Audio Clip

(4:16)
Professor Jimmy Williamson
The agony faced by TB patients

History of NHSScotland – Public Health Challenges – Improving Public Health - Tuberculosis

“It was a very evil thing to have tuberculosis, a very unpleasant thing and there could be this stigma. And of course it was very important because you would get young girls coming down from the Highlands to train as nurses and they had had no contact with tuberculosis. And they would be meeting patients not just in the sanatorium but in the infirmary or in any general hospital, they could easily find themselves at the bed next to somebody who was coughing and had tuberculosis, and the nurses, some of these girls got tuberculosis and quite a proportion of them would be dead within a year of coming to train. Heart rending…. you know, you would see these, I would always remember these young girls, some of them very beautiful and with nice pink cheeks and then you would do everything you could. Prior to the antibiotic streptomycin days, quite often no matter what you did, it didn’t have any good effect, and sometimes it had bad effects. I mean if they had a pneumothorax and that went wrong that could be extremely nasty, you know they could end up with one side of their chest filled with pus, tuberculous pus, and that was no pleasant way to go. It was a pretty grim business. And that girl that you had seen, with her pleasant appearance and nice pink cheeks and here she was you know a sort of skeletal creature, and just fading away. You had to train yourself to deal with that.

The last case I saw, I remember very (well), it was a man in his forties, and he had been picked up. I don’t remember how it was picked up, anyway he was referred to the chest clinic and it was the last session I did in the clinic, because I then left the chest service, and this man was in his forties I think and he smoked significantly, a least twenty cigarettes a day, he didn’t have any symptoms, or at least if he had they were pretty minimal. But he had this shadow in his lung and I remember seeing him and he said “Well, what’s the diagnosis?” and I said “We don’t know but we’ll find out”. We did all the tests and he came back after the test results were available, he came into the clinic and he sat down and said “ What’s the diagnosis?” and I said “You’ve got tuberculosis” and he put his head in his hands and said “Thank God” and that was the last patient I saw as a chest physician. It must have been almost a divine hand that arranged this the way it came out. If I’d said that, if I’d been doing this, certainly ten years earlier and I said “You’ve got tuberculosis” he would have put his head in his hands and wept probably. But he knew he was going to be cured, and he was, of course, cured. That was such a dramatic change in outcome of this disease and also a dramatic change in the public perception of it, because previously, as we discussed, there was this stigma and now the stigma was almost disappearing and the outcome was generally regarded as being very favourable if the patient co-operated and the service was delivered appropriately then the patient would be cured ….and they knew that.