It starts like a great spring exhaustion. But after a couple of days the spaces between my ribs begin to tingle, and my head hurts like I have a migraine.
I think about the Easter eggs, the cake that needs to be baked, and the family excursions we had planned. But once the pressure over my lungs settles in, everything else fades. My ribs are smarting and it feels like a steel corset has been strapped around my chest. I’m sweating. All I can do is lie down and try to breathe as the fever crashes over me in hot, wet waves.
Lung sickness—it’s been so important to literary history! Carl Michael Bellman, Edith Södergran, Harriet Löwenhjelm, Anton Chekhov, Molière—they all succumbed to tuberculosis. Was it the proximity to death that enabled their feverishly productive dispositions? The fact that they knew they were dying, so that their creative work took place in a struggle against time?
Austrian writer Thomas Bernhard’s autobiographical novellas Breath and In the Cold (collected in Gathering Evidence, translated by David McLintock) relate the experience of being admitted to the hospital as a lung-sick eighteen-year-old, and later being interned at various sanatoriums.
You don’t forget the scenes from Breath, in the hospital ward, which the narrator calls the “death ward” because of its function. During a visit, the narrator’s mother feeds him orange slices while a man is dying right behind them. It all happens concomitantly—the eating, the washing, the dying—and the narrator registers every single detail.
The nurses’ attention to the Catholic rituals, rather than the dying patients, combined with the instrumental harshness of the hospital priests and doctors—all this would lay the foundation for the author’s lifelong obsession with Catholic, post-fascist Austria. Austria long called itself “the Nazis’ first victim.” In the postwar period, it wasn’t thought necessary to process the fact that the country had been efficient in its persecution of the large Jewish minority, that an “Austrofascism” had existed since the 1930s, and that many Austrians shared Hitler’s views. In Thomas Bernhard’s work, his anger over the homeland’s silence melds with the lung sickness, and these two turn into a driving force for the linguistic rebellion that would come to characterize his entire oeuvre.
In Breath, the narrator is given the final anointing and knows that before long he will be pulled aside to make room for someone else. His body will be wrapped in a sheet and a piece of paper will be attached to his foot, witness to who he was. Out of this awareness, an unstoppable, inner rage mounts.
“Take the comforter, open the balcony door, I need air,” I hiss at my husband as the pressure on my ribs hardens. But nothing helps. With the lungs on strike, nothing works the way it should, especially not my mood. It’s like my body has imploded. My ribs are a heavy, vice-like shell. Sometimes tuberculosis surgery involved removing a rib to give the lungs more space and reduce the pressure.
In his novels, Thomas Bernhard’s language itself seems to represent the condition I’m experiencing. His language moves in the manner of a cough, with retakes and sidetracks, offers no resolution. The organ meant to provide my body with oxygen and life has gotten stuck; it feels like I’m hawking up phlegm over and over into a spittoon at the Grafenhof sanatorium outside of Salzburg. Like I’m participating in that contest, the one of In the Cold, where they compete over who can fill their spittoon fastest.
“Don’t worry, we have strong lungs,” my mom says when I talk to her over the phone. She’s a retired pharmacist and as a young child she watched my grandmother care for children, home, and farm, all while waiting for a bed to free up at the Sandträsk sanatorium in the northern Swedish town of Boden. Grandma survived two bouts of tuberculosis, and then she came home and lived until old age. I don’t remember ever seeing her sitting down; she was in constant motion between kitchen, root cellar, and the chores of the farm.
Tuberculosis was widespread during the nineteenth century and at the beginning of the twentieth century. In Europe, the number of tuberculosis cases grew during the seventeenth century and peaked in the nineteenth century, when nearly one in four deaths were caused by the illness. Norrbotten, the region in the far north where my mother’s parents lived, was hard hit. At the turn of the century, the illness took around 500 lives each year there. Sandträsk’s sanatorium opened in 1913 with a capacity of 88 patients. There wasn’t room for everyone, even among those who would have needed it. A new sanatorium had to be built; it was completed in 1931 and had 345 beds. It still wasn’t enough. It was only with the breakthrough of penicillin in the 1950s that the rampage of the illness was halted.
A couple of months ago, before the Covid crisis, when the world was still spinning on its regular axis, I had dinner with the German poet Monika Rinck and her partner Valentin Groebner, a historian. We came to talk about lungs. Monica recommended to me the U.S. poet Juliana Spahr’s book This Connection of Everyone with Lungs. Valentin told us that many tuberculosis sufferers of the nineteenth century’s big wave felt that they were alone in their plight. This loneliness, he said, this feeling of having been singled out, was something they had in common across all the various locations in which they lived. They were at once cut off from each other and invisibly connected through their lungs.
In between the sweats I think about all the mistakes I’ve made, how it is likely my own fault that I am now sick. I should have kept my daughter home from school, as people did in many other countries. And why did I not peel those apples from the grocery store? Why did I go to the grocery store at all? And: is it possible that I gave it to the friend I took a walk with the other day? We did hug each other, by mistake, forgot our vigilance when we said goodbye, and laughed about it. Those of us who are well must be able to hug, we said. Is she, too, laid out sick now, because of me?
Sanatoriums are sometimes associated with the rest homes that provided a place for the wealthy to convalesce, where the distinctions between health care facility, asylum, and spa blurred. Numerous are those who have recuperated in the Alps or taken a rest cure elsewhere. Frequently, these institutions have an air of mystique. The Monte Verità sanatorium in Switzerland, for example, was an early-twentieth-century meeting place for intellectuals and alternative thinkers such as Hermann Hesse, Carl Gustaf Jung, Hugo Ball, Else Lasker-Schüler, Paul Klee, and Rudolf Steiner. Organic agriculture flourished alongside new thoughts about dance, art, literature, philosophy.
But the sanatorium experience of Thomas Bernhard’s novels and my grandmother’s life had nothing romantic or esoteric about them. Uncertainty and anxiety marked the Sandträsk cures. Was there a homecoming after this; was there survival?
My daughter brings water and painkillers on a tray. My husband makes tea and scrubs out the buckets of vomit. I am at once held and entirely alone as I face the illness. I move carefully in my bed. The pressure on my ribcage means that I can’t inhale more than halfway. My head is spinning and my face feels prickly. What will happen if I no longer exist? The meaning of Easter has never felt this real. My body has failed me and now I’m about to die.
Breath ends with the young narrator being discharged from the sanatorium, where he has contracted an even more serious lung sickness. It is Easter, and as he is transferred to the more hardline Grafenhof sanatorium, he is told that his mother has cancer. The Easter celebrations are abruptly cancelled.
When I call the health care information hotline on Good Friday, they ask me to describe my breathing. The nurse thinks I sound “unfocused” and recommends that I go to the emergency room so they can take a look at my lungs and at me more generally. Everyone around me is worried. “I just need to sleep,” I say, and then I do.
When I wake up on Easter it’s almost like I’ve been resurrected. My breathing, the one I know and am familiar with, is back. I fling open the doors to the balcony and the air fills my lungs with new vigor. The illness is over, I think. It turns out that I am wrong.
Thomas Bernhard also recuperated; the final anointing had been a mistake, but the lung sickness would remain a constant companion throughout his life. As would his anger. He became known as one of his country’s foremost literary troublemakers, with his grinding monologues about guilt and the after-effects of the war presented in a deeply humanistic critique of civilization and an unceasing love–hate relationship with Austria.
Another person preoccupied with the darker aspects of existence was German-Jewish author Franz Kafka (1883–1924). He too was ill with tuberculosis, and though I’ve engaged with his oeuvre both directly and indirectly through the years, I now realize that there might be entry points there that are nothing like the ones I’d previously thought of.
The concrete physical confinement that Kafka describes in his novella The Metamorphosis (translated into English by Susan Bernofsky), in which the main character discovers one morning that he’s been transformed into a beetle, is perhaps not, in fact, a representation of the alienation experienced by a German-speaking Jew in Prague. This interior claustrophobia could just as well have its root in Kafka’s experience of lung sickness. With the same logic, The Trial (translated into English by Mike Mitchell), a novel in which the protagonist is accused of an unknown crime, might not first and foremost be a portrayal of fear before the father, destiny, or God.
Kafka’s asexual aspect—can it, too, be understood with a view to his lung sickness? After all, who can think of such activities when it’s a struggle just to breathe? And what about the “love letters” to his fiancée Felice Bauer, or those to his soul mate Milena Jesenská, the wildly talented writer and translator who translated Kafka and others into Czech and later died in the Ravensbrück concentration camp? I have always interpreted those letters as egoistic and neurotic, mansplain-y, trapped within the isolated self—but what if they, too, have the same origin?
I slowly recover from my illness. There are several setbacks in the form of lung cramps, and it makes me obsessive and gruff toward my surroundings. Instead of appreciating small victories, like my new ability to get out of bed for a few hours a day and the easing of the headache, I complain about the little things. The insight that my body can betray me at any time cuts deep, and all I want to talk about is my lung cramps. But honestly: who can take that, in the long run?
One of Kafka’s first saved letters to Milena Jesenská reads: “So it’s the lung. [. . .] In my case it began about three years ago with a violent hemorrhage in the middle of the night. I was excited as one always is by something new, naturally somewhat frightened as well; I got up (instead of staying in bed, which is the prescribed treatment as I later discovered), went to the window, leaned out, went to the washstand, walked around the room, sat down on the bed—no end to the blood.” (Letters to Milena, Penguin 1990, translated by Philip Boehm.)
The letter is a response to Milena Jesenská having shared that she’s sick. But Franz Kafka brushes it off, asserting that it’s probably not that bad, only to follow with a detailed description of his own lung sickness, the one that would ultimately take his life. Whether or not this is the way to court someone is open to discussion. But there’s an old saying in Swedish: “That of which the heart is full, thereof speaks the mouth.”
What can you do when your lungs are full of phlegm, blood, virus? Does it become the only thing you can write about? Maybe so, in which case we’re all forgiven—even me.
This essay was originally published May 15, 2020 in Svenska Dagbladet, where Cecilia Hansson is a regular contributor.