WHEN DOCTORS HOSPITAL originally opened its doors in 1929, it was the first of a new kind of hospital, designed specifically for the growing population of well-to-do New Yorkers who up to then were accustomed to receiving medical care at home or in small private clinics, away from the dangerously unsanitary conditions and minimal services of most hospitals for the general public. A fourteen-story, clean-lined, white brick building on fashionable East End Avenue at Eighty-Eighth Street (overlooking the mayor’s residence at Gracie Mansion and beyond that the East River), “Doctors” was known for its spacious private rooms (furnished and decorated at the level of a good hotel), its restaurant-grade kitchen and accommodating menus, and its staff of mostly Harvard-trained medical men, attended by a battalion of brisk, no-nonsense nurses, in turn supported by an army of virtual domestics who, in addition to the usual dirty work, unpacked the suitcases of patients as well as arranged meal tables with the linen cloths and silverware that patients sometimes brought with them.
Patterson, however, was in no shape to be thinking much about whether or not her room had a river view (it had) by the time she was admitted around ten in the morning; later than she intended, since despite a high fever, bleeding, and continued pain, she had insisted on personally handing to her private secretary, Dottie Holdsworth, first the key to a locked cabinet containing all her private correspondence from Stevenson and then a “last letter” she had written to him that night after the dinner, both to be hand-delivered to Stevenson in the event of her death. “When you read this,” the letter read, “I will be residing in spirit by the banks of the Black River. One day perhaps you will pass and I will turn into a breeze and kiss your nose. I’m enclosing the letters you wrote me. I think they are beautiful letters and I hope you will not destroy them. Perhaps you would consider turning them over to the Illinois Historical Society to be opened a hundred years hence when all your family have died. How wonderful it would have been if Lincoln had written Ann Rutledge and those letters had been preserved. With your sense of history please think it over. I love you so much, Alicia.”
Hospital records show that Mrs. Alicia P. Guggenheim, age forty-six, was admitted on September 22, 1952 (assigned room 1005), with a temperature of 104 degrees. The attending physician, Dr. William Rawls, noted: “Patient reports moderate to severe pain in left lower abdomen, also bleeding for 4–5 days. Patient complains when abdomen is palpitated by hand. Probable cause is inflammation of diverticulum.” But that was no more than a guess since doctors had no way of knowing what was going on inside a patient without opening them up. Well, actually, there was another way: a barium enema, which coated the insides with barium and thus could reveal anomalies on an X-ray plate. Doctor Rawls ordered a barium enema for the next day, which however didn’t work, since “patient’s colon did not retain fluid.” He ordered another for the day after, which also didn’t work, presumably for the same reason, and called in Dr. Albert Aldridge.
Dr. Aldridge, a surgeon of some experience, first checked her earlier hospital records, then tried to talk to Patterson, whose fever was still at a high 102 degrees and was only intermittently communicative. Aldridge noted that, “In 1930 patient had an operation for an ectopic pregnancy and subsequently two more operations relating probably to tubular problems.” More significantly, he also noted that, “Eight years prior patient received an insertion of radium to relieve difficulties of menstruation on account of dysmenorrhea.” Aldridge prescribed heavy doses of a new antibiotic, Aureomycin, to lower her fever; two days later, on September 27, he performed a “diagnostic dilation and curettage.” In his notes he reported: “With great difficulty the cervical canal was dilated enough to curette the uterus, removing a large amount of soft necrotic tissue which had the typical appearance adenocarcinoma of the uterus corpus.”
Patterson was returned to her room on the tenth floor, with its view of the East River and its Manet prints. Her temperature was now back to normal, her pain was less. Sister Josephine had flown in from Chicago, and now sat in the room with Alicia as she recovered, both of them drinking the luscious eggnogs for which the Doctors Hospital kitchen was famous, both under the impression that Alicia’s problems had been largely resolved; Dr. Rawls, the only visible physician on the case, stopped in once to take Patterson’s pulse, pronounced it “a fine pulse,” and suggested she order the eggs Benedict, another favorite from the hospital kitchen.
But Patterson herself was not fine. Unfortunately Doctors Hospital, while strong in the kitchen, didn’t have its own diagnostic laboratory, at least not an up-to-date lab for cancer cell diagnosis; thus several days elapsed before the results came back from Dr. Aldridge’s D & C procedure. In fact Aldridge already suspected that eight years before, when Patterson had been given radium treatment for “female abdominal problems” (her insides packed with radium isotopes, as was then the practice), the doctors might have packed in too much, or in the wrong place. On October 1 he noted, “Tissue removed from the uterus appear mixed with fragments from the bowel wall.” And: “In view of these findings there is some suspicion that the patient has a carcinogenic involvement of the sigmoid.” While Alicia and Josephine watched television, special-ordered from the menu, and passed the time waiting for clearance to leave, Dr. Aldridge in the meantime called in a second surgeon, Dr. Henry Cave, to assist him on the case.
On the morning of October 3, Patterson was taken down to the fourth floor and another operating room. Once again Aldridge was in charge, though with Cave assisting; Aldridge started things off by making a six-inch incision on the lower abdomen. “When the abdomen was opened,” Dr. Aldridge noted, “it was found that this patient had an extensive carcinoma of the sigmoid, furthermore the sigmoid was firmly adherent to the left lateral wall of the uterus. There was apparently some thinning of the wall and in doing a curettage on Sept. 27 it was obvious that the curette had passed through the thin uterine wall and removed some of the tissue from the bowel itself.” Cave then stepped in and “mobilized the sigmoid…following this, the entire uterus and left ovary were removed by Dr. Aldridge, employing the Aldridge modification of the Worrell technique.” Much stitching was then done (“No. 2 chromic catgut for the mucosa and musculature”); also some minor patching (“No. 4 chromic catgut to attach the bladder flap of the peritoneum”); and then some decidedly not-so-minor repairs: “Following the hysterectomy,” the careful notes read, “Dr. Cave did a Mickulicz type of bowel resection, bringing the loop of bowel out through the lower angle of the wound.” Apparently a further look into Alicia’s abdomen had revealed intestines abnormally twisted together, a section of lower intestine actually stuck to the colon, with “a large cancerous tumor completely encircling the sigmoid,” which was removed, along with her uterus for good measure, after which she was returned to room 1005, semiconscious, with a colostomy bag attached to her stomach for the emptying of fecal waste.
Surgery is seldom easy on a patient, even nowadays, when medicine is so much more evolved than in the middle of the last century. Back then, in 1952 (a time when medical techniques in the better American hospitals were regarded as the most advanced in the world) pretty much every aspect of an operation was assaultive to the body: Incisions were longer, instruments were larger and clumsier, stitching material was thicker, needles of all sorts were wider, and the anesthetic of choice, sodium pentothal, had the kind of sledgehammer effect that often took days of headaches and nausea to dissipate. And then, for Patterson, there was the ghastly surprise on waking up of the colostomy bag (which fortunately could be removed in six weeks or so when the “bowel resection” healed). In addition there were all the tubes: tubes down the throat, tubes up the nose: rubber tubes (there being no plastic), relatively thick and minimally pliable, which a parade of nurses were regularly inserting, then removing, then sticking and poking back in. Patterson was now in real pain again, mainly from her insides healing, but she seemed to hate the business with the tubes most of all; her throat was narrow, as were her nasal passages, which added the pangs of claustrophobia to the duress of the whole situation. Granted she hadn’t died; in fact the surgeons appeared to have found and excised a threatening cancer; but for many days she despaired, and told Josephine she felt like dying.
Josephine, the good sister, kept a constant vigil, seated day after day in room 1005, sometimes on the sofa, sometimes in the armchair with its view of the gray river, and its barge traffic, reading aloud from the cornucopia of the city’s newspapers, whether Alicia could hear her or not; also listening, with dismay and some surprise, as her older, tough-guy, tomboy sister, the one who was never scared of anything, who was always quickest to “get back on the horse,” lay abed, complaining about the tubes and the pain and just wanting to die; until one afternoon Josephine, having heard enough, in a voice loud enough to get the patient’s attention, told her sister she was sounding “like a yellow-belly quitter,” there being no greater insult one could give to one of Joe Patterson’s children, after which Alicia reportedly settled down somewhat and let the healing process take its course.
Another feature of medical care in those days was the length of time that people were kept in hospitals; for example, one week for a routine appendectomy, which is now usually treated as an outpatient procedure. Patterson remained in Doctors Hospital almost a month, and as she recovered her strength and spirits a small number of visitors were logged in on the nurses’ records. Her older sister, Elinor, wasn’t one of them, staying close to her garden in nearby Greenwich; her mother, too, stayed away in Chicago, her mother whose shamefaced approach to her own hospitalizations caused her to undergo them in grim, determined secrecy. Harry Guggenheim, noted on the record as “husband,” visited four times, although not right away, taking his time getting back from Cain Hoy. Other names in the visitors’ book were Dorothy Holdsworth, Virginia Pasley, also big old Joe Brooks, currently a little the worse for wear but apparently as moony over his former wife as ever. One afternoon, in fact just before one of Harry Guggenheim’s planned visits, Governor Stevenson showed up between campaign stops, seated briefly at her bedside, alternately tongue-tied and overtalkative, before Josephine pushed him unceremoniously out the service door to avoid the arrival of the “husband.” Doubtless Alicia could have received many more visitors, certainly toward the end of her stay, when she was feeling much better, reading, watching television, dining on the hospital’s famous rib-eye steak and baked potato, washed down with Johnnie Walker. But this was an era when cancer was still, by and large an unmentionable illness, something close to leprosy, an ill omen, a black mark of a disease; in fact the word “cancer” almost never appeared in obituaries at the time, being replaced by the euphemism “died of a long illness.” Patterson herself, forthright in so many other matters, seemed no more eager to advertise herself to the world as a cancer patient than she was to acknowledge that cancer was the cause of her hospitalization, rather than some more generalized, abstracted “internal problem.”
She was discharged on the morning of October 25, not quite four weeks after the Stevenson dinner, and was advised to go directly home, continue resting. But she’d been away from Newsday a long time, an important month, and so, instead of going back to Falaise, she had herself driven out to Garden City in time for the daily editorial meeting, at which she dictated the concluding editorial on the presidential campaign, thus keeping an earlier promise to Harry, while doing the best she could by Stevenson. “Both General Eisenhower and Governor Stevenson have turned out to be good, hard-working campaigners,” the editorial declared. “But the major issue today is the need for a change. Because of this, and not because one man is more able than the other, we give our continued backing to General Eisenhower. Stevenson is a Democrat and, despite his skill and devotion, the corruption of the Truman administration, with all its waste, bungling and toleration of Communism, would be so much harder for him to deal with than for Eisenhower. In reaffirming our support of General Eisenhower we also reaffirm our high esteem for Governor Stevenson, who deserves much honor and a high place in government.” And then she went home.