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our noses and mouths. Special containers with lids live in our rooms to contain all our paper tissues and their juicy contents. The tissues are burned in the basement. We all have little plastic jars with little plastic lids that we are supposed to carry around in our pockets whenever we leave our rooms. We are to spit everything into them. The nurses take the jars away every day and give us new ones. In The Magic Mountain , the patients have elegant little blue glass bottles to spit into, but there has been a serious decline in style since the nineteenth century. We are reduced to plastic screw-tops. This ward full of innocent-looking people in bathrobes and slippers—who would guess our pockets are loaded with enough TB germs to infect an entire city? Pray one of us doesn’t escape. Pray one of us, escaped, doesn’t trip getting on a bus in those stupid slippers and smash the tacky—but lethal— plastic vial. (Lack of breakfast combined with the vertical position before sunrise always makes me fanciful.)
    Here we are at the Treatment Room, an oxymoron if I’ve ever heard one. They’re going to mistreat me because I can’t hawk up enough to suit them.
    Once a month, a nurse brings you three specially marked vials. Before breakfast, before tooth brushing, for the next three mornings, you have to cough up what’s accumulated in your throat and lungs overnight. The ward resounds with the echoes of this revolting chorus. Got a weak stomach? Skip this next bit. Feed the cat. Go for a walk.
    If you can do this—hawk up—for the three mornings with results that please the nurses—I mean cloudy swirling things in the bottom of the jar—you’re off the hook. They send your gunk off to be tested and you get the results back in a couple of weeks: positive, or negative. Positive, and you’re depressed for days. Negative is encouraging: the drugs are winning, the germs are cornered, you aren’t infectious. Three negatives in a row and they let you out for a weekend. You are officially Not a Public Menace.
    By this point, however, you’ve usually healed to the point where you aren’t producing much of anything and that’s when they start the gastric washings. Some people, like me, never produce enough sputum to culture. Rotten lungs, but they won’t give anything up. I put this down to all that training-to-be-a-lady my mother put me through. Enough of her teaching stuck so that I could not, cannot, hawk up.
    After the first gastric washing I spent half the next night hanging over the side of my bed, practically standing on my head, container poised to catch anything, anything at all. Tried to will gunk from my lungs. I do believe I might have prayed. Nothing. Couldn’t do it. Can’t do it.
    They work in twos. They’re cheerful.
    â€œGoing to be a nice day,” says Number One as she measures the distance from my nose to my stomach by dangling a length of clear plastic hose down the front of my chest. She decides on the appropriate length, holds the max point between thumb and forefinger. Number Two hands me a glass filled with two ounces of distilled, sterilized water. We have a routine by now. Number One takes the end of the hose with her free hand, and threads it up my nose, down the back of my throat, down my esophagus, and into my stomach. I told you to go for a walk. A half-second before she hits my gag reflex I swallow a tiny amount of water and keep swallowing little sips as the tube moves downward. Not a muscle moves because not a muscle can. I am clenched. I am locked down, totally focused on not puking up the tube. Every time you puke it up, they start over. You don’t get out of that room until they get what they want. Once the tube is in place I start to breathe again, shallowly, through my mouth.
    Number Two, who has been holding my shoulders, asks, “All right?” and I nod yes. I’d nod As well as we can damn well