Living in the Shadow of Death: Tuberculosis and the Social Experience of Illness in American History / Edition 1

by Sheila M. Rothman

Overview

Tuberculosis--once the cause of as many as one in five deaths in the U.S.--crossed all boundaries of class and gender, but the methods of treatment for men and women differed radically. While men were encouraged to go out to sea or to the open country, women were expected to stay at home, surrounded by family, to anticipate a lingering death. Several women, however, chose rather to head for the drier climates of the West and build new lives on their own. But with the discovery of the tubercle bacillus in 1882 and the establishment of sanatoriums, both men and women were relegated to lives of seclusion, sacrificing autonomy for the prospect of a cure.

In Living in the Shadow of Death Sheila Rothman presents the story of tuberculosis from the perspective of those who suffered, and in doing so helps us to understand the human side of the disease--and to cope with its resurgence. The letters, diaries, and journals piece together what it was like to experience tuberculosis, and eloquently reveal the tenacity and resolve with which people faced it.

Product Details

ISBN-13:	9780801851865
Publisher:	Johns Hopkins University Press
Publication date:	10/01/1995
Edition description:	New Edition
Pages:	332
Sales rank:	725,139
Product dimensions:	6.00(w) x 9.00(h) x (d)
Age Range:	18 Years

About the Author

Sheila M. Rothman is Research Scholar at Columbia College of Physicians and Surgeons and Director of the Program on Human Rights and Medicine. She is author of Women's Proper Place.

What People are Saying About This

June Osborn

Remarkably relevant. [ Living in the Shadow of Death] conveys a troubling sense of déjà vu in a decade when we face both the AIDS epidemic and the recrudescence of tuberculosis itself; and it is important reading for those caught up in efforts to deal both effectively and humanely with either.

— June Osborn, former chair, U.S. National Commission on AIDS

David E. Rodgers

A fascinating and powerful book... compelling reading. Tuberculosis was a disease, now reemerging, that killed more Americans, young or old, rich or poor, than any other disease, until well into the twentieth century. It shaped our culture, determined careers, blighted lives. Rothman writes beautifully and with great sensitivity about the human condition. The book will, I believe, become a classic in the field.

— David E. Rodgers, Cornell Medical College

From the Publisher

Remarkably relevant. [Living in the Shadow of Death] conveys a troubling sense of déjà vu in a decade when we face both the AIDS epidemic and the recrudescence of tuberculosis itself; and it is important reading for those caught up in efforts to deal both effectively and humanely with either.
—June Osborn, former chair, U.S. National Commission on AIDS

A fascinating and powerful book. . . compelling reading. Tuberculosis was a disease, now reemerging, that killed more Americans, young or old, rich or poor, than any other disease, until well into the twentieth century. It shaped our culture, determined careers, blighted lives. Rothman writes beautifully and with great sensitivity about the human condition. The book will, I believe, become a classic in the field.
—David E. Rodgers, Cornell Medical College

Editorial Reviews

[A] graceful and lucid history.
--Mirabella

A 1994 Notable Book of the Year
--New York Times Book Review

This is great reading, an illness narrative that dramatically illustrates how an exceptional, atypical life can inform historical knowledge.
--Boston Sunday Globe

[A] moving account of what is was like to live in the shadow of death.
--W. F. Bynum, Nature

[A] remarkable book. . . Elegantly composed . . . It is written, and splendidly so, out of compassion for victims, respect for their courage and hope that their stories will enlighten us about current afflictions. Suffering is the books' compelling theme: not the genius of scientists but the pain and tenacity of the sick . . . [Rothman's] book is invested with a modestly humane hope that the past can teach us something useful . . . At stake is our collective civility as much as our health.
--Alan Trachtenberg, New York Times Book Review

Dr Rothman has hit a home run. Sandlot Stats: Learning Statistics with Baseball is not only a fine book to read, but a text which can also serve as an excellent resource book.
--Father Gabe Costa, CBC New York

From the Publisher

Dr Rothman has hit a home run. Sandlot Stats: Learning Statistics with Baseball is not only a fine book to read, but a text which can also serve as an excellent resource book.

CBC New York - Father Gabe Costa

[A] moving account of what is was like to live in the shadow of death.

Nature - W. F. Bynum

[A] graceful and lucid history.

Mirabella

A 1994 Notable Book of the Year

New York Times Book Review

This is great reading, an illness narrative that dramatically illustrates how an exceptional, atypical life can inform historical knowledge.

Boston Sunday Globe

[A] remarkable book. . . Elegantly composed . . . It is written, and splendidly so, out of compassion for victims, respect for their courage and hope that their stories will enlighten us about current afflictions. Suffering is the books' compelling theme: not the genius of scientists but the pain and tenacity of the sick . . . [Rothman's] book is invested with a modestly humane hope that the past can teach us something useful . . . At stake is our collective civility as much as our health.

New York Times Book Review - Alan Trachtenberg

Dr Rothman has hit a home run. Sandlot Stats: Learning Statistics with Baseball is not only a fine book to read, but a text which can also serve as an excellent resource book.

— Father Gabe Costa

CBC New York

[A] moving account of what is was like to live in the shadow of death.

— W. F. Bynum

Nature

3 Stars from Doody

This book narrates the impact of tuberculosis, the leading cause of morbidity and death in this country from 1800 to 1940, from the standpoint of those sick and otherwise affected, not from the view of the medical profession. The description of disease from the patient's view is unusual and rather unique in nonfiction, though fictional works, especially on tuberculosis, are well known (The Magic Mountain, La Boheme, La Traviata, etc.). Those with the disease were called invalids and faced a chronic, uncertain, and often fatal course. They coped by travel, the climatologic cure, first to tropical islands, later to the southwest and Colorado. They put meaning in their professional lives often by becoming missionaries or abolitionists. These avenues were open only to men of means, however. Women and the poor had no such options. By 1890 the cause and contagiousness of tuberculosis became known, the invalids became patients, and the stigma and disruption of lives by prolonged sanitarium confinement, where the sick and dying were concentrated, became the norm. The historical account is comprehensive, although somewhat repetitious. This saga is relevant to today's world. Not only has interest in tuberculosis reawakened, but the modern scourge of AIDS, a chronic illness profoundly affecting younger adults, shows important parallels. Medical and social historians and tuberculosis health workers will benefit from this work. A more general audience should also include health care planners physicians primarily managing chronic diseases and those that are touched by the AIDS epidemic. The book is written as a series of individual narratives divided roughly by the eras covered as 1800-1850, theinvalid experience; 1850-1890, health seekers in the West; 1890-1940, the patient and the sanitarium. This is an unusual and valuable account of the impact of an important disease on individuals and society with historical and modern applicability. It has a place in medical libraries and in libraries of those individuals noted above.

David Y. Rosenzweig

Rothman's involving social history of tuberculosis is built around patients' own narratives reconstructed from diaries, letters and memoirs. For example, we meet Deborah Fiske (1806-1844), a deeply religious Massachusetts teacher who submitted to God's will even as she desperately tried to prepare her two daughters for their future as orphans; she also joined a support group of tubercular women who read medical texts and pooled their knowledge. Testimonies by patients confined to sanatoriums seethe with shame and anger at being stigmatized. Other health-seekers migrated westward from the 1840s to the 1920s, lured by physicians in California or Colorado touting their region as a curative Eden. In an alarming epilogue, Rothman, a scholar at Columbia's College of Physicians and Surgeons, notes that TB is again becoming a scourge with new strains proving resistant to drugs. Illustrated. First serial to Mirabella. (Feb.)

Publishers Weekly - Publisher's Weekly

While Frank Ryan's The Forgotten Plague ( LJ 5/1/93) described the history of the search for a cure of tuberculosis, Rothman, a scholar at Columbia University's College of Physicians and Surgeons, recounts here the experiences of TB patients through 150 years of American medicine. As death rates soared in the early 19th century, men were frequently urged to abandon their in-door pursuits and travel to more salubrious climates. Women, however, were encouraged to carry on with daily responsibilities, to endure debilitating pregnancies, and to meet death with Christian fortitude. The latter 19th century saw entire communites, such as Colorado Springs, organized for invalids seeking new lives in more congenial climates. Following the discovery of the TB bacteria, minimizing contagion became the focus of public health, and hospitals became far more structured and confining institutions. Rothman has uncovered compelling original sources that she enhances with sensitive analysis. Her evenhandedness is ultimately frustrating, however, as she neglects to explore the implicit ethical conflict between early accounts of extended families ravaged by contagious disease and the later narratives of bored and rebellious infectious patients forcibly confined by public health authorities. Recommended, with reservation, for academic and larger public libraries.-- Kathy Arsenault, Univ. of South Florida-St. Petersburg Lib.

Library Journal

For more than 150 years, until well into the 20th century, tuberculosis was the dreaded scourge that AIDS is for us today. Drawing on the diaries and letters of hundreds of individuals over five generations, Rothman presents an intimate portrait of what it was like for patients, families, and communities. Annotation c. Book News, Inc., Portland, OR (booknews.com)

Booknews

Reviewer: David Y. Rosenzweig, MD (Medical College of Wisconsin)
Description: This book narrates the impact of tuberculosis, the leading cause of morbidity and death in this country from 1800 to 1940, from the standpoint of those sick and otherwise affected, not from the view of the medical profession.
Purpose: The description of disease from the patient's view is unusual and rather unique in nonfiction, though fictional works, especially on tuberculosis, are well known (The Magic Mountain, La Boheme, La Traviata, etc.). Those with the disease were called invalids and faced a chronic, uncertain, and often fatal course. They coped by travel, the climatologic cure, first to tropical islands, later to the southwest and Colorado. They put meaning in their professional lives often by becoming missionaries or abolitionists. These avenues were open only to men of means, however. Women and the poor had no such options. By 1890 the cause and contagiousness of tuberculosis became known, the invalids became patients, and the stigma and disruption of lives by prolonged sanitarium confinement, where the sick and dying were concentrated, became the norm. The historical account is comprehensive, although somewhat repetitious. This saga is relevant to today's world. Not only has interest in tuberculosis reawakened, but the modern scourge of AIDS, a chronic illness profoundly affecting younger adults, shows important parallels.
Audience: Medical and social historians and tuberculosis health workers will benefit from this work. A more general audience should also include health care planners physicians primarily managing chronic diseases and those that are touched by the AIDS epidemic.
Features: The book is written as a series of individual narratives divided roughly by the eras covered as 1800-1850, the invalid experience; 1850-1890, health seekers in the West; 1890-1940, the patient and the sanitarium.
Assessment: This is an unusual and valuable account of the impact of an important disease on individuals and society with historical and modern applicability. It has a place in medical libraries and in libraries of those individuals noted above.

Doody's Review Service