Stalking the Great Killer
Arkansas's Long War on Tuberculosis
by Larry C. Floyd and Joseph H. Bates
Published by: University of Oklahoma Press
Imprint: University of Oklahoma Press
268 Pages | 6 x 9 | 19 B&W Illus.
$34.95
$24.95
$21.95
Imagine a time when a killer disease took lives at a rate rivaling Covid-19 in 2020 and 2021, and continued that grim harvest year after year, decade after decade. Such a nightmare scenario played out in the state of Arkansas—and across the United States—throughout the nineteenth century and well into the twentieth, when the scourge of tuberculosis afflicted populations. Stalking the Great Killer is the gripping story of Arkansas’s struggle to control tuberculosis, and how eventually the state became a model in its effective treatment of the disease.
To place the story of tuberculosis in Arkansas in historical perspective, the authors trace the origins of the disease back to the Stone Age. As they explain, it became increasingly lethal in the nineteenth century, particularly in Europe and North America. Among U.S. states, Arkansas suffered some of the worst ravages of the disease, and the authors argue that many of the improvements in the state’s medical infrastructure grew out of the desperate need to control it.
In the early twentieth century, Arkansas established a state-owned sanatorium in the northwestern town of Booneville and, thirty years later, the segregated Black sanatorium sanitorium outside Little Rock. These institutions helped slow the “Great Killer” but at a terrible cost: removed from families and communities, patients suffered from the trauma of isolation. Joseph Bates saw this when he personally delivered an uncle to the Booneville sanitorium as a teen in the 1940s. In the 1960s, Bates, now himself a physician, and his physician colleague Paul Reagan overcame a resistant medical-political system to develop a new approach to treating the disease without the necessity of prolonged isolation. This approach, consisting of brief hospitalization followed by outpatient treatment, became the standard of care for the disease.
Americans today, having gained control of the disease in the United States, seldom look back. Yet, in the age of the Covid-19 pandemic, this compelling history, based on extensive research and eyewitness testimony, offers valuable lessons for the present about community involvement in public health, the potential efficacy of public-private partnerships, and the importance of forward-thinking leadership in the battle to eradicate disease.
To place the story of tuberculosis in Arkansas in historical perspective, the authors trace the origins of the disease back to the Stone Age. As they explain, it became increasingly lethal in the nineteenth century, particularly in Europe and North America. Among U.S. states, Arkansas suffered some of the worst ravages of the disease, and the authors argue that many of the improvements in the state’s medical infrastructure grew out of the desperate need to control it.
In the early twentieth century, Arkansas established a state-owned sanatorium in the northwestern town of Booneville and, thirty years later, the segregated Black sanatorium sanitorium outside Little Rock. These institutions helped slow the “Great Killer” but at a terrible cost: removed from families and communities, patients suffered from the trauma of isolation. Joseph Bates saw this when he personally delivered an uncle to the Booneville sanitorium as a teen in the 1940s. In the 1960s, Bates, now himself a physician, and his physician colleague Paul Reagan overcame a resistant medical-political system to develop a new approach to treating the disease without the necessity of prolonged isolation. This approach, consisting of brief hospitalization followed by outpatient treatment, became the standard of care for the disease.
Americans today, having gained control of the disease in the United States, seldom look back. Yet, in the age of the Covid-19 pandemic, this compelling history, based on extensive research and eyewitness testimony, offers valuable lessons for the present about community involvement in public health, the potential efficacy of public-private partnerships, and the importance of forward-thinking leadership in the battle to eradicate disease.
Larry Floyd is teaches history at Oklahoma State University–Oklahoma City and is the author of several books, including, with Kent Frates, Oklahoma Hiking Trails (OU Press, 2010).
Joseph H. Bates, MD, is Associate Dean and Professor of Epidemiology at the College of Public Health at the University of Arkansas for Medical Sciences, Little Rock.
"In Stalking the Great Killer, Arkansas's efforts to control tuberculosis are deftly woven into the broader picture of tuberculosis-related developments throughout the world, putting them into perspective and context. The result is an interesting, inspirational, and important narrative which is also a tremendous contribution to the field of public health. This is a story that needs to be told."—Mary Ryan medical historian and coauthor of A Family Practice: The Russell Doctors and the Evolving Business of Medicine, 1799–1989
"Stalking the Great Killer is global history on a local scale. The story of Arkansas’s fight against TB mirrors that of countless places around the world as scientists, doctors, public health workers, and citizens struggled to understand this lethal disease. Arkansas’s history is both unique and typical. Readers looking for a well-written tale of what it takes to understand and finally wrest control of an infectious disease—lessons we can all benefit from in the era of Covid—will find much in this book."—Christian McMillen, author of Discovering Tuberculosis: A Global History, 1900 to the Present.
"Weaving together personal stories with surprising historical details, Stalking the Great Killer is a deeply affecting history of Arkansas’s battles against the terror of tuberculosis. Authors Floyd and Bates provide lessons of compassion in the face of mortal disease, and examples of leadership in the face of prejudice and bureaucracy."—Lynn Downey, author of the award-winning Arequipa Sanatorium: Life in California’s Lung Resort for Women
“Imagine the horrors for mankind if the lingering COVID-19 pandemic had taken a hundred years for science to discover either a preventative or a cure, and you will understand the task confronting the characters in Stalking the Great Killer: Arkansas’s Long War on Tuberculosis. With the help of Joe Bates, the last surviving hero of the century-long crusade against “The Great White Plague,” Larry C. Floyd describes with flair, drama, and fastidious scientific detail the monumental suffering (a billion lives lost!) and the intrigues, jealousies, triumphs, and setbacks as men and women of science in laboratories from Paris and Frankfurt to Booneville and Little Rock, Arkansas, looked frantically for clues to end the scourge. It is the most lucid history of modern medicine from the discovery of the germ theory of disease to the final eradication of TB—a mere forty-five years ago in Arkansas—you are apt to find. Stalking the Great Killer is a page turner, lacking only a villain, unless, of course, you count ignorance or the occasional calumny of politicians.”—Ernest Dumas, noted Arkansas journalist and author
“Stalking the Great Killer, Arkansas’s Long War on Tuberculosis is more than an interesting historical account of the control of tuberculosis. It is an exciting story of human determination against a devastating disease. In this book, Floyd and Bates describe, in scientifically accurate detail, an important public health achievement against one of the most dreaded infectious diseases. Set in Arkansas, the book helps readers understand not only the toll of the disease but the scientific process of discovery and the struggle for control over one of the world’s most destructive killers. I particularly enjoyed hearing about the life story of the young Joe Bates, one of my most admired medical scientists and educators. Tuberculosis impacted Joe Bates and arguably created the determination we see today in his life-long dedication toward the amelioration of this disease and his steadfast advocacy for the health of the public. In this book we see in vivid detail the advancement of medical science and the critical epidemiologic discoveries that moved modern treatment methods toward an effective population perspective. Having served as the State Health Officer in Arkansas, it was also heartening to read of the leading role that Arkansas played in the treatment and prevention of tuberculosis. This disease is not extinct. It still claims thousands of lives around the world and even still a small number today in Arkansas. The book, however, is testament to how scientists working against strong odds make progress and why investment in public health is still desperately needed. A must read for anyone wanting a human and scientific telling of one of the most important advances in our lifetime.”—Paul Halverson, Dean and Professor at Indiana University School of Public Health
“This is the riveting true story of the struggle to vanquish one of the greatest scourges in human history. In the state of Arkansas, courageous men and women took up the challenge to save lives and relieve the suffering of those with tuberculosis. From the first page to the last, this is wonderful reading.”—Nathaniel Smith, Deputy Director for Public Health Service and Implementation Science at US Centers for Disease Control and Prevention
“An impressive history.”—The Lancet
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