Martha Brooks
Of all the European diseases that wreaked havoc on North America in the modern era, none was as heavily mobilized against as tuberculosis. Once doctors understood that TB is an airborne infection, health officials made isolation of TB patients standard treatment. The first public sanatoriums for the treatment of tuberculosis, or consumption, opened in Canada at the turn of the century. They were the first of their kind the world over.
By the 1950s, Canada's sanatoria offered 19,000 beds to Canadian consumptives; there were also extensive social services dedicated to outpatient relief of tuberculosis - home nurses, food dispensation and rent payments for patients. Despite these efforts, there were many Canadian sufferers of TB who were undeserved. It was a true epidemic, and one that was deeply stigmatized: Even after the spread of TB was understood, it was still considered a poor man's disease.
While around the world, TB still kills more people aged 15 to 49 than any other infection, there is generally no longer a need for TB sanatoria in Canada. Successful TB drugs were introduced at the end of the Second World War, and TB is a routine vaccination in the West these days. The once-widespread epidemic was, after centuries, finally controlled. Sanatorium facilities in Canada have all since closed or shifted to some other public-health purpose.
Young adult author Martha Brooks ( True Confessions of a Heartless Girl, Mistik Lake) grew up on the grounds of the Manitoba Sanatorium in Ninette, as the daughter of the sanatorium's medical superintendent. Her new novel, Queen of Hearts, is set on the grounds of a similar place, the fictional Pembina Hills Sanatorium in southern Manitoba, in the years 1940-42. The aching loneliness and chill of the landscape, combined with the austere dark cloud of the war as it raged across the Atlantic, provide the perfect setting for an absolutely absorbing account of life on the inside of a "San," as they were commonly referred to then. The result is a careful, graceful novel, robust with sorrow and triumph in equal measure. It will leave the reader with both a chill down the spine and a lump in the throat.
Fifteen-year-old Marie Claire is the eldest of three French-Canadian farm children, all delighted when their vagabond uncle comes to stay for the summer. He's wheezy and heavy on his feet, and the whole family assumes its lovable uncle's had too much of the hobo life. In truth, his body has been ravaged by tuberculosis, and all three children are discovered to be consumptives a few months after he dies. Their parents, devastated and ashamed, check them into Pembina Hills.
Like a prisoner, Marie-Claire is at the mercy of the sanatorium staff, good-natured nurses and orderlies who force her into strange, uncomfortable treatments, such as sleeping outdoors in winter to fill her lungs with fresh, cold air. All the while, she is terrified for the well-being of her siblings, whom she is not allowed to visit. Her only companion is her insufferable roommate Signy, a chipper, rich, well-dressed girl from Winnipeg, who also happens to have a collapsed chest from an unsightly therapy for TB called pneumothorax. Signy's determined cheerfulness, despite the terrible prognosis for her improvement, only exacerbates the horror Marie-Claire has for the place.
Brooks includes a sweet love story in Queen of Hearts, Marie-Claire's sunny, heartfelt romance with a 19-year-old jazz trumpeter named Jack. Brooks also shines in her descriptions of the disfiguring treatments TB patients of the past had to endure.
But more than anything else, Queen of Hearts is a novel of a friendship. In the grand tradition of sick-lit (the genre of YA novels that feature teenage girls forging friendships as they face terrible diseases), the most heartbreaking passages here are the arduous days and nights Marie-Claire and Signy are side by side in their hospital beds, far away from home, with death looming in every sanitized corner. The complexities of their fraught relationship are laid plain in Brooks's easy, direct prose. They come from different worlds, and "chase their cures" in completely different ways. Marie-Claire makes steady progress toward health. But Signy, it seems, will be confined to the San for the rest of her days, something that fills Marie-Claire with guilt and Signy with deep envy. Readers will cry for them both.
Lucy Silag is the author of the Beautiful Americans series of books for young adults.