Bargaining for Life: A Social History of Tuberculosis, 1876-1938

Tuberculosis was the most common cause of death in the nineteenth century. The lingering illness devastated the lives of patients and families, and by the turn of the century, fears of infectiousness compounded their anguish. Historians have usually focused on the changing medical knowledge of tuberculosis or on the social campaign to combat it. In Bargaining for Life, Barbara Bates documents the human story. Using a wide range of sources, especially the extensive correspondence of a Philadelphia physician, Lawrence F. Flick, Bates portrays the lives of tuberculous men and women as they tried to cope with the illness, get treatment, earn their living, and maintain their social relationships. Their caretakers, including relatives, clergy, physicians, and nurses, all had their own reasons for providing help. In ways that differed with class, race, gender, and sometimes political influence, sanatoriums, hospitals, and visiting nurse societies mediated various bargains between the sick and their caretakers. Bates concludes that the campaign to control and cure tuberculosis had little impact on the disease, but it offered care, assuaged fears of infection, and expanded the welfare system. Choices made by the sick helped to shape the institutions and affected the results of the campaign. Many of the bargains between patients and caretakers are still discernible in the U.S. health care system. Bates has written an extraordinarily insightful book that combines social history, medical history, and nursing history. It will interest scholars, students, health professionals, and general readers who care about and care for chronically ill people.