Episode 4: The Untold Fight of Black Nurses Against Tuberculosis

Maria (00:08.558)
Here we are. Hi, how are you?

Maria (00:15.96)
Yes, lots and lots of times, yeah. Yeah. Yes, I love them. I love doing them. They're so much fun. So yes, I have been. Yeah.

Cara Lunsford, RN (00:18.251)
Awesome awesome, then you're like a veteran you're a pro

Cara Lunsford, RN (00:26.403)
They are so much fun. And I like to think that this podcast is especially fun. We are just having a conversation, just kind of getting to know each other and learning a little bit more about the organization. Okay. All right, Maria. So I would love a little bit of an intro from you. Tell me a little bit about yourself. I try to come into these.

Maria (00:41.398)
Awesome. Sounds great. Let's do it.

Maria (00:50.988)
Okay.

Cara Lunsford, RN (00:55.725)
I always tell everyone when I interview, I do zero research. It's kind of like my thing. So I try not to know anything because I like to come in and ask questions very organically. When they come to mind, I'm like, hey, you know what? Let me ask about this or let me ask about that. Sometimes I think if I do too much research, I'll forget to ask things. So here we go. Maria, tell me a little bit about yourself.

Maria (01:11.501)
Okay.

Maria (01:20.366)
Mm-hmm.

Cara Lunsford, RN (01:25.605)
your history in healthcare and how you got to be part of this organization.

Maria (01:34.936)
So I'm the author of the book, The Black Angels, the untold story of the nurses who helped cure tuberculosis. I discovered, so I was working, I don't have a background in healthcare. I'm not a nurse. I didn't graduate in the School of Public Health. I actually graduated, I was doing a PhD at Boston University in religion and literature. And I was studying death and dying. And at one point I had spent three years.

Cara Lunsford, RN (01:38.969)
Yes.

Yes.

Maria (02:03.97)
volunteering on the pediatric bone marrow transplant unit at Boston Children's because I had thought of either doing child life, I was thinking of doing either palliative care for kids or being a child life specialist, but the pay was really, really low and it would have entailed me, I would have had to keep working as a waitress and I didn't want to do that. So I started teaching English. I got a job back in New York City. I was teaching at an all-girls school. Then I had my daughter and

I stopped teaching because it was too demanding and I wanted, we didn't have childcare is really what it was. Let me just be frank, we didn't have childcare, we couldn't afford to hire somebody. So I stayed at home but then I started freelancing as an editor in the biomedical sciences for Springer and it had been something I was doing on the side over the summers before my daughter was born.

And I was editing a book on orphan lung diseases one day and I came across this line about the cure for tuberculosis being found at Seaview Hospital in Staten Island. I'm a native New Yorker. My grandfather had tuberculosis and I was like, why don't I kind of have this fascination with hospitals and disease and how it moves around the city. And so I Googled it and this article came up about this group of black nurses called the Black Angels who had worked at Seaview and

Cara Lunsford, RN (03:25.06)
is amazing.

Maria (03:26.102)
So I kind of went down a rabbit hole. It mentioned two women. One of them is still alive, Miss Virginia Allen. And I tracked her down and it kind of spiraled from there. I started talking with her and then I tracked down Dr. Robacheck's son who talked to me and gave me his dad's archives. And then from there I tracked down the original isoniazid patients. And so then this idea of to get a book was born.

And so that's how the story of the Black Angels came about. It was an eight year labor of love. But I don't have a background in health per se, like nursing or anything like that. Although now, yeah, I feel like I'm an expert in tuberculosis and I do a lot of advocacy for TB. Yeah.

Cara Lunsford, RN (04:02.457)
That's awesome!

I love this.

Cara Lunsford, RN (04:14.361)
This is amazing. my gosh, so exciting. So I interviewed, well, I've interviewed a few authors, but one who had specifically focused on Florence Nightingale and really kind of did this deep dive into the life and story of Florence Nightingale and then kind of made it into

Maria (04:16.376)
Yeah.

Maria (04:33.614)
Mm-hmm.

Cara Lunsford, RN (04:41.903)
like a historical fiction novel thing. It was very, very interesting. So, wow, this is so cool. First of all, did not even know, I didn't know anything about the Black Angels at all. So the fact that you did this research, wrote this book, so what did you, what did you learn about them? Like, so as,

people as a group, what did you learn?

Maria (05:12.355)
Yeah.

So, well, I mean, the story of the Black Angels was unknown until the book came out. It lived in the confines of Staten Island in this small community of people. mean, Virginia Allen is still alive, but the descendants of the Black Angels are still alive. And so it lived within Staten Island. It had been very whitewashed, very mythologized, like, Black nurses were called up when white nurses quit, and then they helped.

you know, then TB was cured. It had none of the nuance, none of the history, you know, the very ugly, sordid history of Jim Crowism in New York, that the patients that went to Seaview, I mean, the story is about the nurses, but it is also very much about the patients. Like the people at Seaview, Seaview was a municipal hospital. It was the largest municipal hospital for tuberculosis in New York City. For those who don't know, Staten Island is...

one of the five boroughs of New York, but back then it was completely disconnected from the other five boroughs. You could only get there by ferry. In 1964, they built the Verrazano Bridge. So it was an island, and New York loved to use its harbor islands to build asylums and orphanages. The problem was Staten Island was inhabited, Staten Island had this prior to Sea View. Sea View was built in 1913 as a means to

as one of the people who worked in the Department of Public Health in New York City said, to send the indigent, this is a quote, indigent, immoral, uncouth, un-American consumptives. And most of the people he was talking about were the poor of New York who were part of, they lived on the Lower East Side. There were immigrants who came over looking for a better life and they found sickness and stigma and, and seaview. And the other population came from up in Harlem.

Maria (07:10.154)
African American population. And so the idea was if we get them off the island, we'll stop the spread and control the death rate, which the annual death rate at that time had been only in New York City, about 10,000 people a year dying of tuberculosis. That's not how many were sick. And so he did all these figures and he was like, this loses the municipality millions and millions of dollars a year. So we need to get them off the island and quarantine them. And so they built Seaview and

It was, for maybe the first 15 years it worked. It was good. It got, it did get the death rate down. But the problem was then it became like overcrowded, woefully understaffed and underfunded. The islanders hated that there was a hospital there. They, they did not want any more sickness on their island. There had been a quarantine station in the 1850s that they burned down. So they didn't want it there. Now jump ahead, the

And at the end of the 1920s, white nurses began quitting. And they began quitting because they had options for jobs that wouldn't kill them. Roaring 20s were a wonderful time for women, white women, become independent, to get jobs as librarians, salespeople. African American women didn't have that option. And so the choice was to either close the hospital down or call up these black nurses.

Cara Lunsford, RN (08:35.609)
They were more like the canary in the coal mine.

Maria (08:38.54)
Yeah. And just to do an aside here, the patients that went to Seaview, as I said, were from the Lower East Side. And so a lot of them would go up there. They would go to Seaview, and there was no cure for TB, and they would languish and die. So really what these nurses who were going to be called up from the Jim Crow South were doing was palliative care before palliative care was a branch of nursing, an actual branch of nursing. So.

These people were left there to languish and die and the city had two choices, either turn them loose. This would have been maybe over like 1500 people onto the city where they would get other people sick because people were living in tenements 10 to 12 at a time or put out a call for black nurses. And so they saw that it was working with the great migration for, you know, farm hands to come up and work in steel mills and factories. And they did. And

the nurses began coming because at the time black nurses were only allowed to work in black hospitals. There were 6,000 white hospitals versus 236 black hospitals. So there was hundreds of black nurses on or underemployed. Plus they were like, a lot of them, the women in my book, their families told me that this was an opportunity for them to have, the hospital promised them a...

a permanent job, the chance for a professional career. They thought they were coming to New York City. They didn't know that Staten Island was like a two and a half hour commute from the city. But also, they would have steady income. You know, they got paid lower than white people, white nurses, but their income was, when I looked at it, it varied between $600 and $725 a year, which was a very good salary.

back in 1929, a steady salary. And this was also a few months before Wall Street collapsed and the Great Depression hit. And they knew that they would pretty much have a permanent job because nobody wanted to go into TB nursing. They were also promised housing and schooling. A lot of those promises didn't come to fruition. The schooling did, the housing didn't because they were overcrowded. So the nurses began coming up and they...

Maria (11:03.15)
started working at Seaview and it wasn't easy. New York City also did not allow black nurses to work in their municipal hospitals. Only four hospitals out of the 29 allowed them and Seaview was one of them. And they started taking care of these people who had been completely disregarded. So what you had there was two sets of people who were considered second class citizens. You had the patients and you had the nurses and

as one city official said at a meeting with 300 black nurses were, just to give you an indication of the patients were viewed as these second class citizens who were just shoved somewhere to die. The nurses were also perceived that way during a meeting with 300 city officials and nurses had attended this. The president of hospitals gave a talk and at the end of it,

a young black nurse stood up and said to him, Mr. President, why do you send black nurses to Seaview? And he said, quote, "we send black nurses to Seaview because in 20 years we won't have a color problem in America because they'll all be dead from tuberculosis." So the ulterior motive was,

Cara Lunsford, RN (12:14.309)
My gosh. It was extermination.

Maria (12:18.732)
Yeah, except it didn't work.

Cara Lunsford, RN (12:21.581)
Yeah, obviously, obviously didn't, you know, but.

Maria (12:23.522)
I mean, was, that's the kind of like, you know, when you think about the story, you're like, if there was any kind of justice that happened, it was that these nurses ended up standing on the front lines of one of the most galvanizing moments in human history, the cure for tuberculosis.

Cara Lunsford, RN (12:43.301)
You know, it's amazing that this is really only like 100 years ago, that this was the meant, not even, not even 100 years ago. It's astounding.

Maria (12:48.142)
Yeah, I mean, not even 100 years ago. Yeah.

Yeah, yeah. It's the more astounding thing is that they were completely erased from the narrative. I mean, it's astonishing because you're like, how do you erase like a whole group of people and not a single newspaper that descended on Seaview when the story broke? They were the photograph that I have that I had to pin to my wall for the longest time was you see this very famous photograph. would have been a photo that went viral now.

of these patients who were dying. They are now cured and they're kind of jitterbugging and in the back are the black nurses. And these journalists are taking these pictures and they're trying to track down the doctors and they've never stopped to ask the nurses a single thing. They just completely erase these women as if these patients miraculously somehow or another were taking the medication and caring for themselves.

Cara Lunsford, RN (13:55.364)
Amazing, amazing. And so is your book, are you going to make it available in nursing schools? Is it available? It should be required reading in nursing schools.

Maria (14:08.066)
Yeah, so it's been, it's almost two years since it's been out and I've done lots of talks about it. There are a handful of nursing schools that have adapted it into the curriculum. I wish more of them would. I wish it would be required reading for every single nurse. Like I wish that at every nursing conference it was available. I had been invited to do a keynote at the...

American Association of Nurse Practitioners, but I wish more nursing organizations offered the book or somehow or another talked about it just so it could get out there because what? There's like five, six million nurses in America. Yeah.

Cara Lunsford, RN (14:46.372)
Yes.

Cara Lunsford, RN (14:51.535)
Yeah, there's, yeah, and it's important. It's important in America. It's also important in other countries because I think it's.

Maria (14:59.222)
It actually became a best seller in London. The book in London, and maybe because the market is smaller, the book in London was really championed extremely well. And it's being published in the Ukraine. They have a big TB problem, especially since that war started. Tuberculosis loves wars.

It loves wars and it loves poverty. It's a disease that thrives in these places because people live in close quarters, also, you know, the lack of ventilation in places, the lack of, you know, good food and fresh air is a big issue. And sunlight. TV dies in the sunlight. It can't deal with the ultraviolet lights of the sun, believe it or not, as hardy as that microbe is.

But just getting back to the nursing schools, I am grateful that there are some of them that have adapted it. But for me, I just thought like, wow, every nurse in America should know this story. And I'm still amazed that I'm talking to you. And two years later, there's people who call me and say, I just found out about your book. Can you do this talk? In the nursing world. And so I don't know what the disconnect.

Cara Lunsford, RN (16:14.437)
Yes.

Maria (16:18.36)
where it disconnected and what happened. Why it's not in every nursing school? Because it can be. It's not a hard book. Every nursing school has a class on public health.

Cara Lunsford, RN (16:33.827)
Yeah, yeah, and honestly, you know, I have this partnership, I'm working with like Emory and I love Emory and there's, you know, there's so many great nursing schools out there, but you know, one in particular, I went to school at LA County USC and LA County USC was one of these schools that had been graduating, they went,

Maria (17:02.275)
Mm-hmm.

Cara Lunsford, RN (17:02.541)
way back to the time of like diploma nurses and even before that. And, you know, it was County General, and this was where you did all of your clinical rotations. We were right across the street from County General. And so we saw really the sickest of the sick. And County General is a very old hospital. You know, now they've...

Maria (17:25.123)
Yeah.

Cara Lunsford, RN (17:32.1)
rebuilt it and it's new and you can still go and see the old one, which was where I trained. But it was a very, very old, ominous looking place. And you knew there was just stories, like you walk in there and you know there's stories of sickness and death and darkness. It felt dark. And I think that there's a lot of hospitals out there that also

Maria (17:41.592)
Mm-hmm, mm-hmm.

Maria (17:50.712)
Mm-hmm.

Cara Lunsford, RN (18:02.307)
this should be like in their gift store, in their bookstore, in their, yeah, there's, I...

Maria (18:05.315)
Mm-hmm.

I mean, don't, I am so with you. Like I, I don't know how to do that. I'm an author. Like I'm not a marketeer to, you know, to hospitals and stuff. And I don't know how easy that is. I've done a number of talks in the New York City hospital system, like Bellevue and Brooklyn and South Brooklyn hospitals, some of the municipal hospitals in New York, Harlem hospital, Los Angeles, the West coast, it's been like a dead zone.

I've reached out to some of the nursing schools there and people have been like, yeah, we're reading the book, we'll get back to you. And they never got back to me. But yeah, I wish there was some way to get it out on the West Coast. People in tuberculosis have been more, whatchamacallit, they've wanted the book to come West in the world of TB. So I've had...

Cara Lunsford, RN (19:05.497)
Yes.

Maria (19:06.69)
more luck with people in, you know, University of San Francisco has a big TV lab. But, I mean, if you have any way to put me in contact with people, that would be wonderful, you know.

Cara Lunsford, RN (19:19.107)
You don't even realize who you're talking to, Maria.

Maria (19:21.55)
No, I mean, seriously, because for this book, it was a labor of love in the end. know, eight years on one project is a long time. I wrote through COVID. The manuscript went through three different iterations. I started writing it when Barack Obama was president. And, you know, when you write a book like this, you have to have your pulse on where is the culture, like as a whole, where are we as a country?

And we were in a different place than when it was coming to healthcare and to race. And then he wasn't president. And so then I was like, my God, where we are now. And so then the healthcare starts to become more fractured again and this idea that everybody deserves healthcare started to break apart. And then COVID happens. And then I felt like I was actually living my book because.

I experienced COVID in New York City, a mile from Elmhurst Hospital, which was dubbed COVID ground zero. It was where the nurses were wearing garbage bags. I am the daughter of immigrants. grew up in that area actually. And one day I had stopped writing and you know, all we would hear all day long were the ambulances going down that main avenue to get to the hospital. And I went out one day with my daughter. It was like late May and

we walked, we walked all the way to Elmhurst Hospital, we passed morgue trucks and the lines were still sneaking outside. And I remember thinking to myself, that's it. This book is about who lives and who dies based on the zip code in which you live. And then the third iteration, which became the book, was kind of born from that moment because it was just this really powerful moment of

having this like when they thought COVID was a lung disease, you know, this airborne virus. You didn't know if you were going to get sick. You didn't know if you were going to live if you did get past this. You know, the nurses stuck on the front lines, at least in New York City. Most of them were like African-American and Filipino nurses and the people waiting outside, like they didn't matter. Sick, sick, like doubled over. They were in these like

Maria (21:38.091)
They had like an overhead tent in case it rained and you could see them like leaning against the wall and it was like the walking dead in a way and I was like, my God, there's no other place that this is happening. There's no other hospitals where there's lines sneaking out the door and nurses are wearing garbage bags. And that's when this story really took on the kind of life that it has in the book. You I really wanted to push that up that

This was a story about who lived and who died because when rich people got tuberculosis, they went to places like Saranac Lake, know, or Davos in Switzerland, which is ironically now where they hold these talks for climate change and health at a place where people were going to get well from TB. But the people that were...

standing online at Elmhurst were the same people that were being sent to Seaview to languish and die. And it was a really, really powerful moment of where we are and how little we've progressed. And so all that to say is this story now more than ever where they want to cancel the African-American museum and they want to rewrite history. The book is in the African-American museum and I'm just waiting one day for somebody to say, book ban kind of thing, but.

where they're trying to erase black history, women's history. This book is more important than ever, I think, at least in my opinion, and the fact that there are still two black angels still alive and the descendants are alive and the son of one of the nurses. These people are still here and they deserve to see this legacy really go out into the world and have it in every nursing school.

Like that's my whole thing. Like every nurse who goes through a nursing history course, you mentioned Florence Nightingale, you know, I've been told that's taught in schools. Well, this maybe should be taught alongside of it. Yeah.

Cara Lunsford, RN (23:30.485)
Absolutely.

Cara Lunsford, RN (23:43.152)
Yes, absolutely should be taught alongside of this. There's so many nursing associations and organizations that, you know, and it's interesting because at the beginning of our chat, you know, I asked you about the organization because I had this in my mind assumption that this was

part of an organization. Like, this is what I thought. But here's the amazing thing. It should be. Like,

Maria (24:15.821)
now.

Maria (24:23.202)
The Black Angels should be part of, like, I mean, I'm also like...

Cara Lunsford, RN (24:27.149)
It should be its own organization that like pays.

respect to where this

Maria (24:33.102)
Yeah, I mean, I think the tricky part is it's, you know, because it's published under like Penguin Random House. I mean, the Black, the descendants do their own little thing to raise money. know, I can't, sources, journalists can't pay sources, it's unethical and I can't, you know, collect money on their behalf, but they do their own thing. Like I was happy I was able to get a street named after them in Staten Island. So.

The Black Angels have Black Angels way at the entrance to Seaview. Somebody's making, at the new school I got an email one day that somebody was inspired to do an opera. So I hope that comes to fruition. There was like three or four operas on TV and they were very moved by the story. And they wanted permission to use a couple of scenes from the book, which was great. But I wish that...

for me just because I know these people so well. They're like part of my life. The descendants, you know, basically they text me, I haven't heard from you in a week. You know, these are like also like 83 year olds, women, most of them. The son of Edna is also 83. He texts me as well, just like, how are you? Or what are you doing? Any news? Like, you know, they ask me that question all the time.

And I tell them I try. I do as much as I possibly can. The hundreds of emails that I've sent out to people just saying like, there's this new book out or there's a book out. And if you're interested, I'd love to send you a signed copy.

Cara Lunsford, RN (26:13.903)
Well, for sure, you know, we on the podcast landing page, for sure, we have to make some sort of, we have to do something on the podcast landing page that drives people to get the book. And I would also say, you know, and maybe I'm saying this prematurely, but at Relias, so our,

parent company is Relias at nurse.com. We are a sister company to Penguin Random House. We are owned by, yes, we are all owned by Bertelsmann. We're part of the Bertelsmann group of companies and so we have close relationships with Penguin Random House and so.

Maria (26:50.194)
wow.

Maria (26:55.668)
my goodness, well thank you, no.

Yeah.

Cara Lunsford, RN (27:11.173)
it should be very interesting to see what we can do to maybe disperse this a little bit more heavily to nurses throughout the country. So I'm excited to chat. Yeah.

Maria (27:28.11)
Yeah, was so happy when, you know, because I don't know how it came up in my page. I didn't even know about Nurse Doc, because I'm not a nurse. And somehow or another, I think because I now probably get off and my feet will be filled again with like all nerve, but it came up. And I was like, wow, I think it was on Instagram. And so I reached out, I just wrote a note and I was like, you know, hi, I'm the author of this book.

Cara Lunsford, RN (27:45.957)
Mm-hmm.

Maria (27:56.675)
that tells this story and the social media manager had reached out to me. And then she was like, get in touch with Sally, I'm sorry to hear what happened to her. But Sally, when we originally had spoken and gone back and forth, had talked about like doing a article for the website that they would put out also on like Instagram that would link to the podcast.

Cara Lunsford, RN (28:24.729)
Mm-hmm. Yeah.

Maria (28:24.75)
So I don't know if that's still a possibility to do that because she said the engagement on the socials is very good. Like the engagement with your socials and your landing page, I don't know, she had given me some figure and it was like, whoa. But yeah, I mean, I appreciate it and I appreciate people who have uplifted the story. just, you know, I want it to really, I want to see these women like really cemented in the history of Northside.

Cara Lunsford, RN (28:32.623)
Mm-hmm. Yeah.

Cara Lunsford, RN (28:38.916)
Yeah.

Cara Lunsford, RN (28:54.017)
Absolutely. Absolutely.

Maria (28:55.278)
because I think it's an important thing. It's important for their legacy. It's also, you know, one of the other goals I had was, you know, the TB aspect of it and the TB world has done such a wonderful job of ensuring that this is now part of the narrative of tuberculosis. Like when they talk about the cure, they talk about the black angels now and it's really, really amazing to see. And that makes me really happy because...

Cara Lunsford, RN (29:19.823)
That's beautiful.

Maria (29:23.97)
That also honors the patients as well. These people that were, I would say 70 % of them were buried at Potter's Field. That was another part of the book. It was the nurses I wanted to give voice to, but also these patients that have been mistreated. And we see that in today's world too. We see it all the time.

Cara Lunsford, RN (29:45.254)
How many, do you have a statistic on how many of those nurses who were caring for tuberculosis patients actually got tuberculosis and then succumbed to that disease?

Maria (30:00.397)
I love, I get this question all the time and it's so important. I wish I had an answer. The records at Seaview, just to give you an indication of how the nurses were even perceived there, have been destroyed. They lay on one of the floors. It's three feet wall to wall, side to side of files that have turned to pulp. And in them are the human resources files. So from what I was told,

There had to be nurses that died of tuberculosis, but not as many as we think. None of the nurses in the book or in the kind of vicinity of descendants died from TB. A few got sick and then recovered, but they did not die from tuberculosis. Surprisingly, they all lived into their late 80s and 90s, and a lot of them died of cancer.

Cara Lunsford, RN (30:47.662)
is

Cara Lunsford, RN (30:51.375)
Amazing.

I think a higher power was looking over them.

Maria (30:56.876)
That's what they said. know, like Edna's son, one of the protagonists in the book, Edna Sutton Ballard, her son told me that, you my mother, I mean, they would take off their clothes before they got in the house. They wash their hands continuously. Their supervisor was a very interesting woman. And I say interesting because when you talk to some of the families, Miss Mitchell, who

as some of the nurses said, quote, had a gaze that could freeze the devil himself. She was this very tall, almost Teutonic white woman. She was the daughter of a Confederate medic who held the second highest position at Seaview. She liked to try and catch the nurses doing things wrong. You know, that's where she wielded her power. But as...

Virginia Allen had said if it wasn't for Miss Mitchell, we wouldn't have been the kind of nurses we were. So that's why I say she was a nuanced figure. Because I always wanted to give, to nod towards those nurses who talked about her affectionately versus the ones who didn't. And she was a real piece of work. know, yes, she was an absolute in our, in our world today. She was considered a racist and would have probably lost her job had she done what she did.

Back then, she was lauded because her job was to train and retain a staff of nurses. And the reason I brought up Miss Mitchell was because Miss Mitchell treated these, she didn't allow them to wear masks. She thought masks made the nurses complacent and they were more vigilant without wearing masks. So the nurses were not wearing masks. They washed their hands until they almost became raw.

They ate well and they tried to get as much sleep as they could and they had a very deep faith. And it wasn't a kind of thing where Edna's son told me, my mother didn't, like she didn't think that there were these miracles that came from like God. It wasn't that kind of magical thinking. It was just a very deep faith that this is where she was called to this island, to these people, to this hospital. And because she had that calling,

Maria (33:17.898)
it would work. You know, the in her, the way he explained it, you know, she believed God would make it work. But it didn't mean that she, she, yeah, exactly. Yeah. And it didn't mean that she didn't have to take care of herself. That's the magical thinking part of the idea that like, anything I do, I'm just going to not get sick. They were very, very vigilant.

Cara Lunsford, RN (33:27.555)
Yeah, that she was meant to be where she was meant to be for the time that she was meant to be there.

Cara Lunsford, RN (33:39.107)
Right.

Cara Lunsford, RN (33:46.328)
Amazing, And wow, the fact that they weren't allowed to wear masks and that they still were able to, in many cases, probably avoid the disease.

Maria (33:46.84)
Yeah.

Maria (33:52.654)
Mm-hmm.

Maria (34:03.33)
Yeah, just, you know, these were open wards for people who are not familiar with the way TB hospitals were designed. They were narrow open wards. And as one patient told me, if you wanted privacy, Seaview wasn't the place. So it was a bed separated by a small nightstand, bed, nightstand, bed, nightstand. And because it was overcrowded, there were also beds down the center of the aisle. So the proximity of

people and the amount of germs circulating in those wards on a regular basis despite the fact that the windows were open all the time was an extraordinary amount. When you think about one of the statistics that always fascinated me was a sneeze. A sneeze can go 100 miles an hour and almost 27 feet into the air. So these people are coughing and sneezing all the time. So these nurses have no barrier there.

because they're not allowed to wear it unless they were doing surgery.

Cara Lunsford, RN (35:05.381)
And honestly, probably back then, because this was before the time of N95 masks, where there was actually something protecting and sealing, and they were just regular masks. mean, it was probably better to put it on the patient, don't put it on the nurse.

Maria (35:18.403)
Mm-hmm.

Maria (35:23.81)
There were those gauze things. They were like three layers of gauze.

Maria (35:31.715)
They did start doing that at some point. was a suggestion, but that's not what happened at Seaview. Seaview, these women were put through the wringer. They were in many, many ways, their work, their workload and their working conditions were appalling. And they did this for decades without complaining. But.

The great part about this story that I love the most is how they came together as a community to fight for equity because these nurses, the goal of a lot of them was to integrate into the American Nurses Association, which did not allow them to join until 1949. And so that was their fight to join the American Nurses Association. So, you know, one of the main characters, Missouria, came up to see if you specifically

to work with the National Association for Colored Nurses because, my God, her name just eluded me, Mabel Stoppers was the president and she had graduated from Howard, this one particular nurse, and she wanted to be on the front lines to fight for integration, not just in the ANA, but also to desegregate the New York City hospital systems, which they did, and I do tell that story.

That happened because of a nurse from Atlanta. This young woman wanted to get into Bellevue graduate program and she got a letter back saying, I'm going to paraphrase now, that there were no classes for quote, Negro nurses at Bellevue hospital, that she should go to Lincoln. And so she was like, well, she had all the criteria. So.

The first thing she does is she writes to the American Association of Colored Nurses and she writes to, my brain kind of stopped right now. was the, was, Du Bois ran the organization. the NAACP, sorry, yeah. She writes to the NAACP and to the Crisis, which was Du Bois' magazine, and they get right on it.

Maria (37:51.403)
and they started this four year, it was basically four years of trying to unmask the commissioner of health in New York City who was behind all of this and supported all of this and said, you know, he was gatekeeping black nurses from working in the hospitals and black doctors from being hired at Harlem Hospital. And they forced him to resign. Publicly, he stated.

you know, these horrible claims about like that black nurses shouldn't be working in the hospital system and spewing the same mythologies that had been spewed for many, many years that, you know, quote, they were lazy, they were immoral, they couldn't, they didn't do well with directions, they couldn't run wards, which was so ironic because they were running the wards at Seaview and most of the hospitals. And so finally in 1938, he resigned.

LaGuardia hired somebody else and by 1940 they had desegregated all the hospitals in New York City. And black nurses were free to work at whichever ones they wanted. But that came from a lot of work that the nurses at Seaview did. So while they were doing this, these TB patients, were amazing community, like advocates and advocates for racial equity and workplace equity. So, you know.

Cara Lunsford, RN (39:11.097)
Fascinating.

Maria (39:12.064)
That's like the triumphant part of the story. And I always say, you know, what we can learn from them is patience. They had their eye on the long game. They knew that this was not going to happen overnight. And they would come together and say, what is the best way to deal with this? And that's such a... To hear the families talk about it was so, moving.

Cara Lunsford, RN (39:24.665)
Mm-hmm.

Cara Lunsford, RN (39:36.762)
Yeah, it's such a testimony to their belief in what was possible. I mean, being able to see ahead, see into the future and say, I don't think that this is the world we're gonna live in someday. And I think it's interesting because...

Maria (39:50.168)
Mm-hmm. Yes.

Cara Lunsford, RN (40:05.517)
when you say, okay, like now we've desegregated, but on this podcast, people listening, I want them to understand that that doesn't just mean suddenly, everything's okay, right? it's, there is such, mean, once you...

Maria (40:21.622)
It's not.

Cara Lunsford, RN (40:28.833)
Once you bring everyone together, and in a lot of ways, there's going to be people who feel like that's forced upon them and they're there and they don't want that, that creates such a tense workplace to work with maybe other nurses who didn't agree with ending the segregation, working with patients who...

refuse you or don't want you to work with them. And in some situations, I remember hearing a while back and I don't remember who told me something about the nurseries and that there was like black nurses for black babies and there was white nurses for white babies.

Maria (40:57.742)
Thank

Maria (41:15.256)
Mm-hmm. Yeah.

That's true in the New York hospital system that they did the same thing. They had floors or separate maternity wards. And at Harlem Hospital, originally Harlem Hospital was the heartbeat. It is the heartbeat of Harlem. It was the heartbeat of Harlem, but it served a lot of the white population before the white flight happened, right? So they were still, you know, in the 1920, end of 1929, early 1930 when the hospital really began to suffer from

understaffing and overcrowding and the depression hit and so much of the black population was out of work because the jobs that were traditionally going to black people, so for example, like elevator operators or stuff like that, was now going to white people who were unemployed. And so the hospital began to become extremely overcrowded. It fell into disrepair. Some of the conditions, like what I read in a 1935 report, was so...

There was roaches in the kitchen, the elevators didn't work, the nurses were playing Tetris to try and move the gurneys and get people into a bed. They would bring up couches and people would be sleeping on couches. But what you're talking about in terms of white people not wanting to be treated by black people, black doctors or nurses was very, very true, actually. And people think it's...

So long ago, it's not so long ago, it still happens. I heard stories, you know, up till recently, when, you know, during Black History Month and Women's History Month, when I gave some talks, I hear it all the time, you know, when people ask me questions or make statements at the end, you know, like, I've had it happen to me, you know, one nurse was saying, you know, I mean, I've heard this like a lot from African American nurses, how it's happened to them. They walk into a room and they're like, I don't want you as a nurse or you're...

Maria (43:14.702)
Who are you? A lot of them are mistaken for the people who work at the hospitals, like housekeeping and stuff. And when they find out that that's a nurse, that no...

Cara Lunsford, RN (43:28.837)
Candidly speaking, and my grandmother, she passed when she was 96 several years ago. so she, at this point, if she was alive, would be over 100. She would be like maybe 101-ish. And she would say things like, oh, I met the nicest girl,

Maria (43:43.842)
Mm-hmm.

Cara Lunsford, RN (43:58.406)
colored man on the street. You know, this was obviously her language, but she was intending it to sound nice. You know, she would use that in a way where if you asked her, she wouldn't think at all that she was racist. And here's the thing. She also would say, I'm not sure that I want that doctor. His skin is very dark.

Maria (44:08.44)
Mm-hmm, mm-hmm.

Maria (44:17.699)
Yeah.

Maria (44:25.536)
Oof.

Cara Lunsford, RN (44:27.691)
And I was like, grandma, someone's skin has absolutely nothing to do with their ability to provide care. And she was taught at a very, very young age that black people, and specifically the darker they were in their pigment, that the smaller their brain was.

Maria (44:56.014)
That was an enduring ideology that was spewed. And I discovered that in my research. And also when it came to tuberculosis, there was a Dr. Samuel Cartwright who he was in Louisiana. He was a very, very famous doctor from Louisiana. I believe it was around 1880, 1890, who believed that, I don't know if you ever heard of drapedomania.

He believed that when enslaved people wanted to be freed, they suffered from a disease called drapedomania because it was in the Bible that they should be enslaved. He also perpetrated the idea that tuberculosis, that African American people could not catch tuberculosis because it was a disease of the sanguine. Like even down to TB, he was like, no, this is a white man's disease. is not black people do not get.

tuberculosis, it's something else. They wanted to co-op a disease and make it a white man's disease when there were three times the amount of African Americans were suffering from tuberculosis in Harlem versus like white people. The rates in Harlem were off of the charts.

Cara Lunsford, RN (46:22.435)
It just makes my heart hurt is what it does. really does. It's, yeah.

Maria (46:24.184)
Yeah, which is, mean, which goes back to like the importance of telling the story, because if people know the history, we hope that they'll be less apt to repeat it. And I think like, you know, the nursing world, nurses and people in the world, that's why, you know, it was so important for me to get the story into the hands of nurses and people in the TB world, because when you know this history.

Cara Lunsford, RN (46:31.396)
Yes.

Maria (46:51.714)
you are not only less apt to repeat it, but you're also going to become an ally to fix the brokenness of what's happening now. Because it hasn't gone away like you said, it hasn't magically gone away. this exists, tuberculosis in here in the United States, we've been fortunate because we had great TB care. Now it's on the rise because of all the cuts, but when you look at the global south,

Cara Lunsford, RN (47:02.233)
Yes. Yes.

Maria (47:21.506)
Why do we say that the number one infectious disease killer in the world is tuberculosis and there's a cure? That's the only disease that we can talk about with a cure and the number one infectious disease killer in the same sentence. It hammers on the walls of logic. Like, how is that possible? It's possible because now we've cut aid and we don't get the drugs, the affordable drugs to the countries that need them, but also because TB is so stigmatizing in those countries, you know, so.

People are ashamed to go and get help. we've been fortunate to have very strong public health here that we don't have to worry about it. We should start worrying about it because what people don't understand is when you don't treat people in the global South, in the world that we're living, the disease comes over.

and TB takes such a long, people don't get it, it's not like E. coli that proliferates in 20 minutes and you're sick. This can take months, even years. You can be harboring latent tuberculosis and then something happens and it's fascinating, it sits in a cell wall that surrounds it.

Cara Lunsford, RN (48:14.297)
Yes, of course.

Maria (48:41.032)
and it's a kind of cryogenically frozen and then something happens and it wakes up and it burrows out and it starts to multiply. But people don't understand it, you know, three months of walking around with tuberculosis spreading those germs gets other people sick and you don't know you're sick. So, you know, I wish we talked about it and worried about it more.

Cara Lunsford, RN (48:41.199)
Yes.

Cara Lunsford, RN (49:07.621)
Absolutely, absolutely. Well, I mean, this has been an amazing, such an amazing conversation. It's also why I love walking into conversations having very little knowledge. In some situations, no knowledge. Like, let me discover who you are, what do you do? And I always...

Maria (49:08.749)
Yeah.

Maria (49:13.634)
Yeah.

Maria (49:25.325)
Mm-hmm.

Cara Lunsford, RN (49:36.934)
love when I have an interview like this, where I realize that there's so much that can be done. Like there's so much that we haven't done yet to get this this book out to get this message out and that there's a lot of potential. So where where do people go right now? And actually, I was going to ask one more question. Is this available in audio?

Maria (49:42.734)
Thank you.

Maria (49:50.744)
Mm-hmm.

Cara Lunsford, RN (50:05.581)
Is this an audio book as well? Amazing.

Maria (50:06.082)
Yes, it's published by Penguin Random House, Putnam, which is an imprint of Penguin Random House. It's available in audio, it's available in Kindle, and hardback. I will say on the Amazon site, where if you buy it from Amazon, there is a paperback version that is not an authorized version in the United States. Don't buy that. It's some shoddy reproduction of like...

That's a whole other story of issues that happen when you publish books. The only authorized version is the white cover. You can get it from indie bookstores, barnesandnoblebookshop.org. I mean, it's available everywhere. Some of the bookstores may be sold out, but you can order it online from wherever people want to shop at bookstores. If you're in Washington, DC, it's at the African-American Museum. I know that's not the actual name of it. I keep forgetting.

Anyway, the Smithsonian, but yeah, it's available everywhere and in audio and in Kindle. And the audio version is amazing. The woman who did the audio for it, it was like named one of the best audio books. Like she has a beautiful voice. I did not do the audio, somebody else did, a professional. I was like, by that point, I had read the manuscript so many times and you know, I just thought people do this for a living.

And there's somebody out there way better than I can that can do this. you know, I heard some of it and she did a really beautiful job. Yeah.

Cara Lunsford, RN (51:43.685)
That's wonderful. That's amazing. So I want to make sure that everyone knows that when they go to the podcast landing page, so nurse.com forward slash podcast, we will make sure that all of this information is available to you. I know many people are driving in their cars, walking their dogs, taking a jog.

that we want to make sure that you have this available. So just go ahead and visit thenurse.com forward slash podcast. We'll make sure all of that information is available so that you can go ahead and find this incredible book. And I think like to be determined how many other places we can get this into and how much we can share this and get it out there.