1985: My Journey To To The Asthma Hospital

January 9, 1985

On January 8, 1985, I boarded a plane in snowy Grand Rapids, Michigan, with my mom, and three hours later we arrived in an equally white Denver, Colorado. This was not a vacation. The purpose of the trip was for mom to have me admitted to a hospital that specialized in asthma. The estimated time of stay was 6-8 weeks.

While my first ride in an airplane went great, that night at the hotel the asthma beast that I was oh too familiar with struck again.

"Do you think I should take you across the street," mom said as we both stood looking out the window of the hotel room at the unfamiliar complex of the asthma hospital. Undoubtedly we could see the 7-Goodman building and the 2-May building, both future homes for me, but at this moment neither of us were aware of this.

"I don't know," I said, taking a hit of my Alupent inhaler, pretending to be fine. "I think we can wait."

The truth was I was very short-of-breath that night. When mom fell asleep I sat up on the edge of my bed gasping for air. "I should wake her up," I thought. Instead, I took more hits of my inhaler.

The next morning mom and I walked to a nearby restaurant. I concentrated on every minute, thinking each was my last of normal life. When finished we walked back to the hotel room. Mom said, said, "They say you'll only need to be here 6-8 weeks. It's only a short time. Just think of every weekend as a marker of one more week gone by."

I suppose it was mom’s optimism that kept my anxiety under wraps. I was excited about meeting other asthmatics my age, but I was nervous about the unexpected.

Back in the hotel room mom grabbed one end of my trunk. I sighed and grabbed my end, and we were off. While walking across the street I looked up at the buildings wondering which one would be my new home, and what floor?
***

Mom was sitting in the business office filling out paperwork while I sat twiddling my thumbs on a chair in the hall. A few days ago, he called and introduced himself to me, “I will be your counselor during your stay at the asthma hospital. If you have any problems at anytime I will be available.”

He appeared to be of amiable disposition, and his voice was very calm. I looked forward to meeting him. For now, though, I had to wait for mom to finish filling out papers, and “It’s taking forever,” I thought as I peered down the hall where there were several offices.

I leaned forward and thought about going into the office where mom was, but mom told me specifically to stay put. I could hear the muffled sound of mom’s voice followed by the muffled sound of the secretaries, followed by shuffling of paper, and then, for what seemed like an eternity, the click clack of a typewriter.

What would he look like – the social worker? Would he be as nice as he sounded on the phone? I sure hoped so, because I couldn’t handle a mean person. What would the nurses be like? What would my doctors be like? And, perhaps most important, what would it be like to meet a bunch of other asthmatics who were just like me? Would they be just like me? Who would become my friend? Will I find a friend?

These thoughts rolled around in my cranium like balls on a billiards table until finally, the click clacking stopped. I stood up and peered into the crack of the door and saw the tip of mom’s jeans where they covered the knees and the front of a desk with paper scattered about. Why was she still sitting there? How much paper work could there be?

The door opened and there stood mom in her blue top and blue jeans. Her dark hair set in a new perm over her beautiful phlegmatic eyes. She was a young person, only 38, but to me, she was a sagacious god, a permanent barrier to any harm and the answer to all the problems of the world. I know this wasn’t the normal mom/son relationship of your typical teenager, but I wasn’t normal by any means – I was chronically ill. Funny thing was, though, I didn’t think of myself that way. In fact, I didn’t think of myself as chronically ill until 23 years later when I’d send for, receive, and read my medical records from my stay at the asthma hospital.
“He should be here any minute now,” she said, her voice soothing.

“Who?” I said, shaking my head.

“Ric Dexter. She called him. She said he’s a tall man with a well kempt dark beard and is really nice. She said you’d like him.”

“Yeah, I know,” I said.

It seemed like forever, but from around the corner appeared a man who fit the description. "
Hi, I’m Ric Dexter,” he said. “I talked to you on the phone.”

I looked at mom. She said, “Hi. I’m Alice Frea and this is my son, Ric.”

“Hi, Rick, I hope you are as excited as I hope you are,” he said. “Let’s get rid of this trunk, and then I’ll take you on a tour. Then I’ll show you your new room and introduce you to your new room mate.”

Lamely, all I could think to say was: “Okay.”

He grabbed one handle of the trunk while mom and I looked on. “Normally I’d say your son should grab that other handle,” he said, “But he doesn’t look so well right now.”

I took a deep breath as I watched mom grab the handle and HEAVE the trunk. I lagged behind Ric and mom. We were walking down the hall, through a door I suspected would take us back out into the cool winter air that was Denver, Colorado. But the door took us to a hallway that wended this way and that, through this door and that door until finally, we were in some sort of lobby that smelled of cooked bacon.

“This is the lobby of the Goodman building,” he said. He pointed left at a set of see through doors where I could see what appeared to be a restaurant with a few people seated at many tables eating what I suspected was bacon and eggs and toast and whatever came on the early morning menu. “That’s the cafeteria,” he said. He peered down at me. “You won’t be eating here, Ric.” He looked up at mom. “But you will become really familiar with the food here, which is pretty decent for a hospital.”

“I never had good hospital food before,” I wanted to say, but held my tongue.

“Around this corner,” Ric said, “ ah here it is, is the elevator that will take us to the 7th floor where you will be staying.”

He pushed the little round, red button. Ric continued to explain about the hospital to mom and me, and mom occasionally responded with an “uhum,” or “okay, I see.” I stood by the elevator door listening to the thump-thump of my heart in my chest. I wondered if mom and Ric could here it

“This is 7-Goodman,” he said as the door swung open revealing a long hall with bright orange carpet. “This is where my office is,” he said as we passed a window revealing offices set apart by dividers. He opened the door.

“Hi, Sarah,” he said. “This is Ric Frea and his mother Alice.” Sarah was a heavyset lady with dark, curly hair. She smiled pleasantly and offered a hand, which I took. “You will see her several times a week as many of your appointments will be with me and Linda.”

“Who’s Linda?” I asked. “She’s one of your doctors. Her office is right next to mine.” He pointed to an office that had “Ric Dexter” printed on the door. Then he pointed to a door that had “Linda
Hepper” printed on it.

“Okay,” he said, “I can show you around here later. I suppose you want to meet some kids. Right” He patted me on the shoulder and he walked to the door and opened it. “Come on. It’s time to have some fun.”

I felt a lump in my throat as I stepped back into the hallway and waited for mom and Ric to take the lead. I then followed Ric down the hall to a capacious room with the same bright orange carpet that filled the hall. To my right was a large nurses station. Two nurses were sitting there with their heads stuffed into charts.

The majority of the room was filled with square, white tables with chairs pushed neatly in place. Straight ahead I saw a pool table. The long wall to my right was replete with several doors and windows blocked by curtains on the other side. The same scene was on the opposite, Western wall.

A bulletin board on the Western wall had a head of Beetle Baily and Garfield with the words, “WELCOME TO 7-GOODMAN” neatly printed on them. Under that was written, “My way of drawing Garfield. I call him Crashfield.”

While I was busy looking around the room, I didn’t notice the nurses had noticed us and had been now standing beside us. Mom and Ric set down the trunk.

"This is Karen," Ric said, introducing me to the first nurse. She was a young, fine looking curly haired nurse. She bent down before me so I could see right into her pretty blue eyes. She said, "You're blue!

"We better consider this a code blue," said a short, pudgy nurse in a white dress who stood behind Karen. Her nametag read Linda.

Karen grabbed my hand and nearly dragged me across the room. "Have a seat," she said motioning to a chair by the wesst side of the lobby (which I later would learn was the girl's side)You need a treatment NOW."

Mom followed close behind. She kept her distance as Karen took my vitals while Linda disappeared somewhere behind the nurses' station. I groaned as the pressure from the sphygmomemometer exceeded my pain threshold on my right forearm.

“Sorry,” Karen said, “We like to start out high when we have new patients.”

While I listened to the air leave the sphygmomanometer, I looked over Karen’s rich head of hair at mom and Ric. Ric stood there with a cool expression on his face, as though he had been through this many times. Mom looked worried.

My mom recounted her anxieties in a recent email:

"Here we were at the leading asthma institution in the world and they were running a code blue on you. If they were taking it that seriously, it meant you really were THAT bad."

“Ric wanted to take me on a tour,” I said to the nurses, vaguely hoping it might get me out of this predicament.

“Ric understands that we need to do our jobs,” Linda said. She stood beside me now holding a nebulizer. She plugged it into the compressor that sat on a table. “Right Ric?”

She clicked the nebulizer on so it hummed audibly. Over the hum, I could barely hear Ric. “I certainly do. Hey, I’m going to go back to my office while you finish up here. When you are done you can call me and I’ll finish the tour. I’ll put the trunk in Ric's room.”

“Great,” mom said. “Thank for—“

The rest of that conversation was lost as Linda blocked my view of mom and Ric, turned on the compressor, and the nebulizer rumbled to life. She then handed me the misting nebulizer.

"I feel fine," I said.

"You're just used to it," Karen said.

"I feel fine," I thought, forcibly preventing myself from rolling my eyes.

I put the misting mouthpiece into my mouth the way I did many times before in hospitals.

"Sit straight," Karen said, "Your stomach should go out when you breathe in slowly through your mouth, inhaling the white mist. Exhale slowly through your nose."

"I know all that," I said.

"We're going to re-teach you many things," Linda said.

"Plug your nose when you inhale," Karen said, "When you inhale count to three when you exhale count to six... sit up straight... Ric, sit up straight."

Lots of rules for one silly treatment, I thought. But these were the rules I had to follow for the next 6-8 weeks. I sure so hope I'm out of here in 6-8 weeks.

Finally, the treatment was done. "Shake it good," Karen said. "You want to get the most medicine you can out of it."

Several minutes later the comperssor was off and I watched as a petite, dark haired lady in a brown dress walked up to mom. "I'm Dr. Betty," she said, "I'll be your son's doctor. We'll take good care of him."

"That's what we're hoping," mom said, and she told Betty about the asthma attack I had last night

"By the looks of things here," Dr. Betty said, "You should have brought him in. In fact, he should have been in a hospital the past week. She looked mom in the eyes, "Really, HE IS THAT BAD. I just want you to know you did the right thing bringing him here."

Finally, after an hour with the doctor, the smell of spaghetti was in the air and a congregation of asthmatic kids of all sizes shuffled in one by one for lunch and noon meds.

I barely had a chance to meet the other kids when Karen called me to the nurse’s station where Ric was standing. “Well,” he said, “I don’t see your room mate, but how about if we finish our tour now that you’re feeling better?”

He took me to a door on the east side of the room. “This is the boy’s rooms,” he said.

"This place is clean for a boy's dorm," mom said as she entered the room and looked around. I followed closely behind.

"Well," Ric said, "We have a level system here. If the kids follow the rules they can move up to honors and get special privileges. It's a good incentive to keep your room clean." He smiled and looked at me.

On the far side of the room, the eastern side, the wall was basically a huge window with a view of the city around the hospital set amid overcast skies. "If you look north," he pointed, "you can see the Rockies on a clear day."

I followed him to the next room where the bed by the window was unkempt, and books and papers scattered about. "Eric is your room mate. He's a good kid, but he's kind of sloppy."

There were two other beds in the room. "The one by the door is yours," he said. "You have to be close to the nurses until you move up to the next level. If you get to honors you can pick your own bed and even have a chance to get a TV."

After showing me around the boy’s rooms Ric showed mom and me around the rest of the hospital. By the time we were back on 7-Goodman the other kids slowly carted into the room. A plump black kid, who would later introduce himself as Willie, was playing pool with another boy with messy black hair.

“Hey, there’s your room mate,” Ric said. I looked around the room at all the kids that were now scattered about, two boys were sitting at tables involved in a project that was perhaps homework, a conglomeration of girls were standing in the far corner perhaps chattering about the latest gossip, and perhaps the topic of the day was, “Who is the new boy? Gosh, will he turn out to be a cool kid or a chump?”

Ric led mom and me to the pool table to where the messy haired kid was aiming his cue at the black ball. Click. “Aha, I won!” he yelled as the black eight ball bounded into a corner pocket. “Finally I beat you.”

“Ah, that’s fine,” Willie said, “We’re just having fun.”

“Fun, my butt. It’s all about winning.” The messy haired boy’s grin filled his face as he twirled his pool stick over his head.

“Hey, Eric, how’s it going,” Ric said. The pool stick flew out of Eric’s hand and clattered on the floor.

“What? Who?” His smile instantly wiped away and filled with an expression of concern.
“I want you to meat someone.” Ric motioned for me to move forward. “This is Ric Frea

"This is your new roommate. Rick, this is Eric Groch.”

I offered my hand, but Eric walked away. He bent down, picked up his pool stick, and leaned on the table, facing the door to his –and my—room.

Beside me, mom was standing with her camera out. She tried to take a picture of Eric, but he quickly darted out of the range of the camera. Mom aimed through the camera again, but he darted, ducked under the pool table. The camera clicked. The picture of the pool stick and parts of Eric’s red shirt still show in the picture today, the only one of him I have.

Only fitting, though, as he would turn out to be a big thorn in my side – a drug addict, criminal mind moron you might say. The kind of person no mom would ever want her son to meat, and here I was his roommate.

Willie said, "Well, if you're not going to play pool, Rick can play."

"Cool," I said, "I'll play."

Eric plopped himself out from under the table, but when he saw my mom was eagerly standing by waiting to snap another picture, back under he went. An ominous sign of the chump Eric would turn out to be.

Willie would turn out to be a good pal.

(Dean and his mom and dad were standing nearby. Mom talked with his mother. Introduced me to Dean, who was admitted the day before. The next day mom and Dean’s parents went shopping while I participated in an array of tests.)

Later that day, after a ton of appointments with doctors and testing, mom asked my doctor if she could take me to the museum. Dr. Betty said I was too unstable. I understood, but it was a disappointing none-the-less considering mom was in town five days and I couldn't do anything with her.

Finally, on the 14th of January, I kissed her good-bye. I really didn’t have a lot of time those initial days to be homesick as the activities were abounding. Still, there were some dark moments.

This was not a normal hospital where you sat in bed all day. It was more of an institution where you went about your normal daily activities, which were blended in with various tests and appointments. The intent was to get our asthma under control in the process of making us gallant asthmatics.

The next morning I got up at 6 a.m. and walked out to the lobby in my jimmies. A short, curly haired blonde female teenager I had yet to be introduced to was taking a breathing treatment. I could hear the soft audible purr of the machine.

“I can see your underwear,” Eric teased. “Hey everybody, you can see Rick's underwear through his witto jimmies.”

Of course growing up with four brothers I didn’t care and proceeded to the nurse’s station. The night nurse placed three pills on the counter. “this one here tastes really bad, so you might want to take it with grape juice,” she said.

The grape juice was good, but that pill tasted NASTY at the back of my throat regardless. It was the steroid pill. Even through the strong grape flavor, there was nothing I could do to prevent the pill from sliding over the sour receptors of my tongue.

The other pill was Theo-Dur, a bronchodilator in pill form. That pill was relatively bulky, but I had no trouble getting it down.

“Can I take my treatment now?” I asked. I was tight.

“Well, you are gonna have to wait a while. Deana is taking a treatment now, and then comes Eric, Dean, Willie and then Stan. They were up before you. If you want to take a treatment first, you’re going to have to get up a lot earlier than this.”

“Oh, come on. I need one now.”

“Well, you should think about that before you sleep in,” she said, as she set the next kid’s meds on the counter.

“But I didn’t’ sleep in. I’m up right on time.”

“Well, you’ll have to reconsider.”

I sat in a chair by the door of my room while I waited for my turn on the nebulizer. Finally, Stan sat in the treatment chair. Another girl was in the other treatment chair. I walked to the med room behind the nurse’s station. Here, on a counter, where several brown, glass bottles of medicine.

I filed through cardboard papers in a box to the right and pulled out the one with my name on it. Listed on the card was the meds I was supposed to take in the nebulizer: Alupent 0.3cc and Atrovent 0.5mg. As I was reading the card Cathy, my head nurse, came into the room and poked her head over my shoulder. Willie was also in the room doing something with his nebulizer, but I paid him no attention.

“I’ll just watch you do it today,” she said. Before this day she drew up the meds and I watched. So this was progress.

To the left, on a rack hanging on the wall, were plastic bags with our nebs in them. I grabbed the one with my name, heart thumping but only because I had cute Cathy breathing down my shoulder, and dumped out the contents on to the counter. I set it up so the cup was open.

I grabbed the syringe and set it in front of me. I reached for the large, brown bottle of Atrovent and twisted the cap until it was off. On the inside of the cap was a black squeeze bulb. I squeezed up the correct dose as Karen showed me the earlier, and squeezed it into the nebulizer cup. I did the same with the Alupent.

The treatment now together, I walked back to the lobby. Cathy followed me out of the med room, but instead of following me to the treatment chair she went to the nurses' station. My chest was tight. I was audibly wheezing. I was huffing as I walked by the nurse’s station. Stan still had his hand over his nostrils and the neb in his mouth, but I could hear it was close to finished.

“John, can I talk with you,” Cathy said.

I approached her. As I did so Stan got up and another kid took his place in the treatment chair. I had missed my turn. Thank you very much, Cathy. How the heck could I miss my turn when no one came into the med room the whole time I was in there.

On a table near the nebulizer three girls were seated and giggling. Al three were looking at me. One of them got up, giggling the whole way, and walked to the med room.

“John,” Cathy was leaning on the counter looking at me. She whispered as I stood next to and leaned on the counter. I could not hear what she said, so I leaned in the same time she did. We were nearly face-to-face. “I didn’t want to say this in the med room in front of Willie.” She paused and held back a smile before she finished. “First of all, you really ought to wear a bathrobe over your pajamas. Either that or you should get dressed before you come out here for your meds in the morning. We can all see your underwear through your pajamas.”

“You already said that,” I said.

“Well, I guess you didn’t hear me. Do you hear me?”

“Yes,” I said. “I hear you. Tomorrow I’ll get up earlier. What time is good?”

“Well, if you want to get up before the other kids, you better be here by 5:30. You don’t have to, it’s your choice. Remember, you can take your morning treatment anytime between 5:30 and 6:30. But if you need a treatment as bad as you do, you ought to be up earlier.”

“Okay,” I said. From now on the other kids are gonna wait for me.

I turned and started for the nebulizer. Stan was STILL puffing on that thing. Is there anything coming out? I don’t see any mist. I turned to Cathy who was still leaning on the counter looking at me. “Cathy?”

“Yes.” She let her smile show this time. You look darn good-looking for a nurse. I wonder how old you are.

“How did Stan beat me to the treatment chair. I didn’t see him in the med room.”

“He was up earlier and prepared his treatment so he was ready to go. You can do that to if you want.”

The next day my alarm went off at 5 a.m. sharp. I leaned across my bed, hit the off button, and could hear my room mate snoring, his radio still blaring. I hopped out of bed in my pajamas, and I grabbed my green fluffy bathrobe I had set on my nightstand. As I opened the door to the lobby I saw there were no kids up yet. I had all the med room and the nebulizers to myself.

When 5:30 arrived I had my butt in the nebulizer seat. From this point on the other kids had to wait for me.
***
It was my responsibility to know when my meds were due and to take them as instructed. If I missed one dose or used an improper technique, I would lose my allowance for the week. Without allowance, I’d have no money to spend at the weekly field trip. (Which didn't matter at this point anyway because Dr. Betty wouldn’t allow me to go even if I had the points.)

The point sheet is what I used to keep track of my progress. On it was all the things I had accomplished in a day. If I lost it, that was like losing all my points. And it is pointed that determined how I moved up the levels.

As I popped my pills with grape juice, I looked up at the board behind the nurse’s station. Dean’s name and mine were printed on the bottom written in blue marker, while all the other kid’s names were written in black. Next to our names was written the level we were on. My level was 2. Alongside the other names were 1, 2, 3, 4 or H for honors. The goal was to move up to honors, and the place no one wanted to go was level 1, because that meant no allowance and no privileges at all.
***
I followed Eric and the other kids to the elevator and down to the basement. It was time for my first day of school. I followed the other kids through the tunnels.

Mr. Rose was a nice teacher. He seemed a bit obnoxious though, but I suppose when your teaching a bunch of chronically ill kids you have to be a bit different. "We have a new student, today," he said, "This is Rick Frea. Rick, tell us about yourself."

"Um..." I said, "I'm from Michigan and I... uh... I have asthma and it got really bad and so now.. uh.. now I am here to get my asthma under control."

"As is the case with all of us, right guys?"

The class shouted in unison, "Right Mr. Rose."

A short-stout kid with loose fitting clothes and long blonde hair sat in a seat right before Mr. Rose's desk. He never stopped talking for the first 30 minutes of class. Finally Mr. Rose said, "Chico, I think that bandana of yours is tied too tight over your skull and squeezing your brain because it sure doesn't seem to be working today."

"That's because I'm hip," Chico said.

"That's because you're a dip," Mr. Rose said. "Now stop talking a minute so we can educate the rest of the class because obviously, you don't have any interest in education. I'm not even sure it's possible to educate you."

"I'm already fully educated," he chided.

"We can all see how educated you are, Chicohead. Now hush."

At noon I followed the other students back through the tunnels to 7-Goodman. The nurses gave me my noon meds. Karen was there. She told me I had appointments the rest of the day and wouldn't be going back to school.

The second day of school, and many of the days that followed, I had to leave many times for "lots of appointments, which included a PFT," according to my personal diary.

By the time I got back from testing the other kids were done with school. I was told after school was supposed to be our time to relax, do homework or socialize, but up to this day, I never had a chance to do either.

After dinner, at 7.pm., it was time for aerobics. I was told I had to go down to participate, but I wasn't able to do anything physical. It surely wasn't fun standing there while the other kids were playing kickball.
***

The next day I talked to Dr. Betty between appointments and she said I could participate in aerobics if I wanted to that night. But, when I did, my chest got tight, I started to wheeze, and one of the kids had to show me how to get back to 7-Goodman.

"Get an epinephrine ready," a pudgy nurse said as she started a breathing treatment and handed it to me. "Concentrate on your breathing. Sit straight. Concentrate on your breathing."

I did as I was taught those first few days. I concentrated on my breathing, and soon I was able to take in a normal breath, but it didn't come until the treatment was almost finished. I almost bought myself my first Denver Epi that night, but it wasn't needed.

The next day I had to do a barium swallow. That's a test to determine if there were any stomach abnormalities. I'm telling you, while I was there they did every test imaginable. They even did an EEG one day because I had constant headaches.

For obvious reasons, I didn't do very well in school on these initial days. In my diary I kept writing, "School was boring today. I have to study for exams and I hate it." I was probably antsy about all these tests they were doing on me. Well, plus I was homesick being so far away from home.

Finally, it was Friday of week two. I marked my diary: 4-6 weeks to go.

Up to this point, I wasn't allowed to participate in any off campus events -- like there was any time for it anyway. Still, it was something that I was really looking forward to. I walked down to the business office during lunch break with one of the other kids and got money.

Along with seeing Ric on regular basis, I also had to see a psychologist weekly. I didn't understand it then, but she was scoping me for the psychological consequences of asthma.

Every night we either had aerobics or swimming. I had to go but was not allowed to participate that first week. I was wheezing and my chest remained tight.

On day #13 my new friends wanted me to go to the mall with them. I "begged" Dr. Betty to let me go, and she said I could. She also said I could participate in aerobics that night.

But, as I ran around the gym trying to be normal, the asthma beast struck and I became anxious and insisted that I needed a treatment. One of my friends escorted me upstairs, "where Kathy almost had to give me an epi," according to my diary.

The next day school went great. At lunch, I rushed up to the bank to withdraw money to spend at the mall and rushed up to 7-Goodman to eat lunch and get my noon meds. I was wheezing.
After school, and still wheezing after my treatment, Dr. Betty approached me. I had a bad feeling about this.

She said, "John, I've decided you would benefit from being on steroids. We tried you on the basic meds and you don't seem to be responding. Your lips are blue as we speak. I want you to go upstairs to our hospital where we can watch you more closely."

And so slipped my good mood. Here I was at the best asthma institution in the world and my Asthma wasn’t getting any better at all -- it was getting worse.

To be continued.....

1960-1990: The asthma institution

By the 1960s, the two asthma institutions in Denver that were opened to take care of tuberculosis patients were now mainly taking care of asthma patients, according to NationalJewishHealth.org.  And "by this time TB patients comprised only half of the patient population and asthma patients a third." (5)

It was in this decade that National Jewish Hospital opened a facility specifically for the increasing population of asthmatics with high risk asthma that was non responding to conventional therapy.  It was in 1969 that a fee for service based on a patients ability to pay was begun.

By 1976 Asthma was recognized as the most prominent chronic disease among children, affecting 1.5 million children in the United States, and this included myself.  It produced a lot of suffering for those afflicted, and it also accounted for about one-forth of all school days lost. (4, page 164)

It is a debilitating disease not only for the child who is suffering, but for parents who don't understand the disease, and fear their child might die.  Yet perhaps even worse than that for the parent is the helpless feeling that there's nothing you can do, and what you do do doesn't help. Probably because most of what they did back to was based on fallacies of the past, such as putting asthmatics in a steam filled bathroom hoping that would relieve an attack.

Yet for the child the suffering is even worse yet, and here I can allude to my own experience.  Many nights I would stay up late, many times all night long, my wrists firmly pressed on the window sill, by face up against the cold screen with the intend on sucking in cool air and oxygen.  Many nights I suffered in this way from an asthma attack.

When I was little I sat up on the bed, all frogged up, gasping for air.  I did this probably because I didn't know there was anything not normal about it.  When I was older I'd push open the window in secrecy in the middle of the night because I didn't want to bother my busy parents.  Another reason I suffered in secrecy like this was because I didn't want my parents to worry about me.

Another reason may have been because of a poor self esteem exacerbated by parents who disciplined me because I underachieved, even when I was probably underachieving because of my asthma.  Another reason for my low self esteem was because kids picked on me at school because I acted different from the "normal" kids.  I had a runny nose and they didn't.  I wasn't able to play baseball on teh dusty baseball diamond.  So they picked on me.  The same way my brothers sometimes picked on me when I didn't play baseball with them.  I was basically fodder for the other kids.

Now as I look back on all this I think I'm sometimes just saying this kind of stuff to justify why I was picked on as a kid, but based on my own medical records my counselors, my psychologist, and my medical physicians all believed this.  Asthma had taken a physical and psychological toll on me.  And to make matters worse my teachers and parents had no clue this was going on, and the end result was a shot self esteem and shot level of self confidence.

And then I had mood changes. And many children have mood changes, so my parents and physicians probably figured I was just one of those intractable children. I became stubborn sometimes at home, and I was emotionally distraught.  I remember being extremely depressed to the point my parents once grounded me from watching the news.  I remember pacing the living room for hours worrying about the death of a relative, or that I was going to get old and die.  Of course my parents and doctors had no clue I was depressed, or at least at the time they didn't associate it with the fact my asthma was poorly controlled. More recently my mom acknowledged to me she was aware of it, but I don't remember her ever doing anything to help me.

So, again, I can understand the theory that asthma was believed to be psychological.  Plus when a child is admitted to one of these hospitals the environment is controlled.  By the 1970s and 1980s air conditioning was added to both the children's ward and the gymnasiums where children exercised.  There was a focus on a good diet, and we were exercising all the time. Stuffed animals and items that collected dust were not allowed.  Clothing was washed regularly so it was allergen free, and furniture was made of leather or other solid material that was easy to wash and didn't harbor allergens.

By the 1970s there were two prominent asthma hospitals in Denver, one was National Asthma Center and the other was National Jewish Hospital at Denver.  By 1978 National Asthma Center admitted financial trouble, these two great hospitals merged to create National Jewish Hospital/ National Asthma Center.  The main campus was on Colfax Avenue, or the National Jewish Hospital campus.  The merger resulted in the "largest treatment center for pediatric and adult asthma," according to NationalJewishHealth.org.(5)

Once admitted the children would under go an examination by a physician, and then spend the next several days undergoing a variety of tests.  I remember doing many pulmonary function tests, x-rays, electrocardiograms, sweat test (to rule out cystic fibrosis), and so many other tests I can't even recall all of them.  I just remember being exhausted by the end of it.

I met with a counselor on day one, and I think the main reason for my counselor was to help me deal with the day to day life at my new home, and also to help me learn to cope with life once I return home.  I saw my counselor once or twice a week, and once every two weeks I saw a psychologist.  I only saw a psychiatrist once that I remember, and he prescribed Xanax to help me relax. He actually prescribed an antidepressent before that, but I had an allergic reaction that gave me hives all over my body, so he must have decicded just to stick with xanax.  It seemed to work pretty well (I'll tell you the story about that later).

So I was admitted to the hospital in 1985, this was long after the psychosomatic theory of asthma had been proven to not be true.  But I'm certain the doctors trained to work there, and the psychologist, were still privy to these old theories.  I'm certain, especially after reading my medical records, that they believed much of my asthma was in my head.  They noted the anxiety.  They noted trouble when my mom visited, and how my asthma was exacerbated during these times.
Travis quotes one physician as saying that "once asthma has been established, acute attacks may be triggered by emotions.  There is a psychological basis for some emotionally precipitated attacks, particularly when the emotional upset is accompanied by shouting, crying and rapid breathing... it becomes impossible after a time to separate problems which are precipitating asthmatic attacks from those that are secondary to the asthma.  The secondary gain can be a significant problem."  (4, page 169)

This appears to be my proof that asthma was no longer believed to be psychological by the time I was admitted in 1985, although psychological factors can still trigger asthma. Most of the asthmatics admitted by this time were on systemic corticosteroids, and the fear of side effects was paramount.  Although, through the efforts of physicians at the hospital, I believe most patients went home on preventative asthma medicines, with controlled asthma, and off systemic steroids.  At least that was the case with me and the children I was admitted with.

It also must be noted that, even back in the 1940s I'm sure, occupational therapy was a major therapy given to asthmatic children admitted to the hospital.  Children with intractible asthma, and I can attest to this, do not develop many of the skills other kids do to cope with life.  This is the same for kids with other intractible diseases too.  They don't develop skills that most people take for granted, such as balancing a check book or searching for an apartment.  These types of basic skills that are worked on at the hospital, if the need is there.

And, again, there was a major focus on education and exercise.  These two were almost ingrained together at the asthma hospital.  You need to understand your disease and every part of it, and you needed to exercise.  Many times exercise was education, and education was exercise.  You need to know your medicine, and you need to be compliant with your medicine. And you need to now why you are exercising, and how it will make you better.

You need to know what aerobic exercise is, and if your legs weren't being kicked high enough in the air, you will be told this.  And unless you have a good excuse, like  your asthma was really acting up, you did as you were told.  And for the most part you did it because you wanted to, because you were just happy you were able to exercise at all, because most of use weren't able to prior to being admitted.

You will leave National Jewish educated, and if your physicians don't think you have a good grasp on your education, you will probably not be cleared for discharge.You need to take complete responsibility for your medicine, so that even if your parents back home aren't involved in your care, you know exactly what to do at all times.  You need to know why you are taking your medicines and why it's so important to take them every day. And you need to exercise.

You need to plan ahead on the first day of the week, and plan out what pills you will be taking and on what day and on what times during what day.  You need to plan before every trip out of your house to make sure you take your medicine before hand, and that you have all the medicine you will need on the trip, such as your rescue inhaler.  You cannot just take for granted someone else, even your parents, will remember your medicine when you leave the house.  It is solely your responsiblity.

You will have to also know when to take your rescue medicine, and when to wait.  You will also have to know your asthma triggers and how to avoid them.  You will also have to know what your symptoms of asthma are and what to do about them.  You have to know it all, and you have to be completely responsible for your own health.  That is essential, and it is engrained in your head over and over and over and over and over again until you are discharged.

And also you had to exercise every day.  The school I attended, the Kunsburg School, had a pool, and we swam two days a week during school.  And when we weren't swimming we had gym class.  Every evening after dinner we went to the gym in the school to do some form of aerobic activity.  We stretched, and then we moved for 20 minutes.  That was mandatory.  We did kickball.  We did basketball.  We did baseball.  We did dodge ball.  And if you weren't moving, you were pestered by the PE instructor until you did just that.

When you were first admitted you had a complete physical, followed by a series of tests.  Your asthma was stabilited one way or another, and then you were cleared within  You were then required to exercise, and you were required to attend school.

And then, during the evenings, and on the weekends, you had fun just like normal kids do. You go on field trips. You go to the mall shopping and you go to movie theaters to watch the best movies.  And you go to amusement parks, camping, and all sorts of fun things.  Sometimes you go to video stores and rend movies to watch at home.  You have parties with the other kids.  You have dances.  You have icecream socials.  You have dance and singing competitions.  You played games with the nurses and other kids.

In the winter there was a basketball team, and either you joined the team or you traveled with the team and you watched the team.  And in the spring there was a baseball team, and either you played or you watched.  And it was much more enjoyable to play than watch.  And you traveled to other institutions in the area, including those housing other sick kids, or otherwise sheltered kids.  The goal is to make the hospital as much like home as possible.  And, for the most part, they succeeded at this.  It was a really fun experience.  And all along you learned. Everything was a learning experience.

At one point during my stay I wrote in my journal:  "The only thing that makes this place seem like a hospital is the nurses wear stethoscopes over their shoulders."  For the most part that was true.  Although you were still thousands of miles away from your home, away from your parens, and you were chronically sick.  So most of the kids got homesick, and that was another issues the staff there had to deal with.  And, I'd assume, another reason for all the activities.

In 1985, while I was a patient at NJH/NAC, the name was changed to National Jewish Center for Immunology & Respiratory Medicine.  In 1995 the inpatient floors at the hospital were closed and a new pediatric outpatient program was added, and in 1997 the name was chanced again to

References:

1. Minton, Gregg, "Breathing Space,"
2. Wamboldt, Fredrick S. "Asthma Theory and Practice: It's Not Too Simple," April 2, 2008,
3. Jackson, Mark, "Asthma: A Biography,"
4. Travis, George, "Chronic Illness in Children," 1976, California, Ford University Press
5. "Clinical History," NationalJewishHealth.org, http://www.nationaljewish.org/about/whynjh/history/clinical/clinical-history3/, accessed 

1949-1969: The National Foundation for Asthmatic Children

One of the main reasons National Jewish Health was able to stay afloat through the years is that it recognized the changing health needs in America. While both National Jewish Hospital for Consumptives and Denver Sheltering Home for Jewish Children opened to provide opportunities for children and adults inflicted or affected by tuberculosis.

Between the 1940s and 1960s the number of tuberculosis patients declined, and the number of asthma patients increased. Plus there as a need for taking care of patients with other diseases, including emphysema, chronic bronchitis, cystic fibrosis, bronchiectasis, silicosis, sarcoidosis, and fungal infections (1)

Yet there was also an increased emphasis on research, hence the name change of the Sheltering home to Jewish National Home for Asthmatic Children at Denver in 1953, and in 1957 to Children's Asthma Research Institute & Hospital (CARIH). The hospital also performed research into immunity, and this was a major reason for the 1985 name change of National Jewish Hospital/ National Asthma Center to National Jewish Center for Immunology & Respiratory Medicine.

There was another institution in Tuscon, Ariona, that was similar to National Jewish. People with lung ailments flocked to Arizona due to its dry climate, which was perceived to better for adults and children with breathing difficulties. The National Foundation for Asthmatic Children (NFAC) was opened in Arizona in 1949. It was actually the first "diseased based organization to launch a national campaign on behalf of the asthmatic child. (2, page 115) During the 1950s National Jewish Home for Asthmatic Children started a similar educational campaign. (2, page 116)

Back then asthma was a little known disease, yet a massive advertising and public relations campaign by both National Jewish and NFAC increased awareness of the 2.5 million children in America with asthma. The campaigns increased awareness of the hospitals and research centers in both Denver and Tuscon. And the number of patients being referred to these hospitals increased. (2, page 116)

In 1973 CARIH changed its name to National Asthma Center, and admitted financial trouble by 1978, so it merged with National Jewish to create National Jewish Hospital/ National Asthma Center. This created the largest asthma hospital and research center in the world. Although there was an emphasis on patient care, the hospital continued to emphasize research.

While the school at NFAC closed in 1969, the hospital persisted. It was another option for children with hardluck asthma or other respiratory diseases. There was another such hospital in New York called Asthmatic Children's Foundation. In 1981 there were 15 similar residential treatment centers for asthmatics. (3)


In August of 2009 several former patients at NFAC met in Tuscon, Arizona to reminisce about their stay at the institution. The major emphasis back then about asthma was that medicine was used to treat acute symptoms, with included bronchospasm. Asthma was also a disease caused by a nervous disorder, or a suppressed cry for the mother. (4)

These kids were treated with a good course of education, exercise, and a good, healthy diet. They were also allowed to live a relatively normal life outside of that, by going on trips to town like normal kids, shopping, tours, amusement parks, parks, etc. They were also allowed to participate in games and other fun things kids do.

The kids "attend a boarding school for asthmatic children. These children can play out of doors year round and they become confident and competitive because they are competing with children on their own level," according A.B. Sieh, executive director for NFAC, in an article published in the Rotarian in August 1965. (5, page 51)

Boys and girls afflicted with bronchial asthma generally are admitted to the hospital for a one or two year stay, and this is at no charge, similar to the two asthma hospitals in Denver. The school the kids attend has a capacity of 72, and it's usually full (5, page 51)

Sieh notes that the "they come here pigeon chested with hollow eyes and sad faces... we have had children, who upon arrival, who could not walk up a single step without bringing on an asthma attack... the Arizona sun takes over and we have healthy looking children who can go home -- not cured, but rehabilitated to the point that they can cope with their asthma and live a normal life, attend public schools, and not be 'different.'

So while the main goal was to improve asthma, it wasn't like you were living in a hospital, at least not all the time. It allowed kids to get better, so they could go on to live normal lives.

References:

1. "Clinical History," NationalJewishHealth.org, http://www.nationaljewish.org/about/whynjh/history/clinical/clinical-history3/, accessed 11/7/12
2. Mitman, Gregg, "Breathing Space," 2007
3. Melvin, Tessa, "For 36 Children, Hope on Asthma," New York Times, September 26, 1982
4. Beal, Tom, "Tuscon asthmatic kids of reunite, view latest research," Arizona Daily Star, August 3, 2009
5. "These Rotarians: ABCs School," The Rotarian: An International Magazine, August, 1965

1920s and 30s: Memories from National Jewish

 B'nai B'rith Building.  This was the east part of the campus on the opposite
side of Colorado Boulevard as the 7-Goodman Building that I was in.  This
building was for the most severe asthmatic kids during the 1930s.  By the
1980s when I was a patient, this building stood empty.  It appears,
however, that it is no longer empty.  I'm surprised it still stands. And, a
part of me is happy it still stands.
1

Between 1899 and 1999 there were thousands of children with a chronic breathing disease, mainly tuberculosis and asthma, who benefited from a prolonged stay at the Jewish Hospital in Denver.  In 1999 they were all invited back for a reunion. I was among them. However, due to my place in life, was unable to attend. 

As part of the reunion we were all asked to tell our stories and mail them in. I did not do this, but many others did. They were since compiled into a little booklet that I was able to get my hands on.

I would like here to share some of these stories.  Even though these stories were submitted for the public, I will not share any names here.  My only goal is to give you an idea of what it was like to live in a sanatorium or asthma institution for several months, or years, away from your family and friends. 

Fannie E. Lorber Breaking Ground at the Denver Sheltering Home for Jewish Children

1920s:  Denver Sheltering Home for Jewish Children

I have a story from a lady who's family members suffered from tuberculosis, and she and her three siblings were staying at the shelter because her family couldn't take care of her for a time.  Her father paid $40 a month "for the keep of us four children in our family."  Her recollection was taking dancing lessons.  She adds:  "In sharing these notes I can say 'Thanks' for the shelter and the care I was given while my mother laid in a bed in the hospital with tuberculosis."  I would imagine the hospital she's referring to was National Jewish Hospital for Consumptives.  

Mending clothes was one of the routine chores preformed by the girls.

1930s:  National home for Jewish Children

It was just a simple name change, although the home was the same as the one mentioned during the 1920s.  One guy talked of he and his group of friends having boxing matches "because we had gloves our dad gave us.  He writes how some of the guys "hitch hiked -- got a ride on a cement truck," and one of the kids fell off and was run over and killed.  He remembered running through the tunnels under the hospital -- "especially to escape from Mr. Cohen!  Or hiding in the engine room or the locker room.  And various of us getting beaten up in the locker room by the Boss.'

1930s:  National Jewish Hospital for Consumptives

An unidentified woman reads a story to a group of children in
the nursery at the National Home for Jewish Children at Denver. 
 On back of photograph: ''Story hour in the nursery National
Home for Jewish Children at Denver 1931 (2)

(Resident August 1934-January 1936)  At the time of my admission to National Jewish I had been living in Colorado Springs.  My family had moved from Ohio because of my father's health.  He was tubercular and eventually was a patient at National Jewish also.

At a very early age I had typhoid fever,which left me in a weakened condition from which I never fully recovered.  As I grew older, I failed to recover satisfactorily.  Because my father was tubercular, our family doctor thought it best that i be admitted to National Jewish.

A friend of a friend arranged to have me driven to Denver.  I arrived and was admitted to National Jewish on the 23rd of August 1934.  I was 12 years old.  I was assigned to the Heinemen building for a short time and then transferred to the Hofheimer Preventorium.  I was discharged in late January 1936.  

Dance Recital (2)

I remember the names of many of my fellow patients.  During the school year we went to one of the other buildings on the grounds for our classes.  Our teacher was Miss Mayme Smith.  She taught eight grades in one classroom.  She was taskmaster and a strict disciplinarian.  However, she was always fair. 

the doctors I recall are Drs Black and Cohen.  the nurses I remember are Miss Gresharn, Mrs. Sharam, Miss Elsie and Miss Nickey.  Miss Nickey was the night nurse.  

In addition to attending class, we went on many field trips.  Mostly we walked to the playground at City Park.  Once we walked to Cheesman park where we waded in the pool and I believe we had picnic supper there.  We also went to Elitch Gardens and rode all the rides and to the Schoenberg Farm where we spent the day roaming around the area and having a picnic lunch  At Christmas time the ladies of the Eastern Star took us around to see some of the houses that were very well decorated and lit up.

A group of children sit on an outside deck at the National Home for 
Jewish Children.Each child has a plate of food and an unidentified woman serves them.
 Most of the children are unidentified, however, Bertha Katzson, Doris
Greenstein and Reuben Levine are part of the group. The children
 are in the care of the National Home for Jewish Children
at Denver in Denver, Colorado. (2)

We had students from Denver university visit one afternoon each week.  We called them Club Ladies, one for the boys arranged a trip for a few of the older boys to attend a football game at DU Stadium.  

We used to get our hair cut at regular intervals.  A stool was set up in the nurses' station upstairs, we all lined up and had our hair cut.  All the boys looked the same and all the girls looked alike when the barber was through.  We each climbed on the stool in our turn and zip zip and you were through.  We left our dime for the barber and went our way.

As I recall, we were given some candy on Thursday and Sunday nights.  In the evening we used the dining room as a study hall.  On Sunday nights, while studying, we listened to Eddie Cantor, Ed Wynn, and Fred Allen's radio programs.  At some time a few of us discovered where the candy was kept.  We used to raid it once in a while.

(Resident 1936-1940) "50 Years Ago, They Gave me Back My Life."  Looking at the National Jewish Center for Immunology and Respiratory Medicine, the observers sees a campus composed of both time-honored and modernistic buildings uniquely set off from the busy intersection of Colorado Blvd. and Colfax Avenue.  In 1936, however, National Jewish was a very different place.  Ruth lived at National Jewish for four years during her struggle with tuberculosis between 1936-1940.

As Ruth looks back on her stay, she reflects, "They gave me back my life."  Ruth continued to tell us more about the Center as it was 50 years ago.  "The campus was divided into two parts by the Colorado Blvd.  I lived on the east side of the campus in the B'nai B'rith Building, and on the west side of Colorado Blvd. was the research building, the Pisko building for ambulatory patients, and a few other buildings.  The B'nai B'rith Building was for very ill patients.  After three-and-a-half years, when my tuberculosis was at last brought under control, I was able to move to the west side of the campus into the Pisko building.  In this new setting there was an air of triumph and a sense of camaraderie for we were able to dress and walk to the communal dining room and share meals together.  Also, we could take part in the activities and entertainment wisely planned for our benefit."

Ruth came to the National Jewish Hospital from Arkansas in 1936 after struggling for six years with tuberculosis while living in an Arkansas sanatorium.  she described the mood she prepared for her trip to Denver.  "My father explained to me that I was so ill, the doctors were not sure I would survive the trip to Denver and perhaps I should just stay in Arkansas."

However, Rush is indeed a fighter, and in her heart she felt that the doctors in Denver could help her.  She was prepared to take the risk.  She traveled by ambulance to the train, by train to Denver, and again by ambulance to National Jewish.  The trip required a total of 36 hours.

After being released from National Jewish in 1940, Ruth decided to make Denver her home.  She married soon after her release.  Her battle with tuberculosis had lasted ten long years, and had robbed her of her twenties, yet added a new dimension of perseverance, patience, and compassion to her life.  With the help of the wonderful staff at National Jewish, in particular, Dr. Gugenheim, she was victorious.  Since the, her health has remained stable, and her life has been fulfilling and productive.

In July of 1986, on the 50th anniversary of her entry into National Jewish, Ruth came back to the Center.  It was indeed a  very emotional visit as she toured a different, yet familiar, campus.  today the National Jewish Medical and Research Center is world renowned for only for work with tuberculosis, but for research in respiratory and immune system disease, model patient care programs, and excellent educational training for doctors and patients nationwide.

Rush acknowledged the fifty year anniversary of her admittance into National Jewish my making a gift to the Center in the form of a National Jewish Gift Annuity.  This very special gift from the heart, given with deep thanksgiving, will help National Jewish to progress and grow during the next 50 years.

Compliments of National Jewish Health Facebook Page. Opened in 1899. 

References:

1. "Our Memories," National Jewish Medical and Research Center Patient and Resident Reunion," July 30-August 1, 1999, National Jewish Medical and Research Center, Denver, Colorado, Memories is a packet put together for former patients who visited the institution for the reunion.  
2. "Jewish Story at the National Home for Jewish Children at Denver," Penrose Presents, University of Denver, accessed 11/8/12

1940's: Dr. M. Murray Peshkin, Parentectomy, and the rise of the asthma institution

Figure 1 -- NJH patients receiving sunlight exposure treatment

Thanks to better care, improved diets and good hygiene, the number of tuberculosis patients declined significantly during the 1930s. National Jewish Hospital at Denver and National Home for Jewish Children in Denver continued to function mainly because their doors were open to people with other diseases besides just tuberculosis, particularly asthmatics having trouble managing their asthma at home.   (1, page 115)

In the 1940's, the number of tuberculosis patients was generally higher than those with other diseases, like asthma.  However, the number of asthma patients at the institution was on the rise.  And, for the most part, the goal for people with chronic lung diseases was to seek the cool, dry climate of Colorado for improved breathing.  So, both asthmatics and TB patients received open air treatment (see figure 1).

Figure 2 --Children playing on swings at the National Home
 for Jewish Children, 1936 (6)

Likewise, patients who got better were provided the "added bonus of rehabilitation, social and education programs.  The education programs were intended to equip patients, who often came from lives of poverty, to function more effectively, in the world outside of the hospital."  (5)

Now, before I get into the rise of asthma patients at these hospitals, you have to understand the common thinking about asthma in this era. First of all, asthma was a much rarer disease at this time, so it didn't get even close to the type of limelight that a deadly disease like tuberculosis got.

During most of the 19th century the two most prominent theories about asthma were that it was a neurotic disorder that resulted in airway constriction and shortness of breath.  This theory continued to be prevalent in the minds of many physicians, although it sort of took a back seat to other theories, such as the allergic theory. In fact, some researchers were so excited about the new allergic theory that they believed this would lead to a vaccine for asthma.

However, the idea that asthma was nervous was reinvigorated beginning with German and Austrian physicians (like Dr. Alexander) in the 1920's. These physicians described wheezing and asthma as a suppressed cry for the mother. So, the treatment for it, along with controlling asthma triggers, was psychotherapy. Of course it was often noted that most asthmatics were not avoiding triggers nor receiving the therapy they needed to obtain ideal control.

As these physicians migrated to the United States this information migrated with them. Do doctors here, including Dr. Murray Peshkin, medical director for the National Home for Jewish Children, must have been aware of it. This must have inspired him.

So, during the 1930's the number of tuberculosis patients were on the decline and the number of asthma patients were on the rise. Still, at this time, there weren't a lot of asthma patients. This changed after Dr. Peshkin observed a trend among asthmatic children at the hospital. He postulated a theory based on his observations that would cause a spike in the number of asthmatic admissions to National Jewish and all the other asthma hospitals around the nation.

What he observed was there were about 10 percent of asthmatic children who never got better at home, even when he personally visited their homes to make sure they were perfectly clean and antiseptic with no trace of any known allergens.  (2) He observed that as soon as being admitted to his hospital many of these children became immediately better. He observed that 99 percent of the children treated this way had 'substantial or complete relief' of symptoms, according to his own reports. (3, page 145)

He concluded the reason for this was removal from allergens and stress at home. He therefore proposed a strategy that involved abducting (with parental permission of course) these children from their homes and admitting them to asthma hospitals. A slang term for this developed: Parentectomy.

Parentectomy became a popular strategy when physicians observed severe asthma in children despite their best efforts. The children would often stay at these hospitals from 1-2 years. And they weren't like typical hospitals either: they were more like institutions. Sure there were nurses and doctors, but there were also teachers and, most certainly, there was entertainment. We can learn what it was like to live at one of these institutions by reading their stories. (4, page 170)

References:

1. Minton, Gregg, "Breathing Space,"
2. Wamboldt, Fredrick S. "Asthma Theory and Practice: It's Not Too Simple," April 2, 2008,
3. Jackson, Mark, "Asthma: A Biography,"
4. Travis, George, "Chronic Illness in Children," 1976, California, Stanford University Press
5. "Clinical History: The Early Years," NationalJewishHealth.org, http://www.nationaljewish.org/about/whynjh/history/clinical/, accessed 11/7/12
6. Photo from Penrose Library, http://lib-anubis.cair.du.edu/About/collections/SpecialCollections/NAC/index.cfm, accessed 11/8/12

1950s: Asthma at national Jewish Hospital

Figure 1 -- National Jewish Hospital today.  You can see the Goodman bulding
on the right.  It was there, on the 7th floor, where I was a patient in 1985.
The boy's ward looked out in this direction.  On the 7th floor was where kids
12-18 lived, and on the 8th floor was home to younger kids.  I stayed
on 7 Goodman for 3 months, andthen I was a patient of 2-May for 3 months
(another building not seen here).  The treatment greatly helped me.

So by the 1880s about 1 in 4 residents of Denver were patients with lung diseases, and many of them were literally dying in the streets.  It was for this reason the Jewish community came together and donated money to open the doors of National Jewish Hospital for the Treatment of Consumptives.  

It was not the only such sanatorium in the area, nor was it the only one in the United States.  In fact, many had opened both in the U.S. and in Europe, and all had about equal success.  What made National Jewish stand out over time was it's effort in 1914 to open the first building outside of a university with the specific goal of researching a cure for a disease.  

It also became the first such institution to open a ward specifically to treat children with a disease in the 1920s. So by the 1930s National Jewish had the capacity to take care of hundreds of tuberculosis patients of all ages, plus it was a leader in the attempt to find a better treatment and a possible cure.  

And partially through the efforts of this hospital, the number of people getting tuberculosis saw a steady decline beginning at the turn of the 20th century, and then a steep drop off after the discovery of an effective treatment in the 1940s and 1950s. So while the goal of the hospital was to treat consumptives, consumptive patients were slowly disappearing.

When the hospital was opened in 1899 the president of the institution said, "that its doors may never close again until the terrible scourge is driven from the earth." It probably appeared that was exactly what was going to happen. The disease was never driven from the earth, although it's one that is readily controlled, for the most part, in modernized nations of the world, particularly in the United States and Europe.

Yet there were other respiratory disease that continued to plague the west, and we must not forget that these patients were also welcome at National Jewish. So as tuberculosis declined as a leading cause of death, and is now at the bottom of the yearly list, other disease saw a steady rise and deserved the attention of the world's leading lung experts, particularly those at National Jewish Hospital.

Due the the rise of people smoking cigarettes following WWI the incidence of chronic bronchitis and emphysema was on the rise. Likewise, with the modernization of the west, asthma was also on the rise. These folks, mainly adults with COPD and children with asthma, needed a place where they could find help. And that place was National Jewish.

During the 1940s various centers for asthma were opened in the United States, yet National Jewish was already an option for them. Yet the 1940s saw a rise in the number of asthma patients at the hospital. Many asthmatics were taken away from the stress of their home lives, with their parents and doctors that had little knowledge of the disease, and admitting them to these asthma and research centers. (2, page 29)

During the 1960s various discoveries, such as the IgE antibody and cortisone, allowed for better methods of treating asthmatics. Although cortisone worked to trmeat asthma, there were some pretty significant side effects to taking it long term. So this brought about the corticosteroid inhaler, although the fear of side effects prevented physicians from using it as a daily preventative medicine. This fear persisted until the 1980s when studies proved the benefits far outweighed the side effects.

When I was a child in the 1970s with asthma my physicians treated me only when I was symptomatic with rescue medicine like Alupent solution via a nebulizer or epinephrine or susphrine, both when I was admitted to the emergency room. I have discharge papers telling me to use my inhaled corticosteroid inhaler (Vanceril) only until I felt better, and then to only use it when I was having trouble.

But this was the normal accepted means of treating asthmatics back then, so it wasn't that my doctors were not good doctors. Yet the physicians at hospitals like National Jewish were participating in the research, and were privy to the latest techniques in treating the disease. And it's for this reason kids like me with "high risk" asthma were being admitted for long-term treatment, control, and education to hospitals like National Asthma Center/ National Jewish Hospital.

So as the medical needs of society changed through the years, so to did the name of the hospital.  

• 1899 — National Jewish Hospital for Consumptives
• 1925 — National Jewish Hospital at Denver
• 1965 — National Jewish Hospital and Research Center
• 1978 — National Jewish Hospital / National Asthma Center
• 1985 — National Jewish Center for Immunology and Respiratory Medicine
• 1997 — National Jewish Medical and Research Center
• 2008 — National Jewish Health

I was a patient of the hospital in 1985, and was there when the name was changed. That was also the year the address was changed from Kolfax Avenue to Jackson Street. I think the main reason for the name change at that time was to show that the hospital wasn't just for asthma and COPD patients.

In 1990 it was proven that inhaled corticosteroids were safe for asthmatics, or at least the benefits outweighed the side effects. It was also proven that all asthmatics have a certain degree of inflammation always in their lungs. This proved that asthma was a chronic disease that should be treated on a daily basis to prevent symptoms, as opposed to treating only acute symptoms.

By 1997 the children's wards that I lived in were closed mainly because asthma had run its course. Surely there still exists the disease, although back in 1985 regional doctors weren't privy to the latest asthma treatment and the physicians at National Jewish were.

Today, however, partially thanks to the various asthma guidelines, and even while asthma rates continue to rise, asthma is much easier to control. Part of the reason is better medicine, but another reason is the efforts of National Jewish Health physicians making an effort to better educate regional physicians.

Today, under the name National Jewish Health, the hospital's doors are still open. I would imagine COPD patients are still treated on the 2nd or 3rd floors of the Goodman Building as they were back in 1985. Yet asthmatics are no longer living there.

Floors like 7-Goodman, where I stayed for three months, and 2-May, where I stayed for 3 months, and 8 Goodman, where younger kids stayed, are now closed. Replacing this type of long term treatment are very effective outpatient programs.

Why did the hospital wards end? Well, I would imagine homesickness and dealing with teenage boys was a major problem. Yet I think another main reason was that physicians at National Jewish Health, along with other asthma experts, made a major initiative to educate regional doctors to focus on asthma control and prevention, as opposed to simply treating acute symptoms.

Another major reason for the change was the initiative to create asthma guidelines in the late 1990s. These guidelines are created by the worlds most prolific asthma physicians and experts. The goal is to provide a guide for asthmatics all over the world, and the physicians treating them.

So the need to use a hospital like National Jewish Health has greatly diminished for both the tuberculosis and asthmatic patient. However, both those diseases are still present, asthma more so than tuberculosis.

And, when needed, the hospital is still around, and still looking for better ways of treating, and, perhaps more important, curing these disease. Plus, when needed, hospitals like National Jewish provide a way to help hardluck asthmatics gain better control of their disease, so that they can live life more like a normal person.  (3)

References:

1. Dobozin, Bruce S, Stuart H. Young, "Allergies: The complete Guide to Diagnosis, Treatment, and Daily Management," 2011
2. Bjorklund, Ruth, "Asthma," 2005, China, Marshall Cavendish Corporation0
3. In 2008 I interviewed the Public Relations Representative for National Jewish Health and she provided me with an interview where I obtained up to date information about the NJH children's asthma program.