It may be said that in obtaining the intimate history of a woman a difficulty is met with in the natural reluctance to telling what often seems to the patient painful and unnecessary details. To some people it seems inconceivable that fears, pains and aches, sleeplessness, etc., can arise out of difficulties like the monotony of housework, temperament, or troubles with the husband. Furthermore, though some women understand well enough the source of their conflicts, they are ashamed to tell and rest mainly on the surface of their symptoms. To obtain the truth it is necessary to see the patient over and over again, to get somewhat closer to her. This is especially easy to do after the physician has to a certain extent relieved the patient. In other words, except in the cases where the woman is quite prepared to tell of her intimate difficulties, it is best to go slowly from the medical to the social-psychological point of view.
Case I. The overworked, under-rested type of housewife.
Mrs. A.J., thirty years old, is a woman of American birth and ancestry. Her parents were poor, her father being a mechanic in a factory town of Massachusetts. She had several brothers and sisters, all of whom reached maturity and most of whom married.
Before marriage she was a salesgirl in a department store, worked fairly hard for rather small pay, but was strong, jolly, liked dancing and amusements, liked men and had her girl friends.
At the age of twenty-two she married a mechanic of twenty-four, a good, sober, steady man, devoted to her and very domestic. Unfortunately he was not very well for some time following a pneumonia in the third year of their marriage. They drew upon all their savings and fell seriously in debt. This meant borrowing and scrimping for several years,—a fact which had great bearing on the wife's illness later.
They had three children, born the twelfth month, the third year, and the fourth year after marriage. After the first child the mother was very well, nursed the baby successfully, and the little family flourished. Then came the unfortunate illness of the husband, which threw him out of work for six months, during which time they lived on an allowance from his union, his savings, and finally ran into debt. This greatly grieved the man and depressed the woman, but both bore up well under it until the birth of the second child, when their circumstances forced them to move to a poorer apartment. The wife was delivered by a dispensary physician, who did his duty well but allowed the woman, who protested she felt well, to get up and care for her husband and baby much earlier than she should have done.
The nursing of this baby was more difficult. The mother's breasts did not seem to be nearly as active as in the previous case. The baby cried a great deal and needed attention a good part of the night. The husband was unable to help as he had previously done and the fatigue of the care of child and man brought a condition where the woman was tired all the time. Still she bore up well, though when the summer came she greatly missed the little two weeks' vacation that she and her husband had yearly taken together from the days of their courtship.
The husband recovered, but his strength came back very slowly. He went to work as soon as possible but worked only part time for six months. At night he came home utterly exhausted and could not help his wife at all.
During the next year both children were sick, first with scarlet fever and then with whooping cough. The mother did most of the nursing, though by this time the father was able to help and did. The necessary expenses so depleted the family treasury that when the summer came neither could afford to go away.
Both noticed that the mother was getting more irritable than was natural to her. She went out very seldom and her youthful good looks had largely been replaced by a sharp-featured anxiety. Though she carried on faithfully she had to rest frequently and at night tossed restlessly, though greatly fatigued.