[Your Tuberculosis Association Presents] [The Case History of Lucy X] [A story based on the actual case history taken from the files of the Association.] [Images of farm work and animals.] [Narrator:] On a modest farm, far out from town, Lucy X had been living with her aunt for two years. Two years of refusing to believe that she was sick with tuberculosis. She was constantly tired and couldn't seem to get rid of a cough. Still, she had forced herself to stay up to keep working on the farm. But one day the pump handle was too heavy, and the water bucket an unbearable load. That terrible cough again. The taste of blood. Aunt Martha was frightened. She should have taken Lucy to a doctor long ago, but Lucy was so terribly afraid of doctors. Aunt Martha called the family doctor immediately and arranged to send her to his office for a complete checkup. After the doctor had finished the complete physical examination and learned the case history, he sent Lucy home telling her not to worry. But the doctor was worried. That was advanced tuberculosis. Immediate sanatorium treatment was her only chance, and he knew the family could not afford such expense. Then he thought of the Tuberculosis Association. The field worker in the Tuberculosis Association was glad to help in obtaining hospitalization for Lucy. On the doctor's suggestion, she prepared at once to call on the family and to attempt to arrange with the authorities for Lucy's care. Cooperation with physicians and public authorities in meeting the difficult problems of patients is part of the responsibility of Tuberculosis Associations. The public expects it, rightfully. Each year millions of people buy Tuberculosis Christmas seals to help protect their homes from this deadly contagion. Tuberculosis Associations accept this money and spend it on their scientific guidelines. It is a plus symbolized by the double-barred cross. The field worker told Aunt Martha that tax-supported institutions now care for persons who have tuberculosis in order to keep the disease from spreading. Hospitalization of one tuberculosis patient may prevent many new cases. She told Lucy a sanatorium was where complete bed rest was possible, with wonderful equipment that had been perfected to help persons who were fighting tuberculosis. All of these were available for Lucy. Lucy wanted to be left with her Aunt Martha. She offered to stay in bed, do anything the doctor advised if she could stay at home. The field worker explained that this was not enough. The specialized work of the tuberculosis sanatorium cannot be done in a home. Finally, Lucy consented to go, but it was the decision of the sick person too weak to resist longer, not the cooperation of one who has hope. It was late that night when the field worker's car turned into the sanatorium's drive. She'd called in advance and arranged with the night supervisor to have a room ready for the patient. The sanatorium staff feel deep sympathy for the emergency cases, the people who have waited too long, for the staff well knows how deadly delays can be. [Jaunty carousel music.] While Lucy was still sleeping, the floor nurse was preparing to care for her. Working directly over the sick person, the nurse might breathe the tuberculosis germs into her own lungs. For that reason, she wears a mask over her nose and mouth, and the sterile gown over her uniform. The nurse knew that her first task that morning was to make Lucy feel that the sanatorium staff were her friends, and wanted to help her. That was of primary importance. She must also teach her to hold a tissue over her mouth to keep her from spreading the germs. Years before, Lucy had been in a sanatorium where her mother was a patient. Her examination had shown that she had tuberculosis in an early form. The disease cannot be inherited. Lucy had probably taken it from her own mother in the daily contact of the household. Her mother died before Lucy could be placed in a sanatorium. After that, terror-stricken, Lucy refused to go. To her, sanatoriums meant death. She had then fled to her aunt's farm. She thought fresh air would cure tuberculosis, but it had not cured. Rest is the key element in the cure for tuberculosis. Rest, highly specialized rest, such as can be supplied only in a proper hospital. But Lucy had no faith in the sanatorium. Her mother had died in one. She didn't realize that the mother was already fatally sick with tuberculosis when she went there. That it was too late then... Hot with fever and indifferent, she submitted to the examination. For the diagnosis of her case, the doctor needed to know not only the damage done to her lungs, but also her complete physical condition. Whether the sanatorium could cure Lucy now was a question they could not yet answer. Their first job is to show her that the sanatorium is a place of great hope. The doctor asked the nurse to encourage Lucy to eat a good breakfast, and then to prepare her for a chest x-ray. [Music] In a sanatorium, food is of the utmost importance. It is scientifically selected and prepared. Patients in various stages of recovery need different foods. The dietician who plans the meals takes this into consideration. Fresh fruits and vegetables, milk and eggs, all of these are body builders. And with tuberculosis, the problem is just that, to heal those portions of the body destroyed by disease. This is one part of the specialized work which the sanatorium offers. Another phase is done by technicians in the laboratories, whose studies help the doctors in determining the exact conditions of their patients. And then came the x-rays. X-ray is like a flash of lightning that momentarily lights up the lungs so that a shadow picture can be made of the lung tissue itself. [Music] An expert x-ray technician makes the picture and only a specialist can rightly interpret it. A doctor who know how to read such a picture can tell much about the progress of the disease and can decide from that what kind of treatment to undertake. The medical staff studied the x-ray film, comparing it with one sent from the other sanatorium that had been taken at time her mother was there. The first one showed early minimal disease had just started. Now there was a hole in her lung where the disease had eaten away part of the lung tissue. This was advanced pulmonary tuberculosis. Those months on the farm had taken a toll. The doctors decided that surgery might save the lung, but Lucy was too weak now for an operation. To build up her strength, complete bed rest was prescribed. Day after day, Lucy grew steadily weaker because she had no will to live. During her regular rounds one night, her nurse stopped in Lucy's room, and then came directly to the doctor's office. "Lucy seems worse," the nurse reported. Every physician knows that the mental state of a patient can adversely influence the physical. To deal with such a problem is not simple, and to succeed requires more than a knowledge of medicine. Lucy must want to get well and believe that she could get well. Outside of the nurses' station, Lucy's nurse waited anxiously. All of the sanatorium staff are deeply concerned if a patient loses the will to fight. The doctor tried to tell Lucy that she must look beyond the few years here at the sanatorium to the life that awaited her. A normal life that any young girl should enjoy. There should be work, play, romance. Beyond these [?] months waited all the years that could be shaped into useful living. [Music] As the night wore on, he struck the right chord. The listless mask broke, Lucy looked up and smiled. "Yes," she whispered. She would try to get well. She believed she could get well. Lucy cooperated and steadily improved. She became strong enough so that some surgery to close the lung cavity could be applied. Pneumothorax treatments were begun. A pneumo, as they call it, temporarily collapses the lung so that it can rest and heal itself. To collapse the lung in this way, air is injected through a needle into the chest, but outside of the lung sac. This gradually forces the lung up into smaller space so that it will have a chance to heal. The other lung does the necessary work of breathing for the body, while the collapsed lung lies still. A broken leg could not be healed with constant exercise, neither could an ulcer or a lung be healed while the lung continues in full motion of breathing. At first these pneumos are given every day, later every two weeks. The procedure is done under a local anesthetic. There is no pain. It requires but a few minutes of time. For pneumothorax treatment, a fluoroscope is used to study the lung's condition. The degree of collapse can be observed by the doctors. After some months Lucy's sputum carried no more tuberculosis germs. Then she was moved to a two-bedroom with Ann, a girl who was at the same stage of treatment. Lucy's body must remain at complete rest for months to come, but not her mind. The sanatorium's Educational Director now joined the medical staff in working for Lucy's recovery. [Music] In sanatorium, patients are permitted to complete formal schooling interrupted by their isolation in the hospital. [Music] It isn't enough to find the patient a book. That book should help him towards some definite goal. For Lucy, that goal is fashion designing. [Music] In the meantime, Lucy was eagerly completing one high school subject after another. Being allowed up for meals was the next big step for Lucy. Both she and Ann had been transferred to the up-patient wing of the sanatorium where they were allowed to go to the dining room for one meal a day. Even in this stage of improvement, afternoon rest hours were important. The body needed rest to repair the lung tissue that tuberculosis had destroyed. So work towards high school diploma and fashion designing had to be done within strict limitations. Although it would be months before she could leave the sanatorium, plans began for that day when she would reenter the world and look for a job. This is called rehabilitation. In some instances, rehabilitation means the teaching of a new trade. In Lucy's case, it meant finishing high school and choosing a vocation. When she had completed the last course necessary for high school graduation, they brought her a diploma. Diplomas are usually presented on platforms while a large audience of friends look on. Aunt Martha and her teacher were the only audience on Lucy's graduation day. But it was hard to tell who was the most pleased. That was a very special day. [Music] But the real triumph came when Lucy was healed and ready to go back into the world. There was a time when sanatorium patients after several idle years were simply released. No guidance in finding jobs, few friends to help them make contact. Such persons often returned to the sanatorium within a few years, broken in body and spirit. Because sanatoriums have learned from these tragedies, they now begin planning for the patient from the first day of treatment. In Lucy's case, the sanatorium staff had kept her in touch with the outside world. She wasn't being turned out of the sanatorium with no place to go. She had a goal and practical training to reach it. [Music] The rehabilitation agent will continue to be her counselor. "Remember," the doctor cautioned her, "you must come in often for a checkup." Therein lay her assurance, that in leaving the sanatorium she was not losing its protecting strength. The sanatorium stands ever-vigilant, healer of the sick, guardian of the public health. With such a friend, Lucy in happy confidence went out to strive for success, to achieve the life of a normal, healthy girl. The End.