logo
Sanitariums and Stigma: When TB Was Common in the U.S.

Sanitariums and Stigma: When TB Was Common in the U.S.

New York Times21-07-2025
Recently, the writer John Green spoke with The New York Times about his best-selling book 'Everything Is Tuberculosis' and the reason he developed an obsessive interest in the disease, which kills more people worldwide than any other infectious illness does. Tuberculosis has been rare in the United States for decades, but the conversation inspired many readers to write in to share their own families' history with the disease.
Here are excerpts from several.
My mother, Babe, had TB in the early 1930s and was put in the Grasslands sanitarium in Valhalla, N.Y. She survived because her doctor gave her pneumothorax treatment, collapsing one lung at a time, to let the lung rest and repair. She said it was very painful. I was told the story over and over. She was so afraid I would get TB.
One reason she lived is because she had met my father, Grant, on a trip to California and fallen in love. He wrote to her everyday and even said he would go east, climb the walls of the sanitarium and take her to the clean air of the mountains in California so she could get well. Grant was a writer and a stuntman in Hollywood. He had been Errol Flynn's double in 'Robin Hood.' So he really meant it when he said he'd climb the walls to get her out.
He didn't do that. But when Babe recovered, she took a train to California and married my father. Babe's doctor was Dr. William Godfrey Childress, whom I have since found out was one of the well-known TB experts in those days. I met him when she went in for a checkup many years later. (I was born when Babe was 44!)
— Wyn Lydecker
My grandfather, who immigrated from Ukraine, died at 38 from spinal TB. He left a wife and four children, and one of them, my uncle Walter, had spinal TB that left him about 5 feet tall with a hump.
My father was drafted into World War II and came back to the United States and got TB. His brother Walter paid for him to be in a sanitarium called Gaylord in Connecticut. He met my mother there and she had TB, and after two years in the san, as it was called, antibiotics were invented. My mother could take them, but my father couldn't and had to have pneumothorax for many years.
It was awful, and I am terrified about the resurgence of antibiotic-resistant TB.
— Jody Jarowey
I'm a retired M.D.-Ph.D. and I trained at Washington University in St. Louis from 1974 to 1981.
In 1980, I took the admission history for a child being admitted for a lymph node biopsy. I'm sure everyone expected cancer. As a medical student, I did a very thorough history, asking about medications (none), whether the girl was up to date on her immunizations, and whether she'd had a TB test. Her mother said 'yes.' For some reason I asked whether the TB test was positive or negative, and she then told me 'positive' and 'Oh, yes, she's on a drug for that.'
But the girl was growing, the dose hadn't been changed, and the child's uncle was on two drugs for drug-resistant TB. The multiple nodes in her neck? I can't say for sure, but the surgeons canceled the surgery when they learned of the TB.
We had been doing the admission interview in the children's playroom on the pediatric ward.
During my training I knew a fellow resident who was diagnosed with a pleural effusion. Surprise — the effusion was from TB!
As a college student I worked in the genetics building on the University of Wisconsin campus. One day everyone was told we were going to get skin tests for TB, as someone working in the building had active TB.
We don't think about TB much in the United States, but it's still here, and still killing people. The ignorance and the cruelty in our neglect of public health is shocking to me.
Now we have left the W.H.O. and shut down U.S.A.I.D. It's hard to believe we are the same people who wiped out smallpox.
— Laura J. Brown
When I was 14, a small spot was found in my right lung, and I was treated for TB in a sanitarium in Ottawa, Ill. By state law, I had to be there for six months.
The horror of this was that I was never actively contagious. I never coughed once, and no bacillus was ever found in my sputum or in the gastric lavages I underwent when they couldn't find TB in the sputum. The rules of the sanitarium were based on protocols developed at the end of the 19th century, long before the modern drugs I was treated with were discovered.
— Sandy Robertson
Orange background

Try Our AI Features

Explore what Daily8 AI can do for you:

Comments

No comments yet...

Related Articles

SelectQuote to Release Fiscal Fourth Quarter and Full Year 2025 Earnings on August 21
SelectQuote to Release Fiscal Fourth Quarter and Full Year 2025 Earnings on August 21

Yahoo

time4 minutes ago

  • Yahoo

SelectQuote to Release Fiscal Fourth Quarter and Full Year 2025 Earnings on August 21

OVERLAND PARK, Kan., August 07, 2025--(BUSINESS WIRE)--SelectQuote, Inc. (NYSE: SLQT), a leading distributor of Medicare insurance policies and owner of a rapidly growing Healthcare Services platform, today announced it will release its fourth quarter and full year 2025 financial results before market open on Thursday, August 21, 2025. Chief Executive Officer, Tim Danker, and Chief Financial Officer, Ryan Clement, will host a conference call on the day of the release (August 21, 2025) at 8:30 am ET to discuss the results. To register for this conference call, please use this link: After registering, a confirmation will be sent via email, including dial in details and unique conference call codes for entry. Registration is open through the live call, but to ensure you are connected for the full call, we suggest registering a day in advance or at minimum 10 minutes before the start of the call. The event will also be webcasted live via our investor relations website or via this link. About SelectQuote: Founded in 1985, SelectQuote (NYSE: SLQT) pioneered the model of providing unbiased comparisons from multiple, highly-rated insurance companies, allowing consumers to choose the policy and terms that best meet their unique needs. Two foundational pillars underpin SelectQuote's success: a strong force of highly-trained and skilled agents who provide a consultative needs analysis for every consumer, and proprietary technology that sources and routes high-quality leads. Today, the Company operates an ecosystem offering high touchpoints for consumers across insurance, pharmacy, and virtual care. With an ecosystem offering engagement points for consumers across insurance, Medicare, pharmacy, and value-based care, the company now has three core business lines: SelectQuote Senior, SelectQuote Healthcare Services, and SelectQuote Life. SelectQuote Senior serves the needs of a demographic that sees around 10,000 people turn 65 each day with a range of Medicare Advantage and Medicare Supplement plans. SelectQuote Healthcare Services is comprised of the SelectRx Pharmacy, a Patient-Centered Pharmacy Home™ (PCPH) accredited pharmacy, SelectPatient Management, a provider of chronic care management services, and Healthcare Select, which proactively connects consumers with a wide breadth of healthcare services supporting their needs. View source version on Contacts Investor Relations: Sloan Bohlen877-678-4083investorrelations@ Media: Matt Error in retrieving data Sign in to access your portfolio Error in retrieving data Error in retrieving data Error in retrieving data Error in retrieving data

Four Ways Doctors Do Retirement Wrong
Four Ways Doctors Do Retirement Wrong

Medscape

time6 minutes ago

  • Medscape

Four Ways Doctors Do Retirement Wrong

The average middle-class American retires at age 62. Physicians, apparently, aren't average. Twenty percent of practicing clinical physicians in America are older than 65 years — and another 22% are between 55 years and 64 years. More than half the survey respondents in Medscape's 2025 Retirement Report said they don't expect to retire until their mid-60s or later. One reason: For many physicians, practicing medicine isn't just a job. 'No group is perfect, but as a group we tend to be kind, caring, compassionate helpers,' said Debra Atkisson, MD, a psychiatrist who's also certified as an executive coach. 'We embrace that identity as a calling and work very, very hard. We get on that treadmill, and before you know it, 25 years goes by.' That's why you should prepare for retirement, which you know — but you're busy. Listen to these doctors and other experts to help you avoid common missteps and make the most of your post-practice years. Misstep #1: You think retirement means just not working. After more than 20 years as a doctor in eastern Kentucky, Jack Piercy, MD, retired this past June at the age of 49 years. 'The way I think of it is, I'm looking for Act Two. I've always respected people who do one thing and then do something else,' he said. 'I'm not retiring to do nothing.' Piercy embraced a concept known as protirement: retiring so you can move on to something else you find fulfilling. Even if you wait until a more traditional retirement age, that may mean work of some kind. In medicine, that could mean teaching or locum tenens, (filling in for others) or working in another field. Or you might plan to devote time to volunteering, expanding friendships you didn't have time for while in practice, seeing the world, or embracing a new challenge. Piercy, for instance, is writing a novel. 'Physicians' identity is so tightly attached to what they do, they have a hard time conceiving of doing anything else,' said Peter S. Moskowitz, MD. He's well into his own protirement, as a career transition coach for physicians in Palo Alto, California. 'Open your mind and heart to the possibilities. You want to continue to grow and develop in the time you have after stepping away.' Misstep #2: You're blasé about your finances. The physicians in Medscape's Retirement Report estimated they'd need around $4 million for retirement, double what most Americans aim for. The vast majority expressed confidence they'd have enough money when the time came, but the average respondent older than 40 years had amassed less than half that. 'Certified financial planners used to say your plan should generate 80 to 100 percent of your current annual income,' Moskowitz said. He thinks 90%-100% is a smarter goal, given the rising cost of homes, travel, and other expenses. To reach a goal that large, it makes sense to start early — even from day one — and work with a certified financial planner. Piercy opted not to. 'That might be my only regret, wishing I'd sat down with somebody,' he said. 'I probably could've had more peace of mind, set things up a little better.' And look beyond your own financial needs, Atkisson suggested. 'Physicians tend to be caretakers in general, and that's not just our patients. It includes our families. There can be a lot of financial dependency needs. You have to think about who depends on you.' Misstep #3: You don't honor your emotional connection to your patients. If you've been treating a patient for years, even decades, it makes sense that you'd feel something for them. 'For the patient it can be devastating to lose their physician, but we don't often think about what it feels like for the physician to let go,' said Michelle Pannor Silver, PhD, chair of the Department of Health and Society at the University of Toronto, Toronto, Ontario, Canada. She's published several papers related to physician retirement. 'You've given so much over the years, maintained boundaries of course, but there's a human aspect. You derive a sense of self-worth from taking care of those patients, and relationships form. It leaves you with a gap when they're not in your life.' Advance planning as you approach retirement can help you andyour patients. It gives you time to discuss their charts with the practitioner taking over your cases, so you can be confident they'll receive the same level of care. And you'll be able to talk through the transition with the people you treat. After your role changes, you may want to form a new kind of relationship, meeting for coffee or a shared interest. Misstep #4: You don't prepare for your new identity. Younger generations may not feel so strongly, but if you're Gen X or a baby boomer, odds are your professional and work identities are thoroughly intertwined. Retirement calls for leaving a significant sense of yourself behind. That will take some getting used to. 'When you put that white coat on, it's a familiar feeling,' Atkisson said. 'I'm a Texan, so the metaphor I like to use is, if you've got a pair of 15-year-old cowboy boots, they fit like a glove. When you get a brand-new pair, you've got to break those suckers in — they're not comfortable.' The lack of structure also figures in. Odds are, your current schedule is jam-packed, planned out to the quarter-hour. In retirement, your time is your own, without the intense highs that come from, say, a successful surgery. That can feel bewildering at first. 'I suggest people practice before they do it,' Silver said. She recommends taking a month off to see what it feels like, a mini-sabbatical. 'Physicians are really good at practicing. Think about what your day or week is going to look like. There are tons of ways to retire. Let yourself feel what it's like.' Moskowitz pointed out that your significant other probably sees your identity much the way you do, which can cause trouble if it changes abruptly. 'It doesn't work when a doctor walks in one morning and says to their spouse, 'Gee honey, I think I'm going to quit,'' he said. 'It's like hitting your partner with a sledgehammer.' If you have at least a decade until retirement, start imagining what retirement might be. Are you dreading it, or looking forward to it? Ask again at the 5-year mark, and adjust your timing if you're dreading it. As the date gets closer, ease yourself — and your significant other — into it. Reduce your hours by 25% for 6 months to a year, until you're comfortable, then reduce another 25%, and so on, until you're ready to step away completely. It helps if you don't view retirement as a fixed situation. If you could do anything with your time, what would it be? The answer may change as you go. 'Recognize that going into medicine, you weren't great on day one. It took years and years. That's the key,' Silver said. 'Retirement is a dynamic experience. It's a chapter in life, not a destination, different for everyone. If it's not a great fit, you adjust.'

Common Painkiller Tied to Heart Failure Risk in Older Adults
Common Painkiller Tied to Heart Failure Risk in Older Adults

Medscape

time6 minutes ago

  • Medscape

Common Painkiller Tied to Heart Failure Risk in Older Adults

The antiseizure medication pregabalin, which is commonly prescribed for chronic pain, has been linked to an increased risk for heart failure (HF), particularly in those with a history of cardiovascular disease (CVD), new data suggested. In a cohort of more than 240,000 Medicare beneficiaries with noncancer chronic pain, initiation of pregabalin was associated with a 48% higher risk for new-onset HF overall and an 85% higher risk in those with a history of CVD than initiation of gabapentin. The study was published online on August 1 in JAMA Network Open . Widely Prescribed Medications Chronic pain affects up to 30% of adults aged 65 years or older. Nonopioid medications, such as the gabapentinoids pregabalin and gabapentin, are widely prescribed for chronic pain, the investigators, led by Elizabeth Park, MD, Columbia University Irving Medical Center in New York City, noted. Pregabalin has greater potency than gabapentin in binding to the α2δ subunit of the L-type calcium channel and therefore may be associated with an increased risk for HF through actions to cause sodium/water retention. To investigate further, investigators evaluated 246,237 Medicare beneficiaries between 2014 and 2018, including 18,622 (8%) new pregabalin users and 227,615 (92%) new gabapentin users. All patients were aged 65-89 years, had chronic noncancer pain, and had no history of HF. The researchers used inverse probability of treatment weighting to adjust for an extensive list of 231 covariates to reduce confounding and attempted to closely emulate a hypothetical target trial in which Medicare patients filled new prescriptions for pregabalin or gabapentin for noncancer pain. During 114,113 person-years of follow-up, 1470 patients had a hospital admission or emergency department visit for HF. The rate of HF per 1000 person-years was 18.2 for pregabalin and 12.5 — translating to roughly six additional HF events annually for every 1000 patients treated with pregabalin — with an adjusted hazard ratio (HR) of 1.48. The difference was even more pronounced in patients with a history of CVD, with an adjusted HR of 1.85. An increased risk for outpatient HF diagnoses was also seen (adjusted HR, 1.27), but there was no difference in all-cause mortality between groups. The authors said the findings further support current recommendations from the European Medicines Agency to exercise caution when prescribing pregabalin to older adults with CVD. The American Heart Association currently lists pregabalin, but not gabapentin, as a medication that may cause or exacerbate HF. Immediate Clinical Implications The co-authors of an invited commentary noted that the study provides 'timely and clinically relevant insights' into the cardiovascular safety of these two widely used gabapentinoids. From a clinical standpoint, the findings have 'immediate clinical implications,' wrote Robert Zhang, MD, with Weill Cornell Medicine, New York City, and Edo Birati, MD, Tzafon (Poriya) Medical Center, Poriya, Israel. For older adults with chronic pain, particularly those with CVD, 'clinicians should weigh the potential cardiovascular risks associated with pregabalin against its analgesic benefits. This is particularly relevant given the growing use of gabapentinoids in older populations and ongoing polypharmacy issues in this age group,' Zhang and Birati advised. 'Furthermore, if pregabalin use is associated with new-onset HF, it raises the possibility that the drug may unmask underlying subclinical cardiovascular disease, which suggests a need for careful cardiac evaluation prior to prescribing this medication,' they added. 'The study serves as an important reminder that not all gabapentinoids are created equal and that in the pursuit of safer pain control, vigilance for unintended harms remains paramount,' the investigators concluded.

DOWNLOAD THE APP

Get Started Now: Download the App

Ready to dive into a world of global content with local flavor? Download Daily8 app today from your preferred app store and start exploring.
app-storeplay-store