Betty MacDonald’s first memoir, The Egg and I, was a total hoot. The book created a small empire of Ma and Pa Kettle movies and several children’s books with similar characters. MacDonald’s second memoir, The Plague and I, takes on a more serious topic — tuberculosis — but is still written with the author’s wry sense of humor. There’s just not as much space for her to be as funny because TB requires constant stillness.
The Plague and I opens in 1931 near Seattle, Washington. MacDonald has left her husband from the first memoir and is living with their two girls. While she’s working, MacDonald struggles with what seems like an incessant cold, and it doesn’t help that she and everyone she knows smokes. But then she learns she has tuberculosis (TB), the dreaded White Plague. TB, much like COVID-19, spreads through the air in droplets when a person coughs or sneezes. According to the Centers for Disease Control, “In 1904, there were 115 sanatoriums with the capacity for 8,000 patients expanding to 839 sanatoriums with the capacity for 136,000 patients in 1953.” My only encounters with TB are the several times I’ve been tested for it before being permitted to work in crowded places (correctional facility, group home, etc.) and being sad when Val Kilmer dies in Tombstone without his boots on.
In 1931, MacDonald didn’t seem to know what TB really was either. She recalls:
I thought that the only real symptoms of tuberculosis were a dry hacking cough and a clean white linen handkerchief delicately touched to pale lips and coming away blood-flecked.
More of a romantic image than the serious one of millions dying of a bacteria in their lungs (and other body parts, apparently??). Leaving behind her children, sister, and mother, MacDonald enters The Pines, a TB sanatorium, for an undefined amount of time.
The Plague and I captures the feeling of the time period, with its overly stern nurses and authoritarian doctors. MacDonald’s feelings of confusion, being refused information about her own body and condition, and the coldness with which nurses treated all patients reminded me of horror films that hope to capture that old-timey hospital feel. You know, the movies in which doctors are quietly perform experimental surgery on patients?
One staff of The Pines explained, after refusing to call Betty “Ms. MacDonald,” her divorced name, “We do not tell the patients the rules, Mrs. Bard. We find that the trial and error method is the best way to learn them.” Because she doesn’t know the rules, MacDonald is on constant fear of being throw out of the sanitarium, a place she gets to stay at because her doctor brother-in-law asked a favor that would let MacDonald skip the wait list, and because The Pines accepts low-income individuals free of charge.
The rules the author is told early on make the memoir more menacing. We readers get the rules blatantly, much like the author did, and wonder the point of them:
Patients must not read. Patients must not write. Patients must not talk. Patients must not laugh. Patients must not sing. Patients must lie still. Patients must not reach. Patients must relax.
This is not a condemnation of the medical world, though. In fact, we later learn that the rules around movement and perhaps even joy stem from the fact that doctor’s believe (rightly? wrongly?) that any over use of the lungs — anything beyond very relaxed breathing — taxed the tissues and thus harmed the patient. For months, MacDonald napped every hour of the day unless she was eating good, nutritious food (a rule!). Thanks to holding back explanations of the rules, writing them later in the timeline when they were explained to her in real life, makes The Plague and I an effectively lonely, somewhat claustrophobic book.
MacDonald shares personal insight into the 1930s and how people responded to TB, educating readers on medical history, from her experience only, in the process. Doctors’ treatments sound absurd to me, but what if they still use such surgeries? I have no clue. For instance, “A successful collapse of the lung, whether it was accomplished by pneumothorax, thoracoplasty, phrenicectomy or stripping, favored rest for the infected part of the lung and facilitated healing of the disease.” Doctors collapse the lung so it cannot be used, MacDonald explains, as if the doctor had put a stint on an arm to prevent movement. I’d love for a blogger like Lou @ Lou Lou Reads, who is a nurse, to pick up The Plague and I and give some insight into what would be considered bonkers –or normal?? — in 2021!
You may be thinking, “Why would I read a memoir about a disease spread by wet air droplets when I’m living in a pandemic?” Honestly, I felt calmer about COVID-19 while I read The Plague and I because the world feels familiar. Masks, carefully disposing of coughed-on tissues, constantly wondering who is contagious, the mass numbers of people in medical care who don’t know what their outcome will be — death or home. Even the care with which a TB patient released must take reminded me of stories of the COVID long-haul folks, whose symptoms persist after infection. MacDonald’s thoughts aren’t too off from my own these days:
[A sanitarium patient] said, “I was workin’ in a candy factory dippin’ chocolates and one day I had a hemorrhage.” I asked her if she had had a cough. She said, “Oh, God, yes, for years and years. I never thought nothing of it.” I thought something of it. I thought of all those chocolates she had dipped and sprayed with germs.
Birthday cake candles before 2020, anyone? Sneezing and coughing directly into our hands? Ugh. Even after MacDonald leaves the facility, her old friends stay back and even shut their doors on her, which reminds me of when I scoot into my apartment to avoid running into my neighbors, in case any of us aren’t wearing masks. Is it weird to see my own life in a TB memoir? Unlikely. We’ve always had epidemics, pandemics, and outbreaks. We’ve just been too comfortable in the between times to admit that viral and bacterial calamity are kinda normal.
A highly recommended book, and you can read The Plague and I without picking up the first memoir. They are not linked content-wise.