Review: The Plague and I by Betty MacDonald

“Getting tuberculosis in the middle of your life is like starting downtown to do a lot of urgent errands and being hit by a bus. When you regain consciousness you remember nothing about the urgent errands. You can’t even remember where you were going. The important things now are the pain in your leg; the soreness in your back; what you will have for dinner; who is in the next bed.”

Betty MacDonald was a single mother of two young daughters in the 1940’s when she was diagnosed with tuberculosis, or TB, and sent away to a sanatorium. In her memoir The Plague and I, Macdonald reflects on the year she spent away from her family and surrounded by fellow residents from all different backgrounds and walks of life, brought together by a shared battle against a frighteningly prevalent, and often deadly, disease.

“We patients at The Pines differed in color, nationality, political beliefs, I.Q., age, religion, background and ambition. According to the standards of normal living, the only things most of us had in common were being alive and speaking English, but as patients in the sanatorium we had everything in common were firmly cemented together…”

TB, for many of us in the western world, is a disease most often relegated to historical novels and old movies. TB has always reminded me of the old Bing Crosby film The Bells of St. Mary’s, which stars Ingrid Bergman as a beautiful nun who contracts tuberculosis and has to move to a warmer, dryer climate to recover. TB is often mentally placed in a box with other old-timey diseases that only appear in old stories, like scarlet fever, diphtheria, cholera and leprosy – diseases that few of us privileged to live in relative comfort in developed countries will ever witness first-hand, but that sadly still ravage communities in many parts of the world, including parts of my own country.

For MacDonald, TB temporarily robbed of her everything she held dear. She was only able to see her young daughters once a month, for only ten minutes at a time. This was meant both to protect her young daughters from contagion and to limit any “excitement” that might tire MacDonald and prevent her recovery, but it was heartbreaking for the entire family. MacDonald was one of the lucky ones – she was able to leave the sanatorium after only a year of treatment. Many of her fellow residents would spend years at a time separated from their loved ones – it wasn’t uncommon for patients to remain at the sanatorium for five years or more as TB ravaged their bodies. Patients’ lives in the sanatorium were strictly controlled and monitored, to an extent that would horrify modern patients – they couldn’t bring personal belongings into the ward, they weren’t supposed to talk or read or get out of their beds without strict permission, they weren’t even permitted to have an extra blanket if they felt cold, as all bed linens were strictly controlled. They were shouted at and told off off strict, disciplinarian nurses and medical staff for any perceived violation of the rules. Every aspect of a patient’s life was carefully monitored, controlled and regulated, and contact with outside world was extremely limited. In many ways, patients came to feel as though they were criminals, stripped of their most basic freedoms, and with little control over any aspect of their lives. Whereas most contemporary hospitals strive to take a more integrated approach to medicine that works to care for a patient mentally and emotionally as well as physically, these patients were left to battle a potentially terminal disease removed from their loved ones in a setting that often felt more like a prison than a hospital.

As MacDonald reveals in her memoir, though, even in the most difficult of situations, one can always find humour and humanity. MacDonald describes the colourful cast of characters she shared her ward with, and the friendships she quickly developed. While the staff at the sanatorium often seemed cold, hard, even ruthless, their outward demeanour often hid kind, caring souls;

“The Medical Director ruled his sanatorium and the patients with a rod of iron, said constantly that people with tuberculosis were ungrateful, stupid uncooperative and unworthy. Then, carefully screening himself from his own kindness the way he screened his patients from their operations, he loaned those same ungrateful, stupid, uncooperative, and unworthy patients money, bought them bathrobes and pajamas, took care of their families and children, listened to their problems, helped them get work, and fretted twenty-four hours a day over their welfare.”

The medical staff at The Pines TB sanatorium were working with limited drugs, knowledge and resources to treat what was at the time a poorly-understood (by the public, at least), highly contagious and difficult to treat disease that was running rampant through urban areas. MacDonald was herself infected by a coworker who had knowingly been contagious for at least 19 years, and had infected an unknown number of people. Doctors and nurses were applying contemporary medical knowledge and widely accepted ideas surrounding recovery and behaviour, and though some staff were perhaps genuinely unkind and cruel (there are always bad apples in any bunch), by and large they were simply trying to do the best they could with what they had and what they knew.

MacDonald approaches her year in the sanatorium with gentleness and heart, and although the text does feel very much a product of its times (it was written in the 1940’s), MacDonald’s wit and humour are still very approachable and highly enjoyable. She’s just as happy to poke fun at herself as at others, and moments of laughter are tempered with moments of wistful sadness and quiet reflection. MacDonald was one of the lucky ones, a fact she never takes lightly, and while her treatment at the sanatorium left much to be desired, it was also the only affordable option available to a single mother of limited income, without which she likely would not have been able to recover.  While TB is treatable with modern medicines, and is no longer as widespread as it once was, it remains a potent and lethal disease in many communities even in Canada, and should not be taken lightly, or quickly forgotten.

The Plague and I is a fascinating slice of life story, a reflection on a specific moment in history that gives us glimpses into a bygone era that’s both so very similar and dissimilar from our own. It’s a story about never losing your sense of humour, no matter the situation, and about trying to make the best out of even the most daunting realities. Charming, witty, sensitive and heartfelt, The Plague and I is definitely worth checking out.