A late 19th-century physician seeks a cure for tuberculosis at a time when the disease is killing nearly 14 percent of the population in the United States and Europe. He must rely on the rudimentary tools and knowledge of his time to fight back against a growing pandemic that continues to indiscriminately infect and claim victim after victim…
Sitting alone, staring almost blankly at his journal, perplexed by loosely threaded thoughts and a creeping sense of despair, Doctor Iain O’Rourke nurses his third stiff drink, chomping on the end of a drawn-down cigar, agonizing over the loss of yet another patient. Only this time, it’s personal and his usual stoic facade cannot spare him from unrelenting grief.
July 4, 1888,
Today, while the country celebrated its 112th anniversary, marking its newfound independence from the British crown, I watched in utter horror through inescapable, surreal experience as my beloved little sister gasped in desperation for dear breath, painfully suffocating from within. Her futile struggle would be her last battle in a long-fought war with consumption – the dreaded disease that currently strikes down tens, maybe even hundreds of thousands every year, perhaps more frequently. Lilly, sweet Lilly did not deserve such a cruel fate. Though one I’ve seen now countless times before, none who were so cursed were family. Now, her bacteria-ravished, lifeless body lingers in an overcrowded sanatorium, without any care or attention for her last earthly wishes. And even my station as a physician will not spare her the indignity of being another mark on a patient ledger. Outside, some still enthusiastically shout ‘Columbia! Columbia!’ Just like the patriots who valiantly fought in the very unpopular War of Independence – carrying the spirit of freedom in their hearts. As for mine, it is broken, nearly entirely void of hope because my tireless years of work have brought me no closer to a cure.
– Dr. Iain O’Rourke
Tuberculosis ran rampant through Europe and the United States in the nineteenth century. Though it began to grow to epidemic proportions during the Middle Ages, the first and second Industrial Revolutions spread it much further to alarming pandemic levels, with the deadly bacteria now infecting and killing one in every seven people – the result of people moving away from rural environments into unsanitary, crowded cities, totally absent of public health protocols.
Now, in the late 19th century, “lunger’s disease” as it was pejoratively labeled, had already taken tens of thousands, as many as hundreds of thousands of lives annually. Some of its most notable victims included:
English poet John Keats – February 23, 1821
Inventor of stethoscope René Laennec – August 13, 1826
President James Monroe – July 4, 1831
Vice President John C. Calhoun – March 31, 1850
Historian Alexis de Tocqueville – April 16, 1859
Henry David Thoreau – May 6, 1862
But, this certainly isn’t an exhaustive list – not even by the slimmest of margins. Just over twenty-five years later, Doc Holiday succumbed to tuberculosis on November 8th, 1887.
And, with less than twelve years to the turn of the century, there weren’t any standardized treatments that actually produced a track record of results. Cod liver oil, vinegar massages, and inhaling hemlock or turpentine were all ineffective but common treatments for the deadly respiratory disease in the early 1800s. Although, these were not the only fixes of the era. Surgical solutions were used as well.
Operations included purposely collapsing an infected lung by injecting oxygen or nitrogen into the chest cavity and increasing the pressure until it caved in. Physicians of the time wrongly believed the deliberately flattened breathing organ would eventually recover, hopefully returning to function without the presence of harmful lesions. But, this would instead usually result in the lung dying off, after being intentionally deprived of its regular autonomic exercise and blood flow.
Fashion and public behaviors even changed. Women’s garments were shortened so clothing wouldn’t drag on the ground, picking up potentially harmful bacteria. As for men, long beards and mustaches went out of style, and a clean-shaven look prevailed in popularity. Public signs appeared, warning people to refrain from spitting on walkways and streets, even on trains.
To separate the infected from the healthy, sanatoria, or specialized hospitals, opened in various locations, across America and Europe. Isolation from the public and fresh air were thought to be effective ways to stop the spread of tuberculosis. Yet, none of these methods proved to deliver long-term efficacy. Consequently, the disease spread unabated for many years to come.
There weren’t many big cemeteries before the Civil War but the number of deaths forced state and local governments to create such spaces, ending the practice of home funerals and private graves on family property. At the time, the average life span was approximately 42 years from the time of birth, though individuals who survived four decades generally lived another thirty years, to the age of 70. This significant disparity was due to the lack of public health, hazardous working and living conditions, and the paucity of effective treatments for serious wounds and diseases.
Despite a variety of elixirs and surgical procedures, nothing produced desired results. Making matters worse were contemporary societal conditions. The doctor who diligently scribbled notes in his personal diary and conducted countless experiments was himself an outcast – regardless of his personal triumph and stellar, extensive education.
He was a half-breed of the period, his father, was the first in the family to be born outside of Ireland, and his mother was from a tribe of indigenous natives – a group of people who were still considered savages, even among the most notorious outlaws of the day.
Iain O’Rourke was born in 1863. He grew up in a poor family with a fairly tumultuous lineage. His grandfather immigrated from Ireland in 1846, a year after the potato famine outbreak, then went out west in late January of 1848 during the California Gold Rush to strike it rich but like so many others, died pennilessly.
Iain’s father married a native American. He was part of the Union effort to push the Confederacy out of Arizona and New Mexico during the Civil War in 1862. He fought bravely, earning meritorious accommodation from his field commander and personal praise from the overseeing general.
But, his father wouldn’t live to see the end of the bloody conflict. In April of 1965, as the fierce Battle of Appomattox Court House raged on between General Ulysses Grant and General Robert E Lee, Iain’s dad died of smallpox – making him just one of 63% of Union forces who perished from disease. In fact, only 19% of all Union soldiers died on the battlefield, and still fewer, 12%, died from wounds.
Even today in 1888, regardless of his achievements and his father’s sacrifice, some people referred to him as a savage or mocked him as a medicine man. This, despite graduating from medical school at only 22 years of age and having a remarkable track record for healing severely injured patients. This, at a time when about 8 out of 10 people experienced successful operations, but only half of the eighty percent survived during hospital recovery.
Iain approached the practice of medicine in a novel way, entirely different in many respects from his colleagues. Rather than wear blood-stained clothes during surgeries – something other doctors regularly did to demonstrate their experience – he wore clean garments. He also insisted on washing any instruments in alcohol to keep them clean as well. (A clever excuse for an ulterior motive to gulp several swigs from the bottle during surgical procedures and between patients.) Moreover, he would not wash and reuse old bandages, opting instead to use new dressings, even though it was a lot more costly, it was far less time-consuming.
To him, these were not only points of professional pride, taking care to appear his best, but also to set him apart from his peers. Iain maintained the same disposition all during his medical studies. He not only listened attentively to lectures but would routinely challenge instructors with probing questions. While others were content to continue traditional practices, he encouraged spirited debates that advocated for change. But, instead of taking these traits as curiosity, perhaps as an innovative mind, his fellow medical students used such instances as an opportunity to deride and dismiss.
Any pushback Iain gave would immediately be met with collective scorn. Negative solidarity determined to see him ultimately fail out of medical school in shame. Still, day after day, he pressed on and it was this determination that first made him so attractive to his now estranged wife. Once in deeply in love, their relationship had soured to the point she abandon their house, leaving him without a wife or a child.
She left without spoken word or explanatory letter about four years ago. Since that time, Iain’s drinking habit became a coping mechanism – though he maintained control of his compulsion on the right occasions. A pretty young girl, from a well-to-do northeastern family, his bride believed his medical career and ambitions to teach and write would inevitably lead to a lavish lifestyle.
But, his penchant for self-pomposity and acerbic personality resigned them both to a rather ordinary life – no admiration among his professional peers nor the upper class she desperately wanted to join. To all of them, Iain wasn’t an equal, just a slightly paler version of the savages who scavenged and warred among one another in the plains and mountains. His appearance and ill temperament were just too much to look past and overcome. He would never be truly accepted among whites or his mother’s tribe.
But Iain was determined to escape these stigmas by making an enormous contribution to medicine, science, and society. He would pursue a cure for tuberculosis or consumption by expanding the work of Dr. Jean Antoine Villemi who in 1869, demonstrated that the disease was indeed contagious, by injecting tuberculous matter from human cadavers into laboratory rabbits, which then became infected.
Iain would also take key cues from Dr. John Snow, who discovered the link between contaminated water and cholera in London in 1854 by mapping out recent deaths and the victims’ proximity to a public water pump. It was these investigatory techniques that helped interest Iain in medicine as a young boy.
Now, over three decades later, the enterprising physician would put all his experience and knowledge into solving one of the most enigmatic and destructive mysteries of the late nineteenth century.
Putting his smoked cigar into an ashtray on his desk, and swallowing the last of his whiskey, Iain slowly stood up, closed his diary, and walked to a nearby basin and pitcher of water, pouring the water into the bowl and scooping up two handfuls, splashing and rubbing his face, temporarily divorcing himself from the grief over the loss of his sister.
The next couple of hours would be spent studiously reading through every bit of information he had collected on the disease. Books, journals, and notes littered his tiny space, with culture plates scattered around a state-of-the-art microscope, courtesy of a thankful, wealthy patient. All bits and pieces of a complex puzzle, but its assembly pattern remained frustratingly elusive and this night – like so many others before – would not yield its solution.
The morning sun came all too early, interrupting his unrestful sleep before he was ready to wake. Mentally mulling over his schedule for the day, Iain suddenly remembered he had arranged to meet the local undertaker. But, before then, he had to check in on his mother.
“Good to see you, son.”
“Hello, Mother. I’ve brought some more supplies, a bit of fresh food, too,” Iain said, pulling a stuffed saddlebag off his horse and handing it over. “There’s more than enough in there for the next couple of weeks, I reckon.”
“Thank you. But, I’m not sure how much longer I’ll be staying here – though I’m not leaving on my own accord.”
“Indian agents visit again?”
“Unfortunately. They told me it’s the law.”
In fact, it was the law of the land. Over a half-century earlier, in 1830, Congress passed the Indian Removal Act, eagerly signed by then-President Andrew Jackson.
In 1838, President Martin Van Buren dispatched federal troops to march thousands of natives to Plains territory – a journey so infamous, that it claimed approximately 5,000 lives and became forever known as the Trail of Tears. Whooping cough, typhus, dysentery, cholera, and starvation ravaged the tribal people along the 1,200-mile route.
The Indian Appropriations Act followed over twenty years later in 1851. Then, in 1887, the Dawes Act was signed by President Grover Cleveland, dividing large reservations into smaller plots for individual families. This too, proved disastrous for the very people it was intended to help. It placed indigenous families on land unsuitable for farming. And, those who received good plots were often not financially equipped to afford the cost of farming.
With him by her side, she would still occasionally experience discrimination but would not be compelled to move to a reservation. Iain could take his mother in but her pride was too great and she believed her son wouldn’t be single for much longer. After all, marriage wasn’t traditionally permanent among her tribal peers, family, and ancestors. It was common for men and women to marry but separate later on. Though Iain knew his mother’s feelings well, he nevertheless attempted to persuade her.
“You don’t have to live this way. Let me help pack up your things. Come stay with me.”
“No. I won’t lose my house, my land to the white man. It is here I should stay until the Great Spirit calls me to the afterlife.”
Iain sensed the futility of arguing anymore, “Okay, if you insist. I’ll be back in a week or two. I’ve got to be going, I have some business to attend to this afternoon.”
“All your hard work will pay off one day. Until then, stay the course, son. Now, go make history.”
She caressed his cheek, sighed, and watched as he mounted his horse, and slowly rode off into the distance. She knew this might be the last time she saw her son, but she much preferred he retain his freedom, and be allowed to practice medicine, rather than deal with the humiliation and disheartening politics of reservation life on her behalf. If she did comply, these would become an all-consuming reality. As long as she could hold out, her son would have less to worry about. It was far more important for him to get a real shot at a good life and perhaps, eventually become the man who cured the most dreaded disease of the era.
Iain didn’t want to leave his mother by herself again, but he knew all too well that she wouldn’t be swayed. Better to get on with the day’s business and return later; perhaps given some time, she would finally come around. It wasn’t a very likely scenario, but the only hope he had left for her wellbeing. Focusing on his goal would prove a much more rewarding pursuit.
“Good afternoon, sir!” Iain pleasantly greeted the town undertaker.
“Well, good afternoon, to you too, Doctor.”
“Sure is lovely weather we’re enjoying today, wouldn’t you say my good man?”
“Yes, the weather is fine. But, I’m not so concerned about the weather as I am the poor souls you’ve come to disturb. It’s just not right – cutting them up.”
“Now, we’ve been over this before. I’m not desecrating anything or dishonoring anyone. This is simply a necessary function of science!”
“All right, Doctor. All right. I’ve told you I’m not comfortable with these practices. But, since there’s no one to claim them, I suppose…”
“Don’t worry. I am empathetic to your position. I’ve told you, I am not asking for anyone who has placed their trust in your capable hands. As for the unclaimed, well, those are an opportunity.”
The undertaker reluctantly complied, “Here they are, Doctor, the latest to come to me. Four total.”
Iain looked over the bodies, noting, “This one is just a boy, perhaps fourteen, maybe fifteen?”
“Yes, indeed. The Newbrunswick boy. I believe you attended to him not so long ago.”
“I did…barely recognized the lad.”
“Smallpox.”
“I see that – terrible fate, I’m afraid.”
“Those two over there, Doc, are twin sisters, from the Gentry family.”
“And, I take it, the fourth is unclaimed?”
“Correct. Probably a drifter – might even be an outlaw. But definitely a lunger. I’ve seen enough to know just by looking. Now, let’s keep this discrete, shall we?”
“By all means. I’ll be back after sundown. Thank you for your help, sir.”
As dusk settled, Iain worked diligently by candlelight and lantern, carefully removing the infected lung from the unclaimed body to study it under his microscope, taking copious, detailed notes, attempting to expand on the work of Dr. Jean Antoine Villemi, who proved tuberculosis was infectious from one host to another over twenty years ago. The more familiar he became with diseased tissue, the more he could learn about its abilities to spread.
Unfortunately, the bodies he’d studied thus far were fatalities of advanced consumption. So, there were fewer differences to note. Although, he could compare and contrast an infected lung with another absent of the bacteria, and this particular cadaver provided that very opportunity. No trace of the disease was present in the other he later extracted. So, Iain could easily discern the differences between the bacteria-laden organ and the healthy one.
However, disposing of the corpses proved challenging. The first experimental body was a known scoundrel during his life. A miscreant hated by just about everyone. After dissection, Iain simply scalped the reprobate and left his remains alongside a trail, previously patrolled by troglodytes.
But, subsequent subjects were more difficult to dispose of. A couple, Iain left outside a wolf den, and two more he later dumped into a nearby lake. Recently though, he happened across the perfect means of disposal – an abandoned pig farm. The swine had already devoured the smallest and weakest among their drift. The neglected drove further dwindled in size until fresh bodies for feasting became available.
It was a morbid and repulsive affair, but not as daunting as his forever-blood-soaked hands. His palms absorbed so much red, no amount of rigorous scrubbing or turpentine would wash them completely clean. Thankfully, his tinge-red, brownish complexion inherited from his mother provided just enough concealment. Plus, he was a physician who did perform operations. So, the stains could easily be explained away.
After carefully studying the two freshly extricated lungs, Iain administered yet another toxic mineral to a rabbit he infected only days ago. This time, elemental mercury, a widely used mineral, even found in blue mass pills, something President Abraham Lincoln took to treat his hypochondriasis or melancholia. People still relied on mercury to heal a number of ailments, including constipation, syphilis, influenza, parasites, and much more.
Iain chose rabbits because they were small, easy to handle, docile in temperament, simple to raise, and multiplied regularly. Trying various minerals, herbs, and more, in conjunction with closely examining the remains of human victims, would help him form a clearer picture of the nature of the disease. Additionally, he could offer suffering patients potential arresters or cures, if they so accepted the experimental nature of such practices.
July 10, 1888,
My latest test subject shows some subtle signs of recuperating after I administered three injections of mercury straight into the infected lung five days ago. Although, its appetite appears to have diminished notably and it occasionally displays odd behaviors, such as periods of listlessness, followed by manic energy. Also, bare patches, absent of fur have become prominent in some spots. Meanwhile, my sickliest human patient is growing increasingly ill with consumption, even after taking laudanum. She says the opium-based elixir does provide a modicum of relief from chest pain and does help reduce uncontrollable coughing fits. However, my most recent examination reveals her condition is nevertheless advancing, now affecting as much as 60 percent of her lungs.
– Dr. Iain O’Rourke
Laudanman wasn’t the only contemporary medicine Iain gave to his patients he diagnosed with tuberculosis. The physician also tried lithium. To his great disappointment, the mineral did not cure the disease. Patients reported suffering from nausea, along with vomiting, diarrhea, and constipation. They also experienced unusual drowsiness and dry mouth, as well as frequent urges to urinate. One developed a skin rash but none were spared from the deadly inevitably of the lung disease.
Moreover, the rabbit repeatedly injected with mercury did not recover and succumbed to the awful respiratory disease, a subsequent post-mortem examination or necropsy revealed. Frustrated but determined, Iain resolved to keep experimenting with other minerals and alternative surgical procedures. Any progress made must be followed enthusiastically but with skepticism.
“Doctor! Doctor!” A voice cried out, begging for his reply.
“Yes?”
“Doctor Iain O’Rourke?”
“Yes, that’s me. What can I do for you, ma’am?”
“I’m sorry to intrude upon you but a nice gentleman outside of town told my husband and me you’d be happy to help. We’re on our way out west – want to stake out our own parcel of land. But, my oldest son, well, he’s not feeling very good.”
Iain didn’t hesitate, taking the boy in and giving the lad a thorough examination. It was an obvious case, though early on – perhaps just a few months after the initial infection. What’s more, the onset of tuberculosis presently only affected one lung – the disease had not spread to the other.
“I am truly sorry ma’am, I regret to inform you it’s…it’s uh, consumption.”
The mother burst into tears, weeping uncontrollably, cursing the disease, in an ineffective catharsis. Her husband hugged her tightly, his eyes welling, asking,
“What is it we can do? Is there anything you can do for our son?”
“Perhaps. I’m really not sure, though.”
“C’mon, Doc! There must be something, something you can do for him!”
“Well, I suppose I could…I could, uh…”
“You could what, Doc? What?”
“Say, might I ask, when did you lose that leg?”
“Back in ‘64, caught some type of infection. The doctor gave me a choice, he said, ‘Lose the leg or lose your life.’ It was an easy decision.”
“I see, I see. And, may I ask how old you were at the time?”
“Nineteen.”
“And you’re how old now, may I ask?”
“Forty-two.”
Iain thought quietly for a moment. “Of course, ‘lose the leg or lose your life.’ It’s definitely worth a try – might stop the bacteria from spreading” He thought, suddenly realizing it was possible to remove the boy’s infected lung and leave the teen with a healthy one. It was a risky proposition, but the kid was already doomed to a slow, painful death. This novel procedure would at least give him a chance at living a longer life.
“With your permission, I can operate. I can remove the diseased lung and he’ll be left with a healthy one. But, he’ll need at least a few days to recover, maybe as many as four or five before he’s ready to travel.”
The boy’s parents, though hesitant, were desperate to save their son’s life. But, couldn’t afford surgery. Iain agreed to perform the operation free of charge, asking his parents to keep him updated by mail or telegraph once they made it to their destination.
Rumors of an enormous land giveaway had been persisting for some time now. Although, the land grab wouldn’t happen for several months. The official announcement didn’t come until March of 1889 by President Harrison and the actual event would follow a month later in late April. Still, speculation grew feverishly and a good number of eager settlers made their way from the east to the west.
For this family, time was of the essence. If the talk was true, they’d be in wild, unsettled territory with a sickly boy and with no guarantee of a doctor to attend to his condition. The wait was worth the potential upside. Plus, it gave them a much-needed respite, having traveled so far under such strenuous and dangerous circumstances.
July 16, 1888,
Six days ago, I performed what I believe to be the first successful lung removal from a young male patient, sick with early stages of tuberculosis. After a follow-up examination, no presence of consumption is apparent in the remaining lung. He is due to travel anytime now, and I have instructed his parents to keep me updated on his condition. I hope and pray they’ll find a competent physician when they arrive, one who can provide them with sound care and advice. Meanwhile, I have given a juniper berry concoction to yet another patient, one who I have also recently diagnosed with the bacteria. My mother’s people have long relied on Juniperus scopulorum, the leaves and inner bark, as a cure for coughs and fevers. The results of the latter experiment should be known in short order. Until then, I will continue to test other methodologies. Though I am discouraged by the lack of quantifiable progress, I am confident my work will be of great service to my own efforts or possibly to my contemporary or future medical colleagues.
– Dr. Iain O’Rourke
Two days later, Iain returned to his mother’s home, only to find to his alarm well-groomed horses outside. These are clearly not the property of hungry or thirsty travelers seeking a bit of food or water, but of government officials, there to harass and intimidate. As he dismounted, he could hear loud voices shouting at one another from within.
“What’s going on here Mother?”
“These men, these men are telling me I must relocate to the reservation across the county. I have informed them of my full intention to stay right here!”
“I’m afraid there is some confusion here, gentlemen. You see, my mother is the wife of an accommodated, fallen Union soldier – a man who fought for the rights of everyone. And, I am the local physician in the nearby town.”
“I am sorry, Doctor, but all hostiles…err Indians…are required to be resettled. We are trying to save your mother from harm by rogues and rebels.”
“That may be your intention, but I can assure you she is not subject to the Relocation Act!”
“Okay, Doc, have it your way, for now. But there will be uniformed, armed escorts coming and they will not take ‘no’ for an answer. They will fulfill their orders, no matter the objection!”
With that stern warning, the men walked out of the house, got on their horses, and trotted away. This wasn’t a bluff, it was a threat, and one that would not tolerate resistance of any kind. It was useless for Iain’s mother to further put up a fight. But, this type of compliance just wasn’t in her nature. In fact, if anything, such ultimatums only stiffened her resolve to defy, no matter what the cost. He knew it wouldn’t do any good to pile on and attempt to persuade her otherwise. Still, his instinct to protect her couldn’t be suppressed.
“You see! You see what I mean Mother! This is no way to live!”
“I’d rather put up with the white man’s thuggery and live on my own terms than to live on his! Your father and I settled this plot of land and I will not give it up!”
Iain walked out the door to his horse, took the saddlebag off the animal, and gave it to his mother, “I know you’re determined to make a stand. But I don’t think sacrificing your life is commendable. Come stay with me in town, where you’ll be safe.”
“Safe?”
“At least you won’t be harangued and bullied.”
“I’m sorry, this is not the way of our people. I cannot give in to this as long as I can put up a fight.”
“Please, think clearly. This is a long war. Chose your battles carefully, Mother. If you can’t defeat the enemy on the present terms, consider changing those terms. But, until then, don’t create undue tension.”
“Our people have been here for many generations and it’s only right that I carry on their traditions, my son.”
“In principle, I agree, but the circumstances aren’t favorable. Come with me and leave this strife behind.”
“I am not staying because it’s easy. I am staying because it is so difficult. Resolve is a defining quality. You should know – your experiences are a great example of that truth.”
Iain couldn’t argue any longer. His mother wouldn’t give in to simple reason. It was a matter of pride and she could not abide letting go of her dignity, her identity. Still, it was only a matter of time before she could not resist any longer. He could only hope he’d be there when the inevitable came. In the meantime, it was enough to bid her farewell until then, reassure her he’d return shortly, and never let her down. Now, he had to turn his attention back to his work. Doing so would redirect his sense of protectionism nearly seamlessly to ambition – though he could completely put the escalating situation out of his mind.
Upon arriving back in town, he was greeted by Federals. Dressed in their official uniforms and carrying a wounded comrade, they begged for his help.
“Doctor! Doctor! We’ve got a wounded man here who needs medical attention right away!”
“Okay, all right, just let me take a look there, Colonel.”
“We were coming back from patrol. He had to relieve himself. Next thing I know, he’s screaming and carrying on, grabbing at his leg, squeezing his ankle.”
“Snakebite, huh?”
“Yep. Figure it was a rattler, too. Mean creatures, they are.”
“Indeed. Bring him into my office, we’ll get him fixed up, Colonel.”
“Thanks! Hey boys! Bring him in! Quickly, quickly, now!”
“Colonel, go ahead and fetch that bottle of whiskey off the counter, and the bottle of ammonia next to it. And, grab some bandages while you’re at it.”
The Colonel hurriedly scooped up the requested supplies, putting them down on the table on which his wounded soldier laid, “Here ya go, Doc. Anything else?”
“Yeah. Colonel, you and a couple of your men are going to have to hold him down while I cut out the venom. Now, he’s going to struggle, kick, and scream, but you’ve got to keep him as still as possible – all right?”
“Sure, Doc, sure!”
Iain gave his patient a couple of big swigs of whiskey, put a leather belt in his mouth, then worked quickly, first opening the wound and squeezing out as much of the venom as he could. He wiped it clean and poured some ammonia on it to wash it, then applied a bandage to the wound.
“Hey Doc, what about the salt or some gunpowder? Maybe an egg yolk or two?”
“No, Colonel, those won’t help. Just let him spit out that belt and sip a little on that whiskey bottle and keep the bandage tight. But, not too tight – it’ll cut off the blood circulation and he’ll wind up losing that leg for no good reason.”
“Thank you! Thank you so much, Doc! I’ll see you get paid extra for this one. He’s one of my best men. Sure thought he was a goner.”
“He should be fine. We’ll know for certain by sundown if he’ll fully recover.”
“I really do appreciate you lookin’ out for him, Doc. Say, Corporal, run over to the general store. Grab a couple of bottles of premium whiskey, a handful of fine cigars, and a newspaper. Bring them all back here for the Doc. And tell the proprietor, it’s all on me!”
“That’s mighty nice of you, Colonel.”
“No trouble at all. I’ll have one of my men wait here with you, keep an eye on him until you say it’s okay for him to go. That be all right with you, Doc?”
“Sure, Colonel.”
The Corporal rushed out the door and was back in no time. He handed the whiskey bottles, cigars, and newspaper to the Colonel, who gave them over to Iain, “Here you go, Doc. You enjoy!”
“Well, it’s too early for a drink. But, I might enjoy a cigar and read the paper.”
Iain thanked the Colonel again, checked on his patient, then lit up a cigar and sat down in a nearby chair. “Let’s see here, my good man, what’s going on in the world,” he said, unfolding the paper to look at the front page.
Scanning over the headlines, he saw the usual hype – yellow journalism was an ordinary practice, so Iain didn’t pay too much attention to the outlandishness. But, when he got beneath the fold, one particular piece caught his eye immediately – a short article about a tuberculosis patient in an adjacent town who beat the infection. Iain excitedly read through the newspaper account.
“Corporal, Corporal!”
“Yeah, Doc? What do you need?”
“Do you know this town?”
“Yes, yes I do.”
“I need to telegraph the town doctor, do you know his name, Corporal?”
“No, I’m sorry, I don’t, Doc. But it doesn’t matter. Their telegraph was sabotaged recently. Bandits robbed a stagecoach and cut the line so the marshal couldn’t get the word out.”
“In that case, how long does it take to ride to this town?”
“Let’s see. Hmm. Well, a good two and a half, maybe three hours. Be faster by train, if there were tracks laid between here and there.”
“I’ve got to leave right away. You stay here, look over your fellow soldier until the Colonel comes back. Tell him I had urgent business to attend to.”
Iain didn’t waste any time. It was already too late in the day to travel but he could make the journey in one day if he started early enough the next morning. So, he went directly back to his house and prepared for the trip.
July 18, 1888,
Today, I’ve read an extraordinary account about a man who survived consumption. No doubt the town physician has made some magnificent breakthrough and I intend to learn what it is. Perhaps my own work can contribute to truly ending tuberculosis, even if it’s a minor role. I’ll speak with the attending doctor at length and interview the patient. Maybe he followed some sort of regimen or took a new elixir. Regardless, I will endeavor to replicate this exceptional success. I only pray this isn’t an anomaly and the remedy is applicable to a wide scale. If not, too many more will die until a revolutionary leap catapults mankind over the excruciating long path to a real cure for this dreaded scourge that spreads unchecked all over the world.
– Dr. Iain O’Rourke
Before daylight even broke, Iain was already on his way. By mid-morning, he arrived, inquiring from the first person he came across, “Good morning to you! Where may I find the town doctor?”
“Down the street and across, if he’s in.”
“Thank you!”
“You’re welcome!”
Entering the town physician’s office, Iain called out but there was no reply. He walked through each room, finding every single one of them empty. Disappointed, he grumbled to himself, angrily yanking his hat off his head and slamming it to the floor.
“You all right there, Mister?”
“Oh, yes. I’m sorry. Are you the town doctor, by chance?”
“I’m his intern. Just finished medical school and going through an apprenticeship.”
“Tell me, do you know the man who’s featured in this article?”
“Yes. He’s a patient.”
“Could you tell me how the Doctor treated him?”
“Oh, the usual. You know, a little bloodletting, sniffing some turpentine.”
Iain stood puzzled. He knew after extensive experimentation neither worked. In fact, they did nothing at all to stop the bacteria from spreading through the lungs. Still, he wasn’t about to rudely challenge the puppy doctor.
“Well then, when do you expect the doctor to be back?”
“He’s out on a call. But, should be on his way back here soon. I can take you straight to him.”
“That would be great! Thank you!”
The intern led Iain out the office door and down across the street, pointing out the doctor as he approached.
“Hello, are you the town doctor?”
“Yes, I am. And you are?”
“Doctor Iain O’Rourke. I’d like to speak with you for a moment about a patient of yours. His account was written in the newspaper and I was curious about your methodology.”
“Of course. I treated him with bloodletting and turpentine. For whatever reason, the protocols worked. I’ve examined him subsequently, four times now, and can’t detect any presence of consumption. His cough totally abated to a complete stop and he no longer spits up blood, either.”
“Remarkable. May I ask you to introduce us?”
“I’d be delighted, Doctor O’Rourke.”
“Thank you.”
The town physician introduced Iain to his patient. The three of them spoke briefly before the town doctor left them to speak alone further. As the two conversed, Iain asked a number of questions while pondering over the case. But, he just couldn’t pinpoint any specific set of details that would constitute a cure.
“So, you’re feeling well now, I take it?”
“Sure thing, Doc. I don’t know how to explain it – must have gotten some good family blood from my parents, I suppose.”
“Good family blood?”
“Well, I’m just funnin’, but it’s what my Pappy used to say whenever he got lucky with something.”
Iain smiled back, still quietly contemplating what could be responsible for this astonishing turn of events. “‘Good family blood,’ the boy says. ‘Good family blood.’ Maybe that is the answer! Something in his blood fought off the disease!”
It wasn’t a completely crazy notion. After all, the first successful blood transfusion was recorded in the late 17th century in 1665 by Dr. Richard Lower from one dog to another. And again from lambs to humans in 1667. But these transfusions were to help replenish a patient’s blood supply, not to introduce new plasma from a healthy or immune individual to a sick person. What’s more, it was the core belief of the bloodletting practice – bad blood drained will help patients recover. Although, many perished due to miscalculations, losing too much to live. Still, it was worth a try. It might well be a viable cure for tuberculosis.
“Would you be willing to help me find a cure for consumption?”
“Sure, Doc, I’d love to help. But, how?”
“If you’ll permit me to take some of your blood, I can give it to a tuberculosis patient. My guess is your ‘good family blood’ might be the source of a cure!”
The young man agreed and traveled with Iain back to his town. Once there, Iain made the necessary preparations and performed the procedure. “I can escort you back home or have someone accompany you. Thank you so much for all you’ve done, I am grateful!”
“No problem Doc. I can go alone. But, I would like to know if it works out. Would you send me a letter or a telegram?”
“Certainly! I’ll let you know. Be sure to rest for an hour or so before you go. And, take some food and water with you.”
July 22, 1888,
It’s been two days now since I gave my least ill patient the so-called ‘good family blood’ and after a recent examination, there appears to be little to no change. I take this as a good sign, given some patients tend to deteriorate faster than others when struck with this particular condition. It is plain that substantially more time must pass to know if this experiment is successful or if it ends in failure (maybe a couple of months). I am fully prepared to call on the donor again if warranted. The transfusion itself went smoothly but it is difficult to assess its efficacy. It might well be the case that such a healing trait is passed exclusively from one family member to another. But, I do hold out hope introducing healthy blood to an infected individual will yield positive results. More extensive study, trial and error, will only tell in the end.
– Dr. Iain O’Rourke
Iain kept a close eye on his transfusion patient over the next several days. He took down notes, recording any changes in lung function, capacity, and signs of advancing tuberculosis. To his great dismay, the ‘good family blood’ did not arrest the infection. Though it only grew ever-so-slightly pronounced, it would eventually become apparent the experiment fell well short of its lofty goals.
He even called back the donor twice, performing two more transfusions over the course of as many weeks, in the hope it would make a notable difference. But, the very fact the procedure had to be repeated made it evident this was not a viable treatment. Regardless of this failure, he dutifully recorded detailed notes. A full account of everything was imperative to solving the problem.
Iain poured a stiff drink, gulped it down in a few chugs, poured another, lit a cigar, and guzzled the second down in moments. He puffed on the stogie, chewing on the end in anger, pouring a third, when he heard an alarming cry, “Doctor O’Rourke! Doctor O’Rourke!”
“Yes, what is it?”
“I jist got back in’ta town. I seen me some Federals on your momma’s land! Them boys is armed to the teeth – they mean business, I’m here to tell ya!”
Iain rushed to his mother’s home as quickly as his horse would carry him at full gallop. When he arrived, he saw his mother in a stand-off with the soldiers.
“Now, ma’am, it ain’t got to be thisa way! Just put the rifle down and we’ll talk thisa thang out. I’m ah-promisin’ you!”
“There’s nothing left to be said to you white devils! Just get off my land and leave me be!”
Iain leaped off his horse, even though it hadn’t come to a total stop, ran between his mother and the soldiers, and put up his hands. “No one needs to get hurt here! I want you boys to slowly put your guns down and back away a little!”
“Mother, don’t do this! It’s not going to help. I need you to trust me, okay?”
His mother wouldn’t heed his warning. She cocked the rifle, pointing it at the men, causing the soldiers to aim their guns back at her. Iain knew the troops weren’t going to capitulate and his mother showed absolutely no sign of submitting to their demands. Iain had no choice to but try to de-escalate the situation. So he slowly walked over to his mother, stood behind her, and gently pushed the barrel down, while she continued to hold it in defiance, pointing it to the ground.
Giving in to her son’s direction, she loosened her grip, “I will not put you in danger.” Relieved, Iain let go of the rifle and backed away from his mother. She looked back at him, then turned toward the soldiers, tightening her grip and raising the gun.
A shot cracked the air and his mother fell to the ground, grasping her side, bleeding profusely from the wound. Another shot quickly followed and the commander yelled, “Hold your fire, hold your fire!”
But, before the troops could obey, Iain’s mother squeezed off a shot of her own, striking one of the soldiers in the stomach, forcing the trooper to fall off his horse, while causing his horse to neigh loudly and rear up.
“Someone, grab ahold of that there spooked animal!” The commander shouted, continuing, “And someone else, tend to that man!”
Iain crouched down over his dying mother. “This didn’t have to happen, Mother! This didn’t have to happen!”
She clutched his hand tightly, whispering, “It was always going to end this way, my son. Here or on the reservation. But, don’t give up your fight. Don’t let all of this be in vain.”
Iain comforted his mother as best he could in the moment, holding her hand in both of his as it went limp. He stood up, grief-stricken picking the rifle up, turning toward the soldiers, facing them directly.
“Wait! Wait! Don’tcha do it!” The commander warned as his troops trained their weapons straight at him.
Iain held fast, putting the butt of the rifle against his shoulder and pressing it tightly against his body. He aimed right at the commander, leaning his face to lead his right eye down the barrel, his left eye shut to focus.
“This here is an impossible situation! Please, put down that rifle,” the commander implored, signaling his men to lower their weapons to defuse the confrontation.
Iain kept his sight right on the commander, audaciously cocking the rifle, ignoring the pleas of the wounded soldier who cried out for help.
“This here craziness has gone far enough! It’s time to stop!” The commander said in a stern but low voice.
Iain took a deep sigh, slowly decocked the rifle, and gently tossed it to the ground.
“Good! Now, I’d be even more appreciative if you help my wounded man – he needs medical care, right away.”
Iain didn’t say a word. Instead, he crouched down again, picked up his lifeless mother’s body, and began to carry her into the house.
“Doctor! If’in you don’t take action immediately, this man will be condemned to death!”
“That man was condemned to death the moment he committed this heinous crime.”
“Think this through, Doc. The government will throw a noose around yer neck if ya don’t help him.”
Iain refused to answer, turned around, and carried his mother’s body into her house, only to momentarily reappear to slam the door shut.
July 25, 1888,
Tomorrow, I will be let out of this dark, dirty cell only to be led to the gallows. The government has sentenced me to death by hanging for complicity in the murder of a Federal soldier. I have tried to serve mankind to the best of my abilities. But now, due justice is at hand for the real transgressions I repeatedly committed against humanity in the name of science. I can only hope my work will further modern medicine and lead to a cure for not only consumption but other diseases, as well.
– Dr. Iain O’Rourke
Doctor Iain O’Rourke’s notes were later discovered. His work helped his peers and future physicians and scientists to rethink their treatment protocols, and experiments, ultimately steering the medical community on the way to a cure.
Five and a half decades later, biochemist and biologist Selman Waksman discovered a compound during World War II in 1943, that effectively acted against the bacteria, called streptomycin. Six years later, in 1949, the antibiotic was administered to a human, and the patient was cured.
By 2020, a total of 1.5 million people died from tuberculosis around the world, when the global population stood at 7.753 billion, representing just 0.00019347349 percent. During the late 19th century, worldwide fatalities from the deadly lung disease killed 14 percent of the total population.
