Tuberculosis – Murderer of John Keats

‘Young grows pale, and spectre-thin, and dies …’ The poet who wrote these words, John Keats, was only twenty-four when he first coughed up blood. When Keats came home feverish one night, the friend he was staying with urged him to go to bed at once. No sooner did he lie down than he gave a hacking cough that brought with it the unmistakable taste of blood. The candle he lit confirmed his expectations: it revealed a bright red spot on his pillow. ‘That drop of blood is my death-warrant,’ Keats said calmly to his friend; ‘I must die.’

Frightened, his friend ran out into the cold February night for a doctor in the first many attempts to save young Keats over the next year. But all attempts were useless. Tuberculosis germs could have been hiding in Keats’s lungs since childhood; by the time the disease revealed itself, leaving its red signature on his pillow, the battle was already lost.

Keats knew this all too well: as a boy of fourteen, he had cared for his mother when she lay dying of tuberculosis. He allowed no one else to cook her meals, and sat with her through the night in a room with the doors and windows shut tight against drafts. When he was twenty-three, he did the same for his youngest brother. In those long hours, Keats both breathed in countless numbers of Mycobacterium tuberculosis, the germ that cause the disease, and learned firsthand the details of how he himself would die.

It has been estimated that in Keats’s day, the beginning of the nineteenth century, one quarter of all Europeans died young of tuberculosis. At that time, the creative were considered especially vulnerable; one could hardly claim to be an artist without a bloody handkerchief. The poet Lord Byron, who did not have the disease, once went as far as to wish he would die of tuberculosis because, he said, the ladies would all say, ‘Look at that poor Byron, how interesting he looks in dying!’

Of course, once Byron was dead, the ladies would not matter, but pat of the allure of tuberculosis was that dying went on for years: the thin, flushed, and even feverish look was considered romantic, and one was not always too sick to enjoy being so perceived. But this slow, creeping death is also what has made tuberculosis so terrible. Like its relative leprosy, tuberculosis reproduced much more slowly than most germs. This made it difficult to diagnose, concealed the fact that it was contagious, and made it hard to study in the laboratory.

Tuberculosis is stealthy: after it enters a body, the germ will wait as long as it takes, ten days or fifty years, for the moment the host is weak enough to attack. When tuberculosis does attack, the infected person feels tired, gradually more and more so, but does not know why. Tuberculosis gives no outward sign of its presence until too late. Before we learned how to probe the body for evidence of the disease with X rays and skin tests, the bright red spot of coughed-up blood was the first definitive sigh, and by then tuberculosis was well established.

Today, five decades after a cure for the disease was found, tuberculosis, known as TB for short, kills more people than any other single germ. It is the largest single cause of death from infectious disease in the United States. Worldwide, three million people die from it each year; over eight million become infected.

In little more than the time it take you to read this sentence, another person will die of TB.

From Invisible Enemies: Stories of Infectious Disease by Jeanette Farrell