COLUMBIA LIBRARIES OFFSITE 
 
 HEALTH SCIENCES STANDARD 
 
 HX641 35586 
 RC312 .C35 Watching the hour-gl 
 
Columbia SBnifaergitp 
 in tfje €itv of i9etu gorfe 
 
 COLLEGE OF PHYSICIANS 
 AND SURGEONS 
 
 Reference Library 
 
 Given by 
 
1^ 
 
 OORmASS 
 
 BY 
 
 jTEPHEN(llALME]rf 
 
It IS wortk a tkousand pounds 
 a year to nave the naDit of 
 looking on tke trigkt side of 
 
 things,— Dr. Samuel Johnson. 
 
iatrhttig tl|p Ifour-C^laaa 
 
 By Stephen Ckalmers 
 
 "And if any man think that he knoweth 
 any thing, he knoweth nothing yet as he 
 ought to know." — 1 Cor. viii. 2. 
 
 OJIyp Aiirnttiark Stttfrprtsp ^rwa 
 
 aOh.. . r^^.:^ ThoAL 
 
'fl2. 
 
 Copyright, 1909, 
 By the Pearson Publishing Co. 
 
 Copyright, 1913, 
 By The Adirondack Enterprise Press. 
 
Note 
 
 II AM indebted to Pearson's Magazine, in 
 which this article was first published 
 in March, 1909, for permission to reproduce 
 it in its present form. I would also like to 
 make acknowledgement to Mr. James 
 Creelman, master journalist, for the sym- 
 pathetic preface which he wrote upon read- 
 ing- the original manuscript. 
 
 -S. C. 
 
Ktitroh«rtt!in 
 
 (Editorial from The New York Times) 
 
 ^O enormous has the "literature" of 
 2?' tuberculosis come to be of late years 
 that to say anything- new on the subject is 
 a task of exceeding- difficulty. It has been 
 performed, however, by Stephen Chalmers 
 in an article entitled "Watching- the Hour- 
 Glass." 
 
 His success is due in part to the fact 
 that he brought to the study of consump- 
 tives and consumption, as seen at one of 
 the Adirondack sanatoria, powers of ob- 
 servation made keen without being- ren- 
 dered inaccurate by the poetic imagination 
 which is so often necessary for sympathetic 
 interpretation. It results still further, 
 however, from the fact that he utilizes the 
 terrible advantage of being a part of what 
 he described. It is not by hearsay, by the 
 use of his eyes and ears, that he knows 
 what it is for a man with more dependents 
 than money to be told that he has tuber- 
 culosis of the lungs and that his chance 
 for life lies in abandonment of work for 
 an indefinite but certainly long period and 
 in taking a not inexpensive course of 
 treatment in a remote but not inexpensive 
 mountain village. 
 
 This was Mr. Chalmers' own experience, 
 and, being a trained maker of "copy," he 
 watched his own emotions as well as felt 
 them, then and afterward, as well as the 
 emotions and actions of those other exiles 
 
to the wilds with whom he soon found him- 
 self living-. Dark as is the picture he 
 draws, most people will probably be sur- 
 prised that it is not darker still — ^that it is 
 lighted by many a cheerful and even 
 humorous g-leam. The horrors are there, 
 but thej' are not exactly the horrors that 
 one would expect, and the hopelessness of 
 other days is gone. All except a few of 
 the patients have a fighting chance, the 
 majority of them something more, and not 
 a few the assurance of an approach to com- 
 plete recovery. The proverbial courage of 
 the consumptive is nowadays something 
 more than that of despair. 
 
 Besides being admirably written, Mr. 
 Chalmers' article is of practical value in 
 that it will help others over what he found 
 the crudest parts of his own experience^ 
 the time immediately following the an- 
 nouncement of his condition, the journey 
 into the woods, the first hours after ar- 
 rival. The realities were better than, as 
 well as diiferent from, the expectations, 
 and so far from lugubrious is the sana- 
 torium life, that not infrequently it is 
 unnecessarily prolonged by contented 
 patients. 
 
Watrlitng thf Ifour-CllasB 
 
JpVERY time a heart can be made to 
 >* thrill with sympathy for others, the 
 cause of humanity advances. The great 
 silent trag-edy of tuberculosis, which has 
 its victims in nearly every family, has so 
 stirred the civilized world that interna- 
 tional congresses have met to discuss it. 
 But the professional jargon of the doctors, 
 the wrangling of different schools of 
 science, leave the imagination of the 
 strong and well unmoved. One-third of all 
 the recorded deaths in middle age in the 
 world are caused by tuberculosis, a pre- 
 ventable and, it is said, curable disease. 
 It is the chief shame of modern civiliza- 
 tion. 
 
 In this touching picture of the alternate 
 horror and hope of a victim of 
 tuberculosis struggling for life vdth 
 his fellow invalids in the Adiron- 
 dack woods, the author has revealed 
 intimate details of his private life 
 and affairs, without which the story could 
 not be told. He holds his very heart in 
 his hands that you may see it beat. 
 
 If the article can reach into the con- 
 sciousness of the public, if it can awaken 
 the flame of love sufficiently to add even 
 a single crusader to the noble army that is 
 fighting against the "white plague," it will 
 have served the purpose of its author and 
 its publishers. 
 
 —JAMES CEEELMAN. 
 
Hatrtjittg % f nur-OllaajS 
 
 WTHE doctor had more sympathy to spare 
 ^ than tim^e, so his assistant received 
 me. To my mind there was instantly an 
 omen in the general nature of the con- 
 versation betw^een the younger physician 
 and myself. He seemed to be sparring for 
 time. It argued no good finding from a 
 previous visit. 
 
 Suddenly the door opened and the great 
 man appeared. I can see him still — the tall 
 figure, the somber, immaculate dress and 
 the calm, intellectual face. He pulled the 
 door quietly after him and stood in relief 
 against it, very erect, with his hands on the 
 door-knob behind him. 
 
 "In certain cases," he said, with kindly 
 abruptness, "I do not believe in wasting 
 words. I am sorry, but I find that you are 
 suffering from tuberculosis of the lungs." 
 
 "You don't say," I remarked, inanely. 
 
 There was silence. It was, in real life, 
 that much-discussed picture, "Sentenced 
 to Death," wherein the doctor's gaze is 
 fixed on a pale young man, whose eyes. 
 
 11 
 
looking out of the canvas, see and express 
 nothing. 
 
 But, in my own ease, I remember finding 
 much that was quaintly interesting in the 
 pattern of the Oriental rug. I observed, 
 also, that my shoes were muddy, and 
 thought of the miserable, thawing, Janu- 
 ary weather outside. Then I realized that 
 my remark was inadequate; that the as- 
 sistant was looking keenly at me, and that 
 the tall, somber, immaculate figure was 
 still standing in relief against the door. 
 
 "Then, the next thing to do is — get 
 better," I added, hardly knowing what I 
 was saying. 
 
 For, after the first sense of wonder at 
 the sudden truth, the truth lost all sig- 
 nificance. A simile might be that of a man 
 who has been struck down and is Instantly 
 conscious that he has been hurt, before he 
 loses his senses. I had been told that X 
 had tuberculosis of the lungs. I was 
 vaguely glad that the doctor had used a 
 bludgeon instead of the rack. I also felt 
 a decided relief to know that the long 
 doubt, the long fear, the long suspense 
 were at an end. . . . The doctor was speak- 
 ing again. 
 
 "Dr. M here, will tell you what you 
 
 ought to do. Of course, you will have to 
 leave the city at once. Tell him all about 
 
 12 
 
your private affairs. He'll advise you for 
 the best. Sorry I can't find time to talk 
 with you myself. But, whatever you do, 
 my boy," he added, with a sudden soften- 
 ing of manner, "don't get the blues. Keep 
 up your courage. Fresh air — fresh eggs — 
 and read Robert Louis Stevenson." 
 
 Then the hands clasped behind the doc- 
 tor adroitly turned the door-knob and the 
 somber, immaculate figure vanished. 
 
 /|pEAT was all. The fiat had been issued. 
 ^^ Tuberculosis of the lungs. Leave the city 
 at once. Fresh air — fresh eggs — and read 
 Eobert Louis Stevenson. ... I hardly knew 
 what the assistant was saying. It was a 
 jumble of advice, sympathy, hope and — 
 fresh eggs. My mind was still upon the 
 great man's words. Their meaning v^as 
 beginning to be clear. I was reviving from 
 the bludgeon blow and remembering what 
 had happened at the instant of receiving 
 it. 
 
 At first — it was all very interesting. Like 
 the prisoner at the bar, I would be a cen- 
 ter of attraction, anyway. It is human to 
 love to be interesting, even in an unpleas- 
 ant way. There were pleasing features, 
 too, for me. I must leave the city. To get 
 out of foggy, sloppy New York in January 
 was almost worth having tuberculosis for. 
 Leaving New York, too, meant leaving 
 
 13 
 
business. Here was an extended vacation 
 in sig-ht. It would not be like the vacation 
 of a really suffering man — the joyless, 
 daily routine of pain; rather it would be 
 an unlimited holiday with a permanent ex- 
 cuse for it. It mig-ht, indeed, be at my 
 employers' expense. . . . 
 
 Dr. M was still talking". It would 
 
 be necessary for me to g-o to the moun- 
 tains; to some place — say, the Adiron- 
 dacks — ^where it is cold and dry. I would 
 not, of course, be able to work — for a 
 while. I must lie in a chair, so that the 
 lesion in the lung- mig-ht heal. What were 
 my means, by the way? Was I dependent 
 on anyone? Was anyone dependent on me? 
 
 That is as far as Dr. M got. At 
 
 least, it is as much as I remember of his 
 r<imarks. Like a flash, the truth stood up 
 in naked horror before my mind's eye. I 
 felt the flail of the pitiless white plague 
 descend upon my raw senses, just as it 
 daily descends on thousands of victims in 
 doctors' of&ces the world over. The 
 phantom of the white death had blocked 
 the threshold of life; swept the ground 
 from under my feet; deprived a lad of his 
 earning capacity; stolen his independence; 
 robbed others of his support; made vain 
 his every ambition; reduced him and his 
 to the mercy of Chance and Charity, and 
 
 14 
 
banished him to exile among fellow victims 
 of the same scourge. 
 
 I would not be able to work. ... I must 
 lie in a chair. . . . The enormity of the 
 calamity was too much for the mind to 
 grasp at first. Perhaps I displayed some 
 levity in bidding the doctor goodbye. Five 
 minutes later I astonished an Irish bar- 
 tender with a speech like this: 
 
 "What would you do if you had never 
 saved any money, and you and your folks, 
 say, were dependent on the salary you 
 earned, and a doctor around the corner 
 told you, five minutes ago, that you had 
 tuberculosis of the lungs and would have 
 to quit work and lie in a chair for the 
 rest of your life, and — " 
 
 "Furst thing," said the Irishman, plant- 
 ing a bottle and a glass before me, "I'd be 
 timpted to take a drink!" 
 TjTlFTEEN minutes later I was walking 
 up Fifth Avenue, still too astounded 
 at the cataclysm to comprehend it fully. 
 Presently I ran into a man I was usually 
 anxious to avoid. He politely reminded me 
 that I still owed twenty-four dollars on 
 "that old bill." When we parted company, 
 I was somewhat amused and he seemingly 
 somewhat staggered. The idea of any 
 man being interested in a miserable twen- 
 ty-four dollars! 
 
 15 
 
I continued up Fifth Avenue — past the 
 shops that were still breathing of recent 
 Christmas joys — ^past the homes of the 
 rich and independent — threading among- 
 the thousands who were still unfettered. 
 I was still chuckling over that twenty-four 
 dollars. Where were the bills of yester- 
 day? Where were the dreams of yester- 
 day? Tumbled like card-castles! I found 
 myself quoting Omar and vras conscious 
 that I was very sorry for myself. The 
 novelty of having tuberculosis had not en- 
 tirely worn off. Presently I would have a 
 fine sensation to spring upon unsuspect- 
 ing friends. Dramatic instinct fairly rev- 
 eled in the circumstance. And I would be 
 the recipient of much sympathy, which is 
 almost as sweet as congratulation to a 
 man who is very sorry for himself. 
 
 But — What was to become of me — after 
 the novelty? I had no money. Those who 
 were dependent on me might help, me to 
 live on love, but they, themselves, could 
 not live on air. Of course, I had friends — 
 employers, too. They would probably — 
 
 But no! Even if I could swallow charity, 
 would it be fair to my friends? — ^my em- 
 ployers? It was no fault of theirs. And 
 this meant years and years of self-help- 
 lessness. True, they w^ould come to me 
 and say: "Better a year or two of cure 
 and—" 
 
 16 
 
Cure! A year or two! Dear, good 
 friends, did they believe, or did they ex- 
 pect me to swallow, that beautiful old 
 argument? This was the White Death, as 
 incurable now as ever, despite their sani- 
 tariums and their simple life and open air 
 and all their faddism. They would send 
 me to some living morgue, where animat- 
 ed corpses were laid out in rows — long, 
 haggard, coughing lines, where the Last 
 Hope stared up at the skies and wondered 
 when the hour-glass would run out, and 
 w^hen there would be an end to the clinical 
 thermometer and the stethoscope and — 
 raw eggs! They would send me there, 
 would they? Yes — in a strait- jacket ! 
 
 I had plumbed the depths of the tragedy 
 by this time. I had run the gamut of every 
 emotion, save one, that besets the thou- 
 sands of tuberculosis victims. And the 
 particular one came to me thus: 
 
 'ji SAT in a cafe with something amber 
 ^ and effervescent before me. I have 
 reason to remember the date. It was 
 January 15th, 1907. My life had gone 
 smash — seemingly. I could drag on only 
 as a burden upon the State, or upon the 
 charity of the individual. There was in- 
 surance on my life to the amount of $6,000, 
 the premiums upon which I could not hope 
 to continue to pay. If I contrived, some- 
 
 17 
 
how, to pay them, it would be depriving 
 the beneficiaries of material comfort while 
 I lived: depriving my miserable self of the 
 wherewithal necessary to obtain medical 
 aid which would bring me back to active 
 life. If I did not — could not — pay the 
 premiums and the policies lapsed, I would 
 leave the beneficiaries penniless at my 
 death, while I had made my sickly self 
 comparatively comfortable upon the sur- 
 render values. 
 
 It was a problem. On the other hand, 
 there was neither lien nor special clause in 
 any of the policies. Why not avoid the 
 poverty which must inevitably attend me 
 and mine through the payment of the 
 premiunas? Why not avoid the lapse which 
 would relieve me, but leave others un- 
 provided? Why not anticipate the "White 
 Death — now! It would not be cheating 
 the insurance companies. They took your 
 money as they took the risk, and they 
 accepted the risk of suicide by issuing a 
 policy containing no special clause against 
 it. Surely there would be some charitable 
 enough to appreciate the motive. 
 
 UT I leave that moral question for others 
 ■^^ I never had to solve it. In that hour 
 came the news that Kingston, Jamaica, was 
 destroyed by an earthquake. In wiping 
 out a city and over one thousand human 
 
 18 
 
beings in thirty seconds, the Inscrutable 
 had tempered the wind to one who was 
 shorn of everything- but his pen and an 
 intimate knowledge of the stricken city. 
 
 19 
 
^HE first part of this narrative could be 
 ^ nothing- but personal, through the in- 
 dividual nature oi the experiences and emo- 
 tions involved in that first encounter with 
 the scourge of civilization. But human 
 emotion, resulting from similar experience, 
 is much the same the world over, and the 
 foregoing should fairly represent the gen- 
 eral feelings of a great many of the thou- 
 sands who are being exiled from active 
 life by tuberculosis. 
 
 In the present, personal instance, the 
 tragedy is incomplete, because of the 
 chance that led the writer into a business 
 which requires little physical strain. But 
 in that army which presently moves from 
 the doctors' offices to the Valley of the 
 Last Hope, many — very many — go shorn 
 of everything that makes life's prospect 
 bright. A writer's of&ce is where he hap- 
 pens to be at the time of writing (mine 
 is in the Valley of the Last Hope); but 
 how^ can a lawyer plead his case from a 
 reclining chair, or an engineer build his 
 bridges — unless between the spruce-tops 
 overhead? All trades and professions are 
 represented in the Valley, from plumbers' 
 apprentices to college professors, and in 
 
 20 
 
nearly every case it is only sheer human 
 grit, or the sweetness of being" alive, that 
 nerves the white army to life its eyes unto 
 the hills. 
 
 And where is this Valley of the Last 
 Hope? And what is it? Thirty years ago, 
 a young- doctor whose life seemed blighted 
 by the scourge, entered the Valley. Sara- 
 rac Lake was then an Adirondack hamlet. 
 Here the young man turned upon the 
 enemy and planted his standard, the 
 motto on which, I am sure, must have 
 been: "He Who Would Conquer— Can!" 
 Today, Saranac Lake should be called 
 Trudeau City, in honor of the man '.x^ho 
 made it what it is — America's great hos- 
 pital-fortress for the prevention, control 
 and cure of tuberculosis. 
 
 Here, among a population of 5,000, every 
 fourth human being has "the trouble." 
 Here, every man is a soldier, sworn against 
 the common enemy, and here the sentries 
 for the common weal — doctors and nurses — 
 tread the battlements night and day, arm- 
 ed and arming and calling to arms against 
 the phantom which stalks the universe. 
 
 A stranger might walk from end to end 
 of Saranac Lake and not be aware of the 
 existence and proximity of tuberculosis, 
 and such are the health precautions that 
 he need fear no danger of infection. Yet 
 
 21 
 
the shadow is there, walking- side by side 
 with that hope which springs eternal. But 
 the clock ticks so regularly, the sand in 
 the hour-glass falls so unnoticeably, that 
 the days pass as silently, as smilingly and 
 as philosophically as they probably do in 
 Sleepy Hollow. Beneath the surface there 
 is the tvsigedy of real affliction, but there 
 is also that vein of human laughter which 
 no affliction can dow^n. 
 
 'ji who had left the doctor's office, dazed, 
 and w^as now, after a year of rebellion, 
 traveling to the Valley of the Last Hope, 
 knew nothing of all this. My friends were 
 still bidding me "au revoir" and, also, (I am 
 sure) goodbye. It was the drama which 
 can be witnessed any night a few minutes 
 before the departure of the Montreal 
 express from New York City. One par-" 
 ticular section of this train might aptly 
 be termed the "Lungers' Special." It is 
 fumigated after each trip, either way. But 
 when you have traveled on it once or twice, 
 you will see more than tragedy in the 
 Lungers' Special — grim humor though it 
 may seem to some. 
 
 Nobody ever went to Saranac Lake with 
 tuberculosis, and nobody who ever leaves 
 Saranac Lake has it. It is a disease which, 
 developed and discovered in a doctor's of- 
 fice, mysteriously disappears as the victim 
 
 22 
 
leaves the doctor's office. It reappears 
 about a week after the i3atient's arrival in 
 the Valley of the Last Hope and disajj 
 pears once more the instant the patient 
 steps aboard a train for the outside 
 world. 
 
 As a result of this sensitiveness — super- 
 induced by the world's ig-norance and a 
 dread that is of the wrong- sort — ^five or 
 six new patients who are destined to be- 
 come intimate during their stay in the 
 Valley, will strike up acquaintance with 
 Avholesale prevarication. Not one of the 
 six, say, is bound for Saranac Lake — Oh, 
 no! And that coug-h? Merely a little 
 throat trouble. How long- has he had it? 
 About two weeks. Dear me. . . . And each 
 prevaricator is trying to suppress his own 
 little coug-h and hoping that when the con- 
 ductor comes to examine the tickets, he 
 will not say "Sa-ra-nac Lake" with un- 
 necessary chestiness. 
 
 It is a laughing-tearful little comedy, 
 this. That lad in the corner there is silent 
 and far-eyed. In his mind there is the 
 vision of endless years in that hated place 
 —worse than Siberia — where the very 
 buildings are — or should be — "grim, gaunt 
 and ghastly"; where wan skeletons are 
 mustered on porticos and where the night 
 is made hideous with "the cough that won't 
 come off." 
 
 23 
 
This broad-shouldered man, who is 
 smoking (by way of proof that he is not 
 a "lunger") is wondering whether he can 
 get his seat back if he steps out of the 
 smoker for a drink — ^the last! for at Sara- 
 nac Lake the White Eaven shall say of 
 the Balm of Gilead, "Nevermore!" And the 
 long, thin passenger with the silk muffler 
 is already "taking the cure" in the airy 
 vestibule. But none of them is bound for 
 the Valley of the Last Hope. Never heard 
 of the place! 
 
 /|[ EAGEDY and comedy walking hand in 
 ^^ hand. Shattered health and vain ambi- 
 tions journeying out of the Valley of the 
 Lost Hope into the Valley of the Last 
 Hope. And who knows how this will re- 
 turn, and that — this in a wooden box? or 
 on a stretcher, going home to die? or 
 that, bright-eyed and robust — cured? 
 Cured! Oh, beautiful, oft-whispered word! 
 
 The lights flash on the metals as the 
 train bears them to exile. The steamers 
 on the Hudson turn their great rays on 
 the flying express and then turn them 
 away, as if they, too, divined the secret 
 of that Pullman. Albany! Utica! Then 
 goodbye to the world of activity. The 
 Adirondack wilderness stretches away into 
 the north, away to the snows of that Val- 
 
 24 
 
ley of the Last Hope. The exile climbs into 
 his berth. Tomorrow. . . . 
 
 Tomorrow . . . the vale of the shadow, 
 the colony of vain dreams. Some one 
 coug-hs in one of the curtained berths. 
 Which was it? The exile lies sick of heart, 
 weary of mind and wide of eye .... To- 
 morrow! . . . The forests deaden the sound 
 of the toiling locomotive, and the voice of 
 the wheels reiterates among- the woods a 
 song- of sullen rebellion ag-ainst the luck! 
 
 25 
 
®te lallru of thr IGast ^npe 
 
 HEN I came to it, dawn was an hour 
 old. Tlie train rolled into a sunlit 
 town, built like Eome upon seven hills 
 that were painted white and red and yel- 
 low with deep-veranda'd cottages. The 
 first touch of spring was brushing the 
 broken groves of pine and balsam with a 
 delicate greenery. The eyes looked: the 
 heart leaped; and a great load was lifted 
 from the mind. Was this the place to 
 die? No, it rather seemed the jpl^^ce to 
 live! 
 
 "Saa-ranac Lake!" cried the conductor 
 and the broad "a" echoed down the vesti- 
 bule. 
 
 I stepped out, wondering if any curious 
 eyes would note the arrival of this latest 
 Last Hope. There may have been some, 
 but only one person paid me the honor of 
 a moment's attention. I had neglected to 
 don an overcoat, in case — Well, it was the 
 month of May. Yet it was chilly up there 
 in the mountains, and a station official 
 remarked it. 
 
 "Better put on j^our coat," said he kindly, 
 and passed on. 
 
 I can do no more or less, than say that 
 this thousrhtfulness for others is the 
 
 26 
 
"atmosphere" of the Valley. I had a sec- 
 ond demonstration of it within two 
 minntes. A patient — a woman who was toe 
 weak to walk— had arrived by the same 
 train. They were taking- a window out of 
 the Pullman that the cot upon which she 
 rested might be passed out more easily. 
 And porters, conductors, hackmen — all who 
 saw — rushed to bear a hand to the delicate 
 task. I have since learned that many of 
 those Samaritans were "lungers" them- 
 selves, although it seemed to me at the 
 time that they looked robust enough to 
 lift the locomotive from the track. And 
 they did not cough — ^not one of them! 
 
 Presently, a hackman lifted my suitcase 
 and asked where I was going. I had a 
 letter to a doctor in town. It was on my 
 tongue to give the hackman the word, when 
 I remembered that, by so doing, I would 
 betray myself. I said I would walk, so as 
 to have a look at the town. I asked after 
 a hotel. He gave me the required in- 
 formation and offered to drop my suit- 
 case there. 
 
 Then I started into th«^ town, on my first 
 exploration of the Valley of the Last Hope. 
 The first thing I came to was a cafe. What! 
 The Demon here, too? This savored of 
 "high-handed debauch." It suggested ma- 
 terial for some Edgar Allan Poe — "The 
 Masque of the White Death." 
 
 27 
 
I turned into a street called Broadway. 
 All the latest magazines and New York 
 newspapers; hotels, stores, several sport- 
 ing-goods emporia, remarkably few 
 churches, not a sign of a cemetery that I 
 could see, and, as I afterward learned, only 
 one undertaker, who was hidden away be- 
 hind a furniture store. In short, it was a 
 bully little town full of seemingly bully 
 people. Where were the gaunt skeletons? 
 Where the living morgues? Why didn't 
 somebody cough? Why didn't a white and 
 red ambulance appear on the rush? I had 
 been tricked by a popular fiction! . . . Then 
 the horrible thought occurred that I was 
 the only "lunger" in the whole town. 
 
 Unhappy, lonely and depressed, I came 
 to the hotel and registered. Here, again — 
 from manager to bell-boy — the same gentle 
 kindness. Of course, they knew I had 
 come to die. In desperation I scowled at 
 the clerk and snarled like a thirsty pirate: 
 
 "Where's the bar, or don't you sell rum 
 in these parts?" 
 
 "Right straight through the grill-room," 
 said he, imperturbably. 
 
 Grill-room! Then there w^as probably a 
 theatre, perhaps a dance-hall, and — There 
 were! Maybe somebody could suggest a 
 "quiet, four-handed game." Somebody 
 could — and did! 
 
 28 
 
'JJT was either the "Masque of the White 
 ^ Death," or I had come to the wrong 
 place. It was probably the latter. For 
 hours I wandered about the town. Broad- 
 way and Main Street were alive with ro- 
 bust men — mostly young — and neatly, even 
 well-dressed, women. The Town Clock 
 struck midday as cheerily as a cock w^ould 
 announce sunrise. True, I had seen one 
 or two rather cadaverous persons; I had 
 noticed that all of the houses were wide- 
 piazza'd, and on some of those verandahs 
 I had seen some persons stretched out on 
 recliners. But those persons were far 
 from ill-looking, and all of them were on 
 the sunny side, reading latest novels, or 
 talking and laughing. They might be 
 "consumptives" — a taboo'd word, by the 
 way — but to me they were more like peo- 
 ple suffering from that languorous ailment 
 produced by the hook-worm. 
 
 No, there was some mistake. This was 
 not the dark metropolis of the Valley of 
 the Last Hope. I guardedly asked the 
 hotel clerk if there were "many lungers 
 in this section"? Here is his enigmatic 
 reply: 
 
 "A lady came in here one day. She 
 had a young son with her." The cierk 
 was looking me solemnly in the eye. "The 
 young son looked sick. 'Madam,' I said in 
 
 29 
 
my kindliest manner, 'is your little boy up 
 here for the trouble?' Would you believe 
 it, sir? She got quite ang-ry and, after 
 g-laring at me for a moment, said: 'Cer- 
 tainly not, sir! What an idea! Willie — 
 cough for the gentleman!' Willie coughed." 
 
 Completely at sea as to the point of this 
 anecdote, I went with my letter to the 
 doctor, who was to be my physician until 
 the hour-glass ran out. I asked him for 
 an answer to the clerk's enigma. The doc- 
 tor laughed^rather heartily, I thought, 
 for one who lived in the Valley of the Last 
 Hope. I confessed that I had the trouble. 
 I went on to describe my impressions of 
 the Valley. He fairly roared with mirth. 
 I also described my preconceived ideas of 
 the Valley. At that he was almost beside 
 himself with merriment. 
 
 "Why," he finally managed to say, "we're 
 nearly all what you call 'lungers' up here. 
 Your hackman was a lunger. Probably 
 your hotel clerk was, too. About every 
 fourth person you saw was a lunger. Why, 
 the respiration of the Town Clock — " And 
 he went off again in laughter. 
 
 "We?" I said sepulchraily. 
 
 "Why, yes," said my physician, more 
 soberly. "I'm a lunger, too." 
 
 My dark castles and all their moribund 
 inhabitants crumbled to dust. This was 
 
 30 
 
my Valley of tlie Last Hox^e. But I was 
 yet to learn that this real Saranac Lake 
 which I had found, was just what down- 
 right, human bravery had made it! 
 
 31 
 
Iffarta attb MmtxtB 
 
 J^OW, here is one of the strange things 
 ^ about the Valley of the Last Hope. No 
 two persons in it are quite in agreement 
 about it — about its success, its ultimate re- 
 sult, its social conditions and moral influ- 
 ence. They tell me that, with every year 
 of residence in the Valley, a person's 
 viewpoint changes, or becomes completely 
 reversed. Personally, I can speak only in 
 months, but after seven of them, my views 
 on the subject have changed three or four 
 times.* 
 
 Coming from the active world; filled with 
 one's own affliction; resigned to one's own 
 fate and predisposed to a gloomy concep- 
 tion of everything, the Valley of the Last 
 Hope bewilders the sense of the fitness 
 of things. The newcomer finds cafes, 
 grills, billiard parlors, theatre and moving- 
 picture shows, poker games, and other 
 things that the mind associates with the 
 
 * This was written in 1909. After five 
 years, I believe that my opinion has 
 reached the permanent stage. The place 
 at first saddens, then inspires, and, in the 
 end, if it does not, indeed, mend human 
 bodies, it at least cures human nature of 
 much pettiness. — S. C. 
 
 32 
 
g&j life; and while the newcomer may be 
 agreeably disappointed that the picture 
 is far from gloomy, he is momentarily 
 horrified by what his imagination suggests 
 as something akin to a death orgy. 
 
 Of course, he forgets that about three- 
 fifths of the inhabitants of the Valley of 
 the Last Hope are not "lungers" at all, but 
 busy people sawing wood. How could a 
 colony of nearly two thousand invalids get 
 along without a few able-bodied citizens? 
 And how could the able-bodied ones get 
 along without a few lively and enlivening 
 institutions? Where such a work as Dr. 
 Edward L. Trudeau's was being carried on, 
 and where the thousands of ships that 
 came and went spent, each, on an average, 
 one thousand dollars a year, a thriving 
 town like Saranac Lake was inevitable. 
 The newcomer soon gets rid of his morbid 
 viewpoint. The material for that "Masque 
 of the White Death" falls flat in a week. 
 
 The next view of the new-come patient 
 is likely to be one of unqualified enthu- 
 siam over the noble, splendid, magnificent, 
 admirable, etc., work that is being done in 
 the Vallej'- of the Last Hope — a work which 
 is intended to benefit, not only the resi- 
 dent patients, but the whole world-wide 
 cause against tuberculosis. 
 
 The patient comes afilicted. He is un- 
 
 33 
 
happy and lonely. He falls into the hands 
 of a private physician, who knows just 
 exactly how he feels abont it, and gives 
 him straight "medicine talk," which stirs 
 the unfortunate's hope again. Or he is 
 directed to the tactful man who, as secre- 
 tary of the Society for the Control of 
 Tuberculosis, takes the burden off his 
 hands, tells him plainly what he 
 cannot do and the next best thing 
 that he can do. And this tactful 
 manager of what might be termed 
 the Clearing-House of Trouble, steers 
 the cheered-up patient to the maxi- 
 mum possible of comfort, cure and con- 
 tent. It may be to a boarding-house, or 
 it may be to a sanitarium, but wherever 
 the newcomer goes (at this stage of his 
 education) he is struck by the brotherly 
 effort which is being made for the victims 
 of tuberculosis, not only at Saranac Lake, 
 but at the other institutions up and down 
 the Valley, of which Saranac Lake is only 
 the metropolis. 
 
 At the boarding-house, the patient meets 
 with fellows in misfortune, and the older 
 ones advise, console and whisper the talis- 
 manic w^ord, "Hope." In the sanitarium he 
 finds a sort of club, whose members have 
 agreed to be contented, and to help them- 
 selves by helping one another, and where 
 
 34 
 
there seem to be no rigid rules (those 
 dreaded restrictions) because the rules, 
 made for the good of all, are too blessed 
 to be broken. 
 
 He looks upon the Valley of the Last' 
 Hope as the Valley of Rest and Sunshine, 
 where the human being reaches as near 
 to perfect blessedness as is possible on 
 this suffering earth, and where the doc- 
 tors and nurses, themselves often afflicted, 
 are as ministering angels. Indeed, the 
 writer heard one young woman say, in a 
 moment of Valley content: 
 
 "Do you know, I am almost glad I got 
 tuberculosis." 
 
 IJ^D there is the cue to the newcomer's 
 "^^ next change of view, and this change 
 is the "pons asinorum" of life in the Val- 
 ley of the Last Hope. 
 
 It is a known fact that a great many of 
 those who have come to the Valley, "taken 
 the cure" and gone back to the active 
 world, have come back to the Valley 
 again, as surely as the travelling New 
 Yorker returns to his Broadway. This 
 question of the "call of Saranac" — or, 
 strictly, of the Dossible demoralization of 
 patients by too much idleness — ^has been 
 argued to silence. Further argument of 
 the matter is not proposed here. 
 
 But the patient, who is living and learn- 
 
 35 
 
ing-, presently comes to the scoffing- stag-e. 
 He is treated with Koch's tuberculin, say. 
 twice a week, and suddenly he comes to 
 the conclusion that the doctors don't know 
 anything about its effectiveness themselves, 
 and that they are making experiments 
 upon him — a free-born, independent, Am- 
 erican citizen! As for the sanitariums, 
 the patient, at the scoffing stage, de- 
 nounces them as institutions for the 
 breeding of tramps. The alleged patients 
 — the healthy-looking young men in the 
 reclining chairs — are a pack of loafers who 
 ought to be at home supporting the per- 
 sons who are now supporting them! As 
 for the w^omen patients — ^w^ho have grown 
 plump and have got the red back to their 
 lips and the sparkle to their eyes — they 
 only hang on because the men have noth- 
 ing to do, and, in consequence, have plenty 
 of time for flirtation. (Incidentally, few 
 marriages have grown out of such asso- 
 ciations.) 
 
 Also, the cynic points out, while the line 
 of wiser patients in the reclining chairs 
 listen in sad silence (Ah! if it were only 
 true!), witness the patients who are dis- 
 charged — cured. They never were cured. 
 You can't cure tuberculosis! Else why did 
 they come back after six months? Grant- 
 ing that they were cured, will the wiser 
 
 36 
 
patients, then, admit that those who come 
 back like the lazy life and the flirtations 
 and the freedom from the financial respon- 
 sibility which is being- shouldered by their 
 relatives at home? 
 
 So your tuberculosis lawyer arg-ues. He 
 draws the picture of the fellow who, hav- 
 ing spent six months in a chair with the 
 latest novels, goes back to the city, cured 
 of tuberculosis, but inoculated with the 
 germ of downright laziness. He is also 
 full of sanitarium faddism. He must stand 
 on one leg and draw^ three long breaths 
 every morning before breakfast. He must 
 never walk if he can ride. At his city 
 office he is a fresh air fiend and the rest 
 of the office staff is down with the grippe. 
 He has also the clinical thermometer habit 
 and sticks the glass in his mouth once an 
 hour; and if, in the rush of honest hard 
 work, he discovers that his temperature is 
 one-tenth above 98.6 degrees, he takes to 
 bed until it is normal again. Finally, says 
 the patient at the cynical stage, when he 
 has convinced his employer that he was 
 not quite cured, or his employer has con- 
 vinced him of the same thing (in order to 
 get rid of him and his fads), its heigh-ho 
 on half-pay for the Valley of Everlasting 
 Idleness and the reclining chair and the 
 pretty girls and — 
 
 37 
 
About this stage, the rebellious patient 
 throws aside his blanket, springs from his 
 chair, refuses to "take the cure" any- 
 longer, paints the Valley red from end to 
 end, and — 
 
 When his views have changed again, he 
 finds himself flat on his back with a little 
 glass stick in his mouth, a nurse at his side 
 and a grave, but patient, doctor taking his 
 pulse. 
 
 And now he begins to understand the 
 real life and methods and purposes of the 
 Valley of the Last Hope — that Valley whose 
 light and shadow, comedy and tragedy, 
 nobility and self-sacrifice, are here set 
 forth in brief. 
 
 38 
 
7^0 matter how dark a tragedy may be. 
 ^^ its somber nature must lend brilliance 
 to the faintest ray of sunshine. So is it 
 in our Valley of the Last Hope. 
 
 Day after day, month after month, come 
 summer, come snow, our little world moves 
 on, hopeless or hopeful, pathetic or beau- 
 tiful, tragic or touched with humor — as a 
 whole, a commingling of all. 
 
 Some of us lie all day — every day — all the 
 year around — in the reclining chairs, while 
 some of us are so far on the road to re- 
 covery that we may walk, drive, pay calls 
 and even eat festive dinners. That hope 
 which is recognized as a marked symptom 
 of the disease, is ever with us. That death 
 which threatens so many of us, is seldom 
 thought about. It is even considered in 
 bad taste, save in the doctor's private office, 
 to make mention of the disease which men 
 call tuberculosis. In some places, even a 
 vague reference to the "trouble" entails a 
 small fine, w^hich is usually deposited in 
 the boarding-house "pig" and the total sum 
 of fines eventually devoted to some little 
 charity. 
 
 True, in the solitude of his room, a man 
 — certainly a woman — may put down his. 
 
 39 
 
or her, head and "let go." And a man may 
 say, as I heard one do the other day, "I'm 
 so tired of hanging on that I feel like fall- 
 ing off!" But for the greater part of the 
 time those brave people keep a stiff upper 
 lip, each smiling that the other may see 
 the smile, and pass it along. So the days 
 pass, outwardly serene. In truth, our little 
 world is inwardly much happier than the 
 big world might suppose. 
 
 We even have our own jpeculiar brand of 
 humor. The story of the hotel clerk and 
 Willie may not appeal to outside-world 
 people, but it is one of the favorites of the 
 Valley folk, who have become used Cnot 
 hardened) to the grim side of things. An- 
 other favorite is the story about the pati- 
 ent who died and went to Heaven — -or, at 
 least, got as far as the Golden Gates. 
 
 "You're from the Valley of the Last 
 Hope," said St. Peter, eyeing the applicant 
 for admission to celestial joys. The pa- 
 tient admitted the soft impeachment, 
 
 "Well, we don't let lungers in here," St 
 Peter added. "You'll have to take a lower 
 stall." 
 
 The patient j)atiently descended to the 
 gates of the Other Place. The Wicket- 
 keeper — a plumber he had been in life — 
 asked the usual questions. Finally he said: 
 
 "No. We don't take lungers in here!" 
 
 40 
 
"Why not?" asked the patient, wonder- 
 ing- where he could go. "St. Peter said — " 
 
 "Oh, that's all right," said the horny 
 official, winking. "St. Peter can say what 
 he likes, but the last lunger w^e let 
 in here left the windows open over night, 
 so that all the fires went out and the Devil 
 got the grippe!" 
 
 I^HE Valley has a vernacular of its own. 
 too. We speak of a man having the 
 "Saranac mood" w^hen he evinces a mark- 
 ed desire to slay somebody, even if it be 
 himself. The everlasting clinical thermo- 
 meter is referred to as a "worry stick," 
 and its aim in life, the "temp." That 
 aimless watch-you-don't-overdo-it-kind-of- 
 walk of the exercising patient is known 
 as the "T. B. Tread." 
 
 Even the eminent Koch's tuberculin, 
 which is used as an immunizing agent, 
 does not escape banter. It is usually in- 
 jected into the patient's back and is af- 
 fectionately referred to as "my little jab,'' 
 or, irreverently, as "bug-juice" or a "sub- 
 cutaneous cocktail." One patient of a 
 rhyming turn of mind immortalized the 
 serum in verse while he (the penitent rhy- 
 mer) was suffering from a reaction 
 brought about by his own reckless beha- 
 vior. The lines so tickled some of the 
 
 41 
 
Valley folk that they tnay be of interest 
 to the uninitiate : 
 
 ?T HEY say that in forbidden liquors dwell 
 W Serpents and pale-eyed monsters out of 
 
 H— 11; 
 They say that in the potion Juliet drank, 
 There lurked a poison, drowsy, dim and 
 
 dank; 
 But, 0! Tuberculin, thou art the King- 
 Of all the serums jabbed for anything. 
 Thou mak'st me feel— when I can feel at 
 
 all- 
 Like to the sphere when players swat the 
 
 ball; 
 Or as if Devils, bursting- from Gehenna, 
 Were mining- me with picks and drills and 
 
 senna. 
 Seven days a week my back is like the 
 
 cushion 
 Where thrifty housewives pins and needles 
 
 push in. 
 Kather a Jag- for me the Hotel Berkeley in 
 Than any Jab of any d d Tuberculin! 
 
 And we have our romance, too — and our 
 romances. It is but natural that, where 
 opposite sexes are thrown tog'ether ^vith 
 common affliction and mutual sympathy, 
 there should be those harmless flirtations 
 of which the cynic so furiously rag-ed. In 
 summer, especially, when all the Adiron- 
 dacks are clothed in a splendor of green, 
 you can see them — ^I mean the couples — 
 
 42 
 
strolling" along a certain lovely spot of the 
 Valley, known as "Lover's Lane." 
 
 They call this thing- "cousining-," as de- 
 scriptive of the platonic nature of the in- 
 timacy, although one might ask if the old 
 English "cozening" is not the spelling of 
 the word. This "cousining" continues 
 through the winter, too. When the air is 
 dry and the thermometer is below zero, 
 the sleigh bells drown many a whisper 
 coming from the pile of buffalo robes as 
 the runners glide over the snow. And 
 there are special favors to special swains 
 at the Christmas celebration — which is jusi 
 as joyous in the Valley as elsewhere, some- 
 how — and marked attentions when the 
 glorious w^inter carnival comes in February. 
 
 But, as has been remarked, few mar- 
 riages result from these little pairings oi 
 congeniality. Yet the blind god is here, 
 too, his arrows more flinty to meet the 
 bitter irony of the situation. When true 
 love enters here, it is often tragic, but 
 very often beautiful. 
 
 2|i ERE is the man, afflicted, and here is 
 ™ the woman, come to him from the 
 world outside, which she has forsaken for 
 his sake, to be with him to the end. Here 
 too, is the woman, afflicted, and the man 
 unafflicted, coming at intervals from the 
 
 43 
 
city to drain to the last drop the sweet 
 measure of her presence. 
 
 But most beautiful of all, despite the 
 tragedy, is where both are afflicted and 
 Love stands between the reclining" chairs. 
 For them, perhaps, is but a brief portion 
 of happiness. Hands may join across the 
 little space when the lights are low. Thej- 
 may whisper and yearn and hope, but too 
 often the dream is vain. A kiss on the 
 brow — and then — good-night! 
 
 For "goodbye" is the hardest word to 
 say in the Valley. It is seldom said. Some- 
 one passes in the night. There is a little 
 hush: then the shadow is bravely, resolute- 
 ly forgotten. But sterner than this re- 
 minder of death is the home-going of one 
 who has been cured and is now going back, 
 a militant missionary himself, to teach the 
 prevention and cure which he has been 
 taught. The hearts of those he is leaving 
 are heavy, while their spoken words are 
 light and their handclasp firm. There is 
 no envy, but — 
 
 ESPITE one's best efPorts to smile the 
 tears will come. The shadow hangs 
 heavy upon the world. But who shall say 
 that the exiles to the Valley of the Last 
 Hope are not a brave little band? Their 
 motto is Faith, Hope and Love — Faith in 
 
 44 
 
Inscrutable Wisdom — Hope for the best- 
 Love toward one another. So be it! 
 
 45 
 
^amt (§pxnian5 
 
 *■ MATCHING the Hour-Glass" deals in a 
 *^inost realistic and touching- way 
 with a wide spread field of human emotion 
 which has been generally shunned owing" 
 to its sadness. Mr, Chalmers, from the 
 standpoint of personal experience, has 
 shown that the darkness of the shadow 
 makes the contrasting light more lumin- 
 ous; that the great lesson the tuberculous 
 must learn is that the conquest of fate 
 comes not by rebellious struggle, but by 
 acquiescence; and that even when his 
 pathetic struggle for health fails, his life 
 may stand for the victory of the con- 
 quered. — E. L. Trudeau. 
 
 "The article by Mr. Stephen Chalmers is 
 the most vivid description I have seen of 
 the feelings that come to "us lungers." 
 This is the sort of literature that will do 
 more toward making healthy people ear- 
 nestly desire to avoid tuberculosis than all 
 the lengthy treatises that have been writ- 
 ten toward that end." — Thomas Crawford 
 Galbreath, The National Association for the 
 Study and Prevention of Tuberculosis. 
 
 ^N^ wCr ^IP" 
 
 " It is not only very interesting but of 
 so healthy a tone that it cannot help b\h 
 do much good." — Dr. Livingston Farrand, 
 Executive Secretary, The National Associa- 
 tion for the Study and Prevention of 
 Tuberculosis. 
 
 46 
 
"It touched me by its grace, its sincerity 
 and its fine optimism. No one can write 
 of such a thing* from the outside. Like 
 divine revelation, it is not a statement, but 
 an experience." — James Creelman. 
 
Adversity is sometimes hard 
 on a man ; out for one man 
 Tvno can stand prosperity there 
 are a kundrecl tkat will stand 
 adversity. — Carlyle. 
 
X 
 
 It IS a gooci and safe rule to 
 sojourn m every place as if you 
 meant to spend your life tkerc, 
 never omitting an opportunity 
 of doing a kindness^ or speaking 
 a true word, or making a friend. 
 
 —Ruskin. 
 
 ^z 
 
DUE DATE I 
 
 \$im H 
 
 Y jW^ 
 
 5j|y/|Lii (p^ V ,. 
 
 -^ \ 
 
 
 
 mxi 
 
 U ia^o f 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 Printed 
 in USA 
 
C55 
 
 EC512 
 Chalmers 
 
 Watching the bwr-gl 
 
 jf^J/Z 
 
 (Ts 
 
 
 COLUMBIA UNIVERSITY LIBRARIES 
 
 0037541218