“SICKNESS IS THE vacation of the poor,” the early 20th-century French poet Guillaume Apollinaire once said. Around that time, European factory workers routinely left their overcrowded and soot-congested cities for the Alps, where the air was fresh, dry and unsullied by inefficient machinery. They’d return to their grueling jobs rested, rejuvenated and, so the logic went, ready to work. The sojourns were doctor-prescribed, and the sites of revival — high-altitude sanatoriums, staffed with medical workers — were often state-funded. As dramatized in Vittorio De Sica’s 1973 film “A Brief Vacation,” Clara, a Calabrian mother of three living a wretched life in industrial Milan, contracts tuberculosis and is sent to a clinic in Lombardy, where, in addition to receiving X-rays and medication, she eats lavish meals, sleeps in clean white linens, has an affair with a fellow patient, makes glamorous friends and spends inordinate amounts of time bundled up on verandas staring at snow banks. “You shouldn’t read the papers,” she overhears one fellow patient advise another. “Things are so bad, they’ll raise your fever.”
It was a sentiment I found myself relating to this past summer, even as a 21st-century American with pathogen-free lungs and an occupation whose chief hazard isn’t respiratory illness but self-loathing. For a week — first in southeast Switzerland and then in the westernmost reaches of the Czech Republic — I padded around in slippers; brined myself in allegedly therapeutic waters; allowed stern women to wrap me, mummy-like, in blankets; and walked alone through the outskirts of ancient spa towns, blatantly ignoring the first lesson I was ever taught by a book: Don’t dilly-dally in Central European forests. I was massaged daily, ate meals at a two-Michelin-starred restaurant and took midday naps on the kind of “splendid” reclining chairs that so delight Hans Castorp, the malingering protagonist of Thomas Mann’s “The Magic Mountain.” It was obscene. Nothing, though — no rare mountain cheese, no spa treatment — compared to the novelty and thrilling debauchery of not reading the news.
UNTIL 1882, when the German physician and microbiologist Robert Koch identified the bacillus that causes tuberculosis, the disease was thought to be hereditary, not contagious. The vast majority of urban populations in Europe and America were infected by the late 19th century, and for roughly 80 percent of the patients who developed active tuberculosis, it proved fatal. Koch’s discovery led to new health regulations; anti-spitting laws; and isolated, government-run hospitals. In the following decades, hundreds of sanatoriums opened in remote locations across Europe and America, all promising quarantined patients exceptionally fresh air and on-site specialists. Versions had existed before — the first sanatorium is thought to have been opened in central England in the 1830s — but now the programmatic lifestyle that had been developed only intuitively, based on prescriptions going back to Hippocrates and Galen, had scientific-seeming credentials.
The 60-plus years between the identification of tuberculosis’s cause and the discovery of its cure was, in retrospect, a sort of golden period for a very specific mode of architecture, as well as a very specific way of life. The Pennsylvania physician Thomas Kirkbride’s 19th-century mental asylums — designed with staggered wings and extensive landscaping — as well as the radial prisons of the same era, influenced the exteriors of these early sanatoriums. Their interiors, meanwhile, were kept simple and easy to clean. Many of the features we now associate with Modernism — flat roofs, large windows, terraces — were implemented earlier as functional methods for granting tuberculosis patients unrestricted access to light and air, thought at the time to be salubrious.
Alvar Aalto’s Paimio Sanatorium in Finland, completed in 1933 at the height of the International Style movement, remains one of the best examples. He called the building a “medical instrument” and custom-designed every detail: Latches that wouldn’t catch on doctors’ lab-coat sleeves replaced ordinary doorknobs, plywood wardrobes were raised off the floor for easier cleaning, washbasins were designed to reduce splashing noises so consumptive roommates wouldn’t be wakened from their mandated rests, radiant heat panels in the ceiling minimized drafts and balconies were oriented for optimal sun exposure. Other Modernist sanatoriums include the Klinik Clavadel in Davos, Josef Hoffmann’s Purkersdorf Sanatorium outside of Vienna and Jan Duiker and Bernard Bijvoet’s Sanatorium Zonnestraal, which was commissioned by the Amsterdam diamond workers’ union in 1919 and whose name means “sunbeam” in Dutch. Toured by architecture students and described in the leading industry journals of the day, these sanatoriums’ influence can be seen in some of the most celebrated buildings of the 20th century. The public housing projects for which Le Corbusier would become famous included large terraces that may have been inspired by a visit the architect paid to a clinic in Leysin, Switzerland. Even the iconic bentwood recliners manufactured by firms like Thonet were commonly used at — and quickly became associated with — sanatoriums, as they were durable enough to move in and out of doors and could withstand the corroding effects of disinfectants.
By the 1950s, tuberculosis was being treated effectively with antibiotics, and many of the palatial compounds previously devoted to the white plague had shuttered. Some were repurposed as hotels; others became museums, housing developments and general intake hospitals. But the culture they fostered — hermetically sealed worlds of hypochondria and self-indulgence — were by then an indelible part of modern Europe.
Also connected to that culture was a parallel institution that flourished in Europe around the turn of the century: the thermal spa. Since the 1800s, doctors had been prescribing hydrotherapy, and health resorts were being established across the continent. As the historian David Clay Large has written, “the grand spas in their heyday amounted to their world’s equivalent of today’s golf and tennis resorts, conference centers, business retreats, political summits, fashion shows, theme parks and sexual hideaways — all rolled into one.”
People afflicted with everything from gout to arthritis came to “take the waters” at spa towns across Europe, but unlike the sanatoriums with which they were concurrent, their visitors were not always ill. Instead they came to socialize, attend cultural events and negotiate political treaties. The towns themselves — Aix-les-Bains and Vichy in France; Bath and Buxton in England; Aachen and Baden-Baden in Germany — built above the rubble of thermal baths established by Roman conquerors centuries earlier, were plotted to maximize what was known as a “therapeutic landscape,” a kind of aestheticized social engineering that promoted strolling and alfresco mingling. The architectural style of the bathhouses themselves was formal and atavistic, with marble walls, high arches, domed ceilings and mosaic floors. Well-maintained, infrastructurally sophisticated and aggressively promoted, these grand spa complexes were some of the earliest examples of modern tourist destinations.
YEARS BEFORE THE concept of a politically and culturally unified Europe gained traction, withdrawing from life (if even for a week) was a recurring feature of Continental existence. Spa culture — defined by its intentional architecture, geographical remove and somnambulistic ambience — was experienced in direct opposition to the rapid-paced, sick-making atmosphere of industrialized Europe. Unlike in America, where tuberculosis sanatoriums functioned more like hospitals than lifestyle colonies, the bosky outreaches of central Europe served as a sort of mystical destination where people from kingdoms near and far could live temporarily apart from reality — intermingling, arguing, falling in love — even as the security and sovereignty of the world around them remained imperiled. It’s unsurprising that a microcosm containing different types of people with little to do but reflect and cathect provided fiction writers with a generative setting, one which everyone from George Eliot to Henry James to Guy de Maupassant took advantage of.
Indeed, with enough selective reading it can seem as though every 19th-century writer of note spent at least a little time at a spa town. Turgenev and Goethe took the waters at Karlovy Vary in western Bohemia; Dickens and Tennyson visited Yorkshire’s Harrogate. The Black Forest-surrounded Baden-Baden was perhaps the most popular, especially among the Russians: Leo Tolstoy and Fyodor Dostoyevsky both visited; Chekhov died 90 miles south of there in Badenweiler in 1904 after an injection of camphor, a sip of champagne and a few weeks of writing letters to his sister in which he described his diet (boiled mutton, strawberry tea and “enormous quantities” of butter) and complained about German women’s poor taste in clothing. His body was brought home in a refrigerator car meant for oysters. Mark Twain visited the Bohemian spa town of Marianske Lazne (often referred to by its German name, Marienbad) in 1892 and sarcastically cataloged a spa regimen for a patient suffering from gout that involved rising at 5:30 a.m., drinking “dreadful” water, tramping in the hills, wallowing in the mud and eating as much as possible “so long as he is careful and eats only such things as he doesn’t want.”
My daily routine in Marianske Lazne wasn’t actually so different. It began with a walk through the small, central part of the village, whose springs have been touted as curative for centuries and which was visited by an almost-laughable list of luminaries that included state heads (Czar Nicholas II, Emperor Franz Josef I), intellectuals (Freud, Edison, Kafka, Nietzsche, Kipling) and composers (Mahler, Wagner, Chopin, Strauss). The town is made up of pale neo-Classical buildings edged with verdigrised turrets and elaborate spires. The public gardens are tidy and politely pretty. Czech couples stroll along camel-colored crushed-granite paths, carrying flattened porcelain spa cups whose handles also serve as straws and which they fill at public fountains. Large groups of Germans walk briskly in excessive hiking gear, stopping at outdoor cafes where they order steins of pilsner and read Der Spiegel. The Russians wear their bathrobes everywhere and keep to the gilded hotel lobbies, where they play chess with one another as mole-removal videos loop on overhead TVs. At the grand hotels, whose convoluted floor plans also house spas, sublimated weight loss strategies are nonexistent, as are the high-tech instruments and the suggestions of pan-Asian wellness (gongs, bamboo) that one sees everywhere in America. In the absence of vanity and hard science and globalism, a sort of generic and primal prewar Europeanness persists, as unsettling as it is soothing.
And as Twain himself reported, the meals were indeed curious and the prescriptions harebrained. At the Danubius Health Spa Resort Centralni Lazne, treatments are administered in tiled, cobweb-laced rooms. My first was a “mineral bath with natural CO2” for which I was led into a stainless-steel bathtub by a caustic attendant and told to ignore a half-submerged rusty wire. The water, just above lukewarm and smelling of sulfur, fizzed lightly. I had the impression of floating in rapidly cooling club soda. The attendant came back in, unannounced, wrapped me in a blanket, and discouraged me from trying to remove an arm so I could read my book. Benefits are said to include “improved blood circulation, heart and kidney activity as well as reduced stress and anxiety.” Later, I dawdled in a Kneipp foot bath, named for a Bavarian priest who advised walking without shoes through morning dew, and the following day spent a disturbing 30 minutes in a tiled alcove, while dry oxygen was delivered into my nostrils via a latex tube. Each evening, a heavy dinner was served (often including hot sauerkraut, beef tongue in cream sauce, pickled herring and, for dessert, whole peeled kiwis), followed by flutes of Bohemian sparkling wine, which one could sip while classical musicians performed.
THE SANATORIUMS OF Europe are now closed, and the spa towns where acute and imagined maladies alike were elevated to a glamorous lifestyle are today visited almost exclusively by the elderly. But medically informed repose — experienced far and away from the world, quietly and alongside others as sick (or not) as oneself — can still be had. In Vals, Switzerland, not 70 miles from Davos (once studded with about 40 sanatoriums), thermal waters run through the valley’s granite walls. A beautiful if deliberately sterile-feeling spa hotel sits just above the small village and beckons visitors from all over the world, who come to bathe in silence and eat overpriced pear bread while gazing at verdant pastures. Those seeking wellness today do not want outdoor concerts or lectures or chitchat. They want to be by themselves, ideally in a photogenic location with poor cellphone service.
The walls of the Peter Zumthor-designed spa, opened in 1996 under the name Therme Vals and now part of the 7132 Hotel, are made from 60,000 one-meter-long slabs of locally quarried quartzite; the concrete roof is covered with grass. Giant windows overlooking gray mountains somehow don’t do much to brighten what is otherwise a dark and labyrinthine experience. “Moving around this space means making discoveries,” Zumthor has said. “You are walking as if in the woods. Everyone there is looking for a path of their own.”
I often wondered if I would ever find mine. I spent as much time soaking in various baths as I did wandering around through the mist between them. It was easy to appreciate the solemn beauty of Vals’s imposing modern design, which was clearly plotted with great intention and intellect, while still feeling unpleasant panic each time you rounded a corner only to see a dim hallway coaxing you who knows where. Before the property owner stepped in and insisted otherwise, Zumthor was adamant that his spa have no clocks inside. He wanted bathers to feel not just weightless in the water but timeless too. The twin clocks that were installed are nearly hidden (I only found out about them weeks after I had come home) and the cavernous space succeeds in making the minutes melt into hours.
In daily life, it’s rare that I don’t know the time down to the minute, and with the tap of a single skeuomorphic button I can find out where I am anywhere in the world, as well as whatever terrible things are happening halfway around it. In previous centuries, those suffering from ailments and ennui could travel through forests and up glaciers, by train and horse, to drink and dip in therapeutic waters. They endured unthinkable hassle to gain access to legendary liquids and dubious expertise. Today, we know better. Sunlight doesn’t kill germs and physical maladies aren’t cured by carbonated water. The best we can hope for is the kind of psychological balm that comes from temporarily removing oneself from the responsibilities of daily life, which lately seem to involve the helpless monitoring of catastrophes we can do nothing about. To travel from one empire in decline to countries whose golden eras were over 100 years in the past is to accept — and if possible, enjoy — the undeniable fact that disorientation can be its own kind of decadence.