What inspired you to write Breathing Room?
I graduated from college eager to begin my career as a teacher but failed to pass a pre-employment physical exam because of a worrisome spot on my chest x-ray. The county health department insisted that if I wanted to teach, I had to take a year’s worth of a very powerful anti-tuberculosis medicine. So I did, although I was never sick nor ever had active tuberculosis.
Years later when I read The Plague and I by Betty McDonald, author of the Mrs. Piggle Wiggle books I’d loved as a child, I found out that she had been a patient at a TB sanatorium before modern drugs were available and strict bed rest was the only form of treatment. I had to think that would have been my fate had I lived forty years earlier. So began my interest in writing Breathing Room.
How long did it take you to write Breathing Room?
Though I had published many picture books, I had never written a historical novel before. This was a new challenge for me and took me years to finish. To begin, I immersed myself in the research, visiting Saranac Lake, NY (where the sanatorium movement in the United States began), the Mayo Clinic in my hometown of Rochester, Minnesota, and the National Library of Medicine in Washington, DC. I found the subject so fascinating that I found it hard to put aside the research to write the story. Once I did, I wrote countless versions and later many revisions with my editor’s additional insight.
|Saranac Lake, NY|
What are some of your favorite books from childhood? Were there any specific authors who inspired you?
I was a big fan of Betty McDonald’s books, but Harper Lee’s To Kill a Mockingbird changed everything for me. I loved the powerful story and its many rich characters, but the book also marked the first time I understood how a title could be used metaphorically. To Kill a Mockingbird helped me mature as both a reader and a person. Plus I have a personal connection to the book. My father grew up in South Alabama and has family that lived in Monroeville where the story is set. I visited the town when I was young and later received an autographed copy of the book, truly something I will always treasure.
Where did you come up with the characters: Evvy and Nurse Gunderson?
Evvy has some of my mother’s qualities, especially in her relationship with her brother and even, in some small ways, with her parents. But Evvy really came to life for me when she had to face Nurse Marshall and Dena, then develop friendships with the other girls, and finally learn to stand on her own.
As for Nurse Gunderson, she cares about the girls as people, not just patients. When I needed to imagine her, I thought of my best friend who shares Nurse Gunderson’s remarkable goodness and warm spirit, someone who can bring light and humor to even the darkest situations.
If you could befriend a character from any of your books, who would you befriend? Why?
I am fond of all the girls in Breathing Room and could be friends with any of them. But maybe because I didn’t like Dena at first but eventually grew to admire her very much, I might choose to befriend her.
Where do you like to write? Do you listen to music while you are writing?
I started writing Breathing Room on a desk that once belonged to my father but finished it on a desk of my mother’s. Neither of my parents lived to read the book, but I would like to think they were both helping me each step of the way.
I love music, but I do not listen to it while I’m actually writing.
But a curious thing did happen as I was working on Breathing Room. I fell in love with a song performed by the interesting duo of Elvis Costello and Annie Sofie von Otter (an opera singer) and bought their cd, For the Stars. To my surprise, it includes a song about tuberculosis! The final lines of “Just a Curio” (click to listen to an excerpt- words and music by Elvis Costello) read as follows:
Throw the window wide and open, keep this mark from me, Just the letter “T” and its most dread companion “B.”How in heaven? Hadn’t it been conquered long ago? How did it come back again? It’s just a curio.
I felt like this song was a sign of sorts for me to keep working on my story.
If you could live anywhere in the world, where would it be? Why?
I would probably choose to live near a lake with rolling farmland nearby—which pretty much describes either Southern Minnesota where I grew up or Upstate New York where I live now.
The pictures at the start of each chapter were so fascinating. What was your research process like for Breathing Room? Where did you get the pictures?
As I did research on the book, I accumulated all sorts of materials and photographs about tuberculosis. But getting the rights to use the images, plus paying for them—those were my responsibilities, not the publisher’s—proved a serious challenge and took a year’s worth of work for me to accomplish.
I was fortunate to get many of the photographs from the Lung Association of Saskatchewan, including my favorite—the one of the girls resting in bed (part of The Author’s Note). The Library of Congress also had a series of amazing photographs taken at the Triboro Hospital for Tuberculosis in Jamaica, New York, which I used both in the book and for reference. Finally, the American Lung Association (once called the National Tuberculosis Association) and the Works Progress Administration (WPA) both created a series of public safety posters warning of the dangers of the disease. I used three of those posters and think the first that opens the book is a particularly haunting image.
I also took many of the photographs myself and created the Loon Lake brochure, newspaper and menu, along with all the medical forms and records included in the book. Members of my family signed the documents in the roles of the doctors and nurses. Then April Ward, the book designer at Henry Holt, pulled everything together and created the book’s beautiful cover which still takes my breath away.
Are you currently working on a book? If so, can you tell us a little bit about it?
Yes, I am working on another historical novel, also with a medical theme, though set during the American Civil War. My main character arrives at Antietam the day after the bloodiest battle in our history to help tend the sick and injured.
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