Consumption - A Short Story

Follow Matthew's battle with tuberculosis in the Victorian era and his heart-wrenching choice between uncertain treatment and supporting his family.

Trigger Warning: This story contains descriptions of tuberculosis symptoms, which some readers may find disturbing.

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Matthew looked down at his chest and stomach. The brown and copper hairs had turned grey at the edges and were matted against his sweat-layered skin. He adjusted his trouser braces, revealing the red lines they had forged into his shoulders, and inhaled. The wooden tube of the doctor's instrument was pushed hard into his chest. As he exhaled, the doctor in his clean suit pressed an ear against the large disk at the end of the tube.

Matthew focused his eyes onto the faded wooden floor. He could feel his wife's stare from the bedroom door. He knew her eyebrows would be upturned and that she would be chewing her lip like she always did when she was nervours. Noises of his daughters singing and playing came from the room next to them. The family who lived on the floor below were arguing over burnt stew, then glass smashed, and a baby began to cry in the rooms across the hall. The doctor cleared his throat and placed the wooden tube back into the brown suitcase he had brought with him.

‘So, apart from the chest pain and the cough, have you’ve been experiencing anything else?’ He placed the base of his right palm on Matthew’s forehead. ‘You seem to have quite a temperature.’

Matthew continued to stare at the floor focusing on a large knot in the plank by his foot. He had seen and heard of this ‘doctor’ from the Royal London hospital wandering through the streets of Whitechapel in the evenings. To him, it was curious, and a little suspicious, that someone in that position would take the time to help prostitutes and the destitute in a slum-pit like Whitechapel. Had it have been a ‘proper’ question - as his wife, Annie, called it - then he would have asked him why.

Annie took a step forward. ‘He hasn’t been eating and he doesn’t sleep - ’

‘- Annie.’ Matthew looked at her.

‘I can’t determine what’s wrong unless you tell me.’ The doctor stood up and sat next to Matthew on the double bed.

‘I don’t get hungry a lot anymore, but that means more food for Annie and the girls … at night I get too hot and I sweat. It keeps me awake, that’s all.’ Matthew took the brown shirt from beside him and put his arms back through the sleeves, wincing at the stabbing tension in his lower back. He suppressed a cough, ignoring the tight feeling in his neck, and cleared his throat of the sticky phlegm that bubbled into his throat.

The doctor nodded and began to touch Matthew’s neck, underneath his ears, in his armpits and then his back. ‘Your glands seem to be quite swollen and your muscles are very tense. How long have these symptoms been happening for?’

Annie took another step towards them. ‘He’s been ill for a couple of months now, Doctor, and the … symptoms’ she looked at the doctor as if to confirm that she had used the word correctly, ‘keep getting worse. Not that he will tell you this, but I heard him coughing badly before he went to work this morning. Ater he had left I went into the room and I found his handkerchief covered in blood. Here,’ she pulled a square of red and white cloth from the pocket of her smock-apron and handed it to the doctor.

The man took the handkerchief and looked at the blood stains.

Matthew tried to suppress another cough as it sprung into his throat but it forced its way out of his mouth leaving him breathless and choking as the muscles contracted. He grabbed the bottom corner of his undone shirt and placed it over his mouth until he had regained his breath. As he pulled it away from his face, a large spot of blood, crimson against the brown material, glistened in the sunlight that filtered through the gap of their thin curtains.

‘I’m sorry, sir, but you have tuberculosis,’ the doctor placed the handkerchief he was holding onto the bedside table.

Matthew didn’t answer.

‘It’s … erm, consumption.’ Annie looked at him with her eyebrows so upturned that new wrinkles had begun to forge into her forehead. She shook her head. ‘What can we do, Doctor?’

Matthew pushed his hands into his thighs to stop them from shaking, his stomach felt cold and hollow, and with every blink the room became more blurry.

‘How did you know that tuberculosis and consumption are the same, Mrs Richardson?’ The doctor was staring at Annie with a small smile.

‘She wants to be a nurse.’ Matthew rubbed his eyes. He tensed as another bout of phlegm lodged in his chest.

It was Annie's turn to look away from the doctor. ‘I help clean at the Royal London Hospital so I hear, and learn, things from time to time.’

‘Why don’t you check on the girls, Annie? They might be getting hungry.’ Matthew hoped she would take the hint that he wanted to talk to the doctor in private.

‘Yes, the sun is getting low. I wouldn’t be surprised if the street-lighter had started his round already.’ Annie stared at the window for a minute before walking across the room to a shut door on the right hand side of the building. For the brief moment the door was open, the sound of his children laughing made Matthew smile.

‘I know what Consumption does, Doctor … I’ve seen it kill in just a few months, sometimes weeks.’ Matthew put his head in his hands. The phlegm in his torso dislodged itself and rose into his throat, sticking like tar then frothing onto his tongue. He heaved and then coughed hard causing a sharp pain in the back of his mouth.

The thick, glue-like matter choked Matthew for two breathless minutes before it became loose and appeared in his hand like a wine-coloured bruise. Clenching his fist around it, he pushed himself up off the bed. With a stiff back he walked towards a large tin bucket that sat by the small pot-belly stove. There were four metal mugs on a row of hooks in front of him. He took one and dipped it into the water bucket before washing his hands in the cup.

‘I’m going to die too, I’m sure of that, but I just want to know how long you think I have left.’ Matthew turned around to look at the doctor still sat on his and Annie’s grey blankets. He dried his hands on his shirt and then, realising it was still undone, buttoned it back up.

‘If you stay here, surrounded by the bad smells and gases of Whitechapel, then, yes, you will die in a month or two. However, there is another option.’ The doctor reached into his bag and pulled out a one-page leaflet with the words ‘Clean Clear Care: Countryside Sanitarium’ printed in bold letters across the font. A monochrome portrait of a plump, smiling man lounging in an armchair and holding his thumb up to a doctor, was accompanied by the quote, ‘Thank you, Doctor, now I can get back to working at the bank.’

He handed the leaflet to Matthew. ‘The manager in charge of this particular facility is a friend of mine from King’s College. He needs people like you to be treated at the sanitarium.’

‘And this will cure me?’ Matthew stared at the picture. ‘This man doesn’t even look sick.’

‘Exactly. That could be you in a few months.’ The doctor smiled.

‘Could be?’ Matthew stared at him.

‘Well, this is why he needs to recruit some patients, you see. His methods seem to work but only around forty to sixty percent of the time. He wants to improve this.’

‘Either way, Annie and the girls will still be alone … if not now then soon.’ Matthew looked at the door that his wife had left through earlier.

‘That may not happen if you go to this facility. There should be a train tomorrow that’ll take you there so at least think about it.’ The doctor put his hand on Matthew’s shoulder for a moment.

He picked up his briefcase then left through the door that led to the communal corridor and stairwell. The bitter, vinegar smell of urine, gin and vomit drifted into the room until the door shut behind the doctor. Matthew wiped the sweat off of his forehead with his shirt sleeve.

The door at the other side of the room opened and the tap of heeled shoes approached him.

‘Oh, has the doctor left then?’ Annie said as she came to his side. ‘What’s that in your hand?’

Matthew looked at the leaflet again before folding it and shoving it into his trouser pocket. ‘Just something he asked me to think about.’

‘Well, I hope you listened to what he had to say. They’re clever at that hospital. I’m sure he knows what would be best for you.’

Matthew nodded.

‘Should I get some dinner started?’ Annie walked over to the stove and opened the pale, faded cupboard that sat on the floor. Inside, five onions, two leeks and a carrot slumped in the bottom shelf next to a wooden trencher containing a third of a haddock fillet and a handful of sprats. She took the fish and some of the vegetables along with the saucepan from the top shelf of the cupboard and placed them on the stove’s top.

‘Yes, but none for me.’

‘I will make you a child’s portion.’ Annie didn’t look at hin as she half-filled the saucepan using the water from a bucket.

Matthew shook his head. He watched her for a while as she placed the kindling they kept under the stove into its furnace and lit the wood with a couple of matches from the cupboard. He’d miss her when he was gone, he thought.

***

At six o’clock the next morning, Matthew was sitting on the floor by his and Annie’s bed. He had been unable to sleep after waking up breathless and covered in sweat around midnight, and so had decided to count their savings instead. The misty sunlight shone in his eyes as he finished counting the last of the notes. There was almost enough money for his Annie to find a new place to live or to keep their current home for a while longer, but she would struggle after the money had been spent. She had her own job, of course, though he could not see how her £6 a year wages would be enough to provide for her and their daughters.

The bed sheets rustled behind him. Using the side of their thin mattress, Matthew pushed himself up and got dressed.

Annie exhaled deeply and rubbed her nose. As she opened her eyes, Matthew smiled and kissed her forehead.

‘Don’t be late for work today. I love you.’ he brushed a few strands of hair back behind her ear. Annie nodded and whispered that she loved him too.

The wind was cold in the street that morning as the sellers headed past him and towards the Spitalfields market. Matthew stood by the doorway of the red brick building they lived in and pulled out the leaflet from his trouser pocket. He stared at it for a while wondering whether or not he should turn left, towards Spitalfields and the factory he worked for, or go right and catch the train to the countryside.

He sighed and coughed as the fumes he inhaled stung his throat. Swallowing, he ignored the tightness in his throat and the familiar sticky froth, straightened his jacket and headed left.