When thinking about influential nurses in history, Florence Nightingale is often the first name that comes to mind. But when it comes to impact, she wasn't alone.
Throughout history, nurses have played a significant role in shaping healthcare, often without recognition. One of the most powerful examples is the story of the Black Angels, a group of Black nurses whose courage helped turn the tide against tuberculosis (TB) in the U.S.
In a moving episode of the NurseDot Podcast, host Cara Lunsford, RN, interviewed author Maria Smilios about her book The Black Angels: The Untold Story of the Nurses Who Helped Cure Tuberculosis. This conversation explores the lives and legacy of these courageous Black nurses and the hard realities of racism, public health, and forgotten history.
Smilios, who doesn’t come from a clinical background, discovered this story while editing a biomedical science book about orphan lung diseases. During her work, she read a simple line about TB being cured at a hospital in Staten Island, New York, which then sent her down an eight-year research journey, uncovering a hidden chapter of American medical history.
“I'm a native New Yorker. My grandfather had tuberculosis, and I have this fascination with hospitals and disease and how it moves around the city,” she said. “I googled it, and this article came up about this group of Black nurses called the Black Angels, who had worked at Sea View, so I went down a rabbit hole.”
Who were the Black Angels?
The Black Angels were a group of more than 300 Black nurses recruited to care for TB patients at Sea View Hospital in Staten Island, New York, during the height of the TB epidemic in the early to mid-20th century. These nurses stepped in when white nurses began leaving the profession due to dangerous working conditions.
TB, once the leading infectious disease killer in the U.S., had no cure and spread quickly among densely packed tenement neighborhoods. Smilios described how the city’s poor, particularly immigrants and Black Americans, were disproportionately impacted and then effectively quarantined on Staten Island under appalling conditions.
“There were immigrants who came over, looking for a better life, and they found sickness and stigma,” she said.
A fight against disease and a fight for equality
The Black Angels didn’t just care for sick patients. They often provided palliative care before palliative care was a recognized specialty. Many patients at Sea View were essentially left to die. Nurses administered daily care in open wards with little protection.
Smilios shared that Lorna Doone Mitchell, who was a long-time supervisor at Sea View, didn’t allow nurses to wear masks. “She thought masks made nurses complacent, and they were more vigilant without wearing masks,” she said.
Their compensation was far less than white nurses during that time, and promises of housing were often unfulfilled due to overcrowding. And yet, these women stayed, often working under severe conditions for decades.
Despite their contributions, the Black Angels were barred from joining the American Nurses Association until 1949, and many U.S. hospitals refused to hire Black nurses altogether.
Forgotten by history — until now
Smilios pointed out that when the story of the TB cure broke, not one newspaper mentioned these resilient nurses. Photographers captured patients celebrating their recovery, while the women who helped get them there stood unrecognized in the background.
“The more astounding thing is that [these nurses] were completely erased from the narrative,” said Smilios. She added that journalists never stopped asking the nurses a single thing.
“They completely erased these women as if these patients miraculously were taking the medication and caring for themselves,” she said.
What makes this erasure more painful is that the nurses were part of the first successful human trial of isoniazid, the antibiotic that ultimately helped cure tuberculosis. Their role was essential to the clinical success and compassionate care of these patients.
Today, only two Black Angels are still living, along with several descendants who remain deeply invested in seeing their legacy honored.
A story that still matters
The themes raised in Smilios’ book, which include racial inequity in healthcare and the role of nurses in public health, are just as relevant today. The COVID-19 pandemic revealed ongoing disparities eerily similar to those faced by TB patients a century ago.
During the pandemic, Smilios lived a mile from Elmhurst Hospital in Queens, New York, dubbed “Covid Ground Zero.” Hearing constant ambulance sirens and witnessing long lines of people in need of care reminded her just how little has changed.
"This book is about who lives and who dies based on the zip code in which you live," she said.
Getting the story out
Despite its critical acclaim and a successful launch in the United Kingdom, Smilios noted that many U.S. nursing schools have yet to include this story in their curriculum. She dreams of seeing this story covered in every nursing program across the country and believes it should be taught alongside other nursing pioneers.
She has already succeeded in getting a street named Black Angels Way near Sea View Hospital, and there are even operas and stage productions in development.
“I’m grateful that there are some [nursing schools] that have adapted it, but for me, every nurse in America should know this story,” she said.
Learn more about the Black Angels or Maria Smilios’ work here.
Editor’s note: The author has kindly requested that anyone interested in purchasing the book do so at the link provided here or at their local bookstore. She would also like to convey that the blue paperback version available on Amazon.com is not an authorized edition.
