The withered little man in the room across from the nurses' station has a cough so deep it rattles his bones. He has tuberculosis, a drinking problem and an attitude so cantankerous he might harbor a death wish.
In Brice Hilton's dark, sunken eyes, tuberculosis looks like the killer it used to be.
"I did need to come here, but I'd rather be at home," says Hilton, a man who is old at 54. He was in a Polk County hospital last summer and the doctors eventually sent him home with instructions to take this pill this many times a day and that one that many times a day to control the TB. When the social worker showed up to check on him at home, he says, she kept finding him stone drunk. His pill bottles were untouched.
That's when they committed him to A.G. Holley State Hospital. The first of Florida's three giant tuberculosis hospitals to open in the early 1950s, Holley is the only one in the country to survive the public-health decisions of the '60s that shut down similar sanitariums. Back then, everyone thought TB was licked. The 46 patients here know better. Some of them could die here. Others have.
Most of the patients at Holley are street toughs, accustomed to breaking rules and living hard with an energy paced by drugs or booze. Occasionally, some patients break every rule the hospital has: They slip off and buy liquor, smoke incessantly on the ward, fight, refuse treatment or leave for good. One man who broke out of the locked ward where committed patients used to live sent administrators a thank-you note from Georgia.
Just another day at A.G. Holley. Time crawls here as if caught in a movie's special effect. Men and women wander the dim hall, dressed in thin state-issued blue seersucker robes and worn, often tattered, pajamas. They try to find a diversion for their perpetual boredom: cigarettes, TV and pool are the most popular.
Current hospital figures show the per-patient cost is $363 per day. "It's still a bargain," says Ruth Behrman, the soft-spoken superintendent since 1985. Behrman points out the state pays more than $600 a day for these patients if they are sent to private hospitals.
Some state officials have targeted the hospital, with its $8.2-million budget, for closure to save money. But with the recent surge in cases and the discovery of a drug-resistant strain of the bacteria, a task force is recommending the hospital merely shrink from 100 to 50 beds.
The fact that many poor tuberculosis patients can't afford private hospital treatment influenced the task force's decision, said Dr. John Witte, chairman of the Tuberculosis Alternative Care Task Force. The group made its recommendation to lawmakers last week.
TB takes an average of six months to treat effectively, and most of these patients have other problems: HIV and drug and alcohol addictions, primarily.
They arrive in a variety of ways, usually by ambulance or car _ a sheriff's or a relative's. When they are discharged, the hospital gives them a bag lunch, a bus ticket and a few dollars if the trip takes the better part of a day. Their home county pays part of the cost of keeping them here.
One thing most patients have in common is an instant recollection of the date they were diagnosed with TB. For most of them, it is an utter shock.
Danny Pickles found out after he was stopped for a DUI on July 4 and complained in jail of night sweats and a nagging cough: "I said: "Tuberculosis? They gave that up a long time ago.' I didn't think they had it anymore."
_ Information from the Associated Press was used in this report.