Chicago Tribune - June 10, 2007
Julia Keller, Tribune cultural critic

TB -- or "consumption," its evocative nickname -- was the artists' affliction, the poets' plague. It was associated with sensitive souls and elevated tastes. It felled composer Frederic Chopin and writers such as Emily Bronte (and two of her sisters), John Keats, Katherine Mansfield and

Thomas Wolfe. It struck Robert Louis Stevenson and D.H. Lawrence. So thoroughly did TB saturate international culture that one of the last century's most momentous literary works, Thomas Mann's "The Magic Mountain" (1917), is set in a TB sanitarium. And Greta Garbo's signature role is the tormented lover in "Camille" (1936), based on the 1848 novel by Alexander Dumas fils, in which her demure tubercular cough is an instant tip-off to the audience: It's curtains for Marguerite.

But when an Atlanta lawyer infected with a drug-resistant strain of TB recently returned from a trip abroad, nobody asked him for his latest sonnet. They were just aghast at his travel plans. TB is no longer the ailment of the refined and the genteel. We no longer sigh and coo over the legendary signs -- the emaciated frame, the pale complexion relieved only by two spots of hectic color in the concave cheeks -- when TB is suspected. We contact the Centers for Disease Control.

Every illness carries a cultural message, and that message can change. In her study "Fevered Lives: Tuberculosis in American Culture Since 1870" (1996), medical historian Katherine Ott traces how TB went from a dangerous but still vaguely positive-seeming illness -- the shadow that stalked artists and sages, the sure harbinger of divine creative gifts -- to the down-at-heels, distasteful image with which it is currently associated: TB is the disease of prisoners, of users of illicit drugs. Many people don't even know that it's still a threat.

The early romantic image of TB was fed by ignorance, of course. Until 1882, when Robert Koch discovered the tubercle bacillus, no one could say why some people seemed more delicate than others, why they fainted a lot and sometimes coughed blood into lace handkerchiefs. Nowadays, we know that germs cause infectious diseases and that antibiotics and chemotherapy are effective against TB. The mystery is gone.

No one wrote more cogently about the myths of disease than did the late Susan Sontag. In her book-length essays "Illness as Metaphor" (1978) and "AIDS and Its Metaphors" (1988), she brilliantly unpacked the emotional baggage we heap upon particular maladies, and noted that we're constantly shifting the suitcases.

Matching a disease with its stigma is never simple. HIV might be considered the "new TB" (actually, TB often is found among HIV-positive people, because of suppressed immune systems). Like TB, it seems to afflict disproportionately people in the arts. And many fictional characters with AIDS are presented as supersweet and hyper-earnest, such as the likable lawyer played by Tom Hanks in the movie "Philadelphia" (1993).

Yet the truth is, all kinds of people get sick from all kinds of germs.

The cultural representations of illnesses -- their presentation in novels and films, their depiction as either random blows from blind fate or the result of the sufferer's failings and lack of moral character -- matter a great deal when it comes to how we feel about the diseases, and how effectively we're able to raise research funds to find cures. So it isn't just a matter of stereotypes and expectations. It's a question of dollars and cents. And, ultimately, life and death. Thus when it comes to diseases, beware the easy metaphor.

Which is not to say that artists shouldn't use sickness in their works. "The Magic Mountain" is a cloud-topping novel, despite its horrifying (to 21st Century readers, that is) length. This passage haunts me still: "Feeling ... is divine. Man himself is divine in that he feels. He is the very feeling of God. God created him in order to feel through him."

I'm still reeling from the implications of that. I expect to be reeling forever.

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IN THE WEB EDITION

- "The Reagan Diaries" by Ronald Reagan, edited by Douglas Brinkley

- "Einstein: His Life and Universe" by Walter Isaacson and

- "Einstein" by Jurgen Neffe

- "Land of Lincoln" by Andrew Ferguson

- "Right Livelihoods" by Rick Moody

- "Warm Springs: Traces of a Childhood at FDR's Polio Haven" by Susan Richards Shreve

- "Saving for Retirement Without Living Like a Pauper or Winning the Lottery" by Gail MarksJarvis

You can find downloadable, printable pages from the Saturday Books section online at chicagotribune.com/books.

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