'The Black Angels'

A new book examines the courageous women who helped in the fight against tuberculosis

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In 1929, a Staten Island sanatorium known as Sea View, a facility established to treat patients with the deadly tuberculosis disease, began losing its staff of white nurses.  The sanatorium was seen as the last resort for poor New Yorkers who could not afford to be cared for in a private sanatorium.  

It is difficult for us now to comprehend the magnitude of TB at this time, when around one in seven sufferers died of the deadly disease - an estimated one American every eleven minutes - in this pre-antibiotic era of medicine.  

Understandably, much fear surrounded the treatment of these patients.   Sea View was the largest of the municipal hospitals, built on a 400-foot hill and set in rugged wilderness, filling with 800 patients on its first day of opening in 1913.  By 1929, at the height of the disease, its wards were overflowing, with its nursing staff outnumbered by patients.

Sea View Tuberculosis Hospital

As the multitudes of white nurses began quitting, officials desperate to avert a public health crisis found a solution to the lack of nursing staff, summoning Black nurses from the south to plug the gap.  These nurses were lured to Sea View with the promise of a good salary, a nursing career, and as a way to escape the strict Jim Crow laws which limited their nursing ambitions.  

This is the subject of a new book by Maria Smilios, The Black Angels: the untold story of the nurses who helped cure tuberculosis in which she describes in vivid detail the reality for these nurses, arriving at the isolated hill-top facility where they still found themselves the victims of racism, whilst attempting to care for patients in a hospital nicknamed ‘the pest house’ where ‘no one left alive’.  

Her remarkable account spans the Great Depression era through World War II and beyond, following the story of these intrepid young nurses, known as ‘Black Angels’, who risked their lives for twenty years, caring for TB patients in dreadful and inadequate conditions.  They nursed 1,800 of the poorest inhabitants of the city, most of whom were simply waiting to die or becoming ‘guinea pigs’ for often experimental and deadly drugs.

The Black Angels by Maria Smilios

The career opportunities for Black nurses were extremely limited in the racially segregated south, where they were prohibited from working in white hospitals.  The authorities of Sea View were well aware of this, and in their desperation to recruit nurses to work at the facility they attempted to lure the only nursing staff they could think of.  

Their idea paid off: hundreds of Black nurses responded.  Their tenacity in working in the harsh conditions of the sanatorium, together with the pervasive racism they faced, was remarkable, as detailed by Smilios in her book.  What is perhaps even more significant is their contribution to the eventual development of a breakthrough treatment for TB.

Drug treatments for the disease in the early part of the 20th century was at best, primitive; at worst, caused agonising suffering for the patients.  Smilios gives examples of patients who had languished in the facility for over ten years, eventually dying of the disease.  

Smilios introduces the Black nurses who arrive on this scene with acute precision.  We are introduced to Preacher’s daughter Edna Sutton, who, seeing an opportunity to flee the racism of the south, entered pre-training at the Harlem Hospital, where she encountered a segregated cafeteria and heckling orderlies.  She was also subjected to invasive ‘cleanliness’ inspections.  

After her training at Harlem Hospital, Sutton arrived at Sea View in 1932 as a surgical nurse, attending patients in the operating room where it was not uncommon to work in 107 degree heat.  She kept vigil with dying patients, and is reported to have found solace in reciting her favourite Bible verses whilst riding the Staten Island Ferry.

Sutton later enlisted her 16-year-old niece Virginia Allen as an aide on the paediatric ward, and Allen is now one of the last living Black Angels.  Despite Allen’s reportedly easy-going nature, the sight of her young patients with ‘faces and necks turning red and fingers clenched into small fists’ was a harrowing experience ‘that no amount of singing and reading or playing with puppets or cars or paper dolls could eradicate.’

Another nurse in Smilios’ narrative is Missouria Meadows-Walker, who at the age of 24, arrived at Sea View to work on the men’s ward.  There, she encountered male patients who would snarl at her as she shaved them and who frequently engaged in bets on which of them would be the next to die.  

Smilios reports that the nurses continued to face racism and prejudice during their time at the sanatorium.  

In 1944, Meadows-Walker purchased a house on a street close to the hospital.  She became the first Black homeowner on the street, where her white neighbours attempted to drive her out.  She persisted however, living on the same street for decades and eventually nursing some of the other residents who had once been so hostile towards her.

Another example given by Smilios is the opening of a new cafeteria at Sea View, where tables stated: ‘Reserved for Whites’.  Further, the American Nurses Association refused to admit Black nurses, meaning that even if they left the often intolerable conditions of Sea View, they would be ineligible for other nursing roles.  Despite being lured by the promise of good pay, nurses such as Sutton received $720 starting annual salary in comparison to the white nurses who had fled, who had been on a salary of $1,100.  

However perhaps the most shocking of all the indignities endured by the nurses was in the behaviour of the facility’s superintendent of nurses, Miss Lorna Doone Mitchell, who reportedly would not allow them to mask themselves, meaning that they often tested positive for the disease themselves.

Smilios’ book also charts the search for a cure alongside the personal story of the nurses.  Whilst documenting the lack of protection for patients involved in clinical trials, she follows the scientific attempts to discover a drug that would treat the disease, often run by drug companies who saw an opportunity for profit.  

One altruistic pathologist named Edward Robizek, who had lost his father to TB, volunteered at Sea View for decades, involving himself in testing drugs.  This eventually led to a landmark trial in 1951 of breakthrough therapy isoniazid.  However, it was the nurses at Sea View who meticulously collected the patient data that would reveal the drug’s efficacy.  Robizek acknowledged this, calling their work ‘masterful’.  

As the new drug began to be effective in treating the disease, Sea View ceased to function as a TB hospital in 1961.

Smilios’ account of these women’s history provides a compassionate examination of their personal experiences against the backdrop of the scientific search for a cure and world events at the time.  

As with many examples in our history, these women were erased from the story of the treatment and eventual cure of this deadly disease, which is estimated to still affect people in all age groups and countries across the globe.  The vital work of the Black Angels not only involved the care of their patients, who were often condemned to death by the disease, but also helped towards the identification of a cure for TB.  

This is not an easy topic to read about, but Smilios has set out to ensure that the voices and legacy of these extraordinary women are not forgotten.  

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