Thirteen in the Cold: A Tuberculosis Story from 1905

Margaret Shaw was thirteen years old, dying slowly from tuberculosis on an outdoor sleeping porch at Saranac Lake Sanitarium in upstate New York. The "fresh air cure" was all doctors could offer TB patients in 1905—sleep outside year-round, breathe mountain air, hope your lungs healed before the disease destroyed them completely. Margaret had been there eight months, watching winter arrive, snow piling up around her bed while she shivered under blankets, coughing blood into handkerchiefs she'd burn later so other patients wouldn't see how bad she was.

The sleeping porch held twenty beds, all filled with dying teenagers. They'd lie there at night, listening to each other cough, hearing the wet, rattling sounds that meant someone was close to the end. Every few weeks, a bed would empty—someone died, got carried away—and a new patient would arrive. Margaret had watched seven girls die from her bed. She knew she'd probably be next. The disease was in her spine now, causing terrible pain. She couldn't walk anymore, could barely breathe, but still they kept her outside in the freezing air because that was the treatment.

Margaret's parents visited once a month—a twelve-hour train journey each way. They'd sit beside her bed in the snow, trying not to cry, telling her to fight, to keep breathing, to come home soon. Margaret would smile and promise she was getting better, even though they could all see she was dying. Her mother would kiss her forehead—the only physical contact allowed because TB was contagious—and leave crying. Margaret would watch them go, knowing each visit might be the last time she'd see them.

A medical photographer documenting tuberculosis treatment captured Margaret and the other sleeping porch patients in January 1905. The image shows rows of beds outside in winter, each occupied by a bundled teenager, all fighting for breath in the supposed healing air. Snow covers the ground, icicles hang from the porch roof. Margaret stares at the camera with eyes that have already accepted death—she's thirteen years old and knows she's not going home.

Margaret died six weeks after that photograph, in March 1905. She was buried in Saranac Lake's tuberculosis cemetery with hundreds of other young patients who'd come seeking cure and found only graves. Her parents received her belongings in a box—a few letters, a diary, a photograph of them she'd kept beside her bed. In her last diary entry, Margaret had written: "I am so cold. I am so tired. I want to go home but I know I never will. The doctors say fresh air heals but all it does is freeze us while we die. I'm not afraid anymore. I'm just ready. Tell Mama and Papa I tried. I really tried."