A Diva’s Death:  Tuberculosis during the Presidency of Herbert Hoover

By Thomas F. Schwartz

COVID-19 symptoms—fever, chills, cough, night sweats, fatigue, and weight loss—bear a striking similarity to a disease that was prominent during the presidency of Herbert Hoover.  Tuberculosis [TB] has afflicted people from earliest recorded history.  It usually affects the lungs and was often referred to as consumption because of weight loss and it would literally consume the lungs with fluid causing death.  Opera composers frequently used consumption as the tragic death for leading characters.  Giuseppe Verdi’s La traviata plots heroine Violetta dying of tuberculosis in the arms of her lover, Alfredo.  Another Italian composer, Giacomo Puccini in La Boheme casts the heroine Mimi in a similar fate.  A modern rendering of La Boheme is the Broadway musical Rent. George Orwell wrote his most celebrated novel 1984 during the last stages of TB that killed him.  What makes TB so dangerous is that it is highly infectious and can attack tissues throughout the bodily systems: central nervous, circulatory, lymphatic, gastrointestinal, urinary, bones, joints, and skin.  It can kill quickly as in the case of TB meningitis or resides for years without symptoms within a seemingly healthy individual.  It is estimated that 25% of the world’s population is infected with TB.  It spreads through bacteria that often resides in the lungs and is expelled through coughs, spitting, or sneezes.  Areas with dirty crowded living quarters are ideal for the mycobacterium tuberculosis bacteria.  With the advent of antibiotics and vaccinations, TB had almost disappeared in the United States but remains a leading cause of death in developing countries.  New antibiotic resistant strains of TB pose a continuous threat to every country.

The TB bacteria was identified in the late 1800s and popular treatment consisted of isolating patients in a sanitarium, exposing them to plenty of rest, fresh air, sun, and healthy foods.  Until the 1943 invention of streptomycin, an antibiotic effective in curing TB, sanitariums offered the most popular treatments for TB, allowing the body to build up its own defenses against the disease.  Thomas Mann used patients at a Swiss sanitarium as the basis for his novel The Magic Mountain.  During Herbert Hoover’s presidency, retreating to a sanitarium or isolating in a healthy climate was still the typical approach to treating TB.  In two instances–one affecting his eldest son Herbert Junior and another Phillips Brooks, one of the White House staff—TB directly influenced Hoover.

Herbert Hoover Jr., or Herb as the family called him, infected as a child with the 1919 influenza that swept the world left him with a hearing loss.  Photographs of Herb as an adult often show him wearing a hearing aid.  In 1930, he suffered another affliction diagnosed as TB.  The doctors recommended one year of rest.  Married with three young children, Herb had a number of decisions to make.  Fortunately, he had understanding and caring parents who happened to be the President and First Lady.  They offered to have their grandchildren stay with them at the White House and offered their Rapidan Retreat in the Shenandoah Mountains as a place to rest and recover.  Herb and his wife Margaret eventually relocated to a residence in Asheville, North Carolina for the remainder of his recuperation.  It is interesting to note that an Asheville firm was selected by Lou Hoover to produce a series of wooden Christmas gifts from discarded White House beams.

Phillips Brooks first worked for Hoover as a personal messenger and after Hoover’s election in 1928, was hired as a pantry man and butler.  In 1931, a neighbor of Brooks who was a physician believed he was suffering from TB.  The White House physician, Dr. Boone, sent Brooks to the hospital and X-rays confirmed the diagnosis.  When Mrs. Hoover learned about Phillips’ confinement, she reached out to his wife, Katurah, and placed her on the White House payroll as a maid to provide income for the family.  On one of Katurah’s hospital visits, she witnessed the hospital had placed his bed at an open window.  A light snow during the evening left a thin blanket at the foot of his bed.  Upon her return to the White House, Mrs. Hoover inquired: “Katurah, you look all down in the dumps.”  She replied, “Well, I am.  I went out to see Phil this afternoon and when I got to where he was, the bottom of his bed was full of snow.”  According to Mrs. Brooks, the First Lady “jumped up and she went to the telephone and called this hospital and said she wanted him to have special service and to be put in a place where there would be no draft or anything, because she wanted him to get thoroughly well, and if they couldn’t do that she would see that someone was placed at the head of the hospital who would.”   Mrs. Hoover wrote to Brooks, “We all miss you very much at the White House and so regret that you are having this illness.  However we rejoice that you found it even sooner than our Herbert did, and so will not need to take even so long in recovery.  Just be sure that you follow the treatment absolutely and don’t take any exercise or have any worries.”