PLAGUE SEASON: A MEMOIR | Eileen Valinoti
During my senior year, I had to spend three months at Brooklyn's Kingston Avenue Hospital for Infectious Diseases, as required by our nursing curriculum. Such institutions have long faded into history, thanks to the blessings of vaccines. But in the 1950s contagious diseases still took a heavy toll- the most feared was polio. 1952 had been the worst year on record with 57,000 cases of polio nationwide. Headlines screamed, "Plague Season!" 20,000 victims suffered permanent paralysis and 3000 died.
In those pre-vaccine days, the polio virus circulated freely. The virus had a cruel predilection for the young; its victims were mostly blooming teenagers, sweet faced toddlers. Most terrifying for parents was the crippling paralysis that was often characteristic of the disease. In his semi-autobiographical novel Nemesis, Philip Roth describes the fears that gripped a Newark neighborhood one summer as the polio virus decimated a local baseball team: "Many children in our neighborhood found themselves prohibited by their parents from using the big public pool...forbidden to go to the local air cooled movie theatres, forbidden to take the bus downtown...warned not to use public toilets or public drinking fountains...or borrow books from the library or talk on a public phone..." But without an effective vaccine, there was little anyone could do to protect loved ones.
I had never seen a patient with polio; our small community hospital had neither the expertise nor the necessary equipment. But like everyone else, I was constantly aware of the disease. Posters were everywhere, typically of a child on crutches, the caption below reading "Give to the March of Dimes." Almost everyone knew someone personally who had contracted polio. My best friend from high school had a brother whose right arm was paralyzed from polio. He had been an avid baseball player and now had to sit out the season. The atmosphere at home was heavy with anguish as the family tried to console Bobby, who struggled to adjust to his disability.
That fall, one of our classmates was in the fourth week of her assignment at Kingston Avenue. In a letter to a classmate, she wrote that the "bitchy supervisors" there made life miserable. Someone in a moment of madness posted the letter on our bulletin board in the nurses' residence. Our director, Sister Virginia, who regularly toured the halls, tore it down at once, furious that the writer was out of her reach, safe and sound in her room at Kingston Avenue, a long subway ride away from Mercy Hospital in Greenpoint.
My mother asked me if I was afraid of "catching" polio. The thought had never entered my mind. I was really frightened of the supervisors I would encounter at Kingston Avenue, so eloquently described in my classmate's letter. In those days, student nurses were held to strict standards. Our school was run by an order of Catholic nuns. We lived like secular nuns ourselves, rule bound, dressed from head to toe in spotless white, semi cloistered in our nurses' residence where men were forbidden past the lobby and curfews were strictly enforced. On duty in the hospital, we were severely reprimanded for even minor lapses. An imperfectly made bed or a mislaid pair of scissors called forth stinging rebukes from supervisors like "sloppy" and "careless" or even "disgraceful." Such comments wounded me to the heart and I often fought back tears. Most of my classmates were more resilient. "Old Iron Puss is on the warpath today," they would joke when chastised. I tried to forget about the "bitchy supervisors" lying in wait at Kingston Avenue. After all, I would be going with my best friend Cathy, who often had me to dinner with her family at her home in Bay Ridge. So I started packing my small suitcase and tried to put a face on things.
On a bitterly cold day in December, Cathy and I set off. Kingston Avenue Hospital stood alone in a bleak landscape, surrounded by empty lots. Directed to our rooms in the nurses' residence, we unpacked, then hurried to the student lounge where we could smoke, the one vice we were permitted. At nineteen, Cathy and I were dedicated smokers like our parents before us. Everyone smoked- in the hospitals doctors on their rounds lit up, never mind the O2 tanks; so did patients who sometimes nodded off, scattering ashes on the bedclothes. Looking back, I wonder that we all didn't go up in flames.
The next day we started classes. Soon, we were told, we would start work in the hospital. Lessons began with mastering the proper handwashing and mask and gown technique. Out teacher was a grim-faced Miss Dolan who lectured us on the dangers of contagion. Washing one's hands properly was crucial, she said. How complicated could it be, I thought? Everyone washes their hands. But I soon learned there were many steps to follow- precisely and in the correct sequence! Miss Dolan took a piece of chalk and wrote on the blackboard:
"Steps in Handwashing:
1. Run water until it is hot.
2. Wet hands.
3. Apply soap.
4. Rub hands vigorously until a thick lather is obtained,
then clean them thoroughly, fingers,
wrists, palms, nails.
5. Dry hands with paper towels.
6. Cover hand with paper towel to turn off faucet."
Miss Dolan faced the class: "This last step is very important- you must use the paper towel to cover your hand when turning off the faucet. I've seen girls forget and as a result, contaminate their hands." She said "contaminate" in a horrified tone. We all scribbled furiously in our notebooks. To demonstrate, Miss Dolan then washed her hands energetically at the small classroom sink. After drying them on the rough paper towel, she held them up for our inspection. We stared solemnly at her red chapped knuckles, her pale blunt fingernails cut to the quick, her bony wrists.
Next Miss Dolan wrote on the board all the steps for the proper gown and mask technique. Donning the protective garb was easy, but taking them off correctly was tricky, requiring concentration, as I saw when she demonstrated:
1. To remove the mask, grab the ties in back.
2. To take off the gown, grab the ties in back, making sure to keep the gown inside out as you remove it.
3. Roll the gown in a bundle and discard it.
4. Finally, wash your hands.
"Practice all this in your rooms until it's second nature, girls," Miss Dolan said, handing out gowns and masks. "I will be making rounds in the hospital to check on your technique." I wondered how I would perform under the watchful eye of Miss Dolan. I was by nature clumsy, fumbling at the simplest tasks, especially when I was being observed.
After working in the hospital a few weeks, my hands became red and raw. Sometimes specks of blood dotted my knuckles. I perspired freely in the heavy gown and mask- sweat would pour down my face and into my eyes- the hospital was always overheated because of lightly clad patients. Most of our charges were young, a few our own age. Some were critically ill with Bulbar polio, a dangerous, sometimes fatal form of the disease that affected the cranial nerves responsible for swallowing and breathing and speech. Such patients lay entombed in iron lungs, large aluminum tanks on wheels, their bodies inside the tanks and their heads outside sealed at the neck. A bellows mechanism sucked air from the tank and inflated the patients' lungs. There were small openings like portholes for nurses to reach in and give care. A mirror was placed above the individual's head. The patients, many paralyzed, were completely helpless, needing to be fed, bathed, sometimes given oxygen and suctioned when swallowing was impaired.
In our classes, we had been given brief lectures on the care of the patient in the iron lung. But nothing prepared me for the flood of emotion I felt at the sight of beautiful young people, all their vitality and power stilled, their eyes haunted by pain and fear. There was so much distress here. Everyone was so needy. I felt gravely inadequate. I envied the graduate nurses, so skilled, so calm and competent, their tired smiles never fading. It was as if they had worked on the polio unit since the dawn of time.
I was captivated by a Miss Dooley. She was older than the other nurses, her steel gray hair was pinned tightly under her cap, which was always askew. She was never still, always in motion. She even had lunch standing up- a hurried sandwich in the treatment room if she ate at all. She kept up a continual stream of talk with her patients, a soothing comforting chatter like a nanny in a nursery. She referred to all of them as "darling;" she would have embraced them if she could. She was entirely dedicated, volunteering to stay on duty when staffing was short or even give up her day off. It was impossible to imagine her having a life of her own. She was consumed by the catastrophe as if she were on a one-woman rescue mission, unable to leave the scene of the disaster.
I was busied every moment. I had never seen patients so sick. To care for the patients in the iron lung, I had to reach in through the small openings or portholes which then reduced the effectiveness of the respirator. The rubber cuffs around the portholes through which we stuck our arms never provided a tight enough seal. I had to work as fast as possible. The openings were necessary to bathe and change the patients who were at grave risk for developing bedsores. Still, the portholes could be deadly. A young patient told me that one day someone forgot to close one of them. Unable to breathe, he couldn't call out. As he gasped for air, the iron lung became a torture chamber until a nurse happened by and rescued him. His story terrified me. I would check the portholes obsessively. When one day, Miss Dolan came by to observe my work, clipboard in hand, I hardly noticed her. "Bitchy supervisors" had lost their power over me.
In the afternoons, a few volunteers came; mostly housewives, some of them mothers of patients. We were always glad to see them. They brought a feeling of normalcy to the ward, lifting the atmosphere of pain and grief and sweetening the air with the scents of their lily of the valley and rosewater cologne. Dressed in cheerful colors, their hair carefully coifed, they might have been going to an afternoon bridge party. They ran errands, wrote letters for patients, read stories to the children. Sometimes they just chatted with patients, trying to ease the loneliness. Often when their charges fell asleep, the ladies remained in their hard backed chairs and took out their knitting or crocheting. Seeing these gentle women bent over their work and hearing the rhythmic click of the needles gave the bleak hospital room a feeling of intimacy, a sense of homey habits, a hope that home was still there, waiting.
As Christmas approached, Cathy and I were told we would spend the holidays on duty. On Christmas Eve, we reported for the 4 to 12 shifts to a unit where several teenage boys lay entombed in iron lungs. I was assigned to care for Ronnie, a handsome fifteen-year-old. In the cubicle, next to his was seventeen-year-old Bobby. I watched while two student nurses going off duty rushed in to wish Bobby a happy Christmas, planting kisses on his pale cheeks. I fought back tears. Crying on duty was strictly forbidden. I took deep breaths as we had been taught to do when overcome.
Ronnie's mother was by his side, still dressed in her nurses' aide uniform after her long day at work. When Ronnie became ill, she had gotten a job at the hospital so she could see her only child every day. On a small table, a radio was playing Christmas music. Voices soared in the triumphant "Hallelujah" chorus; Nat King Cole sang "I'll Be Home For Christmas."
Unable to hold her son, Ronnie's mother bent down from time to time to kiss his forehead. Tears poured down her face. The doctors had told us Ronnie would never be able to breathe on his own- he would have to live out his life in the iron lung. His mother must know this, I thought. It was unbearable. I felt helpless, stricken, overwhelmed by the power of her grief, unable to take her hand or offer words of comfort, if such words existed.
A young nurse, Miss Hudson, was in charge of the polio ward that evening. When Cathy and I got off duty at midnight she invited us and several of the aides to her apartment for a "cup of Christmas cheer." Neither of us felt in a celebratory mood but it seemed rude to refuse, so we followed Miss Hudson into the elevator to the top floor where many of the staff lived. At Kingston Avenue, nurses were required to live in; in effect, they were on 24-hour call. In Miss Hudson's tiny living room, we sat close together around a small lace covered table on which stood a crystal bowl of punch surrounded by small cups. We sipped politely as Miss Hudson poured a thick syrupy concoction that tasted like over sweetened orange juice. Conversation lagged despite Miss Hudson's encouraging smiles. How kind she was, I thought, trying so hard to bring us a glimmer of joy. Cathy and I were still in our stiff white caps and uniforms, struggling to keep awake, exhausted by the night's sorrows. After a decent interval, we said our thank you’s and good nights.
A week later, we were told that the Director of Nursing wanted to see us. What had we done, we asked each other anxiously? There were so many rules here you could easily break one and not know it. After we came off duty, we went to the Director's office, both of us giggling nervously.
Miss Stone, the Director, was sitting behind her large desk, scanning the pages of an official looking blue volume. She had white hair, a long pale face and a stern expression. She kept adjusting her glasses which were slipping down the slope of her sharp angular nose. She motioned us to two chairs as she closed the book and, taking off her glasses, said, "I'll get right to the point. Were you the students at Miss Hudson's entertainment in her apartment on Christmas Eve?"
Entertainment! I thought of the awkward gathering around the punch bowl. "Well, yes," I answered baffled. Cathy seemed tongue tied. The Director leaned back in her chair. "I understand that spirits were served," she said. "Did you know, girls, that state law prohibits the consumption of alcohol on government property?" She patted the thick blue book. "Once again I double checked the constitution and the by-laws." She cleared her throat and glared at us.
Alcohol! What alcohol? Cathy and I couldn't meet each other’s eyes. We both grew up in hard drinking Irish families. I could recognize the smell of whiskey from babyhood when my mother rubbed it into my gums as a teething remedy. No such whiff had emanated from Miss Hudson's punch; if she had poured a forbidden thimbleful into her concoction, it had been annihilated by the masses of cherries, lemon rinds, orange peels, pineapple slices, and the pounds of confectioners' sugar. How my relatives would have scorned Miss Hudson's punch, the men who demanded their whiskey neat, the women murmuring "go easy on the ice."
When further questioning by Miss Stone revealed that no one had gotten "tipsy," we were dismissed. Outside her office, Cathy and I dissolved into fits of laughter, holding on to our stomachs to contain ourselves, wiping our eyes when the tears came. Fellow students passing us in the hall stared. One stopped and asked, "What's the joke?" When we finally composed ourselves, I told Cathy I might write a letter to our classmates this very day, but Cathy said, "Who would believe us?"
Soon after we left Kingston Avenue and returned to our home school, we heard that Ronnie had died. Cathy, my dear friend, died suddenly herself only a year later of a cerebral aneurysm. As for me, for years I hated the trappings of the Christmas season-especially the music. Hearing the carols and the popular songs, I would rush to turn off the radio or TV- so vivid was the scene that still haunted me of Ronnie and his mother. I thought I would carry the weight of their suffering forever.
But then one day in Spring came the announcement that would be celebrated all over the world- the news of the discovery by Dr. Jonas Salk of the polio vaccine. Church bells tolled as crowds gathered for prayers of thanksgiving. In department stores, schools, hospitals, and offices, people wept openly. The long nightmare was over. I breathed a silent prayer for Ronnie and his mother- for whom the miracle had come too late.
Eileen Valinoti is a freelance writer whose work has appeared in literary magazines such as Confrontation, in the popular magazines Parents and Glamour and in the New York Times.