Students visit Firland Sanatorium

Firland SanitoriumIt is estimated that at the start of the 20th century, 1 in 7 people who ever lived had died of the white plague.  Also known as tuberculosis, treatment in the pre-antibiotic era centered on the “sanatorium cure” and included strict bedrest (laying on your back for 24 hours a day), cold air, sunlight, rich diets, and extreme surgeries that ranged from artificially deflating lungs to rib removal. King county residents had the opportunity to get free treatment at Firland Sanatorium, if they were willing to submit to the strict rules “guaranteed” to improved health. Firland opened in 1911 and over the next few years grew to a capacity of 250 beds.  One of Firland’s most famous patients was Betty MacDonald, famed local author of the Mrs. Piggle-Wiggle series, The Egg and I, and later, The Plague and I, which was based on her experiences at the sanatorium.  While treatment at Firland was voluntary, the concept of informed consent didn’t always apply, and Betty MacDonald’s account gives us a narrative of the personal toll a tuberculosis diagnosis and the stigma and isolation that goes with it can have on a patient.  Stefanie Iverson Cabral teaches several courses in the School of Nursing & Health Studies that focus on infectious disease including two this Fall that center on the history of infectious disease and quarantine. This summer Stefanie connected with the Shoreline Historical Society and Crista Ministries, the organization that currently owns and operates the original Firland buildings. They have been great stewards of history and were generous enough to open their doors to UWB for a tour. This allowed students the incredible opportunity to see firsthand where patients were welcomed, where they spent countless days and nights on their backs, and where surgeries were performed.  While today antibiotics and public health efforts have dramatically reduced tuberculosis in the United States, it is important to remember that 1/4 of the World’s population carry the tuberculosis bacteria in their lungs and are at risk for active disease.  The reemergence of tuberculosis has been complicated by HIV co-infection, as well as the development of drug resistant strains. As a result, doctors and public health officials may see renewed relevance of the sanatorium cure considering some patients today are left with few, if any, treatment options, just as Betty MacDonald and others a century ago.