Revealing account of the experience of tuberculosis from the
patient's point of view. A scholar at Columbia's College of
Physicians and Surgeons, Rothman (Woman's Proper Place, 1978)
examined numerous collections of family papers, diaries, and
memoirs searching for "narratives of illness," specifically for
accounts by those with tuberculosis, the leading cause of death in
the 19th century. First come the writings of young, educated New
Englanders in the opening half of that century - a time when the
disease, then called consumption, was believed to be hereditary and
noncontagious. Its sufferers were considered invalids, a label with
both medical and social implications, requiring the ill to seek
cures and modifying their social obligations. Male invalids might
have to change their careers, giving up the bookish professions,
for instance, to go off on lengthy ocean voyages or take up the
outdoor life of a farmer; women, however, were expected to seek
their cures at home, surrounded by family. Through their
narratives, we see how the sufferers lived with life-altering
illness and how their families and friends responded. Rothman turns
then to the western frontier during the period 1840-90. Here,
consumptives became health seekers, full of confidence and
optimism, until, with Robert Koch's discovery of the tubercle
bacillus in 1882, fear of contagion changed everything. Those
diagnosed with tuberculosis were thereafter segregated in
sanitoriums, their illness narratives narrowing from life stories
to accounts of encounters with the disease, nurses and doctors, and
other patients. Rothman's selection of narrative passages, along
with her own descriptions, make the transition from invalid to
health seeker to patient a poignant one, and her revelations about
the nature of illness from the patient's perspective are especially
valuable in light of the current tuberculosis comeback and the
national debate about health care policy. Rich in detail and human
interest. (Kirkus Reviews)
For more than 150 years, until well into the twentieth century,
tuberculosis was the dreaded scourge that AIDS is for us today.
Based on the diaries and letters of hundreds of individuals over
five generations, Living in the Shadow of Death is the first book
to present an intimate and evocative portrait of what it was like
for patients as well as families and communities to struggle
against this dreaded disease. "Consumption", as it used to be
called, is one of the oldest known diseases. But it wasn't until
the beginning of the nineteenth century that it became pervasive
and feared in the United States, the cause of one out of every five
deaths. Consumption crossed all boundaries of geography and social
class. How did people afflicted with the disease deal with their
fate? How did their families? What did it mean for the community
when consumption affected almost every family and every town?
Sheila M. Rothman documents a fascinating story. Each generation
had its own special view of the origins, transmission, and therapy
for the disease, definitions that reflected not only medical
knowledge but views on gender obligations, religious beliefs, and
community responsibilities. In general, Rothman points out,
tenacity and resolve, not passivity or resignation, marked people's
response to illness and to their physicians. Convinced that the
outdoor life was better for their health, young men with
tuberculosis in the nineteenth century interrupted their college
studies and careers to go to sea or to settle in the West, in the
process shaping communities in Colorado, Arizona, and California.
Women, anticipating the worst, raised their children to be welcomed
as orphans in other people's homes.In the twentieth century, both
men and women entered sanatoriums, sacrificing autonomy for the
prospect of a cure. Poignant as biography, illuminating as social
history, this book reminds us that ours is not the first generation
to cope with the death of the young or with the stigma of disease
and the proper limits of medical authority. In an era when a deadly
contagious disease once again casts its shadow over individual
lives and communities, Living in the Shadow of Death gives us a new
sense of our own past as it equips us to comprehend the present.
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