, Sid. I guess she seen I wasn't that kind of a fella, at all. She starts talkin' about literature again an all off a sudden Barker up and says:

"Mr. Kelly is quite a poet, Mrs. Hall. He has a poem of his own that he thought you might like to hear."

"Oh" she says, "Do let us hear it, Mr. Kelly. I am sure it must be something delightfully original."

"Well," I says, "It ain't exactly original. It's about the war. There is so much of this

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