Forbidden Places–Epilogue

As mentioned earlier, I uncovered the history of Chicago’s Municipal TB Sanitarium but learned little about the purpose it served. Guest blogger Dr. Gilberto Gonzalez, a retired general surgeon, offered to fill in the blanks for me. Dr. Gonzalez trained at Mercy Hospital in Chicago for three years, the Municipal Tuberculosis Sanitarium for one year (1961-62) and two years at the University of Iowa. He practiced for 31 years in Bismarck, ND, and retired in 1995.

Although I remember getting the TB tests as a child, the disease hasn’t been a major public health issue in my lifetime. In his essay, Dr. Gonzalez reminds us that:

Tuberculosis was the leading cause of death in the western world, and was considered incurable before isolation and therapeutic intervention took place.

This is an edited version of Dr. Gonzalez’s comments and I’d like to thank him for explaining what took place across the street from the house where I grew up.

A Medical Resident’s Life at the Sanitarium

by Gilberto Gonzalez, M.D.

TBgate

On July 1, 1961, I started a residency in thoracic surgery at the Municipal Tuberculosis Sanitarium of Chicago. The Sanitarium was one of the largest in the nation and one of the largest tuberculosis hospitals in the world. The hospital could provide treatment for about 1,500 patients at a time.

The resident’s quarters were located about one block from the main hospital.  A tunnel connected both buildings, and a large cafeteria, that fed hundreds of hospital personnel, was located next to the resident’s quarters. Each resident had his own room, and we all shared a common recreation room, which had a television set and ping pong table. The unmarried residents lived on campus, but those who were married stayed overnight only when being on call.

As a City of Chicago employee, the residents had the privilege of working only eight hours a day, something unthinkable on any other hospital other than a city hospital. We received a monthly salary of $300.00; a small fortune in comparison to what I made at Mercy Hospital. (My salary at Mercy Hospital was $100.00 a month with yearly increments of $50.00 a month for the subsequent three years I spent there).

Safeguards Against a Contagious Disease. All the residents donned the hospital attire in the resident’s quarters and walked the tunnel that connected it to the Sanitarium. Approaching the other end of the tunnel, each one instinctively tied the mask’s strings, for it was mandatory to wear a mask at all time while in the sanitarium. Tuberculosis spreads through airborne droplets from sneezing, coughing or talking, and since we were in direct contact with the patients, the potential for contracting the disease was real.

The operating rooms were equipped with ultraviolet lights, which were on all the time. Ultraviolet light was supposed to kill the tuberculosis bacillus, and its use was a common practice in institutions such as the Sanitarium, although its value was controversial and some institutions did not use it any more. Since the operating room attire covered practically every part of our body except our eyes, we were spared a suntan.

A chest X-ray and a tuberculin skin test was a requisite for every one working at the M.T.S. Contracting the disease became real to one colleague resident in surgery when his skin test converted to positive while working at the M.T.S., and he had to receive prophylactic therapy. Dr. Lees used to say that it was easier to contract the disease in the outside world, than it was to get it at the Sanitarium by saying: “Here you know everybody has it and you take precautions, outside you don’t know if the person you are talking to, or riding the bus next to has it or not.”  Although he might have been right saying it, one of our colleagues had proved him wrong, and that was more than a reason never to take any chances.

A positive sputum test for tuberculosis corroborated the diagnosis. In the same manner, a negative sputum test after months or years of treatment was a requisite for the discharged from the Sanitarium. It took a long time for the sputum test to convert from positive to negative, and the discharge hinged upon providing six consecutive monthly negative sputum tests.

Many patients sputum test never reverted to negative and never got out. I recall a patient that had been there since 1931, which is the year I was born.

Treatment. The treatment was very standardized, and it progressed from one regime to the next according to the patient’s response. The results were not spectacular, since we really did not have good drugs to treat the disease at that time, and the ones we had: streptomycin, para amimo salicylic acid, and isoniazid had unpleasant side effects. We used other drugs when the ones I mentioned were no longer effective, but they were not any better and the side effects were more serious.

If we consider that para amino salicylic acid and streptomycin were discovered in the 40s and that isoniazid was discovered in the early 50s, we realize how rudimentary the treatment of tuberculosis was in the past. Tuberculosis was the leading cause of death in the western world, and was considered incurable before isolation and therapeutic intervention took place.

By the early 60s, which is the period I am writing about, the mortality due to tuberculosis markedly diminished. The combination of case finding, isolation, the use of three drugs above mentioned, and better standard of living all contributed to the decline. Yet, tuberculosis was still around and the patient’s population of the M.T.S. proved it.

New Treatments and the End of an Era. In the late 60s, two new drugs came in the market that revolutionized the treatment of tuberculosis; namely, Ethambutal and Rifampin. These two drugs, in combination with isoniazid, were very effective in reverting the patient’s sputum to negative in a short time; therefore, they did not have to be treated in a hospital; instead, they received treatment at home. So successful was the new treatment that the Municipal Tuberculosis Sanitarium and similar institutions around the world closed their doors several years later.

Now, few people may remember what happened there, and tuberculosis is fading from memory at least in developed countries. However, tuberculosis disappearance may be more illusory than real. It has always been prevalent in third world countries, and it is still seen in developed countries, and its rampant return worldwide, in a more virulent form, is not only possible, but it is happening now.  With the emergence of AIDS in the mid 80s, tuberculosis became prevalent among an imuno-suppressed population; therefore, a more virulent form of tuberculosis emerged, which is resistant to the drugs available today, and a new public health hazard may be in our midst.

I hope the world will be prepared to fight it aggressively, so scenes recorded in this chapter will not repeat, and I can safely say I was part of the last generation of doctors who saw the terrible toll that tuberculosis inflicted upon humanity. I hope also that its control extends to all parts of the world; something similar to what is happening to polio control nowadays.

Update: I have uploaded the unedited, full-length version of Dr. Gonzalez’s memoir to the Histories tab.

Photo credit: Jennifer Stix

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23 Responses to Forbidden Places–Epilogue

  1. Judi VanMeerten February 22, 2010 at 8:30 am #

    Thank you so much for an enlightenling post and explaination of the treatment of TB. We can be very thankful that our father was cured and could leave the Sanitarium and also that he could have children. When he got the all clear he was so happy and thankful that now he could have children. They waited 8 years for the all clear. He had 3 girls. His health was never real good afterwards and he passed away at age 60, but he always enjoyed life. Probably because it was so precious to him. Thanks again really enjoyed the post.

  2. frances728 February 22, 2010 at 12:17 pm #

    Judi, thanks for your comment. TB has been nearly forgotten in our times so it’s interesting to hear what an impact it had on individuals, such as your father. The fact that the city of Chicago and the state of Illinois implemented and funded a plan to contain and treat the disease back in the early 1900s is one of the great accomplishments in public health history.

  3. Carol Barstow March 17, 2010 at 7:34 pm #

    This was so interesting — thank you for posting it. (Frances — I was your neighbor two doors down, and I, too, always wondered how the Sanitarium operated and what the “personal” stories were.)

  4. Cecile Kapelanski March 22, 2010 at 11:18 am #

    I worked at MTS as a medical transcriptionist from 1960-1964 and those were some of the happiest years of my life. I had to walk from the main gates on Pulaski and Bryn Mawr, past the guard house, and down about 2 blocks to my office in the Infirmary. The grounds were like a beautiful park, with flower beds, magnificent trees, ponds, ducks, and geese. My starting pay was also $300 a month, and the employees received a free hot lunch in the cafeteria each day. Sometimes I visited the chapel on the grounds. None of the office employees wore surgical masks. Many specialists donated their time one day a week to see the TB patients, and I typed reports for dermatology, gynecology, optometry, as well as x-ray reports for Dr. Seymour Langer. The mood was very upbeat, and the patients I saw in the halls waiting for x-rays or specialists were quite pleasant.

  5. frances728 March 22, 2010 at 11:21 am #

    Cecile, I’m so glad you wrote to give us another perspective on the conditions of the MTS. Since it began as a vision with so much promise, I’m glad to know that it continued to fulfill those original intentions.

  6. Gilberto Gonzalez,MD March 26, 2010 at 3:35 pm #

    Cecile Kapelanski, I enjoyed reading your comments, particularly your description of the MTS well kept grounds. If you worked as a transcriptionist in Dr. Lees’ office, I remember you very well.You are right to point out that office personnel did not wear a mask; however,its use was mandatory for the medical and surgical staff when we came in contact with the patients.
    I wish more people that witness that era will contribute to this interesting blog.
    Gilberto Gonzalez,MD

  7. whitney April 9, 2010 at 7:58 pm #

    My mother is a tuberculosis survivor, she lived in that sanitarium for 2 years. Dr. Fox saved her life which gave me and my sister our life. Unfortunatley, my mothers father died there when she was seven years old, and he was never able to meet his two beautiful grand-daughters. My mother speaks so fondly of that place and she is always looking for some of the friends she made aling her fight for her life. I do however, can see how that would scare a small child because these people were separated from the world. I wish someone would share more information with my mother, she has been lloking for friends and doctors she made there in her two-year fight for her life. She was there from 1964-1966. Please help her complete her search.

  8. Kathleen Felters-Brials April 10, 2010 at 8:14 am #

    Dr.Gonzalez as the young lady wrote (Whitney), I’m her mom who was a resident of MTS among at least 10 people or more in my family which as you said my dad died in MTS March 1957. As far as I know I was the last in my family to live in MTS soon after me leaving MTS was no more. I find that sad considering that containment was the most efficient way to contend with TB. We were not just patients we were educated about our conditions. Even though I was admitted to MTS because of TB it was one most profound and wonderful experiences that I’ve had in my life.

  9. Cecile Kapelanski March 14, 2011 at 5:50 pm #

    Dr. Gonzalez
    I did not work on the surgical floor for Dr. Lees, although I met and respected him very much. You may either be thinking of his long-time secretary, Mary Speciale, or my counterpart in medical transcription, Mary Hendler.

    Do you remember a young surgical resident named Dr. Juanito Bartolome? I was employed at MTS during the time of his residency. We lost touch over the years, but when I was diagnosed with breast cancer in 2003, I was referred to none other than Dr. Bartolome, by then a renowned chest surgeon.

  10. gilberto gonzalez,MD April 17, 2011 at 1:22 am #

    Cecile, I did not meet Juanito Bartolome. He probably came after I left the MTS. Regardless, it is nice to reminice about a bygone era.
    Gilberto Gonzalez

  11. david April 24, 2011 at 9:06 pm #

    Frances,
    I very much appreciated your posting. I’ve lived near the North Park Village for 15 years, knowing it only as a retirement village, a nature center, and a place to recycle Christmas tress. My wife and I were driving by, and an almost rhetorical question spurred an investigation. My wife thought it was initially used as a sanctuary for lepers, but through your efforts, we’ve learned so much more. Thanks to Dr. Gonzalez, also. So much rich history; Many thanks.

  12. Frances Archer April 25, 2011 at 1:45 pm #

    David, the grounds seems to have retained their old power to make neighbors fear the worst. There was never, at least in my time, any effort made to help us understand what the sanitarium was for. I did find an old Tribune newspaper clipping about the Peterson School PTA delivering treats to the children of the Sanitarium either in the late 1930s or early 1940s. Not everyone was contagious; many patients were allowed visitors.

  13. BETTY WELCH WELLS May 10, 2011 at 4:54 pm #

    i was born in feb 1943 and 6 months later my mother was placed in mts, I was the youngest I have 2 older brothers one brother has passed. I have so many pictures of her there.she always was taking pictures that was all she had as she couldn’t be with us. i only have one memory of her and it was there. my grandmother and I went to see her however, as time passes the memory gets more and more faded. She had knitted me a blanket for my doll. and her and my grandmother watched as i played with my doll and covered doll with the blanket. She knew a lot of people there but I do not know any names.She did get to come home but I was so young I don’t remember.. She died in 1948 I was just 5 and she was 29. they said it was from a bad blood transfusion not TB. That’s what they told us .

    Some years later my girlfriends father died there.

    After I was married my father-in-law was there but he did come home.

  14. BETTY WELCH WELLS May 10, 2011 at 4:57 pm #

    correction: My mother did get to come home often but died there.

  15. Frances Archer May 10, 2011 at 6:43 pm #

    Betty,
    thanks for visiting and sharing your family’s story. How sad that you never had the chance to spend much time with your mother. Stories like yours remind us what a terrible disease TB was.

  16. John R January 25, 2012 at 10:46 pm #

    My mother worked there from ~1961 to1972. She was one of about 4 switchboard operators in the admin building–located on the west end of the campus. There was an old fashioned switchboard in a small room just inside the admin entrance. My mom traded shifts and days off with the other 3. There were 2 shifts and the board was open from 7am-11pm every day. The admin bldg was across a circular drive from the ornate theater building. I used to pick my mom up in a car at night–as the admin bldg was a long walk from the Pulaski- Bryn Mawr gate. I believe the admins name in those days was Thomas Cooney and he and his wife lived on the second floor of the 2 story admin bldg. Weird, but my uncle in the UK died from TB at an old age–75. He had it as a child but it went dormant until the last year of his life—or so we were told. My mom commented that most of the patients at MTS were outpatients in the end–but the problem became —many did not faithfully take their medication. I think you can go figure on what happens from there, Last time I went by the MTS 10 years ago, the theater and admin buiding were still standing.

  17. Frances Archer January 26, 2012 at 6:28 am #

    Thanks, for this view on the inside operations. Yes the admin and auditorium are still standing and in use–the auditorium was converted into a gymnastics facility and the admin is still admin.

  18. kathy May 1, 2012 at 6:06 pm #

    My friend was born there in August 1950. Her mother was a resident there, for how long I do not know? I am looking for her mother, in case anyone remembers her Margaret Gene Hogan or Stofell. Dr John Laughlin was the doctor. She was taken from her mother by the fathers family and has no memory of her. Any information would be appreciated.

  19. Dennis Cotter March 31, 2015 at 10:34 am #

    My Mother was a patient there circa 1942-45 (She died there 16Oct1945). Since I was very young at the time I did not know any details about the sickness or attempts at curing it until I read Dr. Gonzalez’s commentary herein. Thanks Doc!

    As a result of my Mother’s sickness, I had to have a chest x-ray until I was 12 years old. I was told this was mandatory but I never knew by whom? Maybe Dr. Gonazlez would care to comment on this rule.

    I still remember as a young child sitting in the guard building at the corner of Pulaski & Bryn Mawr waiting for my Dad to finish his visit ti my Mom. I don’t think I was supposed to be there but the guard had a big heart. If my Mom wanted to see me. my grandparents would take me to stand outside the green iron fence on Bryn Mawr ave. My Dad would bring my Mom to the fence on the inside. All we could do was look at each other from a distance. It must have been extremely tough on my Mother not to be able to give me a hug (at the time I was about 6 years old)

    I have a picture of my Mom in one of the cottage screened porches. I also have a picture of one of my Mom’s best friends in the Sanitarium. The was a Catholic Nun (Sister Gloriousa) from the Felecian Order, whose Mother House was on Peterson Ave directly north of the Sanitarium property. I have a Super 8mm film of the interior of the grounds taken about 1942.

    I tried without success to copy the pictures here???

  20. Frances Archer April 3, 2015 at 12:15 pm #

    Dennis, Thanks for sharing your memories. I will send you an email so you can send me the photos. You won’t be able to upload them directly to the blog. You can also use the contact for to send me a note, and once I respond, you will have my email address. Not great to put emails on blogs as the robots grab them.

  21. Catherine Thornhill April 30, 2015 at 12:01 pm #

    Please let me know of another tour of north park village

  22. Frances Archer May 4, 2015 at 7:14 pm #

    Will do! thanks for stopping by.

  23. edward lang August 23, 2016 at 5:37 pm #

    I was born in Chicago in 1936. My mother held an SC.D DEGREE FROM John’s Hopkins school of Hygiene (1931or32) She discussed various aspects of public health wi the me as a child. I eventually spent my career as a neurosurgeon having trained at Northwestern and George Washington ! I have published an autobiography entitled Lifetime and Fortune (2012).
    I was most interested in the MTS. Since I’m in the process of writing another book probable title. “Emergence of Medicine fromthe Dark Ages.” from just after US Civil War!
    Strangely enough ID never heard of the TB San in. Chicago. Actually no one whom I recall spoke about TB.! Frankly we were taught very little about in @ YALE Medical school in the 1950s.
    Do you know of the Naperville TB San? I had part of my surgical training at Chicago Wesley mem Hosp(Northwestern) with Dr Jerome Head a thoracic surgeon from the Naperville San!
    Ed Lang M.D.

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