Quarantined

Before the development of effective TB drugs, public health officials tried to control the disease's spread by assuming far-reaching powers regarding the reporting and quarantine of tuberculars. By the 1930s, public, private and charitable groups in the United States had built as many as 700 sanatoriums to isolate the infected and provide them with the absolute rest, fresh air and wholesome food that was believed to form the cure.

Private and public institutional care initially were available only to white patients, and life in the early municipal sanatoriums was "cruel and dismal," Sheila M. Rothman says in her book Living in the Shadow of Death: Tuberculosis and the Social Experience of Illness in American History. Rothman describes them as places of last resort that took in new immigrants and indigents, along with prisoners and mental patients sick with TB. The culture demanded passive patients. Rothman says staff made all of the decisions in places that were "more like prisons than hospitals, in which the prescience of death, not the promise of cure, was pervasive."

Tuberculosis infection slowed among the white population but began spreading among black Americans in the early 20th century, after many had moved from the rural South into crowded, segregated urban quarters. The disease became "racialized," according to Samuel K. Roberts, assistant professor of history and sociomedical science at Columbia University's School of Public Health. Black women were a special concern, he says, because of the fear that they would bring infection into the homes where they cooked, cleaned and cared for white families. Roberts, who is working on a book about African Americans and tuberculosis, says, "If you were a poor or working-class black woman in [a] city, you were really vulnerable to coercion and stigma."

To what degree race, class, sex and even geography factored into the tuberculosis-control efforts of Washington is not clear. When Glenn Dale's first building opened in 1934 -- a children's hospital -- community leaders cited the need for a facility for colored residents with TB, whose death rate was six times higher than that of white residents with the disease. Glenn Dale's adult hospital, which opened three years later, took in people of all races but apportioned more beds for the white wards than for the Negro wards. By early 1954, six months before Mama got her orders to go to Glenn Dale, the sanatorium reportedly began assigning beds as they became available, without regard to race. Patients were required to pay for all or part of hospital costs if they were able. Mama did not pay.

Depending on how advanced the disease was at diagnosis, TB patients could languish for years, even decades, enduring cycles in which they passed in and out of the infectious stage. Half of those who got sick from TB died from it.

MAMA NEVER CONSIDERED WHETHER SHE HAD OTHER OPTIONS. She knew nothing of due process, and it is unclear whether she had the right to refuse to go. Local laws allowed compulsory isolation of certain infectious people, and few protested sacrificing the rights of individuals to protect the public good. And so, on July 2, 1954, three or four days after Mama mentioned her shortness of breath at the clinic, Daddy bought veal cutlets, and Mama prepared and plated them so that they could share a meal before she left. Two of Daddy's sisters had already picked up the girls to take them to my paternal grandparents' farm in Virginia. Mama doesn't remember an anguished goodbye, only that the girls would have been excited to go for a ride. As Mama and Daddy sat down to their lunch, a call came from Glenn Dale telling Mama she was supposed to be there in an hour. They got up from the table, and Daddy put Mama's suitcase in the DeSoto. Mama didn't understand the health department's agitated demands -- she thought they should at least let her spend the Fourth of July holiday at home. She imagined the rush must be about me, the child she was carrying. After the baby is born, I'll be back, she thought. Maybe two weeks. She didn't know that the average stay at Glenn Dale was 482 days.

GLENN DALE HOSPITAL WAS A PUBLIC WORKS ADMINISTRATION PROJECT, its design reviewed by the Commission of Fine Arts. It was set 15 miles across the Washington line in rural Prince George's so that the sick from the nation's capital could escape the swampy city and inhale fresh country air. There were other sanatoriums for Maryland and Virginia patients. Many of Glenn Dale's Georgian and Colonial Revival-style buildings, with stone cornices and columns, were built under the supervision of architect Nathan C. Wyeth, who worked on other imposing, authoritative structures, such as the first Oval Office, the Russell Senate and Longworth House office buildings, the city's municipal libraries, courts and schools -- Coolidge and Wilson High, among them -- and elegant residences along Embassy Row.

By all accounts, the sanatorium was a lush, manicured landscape, leading some to dub it "Glenn Dale Golf Club." Today, the campus languishes on Glenn Dale Road at Route 450. Pass a short band of woods and an enclave of $500,000 homes on Legend Manor Lane, and, like a light fog, a hush settles. A small "No Trespassing" sign is hardly noticeable. Beyond it, atop the campus's highest point, stands a red brick building. Vines thick as a garden hose curl around its facade, and in and out of open breezeways running the length of either side of what was once the children's hospital. The sleeping porches -- key to exposing patients to the fresh air that was part of the treatment -- were here. The screens are gone, but shreds dangle, and shards of glass poke out of the corners, leaving rows of empty black holes.

Over time, the campus expanded to include 23 buildings, was home to more than 600 patients and employed almost 500 physicians, nurses, assistants, technicians, office, grounds and maintenance workers, administrators, cooks and housekeepers. The most prominent structure spreads out on one side of the road. The five-story, H-shaped Adult Building is where Mama would learn to play the invalid. When the sanatorium opened, it was hailed as state of the art, but on that day in 1954 when Mama and Daddy passed the high stone cornices and walked through the narrow front door, Mama thought the place looked dingy and bleak. Dark woodwork framed bare, gray walls and dull metal furnishings. High ceilings and dim lights bounced shadows down the halls.

A woman with a wheelchair greeted Mama and snickered about the pregnant woman who had come to the wrong hospital. Upstairs, on the second-floor women's ward, a nurse in starched white cap and dress showed Mama to a single room across from the nurses' station. Told not to stray from it -- her treatment would wait until after the baby was born -- Mama spent about a week in the room, without visitors or access to a phone. All she could do was fret and sob and pray into her pillow: Lord, let me live so I can raise my children.

ON THE MORNING OF JULY 12, Daddy got a phone call saying that his mother, Leah, had died after an illness. The girls were still at her house in Virginia, about four hours away, cared for by aunts as the rest of the family gathered. Daddy got another call that morning: His wife was in labor.