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THE PE0PLE'S PLAGUE: TUBERCULOSIS IN AMERICA
A Film by Diane Garey and Lawrence R. Hott
Florentine Films
Narrated by Joe Mantegna
COPYRIGHT 1995 FLORENTINE FILMS
PART I
THE CAPTAIN OF ALL THESE MEN OF DEATH
ARCHIVAL NATIONAL TUBERCULOSIS ASSOCIATION FILM, FEATURING SINGER
DOROTHY MAYNOR:
Ladies and gentlemen, I have a message for you. It concerns the
health of you and your family. Did you know that every year,
right here in the United States, over 50,000 people die of
tuberculosis? Another name for it is consumption. Some people
call it TB. Maybe you have lost someone that way. A relative, a
neighbor, or a friend. But nobody need die of tuberculosis. We
are not born with tuberculosis. We catch it from someone who has
it.
INTERVIEW WITH JOSEPH BATES:
I remember vividly when I was a young person in training, a young
woman came to the emergency room with symptoms which suggesting
tuberculosis. I thought she probably had it. I made the
diagnosis that night. in the emergency room. I was very proud of
myself. I arranged for her to go to the sanitorium the next day.
I'd called and made all the arrangements and it was all set. I
was proud. I told her about all this, told her how to go. She
had a baby. She was in her twenties. I thought I'd done
everything right. She left the hospital that night and went home
and killed herself.
INTERVIEW WITH FRANK RYAN:
We don't realize how not so very long ago, most of the human race
died from infections. Waves, epidemic waves struck through the
populations right up to the 1930s. Tuberculosis carried a reign
of terror with it. People are still terrified. People are still
in awe to be told that they might be suffering from this disease
even today when we think we can cure most of them.
NARRATION:
Tuberculosis was the greatest killer ever known to mankind. It
was, as John Bunyan called it, "the Captain of All These Men of
Death." At the towering zenith of the epidemic, the disease took
the lives of one out of every four Americans. Death from
consumption seemed as inevitable as the tide.
It was not only a deadly disease; it was an ongoing mythology, an
industry, a culture. It was a literary staple and a domestic
nightmare. For hundreds of years, the disease was a familiar part
of ordinary life in America -- and then it seemed to disappear.
INTERVIEW WITH FRANK RYAN:
Tuberculosis had been receding in America and Britain since the
latter end of the nineteenth century. And they seemed to assume it
would go away. It doesn't behave like that. Someone who really
understands the disease wouldn't believe that for a moment. What
they were seeing was the decline of the epidemic wave in certain
areas. But of course, vicissitudes change, something happens in
human society and back it starts to rise again.
NARRATION:
Once we thought we'd conquered TB forever; now, it's back. Today,
over twenty-thousand Americans are sick with tuberculosis.
Another ten to fifteen million carry the bacterium that causes the
disease. One person out of every four on the planet is infected
with TB. The disease kills three million people a year -- more
than any other infectious disease in the world.
INTERVIEW WITH RONALD GOLDBERG:
I'm in pain...a lot of pain here and here. I'm on pain pills.
Now It's called a pain patch. Changeable every 72 hours. That
dulls it. In the morning when I wake up, bam.
TITLE
ARCHIVAL NATIONAL TUBERCULOSIS ASSOCIATION FILM, "ELUSIVE ENEMY":
This cough, filmed in slow motion, shows how the germs cling to
the tiny droplets that are sprayed into the air which are then
breathed in by others. Once inside the body, the tiny rod-shaped
bacilli travel into the lungs and lodge in the warm moist tissue
which encourages their growth. Immediately the body begins to
fight back. White blood cells attack the germ. If body
resistance is good, and there are not too many germs, some of
them are killed and others are walled up in a small mass where
they can do no harm. This mass is called a tubercle and gives the
disease its name. Millions of people go through life with
tubercles like this without ever getting sick, but sometimes
bodily resistance may go down because of fatigue, poor food, or
some other illness, and the germs, which have been dormant, break
out and spread, leaving behind cavities. As other parts of the
lung become involved, the cycle repeats itself.
NARRATION: People become infected with the TB germ when they
breathe in air exhaled by someone with an active case of the
disease. Usually the bacterium is transmitted only after
prolonged exposure.
Just one infected person in ten will ever develop an active case
of the disease, with its characteristic symptoms -- cough, fever,
night sweats, exhaustion, weight loss, chest pain, the spitting of
blood. For centuries the disease was usually -- though not always
-- fatal.
The most common site for the disease is the lung, but TB can
infect any part of the body: the brain, the bones, even the face.
The disease is as old as mankind; but this current epidemic is
not. It started in Northern Europe four hundred years ago, and
spread slowly across the continent.
INTERVIEW WITH JOSEPH BATES:
It was basically unknown in Russia, for example, by 1850... It was
rare in India in 1880. Tuberculosis didn't reach Africa, sub-
Saharan Africa, until this century. Tuberculosis probably reached
the last place on earth where a lot of people are, that is New
Guinea, in the 1930s and 40s.
INTERVIEW WITH FRANK RYAN:
Now it doesn't come in like the Bubonic plague, arrive for a year
and disappear again. An epidemic wave of tuberculosis lasts
centuries, maybe two or three centuries. It arrives and builds up
very, very slowly and recedes very, very slowly. But once it
arrives in a community it never goes away.
READING:
With his staring eyes in a leaden skin my patient seemed like a
subject from Dante's Hell. He gasped for breath and in his agony
tore at his shirt. He babbled incoherently of wife and children,
of their helplessness, and raved against his Maker for giving him
such weakness. Nothing can be done, no, absolutely nothing. And
when I feel my own weakness to help him, I am ashamed to face the
dying man's eyes, to offer words of hope, and encouragement, for
he knows I lie. -- Dr. Ward Brinton
(Raphael Nash)
INTERVIEW WITH NANCY TOMES:
In the early 1840's it was considered to be a tendency that you
inherited from your parents, it seemed to run in families which
backed up the idea that it was some kind of inherited disease.
Your body would have a certain weakness that would bring out the
disease. You could bring it on by drinking. You could bring it
on by working too hard. The disease could be brought on by your
individual mistakes, misbehavior. It's a very flexible system for
explaining why some people got tuberculosis.
NARRATION:
Most 19th century thinkers tried to make moral sense of nature's
ways. Consumption seemed to search out artists and writers.
Could there be a meaning -- even a splendor -- in illness? For a
time, the harrowing disease became strangely fashionable. Lord
Byron wrote, "I should like to die of consumption. The ladies
would all say, 'Look at that poor Byron, how interesting he looks
in dying!'" It was considered good form to spit blood and to die
before reaching thirty.
MOTION PICTURE "CAMILLE" WITH GRETA GARBO:
INTERVIEW WITH MARK CALDWELL:
If you go back into the 1830s and the 1840s, people thought of
tuberculosis ... that it was a disease of the refined and the
spiritual, that you were prone to get it if you were unphysical in
some way... and as the disease progressed and thinner and thinner
and more and more delicate and more and more wispy, the theory was
that the disease was revealing your spirituality.
INTERVIEW WITH JOHN SBARBARO:
Camille was a beautiful willowy woman...who faded away...in the
arms of her beloved. It is a wonderful story but you just don't
quietly expire like that. TB is not a romantic death, because the
way you normally die is you burst a blood vessel in your lungs and
you drown to death in your own blood. Drowning is not a pleasant
death. You don't play that up because how do you make people who
have that disease feel comfortable and part of society back in
those days, if you tell them, by the way, you are going to drown
to death? It was not a romantic death.
READING:
William Hall. There is nothing in consumption which is ever even
agreeable. It is death by the drop. (John Henry Cox)
READING:
A severe fever comes -- or rather stays, it never goes -- and
therewith a general discomfort... I can scarcely refrain from such
groans and shrieks as a wounded dog gives, crawling off with a
broken back and hind-legs dragging.
-- Sidney Lanier, 1880 (Sam Tsoutsouvas)
INTERVIEW WITH BARBARA ROSENKRANTZ:
Towards the end of the 19th Century. Tuberculosis became
increasingly a disease of the very poor, of people whose health
was impaired by poor nutrition, by overwork, by lack of fresh air,
by dense population. They didn't get the disease, they weren't
infected because they were poor, but their breakdown to actual
disease was probably greatly increased by their living conditions.
READING:
The Creator always has his eye on the poor. Nine-tenths of his
disease-inventions were intended for the poor. The well-to-dos
only get what's left over. Mark Twain. (George Guidel)
NARRATION:
By the last decades of the 19th century, tuberculosis was
unmistakably "the people's plague." The disease spread quickly
through the crowded industrial cities of the Northeast. The TB
victim, who had been seen as intelligent, spiritual, and even
physically beautiful, began to be pictured as a creature of
weakness, ignorance, and immorality.
INTERVIEW WITH MARK CALDWELL:
The national view of the disease had been turned on its head by
1870 or 1880 and it was then seen as a disease of the city... a
disease of crowding, a disease of poverty, a disease that came
from bad sanitary habits, and in that sense a disease that could
be prevented and a disease that if one came down with it, might be
blamed on one.
NARRATION:
There was no effective cure -- so people tried anything and
everything. One self-proclaimed doctor named St. John Long made a
fortune from consumptive ladies -- by rubbing their breasts with
sulfuric acid. Meyer Lotinga offered a simple solution of brown
sugar and water -- a remedy made more respectable by the magnitude
of his fee. At various times the nausea of seasickness, the
exhalations of a cow-house, and a syrup containing millipedes were
extolled as sure cures.
INTERVIEW WITH MARK CALDWELL:
The classic remedy in the 19th century, when narcotics weren't
controlled, was a concoction of one kind or another that almost
always had laudanum in it. Laudanum is a tincture of opium. And
even though there's no evidence that it did anything good for
tuberculosis, it certainly made the people who took it temporarily
feel better.
NARRATION:
It was difficult, of course, to cure a disease when no one even
knew what caused it. Some thought consumption was the result of a
moral failing -- others that it was simply God's will. And then,
on March 24th, 1882, a scientist named Robert Koch announced that
God's will could be seen -- under the microscope.
NARRATION:
Robert Koch was an obscure German doctor with a small-town
practice, a methodical mind, and a laboratory in his living room.
As a researcher, he was stolid, dogged, and zealous. He once ate
a half pound of butter a day for 13 consecutive days -- in the
name of science. In 1876, at the age of 33, he had astounded the
scientific community with his first discovery -- the bacterium
that caused anthrax, the deadly scourge of cattle and sheep.
NARRATION:
With tuberculosis, Koch took cultures of diseased tissue. Then he
did a remarkable thing: he waited. A day... two
days....[nothing]. But after ten days he saw it: the tubercle
bacillus.
INTERVIEW WITH MICHAEL ISEMAN:
It was one of the most extraordinary intellectual medical tours de
force in the history, I think, of all medicine. In 217 days,
Robert Koch went from initiating his studies of tuberculosis to
presenting, in March of 1882, a method to stain the bacteria in
tissues and grow them, to infect animals and to show how
tuberculosis was transmitted.
NARRATION:
This was a new and startling idea -- germs, improbably tiny
creatures, made people sick, in fact, made people die.
INTERVIEW WITH MARK CALDWELL:
Tuberculosis wasn't any longer a mystical affliction the way it
could have been viewed say in the 1830s or 1840s. It was a
condition, it was the natural life cycle of this tiny microscopic
organism. And as soon as man knew what caused it, ... that on the
one hand raised the hope that a cure could be found for it.
NARRATION:
Eight years later, in 1890, Koch made an announcement: He'd found
that cure. It seemed that science in general, and medicine in
particular, could control life and death -- could have the upper
hand over God.
INTERVIEW WITH MARK CALDWELL:
And that led to a world wide sensation. It led to a mass descent
on Berlin by people suffering from tuberculosis. There were
people dying on trains as they pulled into the station in Berlin
in hopes of taking this cure that Koch had put together.
NARRATION:
Koch's treatment was a simple glycerine extract of tubercle
bacilli, later called tuberculin. In Berlin alone, over 2,000
patients were treated with tuberculin. Soon they began to die:
they died at rates higher than those for consumptives who hadn't
been treated at all. Koch's cure simply did not work. Worse, the
Prussian government admitted that they'd made an exclusive
agreement with Koch to sell the remedy and divide the profits.
INTERVIEW WITH MARK CALDWELL:
It was a disaster for Koch, it was a disaster for the Prussian
government, it was a disaster at the time for the cause of
scientific medicine because all of the prestige that Koch had
given to scientific medicine seemed, when this cure collapsed, to
collapse with it.
INTERVIEW WITH BARBARA ROSENKRANTZ:
Like everybody else he wanted to find a cure and the fact that the
cure he thought he found was not a cure at all and the fact that
he resisted recognizing that is probably not so surprising unless
you have a view that scientific heroes are made of different
things than other people.
NARRATION:
For the sick and the dying, faith was lost. A prophecy of hope
had failed. In the remaining years of his life, Robert Koch would
discover the bacteria that caused cholera; he would travel to
Africa to study sleeping sickness and malaria. But when he died
in 1910, he would still be searching for a cure for tuberculosis.
NARRATION:
At the turn of the century, tuberculosis was the leading cause of
death in America. Everyone was susceptible; but some were more
susceptible than others. Northern Europeans, who'd been exposed
for generations, had acquired some resistance to TB, but
populations that had never faced the disease had almost none.
INTERVIEW WITH ALAN KRAUT:
When Caucasian explorers began to come to the New World they
encountered native Americans and the encounter was a deadly one
from the standpoint of the Indians.... - tuberculosis, measles,
smallpox -- and those diseases devastated the native American
population. Hundreds of thousands of Indians died because they
had no immunities to those diseases being brought from Europe.
NARRATION:
The Chiricahua Apaches, a nomadic tribe of the desert Southwest,
had never been touched by TB. Then, in the fall of 1886, 5000 US
soldiers captured a force of 35 Chiricahua Apaches that had eluded
and embarrassed the government for years. The rag-tag band of
warriors, women and children was headed by Chief Naiche and his
now-legendary medicine man, Geronimo. The remainder of the tribe,
500 in all, had been living peacefully on reservations in Arizona;
but the government sent them with Geronimo's band to a Florida
prison.
On the journey from the desert southwest to the humid east coast,
tuberculosis attacked the Chiricahua for the first time.
INTERVIEW WITH HENRIETTA STOCKEL:
It was an unseen enemy. It was not something they could aim their
bows and arrows at, aim their guns at and shoot. It wasn't
something they could outrun. It wasn't something they could pray
to be relieved of. It just wouldn't go away.
NARRATION:
After ten days on the train, the Apaches were interned at Fort
Marion in St. Augustine. They were crowded together on the fort's
parapet; their outhouse was a sandy floor a few feet from the
water supply. Weakened by the journey, sick from unfamiliar food
and filthy living conditions, the Indians did not have the
strength to fight the disease.
Fearing a mutiny, the army shipped Geronimo and his seventeen men
to Fort Pickens, an island prison three hundred miles to the west.
Local authorities began to ferry tourists across Pensacola Bay to
meet and mingle with the famous Apache warriors.
INTERVIEW WITH HENRIETTA STOCKEL:
Well, Geronimo played to the sympathies of the tourists... ladies
were going back and forth in this boat bringing blueberry muffins,
shirts, pants, food to the 17 warriors and none of them none of
them fell ill.
NARRATION:
The army moved the remaining adults to Fort Vernon, in a humid,
swampy part of Alabama; their TB promptly became worse.
Meanwhile, the children were sent away to the Carlisle Indian
School in Pennsylvania.
INTERVIEW WITH HENRIETTA STOCKEL:
There were 116 children initially removed from their parents.
They lived in very close dormitory quarters. Of the 116 Apache
children at Carlisle, 37 died from tuberculosis. Captain Henry
Pratt who was the superintendent of Carlisle at the time devised a
plan and that was to put terminally ill Apache children on trains
and send them back to the prison camp at Mt. Vernon, Alabama to
die and by doing that, he avoided the statistics that were
alarming government officials. Some of the children were so ill
that they dies en route. When the train arrived at the Mt. Vernon
prison camp, those children who managed to survive the trip would
unload the corpses of their friends and put them into the arms of
the waiting parents who buried them. This was the case of Chappo
Geronimo who was at the Carlisle school and was sent home and
after Geronimo took his son off the train, three days later Chappo
died.
INTERVIEW WITH HENRIETTA STOCKEL:
Out of a population of 519 Chiricahua who were first imprisoned,
approximately 300 died as victims of tuberculosis during their 27
years as American prisoners of war.
NARRATION:
The Apache's bitter experience with the U.S. Government was not
typical. In the cities of the eastern seaboard, in fact, the
latter half of the 19th century saw the birth of the opposite
approach: the idea was called public health.
INTERVIEW WITH ALAN KRAUT:
Once germ theory was accepted people went out on a germ hunt. In
cities like New York and Chicago and Philadelphia as well as in
rural communities, there's the formation of these boards of
health, there's this understanding that these boards of health are
going to lead the way in trying to limit the effect of these germs
on the population.
NARRATION:
In America, one of the leading proponent of public health was
Hermann M. Biggs, the General Medical Officer of the City of New
York. He had always been a paragon of order. When he was a boy,
his parents were contractually obliged to pay him a nickel
whenever he played the piano. As an adult, he generated a
meticulous map, locating every single TB death in Manhattan by
both house and date. As General Medical Officer of the City of
New York, he pushed for a government powerful enough to control
disease and preserve the health of its people.
READING:
Public health is purchasable. Any community can determine its own
death rate. Hermann Biggs (Larry Pine)
INTERVIEW WITH ALAN KRAUT:
Hermann Biggs believed that education, preventive health measures
were absolutely essential if you were going to fight disease,
especially in highly congested urban areas.
NARRATION:
Biggs pushed for the disinfection of rooms where the sick and
tubercular had lived. Then he encouraged hospitals to isolate the
tubercular. He urged compulsory registration for anyone with the
disease.
INTERVIEW WITH JOHN SBARBARO:
Hermann Biggs? Hermann Biggs is my idol. Hermann Biggs
understood that public health is law enforcement and that it is
the executive arm of government in controlling health. That if
somebody wants to spread diarrhea by pooing it in the water,
somebody has to say "You can't poo in the water." If somebody
wants to spread salmonella by having uncooked foods, somebody has
got to say "You gotta cook the food." If somebody has
tuberculosis and says "But I like coughing in a grade school and I
like coughing in the church choir and I just love coughing when I
am teaching school. Somebody has to say "You can't do that".
READING:
We are prepared, when necessary, to introduce and enforce...
measures which might seem radical and arbitrary, if they were not
plainly designed for the public good. -
- Hermann Biggs, 1897 (Larry Pine)
NARRATION:
Biggs was considered a visionary. But his drastic control
measures were carried out most strictly against the poor -- a fact
of much concern to the poor themselves.
INTERVIEW WITH MARK CALDWELL:
There was a rumor that was widespread in New York, that public
health doctors went among the poor with a black bottle, and
whenever they diagnosed a case of tuberculosis, they gave you what
they said was medicine from the black bottle, and it was a quick
and painless poison...it reflects, I think, a little bit of the
terror that immigrants may have had for a threatening public-
health establishment.
READING:
I wrote to you some time ago About taking My husband to the
Hospital... [But] they are Not treating him right he's Not as
well Now as when he went. The Dr that is there don t want
Patients there so they are trying to starve them to death.
-- Mrs. Wm. F. Laird. (Helen Stenberg )
NARRATION:
In 1893 Biggs established Blackwell's Island Hospital, an
infirmary for TB patients only. For every three patients, one
died within a month of arrival, and another one packed up and
left. So Biggs ordered "willfully careless" consumptives to be
detained against their will. The welfare of the healthy majority,
Biggs believed, was more important than the rights of sick
individuals. The most seriously-ill "lungers" were literally
dragged from their homes to a hospital known as "consumptive's
prison."
INTERVIEW WITH LARRY GOSTIN:
TB raises very fundamental civil liberties issues principally
about whether you can force people to do things, whether you can
force them to be isolated, whether you can civilly commit them,
whether you can force them to receive treatment.
READING:
You sent two nurses here to see Katie McCarthy and I would like to
know if you can tell me who sent you a letter about my daughter.
I would like you to tell your nurses to please not bother about my
business, for there is only one cure for my child, and that is in
heaven.
-- Mrs. John Schick (Ann Twomey)
INTERVIEW WITH ALAN KRAUT:
One of the groups that's regarded as most dangerous was the
Eastern European Jews... eastern European Jews were seen as
physically smaller, narrower chests, all the sort of physical
profile of someone who might be tubercular. And in fact a number
of Eastern European Jews who were working in sweat shops, who were
working in the worst of conditions were contracting
tuberculosis... The Italians also had a tuberculosis problem
...They came as big, robust laborers, they were working on the New
York City subway system, they were involved in the building
trades, and for these Italians to contract tuberculosis meant to
some, especially within the Italian community that America was
somehow responsible for tuberculosis.
INTERVIEW WITH NANCY TOMES:
There was something there for everyone. If you were a racist you
could try to tie it into the racial inferiority of a particular
group or ethnic group or African Americans. You could come up
with some kind of scientific argument that the reason they were
more prone to the disease is that they had these racial defects.
NARRATION:
For black Americans, mortality from tuberculosis was two to three
times higher than for whites. White writers concocted a variety
of explanations for this -- some of them strikingly far-fetched.
READING:
The negro's small lung capacity, as compared with that of the
white, and his deficient brain capacity render him less resistant
to the disease.
-- John Bessner Huber (George Guidal)
INTERVIEW WITH KEITH WAILOO:
One explanation tuberculosis looked differently or was more
prevalent in the black community proportionate to the white
community had much to do with the fact that tuberculosis was not
seen in its early stages as often or as easily in the black
community as it was in the white community but fascinatingly, what
a lot of white authors did was they took this widely known fact
and said this must say something about the character of black
people.
READING:
Negroes... lead very irregular lives. They often roam about at
night, indulging in licentious debaucheries of the most disgusting
character. Their homes are filthy. Their girls early learn evil
ways... It is the lack of physical and moral cleanliness that
causes the death-rate to be so much more among the negroes than it
is among the whites. L.C. Allen (Jon Lee)
INTERVIEW WITH KEITH WAILOO:
I think one of the images of negroes and tuberculosis is the negro
is a carefree individual who doesn't care about health, doesn't
care about the health of his neighbors and therefore is inclined
to be, is likely to be a menace to not only themselves and their
community, but to the white community in general and that is an
image that one sees over and over again. The fact is that one
could see that African Americans may have been less inclined to
visit public health officials because of these kinds of attitudes.
INTERVIEW WITH TERA HUNTER:
In southern cities like Atlanta domestic workers were stigmatized
as the primary culprits responsible for the spread of
tuberculosis. African-American women performed some of the most
intimate labor in white families as cooks, maids, child nurses and
as laundresses and within this context, their white employers
often associated them as members of a race with certain natural
habits and traits such as ignorance, laziness or uncleanliness or
sexual promiscuity that they thought made blacks susceptible to
tuberculosis and other contagious diseases.
INTERVIEW WITH DEL GARCIA:
There's always the desire to point the finger and blame. And it's
easiest to blame those people who look different than you, who
speak differently than you, who do work that you wouldn't even
consider and then you can house the blame right there and you then
don't have to bear any responsibility for addressing the problem
or even looking at your own health care.
NARRATION:
In 1906, the Department of Immigration began refusing to allow
foreigners with tubercular symptoms to enter the country. The
same year a bill was submitted to the Colorado State Legislature
that would have required lungers to wear bells around their necks.
It didn't pass; but a TB hysteria was spreading across the nation.
Consumptives were expelled from hotels and boarding-houses.
Barbers refused to shave consumptive men. Schoolchildren were
sent home and ordered to stay there indefinitely.
INTERVIEW WITH MARK CALDWELL:
Certain guiding lights of the public-health movement were prepared
to be downright oppressive in the cause of health, I think good
sense prevailed. The public-health movement as a group realized
that, if, if the disease was to be policed, then we'd all live in
a police state. And the movement drew back from that, it was
never pursued.
READING:
As I had but a short time to live, I yearned for the peace of the
great wilderness.... On several occasions I have been so ill my
life was despaired of; and yet little by little, while lying out
under the great trees, looking out on the lake all day, my fever
has stopped and my health slowly begun to return.
-- Edward Livingston Trudeau (Sam Tsoutsouvas)
NARRATION:
Edward Livingston Trudeau was born to a wealthy New York family,
then educated in Paris. He'd already built a successful medical
practice when his own TB was diagnosed in 1873. As his health
grew worse, he went to spend his last days in the Adirondacks,
where he'd seen the happiest times of his life.
INTERVIEW WITH MARK CALDWELL:
Trudeau essentially gave up on life ... so he went up to the
Adirondacks in the 1870s and his condition to his surprise
improved...He... became convinced that the climate there was ideal
for a cure from tuberculosis... Trudeau had built a little tiny
red shack in the Adirondacks outside Saranac Lake and begun
treating patients, initially two patients. And the reports that
came back were phenomenal.
READING:
This spot always has had a wonderful influence on me, and it is
not to be wondered at that I decided almost at once to place the
first little wooden building of my proposed Sanitarium on it.
-- Edward Livingston Trudeau (Sam Tsoutsouvas)
NARRATION: With the construction of the "Little Red" in 1884, the
sanatorium movement began. Trudeau believed in what he called
"the magic influence of surroundings" -- the healing power of the
wild landscape. He set out to prove his beliefs on a small island
in the Adirondacks... with rabbits.
INTERVIEW WITH FRANK TRUDEAU:
Granddad had a camp over on one of the lakes. Off his camp was a
small island. And he put 5 rabbits on the island inoculated with
tubercle bacilli and he fed them regularly and this in essence was
bed rest, and reduction of all problems to a rabbit.
NARRATION: Trudeau injected another five rabbits with TB; this
group he placed in a box, and he put the box down into a hole
without sunlight or freedom. All five of these rabbits soon died.
INTERVIEW WITH FRANK TRUDEAU:
Those that were running around the island, one was ultimately
proven to be sick, three others proved to be negative and one he
had to shoot to catch it and they all proved to be negative...So
the conclusion was that...if you had fresh air and rested, like a
rabbit on a little island, and got good food you got better.
NARRATION:
Over the next fifty years, the TB sanatorium became an industry in
the United States: by 1930 over 600 sans, with a capacity of
84,000 beds, dotted the landscape. The sanatorium builders looked
for places that seemed healthy; so tubercular America chased the
cure on the ocean beaches of Florida, in the shining mountains of
Colorado, among the pine forests of Georgia, on the cold lakes of
Minnesota, and in the shimmering deserts of the Southwest.
Frequently, they died there.
READING:
I find much to my surprise and sorrow that my right lung is also
affected. I have always tried to console myself with the fact
that some people live a long, long time on one lung, and that has
always been my hope, but I never heard of anyone living with no
lungs.
-- Elwell Stockdale (Richard B. Shull)
INTERVIEW WITH JEANNE ABRAMS:
We think of people coming west because of the open spaces and many
in search of silver and gold About 25% of the population of the
entire west was probably settled because of health related
reasons, largely tuberculosis. In Colorado, that percentage was
considerably higher, possibly as much as 60%. People would come to
Colorado without friends, without money, without clothing, without
food with the hope that somehow magically, all those things would
appear the next day.
READING:
I thought I came out here to die. When I left home I had but one
lung and it almost gone. I couldn't speak above a whisper, and
had no appetite. I have been two weeks in Pasadena, have three
lungs, can roar like a descending avalanche, ate three mules for
breakfast, and am going to try it for another week.
-- Los Angeles Porcupine (George Guidal)
INTERVIEW WITH JEANNE ABRAMS:
One of the problems was that many people came out to Colorado as
their last resort, no pun intended, and they had hoped that the
magnificent air and high altitude of Colorado would somehow
magically affect a cure for them. For those who were well-to-do,
there were always up-scale boarding houses and sanatoria. The
real crux of the problem were the indigent patients who literally
came out and many died in the streets because they could not get
into a sanatorium.
ARCHIVAL FILM ASKING FOR FUNDS FOR SARANAC LAKE SANATORIA:
Up at Saranac Lake in the state of New York, they have established
a sanitorium. But the list is long ladies and gentlemen. There
are many more who need the mountain air, the sunshine, the
tenderness, the contentment of mind and the balance of diet and
nourishment that only that well equipped sanitorium can give them.
If you could only see them fight these boys and girls are making,
their smiling contiments, their great optimism, their hope that
they will be saved.
INTERVIEW WITH BARBARA BATES:
Here was a place where they could go, they could be treated, they
would get fresh air, good food, rest, exercise, all under the
supervision of a physician, later nurses, and this was their
chance to recover.
INTERVIEW WITH MAIR BURMAN:
But I do remember arriving there by ah by train. The railroad
main line from New York to Montreal. Passed right through the
grounds of the sanitorium on the edge of the lake. When we were
taken off the train and stepped outside which was all snow covered
you know in February. I remember the uh ahh, the taste of the air
which was like wine compared to what we had come from in New York
City. And I felt sure then that there was no way I couldn't get
better up here.
INTERVIEW WITH MARK CALDWELL:
The first thing that happened to you when you were admitted to any
sanitorium, whether it was a public or a private one, was you were
presented with a rule book... It told you when you rose in the
morning, it told you how to brush your teeth, when to brush your
teeth, when and how to bathe, when and how to eat, when and how to
talk, when and how to read, when and how to rest
INTERVIEW WITH MARIE SHAY:
It was just horrible. I asked the doctor first thing, I says
doctor will I be able to dance. I love to dance, just learned to
dance, and I loved it. And he says, oh yes, he says oh you'll
have the time of your life. He knew it wasn't going to be like
that. But that's what he said.
INTERVIEW WITH MANNY BERNSTEIN:
The first thing that happened is they put you right to bed and
that was one of the rituals and they put you flat on your back and
they said you don't get up except to go to the bathroom and for
one month you're to be flat on you back. So you had to read like
this you know. And not sit up. And they turned you like they
were cooking you every fifteen minutes or a half hour they'd say
"flat on your back, OK, now you got on your left side."
INTERVIEW WITH FRANK TRUDEAU:
Every child in town was expected to be quiet from 2 to 4 because
3,000 people were resting from 2 to 4. And as a matter of fact
most of our mothers went to bed from 2 to 4 simply because it was
the culture of the community.
INTERVIEW WITH JEANNE ABRAMS:
There were a number of sanitoria that put great emphasis on food,
meat, milks and eggs were considered extremely beneficial for TB
patients and I read one memoir of a woman who remembered that she
had to eat 28 raw eggs a day.
INTERVIEW WITH MANNY BERNSTEIN:
They said I had to drink a quart of heavy cream every day. They
didn't know how they were going to get it down me. If you ever
tried to drink heavy cream a little bit is great but a quart, you
know, this big quart would come and they'd flavor it with vanilla
or chocolate but I was to get that down throughout the day
whenever I wanted. But a quart of cream went down. It was really
nauseating.
Interview with Marilyn Robertz:
We could drink all the beer we wanted because that helped to build
up our weight and it was a struggle to gain weight with
tuberculosis. I was down to under a hundred pounds and I was 5
feet 6. I was finally gaining weight after being so so thin. I
was up to 132 and I called myself porky.
NARRATION: Another standard feature of sanatorium treatment was
fresh air -- the colder the better.
READING: It was dreadful. I remember every one of those cold
winter nights. I lived in a tent through three long, miserable
Colorado winters. Twice the wind blew my tent over. I think it
must have snowed all the time. In actual fact, I never knew what
it meant to be warm in the winter until I returned home... to
Minnesota. -- J. Raymond Davies, 1906 (Jon Lee)
INTERVIEW WITH MARK CALDWELL: [AA BB 1330 - 1390]
What you did by say about 1910 was spent the greater part of the
winter outdoors, usually on a cure porch so ... the wind blew on
you but the snow didn't land on you, wrapped up in an elaborate
cocoon of blankets with just your face showing and you breathed
this bracing, pure, sometimes 40 degree below zero air for as long
as it took to isolate the sites of infection in your lungs. And
of course, in a sense, probably this was an effective rest cure,
it's 40 degrees below zero you are not likely to move
unnecessarily.
READING: Place the rug, which should be large in size, fully
extended on the chair. After sitting down grasp the part of the
rug lying on the right of the chair and with a quick motion throw
it over the feet and knees and tuck it well under the legs. Then
do the same with the part of the rug on the other side of the
chair but leave the edge free. Now grasp the free edge of the rug
lying on the right hand side and pull it up hand over hand until
the end which was lying free beyond the feet is reached. then
pull up the far end of the rug, taking care to uncover as little
as possible of the legs, and tuck both sides under the knees.
This will give three or four layers of rug over most of the legs
but only one over the feet. It forms, however, a bag out of the
rug and no air can enter. A second rug folded and thrown over the
first makes such a covering that the coldest weather can be
defied. (Mary O Brody)
INTERVIEW WITH LILLIAN ROBIN:
The first night that it snowed and all of a sudden they came in
and they started opening up all the windows. And I said, I always
had a big mouth. What are you doin', why are you open them
windows, it's cold. And they said you got to have fresh air. And
it was something to do with the first snow and so we went ahead
and went to sleep and when I woke up my pillow was all full of
snow.
INTERVIEW WITH WILLIAM BANTON:
Cold air, cold air really didn't do any good as far as therapy was
concerned. Of course we didn't know it at the time but I would
say it did a lot of good for the staff who took care of TB
patients because it meant that being out on the porches like at
Saranac Lake the air was constantly being diluted. So the cold
air was really turned out to better for the staff than for the
patients themselves.
INTERVIEW WITH MANNY BERNSTEIN:
Part of the philosophy was enjoying the moment. Therefore there
was a great deal of romance too. Romancing, especially when
you're fed, and you're resting, you're in your bathrobe and
pajamas so much.
INTERVIEW WITH LELA LEVINE:
There was lady working at the sisterhood Jewish uh sisterhood in
Saranac Lake. ...And she called me one day and she said there's a
very nice young Jewish man up in Kirks one why don't you go and
see him. I guess I was very marriageable at that time.
INTERVIEW WITH MEL LEVINE:
I was in bed, I remember being in bed all the time and life was
pretty grim...until my nurse showed up.
INTERVIEW WITH LELA LEVINE:
We started talking and then I told him that I played the accordion
and his aunt had sent him a ukelele. So he started writing me,
transposing music and that really impressed me. Then when he was
allowed to go out for the first time. His cottage mates arranged
it that he would sit at my table.
INTERVIEW WITH MEL LEVINE:
And of course, after we met each other and courted the world
looked entirely different, even with TB everything was OK. And we
courted and got married.
INTERVIEW WITH LELA AND MEL LEVINE:
(Lela Levine) One of our daughters got married up here two years
ago.
(Mel Levine) In the chapel at Trudeau.
(Lela Levine) In the chapel at Trudeau.
INTERVIEW WITH MAIR BURMAN:
It was the last six months before I was discharged from Stonywald,
I was allowed to have a week's leave. And that was the first time
I saw my baby after he he must have been about 2, 2 « at that
time, I saw him since he was born. And it really was a pleasure
to see this little blonde boy. For one thing I thought he had
dark hair. To see this little blonde boy, quite a stranger to me,
but it really was a wonderful time.
INTERVIEW WITH BARBARA BATES:
For many people life in the san was pleasant. It was a good
experience, a bitter sweet experience again, because some people
didn't get better but nevertheless they were in it together, they
made friends. The people who survived and have lived to tell about
it are of course a very select sample.
READING:
I write to ask would you take me at your Sanitarium? I am a Poor
boy Afflicted with Lung trouble. My father have spent all his
Money for Doctors Bills and Medicine. I would worked and do all I
could to pay my way. P.S. I am a Colored boy. Do you take
Colored People?
-- Robert D. Freeman 1906 (Raphael Nash)
NARRATION:
African-Americans were far more likely to die from TB than whites,
but much less likely to receive treatment. Most TB sanatoria,
like many American institutions of the time, were segregated by
race. When one physician tried to desegregate a Pennsylvania
sanatorium in 1914, forty-two white patients protested.
READING:
We have no personal enmity against Negroes...but to be forced to
mingle with [them] is unjust. As there is nothing in your
advertising literature sent to patients [saying] they would be
expected to associate with Negroes, we think it is an injustice to
live in daily contact with them.
-- "The Committee for Patients," White Haven Sanatorium (Cynthia
Adler)
NARRATION:
The sanatorium board went along with the white patients. Negroes
were again banned from the aptly-named White Haven Sanatorium. And
many sanatoria were selective in other ways as well. Some wouldn't
take patients who were too poor. Some wouldn't take patients who
were too sick.
READING:
July 20th, 1901. Dear Doctor:
Miss Hackett is failing rapidly, and we would like to have her
removed. The appearance of one so ill has a depressing effect on
the others.
-- Sisters of Mercy, Gabriels Sanatorium (Ellen
David)
INTERVIEW WITH BARBARA BATES:
People who could pay fees usually wanted to go to a sanitorium
where people were getting better and seemed cheerful and didn't
cough a lot in the dining room and weren't depressing to other
people. Having a very sick consumptive who was not getting better
was frankly bad for business.
INTERVIEW WITH JOANN CURTIS:
Nobody ever told us someone was dying ever. Sometimes it would be
in the middle of the night we would hear what was called the death
rattle and you could hear gurgling and the next thing you knew
there would be nurses that you could sort of see shadows whisking
in and out of a certain room and a priest would come or a minister
would come and the next day the bed would be made. And nobody
ever mentioned it at all.
NARRATION:
At most sanatoria, the subject of death was taboo. Treatment
featured liberal doses of optimism; patients were constantly
exhorted to think positively. The fate of the body depended,
patients were told, on the state of mind.
READING:
Why cannot we all throw trouble off our shoulders by vigorously
shaking the right and left shoulder, even though it may appear
that we are doing the enormous applesauce dance?
-- The Mount McGregor Optimist (Mary O'Brady)
NARRATION:
In 1930, Americans with TB numbered three million -- over 35 times
the combined capacity of the sanatoria. Every san had a long
waiting list; millions of the sick waited for a chance they would
never get.
INTERVIEW WITH JOHN SBARBARO:
What did sans do? They took somebody with a contagious disease
who could spread it to ongoing new recipients of the disease
right? Infect new people and put them in a place where they
couldn't spread the disease. It did immense good to society.
Now, did it do any good for the individual? You gained weight,
looked healthier but you died at the same rate as if you had been
in your home. But the high altitude argument is a little more
interesting because what we recently found out is that absence of
oxygen or in lower oxygen tension like would have occurred on the
tops of some of these mountains, the macrophages in the lungs are
more active and more able to control the TB bugs. Did bed rest
work? Not a chance. But it gave the physician total control...
the patient couldn't get out of bed unless you said it was OK.
Couldn't make a phone call to their family unless you said it was
OK. Couldn't have a bowel movement in a bathroom unless you said
it was OK and the san director surrounded by an entourage of folks
would sweep through the halls making decisions. It's great sense
of power. Patients, if you think about it, needed that feeling of
awe and respect because it gave them hope.
INTERVIEW WITH MAIR BURMAN:
At ten o'clock at night we used to lie down in bed and hear the
train come in and if a patient was going home we could hear voices
in the station just below on the ground you know. Everybody, the
leaving patient always had permission to have a few friends to see
him off, him or her off. And you know it was always something to
look forward to. We could hear the talking and laughing down at
the at the station, just a couple hundred yards away and you would
think ah, one day I'll be on that train.
THE PEOPLE'S PLAGUE:
TUBERCULOSIS IN AMERICA
PART TWO: THE GOSPEL OF HEALTH
ARCHIVAL FILM "HOPE.":
INTERVIEW WITH IRMA WILLIAMS:
You won't believe it that you have tuberculosis or you can catch
it like that. Who would believe that you have catch tuberculosis
just with someone talkin' to you in your face. But a lot of
people say, I don't know, when I was a little girl, it was, a man
in my home town had tuberculosis, and we thought he was the
nastiest man in the home town. Now I got to face that.
INTERVIEW WITH EDWARD ZUROWESTE:
Right now there are a billion people in the world that have
positive TB skin tests. It's a huge problem. It's an airborne
disease that is difficult to diagnose and it takes a long time to
treat. And can be latent for 50 years. A person can reactivate
their TB that they were exposed to when they were a child when
they're 60 years old so it's a very difficult disease to totally
eradicate without a huge effort.
BBC NEWSCAST:
This is the face of America's TB epidemic. Last year 26,000
Americans, a record number in recent history, were diagnosed with
the disease. The epidemic is part a consequence of the social
problems that overwhelm New York and other American cities in the
last decade. Homelessness and AIDS have rendered thousands
defenseless against TB infection. Critics say American TB
epidemic could have been prevented, but it serves as an indictment
to the social policies of the 1980s that allowed the disease to
flourish. Tom Brook, BBC News, New York.
INTERVIEW WITH KEITH WAILOO:
We as a society have not paid enough attention to disparities in
wealth and social station and tuberculosis is one of the
consequences. Just a further example of the ways in which
diseases are more than simply biology but they are occasions for
making moral statements, making political statements and making
social statements about what sort of society we live in. What
sort of society we have lived in and what kind of society we would
like to live in.
TITLE
NARRATION:
In the first decades of this century, the American people took an
unprecedented, perhaps even arrogant, step: they declared war on a
disease.
CHILDREN'S CHORUS (TO THE TUNE OF "DIXIE"):
"I am a Health Crusader, Hooray, Hooray,
Against Disease I take my stand
To fight all germs in Dixie Land,
Beware! Take Care! Bad Health's a tricky trader.
Line up! Sign up! and be a Health Crusader."
NARRATION:
Nineteen-oh-four saw the founding of the National Association for
the Study and Prevention of Tuberculosis. This was the first
full-scale, single disease crusade ever -- anywhere.
INTERVIEW WITH NANCY TOMES:
The tuberculosis movement was the most far reaching public health
campaign of the early 20th century. If you went to public school
anytime between 1900 and 1930 you got the tuberculosis message,
which said spit is death.
READING: DON'T SPIT on the floor of your shop.
WHEN YOU SPIT, spit in the gutters or in a spittoon.
DON'T COUGH WITHOUT holding a handkerchief over your mouth. DON'T
sleep in rooms where there is no fresh air.
DON'T DRINK WHISKEY, beer, or other intoxicating drinks.
DON'T SLEEP IN THE SAME BED with anyone else, and, if possible,
not in the same room.
-- Texas Anti-tuberculosis Society (Mary O'Brady)
NARRATION:
The reformers preached their gospel of clean and healthy living,
using the first health propaganda films ever made.
ARCHIVAL MOTION PICTURE "TEMPLE OF MOLOCH":
INTERVIEW WITH NANCY TOMES:
It was never a simple disease to explain. They knew very early on
that almost everybody was exposed to the tubercle bacillus. Why
did only some people develop the disease? Why is it that by the
late 19th early 20th century that poor people seemed to be more at
risk than wealthier people?
INTERVIEW WITH KEITH WAILOO:
In the early 20th century in American society fear featured very
prominently in public-health reform efforts...One needed to do
something about the danger of disease. I think today we are not
sure we live in that kind of society. We think classes are a lot
more carefully segregated and therefore it becomes easy to simply
point the finger and say the particular disease like AIDS is a
problem within the "inner city community" and leave it at that.
NARRATION:
Spurred on by fear, and by compassion, the national tuberculosis
association became an all-out crusade. They tested millions of
Americans for tuberculosis, sent out squadrons of public health
nurses, and sponsored fresh-air schools for children at risk. Who
paid for all this? They did -- by selling Christmas Seals.
BING CROSBY:
It's a great thing, Christmas. For most of us it's the happiest
time of the year. But everybody isn't so lucky. You know there's
lots of folks facing an enemy right here at home. An enemy they
can't handle like our boys in uniform can handle the Nazis and the
Japs. It threatens us everywhere and always with a sneak attack.
By this time you must have received this letter containing your
Tuberculosis Association Christmas Seals. It's you chance to help
in this fight because by buying these seals you're helping the war
against this disease, just as your buying bonds or helping win our
global war. You got this letter so don't forget to answer it.
NARRATION: By the 1930s fewer Americans were dying of TB --
perhaps due to public-health reforms -- perhaps due to improved
living conditions. No one knew for certain, but one thing was
clear: medical science was getting better at diagnosing the
disease.
Doctors had the tuberculin skin test to see if a person had been
exposed to the bacterium; then the sputum culture was developed to
detect the disease in its early stages. The x-ray seemed most
emblematic of progress: an actual photograph of the inner workings
of the body, showing in black and white the power of the tubercle
bacillus.
DOROTHY MAYNOR FILM:
Anybody can have a chest X-ray, everybody should have one. It's
as easy as taking a snapshot, but it's much much more important.
I've had my chest x-rayed. I know my lungs are healthy. Why
don't you have your chest x-rayed, you'll be happy you did, I know
you will.
NARRATION:
Diagnosis was one thing, treatment quite another.
INTERVIEW WITH RICHARD JAHN:
We had a bunch of procedures, the very number of which indicates
the lack of efficacy of any particular one of them. Among those
crazy things we used were sunlight treatment, starvation
treatment, feeding treatment, freezing treatment, heating
treatment. You've gotta laugh to think of it the way we did now.
And then the more invasive types of things like pneumothorax which
is you stuck air into the chest to collapse the lung.
NARRATION:
Artificial pneumothorax came into wide use after 1910. In order
to deprive the bacteria of oxygen, surgeons collapsed the
patient's lung -- repeatedly -- by injecting air into the pleural
cavity.
Interview with Richard Jahn:
Then there were other procedures -- oil in the chest to collapse
the lung. Paraffin in the chest and actually ping-pong balls.
Interview with Joann Curtis:
I started with just a singular pneumothorax in the at City
Hospital and it's quite frightening actually because if they, they
insert this needle in your side and you have to lie like so and
you can't see who's doing what.
INTERVIEW WITH RICHARD JAHN:
But the relapse rate was high. Two or three or four or five years
down the road they'd be back in with a relapse.
INTERVIEW WITH BARBARA BATES:
There were no controlled studies to show whether it was
advantageous or it was not. There are clearly people who had the
procedures who got better. For patients in a san, in the 20s and
30s and 40s, the rest cure got so tedious 2 years, 3 years, so
tedious, that they desperately wanted something else and they
often welcomed pneumothorax or surgery. It was offered as a as a
again hope and they took it.
INTERVIEW WITH DR. JAHN:
The disease, tuberculosis, was characterized by great optimism in
its victims. They felt good, they were sure they were going to
get well if they followed the cure and they followed the cure.
And as a matter of fact on some of the ladies' wards you have
patients that you knew were very sick who would put on their
makeup in the morning and by afternoon be dead.
INTERVIEW WITH RITA ROGERS:
I was in bed about 5 years in all. And of course I had all the
regular things that they gave you then. There were no antibiotics
so they had to give you pneumothorax and various other little
things. And finally with me they had to give me what they called
a thoracoplasty operation. Which name, incidentally, is no
longer in the dictionary. It's in the medical dictionary but not
in the regular dictionary because they don't have to do that
anymore.
INTERVIEW WITH MARILYN ROBERTZ:
I was told that in order to protect me so that I could lead a
normal life I should have a permanently collapsed left lung. And
this would mean thoracoplasty, which was removing seven or eight
ribs in about three major operations. It disfigured you, but I
begged that my parents to sign the papers. Really it was not that
bad., except you really don't enjoy hearing people sawing away on
your bone.
INTERVIEW WITH RITA ROGERS:
My mother said don't let them take your ribs away. I took my ribs
home in a paper bag and I was just young enough to sign them and
give them out to some of my boyfriends.
INTERVIEW WITH MARILYN ROBERTZ:
My first solid meal after my first stage of surgery was, and I
thought this is so typical of a state institution not being more
sensitive, spare ribs. It was very hard to eat that meal I will
say.
INTERVIEW WITH RITA ROGERS:
A friend of a friend had a brother who was in archeology and so I
gave him the biggest, that's the one on top and he put it in his,
he put it in with a shrunken head and a few other things he had.
And my mother said oh my God, she said, get them back again, they
might be able to put them back in your body. Well I think you can
understand if they could take them out it was such an amazing
thing that they could take your ribs out of your body, if they
could take them out maybe they could put them back in again. Oh,
dear.
NARRATION:
In the United States the TB epidemic was truly loosening its grip.
By World War II, the death rate was less than a quarter of what it
had been at the turn of the century. But more than one hundred
thousand Americans still came down with the disease every year;
every year, seventy thousand died.
INTERVIEW WITH FRANK RYAN:
Tuberculosis was regarded as the mountain in medicine, it
dominated every single department in medicine. Worldwide it was
killing 5 million people a year. The medical world at large
believed the disease would never be curable. Most people in the
medical world, the sanitoria directors, did not believe the
disease would ever be curable with drugs.
NARRATION:
In the 1940s, a small group of scientists, working under
improbable conditions in four countries, pulled off an antibiotic
miracle: the combination of drugs that promised to exterminate the
greatest killer ever known to man.
INTERVIEW WITH FRANK RYAN:
In the United States it was Selman Waksman with his colleague
Albert Schatz. In Germany, Gerhard Domagk. And in Sweden Jorgen
Lehmann. Every one of them mattered. Because it was only when
all of their discoveries came together that we had the cure.
NARRATION:
Selman Waksman was born in a small town in Russia. In 1910, at
the age of 22, he emigrated to New Jersey and studied soil
microbiology at Rutgers.
INTERVIEW WITH FRANK RYAN:
Waksman hadn't attended a single medical lecture in his life.
When he eventually began to work with antibiotics, all he knew
about diseases was what he could learn from opening textbooks.
INTERVIEW WITH FRANK RYAN:
Waksman attended the Second International Microbiology Congress in
New York in 1939... He realized I am the world expert on soil
microbes. I am in a position where I can really do something with
this. He spoke to the post graduate students who were working
with him and said, "Stop everything you're doing. From now on,
all our researches will be devoted to finding anti-bacterial
drugs."
NARRATION:
Waksman had help. At the Mayo Clinic, William Feldman and H.
Corwin Hinshaw promised to carry out clinical tests if Waksman
could come up with a drug to fight TB. They would test humans:
the criminally insane. And in Waksman's own lab, he had a young
assistant of unswerving dedication named Albert Schatz.
INTERVIEW WITH FRANK RYAN:
He was a young man. He was driven. Looking for success. He came
from a very poor background. He worked night and day, he slept
in the laboratory. Obsessive research by an extremely intelligent
young man, along principals which had already been laid down by
Waksman.
INTERVIEW WITH ALBERT SCHATZ:
When I began working with the tubercle bacillus, I was advised by
Waksman, by other graduate students and by others who knew what I
was doing that in effect it conceivably would turn out to be a
waste of my time. I should take out conceivably. It would be a
waste of time. First of all, nobody had ever discovered any drug,
antibiotic or synthetic chemical which was effective against the
tubercle bacillus. Because of that waxy, fatty capsule around the
tubercle bacillus no drug could get in. But that didn't make
sense to me -- my feeling was if food got in, certainly an
antibiotic could get in.
NARRATION:
In 1943, Schatz began testing. He tested microorganisms from
manure -- from lawn soil -- from forest soil. He even tested
organisms he'd found in the throat of a chicken. And that, of
course, is where he found something: an agent that stopped the
growth of TB bacteria. He called it streptomycin.
ANTI-TB DRUGS FILM:
Tuberculosis probably causes more deaths more disability more
downright misery and more expense than does any other disease due
to bacterial infection. It has been called and rightly called I
believe, the most important, infectious disease of the human race.
NARRATION:
In 1944 H. Corwin Hinshaw began the first clinical trials of
streptomycin.
INTERVIEW WITH H. CORWIN HINSHAW:
We had been supplied with a small amount of this new drug which
Dr. Schatz and Dr. Waksman had produced, just enough for four
guinea pigs. The four that were treated were doing pretty well
and when we ran out of drugs well we better stop and have a look
see. And to our amazement they were totally different from the
ones who had not been treated. And it's exactly what we had been
looking for five years.
INTERVIEW WITH FRANK RYAN:
So they began work tentatively. You can imagine how tentative.
The first couple of patients they gave to were essentially dying.
There was nothing to lose if you wanted to give them a new drug
that might have proved toxic. But when they gave the drug to
these people, it didn't really save their lives, but when they
died the germs seemed to be damaged. So they knew there was
something here. So now they began with the first real patient and
she was a young woman from Texas.
INTERVIEW WITH H. CORWIN HINSHAW:
So we put her on streptomycin in a dose somewhat larger than we
ever tried before and which she tolerated very well. And to our
total pleasure and satisfaction and surprise, this newly acquired
disease and her formerly good lung slowly and steadily healed and
she got well.
INTERVIEW WITH RICHARD JAHN:
It was one fall afternoon and my associate and I were looking at
the films on the people who were to be admitted that day. Here
was a chest x-ray that looked like a snow storm, individual had
malaria tuberculosis. In questioning him he hadn't had a symptom.
He'd gone in for a mobile unit film with the public health service
bus that had come up. But as Dave said, "You might as well get
out the 45 and give it to him and tell him to shoot himself." No
patient with malaria ever got well. Well something happened and
that something that happened was streptomycin...he became well, x-
ray cleared and became normal and he lived to die a few years ago
of something else. And if you don't think that was sort of a
thrill, guess again.
INTERVIEW WITH WILLIAM BANTON:
Here we had a drug now that could actually kill the TB bacillus.
And we thought this was going to be the answer now that
streptomycin was going to be the answer that was going to cure
tuberculosis.
INTERVIEW WITH FRANK RYAN:
They had enough streptomycin maybe for a hundred patients. Five
million people that year would die from tuberculosis. Once word
began to leak out that this drug was discovered, telegrams,
begging letters, parents with children were dying, desperate to
get this new wonder cure.
INTERVIEW WITH RICHARD GOULD:
I had it in both lungs and I had a cavity on the right side and I
had it in my kidneys. So I thought this is it. And they started
me on streptomycin. It was just coming out then and they gave me
a dosage which if you prescribed it these days you'd probably have
a malpractice suit on your hands. I was getting about 4 times the
dosage that I should get which you would order nowadays. And but
it worked.
INTERVIEW WITH FRANK RYAN:
Waksman was eventually awarded the Nobel Prize in 1952 for the
discovery of streptomycin. A very sad note about that was even
when he was awarded the Nobel Prize, not only did Schatz not share
it, but Schatz' name wasn't even mentioned except as a tail
footnote in a list of people who had worked at Rutgers.
INTERVIEW WITH ALBERT SCHATZ:
I was shocked first, that he had gotten the Nobel Prize
specifically for the discovery of streptomycin and secondly, that
he had accepted it without even acknowledging me. Even in his
speech of acceptance, he never referred to me by name.
NARRATION:
But the debate about credit for the drug was soon diminished by
some disappointing news.
INTERVIEW WITH RICHARD JAHN:
Calls would come in the night, somebody fell and cut their head
again. And this happened with frequency and when we traced it
down these people were all were getting streptomycin.
INTERVIEW WITH HELEN PHILIOS:
My hearing was off. I felt like I was walking on the sides of the
walls. My equilibrium was completely off. They kept me on that
for about three days and then they took that away.
INTERVIEW WITH LYNN MILLER:
They were horrible shots. Thick, oily. So I ran away when they
came looking for me. After the first two I said I want no part of
that. So when I knew it was shot time I'd go hide somewhere and
fight them tooth and nail.
INTERVIEW WITH JOANN CURTIS:
Oh. Streptomycin. Well you got it in you rear-end twice a week
and it made you numb is what it did and made you burn up with a
fever and they'd always have to try to find a spot they haven't
hit before.
NARRATION:
But the inconvenient side-effects were gradually overshadowed by a
more frightening pattern: after patients took streptomycin for a
few months, their TB germs could begin to mutate -- the bacteria
could become resistant to the drug. Streptomycin was not a cure
for everyone.
INTERVIEW WITH MARK CALDWELL:
So it turned out that one antibiotic wasn't enough, you needed
more than one, so that the tubercle bacilli that one drug didn't
get rid of, the other one would -- so that there was a kind of 1-2
punch.
NARRATION:
The second piece of the puzzle came from a Danish doctor named
Jorgen Lehmann, an impetuous man with an unorthodox approach to
science.
INTERVIEW WITH FRANK RYAN:
He was rather like a real life Sherlock Holmes. He often didn't
need to do any research at all. He had such a brilliant brain
that he could be presented with the problem. He'd sit, lie back
on his couch, I won't say it's elementary my dear Watson, but it
was rather similar. He would say, such and such a thing's the
answer.
NARRATION:
From an obscure research paper, Lehmann had learned that aspirin
altered the oxygen uptake of the tuberculosis germ. He realized
that, by changing the aspirin molecule slightly, the internal
chemistry of the germ would be interrupted, and its growth
inhibited.
INTERVIEW WITH FRANK RYAN:
And he actually wrote an extraordinary letter to a little drug
company called Ferrosan, in which he states in the letter without
any research at all, that if you manufacture the para amino salt
of salicylic acid, which is aspirin, I believe it will have
antibacterial properties by which he meant antituberculous
properties. He was absolutely right.
NARRATION:
The drug was called PAS. It was difficult to produce in war-time
Europe, but by the fall of 1944, there was enough for a small
number of patients. Most showed improvement -- but Lehmann's
report still drew fire from every corner of the scientific
community.
INTERVIEW WITH FRANK RYAN:
Everybody believed that aspirin had an anti-fever effect and that
all the witnessing of the patients was a reduction in fever. This
again resulted in a reluctance to accept the message of PAS.
NARRATION:
By spring, the results were irrefutable: PAS cured tuberculosis.
Science had come up with another miracle on demand, and patients
wanted their fair share.
INTERVIEW WITH FRANK RYAN:
At this time throughout Sweden patients were marching around the
sanitoria grounds and out into the streets demanding to be
treated. Word had got round that a treatment was available and
they couldn't get hold of it.
NARRATION:
But even before the second miracle was universally available, it
too began to have its problems.
INTERVIEW WITH JOANNE CURTIS:
Then they also did para amino salicylic acid, PAS, which was about
32, 35 pills a day which made your stomach just rot.
NARRATION:
Again, the irritating side effects were not the worst news. The
stubborn tubercle bacillus soon developed resistance to PAS,
exactly as it had with streptomycin. The puzzle was still not
complete. The cure needed another scientist, Gerhard Domagk with
the Bayer Laboratory in Elberfeld, Germany.
NARRATION:
Domagk developed the first antibiotic drug in 1933. The Nobel
Committee selected him for the 1939 Nobel Prize for medicine, but
the Nazi Government stopped Domagk from accepting the award.
INTERVIEW WITH FRANK RYAN:
He was arrested by the Gestapo, he was taken away at gun point and
practically with a gun to his head, was ordered to turn down the
Nobel Prize for medicine. [GG AA 0663 - 0812]
In 1942 at a time when the factory where he was working was in the
Ruhr and we were carpet bombing the area. the town had been
leveled to rubble, Domagk himself describes the entire skyline in
flames yet this extraordinary man was beginning work against
tuberculosis.
NARRATION: After three years of work in the midst of war, he
found a chemical group that destroyed the tubercle bacillus: a
compound with the unwieldy name of thiosemicarbazone.
INTERVIEW WITH FRANK RYAN:
They kept perfecting it, but as they did so they were running out
of laboratory animals, running out of materials, the germ was
extremely dangerous to work with and the circumstances in which
they were working were really extraordinarily dangerous.
READING: Of the sixty-five employees here in my laboratory, there
are hardly ten left. Many are dead, others are homeless. When I
awoke this morning the whole town was ablaze, the whole sky over
us was a burning red. -- Gerhard Domagk. (Wilfried Malsch)
NARRATION:
But Domagk and his experiments survived the war. By 1946 he had a
drug worth testing on humans, INH. They tried it first on
patients with severe tuberculosis of the face -- with
astonishingly good results.
INTERVIEW WITH FRANK RYAN:
It was extremely cheap to manufacture and it was extremely safe.
And it's remarkably potent against the tuberculosis organism. So
potent that when the drug was found newspaper articles and radio
interviews and all this were appearing all over the world saying
at last, tuberculosis is finished. But of course even before the
drug arrived on the market, before the first clinical trials were
completed, six papers had appeared in the medical press which
indicates that the tuberculosis germ had developed a resistance
with effortless ease to Isoniazid.
NARRATION:
The third miracle, too, had failed. The tubercle bacillus could
defeat almost any individual antibiotic; but then, in Scotland,
scientist John Crofton took a simple but brilliant step.
INTERVIEW WITH JOHN CROFTON:
We came to the conclusion that all failures were due to giving
drugs alone, and getting drug resistance. If you could prevent
drug resistance, you seemed as if you could prevent failure... So
then we initiated the routine of giving all patients three drugs.
INTERVIEW WITH RICHARD JAHN:
With a regimen of strep, PAS and INH you got 90-95% cure rate
which is tremendous. That's that that's it. And that marked the
downfall of clinical tuberculosis in this country.
NARRATION:
In the 1950s, combined drug therapy paid off. So did public
health efforts. Virtually every school child, every soldier,
every worker in major factories was tested, and if necessary,
treated for TB. The Indian Health Service, through an intensive
training and screening program, brought the TB death rate for
Indians down from the highest in the nation... to the lowest.
Across the United States, death rates from tuberculosis dropped
right off the chart. After seventy years, the TB sanatoria began
to close their doors.
READING:
Marshall Watson: For miles around you could see it.... You'd drive
up a long, winding hill, overgrown with bushes, and come to a
chain-link fence. And everybody always thought, whatever the
disease was -- and none of us knew -- you'd get it if you went
inside. We called it "The Haunted Hospital." (George Guidal)
NARRATION:
Millions of people had died. But what had once been called "the
Captain of All the Men of Death" had finally fallen to the power
of human wit and science.
NARRATION:
By 1980, most local prevention programs had been drastically cut;
research funds for drugs and vaccines dried up; the drug companies
even stopped producing streptomycin. The victory of medicine over
the greatest killer of modern times seemed absolute. By 1984, the
United States had its lowest TB rate in recorded history.
Then, in 1985, a peculiar statistic showed up on the tables.
After decades of declining rates, the number of new cases rose.
In 1986, it rose again. By the 1990s, TB was back in the news.
ROBINWOOD NEWS CLIP:
It has been two months since county health officials first began
investigating the TB outbreak at Robinwood. Since then, 900
students, teachers and family members have been tested. 47% of
them tested positive for TB. Of those 37 students have abnormal
chest x-rays; evidence of the disease. The outbreak began through
a teacher with an advanced case of tuberculosis and now health
experts say it is possible the teacher infected students years
before.
NARRATION:
Today, ten to fifteen million Americans carry the germ that causes
tuberculosis. About 26,000 new cases of active TB occur each
year. There have been outbreaks in hospitals, offices and
schools, as well as homeless shelters and prisons. No one is
immune, but TB hits hardest at those on the margins of society.
VETERAN'S STAND DOWN, ST. LOUIS:
We're going to do tuberculosis testing. The St. Louis area
homeless population have had a great surge in tuberculosis over
the last year. Last year we did tuberculosis testing, we didn't
have very many guys come back for their screening after two
days... This year we're going to offer incentives. We're going to
give them things like bus passes and hats, give them some
incentive to go get that test read.
NARRATION:
Over five years, American TB cases increased by sixteen percent;
in 1991, New York City alone registered 4000 new cases of active
TB. The disease has come back under conditions that seemed to
mimic the causes of the 19th century epidemic -- poverty,
homelessness, a flood of immigration.
INTERVIEW WITH LARRY GOSTIN:
It was not too long ago that the United States public health
service got up and declared that we were going to eradicate
tuberculosis within the next number of years. As a result we
stopped funding many of our programs, we lost our public health
infrastructure, we let the whole problem go under the table. If I
were to design an institution, for the purposes of spreading
tuberculosis, I might design exactly where we put many of our
homeless and old people and mentally-ill people in our country
today. The beds are 6 inches to 12 inches apart when there is no
exchange of air. We've really done almost the opposite of what any
good society would do in that we've I think fanned the flames of
tuberculosis.
INTERVIEW WITH IDA RIVERA:
We're at the Krome Detention Center. This is an immigration
facility where they bring undocumented aliens to be detained until
they resolve their immigration issues. We do require that all the
detainees be screened for tuberculosis with PPD's. And we give
the necessary treatments depending upon those results.
NARRATION:
Many immigrants entering the United States show positive skin
tests. Standard policy is to treat all people who have positive
skin tests with a six-to-nine month course of anti-TB drugs -- but
this policy is not always carried out.
INTERVIEW WITH IDA RIVERA:
We don't have them for the six months or nine months, they may
just be here thirty days and have to continue their therapy
elsewhere. We really don't know if they finish their treatment.
...You may have a group of immigrants who came in at the airport
and it's determined they don't need to be detained. Nobody ever
sees them until they get sick and then they go to a physician and
then you find out that they really came in with TB.
INTERVIEW WITH JOHN CROFTON:
With movement and immigration you're getting people with
tuberculosis coming into the United States from various
countries... And so it's just as much a problem for the first
world and it's very much in the first world interest to support
getting effective control programs globally because no man's an
island and even the United States is not an island.
INTERVIEW WITH EDWARD ZUROWESTE:
If we don't look at it globally we'll never solve the problem.
And to try and think that if we just screen every person who comes
across the El Paso Juarez border, put a skin test on them and do a
chest x-ray and keep those people out who might be infected,
that'll never ever work. We have to work between our countries
and solve this problem by educating the population, finding the
cases and treating the cases.
INTERVIEW WITH DENNIS WASHINGTON:
Well, I was taking the medication and a friend of mine says, "you
want to make some money. We can make plenty of money going to New
York picking apples." I was feeling like I was feeling, I was a
fool for doing it, you know, but I did it. I stopped thinking, I
left my medication, got in the van and went to New York. So, I
was at work about 4-5 months, Fine, you know. Making good money
and then all at once, I start coughing up blood.
INTERVIEW WITH EDWARD ZUROWESTE:
When the TB rates were down in the early 80s to 20 some thousand,
the poor people still had tuberculosis, the migrant farm workers
still had tuberculosis. It wasn't decreasing in that population.
We go out to the camps and put a skin test on, we have to come
back in 2 or 3 days to read that skin test. Then if it's positive
we have to get a chest x-ray and we have to get sputum to make the
diagnosis, the culture and that may take 4 to 6 weeks. A farm
worker moves 6 to 8 times possibly in that year.
INTERVIEW WITH DENNIS WASHINGTON:
I just collapsed underneath the orange tree, you know, just went
out and so that's when I wind up going to New Orleans to Charity
Hospital and I stayed there a couple three months and that's when
it turns out I wasn't fully well when the doctor came and told me
to go home. They needed the bed, you know.
INTERVIEW WITH MICHAEL ISEMAN:
I was an intern in NYC in 1965, we had tuberculosis clinics
scattered throughout the city. Individuals could come in and
receive local care. They could have, if they thought they were
symptomatic, they could come in and have an x-ray done. If they
had tuberculosis, they came to a hospital that had specialized
facilities.
NARRATION:
But after a hundred years of anti-TB measures, the government had
largely ceased to fight the disease. In the 1980s, many American
public-health programs were cut back or discontinued. At exactly
the same time, a new medical threat arose.
INTERVIEW WITH JIMMY HOPPER:
Actually, I had AIDS first. Don't don't get shocked. But I was
living on an island in Miami, between Miami and Miami Beach, and
one of the jerks that was staying over there had escaped from here
three times. And coughing. I know I caught TB from him.
NARRATION:
The AIDS virus weakens the immune system, making its victims
susceptible to other illnesses. Normally, nine people out of ten
who carry the TB bacterium never develop disease, because the
body's immune system provides natural resistance. But the AIDS
virus dismantles that protection.
INTERVIEW WITH WILLIAM BANTON:
In the 80s, the HIV epidemic came on the scenes and here we had an
agent which was a devastating agent to destroy the immune system.
So of all those individuals that were HIV positive instead of
waiting for other things to happen like old age to weaken the
immune system or some major catastrophic systemic disease, they
just completely lost their immunity and succumbed to active
tuberculosis.
INTERVIEW WITH MICHAEL ISEMAN:
Unfortunately, when we look at it epidemiologically, for instance
in Sub-Saharan Africa, very high prevalence of tuberculosis, a
huge prevalence of HIV. Terrible, disastrous case rates of
tuberculosis. Many people dying with TB and AIDS and we are
looking at that same phenomenon going on in Asia, parts of Latin
America and certain communities of America.
INTERVIEW WITH FRANK RYAN:
You can now go to parts of the third world, for instance in India
or parts of Asia, and charlatans are dishing out a day's or two
day's supply of antituberculous drugs for all sorts of ridiculous
reasons. Children are selling antibiotics at lorry stops in
Africa like sweets. I think it's absolutely disgraceful and it's
a recipe for disaster. Because of this carelessness with this
wonder cure drug resistance has emerged against tuberculosis.
INTERVIEW WITH GEORGE COMSTOCK:
Let me back up a little bit. When you don't take your medicine
well, when you don't it faithfully and you don't recover, then you
do allow bugs to emerge that are resistant sometimes to one,
sometimes to two sometimes to three or four of the of the drugs.
OCN NEWS CLIP:
This was the year 18 year old Debbie French was waiting for her
whole life. Her senior year at LaQuinta High School. But instead
of carefree days worrying about the prom,... she's in a Denver
hospital with tuberculosis awaiting surgery that may save her
life.
French developed TB during an outbreak at Laquinta High School
last spring. Sixteen others students diagnosed with active cases
were treated successfully with drugs. But not Debbie. Debbie has
come down with a rare strain of TB which modern drugs can't cure.
INTERVIEW WITH FRANK TRUDEAU:
You're back to 1945, you're in the same situation as you were
before drugs. And that presents a big problem. Additionally,
there's there's only my generation of physicians ever saw a TB
patient before drugs.
NARRATION:
The government responded to the surge of drug-resistant TB with
D.O.T., directly-observed therapy. In D.O.T., health-care workers
track down people with TB, and monitor them as they take their
medicine. Begun in Denver in 1967, D.O.T. has become the
principal strategy in the current fight against multiple drug-
resistant TB.
INTERVIEW WITH JOSE ZABALA:
He was a very non-compliant patient, but since I have him, he has
been very good. He likes to drink his medicine with Sustical,
which is a liquid food. I will come back on Wednesday to see him
again because he received twice, every two times in a week,
treatment. He is supervised every two times. Today was Monday
and I will come back on Wednesday to give him the other set of
medication. It's already prepared by the nurse, the public health
nurse from the health department. And they just come and look for
him and makes sure that he takes it. That's basically what I do.
INTERVIEW WITH JOHN SBARBARO:
You think older folks are wiser and take their meds. Older folks
are just as noncompliant as younger folks. You think the more
educated person is more complaint. Every study shows the more
educated person is just as noncompliant. In fact, docs don't take
their pills better than anybody else. Females always the more
reliable gender. Not when it comes to taking their pills. Just
as unreliable. Whether you are married, even religion. Your
choice of religion. Nothing makes a distinction. 35% of people
don't take their pills. That's 1 out of 3.
INTERVIEW WITH JIMMY HOPPER:
They claim that I was noncompliant taking the medicine. But see,
I was living on the street at the beginning and if you hide your
medicine somebody's gonna find it and they're gonna steal it
thinking they can sell it. So and the health department, you get
one dose of medicine, you know, one, you know, your regular
medicine once a month, if you lose if or something happens to it,
that's tough. You don't get no more.
INTERVIEW WITH LARRY GOSTIN:
Directly-observed therapy can be a very effective way to get a
handle on this epidemic. But the problem is we can't know who's
going to be recalcitrant and who's going to be cooperative and so
that the real difficult question is whether or not we're going to
force the entire population to go through some kind of directly
observed therapy. We couldn't decide that the poor person was
going to have DOT but the bank executive wasn't. And that's what
it would come to. And you go tell the bank executive that he's
got to show up at the public-health clinic downtown Mondays,
Wednesdays and Fridays for year and see how happy he is.
DOT VERITE HILLARY BROWN
Can I see the medicine? How many did you take? But when I get
back on here on Thursday, don't take it until I get here.
INTERVIEW WITH JOSE ZABALA:
Well I have a patient that I can never find and I've been looking
for him for about close to a year. Back and forth from his
address. When I talk to him he becomes very aggressive to me and
then after that he get lost.
INTERVIEW WITH RICHARD JAHN:
I would suppose and may a timber shake in my hand, I would suppose
that the only logical thing to do is to go back to the old
methods. They worked to some extent as I said before. They
worked, give them the pneumothorax, try bed rest, try phrenic
nerve, do the whole gamut. It's awful to think of. But what
choice do you have? We have virtually have no choice if you
really start to get a lot of this resistant type of TB, you're
dead in the water.
INTERVIEW WITH DENNIS WASHINGTON:
I got to get another operation. You see, I ain't got but one
lung. They took my left one already but then I find out I had a
spot about the size of a lemon on the right side but it ain't
going to be as serious as my first operation was so the first one,
it was ........... cause the doctor told me I might die, I might
be paralyzed, you know, somebody telling you all that before you
even get on the table, that's kind of a cold feeling for you know
so I though about that so, I just got the bible and started
praying and it came through alright. So, I got to go one more
time but they say its not as serious, the size of a lemon, you
know and they get that and I'll be through with it.
INTERVIEW WITH MICHAEL BRUCE:
This is one of the two patient wards in the hospital. This area
has been locked for about the last six months. One of the issues
in tuberculosis that we face here is that in our role to serve the
fifty most difficult cases of tuberculosis in the state of
Florida. We serve a number of people here who are committed by
court, under court order for treatment. The percentage has
increased systematically over the last couple of years. Used to
be 5-10% of the patients served by the hospital were court-
committed for treatment, that percentage is closely reaching 50%.
The patients who are here though often come from circumstances
where they would prefer not to be here and we had several
instances of people leaving the campus without medical advise or
eloping without permission. The consequence of that was that we
lost the hospital.
NARRATION:
In 1903, Hermann Biggs ordered the incarceration of willfully
careless patients in a place that was called "the consumptives'
prison." Eighty-eight years later, the same thing was happening
again: New York City detained 44 TB patients in hospitals. Soon
it began to happen all over the country. Incarceration -- the
forced confinement of people with tuberculosis -- has become the
second technique in the battle against TB.
INTERVIEW WITH IRMA WILLIAMS:
Well when the police came to pick, to give me a ride, they just
asked are you Irma Williams. We got a small town and I think the
police know practically, mostly all of us in that town. And I say
yes, I'm Irma Williams. I thought I was being arrested for
something. And then I say yes I am Irma Williams, they pulled the
mask out and had plastic gloves on and even hand cuffed me with
plastic handcuffs. They made me feel that I was very filthy and
nasty. They didn't even tell me where I was going'. They say you
come go with us. When he pulled that mask over his face, I knew
it was tuberculosis.
INTERVIEW WITH JOSEPH MCMAINS:
I didn't realize I didn't realize that the law had that much
weight, that they could just get you and detain you but they can.
I'm glad they can really but I hate to get cleared up and go back
on the street and catch it again.
INTERVIEW WITH GEORGE COMSTOCK:
People who deliberately or carelessly infect other people should
be treated like criminals in my opinion. You know, they're just
as dangerous as the guy who goes around shooting off a pistol
randomly. You know, sooner or later they're going to cause
somebody to die with their drug. Just like the guy shooting a
pistol randomly sooner or later it's going to kill somebody. And
I think we need to have facilities to put people in hospitals and
keep them their until their cured.
INTERVIEW WITH IRMA WILLIAMS:
I'm a mother of 8 kids and I'm scared, I was wondering would I be
able to kiss my kids again. Would they be able to want to come
around me, you know. It's just pitiful.
INTERVIEW WITH BARBARA ROSENKRANTZ:
It's important to recognize that the behavior may be dangerous but
it isn't criminal, those individuals who haven't taken their drugs
and who are a threat to society. I am disturbed I think, very
deeply disturbed when I read the reports of anguished physicians
and layman who identify the dangerousness of behavior and very
easily seem to slip into explaining criminality as though it were
something which these individuals had deliberately decided to do.
We have to control the behavior. There's no doubt about it. I
think that confinement and forced confinement is necessary when
nothing else can be done. But there are many steps before that.
INTERVIEW WITH MANNY BERNSTEIN:
I grew up in Saranac Lake. My father came here to cure and it
seemed very normal to me for people to be coughing, for people to
be in bed all the time and in robes. Ah, I don't think there was
any fear at all connected with it although from time to time there
was a double message because with some people who were sick you
really weren't supposed to get too close...] was teaching before I
discovered that the TB had flared up a little...I was not allowed
to see any of the children and yet I was perfectly safe and I knew
it and that I could cough right in their face... I couldn't
possibly have harmed anyone. But everybody was afraid. They were
probably equally afraid of TB as they are now of AIDS.
ORANGE COUNTY NEWS/DEBBIE FRENCH:
Continental Flight 1023, inside Debbie French and her mom and dad.
It was an emotional homecoming for the eighteen year old teenager.
French spent the last two months in a Denver hospital under the
care of tuberculosis specialists. Doctors there removed a portion
of her lungs at the last resort to cure a persistent strain of TB.
It's been a difficult year for French, who contracted TB during an
outbreak at Westminster's Laquinta High School last spring.
Debbie came down with a rare strain of TB that modern medicine
couldn't cure. Surgery was the last resort.
INTERVIEW WITH NANCY TOMES:
The antibiotic revolution was really stunning. So many advances
were made and drugs were made available. But it could not undo the
process of evolution. Microbes evolve, we evolve. What I see
happening now is a reawakening or a new appreciation of the
complexity of our relationship with the microbe and we are
relearning an awe for these micro organisms that our grandparents
and our great grandparents had.
INTERVIEW WITH JOSEPH MCMAINS:
My future prospects? It'll take a year I imagine to clear it up
completely in the lungs, where there's no tuberculosis at all.
I'm not contagious now, but they they still have to get me well
enough that I can go out on the street. It's kind of a long, uh,
extensive procedure to clear up tuberculosis. It takes a long
time.
INTERVIEW WITH MICHAEL ISEMAN:
World Bank has analyzed tuberculosis and said that good
tuberculosis control programs are perhaps the most cost effective
public health intervention in the world today. We have to get
that message out. Somewhere, we have to find the dollars and have
to start doing it right, or our legacy to the 21st century isn't
going to be that we were the generation of scientists that
discovered cures for tuberculosis, but we were the generation that
allowed that cure to be squandered with extraordinary adverse
implications for tuberculosis in the next century.
INTERVIEW WITH RONALD GOLDBERG:
I'm dying from tuberculosis. I've been told that by the doctors,
incurable.
INTERVIEW WITH DENNIS WASHINGTON:
My doctor said I can live a normal life if I get this out. If
not, I have to be in one of these places the rest of my life.
INTERVIEW WITH IRMA WASHINGTON:
I'm lucky they caught my tuberculosis in time, that it didn't eat
up my whole body up. I still have to face my friends and my
family when I go, because people, they're scared of you when you
got tuberculosis.
INTERVIEW WITH JIMMY HOPPER:
I had to come back in. I was gettin', I got so sick I had to come
back. I was beggin' 'em to bring me back. You will get sick
enough to where you got to do something.
INTERVIEW WITH JOSEPH MCMAINS:
I'm glad to get rid of the tuberculosis. I missed the operation
by just a fraction. Next time, I'd lose a lung.
INTERVIEW WITH DIANE FOSTER:
A great many of the patients know that they are leaving at a
particular month, they know that they've got two more months,
three more months, something like that. I'm I'm sure he's going
to let me know when I've got a couple of days coming. But to know
that it's going to be 6 months, 8 months, I couldn't face some
long-term thing like that. So I just have to go day by day, I
don't want to I don't want to think about next month, next year.
THE END