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I wasn’t long into the making of our new documentary movie “On the Lake: Life and Love in a Distant Place,” about the tuberculosis epidemic in 1900s America and globally today, when I realized the uniquely vital role that nurses played in the era of the TB sanatorium.

They not only had primary responsibility for care of patients — they literally risked their lives in the battle against one of the deadliest diseases of all time. But despite the risk, nurses, we found, consistently rose to higher purpose. America in the first half of the 1900s had more than 600 sanatoriums from coast to coast.

Tens of thousands of consumptives, as TB victims were called, were sent to the isolation of these distant hospitals, often for years, in hopes of being cured. No effective drugs existed. Fresh air, bed rest, and healthy food were seen as the best chance to recover, along with various types of surgery.

It was known that TB was an airborne disease, easily spread by a cough or a sneeze — and the nursing staff was unusually vulnerable, given that at most sanatoriums, nurses lived on grounds. At the Rhode Island State Sanatorium (on remote Wallum Lake, on the Massachusetts and Connecticut borders), one of several sanatoriums we profiled in the movie, the medical staff was well-versed in precautions, but the threat of being infected was ever-present.

“Keep up your bodily resistance by having regular meals, keeping regular hours, and by getting plenty of rest,” the Wallum Lake superintendent wrote to his nursing staff in 1941. “If you feel ill or indisposed or have any signs of a cold, obtain medical advice at once. Never let any illness drag along.”

Despite precautions, many nurses did become TB victims — how many exactly, history does not record. Some, like many of the patients they cared for, died. But others — including Nita Worthington, a graduate of New York City’s Bellevue Hospital School of Nursing, the nation’s first — recovered and went back to TB nursing. Other TB nurses had found their vocation as young TB patients; moved by the compassion and care they had received as they returned to health, they joined the cause. Vintage photographs and motion-picture footage of nurses in their old-fashioned white uniforms abound in the final cut of our documentary.

What the images do not fully capture is the passion nurses brought to their care. Nursing, they believed, only began with the physical. Nurse Katherine J. Densford was on the Wallum Lake staff in the 1940s, and during production, we found typewritten notes from a lecture she delivered at the sanatorium.

We were unable to find Densford, if she is still alive, and used an actress to read part of that lecture in the movie. One passage used eloquently captures the dedication of a TB nurse in this terrible time of epidemic: “Nursing care depends on the spirit of the nursing service. It should be a sort of religion to tuberculosis nurses to give the necessary physical care, to care for the mental requirements of the individual, and to provide an atmosphere, and environment meeting adequately the spiritual needs of the patient — that he will be comfortable, contented, and happy.”

Could that not serve as a motto for nursing today? This mind-body philosophy, which today is widely recognized as critical to a patient’s outcome, also was exemplified in a lecture given by Wallum Lake nurse Leah M. Blaisdell in her lecture “Tuberculosis Nursing is Mental Nursing!” It speaks to the role nurses played in addressing patients’ justifiably profound fears at having a disease that killed so many millions before effective drugs were developed — often through an excruciatingly painful and protracted death.

“Fear can make a person forget an appointment for a diagnostic clinic,” Blaisdell told the nursing staff. “Fear of economic strain on his family can make a patient condemn a good sanatorium — its foods, its beds, even its nurses. ... Any of these fears and others may upset the appetite, slow up digestion, hinder assimilation, and cause the person to lose interest in ‘taking the cure’ so necessary to speedy recovery.

“From beginning to end — from tuberculin tests, which uninformed patients may fear, to complete cure and the protection of others — the mental and emotional factors of all concerned should have equal attention with the physical factor. Only in that way will even a dent be made in the tuberculosis patient.”

Today in the U.S., TB no longer is epidemic — although it remains a grave public health risk, as recently publicized cases confirm. Globally, tuberculosis is the second deadliest infectious disease (after HIV/AIDS), killing almost 2 million people a year and with 9 million new active cases. Whether here or abroad, nursing was — and remains — of critical importance in battling this ancient scourge.

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G. Wayne Miller is a journalist and filmmaker. To comment, e-mail editorNE@nursingspectrum.com.

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