Living in the Shadow of Death: Tuberculosis and the Social Experience of Illness in American History (Paperback)

by Sheila M. Rothman (Author) "WHEN I BEGAN THIS BOOK, THERE WERE MANY HISTORIES THAT CELEbrated the achievements of innovative physicians and prize-winning investigators, but few histories looked at the..." (more)
Key Phrases: New York, New England, Colorado Springs (more...)

Editorial Reviews

From Publishers Weekly
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.
Copyright 1994 Reed Business Information, Inc. --This text refers to an out of print or unavailable edition of this title.

From Library Journal
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.
Copyright 1994 Reed Business Information, Inc. --This text refers to an out of print or unavailable edition of this title.

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Product Details

• Paperback: 332 pages
• Publisher: The Johns Hopkins University Press; 1 edition (November 1, 1995)
• Language: English
• ISBN-10: 0801851866
• ISBN-13: 978-0801851865
• Product Dimensions: 9.2 x 6.1 x 1 inches
• Shipping Weight: 1.1 pounds (View shipping rates and policies)
• Average Customer Review: 2.5 out of 5 stars See all reviews (2 customer reviews)
• Amazon.com Sales Rank: #707,014 in Books (See Bestsellers in Books)

Customer Reviews

Most Helpful Customer Reviews

8 of 9 people found the following review helpful:

4.0 out of 5 stars Fascinating, informative...and overwhelmingly sad, July 6, 2004

By	Corinne H. Smith (Athol, MA USA) - See all my reviews (TOP 500 REVIEWER)

"[T]uberculosis was the leading cause of death in the United States throughout the nineteenth century and well into the twentieth. From 1800 to 1870 tuberculosis was responsible for one out of every five deaths. Paying little attention to geography, social class, or age, it struck rich and poor, young and old, and urban and rural residents." These statistics in Rothman's introduction are tragic enough. The narratives that follow are even sadder.

Consumption -- as it was known at the time -- was thought to be either inherited or the result of a sedentary life. (The communicable tubercle bacillus wasn't discovered until 1882.) Doctors focused on a three-pronged cure for their male patients of means: daily exercise, a good diet, and travel to a better climate. On the other hand, female patients were told to handle their domestic duties as best as possible and to get assistance from single female family members who could move in temporarily. Invalids and their families eventually dealt with the inevitable outcome and prepared for death. In the twentieth century, patients were sent off to sanatoriums. Chances are good that someone in your ancestry was affected. At the very least, they knew people who were.

This book is revealing because it is written from the patient's viewpoint and with the individuals in mind. Letters and diaries of consumptives show that people commiserated with fellow sufferers and exchanged news of symptoms and possible curative measures. The focus of the story-telling is thus very personal rather than medical. It makes for compelling reading.

"Living in the Shadow of Death" is mandatory reading for anyone interested in life in the United States in the 1800s and early 1900s. Genealogists and academic researchers in the humanities (especially literature and history) should put this title on their to-read list. "The good old days" really weren't.

3 of 17 people found the following review helpful:

1.0 out of 5 stars Interesting but of Truly No Relevance, December 23, 2005

By	Mobius Day (Chicago, Il) - See all my reviews

As Rothman, ruefully notes in her book there have been studies of medicine from the perspective of the doctor and from the perspective of the disease but not from the perspective of the patient.

Thus, Dr. Rothman sets out to do "a history of patienthood" and how being a patient changed over the course of time with respect to one single disease, TB or Consumption.

The problem is that her original sources are diaries, mainly of women but not exclusively. That by and of itself limits her subjects overwhelmingly to upper crust and educated NE families by and large. Overwhelmingly these are the well-off, relatively speaking. Theretofore, all of Rothman's democratic impulses are naturally very limited. The whole thrust of thesis is thus quite silly. This is not a history truly of patienthood, but of patienthood of the wealthy - of a small well-to-do segment of society.

What was it truly like to a patient with TB among the indigent and the poor? Rothman cannot really say for these people kept no diaries and if they did they were certainly not preserved a hundred and fifty years later in some library archives waiting for her to come find them.

Rothman gives us only the narrowest slice of what it means to be a patient.

Furthermore, this is a telling of history through anecdote. So she takes one, two, maybe 3 dozen diaries and summarizes what the people say in them. Who cares! To say these 3 dozen people are a representative sample (even among the upper crust educated elite of society) is downright silly.

It would be like someone reading 3 dozen blogs today on the net and saying they have a general sense of what society was thinking of the Iraq war. Who actually spends their time writing a blog? What is the motivation of those who write the blog? By definition, they are the people with extreme views, angry, disenchanted, frustrated, opinionated jerks. Represenative of nothing.

And this all leaves out the fact that we still have no clue as to biased selection of diaries that Rothman chose, potentially only using the one's that made her point (or only quoting passages from the diaries that support her thesis).

This is not history. This is not fact-telling. This is historical fiction writing.

If you want to understand disease read the work of Robert Fogel, Nobel Prize winning cliometrician. If you want to read historical fiction, go read Barbara Tuchman or Leon Uris.

This is just bad fiction with labored dense writing posing as history.