To cure sometimes, to relieve often, to comfort always.

E. L. Trudeau

Seeking to bring historical research to life for undergraduate SUNYIT (State University of New York Institute of Technology at Utica/Rome) nursing students, School of Nursing Professor Rhinehart, took her research class to Lake Saranac on Lake Placid to the site of the tuberculosis cure cottages of the last century. She invited Phil Gallos, author of Cure Cottages of Saranac Lake to join the class and guide them on a walking tour of the cure cottages. Mary Hotaling, director of Historic Saranac Lake, joined the class to provide a tour of the old grounds of Trudeau Sanatorium. The students were mesmerized by what they saw and heard. It was on this cold November day at Lake Saranac that the idea for this book began to germinate for Professor Rhinehart. She wondered, "Where were the stories of the doctors and nurses who had cured, studied, and practiced at Trudeau Sanatorium? And where were the stories about other patients who had received the medical and nursing care by those lucky enough to have survived the great white plague of tuberculosis and, in so doing, felt they needed to stay on at the sanatorium in order to help others?"1^(xvi)Portrait of Healing eloquently tells their stories.

Tuberculosis was, and is, a worldwide health threat; this book does not attempt to resolve issues of treatment and care. However, as it gives the details of the lived experience of the patients, families, and medical and nursing staff at the Adirondack Cottage Sanitarium, it reveals much about the care of the sick that rivals any program in existence today. The story that emerges through the personal documents and photographs of those who lived and those who died in the sanatorium describes remarkable circumstances for promoting healing and recovery from this dreaded disease. Furthermore, the full implications of the theory and practice of Dr Trudeau and those involved in providing this care and "cure" are yet to be determined. Certainly, the incorporation of art, literature, music, and nature in health and healing is evident here. One realizes that Trudeau and his staff knew that attention to the spiritual health of patients was essential to healing. Acknowledging the "ennui" of recovering patients, an open air occupational therapy program, the first of its kind, was established in 1903. This is the thrust of expressive arts therapies and occupational therapies in health care today.

Beyond these events is the realization of the experience of community, of belonging, in the cottage system among patients and staff in this period that seems unrivaled today. It is known that once one contracts a contagious disease, which is considered potentially fatal, one is in a state of exile. That is, the sufferer is now set apart from all others who do not have the dreaded disease and feels separated from his/her former self. In Trudeau's wilderness cottages, such was not the case. The sense of community fostered by his and his colleagues' inclusive care promoted health and healing.

Furthermore, the importance of the Ogden Mills Training School for Nurses, conceived and developed by Trudeau, highlights the significance of this book as it chronicles in detail medical and nursing history of this period in time. This necessitates the inclusion of this book as we evaluate the education and practice of clinicians then and now in the United States and elsewhere. The vision and mission of Trudeau and his colleagues are worthy of our deepest consideration.

Moreover, the implications of the lived experience of this life-threatening illness as documented in patients' letters and other communications inform those of us in health care and those of us who may be or are suffering such illnesses of an astounding realization. "[horizontal ellipsis]The seriousness of the disease and the character of the cure forced all but the most unreflective patients into a fundamental confrontation with their goals, their values, and their innermost selves. Many emerged from the cure with totally reoriented systems of beliefs and priorities. They truly became different people, and they were glad, because they knew their exile to the 'city of the sick' had given them an existential understanding of all those universal truths to which most people, caught up in the superficial minutiae of the day-to day round, merely pay habitual lip service."1^(p61)

ADDENDUM

Edward Livingston Trudeau was born to a family of physicians. At 19 years of age, he assumed total care of his older brother who had contracted tuberculosis. Unbeknown to him, he had contracted TB himself from this experience, which was discovered 1 year after he graduated from medical school. Caring for his brother, he occupied the same room and often the same bed. He was advised to never open the window as it would aggravate the cough. Edward did open the window because his brother asked for fresh air.1^(p5) Trudeau wrote of that time, "How strange that, after stifling my brother and infect myself through such teaching as was then in vogue, I should have lived to save my own life and that of many others by the simple expedients of an abundance of fresh air[horizontal ellipsis]. This was my first introduction to tuberculosis and to death[horizontal ellipsis]. It was my first great sorrow[horizontal ellipsis] and I have never ceased to feel its influence. In after years it developed in me an unquenchable sympathy for all tuberculosis patients-a sympathy, which I hope, has grown no less through a lifetime spent trying to express it."1^(p5)

Thinking his life was to be short, he returned to his beloved Adirondack Mountains, spending as much time as possible in the fresh air. He was to live for 47 more years and in that time established Adirondack Cottage Sanatorium, which combined the rest cure in cold, clear mountain air. He established the Saranac Laboratory for the study of tuberculosis, the first laboratory in the United States for the study of tuberculosis, now renamed the Trudeau Institute, which continues today to study infectious diseases.^1(p44)

Rhinehart's book contains abundant material describing the life and work of Trudeau, much of it in his own words, and his legacy of great knowledge and understanding of the disease in specific and in general: "[horizontal ellipsis]the unique world of healing that he created on the side of Mt Pisgah in the little village of Saranac Lake."1^(xvi)

References