Amy Utter's Journeys: TB and Other Tragedies in Rural America's Heartland chronicles a young woman, devastated by a broken marriage in 1924, who searches for "Fun, with a capital 'F,'" yet embraces her Christian fundamentalist beliefs along with her "Romeos." Then comes the "Great White Plague" - tuberculosis. In a Missouri sanatorium she balances faith in her God with trust in 1930 medical science, until the end. The book, taken from her diaries, provides a striking background of the rural heartland of more than 75 years ago, and includes genealogical references to generations of Utter ancestors and descendants.
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Ten questions and answers about Amy's story
Presentation given by Fred Edwards at Missouri Rehabilitation Center
Amy Utter's Journeys:
TB and Other Tragedies in Rural America's Heartland
by Fred Edwards
1. Why did you write Amy Utter's Journeys: TB and Other Tragedies in Rural America's Heartland?
A: For years I had wanted to research the details of a day in the life of somebody who lived before I was born, so that I could take readers to that time and make it real for them. I got the chance when the 1930 diary of 30-year-old Amy Utter came into the possession of my wife, Pauline. So I converted her diary into a biographical memoir that will transplant the reader into the life of rural America's heartland in 1930.
2. How long did it take you to write the book?
A: I worked almost seven years in researching and analyzing what Amy meant by her cryptic entries -- after all, she knew what she was writing about so she didn't explain her comments and activities. When I finally was ready to publish the book, I came upon copies of diaries Amy had kept throughout the1920s in addition to some letters, stories and poems she had written. These filled in the blanks, and six months later I was ready to publish. I even included two of her poems as appendices to the book.
3. What made this diary special?
A: First, Pauline was Amy's niece, which gave me the chance to use the rich family resources Pauline, a long-time family genealogist, had at her fingertips. Second, Amy's 1930 diary demanded to be expanded into a book because of the pure tragedy it contained; in spite of her trust in medical science of 1930 and in her God, she died of tuberculosis -- the "white plague" that had rampaged human beings since the time of the ancient Egyptians -- on Dec. 18.
4. Where was Amy Utter when she wrote this diary?
A: She started it while living with her parents in a ramshackle farm house near Afton, in Delaware County, Oklahoma. She continued making daily entries while staying with her half-sister, Nora Utter Marlow and Nora's husband John, in Purdy, Missouri, where she was waiting for admission to the Missouri State Sanatorium (now the Missouri Rehabilitation Center) near Mt. Vernon. Unexpectedly refused admission, she took her diary with her back to Oklahoma. After finally being admitted to the sanatorium, she continued making daily entries until the end.
5. Does the book describe the treatments she received at the sanatorium?
A: Oh, yes. She had flat-plate x-rays, fluoroscopies, pneumothoraxes, and a series of what were called "hot shots." When her disease spread to laryngeal tuberculosis, she underwent a series of throat treatments. After all the treatments failed, the doctors reverted to the only other alternative -- cod liver oil.
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6. Could you explain these treatments?
A: Sure.
The flat-plate is essentially the same type of x-ray you get today when you get a chest x-ray.
A fluoroscopy is a continuous x-ray emission that lets the doctor watch the patient's lungs and tubercular activity during respiration -- while exposing both doctor and patient to a massive dose of radiation. Amy had 25 of those from May 15 through Oct. 23. As I explain in the book, had she overcome TB, she probably would have succumbed later to breast cancer.
Doctors used pneumothorax procedures to shut down the worst lung by pumping it full of air via a hypodermic needle inserted through the pleura. The idea was to allow the lung to rest. Amy started receiving these every other day starting June 9. Then on June 16 the pneumos were administered on Monday's and Thursdays. Starting July 17 she underwent them weekly. From Nov. 3 on, she was too weak to be taken to the medical building, so she got them in bed in her room.
I never determined what the "hot shots" were, nor could officials at the Missouri Rehabilitation Center enlighten me when I visited there. In the book, I conclude that they were injections of some of the chemicals tried on patients without success for thousands of years, such as iron salts, sodium chloride, calcium chloride, chlorine gas, hydreraganic acid, iodine, or maybe copper and gold salts. Any one of that witch's brew sounds "hot" to me.
Amy had at least 15 throat treatments. I couldn't discover what they were, either. My analysis of her diary entries indicated that they were not injections nor did they involve surgery of the larynx, so I surmised that they were throat swabs. They either were ineffective or punitive because on Dec. 6 she started getting hoarse, the next day she could talk only in whispers, and after that she would never speak again.
7. Today we have super drugs that some call "the magic bullet." Doesn't that make the impact of Amy's story sort of overcome by modern medicine?
A: Not at all, for two reasons.
First, it's a tragic story of a young divorced woman with no children, who devoutly clings to her Bible and her fundamentalist concept of God, thinking she will defeat the inevitable. And it shows what it was like to live in a time and place without electricity, without telephones, and where a diagnosis of tuberculosis was considered a death sentence.
And second, we need to be aware that today's multi-drug resistant forms of tuberculosis make the disease just as dangerous as it was in 1930. In 1930, with a mortality rate of 70 per 100,000 per year, TB took more lives than any other contagious disease. In 1936 1 of every 21 deaths in the United States was due to TB. The largest number were young people aged 15-45, including proportionately more women than men.
8. You mentioned genealogy. Does Amy Utter's Journeys delve into genealogy?.
A: Certainly. One appendix in the book covers her direct ancestors back to Nicholas Mattson Utter, who was born about 1636 in Sweden and emigrated to the United States around 1655. For descendants, since Amy had none, I listed descendants of her father, Leander Scott Utter, who was born in 1862, down to a member of the sixth generation who was born in 1977.
9. How would you summarize Amy Utter's Journeys?
A: Amy Utter's Journeys: TB and Other Tragedies in Rural America's Heartland chronicles a young woman, devastated by a broken marriage in 1924, who searches for "Fun, with a capital 'F,'" yet embraces her Christian fundamentalist beliefs along with her "Romeos." Then comes the "Great White Plague" -- tuberculosis. In a Missouri Sanatorium she balances faith in her God with trust in 1930 medical science, until the end. The book, taken from her diaries, provides a striking background of the rural heartland of more than 75 years ago, and includes genealogical references to generations of Utter ancestors and descendants.
10. Where can you get a copy of Amy Utter's Journeys??
A: You can go to Amazon.com or barnesandnoble.com, or you can go to the publisher's Web site: buybooksontheweb.com. The price is $14.95 plus shipping and handling.
Presentation about Amy Utter's Journeys
Given Sept. 8, 2007, by Fred Edwards during the Missouri Rehabilitation Center's Centennial Celebration
Let's go back 77 years to when the MRC was in its infancy. In 1930 it was called the Missouri State Sanatorium. A young woman named Amy Cora Utter would be celebrating her 31st birthday on Sept. 17 in the Eaton Building. She had been moved from the Minor Building four months earlier to Eaton, which she was told was for patients needing advanced care.Amy had been a patient here several years earlier, but had been released with her TB declared "arrested." She had divorced an unfaithful husband, even though, in her family, farm girls simply didn't get divorced. After the divorce, she had lived in several heartland towns with members of her extended family, trying to find work to pay her way, but the stigma of tuberculosis held her back. In spite of all the tragedy, she held tightly to her fundamentalist religion and searched desperately for, what she called, "Fun with a capital F." Then the Great White Plague came back with a vengeance. She returned to the only place a Tb-er could call home in 1930 -- a sanatorium.
Although today we have problems with multidrug-resistant TB, at least we have drugs. Things weren't that way in 1930, because there was no magic bullet. Amy's treatment was good food -- more about that in a moment -- rest, fresh air, and weekly pneumothoraxes followed by fluoroscopies.
To receive a pneumothorax, Amy would lie on her side and the doctor would insert a re-usable needle through her rib cage into the pleura. Then, using a device called a manometer, he and the nurse would force air through the needle into her lung cavity to collapse the lung. The theory was that this would give her lung a chance to rest in order to fight the disease inside it.
After the pneumothorax, Amy would receive a fluoroscope to see how her lungs were affected. She would stand on one side of a radiation screen and the doctor would sit on the other side in order to study the action of Amy's lungs as she breathed. Nobody knew in those days that, had she survived TB, she probably would have contracted breast cancer, due to the massive exposures to radiation.
Amy also had been taking weekly "throat treatments" up to a month earlier, when Dr. Julius B. Stokes, her favorite doctor, had told her sadly that, not only did she have TB in both lungs, but she also had developed laryngeal tuberculosis -- TB of the throat. No matter how bad things got as she deteriorated, every day she put something into her diary to be "glad about," and her diary entries, even to the last one, were filled with praise for the doctors, nurses and staff who were so kind to her.
In the Board of Managers Report of 1918-1920, Dr. S. A. Newman, who would arrange to admit her in 1930, wrote: "Of course, advanced cases cannot be cured. Hence, all that can be done for them is to improve their general condition with proper housing, feeding, and handling; and their lives may be extended for a period of a few years." But Amy already had used up her few years.
On Dec. 10, Amy made her last diary entry:
"Throat so dry. Couldn't talk out if I wished. Nurses so good. Wait on me and feed me." Her father -- a farmer in northeastern Oklahoma -- hired an ambulance to bring her home so she could die with her family. She passed away eight days later.
Now I never met Amy Utter. Neither did my wife, Pauline (Pauline, please stand up), even though she was Pauline's aunt, because Amy died before Pauline was born. But through my 57-year marriage to Pauline I've been lucky to get to know many of Amy's relatives who live here.
And I can tell you straight from my heart how much I think of folks who live here in America's Heartland. Here are three examples from my book. First, when the family was taking Amy to Mt. Hope Cemetery in Afton for burial, a farmer approaching in another wagon saw the coffin and pulled over. He stepped down into the slushy red mud alongside his wagon, doffed his red-and-green stocking cap (by then it was a week before Christmas) and placed it over his heart while the Utter wagon passed.
Next, Almost sixty years later, near the end of the century, when Amy's sister-in-law (my wife's mother), Beulah Douthitt Utter was to be buried near Purdy, local cars on busy Highway 37 pulled onto the shoulder, drivers got out, and placed their hands over their hearts.
And 16 years after Beulah passed away, her husband Durward (Amy's kid brother), was taken to the same cemetery for burial. Local cars pulled onto the same shoulder, and the drivers turned on their headlights to recognize the procession.
We don't find this sort of care and humanity in most places today. But it's still here in the Heartland. And it has been exemplified by the Missouri Rehabilitation Center. Amy Utter's diary shows that the MRC has a history of loving and caregiving. In many TB sanatoriums, patients were given a book full of rules to memorize and obey. Of course there are rules, like there are in any hospital, but Amy's diary gave no indication that the sanatorium staff had treated her like they were a bunch of drill sergeants.
Indeed, the sanatorium provided more modern living conditions than many of its patients had ever known. For example, consider when Amy had lived with her half-sister, Nora Marlow and husband John, down in Purdy while waiting for admittance to the sanatorium. Once a week, John brought buckets of well water into the kitchen to fill a galvanized tub for baths -- except when the well ran dry in the summer. The family used an outhouse out back. Here at the sanatorium, Amy used what she called a "washroom," because the water tower on campus provided water pressure. Moreover, at the sanatorium she had electricity, refrigeration, ice, and steam heat. This was a far cry from Amy's parents' farm in Oklahoma, where heat came from firewood in an old pot-bellied stove, refrigeration amounted to a shelf cut into the inside of a cistern, and light came from kerosene lanterns.
For food, the campus was self contained, with everything from milk cows to chickens, hogs, fruits and vegetables. And the city of Mt. Vernon did its part to watch over the patients and staff. Amy wrote several times of the Mt. Vernon band visiting the sanatorium on Sundays to play -- even in the heat of the summer.
In closing, ladies and gentlemen, my wife, Pauline Utter Edwards, and I are proud to be part of this celebration by an organization that has shown what humankind can do for those less fortunate. Thank you for having us, and we'll both be more than happy to autograph a copy of Amy Utter's Journeys if you have one or buy one. If the gift shop has sold out, we still have a few copies. The content of Genealogy Makes History may be copied or retransmitted for information purposes, but may not be used for any commercial purpose without my written permission. Please include this notice and credit the source as Genealogy Makes History by Fred Edwards.