The Johns Hopkins Hospital Nov. 17, 1917
Dear Miss Turner,
Your letter of the 14th is a piece of you that is indiscribable. Dr. Mall is just alive. Large pieces of the bowel have sloughed off. He is being kept alive by Locke's Solution, transfusions etc. Every night is expected to be his last.
Yes, I remember Alice Noyes very well. I never liked her well enough to go beyond the formalities of social intercourse. Perhaps I suspected her of visiting Mrs. Lovell's a bit too often. I knew & liked Mary Noyes of 1908 very much.
I agree with you that Alice's present breakdown is probably a part of previous breaks. From your letter I cannot gather how much affect or emotion is in the picture. Is she subjectively or objectively depressed. Or is it a progressive sagging of the whole personality in which efficiency also suffers with a setting of apathy. Upon the emotional element in her present condition depends the whole prognosis. In either case the condition is serious & should be investigated before it progresses further. If she is depressed the prognosis is good, but the immediate danger of suicide is great. If depression is not outspoken & we deal with a gradual slump of the individual as a whole the prognosis is grave. From your description & what I have heard of her I am inclined to fear the latter process. The former Pres. of Sweet Briar College is studying here & is doing some special elective work twice a week under my gentle guidance. I asked her casually if she knew Miss Howland, whom I know at Woods Hole, & then we drifted to Alice Noyes. I asked her how Alice got along down there & she said, "I can hardly answer that. She seemed to lack initiative & finish, & I thought at first it was because she was merely substituting & felt the place was not her own. I talked to her about it, & she seemed so wholly unaware that her work was not up to the work that I let the matter go. I saw her at Cornell last summer, & she told me she wasn't well & tho't she'd put off her degree."
Coincident with your letter we admitted a patient who offers problems of diagnosis similar to Alice's. She is a teacher of 25, who got her B.A. at 19 yrs. (4 yrs courses in 3 yrs) taking scholarship at Phi Beta Kappa. First year out she taught at H.S. but could not get on with discipline & seemed swamped by responsibilities of her job. She felt she had failed, & did not apply for reappointment. Second year she taught primary grades, & felt equal incapacitation. So she quit school, & up to May 1917 has been spending 12 hrs. a week in a library. This she left also because of feelings of inferiority. She has given back her Phi Beta Kappa key, medals, & all money saved from teaching. At present she is normal in behavior, says, "I am dull & stupid; have no life or ambition. I have failed in everything I entered [?] since I left college." But there is no appearance of depression or agitation. Moreover she suspects people mock her & talk about her shortcomings but is quite resigned to this persecution. Just how much we can do with her I don't know.
I doubt whether you can get the family to realize Alice needs anything but rest & change of scene. The [...] Dr. will tell her she has "nervous frustration" & call it neurosthemia in his own mind until she does something strikingly peculiar which I suspect she will sooner or later. Don't quote me to Alice or her family. But give my opinion as your own - if it is.
I am glad to hear life is a little easier with you. I hope you are well.
My mother is raising Cain at the Sanitorium, so I'm in a hot footed correspondence with her physician & the nurses who keep her.
I didn't mean to leave the impression that I am overworking. I did stretch a bit in the summer & fall, but since Oct 15th I've had things easy. I breakfast at 9 AM. I have no ward, no laboratory work or ward duties. I go over the new cases that come in with the intern on the ward, checking up his physical exams, whipping his findings into an organized whole. I prepare the national [?] for Dr. Meyer's two weekly clinics. All this I can do sitting by the stenographer; an elevator takes me from one floor to another. On the wards with students I sit & boss [?] the job. I couldn't have anything easier. I never have a night call any more. There is no reason why my back should "act up." I got my new corsets last week, but don't notice much difference. Dr. Bennet has been out of town for a week, but I'll see him next week. There's nothing he can say or do that I know of. It's one of those things in life that one has to adjust himself to with equanimity. I lie down frequently which relieves the pain for a season, & when I am busy I hardly notice it. So don't waste good sympathy on me.
With much love
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