The Children of Craig-y-nos: Life in a Welsh Tuberculosis Sanatorium, 1922-1959 (review)

With the current increase in multiresistant forms of tuberculosis (TB), especially those that result from patients who do not complete the necessary regimen of antibiotics, the medical community and the public look for more enforceable methods of treatment, including ways of quarantining infected individuals. For decades, the sanatorium represented an active measure against the threat of what was then an incurable and dreaded disease. Even when the rest cure had been proven ineffective and antibiotics made more widely available, the sanatorium lingered, isolating the sick and serving as a reassuring, physical manifestation of the war against TB. Often overlooked and sometimes ignored, however, were patient experiences, particularly those of children. In The Children of Craig-y-nos: Life in a Welsh Tuberculosis Sanatorium, 1922-1959, Ann Shaw and Carole Reeves use oral history interviews to give voice to those who spent part of their childhood in a sanatorium in South Wales, and in doing so, the authors illustrate the problems inherent in segregating the sick and why it "is neither workable nor humane" (9).

Although experiences were varied, noticeable themes emerge from the former patients' narratives. The transition both to the sanatorium and back to the outside world was extremely challenging. Upon entering, many described the loneliness resulting from being separated from their families. Often pervasive in the testimonies is the lack of understanding each individual had about where they were going, what was happening, and why they saw so little of their parents. These children were frequently unaware of the sanatorium's rules, such as only monthly visits from family and friends, and the results were devastating. Some children felt abandoned by their parents, which hampered their ability to form relationships and trust others after being released from the sanatorium. Others, especially those who were toddlers during their years there, did not even recognize their parents when they came to visit. One ex-patient plainly stated, "I think they [the nurses and staff ] weren't trained for our emotional needs" (77).

Although several former patients described close relationships with the nurses, quite a few resented the medical personnel. Procedures, for example, the gastric lavage, exacerbated these tensions. Without explanation, young boys and girls were forcibly held by nurses in order to pump their stomachs for sputum testing, and not surprisingly, individuals recalled this experience with horror. Others disliked the medical personnel for their methods of punishment. Nurses utilized techniques, such as putting the children on the balcony in freezing temperatures, employing straitjackets to tie the children to their beds, slapping, placing noncompliant patients in solitary confinement, and withholding family letters. Commonly, this conflict between staff and patients created a feeling of "helplessness" and frustration for the sick children (49).

In response, patients who were allowed some mobility attempted to form relationships and a community with their peers. These relationships often fulfilled vital emotional needs of friendship through shared experiences, but sometimes the relationships devolved into bullying and enforcing normative behavior through ostracizing, teasing, hazing, and peer pressure. For many, even being discharged from the sanatorium did not immediately solve all emotional needs. They often came home to a new family dynamic: new siblings and, sometimes, a damaged relationship with their parents. These former patients frequently spoke of having left behind friendships, which, for some, were the only relationships they had ever known. A few chose to become nurses or staff at Craig-y-nos in order to remain part of the life that had become their world. For better or worse, these bonds formed at the sanatorium had served as a coping mechanism that could not always carry over into the rest of their lives.

The transition to the outside world resulted in more than displacement and adjustment to new relationships. The vast majority of the testimonies reveal the stigma associated with an infectious disease. Many...