By Barbara Barrett
1. The Shadow of Tuberculosis
Hester Jane Ervin Howard’s death certificate states she died of tuberculosis on June 12, 1936. A puzzling diagnosis and difficult to understand when TB is never referred to in any of the letters written by either her son, Robert E. Howard or her husband, Dr. Isaac M. Howard.
To understand why it is not mentioned by REH and his father, it’s essential to know about tuberculosis, its history, causes, symptoms, pain and suffering and especially the stigma and fear that surrounded it.
Hester Jane Ervin Howard with Robert’s dog Patch outside the Howard home in Cross Plains, Texas, ca. 1924.
A Short History of TB
The girl sits propped up on pillows. Her face has become almost transparent. She turns towards the window. Cold winter sunlight streams in. Faint dashes hint rather than depict her eyes; yet the wistful gaze is miraculously caught. Her orange hair glows against the white linen of the bedclothes. A green curtain billows into the room. Next to her the mother’s head is sunk on her chest, hardly more than a shadow. It is the image of inexpressible grief…This is the picture of Sophie Munch, aged fourteen…a few months before her death from tuberculosis. [Two years later Munch’s mother also succumbed to the same disease.] Painted by her brother Edvard, it is one of the graven images of what was for millions a personal experience. (Dormandy Introduction)
A Sick Child by Edvard Munch, who also painted The Scream
A thousand million people died of tuberculosis in the nineteenth and twentieth centuries. (Ryan 3) Nor was it a new disease. Paleontological records tell us symptoms of tuberculosis appeared in a Neolithic grave near Heidelberg dated at 5,000 BC during the Stone Age, as well as in the spines of Egyptian mummies. (4) The disease was already established in mainland Europe by 2,500-1,500 BC and it is likely it came to England about a thousand years later. (6) TB even predates Columbus in the new world where it has shown up in the skeletons of Native Americans and Peruvian mummies as well as in the bones found in countries around the world, including Japan. (8) In fact, “Dr. John Stanford, who has spent his life studying TB, believes that the tuberculosis germ is very ancient, and may well have fought for its survival in the primeval mud of the earth at the very beginnings of time.” (Ryan 6)
Tuberculosis was called by many names: phthisis, consumption, wasting disease, weakness of the lungs, graveyard cough. (Dormandy 22) During the late nineteenth century there was a growing fear the disease might destroy European civilization. (Ryan 8)
It is a remarkably enduring disease. Once it arrives in a community, it stays. (6) By mid-seventeenth century, one in five deaths was due to consumption, which is an older and rather more descriptive name for the pulmonary form of TB. As a result, it became known as the “White Plague of Europe.” (7) Although the death rate had been declining since the 1840’s in the year 1900, the world’s death rate from tuberculosis was about seven million people a year with fifty million more openly infected and at least half the world population had come into contact with it. (Ryan 8)
There were popular misconceptions about tuberculosis, even as late as the 1970s and 80s. According to L. Sprague de Camp, a Robert E. Howard biographer and author of Dark Valley Destiny,
Tuberculosis is a strange disease. Relatively rare today, in 1900 it was second only to pneumonia as a major cause of death. Whenever people move about a lot, whenever there is crowding, unhygienic living conditions, poverty, or privation, tuberculosis becomes epidemic. (de Camp 32)
De Camp’s statement that TB was second to pneumonia as a cause of death is incorrect. In the early 1900s, it was the primary cause in the USA for many years. (CDC “Leading Causes of Death”) He was also wrong that it was an epidemic.
Unlike most epidemic diseases, TB did not sweep through a city or region and then disappear for several years. TB was endemic – it was a debilitating constitutional illness to which people succumbed slowly over a period of years, infecting and being re-infected, leaving the afflicted compelled to stop work, enter hospitals or sanitariums, and lie and dissemble for self protection. (Ott 6)
Above is a depiction of TB statistics in Kentucky during WWII. On the right are two examples of the Christmas Seals campaign for fighting TB. Both of these were probably familiar to the Howards in Cross Plains.
Tuberculosis Infection
Dr. Frank Ryan in The Forgotten Plague: How the Battle Against Tuberculosis was Won and Lost, explains how the body reacts to TB and how some survived while others did not.
We are infected by the germ that causes tuberculosis in two ways, either by inhaling it in the air we breathe, or by swallowing it food or drink. Inhalation is the commonest way in which it gets into our bodies, taking in bacteria which are suspended in dried dust or in tiny droplets. If a tiny colony on a culture plate contains in excess of a billion tuberculosis germs, consider the numbers of germs flung into the air by the single cough of an infected patient. Unlike AIDS, which is spread only by sexual penetration or by intravenous injection of blood products, tuberculosis is contracted simply by the act of breathing. Everybody is therefore susceptible. (Ryan 17-18)
But it is the pulmonary form of the disease which is by far the commonest and it was in this form that tuberculosis blighted the lives of billions of people. What happens is basically simple if dreadful. The bacteria inhaled in water droplets settle in the periphery of the lung and grow very slowly until they form a small local collection, like a cheesy boil. From this boil, the continuing infection spills over into nearby small airways and forms more of these tiny boils. It was the appearance of these small cheesy collections (like little tubers) which, in the early nineteenth century gave rise to the modern name, the disease in which you find tubercles in the lung or tuberculosis. This replaced the much older and more descriptive name, consumption…From this primary infection in the lungs, several things may happen. (Ryan 19)
In many, the first infection is fought off by the body. The white cells mop up the bacteria and the abscess is walled off from the rest of the lung by a fibrous shell. But our white cells have difficulty disposing of these ingested bacteria. That waxy shell can be as impervious to the digesting chemicals of our white cells as it is to acid, and tuberculosis has the horrifying ability to eat our white cells themselves from the inside and to grow and multiply while actually within the cells. In order to contain the disease, our body decides to accept stalemate and just wall it off. If we succeed, we lull ourselves into a false sense of security: we tell ourselves that we are cured. But tuberculosis remains alive within the fibrous shell and can burst out into life-threatening virulence at any time in the infected person’s subsequent life. (Ryan 19-20)
Where tuberculosis is common, most of the population will encounter germs when they are children. Yet here we discover another of its mysteries: the majority wall it off when it is still just a spot on the lungs and they never know they were infected. But if the body fails to contain it, which is the case in about ten percent of people, the disease continues to invade the lung tissue about it. (Ryan 21)
How tuberculosis infects the body is shown in the following chart:
Tuberculosis Symptoms
A cough that refuses to go away; perhaps a sudden agonizing pain on breathing that marks the beginning of pleurisy; exhaustion, an unrelievable breathlessness, the appearance of bright red arterial blood in the persistent foul sputum. In others, death arrives in one fell moment; for example when an abscess in the lung or intestine erodes into a major artery. (Ryan 22)
Tuberculosis patients lost weight, were overwhelmingly tired, at times felt overwhelmingly irrational and exuberantly gay, and were anemic. (Dormandy 220)
Tuberculosis could not only be transmitted to another person, it could easily infect other parts of the body. It wasn’t a simple disease that affected everyone in the same way. Almost no organ or tissue in the body was immune.
TB starting in one area of the body could be transmitted to other areas. Once the TB patients began coughing up the TB bacteria, they became contagious and had to be isolated from other non-tubercular persons. As the germ was coughed up, it often lodged in the throat, causing TB laryngitis, which in its last stages reduced speech to a hoarse, agonizing whisper…If the TB germ was swallowed, it could cause overwhelming nausea, almost impossible to alleviate. The patient’s breath often became foul smelling. Abdominal pain, vomiting and diarrhea would be added to the already suffering patient…If the infected material went in the opposite direction, it could impinge on the pleura and start TB pleurisy. This was one of the most feared complications. Not only coughing but the taking of every breath became painful…Disturbed nights turned into nightmares: no pain-killer, not even laudanum or later, morphine, could entirely cope with the pain. The spread of the disease in this way could lead to the dreaded tuberculosis meningitis. (Dormandy 221)
One of the most lethal complications occurs when pus spills into the blood stream and quickly spreads to every organ in the body. Or, it spreads from the lungs or bowel and causes great pain and suffering elsewhere. In the skin and soft tissues it causes disfiguring sores and abscesses; in the internal organs such as the bladder and kidneys it causes an agonizing inflammation…In bones it settles into a protracted and gnawing destructive cavitation and the pus eventually finds its way through the soft tissue to the skin. Tuberculosis has the capacity to infect every internal organ from liver to brain, from the fingertips to the delicate structures of our eyes. (Ryan 23)
Even today, without effective treatment, sixty percent of sufferers will be dead within five years of the onset, their bodies wasted to skeletal proportions, their minds lucidly aware of the life that is being taken from them [emphasis mine]. (Ryan 23-4)
A look at the various types of tuberculosis and how they infect the body:
According to Dormandy, pulmonary tuberculosis was the most common form. (22) The Medical Dictionary definition states:
[P]ulmonary tuberculosis is TB that affects the lungs. Its initial symptoms are easily confused with those of other diseases. An infected person may at first feel vaguely unwell or develop a cough blamed on smoking or a cold. A small amount of greenish or yellow sputum may be coughed up when the person gets up in the morning. In time, more sputum is produced that is streaked with blood. Persons with pulmonary TB do not run a high fever but they often have a low-grade one. They may wake up at night drenched with cold sweat when the fever breaks. The patient often loses interest in food and may lose weight. Chest pain is sometimes present. If the infection allows air to escape from the lungs into the chest cavity (pneumothorax) or if fluid collects in the plural space (pleural effusion) the patient may have difficulty breathing.
The symptoms for pulmonary TB according to The White Death also included “A harsh cough, hoarseness or loss of control of the voice, an audible wheezing, shortness of breath on exertion and coughing up of blood.”… Dormandy then adds “In 80 percent of the cases this form of tuberculosis was fatal in five to fifteen years” [emphasis mine]. (22)
Hester Jane Ervin Howard’s Symptoms
REH’s letters do not indicate any symptoms of wheezing, shortness of breath or coughing up of blood. However, comparing the excerpts from his letters describing his mother’s symptoms against those of tuberculosis, the list is impressive.
Night sweats. On May 13, 1936, REH wrote to H. P. Lovecraft:
She started sweating in January and it’s just the last few days that there has been any appreciable lessening of it. Many a night she had to be changed six or seven times, and that many times a day—sometimes more. Woman after woman we hired and they quit, either worn out by their work, or unwilling to do it, though my father and I did most of it. (Roehm REH Letters 3-460)
Pleurisy—one of the most feared complications was mentioned earlier in the same letter.
She seemed to be improving a little when she had an attack of acute pleurisy on her right side, which until then hadn’t been affected. My father handled that, and she was definitely on the mend, although the sweats never ceased, when in the early part of April we had the worst dust storm I ever saw in my life, and she developed pneumonia.” (3-459)
Also present was the characteristic weight loss.
She is very weak and weighs only 109 pounds—150 pounds is her normal weight and very few kinds of food agree with her; (3-459)
The signature cough was mentioned in the December 5, 1935 letter to HPL.
My parents and I went to Amarillo in the latter part of July. None of us had ever been to that city, and I wanted to see if the high altitude, 4500 feet, might help a persistent cough that had been bothering my mother. (3-382)
From these descriptions plus the aspiration treatments she underwent, (Part 2 “Tuberculosis Operations”) it is probable Hester Jane Ervin Howard contracted pulmonary tuberculosis—a type of TB that “was chronic and even intermittent, with seemingly miraculous remissions and startling improvements followed by terrible relapses.” (Dormandy 22)
The bacterial cause of tuberculosis was discovered by Robert Koch in 1882 who found that it grew and divided much slower than normal bacteria. (Ryan 16) Koch had shown that the tubercle bacillus was a strict aerobe: it could survive but not grow and multiply without a generous supply of oxygen. (Dormandy 221)
After Koch’s discovery the “diagnosis now depended on the presence of the tubercule bacillus in the sputum, not the hollowness of the cough or the loss of weight.” (Rothman 17)
Hester’s diagnosis would have been confirmed by medical tests. No records of any such tests have been discovered. The only written confirmation of her diagnosis is in her death certificate (See right hand column about half way down.) It reads: “chronic ulcerative tuberculosis anemia”
Note: that the term “senility” on her death certificate was used in that era to designate old age rather than lucidity. It appeared often on death certificates of elder persons.
Stages of TB
Hester’s night sweats were one of the symptoms described by Howard. The symptom stages vary slightly among the tuberculosis histories. In her book Living in the Shadow of Death Rothman gives this definition:
The first stage is marked by a dry persistent cough, an irritation in the throat, pains in the chest and shoulders, a slightly accelerated pulse and some difficulty in breathing, particularly during exercise. But the very commonness of these made it almost impossible to say with certainty that the person had consumption.
The second stage brought more intense and debilitating symptoms. The cough became increasingly “severe, frequent, and harassing…it produced mucous materials and pus, which as the disease advanced, became, thicker, more opaque, greenish…[with] fine streaks of yellow color. A ‘hectic fever” periodically broke out, spiking twice daily and marked by a rapidly accelerating pulse (to a rate of 120 a minute). The fever often lent a ruddiness to the complexion of consumptives, giving them a deceptive appearance of good health…During this second stage ulcers appeared in the throat causing a continual hoarseness and making it painful to eat or speak above a whisper. (Rothman 16-17)
Dormandy in The White Death gives a further explanation of the fever:
Perhaps the most constant manifestation was fever, usually slight but characteristically recurring in the late afternoon or at night. As the temperature dropped after a few hours the patient became drenched in sweat and felt physically exhausted though mentally alert. (23)
The third stage according to Rothman is more identifiable:
Even with these symptoms doctors were reluctant to give a firm diagnosis. However, this reluctance disappeared in the third stage. The lungs now sounded hollow ..and the cough, known as the “graveyard cough” or “death rattle,” was distinctive and unmistakable…”the pain in the joints was constant, pulse was accelerated, and then became weaker, diarrhea broke out and became uncontrollable, and the legs swelled. All these changes gave a ghostly and cadaverous appearance…” (Rothman 16-17)
Stages of Hester Jane Ervin Howard’s Tuberculosis
According to Rothman, the fever which results in night sweats appears in stage 2. REH states his mother had night sweats in January 1936 (Roehm REH Letters 3-460) which means there is at least one undiscovered earlier stage where her TB “declared” itself. Since the word tuberculosis is never used in the Howards’ letters, searching for this earlier stage is problematic. After examining the letters of Dr. Howard and REH, and statements by Novalyne Price Ellis, REH’s friend, there are four possible dates:
1. In her book, One Who Walks Alone, in late 1934, Novalyne Price Ellis and Bob Howard discuss how long his mother has had health problems:
He raved on about how his mother wasn’t appreciated, although she tried for a long time to mix with people in Cross Plains, going to church, entertaining the various church groups. She had stopped after her health became so bad that she could scarcely venture outside her own house. (Price Ellis 127) (Date for this conversation is approximate, based on a REH letter to Novalyne ca. December 1934 enclosing Petaja’s’s sonnet and his own verse.) (Price Ellis 129)
The timeline mentioned is rather vague. Information about her health during this period doesn’t appear in REH’s letters. However there are indications she was active and helping out in Dr. Howard’s office. According to a letter she wrote to REH on December 9, 1926: “I have collected over $80.00 that I have made myself, so you see we are doing very well with the Electric machinery. I guess we have still over $200.00 on the book for treatment. I think we will get most of that.” (Roehm IMH Letters 6) and on January 4, 1927 she writes to REH “I want to go to town late this afternoon and may go to a show if there is a good one on.” (7)
Whether she was pre-tuberculosis or in remission at this time is not known. However, the 1926-1927 dates would be within the estimated survival time given by Dormandy.
2. In a later conversation with Novalyne Price Ellis, REH offers another date for his mother’s illness. “My mother is almost an invalid. Has been for several years. I don’t know when she’s been really healthy, probably not since I was born.” (Price Ellis 168)
This conversation with Novalyne took place in 1935. REH was born in 1906. If, Hester’s illness was due to TB when he was a baby, she has had many remissions or it has lain dormant for many decades. And decades-long remissions were not unheard of. “There was no way of knowing how long a remission would last. It could be months, years, or decades.” (Rothman 7) This is confirmed by Dr. Frank Ryan in his book The Forgotten Plague: “Relapse is always a possibility, even forty years later and tends to occur at a time when our physical or mental health is low.” (Ryan 20)
An even earlier date for Hester’s illnesses is given by Mrs. Kate Merryman, who was a caregiver for Mrs. Howard during the last two years of Hester’s life. Mrs. Merryman was interviewed by L. Sprague de Camp in 1978. During one of those interviews she stated: ”Dr. Howard said she was a sick woman when he married her.” (de Camp Merryman 45) According to the record of their marriage, Isaac Mordecai Howard and Hester Jane Ervin were married on January 12, 1904. Did Hester have TB at that time? There is no way of confirming this. No mention is made in any of the Hester Howard histories. In addition, Merryman’s statement is dependent upon the reliability of her memories decades later and the accuracy of the transcriptions of her statements by de Camp.
In the Merryman interviews, there was also speculation Hester Howard never would have lived so long if she hadn’t married a physician. (de Camp Merryman 1, 6, 71)
Described below are instances of Hester being ill in 1892, 1909 and 1918. Whether it is tuberculosis in any of these cases is unknown.
December 22, 1892 [probably 1891 per Roehm note]: “Miss Ervin of Mo., sister to Mrs. C. C. Thomas, is spending some time with her sister who has been quite sick with la grippe, but is convalescent.” Then in the February 16, 1893 edition of The Muskogee Phoenix:
Although a particularly virulent case of the flu could be fatal, it could also have “side effects relating to TB.” (Bonney) The article further states:
The acute onset of TB may occur in the form of
- acute pneumonic phthisis
- acute broncopneumonic phthisis
- acute military of the pulmonic type
- initial pulmonary hemorrhage
- acute pleurisy
- acute septic manifestations
- acute bronchitis
- la grippe or influenza
Another possible illness that is on record took place on December 20, 1907 in Big Spring, Texas.
I. M. Howard of Oran, Palo Pinto County, had his medical certificate recorded with the county. Shortly after doing that, he packed up his wife and almost two-year-old son and headed west. The January 3, 1908 edition of The Enterprise which was edited by Hester Howard’s brother, William Vinson Ervin, in Big Spring, Texas has this: (Roehm Ervin in Coke)
The January 24 Enterprise has an update:
It is unknown whether it was Hester who was ill and if so, was it an early indication of her tuberculosis? Again, the lack of information could be related to the stigma of tuberculosis. (see Part 3)
In a telephone conversation dated April 2, 1978, Earl J. Baker, REH’s childhood friend from Burkett states “Mrs. Howard seemed to have gotten sick around 1918. She was in bed a lot, and did a lot of resting because she had to.” (de Camp Baker p.2) Like Merryman’s statement, Earl Baker’s is dependent upon the reliability of his memories decades later and the accuracy of the transcriptions of his statements by de Camp.
3. A letter written by Dr. Howard offers a third possible date. In a letter dated July 11, 1936, to W. J Proctor [son of William J. Proctor and Mary Frances Henry, who was one of Robert Howard’s grand-aunts] Dr. Howard mentions Hester was in failing health for five years. (Roehm IMH Letters 76) With this date, Hester’s death was at the low end of the Dormandy estimate. Considering her age, that is to be expected. There are no references to Hester’s illnesses in REH’s letters during 1930-1932.
4. The fourth possibility comes from another Dr. Howard letter. This time to E. Hoffmann Price dated June 27, 1936, “Robert’s death was not unexpected to me. Three times he made complete preparation to do this thing during his mother’s illness of something more than a year.” [emphasis mine] (Roehm IMH Letters 59)
Checking both his letters and those of Dr. Howard, in a letter to Lovecraft dated December 5, 1935, REH wrote:
My parents and I went to Amarillo in the latter part of July [1935.] None of us had ever been to that city, and I wanted to see if the high altitude, 4500 feet, might help a persistent cough that had been bothering my mother. Those upland plains are monotonous to look at, but the atmosphere whips fresh blood and new life through the veins; at least it always did with me.
REH’s statements were based on facts. Mountain air therapy was at that time very popular, probably made more so by Thomas Mann in The Magic Mountain published in 1924. Mann took his “tuberculosis wife” to the Davos sanitarium in the Swiss Alps and visited her many times.
For those who followed the sanitarium strict rules, there were many success stories. (Dormandy 153)
John Lowe, a medical officer of health whose career seemingly ended at thirty-five when he had a massive hemorrhage from the lungs….Within days of his arrival [at Davos] he found that his sleep and appetite improved. Thereafter he gained a pound in weight each week. After eleven weeks of careful self-management he could walk sixteen miles a day. When he returned to England after nine months all signs of phthisis were gone. (Dormandy 154)
And other mountain sanitariums in both Europe and the USA provide success stories as well. It should be emphasized that these were based on months of living in mountain air and a careful regimen. A quick check of REH’s bookshelf doesn’t show anything listed by Thomas Mann. However, Dr. Howard may have received medical news of the health benefits of these mountain sanitariums.
Mrs. Merryman’s statement she had been taking care of Hester Howard for two years and that Mrs. Howard was ill during that time confirms Dr. Howard’s date. (de Camp Merryman 10-11)
Another confirmation is given by Novalyne Price Ellis in the fall of 1934 when she reports her dates with REH were interrupted by stops to give his mother her medicine. (see “Remissions” below and Part 2: “Morphine, Laudanum and Patent Medicines or REH Gave His Mother WHAT Medicine?”)
Did Hester manifest the early stages of TB in the previous five years? Since the symptoms are so generic to many other illnesses, she may not have known without a TB test being performed. Determining her stages of TB is made even more difficulty by the lack of explicit symptoms at each stage and the nature of TB itself.
For all their immediacy and particulars, the descriptive categories did not enable physicians to give a time frame to the progress of the disease. They could not tell someone whose cough had turned mucosal how many months he or she had left. Indeed, even the debilitating process in the final stage of illness might be suspended for a period lasting as long as a year. In effect, one had to live with the disease and make life plans without knowing whether they would ever come to fruition. (Rothman 17)
There is evidence that Hester was in that final stage at least twice before she died in June 1936. Dr. Howard’s letter to Lovecraft on June 29, 1936 gives more details of the incidents.
Last March a year ago, again when his mother was very low, in the Kings Daughters Hospital in Temple, Texas, Dr. McCelvey expressed a fear that she would not recover. He [REH] began to talk to me about his business, and I at once understood what it meant. I began to talk to him, trying to dissuade him from such a course, but his mother began to improve. As immediately she began to improve, he became cheerful and no more was said. Again this year in February, while his mother was very sick and not expected to live but a few days, at that time she was in the Shannon Hospital in San Angelo, Texas. San Angelo is something like one hundred miles from here. He was driving back and forth daily from San Angelo to home. One evening he told me I would find his business, what little there was to it, all carefully written up and in a large envelope in his desk. Again I begged him not to do it, but he positively did not intend to live after his mother was gone. As the months grew on, his mother showed some improvement. He accepted her condition as one of permanent improvement and one that would continue. I knew well that it would not, but I kept it from him. Two weeks before she died, she began to decline rapidly. I saw the awful worry that came over him. I was following him and watching him closely but did not think he would do anything until his mother was gone. (Roehm IMH Letters 64)
Hester’s TB symptoms showed up in 1935 according to the descriptions in REH’s letters. When she became initially infected and any remissions she may have had since then are unknown.
As Rothman points out in Living in the Shadow of Death, the symptoms were very common to other diseases in the early stages making it “almost impossible to say with certainty that the person had consumption.” Not only were tuberculosis symptoms difficult to diagnose, sometimes the disease would go into a remission and disappear altogether—only to reappear years and decades later!
Remissions
In One Who Walks Alone, Novalyne Price Ellis expresses doubts regarding the seriousness of Hester Howard’s illnesses.
I still keep thinking about Bob. I wonder why Mrs. Howard would let him stay home tonight and break a date with me. I wonder why Dr. Howard can’t take care of his sick wife. Does he think, as I do, that she’s not sick? (Price Ellis 164)
This sentiment is echoed by Novalyne’s mother,
A man who’ll put taking care of his mother, who is not seriously sick, above dating a girl, when he’s got a father who can take care of her as well or better than he can, is so tied to her apron strings that he’d be a poor excuse for a husband. Mother’s voice was firm. (Price Ellis 232)
Neither Novalyne nor her mother can be faulted for their belief. Pulmonary TB, with its remissions and seemingly healthy looks deceived quite a number of people.
The Medical Dictionary of the Free Dictionary by Farlex defines “remission” as a “disappearance of a disease as a result of treatment. Complete remission means that all disease is gone. Partial remission means that the disease is significantly improved by treatment, but residual traces of the disease are still present.”
During Novalyne’s initial visit to the Howard House, she was introduced to Dr. and Mrs. Howard and she gives this description of Hester:
Her hair was nearly white, short, and parted on one side, not stylish. It looked as if she just combed it quickly to get it over with, not to make her look better. She got up with a great effort and stood leaning slightly to one side. (Price Ellis 46)
Although Novalyne doesn’t comment, from Hester’s effort to get up from the chair and her inability to stand erect, it appears she wasn’t strong. Approximately three months later, during the Christmas season in 1934, Novalyne encounters Hester and REH at Woolworth’s. From her description, REH appears to be supporting his mother’s weight although Novalyne saw it differently. Her view is understandable since there is no indication that REH told her about his mother’s tuberculosis. [And there is no mention of Mrs. Howard’s tuberculosis in One Who Walks Alone which was published in 1986.]
Mrs. Howard was standing there, looking at me. Bob and Mrs. Howard! The way he hovered around her! His left arm was around her waist and he was holding her close to him. His head was down and his right hand was picking up objects and putting them down as if he were looking for something. Mrs. Howard was standing straight and tall. (Price Ellis 137)
In both these instances Hester was able to stand and walk. Yet, in between those two meetings REH interrupted his first date with Novalyne to stop by his house and give his mother her medicine. Rather than being a manipulative mother determined to intrude on her son’s date, it’s possible that she was so weak at times, that she was bedridden. According to Dormandy in The White Death (13) tuberculars were subject to spells of being overwhelmingly tired. There’s also the possibility of making certain that she took the medicine correctly and did not overdose.
There is no way of knowing for certain what Hester’s condition was. REH’s letters in 1934 don’t mention trips to Marlin or to doctors for aspirations or other medical assistance. There is however one note about Hester’s health in One Who Walks Alone. Prior to the Christmas season, Novalyne indicates he is still giving his mother her medicine (Price Ellis 48, 51, 58, 65) and she also remarks to him “Didn’t you tell me you may have to take your mother to the hospital?” (Price Ellis 80) Perhaps the medicine worked and his mother felt better, at least well enough to go on a Christmas shopping trip with her son.
In her book, Novalyne did not indicate that Hester Howard looked ill. According to Rothman in Shadow of Death, (4) “An initial ruddiness of the face gave way to a ‘deathlike paleness’ which, at the very last stages of the disease, was masked by a ‘glowing hectic flush’.”
According to the histories of TB: “There was no way of knowing how long a remission would last. It could be months, years, or decades. Lives were lived in the shadow of the disease, as decisions had to be reached about careers, marriage and childbearing.” (Rothman 7) As stated above, pulmonary TB had seemingly miraculous remissions followed by terrible relapses.
When those relapses came, often horrific operations were the only option left for the TB patient who wanted to live.
Article taken from the closed down website REH: Two-Gun Raconteur. Date of the article: September 17, 2015.