News
San Haven's history in saving lives with TB
Scott Wagar
11/06/2012
EDITOR’S NOTE: The Bottineau Courant is conducting a series which is looking at the history of San Haven, North Dakota’s only state run sanatorium, which was operated in the Turtle Mountains for the majority of the 1900s. This week, the newspaper looks at the expansion of buildings, new treatments and patients’ personal time at San Haven as TB patients increased in the state.
In the first 18 months of San Haven, North Dakota’s only state run tuberculosis sanatorium, the institute had admitted 170 patients and had a long waiting list of patients wanting to be received by the facility for treatment.
As of June 30, 1914, with newly completed cottages the sanatorium had 62 beds. However, there was such a demand for admittance to San Havenin 1920 an infirmary Building was constructed for $10,000 that added 60 beds. In 1927, an addition was added on to the infirmary at a cost of $125,000 that brought an additional 80 beds. In 1937, another addition was built for $300,000 with 123 beds. In 1938, the original infirmary was remodeled and added 45 more beds.
With the construction of the infirmary and its two additions a number of problems were solved. First, instead of all the patients being in a number of different buildings, they were all housed in the infirmary. Second, with the completion of the addition in 1938, San Haven for the first time did not have a waiting list for individuals who wanted admission into the sanatorium.
The primary treatment at the San continued to be fresh air, rest and a well-balanced diet. San Haven followed a number of rules they adopted from the physician who originated the sanatorium concept, Dr. Edward Trudeau. The sanatorium had a strict routine and the patients were expected to follow the routine precisely.
The late Lilly Petterson, a resident of Bottineau who spent four years at San Haven, spoke of her time at the sanatorium in an oral history she gave the State Historical Society of North Dakota in the 1990s.
“They woke us up in the mornings and brought us a basin to clean ourselves after breakfast. Then our mornings were our quiet time. We read and studied our Bibles, and wrote letters, too. I wrote more letters than I ever wrote in my whole life. I wrote several service men in war (WW II), my part for the war effort,” Petterson said. “In the afternoons we had to take naps, after our naps we did fancy work like crocheting and embroidering. In the evenings, we had visitors, or just had fun. Each bed had a radio with earphones. I was the biggest baseball fan and I always listened to all the games.”
Patients who were well enough to become ambulatory were allowed to work a few short hours a day in different departments at San Haven. Bands, choirs and theater groups (including Dakota College at Bottineau’s Drama Club) from throughout the state entertained patients,
The San had its own U.S. Post Office and its own newspaper called the San Piper, which housed its own printing press and was published monthly.
Numerous patients in bed spent their days writing poetry, which were published in the San Piper and eventually collected into an anthology titled, “San Musing.”
In the Assembly Hall of the Refractory Building church services were held for the different denominations of the patients. The hall also granted patients movie nights where they were given the opportunity to see the latest movies coming out of Hollywood.
Holidays were always made special for the residents of San Haven. During Christmas time, the grounds were decorated and lighted for the patients to see out of their open windows. Within the Infirmary Building, every floor and each of the patients rooms had a decorated Christmas tree and each of the patients received a gift from the sanatorium. The staff made fruit cakes, popcorn balls, and boxes of nuts and candy for its residents. On Christmas Day, those who were ambulatory were given a sleigh ride through the Turtle Mountains.
During Easter, the employees also colored Easter eggs for the patients and on the Fourth of July the San entertained the patients with a fireworks show.
Entertainment was important for patients because although fresh air, rest and a well balanced diet was the primary treatment, other procedures began to play an important role. By 1920, surgeries began at San Haven which granted patients’ lungs to rest completely, allowing them to heal natural through the body forming a calcification around the TB in the lungs, which stopped the disease from spreading.
The procedures to rest the lung was to collapse the infected lung. The surgeries began at San Haven on July 1, 1920, and physicians utilized numerous types of surgical procedures to collapse the lung. Most patients at the San had a procedure called artificial pneumothorax. In the procedure, the surgeons would inject air with a needle into the lining around the lungs causing the lung with TB to collapse.
Unfortunately, artificial pneumothrax would have to be performed numerous times because lungs would naturally fill up with air again. The re-collapsing procedure was called, “refills” because the physicians would “refill” the lung’s lining with air again.
Another procedure performed at San Haven was called phrenemphraxis, where the surgeon would temporary paralyze the phrenic nerve, the nerve that sends a message to the brain to control the diaphragm moving up and down. Through this procedure, compression to the phrenic nerve would cause the diaphragm to lift upward, causing negative pressure, collapsing the lung.
If patients were in the advanced stages of TB, surgeons wanted the lung to rest permanently. This was accomplished by a surgery called thoracoplasty where the physician would remove on an average mean seven to eight of the patients’ ribs on the side where the lung was infected. Once the ribs were removed, the lung would collapse permanently.
This was a difficult procedure for patients because they could not use anesthesia because their lungs and body could not safely take the anesthetic. So, the patients were given local anesthetic and the surgeon would remove the ribs while they were awake. Thoracoplasty was such a difficult surgery for patients; so, it had to be done through several stages.
Another phrenic nerve procedure that took place was called phrenexexresis, where the surgeon would enduringly paralysis the nerve by avulsion collapsing the nerve undyingly.
For Petterson, her TB was so advanced when she came to the San, the surgeon’s conducted a thoracoplasty on her. The surgery left her bending forward at her side because she had no ribs to keep her posture upright.
Petterson spent the remainder of her life in that uncomfortable posture, walking at all times with a cane, but as she stated in her oral interview with the SHSND, it was a horrible and painful surgery, but she was alive and San Haven cured her of TB.