~Ryan, Frank. Tuberculosis: The Greatest Story Never Told (1992) *****
The once and future scourge
Because I grew up during a time when tuberculosis had been (at least temporarily) conquered, I tended to think of it as a disease of the past, something that had slowly wasted away artists and languid ladies of society after many a year in a remote sanatorium, something almost romantic, more a relic of the nineteenth century than something that might threaten me.
However, one cannot read this extraordinary book without becoming fully imbued with the horror that is tuberculosis. Ryan shows in graphic language (and some photos that make one recoil), how the tuberculosis germ can eat away at human bodies, how it can poison and destroy lungs and internal organs, brain cells and bone, our skin, and indeed virtually every part of our body. One sees through Dr. Ryan's eyes a parasitic pathogen that "knows" its victims so well that one gets the sense that tuberculosis has been a cruel and grotesque tax on humankind since the first light of history, that tuberculosis is the price we've had to pay for learning animal husbandry, for agriculture, for civilization itself.
And then came the medical science of the twentieth century which developed antibiotics and chemotherapies that by the 1950s had tuberculosis so in retreat that many spoke of its eradication. Ryan brings the personalities that developed these cures and their struggles to life. We see them fight against not only the microbe but the nearly intractable belief held by most medical authorities that nothing could defeat the tuberculosis germ, that such efforts were doomed to failure, and anyone claiming otherwise was a charlatan and a fool. Ryan's book chronicles the story of the courageous, brilliant, and dogged people in the United States and in Europe--Gerhard Domagk, Rene Dubos, William Feldman, H. Corwin Hinshaw, Jorgen Lehmann, George W. Merck, Albert Schatz, Gylfe Vallentin, and Selman Waksman, to name a few of the most prominent--who actually developed a cure for this most horrible of diseases. It is a story of personal danger, intrigue, obsession, personality conflict and territorial spats, patent laws and priorities, money, jealousy and friendship--failure and eventual triumph set against the backdrop of two world wars.
How ironic the story is! How in direct contrast these two very human activities were: the heroic endeavor to cure disease, and the process of war--the latter a gross stupidity that served only to enhance the fertile ground of disease! As one reads one cannot help but exclaim, Oh, shame, shame on you humanity for your cruel and mindless stupidities! And hurrah for those who devoted their life to trying to understand the microbial world and its chemistry, to those who rose above the slaughter all around them and worked tirelessly to alleviate the pain and suffering of disease!
One wonders in reading this extraordinary story, how such grossly divergent behaviors by human beings can exist side by side: madness and the pursuit of knowledge. The nature of these schizophrenic bed fellows of humankind is what Ryan has really chronicled here.
But the story, after perhaps two decades of euphoria, takes a ominous turn sometime around 1978 with the incipient rise of "reactivation tuberculosis" and the "AIDS-tuberculosis syndrome" (pp. 395-396). Ryan shows that the struggle against TB, far from being over, is upon us once again with a new and terrible ferocity. He notes with alarm how the tubercular bacterium has continued to mutate against the drugs that once cured it while HIV-crippled immune systems allow the pathogen to once again run rampant through the bodies of the compromised. Already in our cities the tide against the "greatest killer of all time" has turned and the mortality rates are climbing. And in the developing nations, especially in sub-Saharan Africa, the disease in combination with AIDS threatens entire generations.
Ryan estimates that 1.7 billion people in the world harbor the tuberculosis germ, an astonishing number. He calls this a "global time bomb" waiting to explode. (p. 404) He quotes health officials as claiming as long ago as 1991 that Africa was "already lost."
This is a beautiful and horrifying book that chronicles one of the greatest triumphs of medical science while making all too vivid the fact that "the ageless leviathan of terror" (p. 378) is still very much with us, and is likely to continue to evade our efforts to eradicate it.
--Dennis Littrell, author of “Understanding Evolution and Ourselves”