Life, In Purgatory (A Twainiac Quarantine Diary)


Mark Twain’s parable of social distancing is called “Was It Heaven? Or Hell?” (1902). At the center of the tale are a pair of amateur nurses pressed into service by tragic circumstances. Hannah and Hester Gray must care for their sister and niece, each stricken with typhoid fever. The local doctor tasks them not only with carrying out his treatment, but, more importantly, preventing each patient from learning the progress of the disease in the other, as the stress caused thereby might overwhelm their already compromised immune systems.

Twain fashions a premise in which truth and transparency are directly correlated to the transmission of disease. The Grays have lived their whole lives in a household religiously committed to honesty: “In it speech was restricted to absolute truth, iron-bound truth, implacable and uncompromising truth, let the resulting consequences be what they might.” In the name of their dogma, they forced their niece, Helen Lester, to confess a minor transgression to her bedridden mother, Margaret, who cannot resist embracing the remorseful child. 

Walking in on this brazen violation of social distancing, the doctor scolds the Grays for lacking “sense enough to discriminate between lies.” Recognizing that Helen has now, most likely, been infected, he exclaims, “Reform! From this mean and sordid and selfish devotion to the saving of your shabby little souls, and hunt up something to do that’s got some dignity to it! Risk your souls!” 

The Grays follow this advice quite literally, constructing increasingly elaborate fictions of recovery in hopes of healing Helen and/or her mother, though they also continue to believe these lies, regardless of benevolent intention, may bring them closer to damnation. Eventually, both Lesters die anyway, but they die peacefully, each comforted by the belief that the other is recuperating.

Twain always insisted that “Was it Heaven? Or Hell?” was based upon real events. And it was. Though not necessarily when he wrote it. And he never could quite keep straight exactly which real events it was based upon. 

Sometimes he testified that it was inspired by the death of his own daughter, Susy Clemens. Near the end of her life, blind and delirious from spinal meningitis, Susy “rapturously embraced” her nurse and “died happy, thinking it was her mother.” 

Other times he claimed he was reporting sensational events which had transpired in York Harbor just before the Clemens family rented a cottage there in the Summer of 1902. Twain began composing “Was it Heaven?” that July.

Later he suggested that the story was privately a homage to Winifried Howells, the daughter of his friend and sometimes collaborator, William Dean Howells. Susy and Winifried were exactly the same age, 26, when they died. The Howells family’s summer retreat was less than ten miles from York Harbor and the bereaved fathers took comfort in each other’s company.

Twain’s inconsistency in describing the story’s origin is typical. The author was often shifty on questions of his method and materials. But it also captures the extent to which he succeeded in composing a story whose content would be broadly familiar to readers of his time. After “Was it Heaven? Or Hell?” was published in the popular Christmas issue of Harper’s, the magazine received a stream of letters from grief-stricken survivors convinced that Twain was reproducing scenes from their own family tragedies.

By the time the Harper’s issue was available to the public, it was a story more true than when Twain had written it. By cruel serendipity, the author found himself, on Christmas Eve, listening helplessly at the door as his eldest living daughter, Clara, lied expertly to her prostrate mother about the health of her younger sister, Jean, who had contracted pneumonia two days earlier. He wrote to Howells, “Every day, from the first, Clara has been persecuted and worried and distressed by superstitions born of my Xmas story ‘Heaven – or hell?’ and darkly divining prophecy in it.”


In my early twenties, I moved from St. Louis to suburban Chicago, into a basement apartment in the house owned by my step-sister and her husband, who had two adolescent children. Each of us brought to this slapdash domestic unit a recent history of calamity and grief.

In the coming years, when I needed to account for this gap on my resume, I would say I was a personal chef. And that was true enough, I suppose. Home-cooked meals were the daily service I most reliably supplied. But, more importantly, I was an extra set of hands, eyes, ears, and keys. Fred Kaplan describes Katy Leary, ostensibly the Clemens family’s servant, as “comforting as a familiar piece of old furniture and slavishly useful.” My tenure was a fraction of Leary’s, but I can sympathize with this characterization. 

I was somebody who could troubleshoot the WiFi. I was somebody who could shag flyballs. I was somebody who could chaperone a Green Day concert, sparing teenagers and their parents mutual mortification. I knew the beats of a basketball game well enough to make small talk between them. I made sure there was scotch in the house, and that nobody ever had to drink alone. 

Slavishly useful. 

My brother-in-law, John, had been an Asian Studies major and a power forward at University of North Carolina before going on to Harvard Law and eventually a career in informatics. He remained an inveterate reader. Not unlike Katy Leary, while I was part of his household I pillaged his library. His books sustained me while I pondered “going back to school,” prepping for the exams I would be required to take if I did, and finally writing an application essay on Henry James and magic realism. 

John and I spent many an evening talking geopolitics and metafiction between pitches. One Sunday afternoon our conversation swerved, like a Jose Contreras slider, into corporate finance, a realm where I was out of my depths, but largely oblivious to the fact. I forged ahead. John justifiably dismissed my knee-jerk second-hand anti-corporate arguments while also becoming, as he did every Sunday, increasingly restless and agitated by the encroaching workweek. He was steeling himself for the cruelties of corporatism even as he was debating them with me. 

This weekly ritual, my vibrant, cosmopolitan, and mildly bohemian friend painfully metamorphosizing into organization man, didn’t increase the allure of the white-collar world. He would spend 60+ hours over the next five days doing a job he hated for a poorly-run firm which nevertheless managed to profitably skim along on the froth and scum of the system he was half-heartedly defending. 

At dusk he disappeared briefly into the library. Just before he climbed the stairs to bed, appearing suddenly as exhausted as he had been three days earlier, he handed me a slim paperback, John Kenneth Galbraith’s A Short History of Financial Euphoria (1990). Though I didn’t recognize it for more than a decade, this moment would shape my professional identity.

I read Galbraith’s anatomy of economic crisis that night. In the coming weeks I would borrow from the branch library down the street his postmortem of the 1929 stock market crash, one of his memoirs, and the middle volume of his trilogy on American corporatism. Though I had taken economics courses, it never occurred to me that economists were authors, much less that they might be authors who I would electively and energetically read. 

At the end of the fourth chapter of The Great Crash (1954), Galbraith reports that on the morning of Black Monday in 1929, the worst day of the financial panic which inaugurated the Great Depression, the Wall Street Journal chose as its “Thought of the Day” an aphorism from Pudd’nhead Wilson’s New Calendar (1897): “Don’t part with your illusions; when they are gone you may still exist, but you have ceased to live.”

What did the WSJ editors intend to signal with their “Thought of the Day”? Were they desperately clinging to the irrational confidence which fueled the Twenties boom? Or did they recognize the underlying irony of this nugget of Twainian wisdom, which first appeared within the chronicle of the worldwide lecture tour he undertook to pay off his creditors. When he wrote it, Twain was living through the worst depression in U.S. history…before 1929.

Meditating upon the selection Galbraith wrote, “The end had come, but it was not yet in sight.” What made Galbraith’s work formative for me were moments like this. He insists that for our understanding of the causes and consequences of fiscal crises interpretations of the newspaper masthead, the presidential address, even anonymous verse written by helpless investors, are as relevant economic knowledge as the audit of Goldman Sachs or the Federal Reserve stimulus. Negotiating this nexus between the cultural and the financial became, and remains, my daily obsession.


In the decades since I left them for graduate school, Kim and John continued to build their nest egg. A few years ago they relocated to Indianapolis, to be surrounded by extended family, and began easing gradually into semi-retirement. They were enjoying one of those pleasures long deferred – a warm-weather winter vacation – when the first wave of travel restrictions began rolling out. During the long drive home, John developed an ominous cough. By mid-March they had both been diagnosed with COVID-19.

The progress of their illness dovetails with the now familiar media accounts. The cough developed into a fever and then, over the course of several days, into an almost crippling fatigue. Kim, somewhat younger, conformed perfectly with her demographic. Within a week she was well on her way to recovery and by the end of two would’ve been the picture of health again, were it not for the stress. 

John did not fair so well. When it spread to his lungs he was hospitalized, and a day later he went on a ventilator, where he remained, days turning into weeks. All of us counting each of them, reminded by public health professionals, government spokespeople, and news anchors that after three weeks of machine-assisted breathing, the possibility of recovery dropped rapidly towards zero.

I waited anxiously for daily third- and fourth-hand reports. He was barely conscious. Doctors spoke to nurses, who called Kim, who, even as she herself processed it, was disseminating information through her network of family and friends, all of us frantically googling medications, dosages, ventilator settings and readings, symptoms and side effects. My mom would sometimes cut-and-paste portions of Kim’s text messages into her own, creating a collage of misspelled medical terminology, family vernaculars, and ambiguous pronouns. 

I regretted living so far away, then realized family members living a few blocks over were equally helpless. Nobody can go to the hospital. They dare not run to Kim’s side for fear of bringing the virus back to their own households, all of which include somebody over 65 or with compromised immunity. My mom drops tupperware in the yard while Kim stands behind the storm door, crying and waving. Sending care packages via Amazon Now, I realize, actually spared us such torture.

All we knew depended upon what healthcare workers at Community Health North chose to tell Kim, and this we clung to, dressed up in optimism or pessimism depending upon temperament and mood. Most of the plaudits for healthcare workers during this crisis have been drawn from military metaphors. They are “risking their lives” on the “front lines” to “fight the disease.” But war is an insufficient analogue, and a misleading one I think (though I have clearly indulged it myself). In particular, it lacks any accounting of the communicative and humanitarian burden which nurses and doctors have had thrust upon them. 

Twice daily, and without fail, somebody from the ICU called my stepsister, relating John’s progress, which was often no progress at all. But this was her only remaining connection to her husband. Anxious and isolated, these phonecalls were her lifeline, however tenuous. The trickle of information they provided, consistent though not robust, fueled her hope and, as important, gave her opportunity to tell somebody how she loved him, how his kids loved him – somebody who she knew sometime thereafter would stand in the same room with him, knowing for whom he labored to breath. She had no way of knowing whether her messages would be delivered or, when they were, how they would be received. But the voices of strangers on the other end of the line were what she had, and so she trusted them.

These are not soldiers. They are conduits of love. They are the amanuensis of our grief. Their duty has been to save, but also to mourn those who could not be saved, to bear witness and give testimony. How many have stood bedside these last weeks knowing that their eyes and ears were all that was left to mediate between the dying and the bereaved?


“Life is purgatory at all times, and a swindle and a crime,” Twain wrote to Howells on September 24th, 1902, adding, “yesterday it was hell.” 

Six weeks earlier, his wife, Livy Clemens, had suffered shortness of breath so debilitating they both became convinced she would die. She never really recovered. For the next 22 months, the Clemens household would include a series of doctors and nurses, and would search the globe for a climate which would ease Livy’s recuperation. 

 From the start, the expensive specialists Sam summoned from Boston and New York failed to make sense of Livy’s symptoms. “It has been one continual guess, guess, guess, change, change, change, from one incompetent drug to another, and from one indigestible food to another,” he wrote to Henry Rogers, “It seems stupid to keep a student four years in medical college to merely learn how to guess – and guess wrong.”

Lacking any more reliably diagnosis, the doctors were increasingly intent on prescribing the “rest cure,” as was customary, particularly when the patient was a woman. To their credit, both Livy and her family resisted. Sam, Clara, and Livy’s sister, Susan Crane, took turns firing the doctors and nurses who tried to bar the family from the sickroom. They eventually agreed to visit one at a time, and then, like the characters in “Was it Heaven? Or Hell?”, not to talk about anything that was likely to excite the patient, a list of topics which was constantly expanding. He reported to Howells, bitterly, “We guard her against feeling and thinking all we can.”

Sam, grasping for some hope, began making complicated arrangements for transporting Livy to the Crane house in Elmira. “There is but one place where she will be entirely at home, and that is Quarry Farm,” he told Rogers, begging him to bring his yacht to York Harbor and ferry the family to the port at Hoboken, where Livy’s brother, a railroad director, would have a private car waiting to carry them into Elmira. Rogers was prepared to hold the yacht indefinitely, but in mid-September the doctors concluded that travel, especially by sea, was too risky. 

“She is only a shadow now,” he told Rogers and the same day withdrew a sketch titled “Amended Obituaries” from the publication schedule at Harper’s, fearing that the jokes in it about his own demise might be published just as real obituaries for his wife were going to press. It was no trivial decision. The Clemens family’s wealth, though sizable, was not particularly liquid. They owned three expensive properties and were renting a fourth. “The newspapers are trying to make me out a rich man,” Twain wrote, “but the continued discrepancy between my income and my outgo convinces me that they are not succeeding.” 

Yet they would spare no expense when it came to Livy’s care, so, despite his sorrow, he continued to churn out content for multiple magazines. When payment for one of his pieces was delayed, he responded angrily, “Oh, come, now, it is irreligious, the way you accept articles and postpone the payment. When you keep four doctors and two trained nurses all summer, with a war-price specialist from Boston now and then as an additional strain on your bank balance you will reform.”

In September, Clara hired and fired another set of doctors and nurses. The replacements were even more emphatically committed to the rest cure. With Livy worsening, the family’s will to resist was failing. A compromise was reached. Clara and Susan would be allowed to come and go, as long as they promised to remain calm when in Livy’s presence and never discuss matters unrelated to her health and comfort. All agreed that Sam could not be trusted to adhere to such conditions and, moreover, he was most prone to excite his wife with his notoriously boisterous personality, no matter how their discourse was constrained. There was no subject that Mark Twain could not riff on for hours. He was to be “banished.”

Sam felt betrayed, but when even Livy agreed to these conditions, he relented and entered his self-described purgatory, where he would remain for most of the next four months. He pitied himself for being excluded from Livy’s company when any day could be her last, but reconciled himself by trying to believe that by obeying doctor’s orders he could protect her from the sickness of his self, which he’d always regarded as diseased anyway.

But he could not bear depending solely on second-hard reports which were “like watching a thermometer…a degree up, a degree down – repeat indefinitely.” So Sam took up residence in an adjoining room, from which he could slip notes under the door at his liberty. After more than three decades of marriage, they became pen pals again. Livy, even when enfeebled, “put her daily message of love in trembling characters upon little scraps of paper.”

Sam adhered to the prescriptions of “Was it Heaven? Or Hell?”, never sending Livy any bad news, even as several of their friends fell ill and died. “Mrs. Clemens lives in a world where no sorrows come from without,” he wrote on one such occasion, “a blessed ignorance which sometimes seems a compensation for her captivity.” The whole household had been developing their capacity for withholding, misleading, and outright lying. Sam said of Clara, “She has been lying for five months, and has long ago lost anything like compunctions. To save her mother a dangerous emotion she would stop at no kind of falsehood.”  

But their talents would be tested when Jean fell ill. The youngest Clemens had also been banished from Livy’s bedside. Her mother, even in the best of times, was prone to worry over Jean’s epilepsy, searching for signs of seizure in every expression and gesture. The doctors had promised a Christmas reunion if Livy’s condition stayed stable. But, as Sam put it, “We could never explain how it was safe for her to see me and not safe for her to see Jean.” So he listened alone at the door as Livy and Clara exchanged abbreviated holiday greetings. They seemed to him empty banalities under the circumstances. “There isn’t going to be any merry Christmas here,” he wrote.   

Clara and one nurse, Margaret Sherry, continued their now months-long sentry at Livy’s side while another nurse, Maria Tobin, Katy Leary, and Sam stood watch over Jean, who looked “like the survivor of a forest-fire.” During his shift, Twain composed a series of long, dismal letters, ending one to Howells by saying, “Pious maniacs are in the habit of regarding life as a ‘boon,’ and of trying to be grateful for it.”

How many households around the world are simultaneously gripped by some variation of this vigil? How many more will be before our watch is lifted? Like Twain, I don’t know who to pity more, the severely ill or those who wait on them, those who are deciding how and when their families should be separated and those who, standing at the threshold, tell fathers, brothers, daughters, you can go no further, we’ll call you. Maybe, as Twain says, “The dead are the only human beings who are really well off.”   


Twelve days after he was admitted to the hospital, John’s temperature broke. Two days later he was off the ventilator, and though he couldn’t speak, the nurses used the iPads the hospital had purchased to allow him to videoconference with Kim and his kids. It’ll still be an indeterminate amount of time before he can return home, but he is out of the ICU and Kim’s reports of slow and steady progress have become the highlight of my self-quarantined days. 

 Jean Clemens’s fever broke on December 30th, 1902 and though she would be bedridden for another week, the doctors were sure she would have a full recovery. On the eve of the 35th anniversary of their first date, Sam was allowed to spend five minutes with Livy. The next day he reported “3 minutes and 50 seconds.” On New Year’s day she slipped a greeting under the door between their bedrooms and when they saw each other that evening, for four minutes, he found her “in great spirits – like 35 years ago.” 

He wrote in his notebook, “Only he who has seen better days and lives to see better days again knows their full value.”