On March 24, 1882, the German bacteriologist Robert Koch announced to the Berlin Physiological Society that he had isolated the cause of tuberculosis: a rod-shaped bacterium visible only under a microscope. With Koch’s discovery of a bacterial etiology for tuberculosis, hopes ran high among both physicians and sufferers that a cure would soon follow. But a cure that specifically targeted bacteria was slow to come. Between the time of Koch’s proclamation and the development of the first anti-tuberculosis drugs in the 1940s, the relationship between causality and cure was thrown out of sync. As historian Katherine Ott puts it, “Koch’s discovery created both a theoretical and technical void rather than any insight into therapeutics and prophylaxis” (1996, 53).
Nancy Owen Lewis’s Chasing the Cure in New Mexico: Tuberculosis and the Quest for Health provides us with a glimpse into that void through a history of tuberculosis in New Mexico from roughly 1880 to 1940. Lewis examines the ways in which the desire for healing in New Mexico catalyzed a range of ambitions around what might be loosely termed economy and politics. “Health-seekers,” also known as “lungers,” brought money into local economies throughout New Mexico, spawning a booming private health care industry devoted to the treatment of tuberculosis. At the same time, the resettlement of these primarily white tuberculosis patients was thought to provide an effective argument for persuading the federal government to grant New Mexican statehood.
As such, a major contribution of Lewis’s book lies in establishing how important tuberculosis was to the shaping of contemporary New Mexico. Health seekers came with their families and settled down. Treatment was notoriously prolonged, and there was no guarantee against relapse upon return to the unwholesome climate of the east. To remain cured—or at least healthy—often required remaining in New Mexico. These lungers and their families quite literally reshaped the landscape of New Mexico. The tuberculosis boom led to the construction of temporary cottages and tent towns, as well as to a vast array of hospitals and sanatoriums. Such buildings became an important part of the architectural backbone of present-day New Mexico, as Lewis shows us in the last chapter of her work.
The broader story that Lewis tells focuses on the ever-widening gyre the develops around a specific form of etiological reasoning: in this case, the idea that disease, and therefore, cure, depended on climate. However, as Lewis amply demonstrates, it would be incorrect to assume that New Mexico became a therapeutic destination simply because of its high altitude and dry climate. Rather, the migration to New Mexico was largely brought about through carefully orchestrated publicity efforts. Doctors across the country were exhorted to send their tuberculous patients to New Mexico. Pamphlets were distributed, newsletters were circulated, talks were given at conferences. Major corporate sponsors were solicited to subscribe to sanatoriums for their employees. As a result of such concerted efforts, the lungers poured in.
Lewis shows that a critical argument advanced through these extensive publicity efforts joined etiological claims with epidemiological assertions to insist that the residents of New Mexico—specifically Hispanos and native peoples—were inoculated against the dreaded white plague by the magisterial climate. In this manner, non-white bodies became the lure and justification for the settlement of whites in a terrain marked as inadequately or improperly populated. As Lewis points out, this desire for white bodies—as articulated by territorial legislators, businessmen and the New Mexico Bureau of Immigration—led to a permissiveness around the immigration of indigent health seekers. Unable to pay for sanatorium care, and often unable to pay for food and shelter, poor Whites established tent towns in the hopes that the climate in and of itself would be an adequate cure. Yet with the growing recognition of the economic burden posed by poor Whites and the widening acceptance of the possibility of contagion even within the salubrious New Mexican climate, whiteness proved no longer to be sufficient—especially in the wake of the Great Depression.
Nonetheless, New Mexico and its inhabitants had been radically transformed by the experience of health seeking. By the early 1930s, Hispano and native populations, the alibi for a settler colonialist project organized around tuberculosis, were found to be afflicted with the condition in devastating numbers. Given the focus on private sanatoriums, a properly public health care system was late in coming, leaving local peoples with little therapeutic recourse. Even earlier, there had been few options for tuberculous non-Whites. Lewis notes the existence of separate sanatoriums for Black and native peoples but provides scant detail about these institutions and their clearly racialized relationship to the broader therapeutic and political landscape. This might well be due to a lacuna in Lewis’s otherwise extensive source materials, in which case an explicit consideration of the limits and possibilities of the archive would have been of some value. We might think, for example, of the plaintive missives sent as audio recordings by tuberculous Inuit forcibly relocated to sanatoriums, as documented by Lisa Stevenson (2014). There, a rather different, and perhaps unintentional, archive provides us with a sense of these colonized lives and deaths.
In considering such questions of race, colonialism, and the archive, Lewis’s heroic framing of this largely white, settler colonial quest for health demands further scrutiny. Certainly, the lives of these lungers were not easy. Often hopelessly ill and destitute, these health seekers undertook what must have been a difficult relocation for a chance at survival. Nonetheless, their immigration depended on the use of native bodies as lure (“The climate is great, even the natives don’t get sick!”), labor (as workers in sanatoriums who often contracted tuberculosis), and justification (too many native bodies and not enough white ones). Lewis makes all of this clear, but what is still needed, if the archive permits, is yet another history that shows us what this quest for health looked like from the other side.
Ott, K. 1996. Fevered Lives: Tuberculosis in American Culture since 1870. Cambridge, MA: Harvard University Press.
Stevenson, L. 2014. Life beside Itself: Imagining Care in the Canadian Arctic. Berkeley: University of California Press.