While planning the expansion of the Sanatorium (it grew from one building in 1904 to at least four, plus a farm, by 1915), overseeing the treatment of patients, raising money, and tending to other administrative duties, Dr. Estes Nichols also responded to the numerous letters.
The letter writers sought admission to the facility, sought reduced rates for treatment, sought advice about home treatment, and reported their progress following discharge from the sanatorium.