BMR: The TB Sanatorium’s “Little Presses”

Recommitting to Public Scholarship
Last fall, I began “blogging my research” by writing about material I’m examining in preparation for conference presentations. With this post, I renew my commitment to public scholarship for the second-half of the academic year: I’m currently preparing a conference paper, which I’ll deliver in March at the PCA/ACA national conference. Here, I want to share an overview of the presentation and explain how my paper squares with the focus of the conference—popular and American culture.

Photo by the author. All rights reserved.

Photo by the author. All rights reserved.

My PCA/ACA Conference Presentation
My conference presentation is titled, “Discursive Rest: The ‘Little Presses’ of the Sanatorium Era.” In it, I concentrate on the Hoosier Res-Cuer, a magazine produced by and for TB patients who were receiving treatment at the Indiana State Sanatorium during the early twentieth century. Before the widespread availability of antibiotics, TB could not be eliminated from the body; however, it could be managed, and during the 1880s to 1940s, sanatoriums like the Indiana state facility in Rockville, Indiana provided hope, at least for some.

A mash-up of original and reprinted news items, poetry, non-fiction prose, jokes, and gossip, the Hoosier Res-Cuer was issued monthly from 1926-1946; patients who were well enough wrote and managed the writing of material for the magazine. Though certainly remarkable in its own right, the Hoosier Res-Cuer represents only one of several such publications; many sanatoria in the U.S. facilitated the creation and production of media during the 1920s, 1930s, and 1940s. (Firland Sanatorium in King County, Washington, for instance, published a magazine called Grit and Grin, whose name later was changed to PEP and Courage.)

CC-licensed photo by flickr user jimmywayne

CC-licensed photo by flickr user jimmywayne

The production of magazines and newsletters not just on sanatorium grounds but also by patients themselves is curious, given the principles that were (and continue to be) associated with sanatorium-based TB management. Chief among them were physical and mental rest as well as “regularity”—that is, a “systemized” schedule in which every aspect of the patient’s daily life is planned and controlled. Not surprisingly, life at the “san” was infamously monotonous.

In my paper, I argue that the “little presses” of the sanatorium were more than diversion; they aided treatment by discursively re-inscribing rest at a key moment: when the patient’s treatment was almost complete. Not long before the patient’s reintroduction to life outside of the sanatorium, his or her body necessarily became more active. However, such activity violated the most sacred tenets of sanatorium treatment: total rest. As I see it, the creation and publication of diverse genres like poetry, first-person narrative, news, and even the gossip column helped newly ambulant patients achieve rest.

Physical rest, though, was only one of several pathways to improved health: the sanatorium also managed TB by instilling patients with appropriate habits, including those related to labor. Before leaving the sanatorium, patients received occupational training to decrease the likelihood of relapse. The sanatorium’s little presses were instrumental in fulfilling this goal.

Most significantly, the sanatorium’s little presses instilled emotional habits that were seen as crucial to long-term recovery. Across genres, patients expressed positive and eerily uncritical assessments of draconian sanatorium life, but whether this docility to authority was genuine or a subversive performance is unclear.

CC-licensed photo by flickr user jimmywayne

CC-licensed photo by flickr user jimmywayne

Reconceptualizing Participatory Cultures
Through its focus on the Hoosier Res-Cuer, my paper not only illuminates beliefs about TB treatment prior to antibiotics; more broadly, it also explores how the bodies and minds of the sick were policed and liberated through the creation of popular media. The context of this production—the who, how, and why—bears a striking resemblance to participatory culture.

As defined by Henry Jenkins, et al. in Confronting the Challenges of Participatory Culture: Media Education for the 21st Century, participatory culture is organized around the creation, sharing, and circulation of media by everyday individuals. Participatory culture also is accessible. As Jenkins notes, it is defined by “relatively low barriers to artistic expression” as well as systems for “informal mentorship whereby what is known by the most experienced is passed along to novices” (2)

Another significant feature of today’s participatory culture is the extent to which it is shaped by and produced within web 2.0 technologies that “make it possible for average consumers to archive, annotate, appropriate, and recirculate media content in powerful…ways” (Jenkins, et al. 8).  Participatory culture, at least as Jenkins theorizes it, is a wholly postmodern phenomenon. However, my analysis of sanatorium magazines produced by TB patients asks us to consider the historical legacy of participatory culture and its roots in print.

The overlap between web 2.0 participatory culture and that of the sanatorium’s little presses is striking; however, I should note that I’m still exploring these similarities and differences at this point in the research process. Like today’s participatory cultures, those associated with TB magazines spawned “new creative forms” (Jenkins et al. 3). This is because TB magazines unabashedly addressed the contagious body as well as the subjective experiences of those defined by a certain kind of embodiment.

Wordle of Wikipedia Entry for "Participatory Culture."

Wordle of Wikipedia Entry for “Participatory Culture.”

When Jenkins’s participatory culture and the sanatorium’s little presses are compared, significant differences also emerge. Consider that Jenkins has argued that participatory culture produces a “more empowered conception of citizenship” (3). However, without access to patient interviews, diaries, or personal letters, it is unclear if the Hoosier Res-Cuer or other little presses of the sanatorium enhanced patients’ communal identities and collective sense of agency.

Works Cited
Jenkins, Henry, Kate Clinton, Ravi Purushotma, Alice Robison, and Margaret Weigel. Confronting the Challenges of Participatory Culture: Media Education for the 21st Century. MacArthur Foundation. 19 Oct. 2006. Web. 13 Feb. 2013. <;.
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Posted in Blogging My Research, Medical Humanities
5 comments on “BMR: The TB Sanatorium’s “Little Presses”
  1. essiepett says:

    Wow sounds really interesting, looking forward to hearing more. Some of the ideas you discuss bring to mind Herndl’s Invalid Women, particularly the chapters on New Thought and women writers (chapters 3 and 4?). I think you’re on to something really important with the historical legacy of participatory culture – I love the idea that early twentieth century illness communities might be hotbeds for participatory subcultures! I wonder what other examples are out there…

  2. essiepett says:

    Also, this might not be relevant, but the kinds of issues you raise here bring to mind this paper by McDermott and Varenne: “Culture as Disability” in Anthropology and Education Quarterly 26 (1995):323-348. Ok enough must get back to my own work!

  3. eMKay says:

    Are you willing to share your conference presentation? I am writing a book about the Glen Lake Tuberculosis Sanatorium in Minnesota. It, too, had its own press. The production by patients isn’t really so curious as you think. In addition to the magazine’s role in communication, the publication was intended to give “up” patients new skills for them to take into the workplace. The first issues at Glen Lake were printed at the sanatorium as training for potential press operators, until the circulation numbers rose beyond the patients’ ability to produce the magazine within their allotted exercise hours.
    Notice that occupational therapy and vocational therapy are not the same. OT kept them occupied while on bed rest; VT trained them for new jobs, as many could not return to former ones.
    Also, the docility to which you refer has been explained to me many times by former patients I have interviewed. Before the advent of antibiotics, if your choice was to behave or die (or be thrown out), you did the former. So many authors wrongly judge the authoritarianism of the sanatoriums through their own background or sensibilities. During the Depression and the era of large families, a sanatorium was often a luxury hotel compared to home — a bed to oneself, good food, and entertainment. Escapees were usually mothers of young children or alcoholics.

    • Amy says:

      Thanks for reading, Mary. Naturally, your book sounds very interesting! I’m in the process of transforming the conference paper into an academic article, and so my understanding of sanatorium magazines has expanded considerably since I first published this post. As for your request: I share my in-progress (meaning, early and tentative) work for conference presentations but not the papers themselves (an impetus I blogged about earlier). If you’d like to see a copy of the paper’s bibliography, I’d be happy to share.

      I say the existence of such magazines is “curious” because, at first glance, it directly undermines what appears to be the main tenet of sanatorium-based TB treatment: mental and physical rest. In fact, any form of vocational training would be at odds with such a mandate. The same could be said of occupational therapy. (And, I appreciate the distinction you’ve made between occupational and vocational therapy. This is an excellent point.)

      Of course, sanatoria did not attack TB through rest alone, a notion to which you allude. Although I have not formally written about sanatorium magazines, I wrote extensively in my dissertation about TB, US sanatoria, and texts (literary and otherwise) that engage with these topics. I argued that sanatoria improved physical health through the rehabilitation of a broad range of habits. Narrowly conceived, this means that patients were taught better hygienic behaviors and given opportunities to acquire job skills that would serve them well upon release. But most importantly, I argue, patients also were groomed—actually, forced—to adopt social, emotional, and mental habits that were seen as conducive to health.

      I’m interested in the psychic costs of this rehabilitation, which was compulsory, all-consuming, and lengthy. Certainly there are psychic costs involved with giving up one’s self and body to medical authorities, even when one is willing, has little choice, and/or views the material conditions of the sanatorium favorably. The sanatorium magazine I’ve been working with does not fully reveal the extent of these psychic costs and may, in fact, surreptitiously convince patients that such sacrifices never existed in the first place.

  4. Amy, your work sounds fascinating! I found your blog while looking (in vain) for digitized TB sanitorium in-house newsletters online. I want to read them from a sociolinguistic perspective: how did the patient community define itself linguistically? What metaphors are used (e.g., military ones) for the disease itself? Can you tell me where I might be able to find the Hoosier Res-Cuer, Grit & Grin, or others? I’d like to work with as wide a variety as possible. Thanks!

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Dr. Amy Rubens
I'm an "ambulant scholar," and I move among several worlds. As a professor of English, I research and write for audiences within and outside of academia. As a teacher of writing, literature, and culture, I facilitate learning. As a blogger, I critique, question, and reflect. Learn more about this blog and the work I do as a professor and workplace writing consultant.

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