CHAPTER FOUR
1
BRONCHIAL ASTHMA is among the most serious of childhood afflictions—baffling, capricious, expensive, and, in its acute stages, terrifying. It is also a family affliction and a severe one, which is something seldom understood by those who have never lived with an asthmatic child, for rarely does anyone beyond the immediate family or the medical profession see an actual attack or have any idea of the suffering involved. The child known by the outside world is the child between attacks who appears to have little or nothing the matter with him, who can play and carry on like most any healthy youngster, even hike twenty miles in the Alps. It is only those closest to him who know how tenuous such intervals are. For the parents it is “living with a time bomb.” The attacks, when they come, are a shattering, numbing experience—always, no matter how many times it has happened before. Nights are made a shambles, sleep is lost, nerves are frayed. Parents become intensely wary of anything that might bring on an attack. They grow increasingly protective, often engulfing in their good intentions. And if, as the years go by, the child shows no improvement, they begin feeling desperate and depleted; they see themselves caught in the grip of something altogether beyond comprehension and their ability to cope. Some mothers “just about go crazy” with worry.
On the third day of October 1869, her fifth day in Vienna, Mittie Roosevelt sat in the garden at the Schönbrunn Palace, writing still another long letter to her sister. Again that morning, as in London, it had been necessary for Theodore to rush Teedie out of the city for a “change of air.” By this point in their married life, she and Theodore had been living with Teedie’s asthma for about seven years.
This morning Thee and Teedie left us immediately after breakfast to spend the day and sleep tonight at [Bad] Voslau, an hour by rail from Vienna. Teedie . . . seems hardly to have three or four days’ complete exemption and keeps us constantly uneasy and on the stretch. For instance on Lake Como . . . it came to a point where he had to sit up in bed to breathe. After a strong cup of black coffee the spasmodic part of the attack ceased and he slept; consequently woke up partly restored. Had the coffee not taken effect, he would have gone on struggling through the night. . . . Thee had warded off one or two attacks with this coffee, but likes to keep it for our trump card. . . . On Saturday was exactly the fortnight since we reached Venice. These entire two weeks he has had nothing but diarrhea and threats of asthma . . . and this morning, as I said, they have gone out of the city for this little change of air. We had almost every day lovely weather in Venice and these few days in Vienna cloudless blue skies and soft breeze. So what it is that keeps up the attacks is a mystery.
How conversant she and Theodore were with the latest medical theories on asthma, what medical advice they were getting, we may only speculate; but their concern for health being what it was and given the frequent contact they had with physicians—Hilborne West, Charles Fayette Taylor, John Metcalfe, the family doctor—they probably knew as much as did any parents of that day. And while it is true that enormous strides have since been made in pulmonary medicine, the things then perceived were neither trivial nor tangential. Asthma had been recognized as a definitive clinical disease for more than a century. A hereditary tendency, the fact that there is a “genetic predisposition” to asthma, had been noted. A seasonal pattern was perceived by many physicians. Certain foods, certain odors, bed feathers, house dust, cat fur, as well as abrupt changes in temperature or humidity, were cited as specific irritants that could bring on an asthmatic “fit” and patients were advised accordingly.
Equally impressive was the mounting body of opinion that the key lay somewhere in the “neurotic character of the complaint.” The first experimental work on the psychological factors in asthma was not to come until the 1880s. Freud and his revelations concerning the unconscious world were further still in the future. But the idea that asthma might be somehow connected with the emotions was very old—allegedly Hippocrates had warned, “The asthmatic must guard against anger”—and from the early part of the nineteenth century increasing numbers of physicians had become convinced that states of grief, anger, joy, “nervous influences” or “passions of the mind” played a more important part than heretofore reckoned.
The fact that an asthmatic’s lungs may be quite “perfect”—as the doctor in London found Teedie’s lungs to be—had been determined as early as 1819 by the famous French physician René Laënnec, inventor of the stethoscope, who perceived no organic causes to which asthma could be attributed but listed “mental emotion” among the primary probable causes.
“A preternaturally nervous . . . temperament, if not the cause, wonderfully favors the attack of asthma,” wrote an American doctor named Joshua Bicknell Chapin in 1843. “Extreme nervous irritability not only invites the attack, but aggravates the symptoms and prolongs continuance,” he said, and elucidated on the frustrations of trying to pin down a specific dietary or environmental cause.
What will almost universally relieve one case, will as assuredly induce a paroxysm in another. Ordinarily the air of low situations is more congenial than mountain breezes. . . . Some suffer in a certain room, but are immediately relieved if removed to an opposite room in the same house. One cannot sleep or rest in one street, or lane, but slumbers quietly if removed to another part of the same village or city. Another can breathe freely if he can only be allowed to sit in a room filled with smoke to suffocation, but pure air is almost intolerable. . . . While one is benefited by a journey in the country, another will find more relief in the contaminated atmosphere of the densest mart. . . . Most will avoid a crowded assembly as they would a pesthouse; but I have a friend who always resorts to such a place when practicable, for a moment of private breathing.
All such cases, he surmised, “owed their origin to certain mental impressions, or emotions.”
In 1864, or two years after the infant Teedie’s asthma had begun, a highly important work was published in Philadelphia, a book of 256 pages titled On Asthma. The author was an English physician, Henry Hyde Salter, a very keen observer who as the father of an asthmatic child had “experienced the horrors” of the disease. Like Laënnec, Salter had found no abnormalities in the lungs of his asthmatic patients, no trace of the disease in either the respiratory or circulatory system, and hence concluded that the trouble lay in the nervous system. Asthma, a disease of “the direst suffering,” a disease “about whose pathology more various and discrepant ideas prevail than any other,” was “essentially a nervous disease.”
Sudden “mental emotion,” Salter said, could both bring on an attack and abruptly end one. He did not know why, only what he had observed. He reported on a patient whose attack ceased the moment he saw a fire outside the window and another who had his asthma stop when put on a fast horse. Still other patients found that as soon as they neared the doctor’s office their asthma vanished, “suddenly and without any apparent cause except the mental perturbation at being within the precincts of the physician.” The onset of an attack, he noted, was frequently preceded by a spell of depression or “heaviness” (what Teedie called feeling “doleful”), and twenty years in advance of what might be regarded as the first studies in the psychosomatic side of asthma he reported on a small boy who “found his disease a convenient immunity from correction.”
“Don’t scold me,” he would say, if he had incurred his fathers displeasure, “or I shall have the asthma.” And so he would; his fears were as correct as they were convenient.
The nature of an actual attack was described by Salter in accurate, vivid detail and with considerable sympathy for anyone who had to try to deal with the situation. Specific kinds of treatment were described, including the “beneficial influence of sustained bodily exertion.” It was the most comprehensive study on asthma that had as yet appeared, the definitive word, and either Hilborne West, Taylor, Metcalfe, or all three, must have known about it and so consequently would the Roosevelts, in part if not in whole. Much of what Salter wrote on the importance of exercise reads as if it might have been the very text for all Theodore was to preach to his small son and that the son himself would choose as his own lifelong creed. “Organs are made for action, not existence; they are made to work, not to be; and when they work well they can be well,” insisted Dr. Salter.
The common methods then used to confront an attack varied greatly and to the present-day reader seem excessively harsh. Emetics and purges were standard. The common way to avert an attack was to make the patient violently ill, to dose him with ipecac or with incredibly nauseating potions made of garlic and mustard seed and “vinegar of squills,” a dried plant also used for rat poison. Children were given enemas, plunged into cold baths. Whiskey and gin were used, laudanum (opium mixed with wine) and Indian hemp (marijuana). The patient was made to inhale chloroform or the fumes of burning nitrate paper or the smoke from dried jimson weed (Datura stramonium), another poisonous plant, coarse and vile smelling, that had been used in treating asthma in India for centuries. Many children were made to smoke a ghastly medicinal cigarette concocted of jimson weed and chopped camphor.
Black coffee may have been the Roosevelts’ “trump card,” as Mittie said, but Teedie was also made to swallow ipecac and smoke cigars. The purpose of the cigar was to subject the child to what, in essence, was a dose of nicotine poisoning. “In those who have not established a tolerance to tobacco,” explained Henry Hyde Salter, “its use is soon followed by a well-known condition of collapse, much resembling seasickness—vertigo, loss of power in the limbs, a sense of deadly faintness, cold sweat, inability to speak or think, nausea, vomiting.”
The moment such a condition could be induced, he said, “the asthma ceases as if by a charm.”
The picture of such loving parents as Mittie and Theodore inflicting punishment of this kind seems almost inconceivable. But they did, which, if nothing else, is a measure of the extremes to which a mother and a father will go to avoid a bad attack. Also, violent vomiting very often works, just as Salter said. It can in fact avert an attack and is still resorted to in certain situations. And black coffee, it happens, was also a sound choice; caffeine, a stimulant, is closely akin to theophylline, among those drugs used most frequently to treat present-day asthmatics.
The sensation of an acute asthmatic attack is that of being strangled or suffocated, only infinitely more complex. The whole body responds. When Victorians used the words “fit” or “seizure” they were close to the mark. The trouble is not just in the lungs. The central nervous system is involved, the endocrine system, both sides of the brain, possibly the stem of the brain as well. The agony is total, unlike that, say, of smashing a finger in a door, where the pain is concentrated at one point. And the largest part of the agony is psychological—inexpressible terror, panic.
“Witches in my chest” is an expression sometimes used by children, while most adult asthmatics find it impossible to give words to what they experience during an attack. A feeling like drowning is frequently mentioned—slow drowning—but not even that quite suits. In the words of one asthmatic, “If I were drowning I would know I was drowning and I was going to die and that wouldn’t be so bad. Asthma is just plain terrifying. . . . You may die . . . but your fear is you won’t.”
Many asthmatics cannot bring themselves to talk about their illness, largely, it would seem, for fear that the mere thought of an attack might bring one on. Ten-year-old Teedie, for all that he was capable of including in his diary about the contents of museums or the events of a day, writes nothing of the feelings he experienced when “very sick” or having “a miserable night.” In later years he would remain equally reticent—very uncharacteristically reticent—saying only that as a child he had been “wretched,” “suffered much” from asthma and that “nobody seemed to think I would live.”
For reasons that are still imperfectly understood, the attacks come nearly always at night, usually about three or four in the morning. Asthma is a disease of the night, which, for a small, impressionable child, can contribute greatly to its terrors. The onset may be sudden or gradual. The first stage is a tightening of the chest and a dry, hacking cough. Breathing becomes labored and shallow. The child starts to pant for air (”asthma” in Greek means panting). A high-pitched wheeze begins. The child has to sit up. If he tries to speak at all, it is in short, desperate bursts. Soon he is unable to speak or move, except with the utmost difficulty. He is battling for breath, tugging, straining, elbows planted on his knees, shoulders hunched high, his head thrown back, eyes popping. Fiercely as he pulls and gulps for air, what he gets is never enough. A distance runner near the point of collapse knows much the same agony, except he also knows he can quit running if he chooses. The asthmatic has no such choice, and there is no telling how long the agony will go on.
“I sat up for 4 successive hours and Papa made me smoke a cigar,” reads the entry describing an attack the night of the crossing to Trieste.
“Poor little Teedie is sick again . . .” reads part of a letter written by Bamie from Munich,
it was coming on all day yesterday, but in the evening he seemed a little better so Father went out—before his return, however, Teedie had a very bad attack. Mother and I were very much worried about the poor little fellow and at last Mother gave him a strong cup of coffee, which failed as he could not sleep but sat in the parlor to have stories of when Mother was a little girl told to him.
At another point in the diary, he writes that he was rubbed so hard on the chest “that the blood came out.” By whom he does not say.
The cause of the horrendous difficulty in breathing is a swelling of the bronchial tubes which lead to the lungs, specifically the branchlike extensions of the bronchial tree. The normal involuntary muscular action of these airways is not functioning as it should. The bronchial tubes are filling with mucus. They are in spasm, no longer dilating (contracting and releasing) properly; they narrow and close down. Hyperventilation occurs, as less and less air is pulled into the lungs. The feeling, it has been said, is of taking in mere spoonfuls of air, these reaching only the top of the lungs, “and you know that no more is going to penetrate, that everything under that has turned to lead, and you’re depending on that little tablespoon as fast as you can get it.” Back and chest muscles are put to tremendous strain. The heart is pounding. The child coughs and perspires and turns deathly pale, a ring of compressed white around the mouth. He is being strangled to death. And the alarm of those with him does nothing to relieve his own terrible anxieties.
But though the sensation is of being unable to take air in, the problem is actually the reverse; the air already inside cannot be expired as in normal breathing. It is the used air trapped within the swollen lungs that is keeping the child from breathing in the fresh air so desperately wanted. The struggle is to get the used air out.
If the severity of the attack continues, if his strength begins to fail, the child will start to turn blue—the sign that he is in “status asthmaticus,” very near death from asphyxiation. With modern drugs, with potent bronchodilators like epinephrine, ephedrine, or aminophylline, such a state can usually be avoided, the attack kept within bounds. Oxygen can also be given. But no such drugs, no nebulizers or oxygen tents, were available in the Roosevelts’ day. How near Teedie came to dying during the worst of his attacks, whether, for example, he actually ever turned blue, is impossible to determine.
Once the attack is ended, the ordeal at last over, the child commonly experiences an upsurge of good feelings, an exuberance unlike any other. Nothing seems too big or too difficult to tackle. The fact that Teedie could get up and do all he did the day after a bad attack—that his best, most strenuous days during the European year were often those immediately following his worst nights—fits the pattern exactly. The attack the night of the crossing to Trieste was among the most severe, yet the day after, literally within hours, having had almost no sleep, he was out happily exploring the city on his own. The day following he hiked two hours, “in the broiling sun,” up and back, to a castle on a hilltop in what is now Postojna, Yugoslavia.
For the parents of the child, however, there is little such relief. As the attacks grow worse, their worry and frustration are compounded accordingly, as Mittie’s letter from the garden of the Schönbrunn Palace amply illustrates. Still, such concerns, like asthma itself, remain largely private matters. It is not the severity of the child’s condition or the anguish of the parents that the outside world sees. It is the special treatment the child gets, the costly, sometimes ostentatious things done in his behalf—special medicines, doctors, emergency travel to some distant, exotic change of scene. And if there happens to be money in the family, then such “signs” of the seriousness of the case are heavily accentuated, for while any family may be willing in theory to try almost anything to help the child, the family of wealth can in fact try almost anything. Money being no obstacle, the rich can respond to asthma in ways the poor or even the moderately well-to-do cannot, and this was particularly so in the days before public clinics and health insurance.
With asthma and wealth combined in the same family, it is as if the drama of the problem—and asthma is nothing if not dramatic—can be played out on a much larger, showier stage. And naturally the leading player, the small, ailing child, becomes even more special and out of the ordinary, his influence on the family destiny larger by far.
So it was not merely that Teedie was acutely asthmatic, but that he was acutely asthmatic in conjunction with virtually all the relief, diversion, every advantageous change of scene or consideration that money could buy. When he set things spinning, as every asthmatic does, the result was quite different from what it would have been for a child of lesser station. An attack comes at home and he is whisked into the night in a family carriage pulled by magnificent, matched horses, a carriage that may be summoned to the door at a moment’s notice, whatever the hour. It is a very privileged kind of resolution to the crisis, not to mention an exciting one.
The ocean breezes at Long Branch do not suffice, so off he is taken to Saratoga. Visits to Philadelphia are arranged whenever need be. Or summers in the country. Or a year in Europe.
This is not to suggest that his suffering was any the less for such treatment—or that the burden he presented was any less heartrending for Mittie and Theodore—but to emphasize the special circumstances within which the problem was cast. For in the light of what has since become known about asthma, there is little question that the family milieu, the specific ways in which the family responds to the problem—as individuals and collectively—bear directly on the severity of the disorder, even the timing of attacks.
2
The exact role of the emotions in asthma is still elusive, after nearly a century of study. Recent investigations strongly suggest that the disease is physiological in origin: something about the asthmatic makes him abnormally susceptible to an irritant of some kind—an airborne allergen in most instances—and so in the beginning stages, many physicians now contend, asthma can be properly described as allergic. But the interplay of emotions may also figure in the allergic process itself—nobody really knows—and once the asthmatic “mechanism” or “habit” is established, the part played by the emotions in “triggering” attacks is indisputable. It is as if the patient has somehow established a freak circuit and the emotions can trip it, setting him off. The attack is not deliberate (though it can be), rather it is provoked by certain painful feelings—buried anger, guilt, fear of abandonment, fears of all kinds—or of tensions that need not necessarily be unpleasant, the approach of a birthday or Christmas, for example. “It isn’t that the emotions of the asthmatic patients are different from those of other people,” stresses a specialist, “it is that with them the effects of an upset can be explosive.” If the patient is a child, the causes are essentially “wrapped up in the fears which beset most children and which they find so hard to acknowledge or discuss.” More important than the feeling itself is the fact that it remains bottled up inside. Dust, animal dander, the pollen season, damp night air, a hundred and one impersonal, external factors may play a part, but the psychological factors weigh heavy in the balance and it is in this sense that asthma is understood to be a psychosomatic disorder, like duodenal ulcers or hypertension. A view frequently heard among experts in pulmonary medicine is that there is no such thing as a totally nonpsychosomatic case of asthma—a view that, understandably, is often difficult for parents to accept.
The medical paper regarded as the first study of asthma’s psychological side appeared in The American Journal of the Medical Sciences in 1886, too late to have any effect on Mittie or Theodore Roosevelt. A Baltimore physician, John Noland Mackenzie, reported on a severely asthmatic patient, a woman in her early thirties, whose attacks could be brought on by everything from thunderstorms to overeating to perfume, but who was particularly susceptible to the smell of roses. She was unable to be in a room where roses were present for more than a few minutes without having a violent attack. But then Mackenzie found that the sight of an artificial rose produced exactly the same result, a discovery, he said, that “opens our eyes to the fact that the association of ideas sometimes plays a more important role in awakening the paroxysm . . . than the alleged vital property of the pollen granule.”
While the validity of Mackenzie’s experiment was to be challenged, it nonetheless inspired countless studies along similar lines, the results of which were often astonishing, Asthmatic children said to be sensitive to house dust, for example, have been hospitalized in rooms generously supplied with dust from their own homes, and in nineteen out of twenty cases no asthma has resulted. Physicians have developed techniques whereby patients can be talked out of an oncoming attack. Important work has been done in the “family dynamics” of asthma—chronic unresolved conflicts within the “family constellation” are probed for—and a major facility, the Children’s Asthma Research Institute and Hospital in Denver, Colorado, has been founded on the proposition that the best possible therapy for many acutely asthmatic children is to get them away from their families altogether.
Asthma is now commonly explained to parents as a form of behavior; the child is unconsciously “using” his affliction for purposes of his own. “We tend to use what is available to us to influence our environment or to solve our problems,” writes a leading authority. “Children with asthma have asthma available to them . . . [and] behavior, not verbalization, is the language of children.”
The likeliest source of the child’s anxieties, it has long been thought, is the mother. Asthma is repeatedly described as a “suppressed cry for the mother”—a cry of rage as well as a cry for help. The child has an intense fear of being abandoned by the mother or of any form of rivalry for her affection. If the advent of asthma coincided with actual separation from the mother—from either parent—this too is considered an important piece to the puzzle. Thus a present-day specialist analyzing Teedie’s case would take very seriously the fact that his troubles began during the Civil War, years of great confusion and tension for the Roosevelts, when Theodore was away months at a time and two new infants arrived on the scene to vie for Mittie’s attention. The whole “climate” of ill health within the Roosevelt household—Mittie’s palpitations and headaches and intestinal grief, Bamie’s troubles with her back, Conie’s asthma—would also be reckoned as much or more an environmental factor in Teedie’s asthma than, say, the quality of the air he happened to be breathing.
Oncoming attacks in his case were often signaled a day or so in advance by moods of dark melancholy or homesickness. “I feel very, very homesick tonight,” he writes one Friday in Lucerne. “Teedie threatened with asthma,” Mittie notes in her journal the same evening. The attack followed in less than forty-eight hours.
But in nothing the Roosevelts said or wrote during the year is there even a suggestion that his condition was the result of an allergy, or thought to be. There is no talk of the hay season, no obvious avoidance of dogs or cats or specific foods.
Nor, we find, is there a seasonal pattern to the attacks. As the diary shows, they came in every season, year around. They happen in city and country, in damp, cold climates and the heat of summer, at sea level and in Switzerland. No one time of year or environment seems to be any more beneficial or harmful than another. The fact that he was abroad—away from New York and anything at the 20th Street house that might have been the cause—did him no apparent good. If anything, the year abroad appears to have been his worst yet.
Indeed, from looking at the diaries one might be inclined to see the attacks as entirely random—that is if one were to note only where they occurred or in what season, rather than which day of the week. It is when the attacks are plotted day by day on a calendar for the years 1869 and 1870 that a distinct pattern at once emerges.
His asthma strikes on weekends, usually Saturday night or what was actually early Sunday morning. There are exceptions, ordinary weekdays when he is “rather sick” or “still sick.” Tuesday, October 26, the day before his birthday, his condition was serious enough to cause a hurried departure from Berlin, ahead of schedule, though in this instance apparently it was the sign of an oncoming attack, rather than an actual seizure, that set everyone in motion. (”I feel very doleful and sick and homesick and there is such a bustle my head aches. . . . Perhaps when I’m 14 I’ll go to Minnesota, hip, hip hurrah!”) But the number of times in which Sunday figures as his bad day is astonishing. The worst attacks, moreover, virtually all occur on Sunday.
His first illness of the trip, it will be recalled, the siege of seasickness, his one bad day aboard ship, occurred Sunday, May 16. In July he was rushed from London by train to spend the weekend of the fourth, a Sunday, at Hastings with his father. Sunday, August 29, at Lucerne, he writes, “I was very sick on the sofa and lay in bed all day. . . .” The bad night at Lake Como mentioned by Mittie in her Schönbrunn garden letter happened the weekend of September 11–12. The attack on the way to Trieste began at approximately three o’clock the morning of Sunday, September 26.
The following Sunday, October 3, was the morning Theodore took off with him from Vienna to Bad Voslau, the morning of Mittie’s letter.
The attack at Munich described by Bamie took place the following Saturday night and Teedie’s diary entry for that Sunday, October 10, reads: “I was very sick last night and Mama was so kind telling me stories and rubbing me with her delicate fingers. I was so sick in the morning that in the afternoon Father, Ellie, and I went to Starnberg.”
This made the third such emergency exit to spend a Sunday out of town. In Paris it would happen twice again. On two consecutive weekends, because of his condition, the child was hurried from the city to the fresh air of Fontainebleau, these expeditions coming immediately after the initial trip to see Bamie’s school.
The intriguing question, of course, is why this should have been so. Why the weekends? Why Sunday?
The pattern is too pronounced to be coincidental. How long it had been the pattern, what the timing of attacks may have been prior to that year abroad, is impossible to resolve, since there are no comparable records. References to his condition in earlier years rarely specify when the seizures came. Interestingly enough, however, the one bad time for which we do have a calendar date occurred on a weekend and reached its greatest severity on a Sunday. The letter in which Grandmamma Bulloch tells how Mittie and Theodore packed the child off from Long Branch to Saratoga—the first known mention of his asthma in family records—was written the day of their departure, Monday, June 22, 1863. The difficult time had been the day before.
Salter, in his book, had written on the strange “periodicity” of asthma among some patients, noting that a weekly cycle was not uncommon. His example was of a small boy whose attacks came every Monday morning, a pattern that appeared to be an effort to avoid school but that Salter attributed to the family routine of a large Sunday meal.
In Teedie’s case the answer may lie in the nature of Sunday itself, which in the Victorian era was still the Lord’s Day, the sanctified day of rest and the one day of the week when the head of the household was home from work and thus also available to his children. Among such properly devout families as the Roosevelts it was a day of rigidly prescribed dress and behavior, of formal family gatherings, of little or no play, of church, Bible readings, family prayers, evening hymn singing in the parlor. The Roosevelts “kept” the Sabbath. It was a day for letter writing, a quiet walk perhaps, and for Theodore, his weekly turn at the Newsboys’ Lodging House (with other children outside the home). Teedie, in his mature years, would remember it as a day “we children did not enjoy—chiefly because we were all of us made to wear clean clothes and keep neat.” The single redeeming feature was the chance to gather in the front parlor, a room of “splendor” with its cut-glass chandelier.
On the expedition across Europe, Sunday invariably meant church, wherever the Protestant variety could be found, and a day off from touring. The few Sundays when they did not attend church the children were required to remain quiet—to draw a church or memorize several verses from the Bible. It was permissible to look at things as the day went on, but not to do much. At Pisa one Sunday, the family went to see the tower, but not until the following day did they climb it.
As a very small child Teedie had also experienced a peculiar and memorable fear of church. It was a small incident that, in later years, made an amusing anecdote of the kind every Roosevelt loved to tell. But for him at the time it was no joke and should not be discounted.
Mittie had found he was so afraid of the Madison Square Church that he refused to set foot inside of it alone and so she pressed him to tell her why. He was terrified, she discovered, of something called the “zeal.” It was crouched in the dark corners of the church ready to jump at him, he said. When she asked what a zeal might be, he said he was not sure, but thought it was probably a large animal like an alligator or a dragon. He had heard the minister read about it from the Bible.
Using a concordance, she read him those passages containing the word “zeal” until suddenly, very excited, he told her to stop. The line was from the Book of John, chapter 2, verse 17: “And his disciples remember that it was written, The zeal of thine house hath eaten me up.”
The Sundays he was sick in Europe he was seldom obliged to go to church. That certainly, the diaries show, was among the immediate, obvious consequences of a “bad night” or of merely being “a little sick,” even those Sundays when he was not whisked off to the country. During the first stay in Paris, for instance, he missed church three consecutive Sundays. (”I was sick and did not go out at all except for my Russian bath.”) In Rome, Saturday, January 8, 1870, he is “a little sick.” Sunday, January 9, he “did not go to church at all.” In Florence, Sunday, February 27: “As I was sick with a headache I and Ellie went out to the garden and made roads with stones. . . . No Sunday school.”
But the outstanding examples, of course, are the Sundays afield, out of London, Vienna, Munich, Paris, immeasurably wonderful times in the blessed open air, the best being those spent alone with Papa. The Sunday at Hastings was “the happiest day I have ever spent.” He did attend church in this instance, but Sunday school was conducted beside a castle wall, in view of the sea. The Sunday at Bad Voslau was again like Hastings, “viz, there were only the 2 of us,” and “we had Sunday school out. . .” “Papa and I went a long way through the wood and had Sunday school in them.” The Sunday away from Munich with Ellie also along was “splendid” and of the two escapades outside Paris he writes as follows:
Saturday, April 16, 1870
I had such a bad night that we went to Fontainebleau. We children went first. We played in the garden and woods. We had a nice time but in the night I was sick.
Easter Sunday, April 17, 1870
Today was the happiest Easter I ever spent. After breakfast and a walk in the woods alone, Mama, Papa, and all we children went out in the woods to hunt for violets. . . . We played . . . and then had Sunday school in the woods and picked cowslip and heard the cuckoo sing.
After dinner we all drove out through the woods to the rocks. We then walked all round the rocks and over crevasses. We saw a tree 1,400 years old and [an]other 300 years old. We saw a stream of pure and cold water. We had such a happy time.
Saturday, April 23, 1870
We went to Fontainbleau in the cars with Bamie. I had a bad time till two o’clock, when after dinner we went to the rocks and there we made such a scramble and went in dark caves and over big cracks, and up steep places and all over.
Sunday, April 24, 1870
We went in the park where on a sand bank we made tunnels 10 paces long. After dinner we went to the rocks where we jumped over crevasses and ran in them and had such fun. . . . In one of our rambles we saw very fresh traces of a deer.
All the stifling formality and constricted horizons of Sunday were at once transformed by the space and excitement of the natural world—by a tree 1,400 years old, streams of pure water, dark caves, and fresh deer traces. “If Raphael had only painted landscapes instead of church things,” he laments in the diary after a visit to the Vatican. To be with Papa, to have Papa’s undivided attention, to be off and away on an adventure together, was the ultimate joy. Any opportunity to be with Papa, then, later, made him feel better. (”Well, well, said Mr. Greatheart, let them that are most afraid, keep close to me.”)
Their day at Bad Voslau was nearly ruined by a chance encounter with a few of “Papas friends (or as I thought of them, enemies).” With their unexpected appearance, it became a “miserable time,” he writes, adding quickly, “but it was not Papa’s fault.”
Neither Mittie nor Theodore, nor any of the family, appears to have been aware of the timing of the attacks. Nor, apparently, was Teedie. Twice, however, he reports testily that Conie tries to get attention by faking she is sick. She complained she was too weak to walk, “and then went bouncing down the stairs . . . until she saw Mama, when she suddenly became very sick again (sarcastic).” Another time, “Conie was sick but her sickness always decreased when Mama was out of the room and she could not be petted.”
Both of these performances occurred on weekends, the first on a Saturday, the second on a Sunday, and at neither time did Teedie himself become ill. He was struck instead, in the first instance, by a siege of abject homesickness; in their hotel suite at Dresden he lay on the floor in the light of the fire pining away for “times at home in the country.” Of the morning of Conie’s own Sunday “sickness,” he further reports, “Papa, Bamie, Ellie, and I went to church but I did not like it.” Conie’s condition required that Mama stay behind.
Mama’s love and attention were magic. His physical need for her, the intense attachment he felt, are expressed with striking candor and frequency. In Paris they went together to the Russian baths six days in a row, to be subjected to clouds of steam and switches of fir boughs. She was with him through his headaches and stomach cramps. To pull him out of his doleful spells, she told him stories and looked at pictures with him. One evening in Paris she showed him a photograph of little Edith Carow and the effect was devastating. Her face, he noted in an air of grand tragedy, only “stirred up in me homesickness and longing for the past which will come again never, alack never.”
Whereas Papa made him drink black coffee or smoke a cigar or swallow ipecac (with “dreadful effects”), Mama soothed, petted, “rubbed me with her delicate fingers.” After a day of unremitting rain at Nice, when he was up late alone, “Mama came in and then she lay down and I stroked her head and she felt my hands and nearly cried because they were feverish. We had a fine sociable time. . . .” Papa took him to the doctor (in Vienna and Paris), and on the train from Berlin, it was Papa who made him get out for air at every station stop, despite the cold and the falling snow.
Why it was Papa nearly always who rushed him off to Hastings and the other places is an interesting point, since Mittie could have managed it as well, or she could have gone along with them to make a day of it. Or the whole thing could have been turned over to Bamie or a servant. Doubtless Theodore knew how large he loomed in the child’s eyes, how desperately the boy needed him. Almost certainly he wanted to give Mittie some relief, to get him away from her, for her benefit.
Another likely possibility, of course, is that Theodore himself, for all his piety and adherence to convention, enjoyed being off and away; he wanted a day of freedom every bit as much as did his small companion. If so, then the asthma was serving both their needs—it was doubly “convenient,” to use Dr. Salter’s word—and Teedie, conceivably, would have sensed as much. In some way for which there were no words he could have understood perfectly what those days meant to his father and this too would have figured in whatever troubling, complex combination of feelings lay at the heart of his troubles.
3
As different—as very different—as is every case of asthma from another, much of the impact of the disease is commonly shared by severely asthmatic children. Many of the same feelings and fears are engendered, many of the same perceptions of the world, and there is no reason to believe Teedie was an exception. For a child as acutely sensitive and intelligent as he, the impact of asthma could not have been anything but profound, affecting personality, outlook, self-regard, the whole course of his young life, in marked fashion. The asthmatic child knows he is an oddity; that somehow, for some reason no one can explain, he is a defective, different. But he knows also that his particular abnormality lends a kind of power. He knows, in ways a normal child can scarcely imagine, what it is to be the absolute center of attention. His attacks, horrible as they are, dreaded as they may be, are riveting to all who are present, his hold on his audience is total. Nothing can go on as usual, no one can remain indifferent to him, in the presence of an attack, and it is for no mere fleeting moment that he commands center stage. “A beheading is over in seconds,” observes one of the few chronic asthmatics who are willing to talk candidly. “A hanging—how long does that take? Three, four minutes, possibly five at the most. But an attack of asthma!”
The inclination, as time goes on, is to demand more and more attention—if not through asthma, then some other means.
Inevitably, as part of his way of coping with the world, the asthmatic also acquires a highly sensitized feeling for his surroundings. Of necessity he becomes acutely cognizant of the size and shape of rooms, the nearness of people and their comparative size, the whole look and feel and smell of spaces small and large, of fresh air, of skies and winds.
Ailments other than asthma, any of the inevitable knocks and scrapes of childhood, or of later life, are often taken with notable stoicism. It is as if having experienced asthma, he finds other pains and discomforts mild by comparison.
He has learned at an early age what a precarious, unpredictable thing life is—and how very vulnerable he is. He must be prepared always for the worst.
But the chief lesson is that life is quite literally a battle. And the test is how he responds, in essence whether he sees himself as a helpless victim or decides to fight back, whether he becomes, as Teedie was to say of a particular variety of desert bird, “extremely tenacious of life.”
Oftentimes it is a question of which parent is chosen to identify with and emulate.
In the history of asthma, among the most celebrated cases is that of the French novelist Marcel Proust (1871-1922), who thought his asthma, like his homosexuality, was rooted in the unconscious and was part of a price he had to pay for his creative gifts. “We enjoy fine music, beautiful pictures, a thousand exquisite things,” Proust wrote, “but we do not know what they cost those who wrought them in sleeplessness, tears, spasmodic laughter, rashes, asthma, epilepsy.... Neurosis has an absolute genius for malingering. There is no illness which it cannot counterfeit perfectly.”
Some aspects of Proust’s case have a familiar ring. His mother, like Mittie Roosevelt, was a cultivated, sensitive woman. Being a Jew set her off from her Catholic husband and his background much as Mittie’s southern origins set her off from Theodore and the rest of the Roosevelts. Proust, like Teedie, had a younger brother, close in age, who was the stronger, more robust of the two. His father, however, unlike Theodore, was a distant and indifferent figure. As a child, Proust, also, had been considered too weak to live. His devotion to his mother was intense, overwhelming. Indeed, among those specialists who see asthma as a suppressed cry for the mother, Proust’s case is the classic example. “You demolish everything until I am ill again,” he once accused his mother, while on another occasion, he told her, “I’d rather have asthma and please you.”
Proust never saw himself as anything but a victim, Proust, sealed off in his cork-lined writing room, is the quintessential recluse. Following his mother’s death, he remained a semi-invalid, dying ultimately of respiratory complications.
Just as no two cases of asthma are ever exactly alike, so the response to the disease varies infinitely. In the end, it seems to depend on the individual. Many children “grow out” of it. For others it is a life sentence. Henry Hyde Salter’s prognosis was hardly encouraging. The asthmatic, he wrote, “knows that a certain percentage of his future life must be dedicated to suffering . . . and from many of the occupations of life he is cut off. . . his usefulness is crippled, his life marred. . . . The asthmatic is generally looked upon as an asthmatic for life.”
For Teedie, in some powerful way, father and the out of doors meant salvation, and Theodore, in his efforts to bring the shy child out of himself—in all the ways he encouraged confidence, gave diversion, companionship, set an example of strength—was, consciously or not, taking the best possible approach, given the circumstances. The goal, according to a treatise written a century later, is to make the child “a participant, not a spectator in his own care.” “I am to do everything for myself,” Teedie wrote proudly at the close of one of those days alone with his father.
As interesting perhaps as any line in the journal, in what it foreshadows, is one written at Nice, in which he reflects on a joyous day’s hiking. “It was,” he writes, “the first time I had walked up a hill of decent size for a long time and I felt quite refreshed.”
Walking—even a day of “severe walking”—was strongly recommended by Salter and other authorities, and horseback riding was considered the most beneficial exercise of all for asthmatics. Get action, Theodore had long preached. His beloved Bamie had been saved by the “movement cure” and by a doctor who believed in treating the patient as a whole being in mind and body.
“Organs are made for action . . .” Salter wrote; “they are made to work, not to be; and when they work well they can be well.”