American Experience (1988) s27e06 Episode Script
The Forgotten Plague
1
(wind blowing loudly)
SHERWOOD DAVIES:
I can remember
exactly where I was
when my mother told me
my father had died.
We had snow.
I was sitting on a step,
trying to put on my boots.
She came over and said,
"Sherwood, your father died
last night."
She was very depressed.
And I felt concerned
for my mother
because what she had
gone through.
My mother's father
had tuberculosis
and he died
when she was one year old.
Her mother had tuberculosis
and was in and out of hospitals.
My mother
developed tuberculosis,
and, of course, my father
succumbed to tuberculosis.
And then I had developed
tuberculosis.
It's mind-boggling.
I mean, you think of
You worry about both your mother
and your father.
But then you say, "Well,
what's gonna happen to me?"
NARRATOR:
For centuries, people called it
the Captain of Death.
By the dawn of the 19th century,
the disease had killed
one in seven of all people
that had ever lived,
more than any other illness.
The ancient Greeks called it
"consumption."
NANCY TOMES:
The name "consumption"
came from the emaciation
as the fever built
and as the coughing continued
The sensation of essentially
coughing yourself to death.
ANDREA BARRETT:
The disease is what used to be
called "the wasting disease."
You just get thinner
and thinner.
And so if you look
at pictures of people
who are dying of the disease,
their cheekbones
are very prominent.
Their eyes seem very large
and hollow.
All the flesh has wasted off
their face and their throat.
NARRATOR:
Victims were racked
with hacking, bloody coughs,
debilitated by pain
in their lungs,
and so consumed with fatigue
they could barely
get out of bed.
The end could come quickly
or unfold slowly
over years of suffering.
There was no known cure.
In the early 1800s, consumption
struck America with a vengeance,
ravaging communities,
touching the lives
of almost every family.
SHEILA ROTHMAN:
No one was spared—
rich, poor, young, old
And no one knew
who was going to be attacked
and how long they would live.
Women who had children
understood that their children
might well become orphans,
and that they had to train them
how to behave
in other people's households.
There's a desperation
in the stories of,
"How can I be sure that
when I'm gone,
my children
will be taken care of?"
And a lot of talk about death.
And you had to train children
for dealing with death
and dealing with the death
of parents
and how to go on and manage.
NARRATOR:
Faced with a deadly
and painful disease,
tens of thousands of Americans
would journey
to far-flung parts
of the country
Some to the remote wilderness,
others to new cities
in the south and west
All in search
of an elusive cure.
(birds chirping)
In 1873, the Adirondack
Mountains in New York
was one of the most remote
regions in the country.
That June,
a 25-year-old physician
arrived from New York City
to spend his final days
in the woods and lakes
that he had loved as a child.
Edward Trudeau had just received
a crushing diagnosis.
MARY HOTALING:
The doctor tells him that
the upper third
of one of his lungs
is involved in an active
tuberculous process.
He just stutters his way
out the door
and stands on the stoop
and he says,
"The world had gone dark."
He just
he couldn't believe it.
NARRATOR:
Trudeau had no illusions
about the disease.
Seven years earlier,
it had claimed the life
of his older brother.
TOMES:
Trudeau marked
his brother's death
as one of the turning points
in his life.
At the time, he'd been
very close to his brother,
and that experience
of caring for him
in his final days
Imagine then his horror
when he finds out he himself
develops tuberculosis.
HOTALING:
He was sure he would die.
He expected to die,
and he couldn't believe that
this had happened to him.
NARRATOR:
Trudeau's doctor had told him
to spend what time he had left
in nature.
Physicians of the day
believed consumption,
as they called it,
was hereditary.
But they had started to notice
that fresh air
and outdoor living
could sometimes change
the course of the illness.
Though he could barely walk,
Trudeau pursued
his passion for hunting
by lying down in a canoe
padded with balsam branches.
"My hunting blood responded
at once," he recalled,
"and I forgot all the misery
and sickness
I had gone through."
By the end of the summer,
Trudeau had put on 15 pounds.
But as soon as he returned
to the city,
his health deteriorated.
Three years later,
nearing death,
Trudeau decided to move his wife
and two young children
to a small Adirondack outpost
called Saranac Lake,
one of the coldest places
in the country.
Even in the dead of winter,
Trudeau's health improved.
He was becoming convinced
the clean mountain air
was like medicine for the lungs.
"The open-air life,"
he declared,
"has a wonderful effect
upon my health."
TOMES:
Using climate
to treat consumption
goes all the way back
to Greek medicine.
In the 19th century, when they
started to get more scientific,
they also started to try
to break that down and think,
"Is it cold mountain air?
Is it warm, dry air that does
better for the consumptive?"
Some would say,
"Go to the mountains.
The air is good there."
Others would say,
"Go to the beach.
Sit in the sun."
In fact, physicians advocated
all of the above.
NARRATOR:
No region would hold
greater lure for consumptives
than the newly opened
territories
of the American West.
ROTHMAN:
The men who began
to explore the West
came back
with all sorts of stories:
that the West was Eden,
that the West was health-giving,
that people who were thin
went out there
and became healthy and strong.
And so you began to get
this image of the West
as a place to go
because you would get well.
"Come west and be cured.
Come west and get life."
It was a health-giving Eden,
this outdoors, beautiful,
unsettled part of the country.
NARRATOR:
Starting in the 1840s,
health seekers fanned out
across the vast plateau
between Mississippi
and California,
living rugged, primitive lives
in the wilderness.
Together with pioneers
and explorers,
they played an integral role
in settling the West.
TOMES:
Every western state,
you look at the history
of their larger cities
and you will find that
health seekers,
many of whom were consumptives,
were among the earliest
migrants
Young men with consumption,
who were moving to cities
like Denver or Los Angeles
in search of the cure,
chasing the cure.
NARRATOR:
In the 1870s,
railroad lines began to stretch
into the farthest reaches
of the country.
Jumping on the interest
in the climate cure,
developers launched
an unprecedented campaign
to entice people
with consumption
to settle in stops
along the newly laid tracks.
ROTHMAN:
There were railroad
advertisements all over,
where they would show a picture
of somebody thin and tubercular,
and say,
"Go West and have health."
And there were developers
that were building communities,
settlements,
where they said the air
was particularly wonderful,
and the climate
was particularly great,
and come here,
live in our community,
and you will be cured.
TOMES:
There was no nothing
that was too excessive to say.
You didn't worry about
over-selling the goods.
Los Angeles is the healthiest
place in the world?
Sure.
Who's gonna argue?
Well, maybe Denver.
But they're not around, so you
could get away with it then.
NARRATOR:
Tens of thousands
of health seekers migrated west.
Dozens of new cities sprang up
to accommodate the influx:
places like Albuquerque,
Colorado Springs, and Tucson.
The city of Pasadena
started as a colony
for consumptives from Indiana.
Some got better, but many were
buried in newly dug cemeteries.
Promoters had given
little thought
to what would happen
to their communities
if climate was not a cure-all.
In the Adirondacks,
Edward Trudeau
had started practicing again,
gaining fame as the doctor
who saw patients
in his hunting clothes.
But he suffered one relapse
after another,
each bringing with it the memory
of his brother's death.
TOMES:
There was the so-called
galloping consumption
where it would go
into the blood stream
and you would die very,
very quickly.
But in other cases,
it was a long, slow,
and agonizing death.
And no one quite knew why or
what made a difference to that.
But for the most part,
consumption was a disease
that could last
for ten, 20, 30 years.
NARRATOR:
More and more, Trudeau
was becoming preoccupied
with finding a cure
for consumption,
combing medical journals
for the latest information
on the illness.
He stumbled
on a startling revelation
in an obscure article
written by a German scientist.
TOMES:
And he reads a copy
of Robert Koch's paper,
and it is like a religious
experience for him.
You know, "My eyes were opened.
I could hardly believe
what I was reading."
It was transformative.
NARRATOR:
Robert Koch was one of a handful
of European scientists
promoting a radical new idea
that germs cause disease.
Most doctors believed sickness
was caused by disturbances
in bodily fluids,
or from toxic gases or filth,
or was inherited.
In a complete departure,
Koch announced that
he had found a bacterium,
the tubercle bacillus, that
he claimed caused tuberculosis.
He explained that
when he injected the bacteria
into a healthy animal,
it rapidly developed
the disease.
ANDREA COOPER:
And what Koch did,
and this is the basis
of modern science,
is that he took bacteria,
he grew it to purity,
and then he delivered it
and caused disease,
and this was the key point.
You could isolate the bacterium
from the infected person,
you could grow it in isolation,
and then it would cause disease
when it was transmitted again.
NARRATOR:
Koch also described
how the bacteria spread.
The germs, he said,
were expelled through coughing.
Someone close by could inhale
the airborne bacteria
into their lungs,
where it lodged
and caused disease.
There was no doubt, he declared,
that the disease
was highly contagious.
His findings were so outside
mainstream thinking,
the medical profession
simply ignored them.
The idea of tuberculosis
being communicable
was so hard to fit
with medical tradition.
And a lot of the resistance
really came out of people
who had been looking
and thinking for a long time.
It just didn't make sense
to them.
NARRATOR:
Trudeau, on the other hand,
believed he was witnessing
the dawn of a new era
in medicine
and set out to learn how to grow
the bacteria himself.
HOTALING:
He was an intuitive scientist.
He was not a trained scientist
at all.
When he went to medical school,
they didn't have a lab.
He never learned how to use
a microscope.
So, you know, this was
a new territory for him.
NARRATOR:
Trudeau set up
a rudimentary laboratory
in his house in Saranac Lake.
Months went by as he struggled
to replicate Koch's experiments.
COOPER:
He has no running water
in his house,
he has no electricity,
of course,
and he had to create his own
thermometer, his own incubator,
and he would have doors
that he would open and close
depending on what
the temperature was
on his homemade thermometer.
And he was trying to maintain
a 37-degree centigrade
environment
for the bacteria to grow.
So he did that,
and he had little candles
underneath his incubator
warming it up, and opening
the doors and closing the doors,
and he was doing this constantly
for three weeks
to grow the bacteria.
He's all alone.
He has no faculty,
he has no help.
You know,
he's doing it by himself
just out of his own
intellectual curiosity.
NARRATOR:
After countless attempts,
in 1884, Trudeau became
the first American
to verify Koch's discovery.
TOMES:
He takes a sample
from his own throat,
develops a culture of it,
and he can see
he himself is carrying
this rod-shaped bacillus
that Koch has described.
So imagine, he was able
to test the hypothesis
and to show that indeed,
there it was.
NARRATOR:
Far away from the power centers
of medicine,
Trudeau's work went
largely unrecognized.
For the next decade,
Americans continued
to go about their lives,
unaware of the contagion
in their midst.
NARRATOR:
In 1886, a young writer
with consumption
arrived at the Los Angeles
Railroad Station,
where many newcomers
were greeted by a 30-piece band.
Charles Willard was hoping
to get well enough
to restart his career.
Los Angeles was hardly more
than a sleepy pueblo town,
its streets still unpaved.
Yet civic leaders
had grand visions for the city
and eagerly hawked
the dry, temperate climate
to East Coast invalids.
After working a few odd jobs,
Willard landed a position at the
Los Angeles Chamber of Commerce,
where he was put in charge
of luring health seekers
to California.
So here's the irony:
he himself is still very sick,
but there he is, promoting
the idea of the climate cure
when he has not been cured
by it.
NARRATOR:
Willard started a journal
called The Land of Sunshine
and filled it with testimonials
to the healing powers
of Southern California.
He targeted the publication
to East Coast readers,
especially those with money.
TOMES:
Charles Willard
did not want to attract
the wrong kind of sick people
to Los Angeles
People who were not educated,
people who were not
White Anglo-Saxon Protestants.
So there was a real
double message there.
"Yes, come if you're like me,
but don't come if you're not."
NARRATOR:
The fine points
of Willard's message
would quickly get lost
in the stampede.
Thousands of people
with consumption
swarmed into the city.
A metropolis
priding itself on health
soon contained a huge population
of sick and dying people.
One resident described
the sounds of the city
as "a constant chorus
of coughs."
TOMES:
Try to imagine L.A.
as a city of invalids.
It really is hard to imagine.
But indeed, that was the effect
of this kind of boosterism.
And when too many of them came,
it got to be
another kind of problem.
Charles Willard
succeeded too well.
NARRATOR:
Los Angeles was not unique.
Across the West, other cities
were also paying a price
for their recruiting success.
ROTHMAN:
And suddenly these cities
that saw themselves catering
to middle-class
and upper-class people
had a large number
of poor, sick people
all over in their midst,
and they were unable
to care for them.
And they didn't have
the resources
to care for them, either.
NARRATOR:
In Saranac Lake, Edward Trudeau
had watched with alarm
as the science of contagion
continued to go unheeded.
Along with other scientists,
he started publishing papers
and attending
medical conferences
to explain the body of evidence.
Finally, by the mid-1890s,
the medical
community was persuaded.
The term "consumption"
was dropped in favor of the name
that linked it to the bacteria:
tuberculosis, or TB.
Within a decade,
Robert Koch would go on
to win the Nobel Prize.
For patients, the new
understanding of the disease
would only add to the suffering.
TOMES:
The sad aspect
of this scientific progress
is that it made the person
with tuberculosis
into more of a threat.
When you thought consumption
ran in families,
you couldn't do anything
about it.
If you got it,
you were not to be blamed.
Now the individual with
tuberculosis was the danger.
The more focus there was on
person-to-person transmission,
the more that stigma,
that prejudice, intensified.
BARRETT:
The idea that although outwardly
you may look like a healthy,
beautiful, 22-year-old woman,
you are in fact vile
in some way, contaminated.
You know that something awful
is happening in your body,
and everything around you
is sending a signal
that you are disgusting
in some way,
that you have to be separated
from healthy people.
That seems like
the most astonishing
psychological burden.
NARRATOR:
Across the West,
communities that had once lured
health seekers
now scrambled to keep them out.
Several Western states
sought to enact laws
to stop people with coughs
from crossing their borders.
Others looked for ways to remove
them from populated areas.
ROTHMAN:
They often set up tent cities
on the edge of town.
So the sheriff would take them,
drop them off in this tent city,
and most people were kind of
having to fend for themselves,
and other people
who had tuberculosis
who weren't so sick
would help them,
and some charitable people
would bring food and so on,
but they were isolated
and indigent
and really, really unwelcome.
NARRATOR:
Even Charles Willard
was not immune.
When his symptoms
became impossible to hide,
he also became a target.
After his home accidentally
burned to the ground,
no one would rent him
a place to live.
In cities across the country,
public officials began to call
for government intervention.
Health departments
primarily concerned
with preventing diseases
carried in the water supply
now had to confront
a deadly illness
spread through the most casual
of contact.
TOMES:
Public health officials
felt they had to conduct
a massive national campaign
to bring the news to everyone
in the United States.
In fact, it's the first
mass public health campaign
in American history.
There's nothing like it before.
The campaign to teach
every single American
that they needed to be careful
about how they coughed
and sneezed
because you could never tell
who was sick and who wasn't.
ROTHMAN:
And they pass
these brochures out
so that people could understand
that spitting
could spread the disease.
Coughing without a handkerchief
could spread the disease.
They promoted the use
of Kleenex.
I mean, this is how Kleenex
came about.
Women's hemlines start to go up
after 1900.
It was so you could get
your skirts out of the dirt
and not carry home
a load of germs into your house.
Men's style
of wearing beards changed.
The anti-TB handouts would say,
"Get rid of your whiskers,"
because you don't want to kiss
the baby or kiss your wife
and give them tuberculosis
with your beard germs.
NARRATOR:
Crowded neighborhoods
transformed
as parks and playgrounds were
built to provide urban dwellers
with islands of fresh air.
New Yorkers began to call
Central Park
"the lungs of the city."
By the early decades
of the 20th century,
improved hygiene
started bringing
the overall cases of TB down.
But in poor,
crowded neighborhoods,
the figures continued to climb.
In some cities,
immigrants were twice as likely
to die of the disease
than their more affluent
neighbors.
For African Americans,
the death rate
was three to four times higher.
ROTHMAN:
And suddenly you have
a new understanding
of why it is a disease
of the poor and the immigrant.
They are living in places
without ventilation.
They are working together
in crowded sweatshops.
So it kind of feeds on itself:
a new understanding
of the disease,
and the whole beginnings
of policies
to try to lessen the impact
and reduce the spread
of the disease.
NARRATOR:
Public health officials
began to call
for improving the lives
of the poorest Americans:
better housing
and working conditions,
reduced working hours
and child labor laws.
Yet the anti-TB campaign
gave government officials
unprecedented power
to police the sick.
Health inspectors
were instructed
to monitor people's movements,
inspect their homes
or commit them to ill-equipped
public institutions,
often against their will.
TOMES:
The pressure
from public health officials
to segregate the very sick
fell most heavily
on working class,
poor Americans,
immigrant Americans.
They did not go knocking
on doors on 5th Avenue asking,
"Do you have any consumptives
in the house?"
There was a sense
if you were wealthy,
you were going to be allowed
to manage your illness
however you wanted to.
It was the poorer people
who really felt the pressure
from public health officials
to make their sick relatives
leave the home
and go into one of these
institutional facilities.
NARRATOR:
"Sanitary measures
are sometimes autocratic,"
declared a prominent
health official.
"We are prepared
to enforce measures
"which might seem radical
if they were not designed
for the public good."
TOMES:
It's an area of public health
practice where increasingly,
the need of the community
to be protected from the illness
starts to trump the individual
rights of the patient.
When people say,
"I don't want to be taken away,"
their right to resist that
is overridden
in the name of public health.
BARRETT:
How do we ever live
with a contagion in our midst?
Someone is sick among us,
that person needs care and help,
that person is also contagious
and can give us what they have.
What is the balance between
taking care of the community
and taking care of the person?
That question's always with us,
and it almost never has
a good answer.
NARRATOR:
With each passing year,
hundreds of thousands
of Americans with tuberculosis
scrambled to find medical care.
Hospitals were overwhelmed.
To cope with the flood
of patients,
New York City's
Bellevue Hospital
transformed ferry barges
into makeshift wards.
BARRETT:
There was no room to put people
who had tuberculosis.
So this was one way to
separate out contagious people,
was to take all the consumptives
from a local neighborhood
and put them
onto these day camps,
and they'd spend the whole day
on their little chairs
in the barge
moored on the river.
It was just a way of keeping
them out of their rooms
and their rooming houses
and out of their workplaces.
Some of the hospitals
would only take people
who were in their first attack
because they didn't want
to take people who were dying.
They weren't in the business
of caring for the dying.
So sometimes you had
to change your name,
pretend you were
someone different,
go to a different hospital.
It became a game of trying
to figure out how to survive
and how to make it when
you really had no resources.
NARRATOR:
Years earlier,
Edward Trudeau told friends
that he wished more people could
find relief,
as he had done,
in the cool, fresh climate
of the Adirondacks.
He had begun reading
about European sanatoriums
Facilities built
in the countryside
that provided long-term care
for TB patients.
COOPER:
Edward Trudeau was familiar
with the treatments
that were occurring in Europe
at the time,
and there was a growing idea
that one should take people
who have tuberculosis
and take them
into an environment
that was perhaps different from
the environment they were in.
And one of the ideas
that they had
was that they would go out
into the country.
They would be resting,
they would be given good food,
and they would be exposed
to the sunlight.
So the idea of the sanatorium
was to create a place
where people
who had been infected
could rally their body's
healing forces to throw it off.
We, today, talk about
the immune system.
They didn't use that language,
but it's clearly the phenomena
that they were describing.
NARRATOR:
Trudeau was determined to build
the first tuberculosis
sanatorium in the United States.
He had grown friendly
with wealthy TB patients
from the city
and now urged them
to open their wallets
to help create
a treatment facility
for people of modest means.
HOTALING:
The people who came originally
were wealthy patients.
They were the people who could
afford to take a difficult trip
through the wilderness
to get here,
and then they could hire
a place to stay, in a hotel,
or rent a house
or build a house,
but Trudeau felt that
there ought to be a place
for people
who were not so well off.
That's why he founded
the sanatorium.
NARRATOR:
By 1900, Trudeau's sanatorium
would grow
into a sprawling campus
of 22 buildings,
including a church
and a research laboratory.
News of its success
spread so quickly,
medical professionals
flocked to Saranac Lake
to see it for themselves.
Trudeau ignited a movement.
Over the next decade, hundreds
of sanatoriums would spring up
in every part of the country,
many of them set up
by charity or religious groups.
State governments
opened huge complexes for people
who couldn't afford care
in private institutions.
Many facilities
were segregated by race.
African Americans barred
from white-only sanatoriums
helped start their own.
In the first decades
of the 20th century,
one out of every 170 Americans
lived in a sanatorium,
some for many years.
It was a life of exile.
WHITNEY SEYMOUR, JR.:
I began to realize that
I was getting extremely tired
and then started
coughing up phlegm.
And so I made an appointment
to go see the family doctor.
And he saw the tubular bacilli
right away
and he said, "Young man,
you have tuberculosis,
and you gotta go to Trudeau."
He didn't fool around, saying,
"You can think about it."
He was very adamant.
And all of a sudden,
it was all over
and I was now suddenly
being told to,
"Get yourself on a train
and get up to the mountains
"and start curing.
You're a very sick young man."
ROTHMAN:
People often left
in the middle of the night.
They left
without telling people.
They just quit their jobs
or they just left.
Sometimes they were trying
to protect their families,
and sometimes the families were
trying to protect themselves.
NARRATOR:
For some, the sanatorium
held the promise of cure.
For others,
it was the place to go to die.
The white-coated doctors
coming in and looking down,
saying, "Mm-hmm, uh-huh,"
and walking out.
And so I would figure these guys
were measuring me for a coffin.
I was left there
in a hospital bed
and I really was overwhelmed
by a sense of despair.
I really thought that
I was about to die.
The hardest time was accepting
that I was there
and maintaining hope
that I would get better
and being optimistic.
So it was a separation
from your usual life
that really was
very hard to take.
You were really
basically lonely.
JOANNE CURTIS:
They never told me how long
I would be at the hospital,
and I never asked.
Don't ask me why.
I never cried, I never asked.
I just took one day at a time,
kept my sense of humor,
and that was it.
That was my armament,
that was it.
NARRATOR:
Entering a sanatorium
required complete submission.
Physicians and nurses regulated
every moment of the day,
measuring patients' progress
towards health
by testing for bacteria
in their phlegm
and x-raying their chests.
Trudeau believed TB patients
needed to be well fed
and insisted they consume
at least six glasses of milk
and six raw eggs a day.
And he ordered them to rest.
BARRETT:
When people first came
to a sanatorium,
many were put on 24-hour rest.
They were put directly to bed.
They stayed there.
All their meals
were brought to bed on trays.
They were not allowed to even
get out to go to the bathroom.
They had bedpans.
CURTIS:
Class One was bed rest.
Class Two,
bathroom privileges only.
Three,
I could walk around a lot.
By the time I got to Two,
I was restless.
I got yelled at by my doctor
because I would be ripping
up and down the hallway,
and he said, "Young lady,
aren't you in Class Two?
You're supposed to just have
bathroom privileges."
And I said,
"Oh, I didn't know that."
He said, "Yes, you did.
Go back to your bed."
So that's yes, I did.
NARRATOR:
For Trudeau,
where his patients rested
was as significant as how long.
He was convinced that fresh air
was the single most important
treatment for a diseased lung.
He instructed his patients
to lie outdoors
on reclining chairs,
day and night,
regardless of the weather.
SHERWOOD DAVIES:
I'd sleep at night on the porch,
get fresh air.
(laughing)
That's what they called it.
When it was ten below,
it was a little more
than fresh air.
Damn cold weather.
But I would have
an electric blanket
and I'd have about four or five
other blankets
over the electric blanket,
and then a rubber sheet
over that,
and then a wool cap
over my ears.
SEYMOUR:
The cure cottage
that I was assigned to
was not an outdoor cure cottage,
but glassed in.
That is,
I slept outside the building,
but you could see nature
all around you.
And the thing
that I still remember
was the sunlight
bouncing off Mount Marcy
and then streaming in
through these windows
and making it just very cheerful
and hopeful
and make you begin to think,
"Gee, it'd be nice
to be out there."
NARRATOR:
With no treatment available
other than rest and fresh air,
tuberculosis sufferers
everywhere
strived to imitate
Trudeau's method.
Across the country, people
added porches to their homes.
When that wasn't possible,
they simply made do.
BARRETT:
There were tents on the roofs
of some tenement buildings
all over Brooklyn,
a cure chair inside,
and someone wrapped
in all their hats and clothes.
And then there were also tents
that could be inserted
into a window
so that if you were
in your apartment house,
your legs would be
inside the house
and the white tent
would stick out the window,
and somehow the fresh air
was supposed to come into you,
just from your head
sticking out the window.
NARRATOR:
For all they surrendered
when they entered
the sanatorium,
patients also found
a certain freedom.
Unburdened from the fear
of infecting others,
they sought comfort
in each other's company.
ROTHMAN:
In these situations, there was
a great deal of gossip.
Everybody gossiped
about everybody else:
who's talking to who,
who's trying to run away
and drink,
who left, and also, who died.
BARRETT:
Even if you're out on the porch
and it's a sunny day
and you're having conversation
with a friend
or flirting with someone,
just a few beds
or a few rooms away,
someone else
is coughing horribly
or having a horrible hemorrhage
that's being cleaned up
within your sight,
or a body's being taken down
the corridor on a gurney.
I think the presence of death
had to be with you
virtually every minute
of every day.
DAVIES:
I remember two young ladies,
very personable,
and I was in my teenagers
and these were attractive
young girls,
and I got to know them
Ruth Templeton
and Mary Patterson.
And within four to six months
of their arrival,
both of them had died, which
It troubled me no end.
Two young ladies like that
that developed the disease.
I still remember their names
to this day.
It's
It was very unfortunate.
NARRATOR:
Trudeau's own studies revealed
that only a third
of his patients got well.
He stood at the bedside
of hundreds of dying patients,
but the hardest death to bear
was that of his own daughter.
Charlotte Trudeau died of
tuberculosis at the age of 16.
The doctor was rarely free
of symptoms himself,
frequently having to stop work
to take the rest cure.
When Edward Trudeau died in 1915
after a 40-year struggle
with tuberculosis,
a miracle cure
was still a dream.
NEWSREEL ANNOUNCER:
Through mass production methods,
America is continually
increasing
its output of penicillin,
the new drug that effects
almost miraculous cures.
The liquid charged
with penicillin
is poured from the bottles.
Turned into a powder,
it is ready for use.
NARRATOR:
In the early 1940s,
the discovery of penicillin
revolutionized the treatment
of infectious diseases.
Derived from a mold,
this first antibiotic
cured a host of infections,
but not tuberculosis.
A microbiologist
at Rutgers University
believed he knew where to look
for an antibiotic that would,
literally beneath people's feet.
Selman Waksman was one
of the few people in the country
who understood
the true nature of soil.
Early in his career,
he had written a definitive work
on the microscopic organisms
that live in the ground,
describing the earth
in an ordinary garden
as a killing field
where warrior microbes
fight each other for supremacy.
His previous work pointed
to the Streptomyces:
strange organisms,
half bacteria and half fungi,
responsible for the sweet odor
of earth after a light rain.
But there are
over 500 different species.
Finding one that could kill
harmful bacteria
without toxic side effects
would prove to be
extraordinarily difficult.
And it was unbelievably
time consuming
and, if you like, boring,
and you could look all day long
and see absolutely
nothing happening
through your microscope.
So you go
to a different soil patch,
maybe you go closer
to the horse's stables
because the bacteria
that you really want
are those which feed
on horse dung
rather than dried leaves.
So it's a huge
hit-and-miss affair.
NARRATOR:
In late summer 1943,
Waksman assigned the research
project to Albert Schatz,
an energetic 23-year-old
graduate student.
The hunt for antibiotics
captured Schatz's imagination.
He would often spend
18 hours a day
peering into his microscope,
looking for the telltale sign
of an antibiotic.
In what was known
as "the streak test,"
Schatz placed common bacteria
in a Petri dish,
swiping a strain of Streptomyces
down the middle.
If the strain
were potent enough,
it would create a dead zone
around it.
PRINGLE:
It's a battlefield,
and the clear zone
gets bigger and bigger,
and eventually,
you're watching it destroy
your harmful bacteria
and you say, "Whoopee,
I've got something!"
NARRATOR:
Three months in,
Schatz stumbled on a variety
that appeared quite powerful.
On October 19,
he sealed a test tube
containing the promising batch
and gave it to his mother
as a memento of his achievement.
Schatz was eager to test the new
antibiotic against tuberculosis,
even given the risk.
VIVIAN SCHATZ:
That laboratory was not set up
for a dangerous germ
like tuberculosis.
So there were a couple
of basement windows
and some stools to sit on,
and that was it.
It was very sparse,
and not what you would expect
where people would be working
with a very virulent organism.
PRINGLE:
And the equipment
is very primitive.
It's not exactly clean.
There was none of the stuff
that you see today
of, you know, enclosed labs
where people are manipulating
their Petri dishes
with mechanical arms.
It was nothing like that.
NARRATOR:
Schatz talked Waksman
into letting him proceed.
VIVIAN SCHATZ:
He slept in the laboratory
because he had to add fluid
to the glass containers
that were being distilled,
and when the liquid
in a container
got to a certain level,
he had to add more liquid.
So it was very, very tiring,
hard work.
NARRATOR:
Within weeks,
Schatz would witness
one of the most dramatic events
ever seen under a microscope:
the destruction
of the tubercle bacillus.
Waksman and Schatz named
the antibiotic "streptomycin."
The following spring, Waksman
sent the drug to the Mayo Clinic
for testing with patients.
Starting in November of 1944,
researchers gave five courses
of streptomycin
to a 21-year-old woman
dying of tuberculosis.
Within days, the infection
in her lungs began to disappear.
A few months later, she was
discharged from the hospital.
So with streptomycin,
for the first time
in human history,
there's a magic bullet.
There's a drug
you can give to people
that is going to make
the majority of them
far, far better.
You can cure tuberculosis.
ROTHMAN:
I mean, it was unbelievable.
A disease that had plagued
humanity for 3,000 years
was suddenly able to be cured.
DAVIES:
The medical director
assembled all the patients
and all the staff
and announced this drug
that they had just discovered.
And what a reaction
from the patients there that
I mean, you could see the smiles
on their face.
Well, it
it was indescribable.
NARRATOR:
The euphoria would not last.
Within months of treatment,
many patients began to relapse.
Scientists would come
to understand that streptomycin
does not destroy
all the bacteria in the body,
and the organisms
that do survive
grow stronger and more resistant
to the drug.
Suddenly, the drug
was not being effective
when it had been so effective
so quickly.
And so they understood
very rapidly that it was
the resistance was occurring.
And so they needed to develop
further drugs.
NARRATOR:
By the late 1940s,
two additional drugs were added
to streptomycin.
The drug cocktail,
properly administered,
was far more effective.
COOPER:
And with tuberculosis,
it's clear.
You need a combination of drugs.
So the bacteria has to combat
two or three attacks at once
rather than the simple
one attack.
It can cope with one,
it can't cope with two,
and it can cope even less well
with three.
And then when we take
the antibiotics,
we need to take them
consistently, correctly,
not overdo it
and not underdo it,
because then you will facilitate
the development
of drug resistance.
NARRATOR:
Before antibiotics, half
of all people with active TB
could expect to die
within five years.
By 1950, most were getting well
and going on to live normal,
healthy lives.
As cures mounted,
the sanatoriums began to close.
Many were demolished.
A few became ski resorts
or hotels.
SEYMOUR:
Almost from the very beginning,
when I was in the infirmary,
these young doctors
came by and say,
"We're going to experiment
with these new drugs."
And so it was then quite obvious
that Trudeau was going to close
in a few weeks.
And we're instructed
to go find apartments in town
so we could continue
to get well.
And all of a sudden,
I realized I can overcome it
and live a long, healthy,
hardworking life.
DAVIES:
I had looked back at the
family's history of tuberculosis
and said how lucky I was.
And when they said I was
essentially cured, I was elated.
I wasn't thinking so much
of a big relief on my part
but what my mother
had gone through,
because here she was,
she had dealt with her mother,
she had dealt with my father,
and now she had to deal with me.
I think the proudest thing
in her life
was when she came
to my college graduation.
(voice breaking):
And
she
Her life was fulfilled.
NARRATOR:
In November 1954,
a former professional baseball
player named Larry Doyle
ate his last meal
at the head of a long table
at the Trudeau Sanatorium.
He had been a patient
for 12 years.
After lunch, he walked out
the front door
and strolled through the snowy
streets of Saranac Lake.
He was the last tuberculosis
patient to leave Trudeau.
Captioned by
access.wgbh.org
(wind blowing loudly)
SHERWOOD DAVIES:
I can remember
exactly where I was
when my mother told me
my father had died.
We had snow.
I was sitting on a step,
trying to put on my boots.
She came over and said,
"Sherwood, your father died
last night."
She was very depressed.
And I felt concerned
for my mother
because what she had
gone through.
My mother's father
had tuberculosis
and he died
when she was one year old.
Her mother had tuberculosis
and was in and out of hospitals.
My mother
developed tuberculosis,
and, of course, my father
succumbed to tuberculosis.
And then I had developed
tuberculosis.
It's mind-boggling.
I mean, you think of
You worry about both your mother
and your father.
But then you say, "Well,
what's gonna happen to me?"
NARRATOR:
For centuries, people called it
the Captain of Death.
By the dawn of the 19th century,
the disease had killed
one in seven of all people
that had ever lived,
more than any other illness.
The ancient Greeks called it
"consumption."
NANCY TOMES:
The name "consumption"
came from the emaciation
as the fever built
and as the coughing continued
The sensation of essentially
coughing yourself to death.
ANDREA BARRETT:
The disease is what used to be
called "the wasting disease."
You just get thinner
and thinner.
And so if you look
at pictures of people
who are dying of the disease,
their cheekbones
are very prominent.
Their eyes seem very large
and hollow.
All the flesh has wasted off
their face and their throat.
NARRATOR:
Victims were racked
with hacking, bloody coughs,
debilitated by pain
in their lungs,
and so consumed with fatigue
they could barely
get out of bed.
The end could come quickly
or unfold slowly
over years of suffering.
There was no known cure.
In the early 1800s, consumption
struck America with a vengeance,
ravaging communities,
touching the lives
of almost every family.
SHEILA ROTHMAN:
No one was spared—
rich, poor, young, old
And no one knew
who was going to be attacked
and how long they would live.
Women who had children
understood that their children
might well become orphans,
and that they had to train them
how to behave
in other people's households.
There's a desperation
in the stories of,
"How can I be sure that
when I'm gone,
my children
will be taken care of?"
And a lot of talk about death.
And you had to train children
for dealing with death
and dealing with the death
of parents
and how to go on and manage.
NARRATOR:
Faced with a deadly
and painful disease,
tens of thousands of Americans
would journey
to far-flung parts
of the country
Some to the remote wilderness,
others to new cities
in the south and west
All in search
of an elusive cure.
(birds chirping)
In 1873, the Adirondack
Mountains in New York
was one of the most remote
regions in the country.
That June,
a 25-year-old physician
arrived from New York City
to spend his final days
in the woods and lakes
that he had loved as a child.
Edward Trudeau had just received
a crushing diagnosis.
MARY HOTALING:
The doctor tells him that
the upper third
of one of his lungs
is involved in an active
tuberculous process.
He just stutters his way
out the door
and stands on the stoop
and he says,
"The world had gone dark."
He just
he couldn't believe it.
NARRATOR:
Trudeau had no illusions
about the disease.
Seven years earlier,
it had claimed the life
of his older brother.
TOMES:
Trudeau marked
his brother's death
as one of the turning points
in his life.
At the time, he'd been
very close to his brother,
and that experience
of caring for him
in his final days
Imagine then his horror
when he finds out he himself
develops tuberculosis.
HOTALING:
He was sure he would die.
He expected to die,
and he couldn't believe that
this had happened to him.
NARRATOR:
Trudeau's doctor had told him
to spend what time he had left
in nature.
Physicians of the day
believed consumption,
as they called it,
was hereditary.
But they had started to notice
that fresh air
and outdoor living
could sometimes change
the course of the illness.
Though he could barely walk,
Trudeau pursued
his passion for hunting
by lying down in a canoe
padded with balsam branches.
"My hunting blood responded
at once," he recalled,
"and I forgot all the misery
and sickness
I had gone through."
By the end of the summer,
Trudeau had put on 15 pounds.
But as soon as he returned
to the city,
his health deteriorated.
Three years later,
nearing death,
Trudeau decided to move his wife
and two young children
to a small Adirondack outpost
called Saranac Lake,
one of the coldest places
in the country.
Even in the dead of winter,
Trudeau's health improved.
He was becoming convinced
the clean mountain air
was like medicine for the lungs.
"The open-air life,"
he declared,
"has a wonderful effect
upon my health."
TOMES:
Using climate
to treat consumption
goes all the way back
to Greek medicine.
In the 19th century, when they
started to get more scientific,
they also started to try
to break that down and think,
"Is it cold mountain air?
Is it warm, dry air that does
better for the consumptive?"
Some would say,
"Go to the mountains.
The air is good there."
Others would say,
"Go to the beach.
Sit in the sun."
In fact, physicians advocated
all of the above.
NARRATOR:
No region would hold
greater lure for consumptives
than the newly opened
territories
of the American West.
ROTHMAN:
The men who began
to explore the West
came back
with all sorts of stories:
that the West was Eden,
that the West was health-giving,
that people who were thin
went out there
and became healthy and strong.
And so you began to get
this image of the West
as a place to go
because you would get well.
"Come west and be cured.
Come west and get life."
It was a health-giving Eden,
this outdoors, beautiful,
unsettled part of the country.
NARRATOR:
Starting in the 1840s,
health seekers fanned out
across the vast plateau
between Mississippi
and California,
living rugged, primitive lives
in the wilderness.
Together with pioneers
and explorers,
they played an integral role
in settling the West.
TOMES:
Every western state,
you look at the history
of their larger cities
and you will find that
health seekers,
many of whom were consumptives,
were among the earliest
migrants
Young men with consumption,
who were moving to cities
like Denver or Los Angeles
in search of the cure,
chasing the cure.
NARRATOR:
In the 1870s,
railroad lines began to stretch
into the farthest reaches
of the country.
Jumping on the interest
in the climate cure,
developers launched
an unprecedented campaign
to entice people
with consumption
to settle in stops
along the newly laid tracks.
ROTHMAN:
There were railroad
advertisements all over,
where they would show a picture
of somebody thin and tubercular,
and say,
"Go West and have health."
And there were developers
that were building communities,
settlements,
where they said the air
was particularly wonderful,
and the climate
was particularly great,
and come here,
live in our community,
and you will be cured.
TOMES:
There was no nothing
that was too excessive to say.
You didn't worry about
over-selling the goods.
Los Angeles is the healthiest
place in the world?
Sure.
Who's gonna argue?
Well, maybe Denver.
But they're not around, so you
could get away with it then.
NARRATOR:
Tens of thousands
of health seekers migrated west.
Dozens of new cities sprang up
to accommodate the influx:
places like Albuquerque,
Colorado Springs, and Tucson.
The city of Pasadena
started as a colony
for consumptives from Indiana.
Some got better, but many were
buried in newly dug cemeteries.
Promoters had given
little thought
to what would happen
to their communities
if climate was not a cure-all.
In the Adirondacks,
Edward Trudeau
had started practicing again,
gaining fame as the doctor
who saw patients
in his hunting clothes.
But he suffered one relapse
after another,
each bringing with it the memory
of his brother's death.
TOMES:
There was the so-called
galloping consumption
where it would go
into the blood stream
and you would die very,
very quickly.
But in other cases,
it was a long, slow,
and agonizing death.
And no one quite knew why or
what made a difference to that.
But for the most part,
consumption was a disease
that could last
for ten, 20, 30 years.
NARRATOR:
More and more, Trudeau
was becoming preoccupied
with finding a cure
for consumption,
combing medical journals
for the latest information
on the illness.
He stumbled
on a startling revelation
in an obscure article
written by a German scientist.
TOMES:
And he reads a copy
of Robert Koch's paper,
and it is like a religious
experience for him.
You know, "My eyes were opened.
I could hardly believe
what I was reading."
It was transformative.
NARRATOR:
Robert Koch was one of a handful
of European scientists
promoting a radical new idea
that germs cause disease.
Most doctors believed sickness
was caused by disturbances
in bodily fluids,
or from toxic gases or filth,
or was inherited.
In a complete departure,
Koch announced that
he had found a bacterium,
the tubercle bacillus, that
he claimed caused tuberculosis.
He explained that
when he injected the bacteria
into a healthy animal,
it rapidly developed
the disease.
ANDREA COOPER:
And what Koch did,
and this is the basis
of modern science,
is that he took bacteria,
he grew it to purity,
and then he delivered it
and caused disease,
and this was the key point.
You could isolate the bacterium
from the infected person,
you could grow it in isolation,
and then it would cause disease
when it was transmitted again.
NARRATOR:
Koch also described
how the bacteria spread.
The germs, he said,
were expelled through coughing.
Someone close by could inhale
the airborne bacteria
into their lungs,
where it lodged
and caused disease.
There was no doubt, he declared,
that the disease
was highly contagious.
His findings were so outside
mainstream thinking,
the medical profession
simply ignored them.
The idea of tuberculosis
being communicable
was so hard to fit
with medical tradition.
And a lot of the resistance
really came out of people
who had been looking
and thinking for a long time.
It just didn't make sense
to them.
NARRATOR:
Trudeau, on the other hand,
believed he was witnessing
the dawn of a new era
in medicine
and set out to learn how to grow
the bacteria himself.
HOTALING:
He was an intuitive scientist.
He was not a trained scientist
at all.
When he went to medical school,
they didn't have a lab.
He never learned how to use
a microscope.
So, you know, this was
a new territory for him.
NARRATOR:
Trudeau set up
a rudimentary laboratory
in his house in Saranac Lake.
Months went by as he struggled
to replicate Koch's experiments.
COOPER:
He has no running water
in his house,
he has no electricity,
of course,
and he had to create his own
thermometer, his own incubator,
and he would have doors
that he would open and close
depending on what
the temperature was
on his homemade thermometer.
And he was trying to maintain
a 37-degree centigrade
environment
for the bacteria to grow.
So he did that,
and he had little candles
underneath his incubator
warming it up, and opening
the doors and closing the doors,
and he was doing this constantly
for three weeks
to grow the bacteria.
He's all alone.
He has no faculty,
he has no help.
You know,
he's doing it by himself
just out of his own
intellectual curiosity.
NARRATOR:
After countless attempts,
in 1884, Trudeau became
the first American
to verify Koch's discovery.
TOMES:
He takes a sample
from his own throat,
develops a culture of it,
and he can see
he himself is carrying
this rod-shaped bacillus
that Koch has described.
So imagine, he was able
to test the hypothesis
and to show that indeed,
there it was.
NARRATOR:
Far away from the power centers
of medicine,
Trudeau's work went
largely unrecognized.
For the next decade,
Americans continued
to go about their lives,
unaware of the contagion
in their midst.
NARRATOR:
In 1886, a young writer
with consumption
arrived at the Los Angeles
Railroad Station,
where many newcomers
were greeted by a 30-piece band.
Charles Willard was hoping
to get well enough
to restart his career.
Los Angeles was hardly more
than a sleepy pueblo town,
its streets still unpaved.
Yet civic leaders
had grand visions for the city
and eagerly hawked
the dry, temperate climate
to East Coast invalids.
After working a few odd jobs,
Willard landed a position at the
Los Angeles Chamber of Commerce,
where he was put in charge
of luring health seekers
to California.
So here's the irony:
he himself is still very sick,
but there he is, promoting
the idea of the climate cure
when he has not been cured
by it.
NARRATOR:
Willard started a journal
called The Land of Sunshine
and filled it with testimonials
to the healing powers
of Southern California.
He targeted the publication
to East Coast readers,
especially those with money.
TOMES:
Charles Willard
did not want to attract
the wrong kind of sick people
to Los Angeles
People who were not educated,
people who were not
White Anglo-Saxon Protestants.
So there was a real
double message there.
"Yes, come if you're like me,
but don't come if you're not."
NARRATOR:
The fine points
of Willard's message
would quickly get lost
in the stampede.
Thousands of people
with consumption
swarmed into the city.
A metropolis
priding itself on health
soon contained a huge population
of sick and dying people.
One resident described
the sounds of the city
as "a constant chorus
of coughs."
TOMES:
Try to imagine L.A.
as a city of invalids.
It really is hard to imagine.
But indeed, that was the effect
of this kind of boosterism.
And when too many of them came,
it got to be
another kind of problem.
Charles Willard
succeeded too well.
NARRATOR:
Los Angeles was not unique.
Across the West, other cities
were also paying a price
for their recruiting success.
ROTHMAN:
And suddenly these cities
that saw themselves catering
to middle-class
and upper-class people
had a large number
of poor, sick people
all over in their midst,
and they were unable
to care for them.
And they didn't have
the resources
to care for them, either.
NARRATOR:
In Saranac Lake, Edward Trudeau
had watched with alarm
as the science of contagion
continued to go unheeded.
Along with other scientists,
he started publishing papers
and attending
medical conferences
to explain the body of evidence.
Finally, by the mid-1890s,
the medical
community was persuaded.
The term "consumption"
was dropped in favor of the name
that linked it to the bacteria:
tuberculosis, or TB.
Within a decade,
Robert Koch would go on
to win the Nobel Prize.
For patients, the new
understanding of the disease
would only add to the suffering.
TOMES:
The sad aspect
of this scientific progress
is that it made the person
with tuberculosis
into more of a threat.
When you thought consumption
ran in families,
you couldn't do anything
about it.
If you got it,
you were not to be blamed.
Now the individual with
tuberculosis was the danger.
The more focus there was on
person-to-person transmission,
the more that stigma,
that prejudice, intensified.
BARRETT:
The idea that although outwardly
you may look like a healthy,
beautiful, 22-year-old woman,
you are in fact vile
in some way, contaminated.
You know that something awful
is happening in your body,
and everything around you
is sending a signal
that you are disgusting
in some way,
that you have to be separated
from healthy people.
That seems like
the most astonishing
psychological burden.
NARRATOR:
Across the West,
communities that had once lured
health seekers
now scrambled to keep them out.
Several Western states
sought to enact laws
to stop people with coughs
from crossing their borders.
Others looked for ways to remove
them from populated areas.
ROTHMAN:
They often set up tent cities
on the edge of town.
So the sheriff would take them,
drop them off in this tent city,
and most people were kind of
having to fend for themselves,
and other people
who had tuberculosis
who weren't so sick
would help them,
and some charitable people
would bring food and so on,
but they were isolated
and indigent
and really, really unwelcome.
NARRATOR:
Even Charles Willard
was not immune.
When his symptoms
became impossible to hide,
he also became a target.
After his home accidentally
burned to the ground,
no one would rent him
a place to live.
In cities across the country,
public officials began to call
for government intervention.
Health departments
primarily concerned
with preventing diseases
carried in the water supply
now had to confront
a deadly illness
spread through the most casual
of contact.
TOMES:
Public health officials
felt they had to conduct
a massive national campaign
to bring the news to everyone
in the United States.
In fact, it's the first
mass public health campaign
in American history.
There's nothing like it before.
The campaign to teach
every single American
that they needed to be careful
about how they coughed
and sneezed
because you could never tell
who was sick and who wasn't.
ROTHMAN:
And they pass
these brochures out
so that people could understand
that spitting
could spread the disease.
Coughing without a handkerchief
could spread the disease.
They promoted the use
of Kleenex.
I mean, this is how Kleenex
came about.
Women's hemlines start to go up
after 1900.
It was so you could get
your skirts out of the dirt
and not carry home
a load of germs into your house.
Men's style
of wearing beards changed.
The anti-TB handouts would say,
"Get rid of your whiskers,"
because you don't want to kiss
the baby or kiss your wife
and give them tuberculosis
with your beard germs.
NARRATOR:
Crowded neighborhoods
transformed
as parks and playgrounds were
built to provide urban dwellers
with islands of fresh air.
New Yorkers began to call
Central Park
"the lungs of the city."
By the early decades
of the 20th century,
improved hygiene
started bringing
the overall cases of TB down.
But in poor,
crowded neighborhoods,
the figures continued to climb.
In some cities,
immigrants were twice as likely
to die of the disease
than their more affluent
neighbors.
For African Americans,
the death rate
was three to four times higher.
ROTHMAN:
And suddenly you have
a new understanding
of why it is a disease
of the poor and the immigrant.
They are living in places
without ventilation.
They are working together
in crowded sweatshops.
So it kind of feeds on itself:
a new understanding
of the disease,
and the whole beginnings
of policies
to try to lessen the impact
and reduce the spread
of the disease.
NARRATOR:
Public health officials
began to call
for improving the lives
of the poorest Americans:
better housing
and working conditions,
reduced working hours
and child labor laws.
Yet the anti-TB campaign
gave government officials
unprecedented power
to police the sick.
Health inspectors
were instructed
to monitor people's movements,
inspect their homes
or commit them to ill-equipped
public institutions,
often against their will.
TOMES:
The pressure
from public health officials
to segregate the very sick
fell most heavily
on working class,
poor Americans,
immigrant Americans.
They did not go knocking
on doors on 5th Avenue asking,
"Do you have any consumptives
in the house?"
There was a sense
if you were wealthy,
you were going to be allowed
to manage your illness
however you wanted to.
It was the poorer people
who really felt the pressure
from public health officials
to make their sick relatives
leave the home
and go into one of these
institutional facilities.
NARRATOR:
"Sanitary measures
are sometimes autocratic,"
declared a prominent
health official.
"We are prepared
to enforce measures
"which might seem radical
if they were not designed
for the public good."
TOMES:
It's an area of public health
practice where increasingly,
the need of the community
to be protected from the illness
starts to trump the individual
rights of the patient.
When people say,
"I don't want to be taken away,"
their right to resist that
is overridden
in the name of public health.
BARRETT:
How do we ever live
with a contagion in our midst?
Someone is sick among us,
that person needs care and help,
that person is also contagious
and can give us what they have.
What is the balance between
taking care of the community
and taking care of the person?
That question's always with us,
and it almost never has
a good answer.
NARRATOR:
With each passing year,
hundreds of thousands
of Americans with tuberculosis
scrambled to find medical care.
Hospitals were overwhelmed.
To cope with the flood
of patients,
New York City's
Bellevue Hospital
transformed ferry barges
into makeshift wards.
BARRETT:
There was no room to put people
who had tuberculosis.
So this was one way to
separate out contagious people,
was to take all the consumptives
from a local neighborhood
and put them
onto these day camps,
and they'd spend the whole day
on their little chairs
in the barge
moored on the river.
It was just a way of keeping
them out of their rooms
and their rooming houses
and out of their workplaces.
Some of the hospitals
would only take people
who were in their first attack
because they didn't want
to take people who were dying.
They weren't in the business
of caring for the dying.
So sometimes you had
to change your name,
pretend you were
someone different,
go to a different hospital.
It became a game of trying
to figure out how to survive
and how to make it when
you really had no resources.
NARRATOR:
Years earlier,
Edward Trudeau told friends
that he wished more people could
find relief,
as he had done,
in the cool, fresh climate
of the Adirondacks.
He had begun reading
about European sanatoriums
Facilities built
in the countryside
that provided long-term care
for TB patients.
COOPER:
Edward Trudeau was familiar
with the treatments
that were occurring in Europe
at the time,
and there was a growing idea
that one should take people
who have tuberculosis
and take them
into an environment
that was perhaps different from
the environment they were in.
And one of the ideas
that they had
was that they would go out
into the country.
They would be resting,
they would be given good food,
and they would be exposed
to the sunlight.
So the idea of the sanatorium
was to create a place
where people
who had been infected
could rally their body's
healing forces to throw it off.
We, today, talk about
the immune system.
They didn't use that language,
but it's clearly the phenomena
that they were describing.
NARRATOR:
Trudeau was determined to build
the first tuberculosis
sanatorium in the United States.
He had grown friendly
with wealthy TB patients
from the city
and now urged them
to open their wallets
to help create
a treatment facility
for people of modest means.
HOTALING:
The people who came originally
were wealthy patients.
They were the people who could
afford to take a difficult trip
through the wilderness
to get here,
and then they could hire
a place to stay, in a hotel,
or rent a house
or build a house,
but Trudeau felt that
there ought to be a place
for people
who were not so well off.
That's why he founded
the sanatorium.
NARRATOR:
By 1900, Trudeau's sanatorium
would grow
into a sprawling campus
of 22 buildings,
including a church
and a research laboratory.
News of its success
spread so quickly,
medical professionals
flocked to Saranac Lake
to see it for themselves.
Trudeau ignited a movement.
Over the next decade, hundreds
of sanatoriums would spring up
in every part of the country,
many of them set up
by charity or religious groups.
State governments
opened huge complexes for people
who couldn't afford care
in private institutions.
Many facilities
were segregated by race.
African Americans barred
from white-only sanatoriums
helped start their own.
In the first decades
of the 20th century,
one out of every 170 Americans
lived in a sanatorium,
some for many years.
It was a life of exile.
WHITNEY SEYMOUR, JR.:
I began to realize that
I was getting extremely tired
and then started
coughing up phlegm.
And so I made an appointment
to go see the family doctor.
And he saw the tubular bacilli
right away
and he said, "Young man,
you have tuberculosis,
and you gotta go to Trudeau."
He didn't fool around, saying,
"You can think about it."
He was very adamant.
And all of a sudden,
it was all over
and I was now suddenly
being told to,
"Get yourself on a train
and get up to the mountains
"and start curing.
You're a very sick young man."
ROTHMAN:
People often left
in the middle of the night.
They left
without telling people.
They just quit their jobs
or they just left.
Sometimes they were trying
to protect their families,
and sometimes the families were
trying to protect themselves.
NARRATOR:
For some, the sanatorium
held the promise of cure.
For others,
it was the place to go to die.
The white-coated doctors
coming in and looking down,
saying, "Mm-hmm, uh-huh,"
and walking out.
And so I would figure these guys
were measuring me for a coffin.
I was left there
in a hospital bed
and I really was overwhelmed
by a sense of despair.
I really thought that
I was about to die.
The hardest time was accepting
that I was there
and maintaining hope
that I would get better
and being optimistic.
So it was a separation
from your usual life
that really was
very hard to take.
You were really
basically lonely.
JOANNE CURTIS:
They never told me how long
I would be at the hospital,
and I never asked.
Don't ask me why.
I never cried, I never asked.
I just took one day at a time,
kept my sense of humor,
and that was it.
That was my armament,
that was it.
NARRATOR:
Entering a sanatorium
required complete submission.
Physicians and nurses regulated
every moment of the day,
measuring patients' progress
towards health
by testing for bacteria
in their phlegm
and x-raying their chests.
Trudeau believed TB patients
needed to be well fed
and insisted they consume
at least six glasses of milk
and six raw eggs a day.
And he ordered them to rest.
BARRETT:
When people first came
to a sanatorium,
many were put on 24-hour rest.
They were put directly to bed.
They stayed there.
All their meals
were brought to bed on trays.
They were not allowed to even
get out to go to the bathroom.
They had bedpans.
CURTIS:
Class One was bed rest.
Class Two,
bathroom privileges only.
Three,
I could walk around a lot.
By the time I got to Two,
I was restless.
I got yelled at by my doctor
because I would be ripping
up and down the hallway,
and he said, "Young lady,
aren't you in Class Two?
You're supposed to just have
bathroom privileges."
And I said,
"Oh, I didn't know that."
He said, "Yes, you did.
Go back to your bed."
So that's yes, I did.
NARRATOR:
For Trudeau,
where his patients rested
was as significant as how long.
He was convinced that fresh air
was the single most important
treatment for a diseased lung.
He instructed his patients
to lie outdoors
on reclining chairs,
day and night,
regardless of the weather.
SHERWOOD DAVIES:
I'd sleep at night on the porch,
get fresh air.
(laughing)
That's what they called it.
When it was ten below,
it was a little more
than fresh air.
Damn cold weather.
But I would have
an electric blanket
and I'd have about four or five
other blankets
over the electric blanket,
and then a rubber sheet
over that,
and then a wool cap
over my ears.
SEYMOUR:
The cure cottage
that I was assigned to
was not an outdoor cure cottage,
but glassed in.
That is,
I slept outside the building,
but you could see nature
all around you.
And the thing
that I still remember
was the sunlight
bouncing off Mount Marcy
and then streaming in
through these windows
and making it just very cheerful
and hopeful
and make you begin to think,
"Gee, it'd be nice
to be out there."
NARRATOR:
With no treatment available
other than rest and fresh air,
tuberculosis sufferers
everywhere
strived to imitate
Trudeau's method.
Across the country, people
added porches to their homes.
When that wasn't possible,
they simply made do.
BARRETT:
There were tents on the roofs
of some tenement buildings
all over Brooklyn,
a cure chair inside,
and someone wrapped
in all their hats and clothes.
And then there were also tents
that could be inserted
into a window
so that if you were
in your apartment house,
your legs would be
inside the house
and the white tent
would stick out the window,
and somehow the fresh air
was supposed to come into you,
just from your head
sticking out the window.
NARRATOR:
For all they surrendered
when they entered
the sanatorium,
patients also found
a certain freedom.
Unburdened from the fear
of infecting others,
they sought comfort
in each other's company.
ROTHMAN:
In these situations, there was
a great deal of gossip.
Everybody gossiped
about everybody else:
who's talking to who,
who's trying to run away
and drink,
who left, and also, who died.
BARRETT:
Even if you're out on the porch
and it's a sunny day
and you're having conversation
with a friend
or flirting with someone,
just a few beds
or a few rooms away,
someone else
is coughing horribly
or having a horrible hemorrhage
that's being cleaned up
within your sight,
or a body's being taken down
the corridor on a gurney.
I think the presence of death
had to be with you
virtually every minute
of every day.
DAVIES:
I remember two young ladies,
very personable,
and I was in my teenagers
and these were attractive
young girls,
and I got to know them
Ruth Templeton
and Mary Patterson.
And within four to six months
of their arrival,
both of them had died, which
It troubled me no end.
Two young ladies like that
that developed the disease.
I still remember their names
to this day.
It's
It was very unfortunate.
NARRATOR:
Trudeau's own studies revealed
that only a third
of his patients got well.
He stood at the bedside
of hundreds of dying patients,
but the hardest death to bear
was that of his own daughter.
Charlotte Trudeau died of
tuberculosis at the age of 16.
The doctor was rarely free
of symptoms himself,
frequently having to stop work
to take the rest cure.
When Edward Trudeau died in 1915
after a 40-year struggle
with tuberculosis,
a miracle cure
was still a dream.
NEWSREEL ANNOUNCER:
Through mass production methods,
America is continually
increasing
its output of penicillin,
the new drug that effects
almost miraculous cures.
The liquid charged
with penicillin
is poured from the bottles.
Turned into a powder,
it is ready for use.
NARRATOR:
In the early 1940s,
the discovery of penicillin
revolutionized the treatment
of infectious diseases.
Derived from a mold,
this first antibiotic
cured a host of infections,
but not tuberculosis.
A microbiologist
at Rutgers University
believed he knew where to look
for an antibiotic that would,
literally beneath people's feet.
Selman Waksman was one
of the few people in the country
who understood
the true nature of soil.
Early in his career,
he had written a definitive work
on the microscopic organisms
that live in the ground,
describing the earth
in an ordinary garden
as a killing field
where warrior microbes
fight each other for supremacy.
His previous work pointed
to the Streptomyces:
strange organisms,
half bacteria and half fungi,
responsible for the sweet odor
of earth after a light rain.
But there are
over 500 different species.
Finding one that could kill
harmful bacteria
without toxic side effects
would prove to be
extraordinarily difficult.
And it was unbelievably
time consuming
and, if you like, boring,
and you could look all day long
and see absolutely
nothing happening
through your microscope.
So you go
to a different soil patch,
maybe you go closer
to the horse's stables
because the bacteria
that you really want
are those which feed
on horse dung
rather than dried leaves.
So it's a huge
hit-and-miss affair.
NARRATOR:
In late summer 1943,
Waksman assigned the research
project to Albert Schatz,
an energetic 23-year-old
graduate student.
The hunt for antibiotics
captured Schatz's imagination.
He would often spend
18 hours a day
peering into his microscope,
looking for the telltale sign
of an antibiotic.
In what was known
as "the streak test,"
Schatz placed common bacteria
in a Petri dish,
swiping a strain of Streptomyces
down the middle.
If the strain
were potent enough,
it would create a dead zone
around it.
PRINGLE:
It's a battlefield,
and the clear zone
gets bigger and bigger,
and eventually,
you're watching it destroy
your harmful bacteria
and you say, "Whoopee,
I've got something!"
NARRATOR:
Three months in,
Schatz stumbled on a variety
that appeared quite powerful.
On October 19,
he sealed a test tube
containing the promising batch
and gave it to his mother
as a memento of his achievement.
Schatz was eager to test the new
antibiotic against tuberculosis,
even given the risk.
VIVIAN SCHATZ:
That laboratory was not set up
for a dangerous germ
like tuberculosis.
So there were a couple
of basement windows
and some stools to sit on,
and that was it.
It was very sparse,
and not what you would expect
where people would be working
with a very virulent organism.
PRINGLE:
And the equipment
is very primitive.
It's not exactly clean.
There was none of the stuff
that you see today
of, you know, enclosed labs
where people are manipulating
their Petri dishes
with mechanical arms.
It was nothing like that.
NARRATOR:
Schatz talked Waksman
into letting him proceed.
VIVIAN SCHATZ:
He slept in the laboratory
because he had to add fluid
to the glass containers
that were being distilled,
and when the liquid
in a container
got to a certain level,
he had to add more liquid.
So it was very, very tiring,
hard work.
NARRATOR:
Within weeks,
Schatz would witness
one of the most dramatic events
ever seen under a microscope:
the destruction
of the tubercle bacillus.
Waksman and Schatz named
the antibiotic "streptomycin."
The following spring, Waksman
sent the drug to the Mayo Clinic
for testing with patients.
Starting in November of 1944,
researchers gave five courses
of streptomycin
to a 21-year-old woman
dying of tuberculosis.
Within days, the infection
in her lungs began to disappear.
A few months later, she was
discharged from the hospital.
So with streptomycin,
for the first time
in human history,
there's a magic bullet.
There's a drug
you can give to people
that is going to make
the majority of them
far, far better.
You can cure tuberculosis.
ROTHMAN:
I mean, it was unbelievable.
A disease that had plagued
humanity for 3,000 years
was suddenly able to be cured.
DAVIES:
The medical director
assembled all the patients
and all the staff
and announced this drug
that they had just discovered.
And what a reaction
from the patients there that
I mean, you could see the smiles
on their face.
Well, it
it was indescribable.
NARRATOR:
The euphoria would not last.
Within months of treatment,
many patients began to relapse.
Scientists would come
to understand that streptomycin
does not destroy
all the bacteria in the body,
and the organisms
that do survive
grow stronger and more resistant
to the drug.
Suddenly, the drug
was not being effective
when it had been so effective
so quickly.
And so they understood
very rapidly that it was
the resistance was occurring.
And so they needed to develop
further drugs.
NARRATOR:
By the late 1940s,
two additional drugs were added
to streptomycin.
The drug cocktail,
properly administered,
was far more effective.
COOPER:
And with tuberculosis,
it's clear.
You need a combination of drugs.
So the bacteria has to combat
two or three attacks at once
rather than the simple
one attack.
It can cope with one,
it can't cope with two,
and it can cope even less well
with three.
And then when we take
the antibiotics,
we need to take them
consistently, correctly,
not overdo it
and not underdo it,
because then you will facilitate
the development
of drug resistance.
NARRATOR:
Before antibiotics, half
of all people with active TB
could expect to die
within five years.
By 1950, most were getting well
and going on to live normal,
healthy lives.
As cures mounted,
the sanatoriums began to close.
Many were demolished.
A few became ski resorts
or hotels.
SEYMOUR:
Almost from the very beginning,
when I was in the infirmary,
these young doctors
came by and say,
"We're going to experiment
with these new drugs."
And so it was then quite obvious
that Trudeau was going to close
in a few weeks.
And we're instructed
to go find apartments in town
so we could continue
to get well.
And all of a sudden,
I realized I can overcome it
and live a long, healthy,
hardworking life.
DAVIES:
I had looked back at the
family's history of tuberculosis
and said how lucky I was.
And when they said I was
essentially cured, I was elated.
I wasn't thinking so much
of a big relief on my part
but what my mother
had gone through,
because here she was,
she had dealt with her mother,
she had dealt with my father,
and now she had to deal with me.
I think the proudest thing
in her life
was when she came
to my college graduation.
(voice breaking):
And
she
Her life was fulfilled.
NARRATOR:
In November 1954,
a former professional baseball
player named Larry Doyle
ate his last meal
at the head of a long table
at the Trudeau Sanatorium.
He had been a patient
for 12 years.
After lunch, he walked out
the front door
and strolled through the snowy
streets of Saranac Lake.
He was the last tuberculosis
patient to leave Trudeau.
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