Contagion and Confinement: Controlling Tuberculosis along the Skid Road

by Barron H. Lerner

In Contagion and Confinement, Barron H. Lerner offers the first in-depth look at the history of tuberculosis control in the antibiotic era, providing a vital account of this neglected chapter in the history of the disease. He argues that the new antibiotic drugs, rather than being a simple panacea, actually highlighted the complex social problems that continued to predispose people to tuberculosis and interfere with its treatment. The most controversial strategy used by American health officers to control tuberculosis was forcible detention. Since 1903, Lerner notes, health departments have locked up tuberculosis patients whose behavior presented a public health threat. Using Seattle's Firland Sanatorium as a case study, he focuses on the surprisingly recent use of detention, between 1950 and 1970. Although Firland planned to use confinement only as a last resort, Lerner explains, the facility detained nearly 2,000 patients, most of them alcoholics from Seattle's famous "Skid Road." In retrospect, it is clear that Firland staff members overused detention. But Lerner also finds that they worked hard to improve the lives of the alcoholic patients society had forgotten.

Genres: History

264 pages, Hardcover

First published November 16, 1998

About the author

Barron H. Lerner is a Professor of Medicine and Population Health at the New York University School of Medicine. Dr. Lerner received his M.D. in 1986 and his Ph.D. in history in 1996. His book, The Breast Cancer Wars: Hope, Fear and the Pursuit of a Cure in Twentieth-Century America, published by Oxford University Press, received the William H. Welch Medal of the American Association for the History of Medicine and was named one of the 26 most notable books of 2001 by the American Library Association. Dr. Lerner has published extensively in scholarly journals and contributes essays to the the Science Times section of The New York Times, the Times' "Well" blog, Slate, Atlantic.com and the Huffington Post. He has also appeared on numerous NPR broadcasts, including “Fresh Air,” “All Things Considered” and “Science Friday.” Dr. Lerner’s latest book, "The Good Doctor: A Father, A Son and the Evolution of Medical Ethics," was published by Beacon Press in May 2014.

Reviews

[Lionel Taylor · Rating 4 out of 5]

This is an academic book that I read for some research that I was doing. it is about the treatment of TB in Seattle in the first part of the 20th century. TB is a disease that has been treated as both a personal and a social sickness and the author looks at it from both of these perspectives. The book focuses on Firland Sanatorium a TB hospital that treated patients from Seattle's poorest areas including Skid Road whose name became synonymous with blighted parts of town populated by people who have fallen through the cracks of society. The book examine the different forms of treatment for these patients who usually had a variety of problems that went beyond TB such as, homelessness, unemployment and alcoholism. These other problems would often make treatment of TB much more difficult and the doctors of Firland would resort to forced confinement sometimes to ensure that their treatment regimen was followed. In the last chapter the author draws the connection between the treatment at Firland and the contemporary problem of treating drug resistant TB as well as TB among AIDS patients.

As I said before this is an academic book and I suspect that it is the authors cleaned up dissertation. That being said this is still a very readable account about the history of the treatment of one of mankind's most deadly diseases. I think that this book would be of interest to anyone with and interest in the history of Seattle or the treatment of marginal populations.