… a Holley resident once told a reporter, at A.G. Holley, “the principal thing is to get well and get out of here.” (‘In Florida, a Lifeline to Patients with TB,’ The New York Times, June 12, 2010)
As someone born after the de-institutionalization of all kinds of patients – those suffering from both mental illnesses and what we like to call plain old illnesses – I have never stopped to consider the environment of the sanitarium. Even as someone who studies the 19th and early 20th centuries, where authors whose works I read more often than not succumbed to early death at the hands of diseases we now cure easily, it doesn’t register with me that as recently as fifty years ago, treatment could consist of anything besides a quick hospital visit and then a solitary regimen of medications taken at home, sick days meaning isolation in the private home.
When I think now about the few forms of institutionalized care that I’m familiar with, the association is purely negative: nursing homes and mental hospitals. They’re frightening, alienating environments, signaling to me the helplessness of the patient and the power of authorities over not just their well-being but over their very lives. Even I assume that I would become someone holding onto their “own” house for dear life, even after no longer being able to care for it, rather than go to someplace where I trade independence for life.
Yet reading about one of the last tuberculosis sanitariums in the United States, I was struck by the idea of community, environment, and disease. Community not in the sense of connections to family and neighbors or friends, but connections to caregivers and to a different kind of neighbor – those who share not your locale but your condition. Your way of life as influenced by what makes you suddenly abnormal. The illness.