At the beginning of 1936, when Hester’s health took a turn for the worse, Isaac and Robert drove her 100 miles southwest from Cross Plains to the town of San Angelo for treatment. This was shortly after they had returned from hospital trip to Marlin. Robert outlines the San Angelo visit for H. P. Lovecraft in this letter dated February 11, 1936.
After our return from Marlin we stayed at home for about two weeks, and then my mother’s pleura filled again, and we took her to a hospital in San Angelo, 105 miles southwest of Cross Plains. After a few days then we put her in a sanatorium about seventeen miles northwest of San Angelo, where she stayed for six weeks, when her condition got so bad we put her back in the hospital at San Angelo. She remained there twelve days, and then we brought her home, since it seemed they had done all they could for her. Her condition is very bad, and she requires frequent aspirations, which are painful, weakening and dangerous. It is wonderful with what fortitude she endures her afflictions; in every hospital she has been, the doctors and nurses speak of her cheerfulness, her nerve, and her steadiness in the highest terms. But it is only what can be expected in a woman of the old pioneer stock.
This was the beginning of a slow decline for Hester and the desperation Robert expressed in this correspondence with HPL, having knowledge of the impending end of her life, is almost too devastating to read. Isaac was aware of this desperation as well, as he recounts Hester’s San Angelo stay and Robert’s frame of mind to Lovecraft in a June 29, 1936 letter.
[T]his year in February, while his mother was very sick and not expected to live but a few days, at that time she was in the Shannon Hospital in San Angelo, Texas. San Angelo is something like one hundred miles from here. He was driving back and forth daily from San Angelo to home. One evening he told me I would find his business, what little there was to it, all carefully written up and in a large envelope in his desk. Again I begged him not to do it but he possitively [sic] did not intend to live after his mother was gone.
The sanatorium where Hester stayed for six weeks was the State Tuberculosis Sanatorium, which was located sixteen miles northwest of San Angelo on U.S. Highway 87 in an incorporated town known as Carlsbad. The facility was so large, it had its own post office designated as “Sanatorium, Texas.”
Pulmonary tuberculosis caused more than 4,000 deaths a year in Texas during the first decade of the twentieth century. This led to the Texas Senate to pass a bill in 1909 creating a TB colony, but it was defeated in the House. Two years later, when the state congress met again, both houses passed a bill creating two colonies – one for advanced and one for early cases – dedicated to the treatment and education of people infected with TB.
Although plans for the former were abandoned, 330 acres was purchased near Carlsbad for the location of the Anti-Tuberculosis Colony No. 1. This colony was the first institution of its kind in Texas and provided the isolation to calm the fears of the public, as well as rest and clean air, the only known cure for TB sufferers. Admission to the facility was restricted to patients between the ages of six and sixty for a period no longer than six months.
On July 4, 1912 the fifty-seven-bed sanatorium opened with a cookout and celebration. The following year the facility was renamed the State Tuberculosis Sanatorium, and in 1914, Governor Oscar Colquitt named Joseph McKnight resident superintendent. Under McKnight’s guidance, the sanatorium expanded for the next thirty-five years.
In addition to low wages, and geographic isolation, the fear of TB made it difficult to recruit employees for the facility. To counter these issues, the Sanatorium School for Nurses in Texas was created in 1915 to train the needed staff. Nearly all the students who attended two-year training course, which focused on tuberculosis treatment, were recovering TB patients. The first class of four graduated in 1917 with a R.T.N. degree (Registered Tuberculosis Nurse).
Originally beginning with four buildings constructed at a cost of $10,000, the facility grew to thirty-five buildings valued at $1.5 million. In 1930 there were thirteen buildings with 662 patient beds, including 162 beds in the children’s Preventorium, and over 13,000 patients had received treatment. The grounds tripled in size to nearly 1,000 acres and included barber and beauty shops, a post office, library, dairy, hog farm, butcher shop, bakery, power plant, laundry, printing press with its own newspaper, four water wells, and a school for the children. Other on-site amenities included church services and organized meetings for the Masons, Order of the Eastern Star, bridge club, sewing club and stamp collectors’ club. Indeed, the complex had grown into a virtually self-sufficient community known as Sanatorium.
Sanatorium continued to grow to 970 beds with 300 patients on the waiting list. In 1949 McKnight proposed additional expansions, including a new seventy-five bed dormitory, increased space for employee living quarters, and a twenty-five bed surgery unit to supplement the existing surgical building constructed in 1947–48. Surgeon Raymond F. Corpe, who was on loan from the United States Public Health Service, had begun to perform thoracoplastic operations.
The 1950s brought dramatic change to the institution. McKnight, who had become synonymous with the battle against TB, retired in 1950. In June 1951, the Texas legislature renamed the institution the McKnight State Sanatorium in his honor. The ancillary operations such as the dairy, hog farm, and the Preventorium were systematically closed during the decade.
The nursing school was renamed the State Tuberculosis School of Nursing in 1938 and continued operating until 1961, graduating a total of 501 nurses.
The number of TB beds was gradually reduced to 550 and the length of treatment continued to shorten due to new drugs and surgery techniques. Unfortunately, Hester lived in a time before the development of anti-tuberculosis antibiotics, which did not come into the picture until the late 1940s.
From 1912 through 1969, approximately 50,000 adult and 5,000 juvenile patients were treated at the McKnight State Tuberculosis Hospital. By 1969 medical techniques and drugs were successful in more than 90 percent of tuberculosis cases, making Sanatorium and related TB institutions unnecessary. So the institution was tasked with a new mission — serving the needs of mentally challenged men and women, which it continues to do today.