How the Great TB Sanatorium Craze came to the Rocky Mountain West

Part 2 of my review of John Green's "Everything is Tuberculosis: The History and Persistence of Our Deadliest Infection." Read Part 1 here.

There was a rush in the early part of the 20^th century to isolate humans with TB, an incredibly virulent bacterium. Call it the TB Sanatorium Craze. Colorado jumped on the bandwagon early. So did New Mexico, Arizona, and California.

While I am a Colorado native, I spent 33 years living and working north of the border in Wyoming. The Wyoming State Legislature approved a TB hospital in Basin and it opened in 1927 . This probably was due to the Legislature’s tendency to parcel out important government functions: Cheyenne gets the capitol, Laramie gets the university, Basin gets the patients of a worldwide plague. It was only fair. As the years progressed, TB patients sought out famous hot springs in Saratoga and Thermopolis. The steam, heat, and sunlight were viewed as crucial TB treatments.

The Wyoming Legislature discussed a TB sanatorium as far back as 1909. During that same time, the National Tuberculosis Association sponsored a well-attended “Tuberculosis Exhibit” in Cheyenne and Laramie. The NTA traces its roots to 1904 when concerned citizens formed the National Association for the Study and Prevention of Tuberculosis. This was their advice during the Wyoming tour, as outlined in the 1910 edition of The Journal of the Outdoor Life from the University of Michigan:

“The cure consists of plenty of good, simple food, constant fresh air during the night as well as during the day, constant rest in the fresh air until there is no fever , and then carefully and gradually increased short walks, proper care and washing of your body, and proper clothing  and, finally, a determination to get well and to be cheerful in spite of everything, and only to look on the bright side of things, however hard your circumstances may be.”

Sanatoria offered all of these things with the predictable results: The Wyoming State Archives in Cheyenne shows that in 1910-1912, when most counties in Wyoming had between one and 20 cases of TB per year. Albany, Park, and Carbon counties were on the low end with one to three cases per year (Converse County had zero!) and Sheridan, Sweetwater, and Laramie counties were on the high side with Laramie County showing 18 cases in 1911.

At the beginning of the Great Depression and the Dust Bowl in September 1930, patient census at the Basin Sanatorium in September 1930 showed 15 women and 37 men. When effective TB treatments such as streptomycin emerged in the 1940s, the heady days of sanatoria came to a close. Old Archives photos show the building in Basin where patients struggled to breathe. Sad, isn’t it, that some settlers came West for breathing room but died for lack of breath?

Why is Green’s book important to us in the 21^st century? The U.S. has a 99-percent TB cure rate and about 10,000 patients yearly although that’s going up. Green takes pains to tell the story of Americans with TB and the tough time they had before modern meds. The Rocky Mountain West, especially, was home to a number of sanatoria for TB patients. The Wyoming State Archives has documents tracing the origins of the lone state TB sanitorium in Basin.

Construction began in Basin in 1926 and the Sanitarium was opened in May of 1927. By 1969 all references to tuberculosis were removed at the Wyoming Sanatorium due to the significant decrease in the incidence of tuberculosis in the state. It was replaced by the Wyoming Retirement Center which provides nursing care to residents with mental health, dementia and other medical needs.

Colorado boasted plenty of facilities. Green writes that some cities in the West were founded by TB. Colorado Springs is one of them. National Jewish Hospital in Denver had a treatment center for consumptives. It’s still known as one of the best pulmonary hospitals in the country. Fitzsimons Army Medical Center in Aurora opened in 1918 at the tail end of World War One and its specialty was treating men with TB and those whose lungs were damaged by gas attacks.

The U.S. Army sent my unhorsed cavalry officer grandfather to Fitzsimons as he struggled with a bad case of pneumonia aggravated by chemical weapons used in the war. My grandmother, an army nurse and veteran of a M.A.S.H-style unit in France, treated him there. They married in 1922. Their eldest was my U.S. Army Signals Corps veteran father who in 1950 married a U.S. Navy-trained nurse and here I am.

Lung ailments have figured heavily in my family. My brothers, sisters, and I struggled with asthma in our youth. I almost died after a bad reaction to horses at a Weld County ranch. This pretty much demolished my dreams of replacing The Lone Ranger.  

Movie westerns have featured tubercular characters. In “Tombstone,” Val Kilmer’s Doc Holliday gambles, drinks, shoots people, coughs and sweats, not necessarily in that order. A gambler calls him a “dirty lunger” and pays the price. Gunfighter Johnny Ringo calls him a “lunger” and also pays the price. The message is clear. ”I’m your huckleberry,” Doc says, before or after shooting someone. Not bad for a lunger or consumptive patient. Doc succumbed to consumption in 1887 in Glenwood Springs, Colo. He went there in 1886 when told that the hot springs had curative powers. He apparently was misinformed. Visit his grave at the Doc Holliday Grave and Hiking Trail. Flatlanders beware: it’s located more than a mile high and it’s all uphill. Healthy lungs required.

One of our U.S. presidents, sought out the West’s fresh air and healthy lifestyle in North Dakota. Theodore Roosevelt thrived, returned to politics, declared Wyoming’s Yellowstone a national park and Devils Tower a national monument, and the rest is history and myth-making.

North Dakota’s San Haven Sanatorium in the Turtle Mountains treated TB patients from 1909 until the 1940s. As final plans were made for a 1911 opening, Superintendent of Public Health Dr. J.L. Grassick referred to TB as “The Great White Plague” because physicians marked TB-infected lungs with white arrows and healthy ones with black arrows. and assessed the illness as more a lifestyle choice than a microscopic rod-shaped bacillus with plans of its own.

“Wherever man builds his habitation, depresses his vitality by overwork or by debilitating excesses, lowers his powers of life by using insufficient or improper food, surrounds himself with the expectoration of his fellows and deprives himself of the blessings of God’s free air, there you will find it.”

Sanatoriums such as San Haven offered a higher altitude than the surrounding prairie, plenty of God’s free air, proper food, and all the available treatments. One of the more gruesome ones was puncturing and deflating one sick lung to nurture the other. During its time, more than 50 percent of the patients died.

And then came bacteria-battling antibiotics. San Haven closed. The abandoned building is billed on N.D. tourism sites as a good place for ghost-hunting. No mention of how the ghosts of The Great White Plague feel about this.

To John Green’s credit, the book includes blasts at the healthcare industry (especially – surprise! -- major drugmakers) and global policymakers. He does this surprisingly quickly in 208 pages (hardcover) and 256 in paperback. I read it on my Kindle. He requires more pages to describe faulty stars and why those turtles go all the way down, but fiction is one thing and non-fiction is another.

The story that holds “Everything is Tuberculosis” together is one 13-year-old’s journey. Green is a fine storyteller and the one he tells about Henry keeps the reader hanging on to the end.

Postscript: A big thank you to my son Kevin, a writer and tech guy in Cheyenne, for hands-on research at the Wyoming State Archives. As always, the Archives staff went out of their way to help a researcher.

Go West, young man -- historical fiction along the open roads of the West

My two most recent reads were “on the road” style of historical fiction novels: “West with Giraffes” by Lynda Rutledge and “Gone, the Redeemer” by Scott Gates. I enjoyed both and probably would not have found them if I wasn’t part of the Historical Fiction Book Lovers group on Facebook. These people like to read and recommend some fantastic books that interest me now as I finish writing my second historical fiction novel.

“Gone, the Redeemer” by Scott Gates is a rollicking good journey across the U.S. of 1900 and its pivotal scene takes place in my home state of Colorado. It’s in the first-person voice of army deserter Thomas Sparkman and the reader gets to decide if he is a reliable narrator or unreliable narrator or falls somewhere in-between. Thomas runs into some amazing characters along the way including a manikin (from the Dutch manneken meaning "small man") named James who is escaping a circus, a giant who is handy with his pistols, and an Apache woman seeking her errant husband.

The bad guys are memorable too, notably the uber-capitalist Junior John. Thomas robs Junior John twice and that is almost two times too many.

Denver readers will recognize the streets of downtown Denver, mentions of infamous conman Soapy Smith, the interiors of the Brown Palace Hotel, and the old stockyards.

The author leaves us hanging in a couple places meaning there are a couple of story lines that don't get wrapped up. Also, there are some abrupt endings to chapters where the author doesn't make the most of the tension of the scene he's set up. I got a bit frustrated reading the novel in Kindle format because it's so annoying to go back to previous chapters. But that's my mistake in not going to the library or buying a hard copy, you lazy cheapskate.

The novel's ending, well, it may be a happy culmination of our protagonist's journey from wartime Cuba to his lover in California. Or it may not --- that's the risk the reader takes when he embarks on a journey with a first-person narrator. But it is a journey worth taking.

"Gone, the Redeemer" is published by Blue Ink Press, a small publisher in North Carolina. Lot of good books come out of these presses and they don’t get the attention they deserve.

Next time: I travel "West with Giraffes."

The land of historical fiction is a great place to visit

I belong to the Historical Fiction Book Lovers Facebook group. I spend a lot of time there suggesting books on various topics. I'm surprised by the number of novels that I've read that are based on historical events or eras. One person in the group asked about Native American historical novels and I rattled off some titles: "Mean Spirit" by Chickasaw writer Linda Hogan, "Children of the Lightning" by Kathleen O'Neal Gear, and "Ridgeline" by Michael Punke. Hogan's 1990 book is about the infamous Osage murders in Oklahoma in which tribal members were murdered for their oil rights. If it sounds familiar, it's also the subject of the the non-fiction book, "Killers of the Flower Moon: The Osage Murders and the Birth of the FBI" by David Grann. The book's been transformed into a movie due out in the fall. In it, the newly created FBI plays a role in exposing one of the grisliest conspiracies in U.S. history. While I knew about the Osage murders, I didn't know that the FBI blew the case wide open and that it helped propel it to bigger and stranger and unconstitutional things. But they're the good guys in this story. 

"Children of the Lightning" is an excellent novel by Wyoming writer Gear. The setting is the Central Florida East Coast and the Natives who made it their home in pre-Columbian times. Gear is not Native but she did her homework. I did some of my growing up in this part of Florida in the 1960s and 1970s. As I read the novel, I imagined Florida without the condos, tourist traps, and air conditioning. A slice of paradise but one with panthers and snakes, alligators and sharks. A wonderful read.

I reviewed "Ridgeline" for WyoFile in 2021. It tells the story of the Fetterman Fight (formerly called the Fetterman Massacre) along the Bozeman Trail's route in Wyoming. It's told from the POV of the tribes and cavalry with one particularly poignant view of the event through an officer's wife's secret diary. Punke wrote "The Revenant" in which mountain man Hugh Glass gets mauled by a bear and has to find his way home through the Wyoming wilds. Leonardo DiCaprio plays Glass but it's the imagined bear that steals the main scene. Grisly and scary. In high school, Punke was a history interpreter at Wyoming's Fort Laramie. He's also done his research on Red Cloud's War and has written a terrific novel. 

As I contemplated these books, I thought about books by Sherman Alexie, Debra Magpie Earling, and Joseph Marshall and poetry by Joy Harjo (Muscogee) and Simon Ortiz of the Acoma Pueblo. We're also seeing a revival of Native American series and movies. "Reservation Dogs" is an all-Native production that evokes the present and the past on the rez. Humorous and deadly serious. "Dark Winds" is another series featuring Navajo cops created by Anglo writer Tony Hillerman. In "1883," the bad guys are the killers from the Wyoming Cattlemen's Association and the guy in the white hat is an Indian who doesn't wear a hat. We writers like to see characters who defy stereotypes. We also like to see the times portrayed as what they probably were and not the whitewashed version as seen in old Hollywood westerns. 

I've read a lot of books. I have to mention one I'm reading now. "West with Giraffes" by Lynda Rutledge is a kooky tale of a 17-year-old hobo (Woody Nickel) in 1938 who volunteers to drive two giraffes from the East Coast to the San Diego Zoo. It's told from the POV of Nickel at 100 in a retirement home who writes his memoir and imagines one of the giraffes outside his window. 

I love the imagination writers bring to history. That's what fiction is all about. So many novels I admire were once just novels and now can be described as historical fiction. Every World War II novel including "Catch-22" and "Slaughterhouse-Five." Novels about the Old West, the Great Depression, even the 1960s and Vietnam. What was new is now old and that pretty much describes me too.

I’m no historian but Taylor Sheridan’s “1883” seems bona fide

At the urging of one of my sisters (her first name starts with M), I tuned in to "1883" last night and was up to all hours. My favorite line thus far comes from Sam Elliott, the grizzled veteran of the trails. He hates all of their delays and warns Dutton that it puts the wagon train at South Pass in October. South Pass in October can be nice from a car window in 2023. It can also be the other thing -- a white-out nightmare. Imagine yourself on horseback or in a wagon or on foot, still miles to go until Oregon.

I stayed away from Taylor Sheridan’s “Yellowstone” series because its biggest fans also seemed to be FOX viewers. I didn’t want to watch another  “Dallas of the Tetons” or a color version of “Wagon Train.” I didn’t want to see all the old tropes from a John Ford movie. The early part of his career, until “The Searchers” brought some reality to the genre. I loved the old “Wagon Train” and “Rawhide.” I loved all those TV westerns. I was a kid and looking for heroes. I got ‘em by the wagon-load. They’ve channeled my behavior ever since. My politics are a combination of Rowdy Yates and Sister Norbert. They were both enforcers who rode for the brand. Moral and fair. A bit rough around the edges.

I like “1883” thus far. It is cold-blooded in its portrayal of the migration to the West. Cheyenne at this point was 17 years old. It might have been a bit more civilized than Fort Worth, not nearly as crazy as Deadwood. Fortunately for streaming services, Frederick Jackson Turner would not declare the frontier “gone” for another decade. The Duttons will have settled in Montana or Wyoming or a version of Wyotana filmed in Canada. Wyoming would become a state in 1890 and was fairly civilized until MAGA Republicans took over the state legislature. Now all is lost.

But back to “Yellowstone.” I am watching the entire series to keep me occupied until “The Last of Us” returns with Season Two. It’s an odd coincidence but episodes 7 & 8 of “The Last of Us” take place in the winter wilderness of Wyoming and Colorado. The characters ride horses and hunt for their own meat. There are bandits and cultists and killers everywhere. And don’t forget the fungi zombies although they’ve been scarce the last two episodes. The protagonists are killers, as both Sheriff Jim Courtright (Billy Bob Thornton) and Trail Boss Shea Brennan (Elliott) call themselves in “1883.” Ellie proved to be a very capable killer in TLOU Episode 8 and Joel long ago proved he can eliminate those who threaten him or his young charge.

I am thankful when the depiction of killing is put in able hands. My wife keeps asking if we can watch something civilized such as “The Sound of Music” (she is not a “Yellowstone” fan). I say just wait as I’m standing by for the latest body count. That would be “Yellowjackets,” season 2 coming March 24 on Showtime.

Sunday morning round-up: Legislature weirdness, online publishing, and "The War on Powder River"

Russia invaded Ukraine this week. Putin does not want a democracy on its border. The Ukrainians are fighting back. The U.S. knows what joining the fight would bring. So we work with sanctions and what’s left of our free press. We also send war materiel to help Ukrainians fight the despot’s hordes. Any student of warfare knows a declaration of war would bring disaster. So what do we do?

I hope to have the print edition of my book of stories up on Amazon this week. The e-book is already on the site. Working with Kindle Direct Publishing can be a challenge. A traditional press would do most of this work. Formatting the text, deciding on a book cover, overseeing the printing process, sending out proofs, publicity. It’s all up to me now. Not sure if I’m going to put my second book of stories on KDP. I just want to have books in hand instead of taking up space in the Cloud. This blog is more of a journal than a publishing platform. Wish me luck.

The Wyoming State Legislature is in town. They will do plenty of damage in 20 days. We now experience first-hand what gerrymandering and voter suppression can do. Also Trump. And right-wing social media and TV. The nuts are out in force to suppress mask mandates, UW’s gender studies curriculum, American racism discussions in K-12 classrooms, gender equity, party-switching at election primaries, voting access, and any talk about Medicaid expansion for the state’s working poor. I’m sure more ridiculous proposals will emerge from the muck in the next two weeks. Wyoming voted overwhelmingly for Trump in 2016 and 2020. We now live in a Trumpist fiefdom.

I did not expect a nonfiction account of the Johnson County War to be shot through with irreverent humor. But that's what I got when I picked up Helena Huntington Smith's “The War on Powder River: The History of an Insurrection.” The book was published in 1966 as a Bison Books imprint from the University of Nebraska Press. This 1890s event is often referred to as the Johnson County War. It pitted the rich owners of large cattle herds against the little guy who owned a few head or a few hundred. The cattle cabal wanted to keep the open range in WYO. The little guys wanted to keep the maverick cattle that they found, stragglers from massive herds brought to Powder River Country by rich Easterners and Brits with the hope of amassing beef fortunes. Smith did an amazing job at taking a jaundiced view of an 1890s event that many people outside of Wyoming know little about. Smith’s research is impressive although this non-historian cannot vouch for all of the details. She cracks wise when describing the gentry founded ranches in Powder River Country which they enjoy in summer and desert once the first snow flies. Cowboys remain behind to watch the herds. While the winters of 1884-86 were balmy by WYO standards, the winter and spring of 1986-87 was a whopper. Many thousands of cattle froze to death on the overcrowded prairie. When the beef barons returned from the south of France, they left the round-up of strays to cowboys and got pissed off when small landholders rustled a few cattle. They got their payback in 1892, and also their comeuppance. It is easy to see the hubris of 1892 in Wyoming’s present.

Smith was an Easterner who spent some time in WYO. The TA Ranch south of Buffalo has named one of its dude ranch accommodations for Smith. The TA has the last surviving structures from the range war. Smith was a combat correspondent for Crowell-Collier magazines (Collier’s, Victory, Woman’s Home Companion) during World War II. In 1957, American Heritage magazine republished her account of the Battle of the Bulge. She recounts the breakout of Panzer divisions and how rear echelon soldiers, mechanics and engineers, were issued bazookas and ordered to stop Nazi tanks. Some of them were surprisingly successful and earned medals. Smith’s account has all the battlefield dark humor one finds in a good soldier’s memoirs. She brought that same humor to her account of the Johnson County War. I couldn’t find a full bio online but discovered she was a Smith College grad and wrote for magazines and wrote several books. The UW Heritage Center and State Archives probably has some good info on her. She obviously loved a good story.