1918: A killer worse than a war x

Figure 1 -- People infected with the Spanish Flu

In 1918 two wars were raging.  One was was reported on daily in the newspapers, and most families new at least one person sent off to battle.  The other was a surreptitious pest that didn't stop on the battlefield, traveling around the world, infesting anyone in the vicinity of its victim.

The surreptitious war was waged by a killer that was not seen by the naked eye. Scientists new about virus's, yet they had never seen one as the electron microscope hadn't been invented yet.  They had yet to learn about DNA and RNA, "the genetic material of viruses."  They didn't know the lungs were the ideal burrowing ground for the influenza virus due to an enzyme there that, once connected to a cell, allows the virus to "split one of its proteins during teh manufacturing of new virus particles."  (1, page 27-28)

Figure 2 -- Chart showing mortality from 1918 influenza
pandemic in the U.S. and Europe (published 2006)

So there were some wacky theories postulated as to what caused the Spanish flu.  One theory was that a so called Pfeiffer's bacillus caused it.  At Chelsea Naval Hospital north of Boston the Pfeiffer's bacillus was present in the throats of 80 percent Spanish Flu victims autopsies.  It was the accepted theory, even though other victims didn't have the bacillus.  (4, page 271)

The Pfeiffer bacillus was first discovered by the man who named it, Richard Friedrich Johannes Pfeiffer, in 1892.  It was a small rod-shaped bacteria that he found in the upper respiratory tract of patients infected with influenza.  With the germ theory being well known by this time, many didn't doubt the claims of Pfieffer. (Wikepedia, will find a reliable reference later)

Figure 8 -- Burying flu victims, North River, Labrador (1918)

We now know Pfieferr's bacillus as Haemophilus Influenzae.   Later studies confirmed it's a bacteria that it normally lives in humans without causing disease, although in the right circumstances is known to cause a variety of diseases, such as eppiglotitis.  (Wikepedia)

While the cause was being debated, the Spanish Flu continued to make it's way around the world, aided by the ignorance of the populace.  It was transferred from one person to another when it was exhaled, coughed or sneezed into the surrounding air, and inhaled by another person.  This surreptitious killer was a new and powerful strain of influenza.

Influenza was the last thing on anyone's mind, mainly because it was considered minor ailment, and it had been more than twenty years since the last pandemic.  The flu was considered a "minor inconvenience" compared with the smallpox or yellow fever.  It was so minor that the government didn't require new victims to be reported, and so there was no way of knowing a new pandemic was raging, until the bodies started to stack up. (3, page 5)

Figure 3 -- Men in an Alberta field wear masks during the Spanish flu,
Fall 1918, Canada.  Masks were made of gauze or cloth

It was called the Spanish flu because it was believed to have started in Spain. Although the truth is no one knows where it started.  In Spain it was called the "three day fever."  The rest of the world called it the Spanish flu, probably because Spain was a neutral state, and it was among the few European nations "that did not censor its news reports."  Yet before long the flu had spread to all of Europe, Asia, and the United States.  (1, page 10)

It hit hard.  While the flu normally kills 1.5 percent of its victims, mainly the very young and the very old with weakened immune systems, the Spanish flu was different: it killed men and women with fully developed immune systems:  people who we think of as being healthy and strong enough to fight off the virus; people strong enough to fight in a war

Figure 4 -- Patient's at Walter Reed Hospital are separated by sheets.  Nurses
wear cloth masks over mouth and nose (circa 1918 or 1919)

It was normal for the flu to spread fast through military barracks, prisons and schools.  But the Spanish flu was aided by a war, with thousands of troops huddled together in trenches.  These men traveled all over the world, carrying the virus with them.

Within 2-3 days of contact with the virus, they started showing the typical signs of flu: headache, fatigue, sore throat, aches and pains, dry cough, fever and chills.  Yet these typical signs progressed in some victims to chest discomfort, pneumonia, and then cyanosis of the fingers, toes and then face.

The pneumonia caused bleeding in the lungs, and the victims would cough up blood.  Their faces turned dark blue, and their toes black.  These were ominous signs that usually resulted in death from suffocation.  And unlike regular pneumonia, death from pneumonia caused by the Spanish flu was quick, sometimes in less than 48 hours. (3, page 8)

Perhaps it was the helpless feeling of watching these people suffocate that provided one of the reasons why many studies were performed during WWI on oxygen therapy, and oxygen equipment greatly improved.  By the 1920s oxygen was available in hospitals to treat diseases that caused hypoxemia, although to the victims of the Spanish Flu in 1918 this was of little help.

Figure 5 -- Spanish Flu public notice from 1918

The Center for Disease Control (CDC) provides us with the following statistics regarding the Spanish Flu (2):

• A third of the worlds population (500 million persons) were infected
• Greater than 2.5 % of those infected died, as compared to the average flu virus killing 1.5%
• Total deaths are estimated anywhere from 50 million to 100 million

The most significant statistic is the last one there: over 50 million people died.  This made the Spanish Flu the worst pandemic in the history of the world.  Compare that with the following (1, page 7):

• 11.7 million died in the first 25 years of AIDS
• 9.2 million died in combat deaths in WWI
• 15.9 million died in combat deaths in WWII

Figure 6 -- Policemen wearing masks provided by the
American Red Cross in Seattle, 1918

Basically, the only remedy was to wait it out and hope you, or the ones you loved or were taking care of, survived.  A remedy tried was to inoculate "troops with vaccines made from body secretions taken from flu patients or from bacteria that they thought caused the disease.  They made them men spray their throats each day and gargle with antiseptics  or alcohol.  They hung sheets between beds, and at one camp they even hung sheets in the centers of thh tables at mess halls.  At Walter Reed Hospital, soldiers chewed tobacco each day, believing that it would ward off the flu."

While the origin of the Spanish Flu is unknown, some have developed conspiracy theories that postulate that the governments attempt to prevent the flu by giving such vaccinations were what caused the deadly strain in the first place.  We have heard stories of worse things being done by the Germans later, in the 1930s.  Yet such an attempt may have been performed in just about any country, including the United States.  Yet such conspiracies were never proven, and probably never will be.

Figure 7 -- A street car conductor iSeattle in 1918
refusing to allow passengers aboard
 who are not wearing masks

Another attempt to prevent the spread of the Spanish flu was to require people to wear masks made of gauze or cloth.  The problem with this is these masks often gave people the courage to go out into public places, and the virus was so resilient that it would make it's way right around the masks.  It was airborne, tiny enough, and wicked enough to do such a thing.

The Spanish flu went away as fast as it arrived, probably because it infected all the people who were vulnerable.  Eager to forget the dreadful events that just occurred, many newspapers refused to publish anything about the flu.  People were eager to put it behind them, and move on with their lives

Yet the Spanish flu had a major effect on society.  It interrupted society and economies all over the world, where people stayed home to care for their friends and relatives, and to keep themselves from getting the flu.

It also impacted the health care industry, whereas the government from then on required new epidemics of the flu to be reported.  Much of the way the influenza virus is kept in check today is based from researchers and scientists studying the outbreak of 1918.

Later, during the 1930s and 40s antibiotics and sulfa drugs were discovered to prevent and treat bacterial infections.  This made it so people who developed pneumonia as a complication of the flu could be treated and cured.  These medicines made the influenza bug less likely to be a killer.

Today we also have the ability to create an influenza vaccine and have it ready to give to people at high risk, if the strain can be isolated soon enough.  The problem that continues to plague scientists is there are many strains of the flu, and to inoculate against all of them wouldn't be cost effective.

Figure 9 -- "Demonstration at the Red Cross Emergency
Ambulance Station Washington, D.C.,during the
influenza pandemic of 1918."

So for this reason scientists must continue to be vigilant.  When new cases are reported, they are monitored.  Each year the "suspected" strain of influenza is readied in a vaccine and recommended for anyone at high risk, which generally are the very old, very young, and caregivers.  Although, as the Spanish Flu reminds us, sometimes those at risk aren't the typical victim.

Further reading:

1. Spanish flu creates the 'living room'

References:

1. Kolata, Gina, "Flu," 1999, New York, Farrar, Straus and Girouxx
2. Taubenberger, Jeffrey, David Morens, "1918 Influenza: the Mother of All Pandemics," Emerging Infections Diseases, Centers for Disease Control (CDC), http://wwwnc.cdc.gov/eid/article/12/1/05-0979_article.htm, accessed 11/26/12
3. Crosby, Alfred, "America's Forgotten Pandemic: The influenza of 1918," 2003, United Kingdom, Cambridge University Press
4. Wikepedia: all the photos for this post are from Wikepedia: The free online encyclopedia.  

1870: The year of the portable inhalers

Here are some advertisements for inhalers that ran on the same page as the Nelson Inhaler in the December 24, 1870, edition of the British Medical Journal: (1)

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MAW'S DOUBLE VALVED
EARTHENWARE INHALER 
For the inhalation of vapour of Hot Water, either alone or impregnated with Ether, Chloriform, Henbane, Creosote, Vinegar, etc, in affections of the throat and bronchial tubes, Asthma, Consumption, etc. For this apparatus, is especially adapted for Chloriform, Ether and other active volatile substances, as from its construction the exact quantity required may be inhaled. The lower valve opens only during inhalation, whilest the exhaled breath passes freely from the upper valve, instead of through the vessel, dissipating a large portion of the medicated vapour, as is the case in the use of most other inhalers.

Price to the Trade, 4s 6d. each; Retail, 7s 
DESCRIPTIVE HANDBILLS ON APPLICATION
S. MAW, SON, AND THOMPSON 
10,11 & 12, ALDERSGATE STREET, LONDON, E.E.

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MAW'S EARTHENWARE INHALER, double-valved, with mouth piece, as Fig. 4 .... 0 5 6NELSON'S EARTHENWARE INHALER, as Fig. 5 040 (1, page 672)

Here's the second advertisement, which is for the Eclectic Inhaler.  According to Mark Sanders at the Inhalatorium.com it's an inhaler described in the 1871 book, "The Laryngoscope’ which was "written by the famous physician Morell Mackenzie".  (2)

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 Eclectic Inhaler with mouthpiece (2)

BULLOCK AND REYNOLDS' 

 ECLECTIC INHALER 

AS RECOMMENDED BY DR. MORRELL MACKENZIE

Physician for the hospital for Disease of the Throat; and assistant physician to the London Hospital

 This apparatus can be used for all medicated vapours, and may be employed from all positions of the patient.  It requires no effort on inspiration, insures the thorough medication, of the vapour, and accurately maintains the temperature desired.

Price with thermometer: Wholesale 7s 6d; Retail 10 s 0d each

Ditto with Stand and Spirit Lamp comlete:  Wholesale 9s 6d; Retail 12s 6d. 

DESCRIPTIVE HANDBILLS ON APPLICATION

S. MAW, SON, AND THOMPSON 

10,11 & 12, ALDERSGATE STREET, LONDON, E.E.

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I am certain the zero in the price their is a typing error. However, I'm not traveling in my time machine just to find out. Sorry.

Below is a review of the new Eclectic Inhaler from the July 16, 1870 edition of the British Medical Journal:  (3)

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INVENTIONS, &c.,

IN

MEDICINE, SURGERY, DIETETICS, AND

THE ALLIED SCIENCES

A NEW INHALER

Messes. Maw & Son have supplied us with a description of Dr. Morrell Mackenzie's new "Eclectic Inhaler."  It is believed that this apparatus combines, in a manner hitherto unattained, the qualities necessary for a perfect inhaler.  It holds a considerable quantity of water, and has a large chamber for mixed air and medicated vapour; it can be kept at a nearly uniform temperature for a considerable time; it's use requires but little effort on the part of the patient, and it may be employed either in the sitting or incumbent posture. 

The inhaler will probably be exhibited at the annual meeting of the Association, when members will, no doubt, be able to inspect it.

---

Reference:

1. Hard, Ernest, editor, "Maw's double valved earthenware inhaler," British Medical Journal, The Journal of the British Medical Association, volume II, July-December, 1870, (December 24, page 672 of this publication)
2. Sanders, Mark, "Inhalatorium.com," Eclectic Inhaler, page 181, 
3. Hart, Ernest, editor, "Inventions etc. in medicine, su rgery, dietetics, and the allied sciences: A new inhaler," British Medical Journal: The Journal of the British Medical Association, 1870, July 16, volume II, London, page 67

Further reading

The pharmacopoeia of the Hospital for Diseases of the Throat and Chest ...

 By Hospital for Diseases of the Throat and Chest (London)

1940-1970: The decline and return of TB x

By the 1940s there were a variety of antibiotics that allowed physicians to control most cases of tuberculosis. For patients that seek medical attention and follow the prescription of their physician, tuberculosis can be controlled and even cured. By 1969 it seemed that the disease had been conquered, and attention was diverted from it.

It seems to be normal for human beings to forget that of which they do not see. When we don't have a war for a while, we tend to assume one will never occur again and we cut our military spending. When a war occurs, we usually aren't prepared. The same can be said of disease. When we go years without a plague, we assume the disease is cured. When the plague strikes, we aren't prepared. A perfect example of this is the Spanish Flu of 1918.  

There was a friend of mine who often said that we ought to have a war every ten years so we don't forget that freedom comes with a price. We should have a plague every so often so that we don't take these diseases for granted. Surely we don't want wars or plagues, but my friend had a valid point.

By the 1930s and 40s sulfa drugs and antibiotics were discovered as a means of treating infection. These and other medicines allowed physicians to effectively treat and even cure tuberculosis. This decade saw a rapid decline in the number of tuberculosis patients.  

According to Elaine Landau, in her 1995 book "Tuberculosis:"

As late as 1969, the federal government was still channeling annually more than $20 million in TB project grants to local clinics and hospitals throughout the nation. But the declining TB rate made people feel that the crisis was over. So when the government began giving blocks of aid to states and municipalities to be used at the areas' discretion, the funding generally was not expended for TB controll. 

As time passed,countless successful TB programs were dismantled. In New York City alone, more than one thousand beds formerly reserved for TB patients were eliminated from municipal hospitals. Although outpatient services were supposed to be established to ensure the disease's continued decline, these were never made available. Instead, funding was diverted to meet more immediate needs. As one physician who's treated numerous TB victims described the situation, "We knew how to cure it. We had it in our hands. But we dropped the ball. (1, page 3, 4)

Once the "ball was dropped" it was difficult to pick it up again. Organizations with the ability to provide methods of preventing the spread of such diseases, such as the Centers for Disease Control and Prevention (CDC), were not provided with enough funds to effectively perform this task. (1, page 34)

In 1989 a plan was made to provide the CDC with $30 to $34 million dollars to create a TB control plan. Yet the plan was never made "because each year that it was proposed, the White House eliminated its funding from the budget." A similar plan was proposed in 1993 to offer $484 million for TB prevention, but the budget was cut by the Clinton administration to $124 million before it was sent to Congress. So the return of a disease that once ravaged a nation was greatly ignored by Reagan, Bush and Clinton. (1, page 35)

What may have opened the eyes of the government was the AIDS epidemic that struck during the 1980s. Studies showed that with weakened immune systems, up to 50 percent of AIDS victims were developing tuberculosis, and were unable to fight it off. This is one reason tuberculosis spread through prisons and homeless shelters rather fast, particularly in cities like New York "where nearly one-fifth of prison inmates have TB, but none of the jails have separately ventilated cells for contagious cases." (1, page 35-37)

To make matters worse the TB bacteria has the ability to mutate to create drug resistant strains. This occurs when people who are given antibiotics, which are proven to cure TB if used properly, were not taking the antibiotics once they started feeling better. Effective treatment usually takes 6-9 months, but many would stop taking it within weeks.

Landau also said that "this is actually worse than not taking any medication at all, because over a period of time the illness no longer responds to any form of medication, and they have, in fact, dissipated the drug's effectiveness... Unfortunately, significant numbers of people have misused their medication this way. The tendency to do so appears to cut across racial, class, and economic lines." (1, page 39)

Studies show that up to 50 percent of TB patients do not take their medicine as prescribed, and that 14.1 percent of TB cases responded poorly to TB medicines. Studies also showed that TB resistant strains have a 50 percent mortality rate. (1, page 39-40)

References:

1. Landau, Elaine, "Tuberculosis," 1995, New York, Chicago, London, Toronto and Sydney, Franklin Watts 

1865?: Dr. Nelson's inhaler

Nelson Inhaler with glass mouthpiece

By the mid 19th century various methods were invented for the inhalation of medications through steam.  One such device was the Nelson inhaler, which ultimately became one of the most popular inhalation devices.

Spencer Thomson described the inhaler in his 1866 book "A dictionary of domestic medicine and household surgery."  He said:

Dr. Nelson's improved earthenware inhaler, an apparatus for the inhalation of  ether, chloroform, henbane, creosote, vinegar, etc., in affections of the throat and bronchial tubes, asthma, consumption, etc. (6, page lii)

John M. Scudder described it in his 1867 book "On the use of medicated inhalations, in the treatment of diseases of the respiratory organs."  He writes:

 "The most efficient apparatus for the inhalation either for simple steam or of medicated vapors... It is constructed of earthenware, and, in addition to its complete adaption to the purpose for which it is intended, possesses the triple recommendation of cleanliness, portability, and cheapness."  (1, page 22)

The inhaler is manufactured by Maw & Son of Aldersgate St., which was later changed to Maw, Son, and Thompson.  Dr. Nelson's name with directions were on the side of the inhaler.   The inhaler was commonly sold and used for many years, sold by various manufacturers who made slight adjustments to the design.  (2, page 258)

The Nelson inhaler was called "New and Improved," perhaps because of the unique design and that it's small and relatively portable compared to other inhalers, or tea pots.  Below is a news clip from the February 11, 1865, edition of the Medical Times and Gazette:  (3, page 160)

1700-1900: Influenza wreaks havoc

The beast that we now call influenza went on a brief hiatus during the 18th century, yet that vacation did not last long.  During the 19th century the best woke up and started wreaking havoc once more.  It showed it's devastating symptoms again and again (1, page 33)...

• 1729-30
• 1732-1733
• 1781-1782

From this century on the influenza beast would show up at least three times every decade, causing havoc all across the globe.  Surely few people died, yet the misery it created, and the fear that you could die, disrupted cultures and economies world wide.  Like the beast consumption, the beast influenza was a beast that affected nearly every person in the civilized world.  

The cause of these frequently occurring pandemics was the industrial revolution.  Where most people once lived and worked on isolated farms, occasionally making their ways to cities, the industrial revolution caused many people to move to the cities, and to work in crowded, poorly ventilated areas.  This created a breeding ground for the spread of airborne germs, such as influenza and tuberculosis.  

Once you caught influenza, the germ was expelled every time you exhaled.  Making it worse, it was expelled in large numbers every time you coughed or sneezed.  If you weren't covering your mouth, which most people probably did not, you were coughing and sneezing thousands, if not millions, of tiny germs into the air.  In in close proximity, anyone could inhale those germs, quickly spreading it from one person to another.  

Influenza set up shop in any person it could.  It did not care what your age was, nor your color.  It didn't care what sex you were, nor your economic status.  If you inhaled it, it went to word wreaking havoc inside your body.  It causes your body's immune system to stake out an all out attack, and the result is inflammation of your respiratory tract that results in:

• Fever
• Achy muscles
• Chills
• Sweats
• Dry, hacking cough
• Fatigue
• Nasal congestion

The disease affected nearly everyone.  It, along with consumption, forced many men and women to become humble.  These diseases were the will of god, and an ignorant society had no way of knowing what to do to prevent one from getting sick.  You simply had to go on about your business and hope for the best.  

It wreaked havoc again in the 19th century, in (1, page 33)...

• 1830-31
• 1833
• 1889-90

It didn't stop there, as it struck again in 1918-1920.  This is the influenza outbreak that we read about the most often, mainly because it was the most recent outbreak.  Many of our grandparents were affected, so in all likely hood your genetic line was exposed to one strain of the disease or another  

So once our bodies fight off one strain of influenza it vanishes.  A society is humbled after the devastation, and many experts write about what had just happened, using a variety of different names to describe the "plague" or "pandemic" or "epidemic."  They use a variety of different names to describe the symptoms of the beast that ravaged the world.  

Yet as soon as a new strain was introduced, it found it's way into a human body, and began, once again, to wreak havoc.  As you traveled from one area to another, the germ went with you.  

References:

1. Kelly, Evelyn B., PhD and Claire Wilson, Claire Wilson, "Investigating influenza and Bird Flu: Real facts and real lives," 2011, Enslow Publishers, U.S., Chapter 2, "The History of Influenza," pages 29-47

Further reading:

1. Hopkirk, Arthur F., "Influenza: It's History, Nature, Cause and Treatment," 1914, New York, Charles Scribner and Sons
2. Kuszewski, K, L. Brydak, "The epidemiology and history of influenza," Biomed & Pharmacother, 2000; 54: 188-95
3. herer check this out too

1778: The Mudge Patented Pewter Inhaler

In 1778 Dr. John Mudge introduced to the world the first mass producible inhaler.  He described it in his 1778 bo0k, "A Radical and Expeditious Cure for A Catarrhous Cough." Please refer to figure #3 as this one is the one in the book that Mudge is referring to.

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The Mudge Inhaler with mouthpiece missing (figure 1)

Figure I: THE Inhaler, as it appears when fitted for use; except that the Grating (a), which then ought to cover the hole, is now turned back, to shew the opening into the Valve.

Figure II:  A Section of the Cover; in which is shewn the construction of the Cork Valve (b)% and also the conical part (c), into which the flexible Tube (d) is fixed.

 A Section of the Cover; in which is shewn the construction of the Cork Valve (b)% and also the conical part (c), into which the flexible Tube (d) is fixed.

When the Inhaler, which holds about a pint, after being three parts filled with hot water, Is fixed at the arm-pit under the bedcloaths, the end of the Tube (e) is to be applied to the mouth; the air, in the act of inspiration, inspiration, then rushes into the Apertures (f), and passing through the hollow handle, and afterwards into a hole in the lower part where it is soldered to the body, and therefore cannot be represented, it rises through the hot water, and is received into the lungs,. impregnated with vapour. In expiration, the contents of the lungs are discharged upon the surface of the water; and instead of forcing the water back through the hollow handle, the air escapes by lifting the round light Cork. Valve (b)J so as to settle upon the surface of the body, under the bed-cloaths. 

Plate from Mudge's book (figure 2)

Thus the whole act of respiration is performed, without ever removing the instrument from the mouth.

The flexible part of the Tube (d) is about fix inches long, fitted with a wooden mouthpiece (e) at one end, and a part (g) of the fame materials at the other, to be received into the Cone (c) on the cover. This flexible tube is made by winding a long slip of silk oil-(kin oil'skin over a spiral brass wire. This should be then covered with one of the fame size, of thin silk, and both be secured by strong sewing silk wound spirally round them. Some length and degree of flexibility is necessary to this tube, for the fake of a convenient accommodation to the mouth when the head is laid on the pillow

Care should be taken by the workman, that the cover should be made so as to fit very exactly; or, if k does not do so, the defect should be remedied by winding a piece of cotton wick, or some such contrivance, round the rim underneath the cover, so as to make it airtight. The Cork, likewise, which forms the Valve, should be made, for the above reason, as round as possible. It is also necessary to remark, that the area of the holes, on the upper part of the handle, taken together; the size of the hole in the lower part of the handle, which opens into the Inhaler; the opening of the conical Valve itself; and that in the mouthpiece, as well as the cavity or inside of the flexible Tube, should be all equally large, and of such dimensions, as to equal the size of both nostrils taken together: in short, they should be, severally, so large, as not only not to obstruct each other, but that respiration may be performed through them with no more labour than is exerted in ordinary breathing.

   It is necessary to observe, that care should be taken, when the Inhaler is in use, that the ingress and egress of the air through the holes on the top of the handle, and those in the grating on the cover, should not be interrupted by the bed-cloaths.

Indications:  Dr. Mudge recommended the inhaler for catarrhous cough.  

Medications:  Opium, Benzoil, Camphor, other

Purchase:  The inhalers are to be purchased of fW. Barnes  Pewterer, No. 157, Fleet-Street, by particular Appointment of the Author.  

A sample of a 19th century version of Mudge's Inhaler (It is rare to find one with an intact mouthpiece)(figure 3)

Reference:  

1. Mudge, John, "A radical and expeditious cure for a recent catarrhous cough: preceded by some observations on respiration with occasional and practical remarks on some other diseases of the lungs," 2nd edition, 1779 (original edition was in 1778), London, printed by E. Allen, Fleet Street, from the opening pages of the book.  

1985: The flow of 2-may

Life was different on 2-May than it was on 7-Goodman.  After the first two weeks passed, and after my depression, I wrote in my journal: 

"Actually, 2-May is better than 7-Goodman in that you are able to move around the hospital more, and you can even get passes easier to go off campus, even by yourself.  It's much more like real life.  We can go outside to ride bikes, and we can even ride our bikes to the park across the street, something we did nearly every weekend.  We can also go to the store across the street, something I don't generally do.  The rule here is in order to leave the campus you have to have an adult escort, which isn't hard to do. While on 7-Goodman you had to get permission from one of the nurses to leave 7-Goodman, on 2-May all you have to do is sign out and you get to go wherever you want.  So it's much easier to visit 7-Goodman when you live on 2-May, than it is to visit 2-May when you live on 7-Goodman.  And considering the kids on both floors are the same age, most of our activities were done together, so many of us have friends in both places."

For a while I forgot about my friends on 2nd or 3rd Goodman (or maybe it was 4-Goodman), and one day I went over there to visit my COPD friends.  The guy was discharged, but my lady friend was still there.  Now that I was on 2-May I visited her more often.  I didn't spend as much time with the nurses there anymore, I just spent time with this patient.  I have no memory of what his name was.  In fact, I don't know that I ever knew it, as remembering names is not one of my strengths, never has been.

As the weather warmed up we spent more and more time outside.  We rode bikes, rode them to the park, and we played baseball.  I had a friend on 7-Goodman who was a couple years younger than me.  His name was Jeff, and he was from Chicago.  My other friend, Tim, was discharged to home, so now I spent all my free time with Jeff.  He was an avid Cub fan, perhaps as good of a fan as I as a Tiger fan. We went outside to play catch nearly every day.  I made my way to level 4 on 2-May, so I was able to escort him to outside.  I usually had to go up to 7-Goodman and sign out with him from there, unless his mother as visiting.  If she was there, she'd sit on the picnic tables outside and watch us.

These were the same picnic tables mom had me sit on one day and she cut my hair during one of her visits.  She was too cheap to take me to a barber.  I remember being embarrassed that my mom cut my hair, and I never let her do it again.

There was another kid who was from New York, and his name was Chico.  I think he used that name because he loved Chicago.  He was a unique kid, who looked and acted like a Hippy.  He even listened to music from the 60s.  He was different, but for some reason he was hanging around me when mom visited with her sister Clara, and mom invited Chico to go with us.  It was a nice day as we went to the Capital of Denver, and walked around a park downtown.  It was one of the nicest days of the year so far.  I remember lying in the grass with Chico, mom, and Clara and staring at the blue sky.  I closed my eyes and thought of how nice it was to be off campus with my mom and my aunt.  I wished I could just go home with mom.  But my counselors and psychologist didn't think I was ready.

And that sets up a post about my psychologist named Casey and my Counselors.  I loved my counselors, but I hated Casey.  Yet as I reminisce, I'd like to