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Florida’s Sanatorium: TB Time Warp

June 21, 1998 GMT

LANTANA, Fla. (AP) _ It stands as a monument to disease _ a relic from days past when sanatoriums dotted the landscape to treat people afflicted with tuberculosis.

Behind its pink exterior, patients would linger in isolation by the hundreds, fighting the ``white plague″ in the years before modern medicine had found a cure.

Some would have their ribs cracked or pingpong balls placed into their chests to keep their lungs from fully inflating _ on the theory that tuberculosis needed oxygen to thrive. Others would sleep with their heads out open windows, hoping the fresh air would cleanse them of their respiratory illness.

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Opened in 1950, the A.G. Holley State Hospital is now a dinosaur of a medical facility, the only remaining free-standing sanatorium in the United States dedicated solely to the treatment of tuberculosis.

Its mere presence is haunting.

``It’s like a time warp,″ said Dr. Michael Iseman, the chief of the clinical tuberculosis service at the National Jewish Center for Immunology and Respiratory Diseases in Denver, who gave a lecture at A.G. Holley six months ago.

``Without being melodramatic, I feel a sense of ... the ghosts of all the patients who came there, many of whom died there,″ he said.

It’s no wonder.

Very little has changed at the hospital since it opened as the Southeast Florida State Sanatorium _ a 500-bed hospital in the then-undeveloped community of Lantana, about 70 miles north of Miami.

The town had only 700 residents _ the same number of people needed to run the hospital. The complex built its own power plant and water tower and added housing for its employees.

However, soon after it opened, the first medicine to treat the disease was discovered. Slowly, most of the 600 sanatoriums built since the 1930s started to shut their doors, or they were converted to other uses, including insane asylums and mainstream hospitals or condominiums.

Florida closed its other state sanatoriums in Tallahassee, Orlando and Tampa. The legislature reduced the capacity at A.G. Holley from 500 patients to 150, and eventually to 50 _ leaving the remainder of the facility for other state agencies to use.

Health officials believed then they might have conquered tuberculosis, which has been around so long it is even referenced in the Bible in the Book of Deuteronomy.

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But in the early 1990s, tuberculosis cases surged, fueled by even more potent drug-resistant strains. So the need for isolation treatment centers such as A.G. Holley was never quite eliminated. Even today, tuberculosis kills about 3 million people worldwide.

``Those of us working in tuberculosis hoped sanitized hospitals would remain a chapter of the past,″ Iseman said.

A.G. Holley is now home to patients with the most severe cases in Florida _ most of whom are sent to the hospital by court order because they’ve refused to follow their regimen of medicines.

More than 90 percent of the 50 patients are alcohol and drug dependent, and most have other diseases, such as AIDS or hepatitis, which complicate their treatment for tuberculosis, said Dr. David Ashkin, the state’s TB controller and medical director at A.G. Holley.

``Of all the conditions my patients have, TB is the least of their problems,″ Ashkin said.

To keep these patients from trying to leave the hospital, the windows are barred and the doors in the hallways are locked. The walls are painted a stark white.

``The floors really have not been changed in 30 years,″ Ashkin said. In the basement, a chalk board still has the scrawled notes from the last autopsy done there more than 20 years ago.

When patients are no longer contagious, they are lodged four to a dim room.

Elmer Wise is not complaining about the bleak accommodations.

The 39-year-old patient _ just three days from release after four months of court-mandated treatment _ passed the time recently sitting alone in a hallway, painting a moonlit landscape on a 6-foot canvas.

Wise said he wasn’t happy when he was forced into the hospital for treatment of a disease he’d considered no more serious than a common cold. But, in the end, he said he was thankful _ no matter what the conditions of the facility.

``To me it was like a relief,″ Wise said. ``Somebody was taking me out of society and putting me somewhere where I could get some rest.″

Wise may be among the last patients in the era of traditional sanatoriums.

Ashkin said there are plans under way to revamp the fourth floor of the building and to make it into a modern treatment center for tuberculosis.

``The last of the true sanatoriums will not be here,″ he said, wistfully. ``We kind of feel an obligation to preserve the history of the sanatorium because people forget about them.″