T By L. AGNES MERCURE, Wright, N. Y. HE letter in the December JOURNAL OF THE OUTDOOR LIFE* was exceedingly interesting to me inasmuch as it gave an entirely new viewpoint in the matter of curing. I thought I had viewed it from every possible angle. Some fourteen years ago I first took the cure. After six months, having been pronounced an arrested case by the physician who attended me, I accepted a position on the staff of a private sanatorium of which he was one of the directors. Much of my work since leaving training school had been for this same doctor, but this was my first experience in T. B. work, and after my own personal experience it appealed to me very strongly; so much so that I did this work almost exclusively, both private and institutional nursing, until my second attack two years ago. Since then I have been taking the cure and am still "on the job." Perhaps the reason I have never gotten just this viewpoint before, is because in all my experience I have never had a patient who could afford to take the cure as this one curing in Switzerland evidently can. To the most of us it means not only the giving up of all one's plans for the future, work, salary, etc., but in many cases it means the sacrificing of one's family as well. I have seen business men who have been able to provide a pleasant home for their families, a little vacation trip now and then, and who, while not rich, still could afford all the comforts of life as well as a few luxuries. After several years of "chasing the cure" and all its attending expenses, the business has to be sold, perhaps, the son in college has to leave and find a position, or the daughter in high school has to go into an office. I have in mind a man who cured eight years under such conditions, and he had a most wonderful philosophy which kept him courageous under the most adverse circumstances. To me this is true heroism and points the truth of the saying, "The man worth while is the one who can smile when everything goes dead wrong." He knew he could never be well and yet he never "railed" at his fate as some of us do. He once said, "I hope it can never be said of me that I complained or 'kicked' against my fate. What am I that I should complain? There are thousands of others bearing the same affliction and it is no worse for me than for them." To quote from the patient in Switzerland: "You will learn the lesson of how to turn misfortunes into blessings, and you will find that we need misfortune from time to time to wake us up to fuller consciousness to make us forget the trifling worries of the day in which we are always wrapped up, and to remind us of things that really count." It is true we may forget the trifling worries, but, oh, how much larger worries we become See page 339, December, 1921. burdened with! And as rest of mind is quite as essential as rest of body in taking the cure, that is why so many, many cases fail to improve under sanatorium treatment. To see one's funds fast disappearing, to know that one's family is sacrificing everything possible, and that the fight is not a short one by any means, but must be prolonged over one, two or possibly several years-how can one keep from worrying? Curing has been made easier for the working classes since State aid has been established, but even though a man's expenses are paid at a sanatorium, the fact that his family is left unprovided for, and the wife and mother has to become the bread-winner, leaves plenty of room for worry. Or when a mother has to leave a family of children, one of them, as often happens, a baby of only a few months, can you imagine that mother not worrying? Every one nas not the optimistic view of a young Italian who was a patient in the sanatorium where I was curing two years ago. Some of us were discussing a man who was seemingly not making much progress, and when someone remarked that he worried too much about his family, Joe said: "With the State paying his expenses here and the town taking care of his family, 'he should worry.' It has always been said of tubercular patients that they are always optimistic, always hopeful of their complete recovery. This is not true of all cases by any means. Oftentimes it is not optimism but pure "bluff." One has to think of others, and carrying a cheerful aspect for the sake of one's family is often the greatest motive. If the patient is at a sanatorium he strives for the cheerful attitude to help the "other fellow" along. All honor to the men or women who can face the world with a smile when they know full well they are fighting a losing game, and the most of them do it. Once in a while you find a patient who seems to blame the world and everybody in it because he has T.B. Needless to say he is not a popular person. The other patients usually treat him with goodnatured tolerance, but among themselves he is just "the grouch." To a person of unlimited means curing may be the wonderful experience that it seems to have been to the patient in Switzerland. I can imagine that under such conditions one might "be perfectly happy not only in spite of but even on account of misfortune," but to the most of us the experience is far from wonderful. However, one does learn a great many lessons in the process of curing. It certainly teaches patience, submission, self-sacrifice and brotherly love. I do not know of any place on earth where the latter is more fully exemplified than in a sanatorium. I think that is the one thing that stands out most forcibly in my long experience in T. B. nursing, the feeling of good fellowship that exists between all classes and conditions of patients in a sanatorium. It is sometimes marvelous. The man of education porching with the Italian fruit vender; professional men, doctors, lawyers and business men living in close proximity and daily companionship with the day laborers, all goes to show how little class distinction amounts to after all, and how readily it is forgotten in the common cause of curing. The same spirit prevails in this war as did in the World War when the millionaire's son and the workingman stood shoulder to shoulder, and formed a lasting friendship; with all thought of birth or class distinction brushed aside, the fact that "a man's a man for a' that" stood out clearly and definitely above all else. The soldiers in this war may not win distinction by brave deeds, or give their lives so heroically as our boys did fighting under the Stars and Stripes of Old Glory. Ours is an unglorious war, our flag a field of white with the double-barred cross of red; but it calls for much faith and some heroism to win the battle. A Sleeping Porch for Three Years at a Cost of $25.00 A By IDA L. REED, Moatsville, W. Va. FEW years ago I was fighting a lifeand-death fight-had been ill for years and it seemed as if I was reaching the end of the battle a loser. Added to a complication of other troubles was a growing lung trouble, and I had not means to fight this, or any other illness, efficiently. Neither did I find anywhere any encouragement to hope for a cure or any worthwhile measure of alleviation. For lack of money I could not have any of the helps, comforts, or luxuries other invalids have. I lived alone and had to fight the best I could for myself under the most disheartening conditions, and, as may be imagined, it was a hard and losing fight at best. I was renting at the time a cheap, plain little cottage with a little dark lean-to kitchen at back, and a little narrow, plain porch running all the way along front of house. This porch was not railed in, there was only the floor and cheap plain upright posts to support the roof. Each of the two rooms had a door opening upon this porch and a door opened between them. There was only room between the house and the street for a path and a flower-bed along the fence, and the windows were so near the ground that I was afraid to raise them at night, so I suffered for lack of needed fresh air. In summer I trained vines around the porch until they formed a thick screen with only a small opening at the end, away from the street, where I went in and out. I moved a cot out there where I rested a part of the day, but when the vines died in the fall I had to stay in. I found this hard, for, as I have said, I had no way of securing fresh air and the gas was so smothering, no matter how I burned it, high or low, that it was a constant source of suffering. I was unable to build the smallest of sleeping-porches, even if I had owned the cottage I lived in. But as "necessity is the mother of invention," my very need helped me think out a way to obtain a substitute for the sleepingporch I could not afford. I secured permission from my landlady to make of the front porch an outdoor sleepingroom according to my plan which I explained to her. I hired a carpenter to make a skeleton frame-work running about two-thirds of the length of the porch. This consisted of three rows of smoothly-dressed strips of lumber, fastened securely to the end and side of the house, and supported by the plain posts of the porch. This, when enclosed, gave me one door and window opening upon it, and left me one door and window opening upon that part of the porch which was not enclosed. It was so constructed that the finished porch would have at each end a wide open space where the wind could sweep across above me when I should sleep there. At each end of the long side also was a wide open space, like very wide-open windows, and here the wind would blow in without touching the bed. A strip of oilcloth covered the strip next to the porch and made it water-tight, and air-tight as well, preventing, when finished, any drafts from below and making it impossible for rain to beat in on the floor. I then measured the porch and ordered for the walls a piece of heavy water-proof awning which then was very reasonable in price. The framework was all ready for it, even to the framed spaces for the windows. Cutting, fitting and sewing cost but $3, since it was only long straight seams generally. The carpenter who made the framework stretched it into place and tacked it on the outside, and I myself lined and finished it inside. Only about two-thirds of the side length had a solid canvas wall from floor to ceiling, and against this my bed was to stand. I had double curtains of the awning made to close openings in the worst weather, but found they were not helpful as the wind threshed them in and out so badly that the drafts were worse with them than without. So I abandoned them and placed instead a heavy covering over the head of my bed, tucking it well under the mattress, and found this answered the purpose much better and left me free from drafts. My bed was one of the small white enameled iron ones such as are used in many hospital wards, and I kept it always standing against the canvas wall on the outer edge of the porch. That was the only place free from drafts. I kept plenty of bed-clothes and wore a warm hood, so I slept comfortably there during the coldest winter weather, even when it was so cold my breath made the top cover icy when it froze in the below-zero weather. It was only a cheap substitute for a sleepingporch, so cheap perhaps that many might scorn the thought of it, but I think I am alive to-day because I had it, even though I am not yet well. It meant a great deal to me in the way of comfort, and I like to think of it still since I no longer live there. All told, it cost me scarcely over $25.00, or $8.50 per year for three years, for it lasted that long before the sun, wind and rain whipped it into such condition that it was not safe or comfortable to use longer. Might not many who suffer for lack of the fresh air, that only outdoor sleeping-rooms provide in sufficient measure, avail themselves of these inexpensive substitutes for sleepingporches? Apologies to the "Old Oaken Bucket" By FRED L. REED, Saranac Lake, N. Y. EDITORIAL STAFF-JAMES ALEXANDER MILLER, M.D., Editor-in-Chief; H. R. M. LANDIS, M.D.; LAWRASON BROWN, M.D.; FRED H. HEISE, M.D.; CHARLES L. MINOR, M.D.; ALLEN K. KRAUSE, M.D.; PHILIP KING BROWN, M.D.; A. W. JONES, JR., HOMER FOLKS, GEORGE THOMAS PALMER, M.D.; JOHN TOMBS. CHARLES J. HATFIELD, M.D.; PHILIP P. JACOBS, Ph.D., Managing Editor. The aim of this Journal is to be helpful to persons seeking health by an outdoor life, and particularly to disseminate reliable information looking to the prevention and cure of tuberculosis. It should be distinctly understood, however, that the JOURNAL OF THE OUTDOOR LIFE is not intended to supplant personal medical advice. Anyone suffering from pulmonary trouble who is not under the care and guidance of a physician is taking grave chances. A Mr. Social Worker Professional FEW years ago Dr. Abraham Flexner startled the social workers of the country by announcing that he did not consider social work a profession. There has been a good deal of criticism and comment on Dr. Flexner's pronouncement since that time. The consensus of opinion among social workers at the present time is clearly opposed to the views of Dr. Flexner. This is evidenced in the rapidly-developing movement organized under the American Association of Social Workers. From every source and from almost every group of social workers have come commendation of the association's stand for social work as a profession and for social workers as professional men and women. One may find room for argument in an analysis of the content of the daily routine of a social worker, or in a study of his academic and professional requirements. Be that as it may, no one can deny that every year those move ments for the betterment of human relations that are commonly known as social work are developing, increasing and improving the content of their programs. At the same time they are developing a more perfect technique. A profession demands that the worker have a definite content of program which can be passed on by means of teaching to others, and that he have a methodology which is fairly stable so that it can be imparted to those who wish to learn it. Social workers are qualifying in both of these capacities. Leading the movement is the American Association of Social Workers.* The greatest need of the Association at the present time is the support of every man and woman who believes that he or she is doing a professional job and that recognition as a professional person is desirable. For further information address the American Association of Social Workers, 130 East 22nd Street, New York City. T is a serious matter to any municipality or state when political considerations are preferred to the public welfare. In such administrative departments as those dealing with public buildings or roads, the loss of money entailed by such political tactics is bound to be of great consequence. Such loses, however, can be repaired, and the damage done is purely a monetary one. In those departments that deal with life and health the loss cannot be repaired. Dead people cannot be brought back to life. Crippled, maimed, healthless bodies cannot be restored by political chicanery. It is a sad spectacle, therefore, when a great commonwealth like the state of Ohio finds itself in a position where political preferment and political consideration are apparently placed ahead of the health of its citizens. A recent bulletin of the Ohio Public Health Association commenting upon a year's health administration under the so-called reorganization law, sometimes called the "ripper bill," as advocated by Governor Davis, says: "For years, under Republican or Democratic administrations, appointments to the staff of the State Department of Health were made upon a basis which required the individual to have physical, mental and technical qualifications which approxim..ted the duties of the position to be filled. In other words, it has long been recognized in Ohio that the business of safeguarding the health of the men, women and children of the state was highly technical in character and could only be successfully conducted on a basis of continuity of policy and that such policy was above any considerations of successful party politics. Appointments made to the staff of the State Department of Health since July 1st have not met the previous standards of physical, mental and technical qualifications. "Never in the history of the State Department of Health have decisions affecting local communities been subject to attack through the political channels of the state government. Now, when a decision is rendered by the State Department of Health which may not meet the approval of the local authorities the local political machinery is set in motion to secure a complete reversal of the decision, and pressure is brought through the county committee to the state committee, then to the Governor as head of the political party, and as chief of the administration, and finally to the Director of Health. What individual can stand against such a system? And if he did how long would he continue as Director of Health and a member of the Governor's cabinet?" Such policies and practices are bound to reflect themselves in mortality and morbidity rates. Inefficient, unqualified health officers whose first reaction to any proposition is whether it will please the political bosses and not whether it will work for the public good, will not succeed in the long run in producing a healthful citizenry. Fortuitous circumstances or the activities of the non-official health agencies may for a time seem to bring favorable results, which the health officer may credit to his own activity. It is only a question of time, and that a relatively short time too, when the nonofficial health agency must arrive at a point where it cannot further cut down the death rate from disease, unless there is solidly back of it a well-qualified, technically efficient, fearless and politically unhampered health officer and health administration. The health of the people, in other words, cannot, without fatal results, be tampered with by political health officers. |