In 1929, white nurses began deserting Staten Island’s Sea View Hospital, a tuberculosis facility known as a place of last resort for thousands of New Yorkers who couldn’t afford care at an expensive private sanitarium.
Perched on a 400-foot hill in then-rugged wilderness, Sea View opened in 1913 and on its first day filled with 800 patients too sick for general hospitals. By 1929, its wards were overflowing and its nurses increasingly outnumbered as they cared for patients who, in Maria Smilios’s vivid telling, “sweated and groaned and cried out” as they “coughed and choked and spit up blood, each hack sending swarms of live germs onto bedpans and sheets, tables, chairs and doorknobs.”
In her first book, “The Black Angels: The Untold Story of the Nurses Who Helped Cure Tuberculosis,” Smilios paints an indelible portrait of an era when this untreatable bane killed one American every 11 minutes. Others have covered this territory before. But this account breaks new ground by recovering the forgotten heroics of a corps of Black women who stepped into a void that no one else would fill.
When white nurses started to quit, the city’s panicked commissioner of health turned to the only skilled caregivers he thought he could lure: Black nurses whose career opportunities were all but nonexistent in the Jim Crow South. Hundreds answered the call. Their tenacity in the face of harsh working conditions and pervasive racism is humbling and inspiring — as is their contribution to the development of a breakthrough TB treatment.
Such drugs were desperately needed. In the first half of the 20th century, physicians administered “therapies” like gold salts, and sawed out people’s ribs to collapse their afflicted lungs, in the hopes of slowing the infection’s progression. The patients’ suffering — their slow suffocation, mostly (although bones, brains, tongues, kidneys and genitals could also be invaded) — was agonizing. One young woman had spent nearly 10 years at Sea View by the time she died in 1952; she was only 20 years old. Hundreds of others languished, “turning tuberculosis into a dreadful job, a grotesque career.”
Into this scene of despair marched the Black Angels. We meet the tall, graceful preacher’s daughter Edna Sutton, who fled Savannah, Ga., only to encounter a segregated cafeteria, heckling orderlies and invasive “cleanliness” inspections during her training at Harlem Hospital (dubbed “the Morgue” for its shocking mortality rate). After arriving at Sea View in 1932, Sutton became a surgical nurse, working in an operating room where temperatures could reach 107 degrees. She would keep vigil with dying patients, later bringing herself solace by reciting favorite Bible verses on the Staten Island Ferry.
Sutton enlisted her easygoing 16-year-old niece, Virginia Allen, now one of the last living Black Angels, as an aide on the pediatric ward. Children with “faces and necks turning red and fingers clenched into small fists” wailed in pain. It was a harrowing experience “that no amount of singing and reading or playing with puppets or cars or paper dolls could eradicate.”
Then there was Missouria Meadows-Walker of Clinton, S.C., who arrived at Sea View at age 24 to work on a men’s ward where patients snarled at her as she shaved them, taking macabre bets among themselves on who would be the next to die. She would sing “Swing Low, Sweet Chariot” to the dead as she bathed their corpses.
Smilios’s subjects faced constant discrimination. In 1944, Meadows-Walker became the first Black homeowner on a street near the hospital; white residents tried to drive her out. She went on to live there for decades, eventually nursing some of her once hostile neighbors.
When a new cafeteria at Sea View opened, tables bore signs reading, “Reserved for Whites.” The American Nurses Association repeatedly refused to admit Black nurses, which meant many who might have left the horrors of Sea View were ineligible for other jobs. The Black nurses were also underpaid: Sutton’s annual starting salary at Sea View was $720; the white nurses who fled the place were making $1,100.
But the daily indignities are best exemplified by the behavior of Sea View’s superintendent of nurses, Miss Lorna Doone Mitchell, a “Teutonic” woman who wouldn’t allow her nurses to mask even as patients sprayed them with hacking coughs. Most nurses soon tested positive for TB themselves.
Smilios is not at her strongest when she tackles the science, but she still spins a lively, parallel account of the quest for a cure for TB, documenting the appalling lack of protections for patients in clinical trials, and the eager media’s hype of “wonder” drugs that fell short again and again.
She follows several key scientists as they labor in academic labs and at big drug companies — potential profits often on their minds. A notable altruist was Edward Robitzek, a pathologist whose own father had died of TB. He volunteered his time at Sea View for decades, testing drugs and ultimately overseeing a landmark 1951 trial of the breakthrough therapy isoniazid. But it was the Sea View nurses who meticulously collected the reams of patient data that revealed the drug’s effectiveness. “Their work was masterful,” he said. Robbed of patients by the new drugs, Sea View ceased to function as a TB hospital in 1961.
In an otherwise excellent book, there is a disappointing lack of transparency in Smilios’s note to readers, which claims that “all the accounts and scenes in the book — including quotes, thoughts and reactions — are based on oral reports” corroborated by written documentation. But it defies belief to write that Robitzek, preparing to conduct an autopsy in 1940, “blew into his hands before unbuttoning his woolen coat and hanging it on a hook.” The scene is sourced to interviews with one of his sons, not yet born at the time, and unspecified articles and photos that he saved.
There’s a debate among writers as to whether invention in “creative nonfiction” is good practice. But even proponents agree that when it is done, it needs to be disclosed. And it did not inspiure confidence to learn from the publisher that Smilios has reversed her plans to post online the “complete source list” that is promised in the book’s seemingly incomplete notes.
Despite this flaw, this is a book that deserves reading and remembering in the pandemic age, and as TB continues to kill 1.6 million of the most vulnerable people on the planet every year.
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