Tuberculosis and Tragedy in Iowa

At the end of summer, I came home from a book shopping spree at the local second hand shop run by the Lutheran Church in Germany, toting Thomas Mann’s novel ‘The Magic Mountain.’ As soon as he saw the title, my German husband said, ‘Oh no! Not THAT book.’ I wondered what was so offensive about a book full of rich characters staying at a tuberculosis (tb) clinic. Somehow the themes, gleaned from the back cover lent themselves to the tale of my grandfather, an Iowan who spent time, as did his father, combating the symptoms of tuberculosis via protracted stays at sanatoriums in Arizona, California and Iowa. In those days tb was often referred to as ‘the captain of death.’

Great-Grandpa and the ‘City of Hope’

My great grandpa, a first generation American, born to Welsh immigrants, found work as a farmer in his youth in Illinois, then as a stoker or ‘fire man’ on a train and was eventually a railroad engineer for the Chicago and Northwestern. He contracted tuberculosis while living in the mid-West. Toward the end of his life, he stayed at sanatoriums in the desert regions of Winslow, Arizona and Los Angeles, California. His treatment at those early American sanatoriums most likely consisted of a special diet (emphasizing fruit, vegetables, eggs and milk),and plenty of fresh air and rest, as these were among the few ways in which tb patients were handled in his lifetime. Patients knew they were simply biding time before ‘the captain of death’ handed them their permanent leave papers.

His last stop was the Hotel San Gabriel in the then sparsely populated, pre-Hollywood, Los Angeles, California. His departure from the ‘City of Hope,’so named because of the tb sanatoriums sprouting up there, and his return to rural Iowa, are marked on the 1900 Census where the census taker drew a line over all the pertinent information columns and simply wrote ‘left before enumeration.’ Enumeration day was June 6, 1900. Today his homeward journey would last 24 hrs, driving long highways through Nevada, Utah, Wyoming and Nebraska. In his day, railroad tracks carried not just freight but passenger cars across those states. He returned to Iowa and died a few days later. Gone at 39, he missed leaving behind a rail worker’s pension, as the C & NW only started a pension plan in 1900, and a home in Sutherland, Iowa for his wife, two daughters and my grandpa, who was 3 years old at the time.

What is Tubeculosis

Tb is a contagious disease which, when caught, can lie dormant or inactive for a lifetime or suddenly activate, usually when a person’s immune system is compromised by another illness, drug abuse or alcoholism. Though also referred to as the ‘white plague,’ in America, it affected people of all colors and ethnicity around the world.

In the early decades of the 20th century, America’s various states passed their own laws and came up with their own standards for how to try and stop the spread of tb. Early on, many states passed ‘no spitting’ laws, after considering that chewing tobacco spit flying from a mouth to hit the slime in a brass spittoon might even splash and spread the contagion. There were many mishaps along the road to a cure for tb.

Thinking isolation was the answer, some states created space in existing state mental hospitals or built add-on space to house tb patients. This led to a stigma about tb patients somehow being crazy. In the 1920s, chest x-rays were the standard method of tb detection and unfortunately gave out a high dose of radiation to the potentially already compromised lungs. The practice of collapsing a lung to let it ‘rest’ and ‘heal’ from tb proved worthless. In the 1940s and 50s various drugs, thought to cure tb, led to a rise in drug resistant tb. Last resort surgeries to remove part of or all of a lung,sometimes along with as many as 6 to 8 ribs, were drastic and prolonged a life of suffering.

In my youth I thought of tb as ‘the artists’ disease’ as many famous writers and artists of the past lived with tb and died of it. Two of the better known are Aubrey Beardsley and D.H. Lawrence. Only D.H. Lawrence set foot in America. In the 1920s, he moved to Taos, New Mexico, a high arid desert with hot summers and cold winters, the recommended climate for ‘consumptives.’ He later died in France, having sought treatment in a sanatorium there. We have his poems, short stories and novels to read, his letters and many photos of him exist. I have no such literary mementos or photos of my great grandpa, but I do have a few photos of my grandpa and, through digitized Iowa newspapers, I discovered my grandpa had a bit of a creative streak himself.

Grandpa and Oakdale Sanatorium, Coraville, Iowa circa 1950s

A family story suggests my grandfather contracted tb from a tubercular corpse he embalmed in the small town basement of his home, which served as a family run, rural area funeral business for several decades. I never quite bought this macabre story and my life-long curiosity about my grandpa, who was rarely mentioned and whose photos remained absent from our home when I was growing up, led me on a quest to try and at least discover him through news articles.

Reading 1910s-1930s newspapers,  I certainly got to know my grandpa from a perspective of youth, activity, creativity, humor and adventure. In his youth he played high school football, baritone in a uniformed small town cadet band of 40 members, and he tripped the lights in small roles in the junior and senior class plays. In 1917, as a member of the Iowa National Guard’s Machine Gun Troop, he shipped out by train, first in Camp Dodge, Iowa, then Camp Hancock, Georgia, the farthest East he would ever travel in his lifetime. At Camp Hancock he became a machine gun instructor, and later served along the Mexican boarder at Camp Cody in Deming, New Mexico, where he advanced to Battalion Sargent Major. Though he never saw action abroad, he lived in a fascinating microcosm of a tent city in the desert of south west America.

Grandpa in his late teens at training camp WWI

A highly detailed WordPress blog  documents life at Camp Cody with articles and photos, offering many insights into daily life which my grandfather would experienced. Among the news from Camp Cody was the spread of tb, pneumonia and influenza. Soldiers returning from overseas duty brought the latter disease, sometimes called the Spanish Influenza, with them.

50 years after his father died of tb, my grandfather’s tb became active. He’d seemingly escaped the diseases at Camp Cody, returned to finish high school at age 23. In his mid-20s, grandpa struck out on his own, leaving Iowa for Oak Park, Illinois, to further his interest in auto mechanics, only later to return and live with one of his sisters and her husband, working in his brother-in-law’s auto shop. A family story claims he and a WWI pilot friend built their own airplane. In the late 1920s, grandpa met my grandma, whose own father and several brothers, were funeral directors in Iowa and Minnesota. A family story goes that my grandma’s father would only allow her to run a funeral home if she married. Another story is that my grandpa fell head over heels for my under five foot tall grandma, who played incidental music at the local cinema, and wrote her love letters. Letters lost to time.

In marrying my grandma, my grandfather had to change careers. The auto mechanic re-trained and became a licensed embalmer as well as director of a family run funeral home. My aunt once said he disliked the business. I imagine he still tinkered on cars in his spare time.

Through the 1930s and 40s he ran the funeral business as well as a county ambulance service but in 1951 he took a long pause when he entered a prairie sanatorium called Oakdale, located in Coraville, Iowa, just outside of Iowa City. His first stay of 18 months saw him living at this sanatorium along with a two neighbors from home. Once a week, my grandma traveled, alone or with neighbors, to visit the patients at Oakdale, a four hundred mile, one-way, journey. My grandpa missed a few Christmases at home but one year his family visited him for a special Thanksgiving dinner for patients at Oakdale.

Still wondering about the family story that he’d contracted tb when embalming a tb victim’s corspe, as part of the funeral business, I scrolled through newspapers and found a bit of gold. Or maybe a bit of brass. From 1937 onward, the Iowa Department of Health sponsored a county nurse to investigate any possible cases of tb in Iowa. People who had been in contact was tb patients or who were suffering various lung issues, were encouraged to allow the nurse to visit their home, create a case history, and suggest appropriate follow-up, as needed. Follow up included, visiting a doctor, having a chest x-ray and possibly staying at a sanatorium for treatment. Perhaps my grandpa had the nurse stop by, as in 1950, there were 10 cases of tb discovered in his county between July, when the survey began and November, when the survey ended. Ironically, a family friend, who hosted dinners for my grandparents, and my grandparents returned the favor, also had tb. She was several years older than my grandpa but joined him for three months at Oakdale and went on to live a long life, never returning to Oakdale. She was ‘cured’ of tb. Did contact with my grandpa infect her or was she the carrier who infected him? Perhaps. Another reason for so much tb was noted in a report about the tb surveys in Iowa, which revealed that for some unknown reason, tb was more prevalent in Iowa than in any other part of the United States. Why? I haven’t found an answer yet. Tb still exists in Iowa but these are few cases when compared to the number of tb patients in the 1950s.

Daily life at Oakdale consisted of a special diet which emphasized whole grains, vegetables and fruit, eggs and milk, and lots of fresh air and rest. The fresh air treatment meant patients sat or lay on bed arranged on poaches year round, whatever the weather for part of the day. Occupational therapy and physio therapy kept patients busy, and enforced rest and silence for several hours a day as well as lights out at 9:30 p.m. It was a highly regulated lifestyle punctuated by visits from medical staff, and, when one was lucky, family and friends. In those days, local newspapers gave updates on who visited who, keeping neighbors informed about friends at the sanatorium.

In pamphlets about life with tb, emphasis is placed on the importance of keeping patients’ spirits up via hobbies. Understandably, famous creative tb patients drew or wrote their time away but less talented or resourceful patients must have found the long sedentary lifestyle trying. Knowing my grandpa had been a sportsman and mechanic, I wonder what his hobbies were when the sparkling deep prairie snow of winter fell and refused to melt for weeks on end. In two news articles, one written during his second stay at Oakdale and the second after the removal of his lung and some ribs, the journalist shared his request that friends write to him, his address was provided for Oakdale and later for a Veteran’s Hospital in Minnesota. I wonder if anyone wrote to him and where those letters are now.

After almost two years at Oakdale, the doctors gave grandpa a ‘clean bill of health.’ Less than a year went by, then his health went downhill again. A second stay at Oakdale led to the last resort treatment of the 1950s, removal of a lung at a Veteran’s hospital.

Tuberculosis and Suicide

As if living with a then fatal disease wasn’t struggle enough, and the removal of part or all of one lung, another factor leading to exhaustion and depression, a blog article, ‘Cycloserine, Suicide and TB’, reveals that one of the drugs used in the 1950s, and still used today for treating tb, has known side effects of ‘anxiety, confusion, irritability, depression, nervousness, nightmares, mood changes and thoughts of suicide.’

While reading Iowa newspapers, I was shocked to find details of my grandpa’s suicide published on the front page of his former hometown’s newspaper, including the type of gun he used, how long it took him to die, and a letter he had left for my then 16 year old father. My father says he never saw that letter, nor the news article, which was published in an aunt’s town paper and not in the town paper where my grandpa died. Today such an article would probably mean suing the newspaper and/or firing the journalist due to its insensitive nature. In 1955, the letter slipped by my grandpa’s business hometown news journalists, who focused on his upstanding character and decades long involvement in the local chapter of the American Legion. I am grateful for the tacky jounalistic expose as it enabled me to share the unknown letter with my father this month, who was grateful to find more closure and who, in turn wished his sister, who passed away last year, had had the same chance to read their father’s last words and find some kind of peace.

Besides his illness and the nature of his latest treatment for tb, my grandpa had recently lost his mother, age 91, a longtime single mother, who had raised him and his sisters from 1900 to the mid-1920s. A creative woman, she won prizes at county fairs for her pastel paintings and craftwork over the years.

Grandpa in his 20s-early 30s, 1920s-30s

His mother later lived with him and his family from 1940 to a year before her death at a local nursing home. In 1944, my great grandma, then living in her son’s home, fell down a complete flight of stairs, mistaking the door to the stairway for the door to the bathroom, and lay in bed some days recovering from her injuries. In the 1950s, she helped raise my teenaged father and aunt, while my grandpa was in and out of Oakdale and Veteran’s Hospitals. My grandma kept the family funeral home afloat with the help of a brother and later a hired assistant.

The loss of a parent with whom he had shared a creative sensibility and amiable relationship was most likely a heavy blow to him. His lack of health also meant he could no longer work with embalming chemicals, and though he could have dealt with the paperwork and social requirements of the funeral business, perhaps it seemed his second career was also at an end. Though his wife was a highly capable busninesswoman, it seems her husband’s deterioration led her to claim he was ‘no longer a real man,’ or so another family story goes. It casts a shadow on a realtionship that started so seemingly full of potential, sheds light on the strain of an almost four year commitment to a long distance relationship, and makes me wonder about another family story, grandma’s alcoholism.

When I consider his years of sanatorium life, extended distance from everyday family and neighborhood life, witnessing fellow patients not surviving tb, loss of his father to tb, recent loss of his mother, potential loss of a career he may never have wanted anyway, I can imagine his sense of hoplessness. In 1955, a month after his latest discharge from the Veteran’s Hospital, he took a gun, bought a gun at a local pawn shop, got drunk, fought with my grandma, then locked himself behind the bathroom door and never opened it again. My aunt once said she later met the pawn shop owner, who told her how much he regretted having sold her father the gun. The neighbor lady, who had spent three months at Oakdale with my grandpa, lived to her late 70s, but after a dinner with my grandma, two weeks after my grandpa’s suicide, the local Iowa newspapers never mention the families having anything to do with one another socially again. Did my grandma consider the friendly hostess the cause of my grandpa’s demise? We will never know.


The story of tb can be found in Edvard Munch’s painting ‘The Sick Child,’ government pamphlets and newsreels, medical and historial articles,  statistics, films like ‘Heavenly Creatures,’ novels like, well, ‘The Magic Mountain,’ Puccini’s opera ‘La Boheme,’modern documentaries, publications for tb sanatoriums, and numerous biographies.

Special Thanks 

Special thanks to James Conway, whose blog article ‘Suicide must be a vocation,’ unwittingly inspired me to research my grandfather’s life and suicide.

Using Newspapers for Family Research

Free online access to Iowa Historical Newspapers helped me find my grandpa, whose struggle with tb ended so tragically a life begun with the kind of small town, mid-West talent and adventure that so often goes unsung, because, by today’s standards, it looks seemingly ordinary if not extraordinary at all. It’s the extraordinary in his ordinary life that makes him, for me, unforgetable.




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