The Black Angels

July 15, 2023
A breathless but illuminating conquest-of-disease narrative. In her first book, Smilios explains that, unlike fiercely contagious infections (measles, strep, polio) that attack quickly, tuberculosis comes on slowly, with symptoms that emerge over weeks or months. By 1900, prosperity and improved sanitation had vastly reduced infections among the middle-class, but the poor still suffered in densely packed, dirty tenements. Convinced that the infected endangered the citizenry, New York built a dedicated TB hospital to isolate the worst cases on Staten Island. When Sea View Hospital opened in 1913, it quickly overflowed with patients suffering from an incurable disease, cared for by overworked staff, most of whom became infected. By the 1920s, white nurses began quitting, attracted by better job options for women. Sea View employed a few Black nurses, but most white-run hospitals did not, and nursing schools refused to admit them. Black nursing schools existed, but their graduates often had trouble finding work. Understaffed at the best of times, Sea View faced disaster, so it aggressively recruited Black nurses, who soon became a majority. Smilios narrates the story through the eyes of individuals such as Edna Sutton. Born in 1901 in Georgia at a time when treatment of Blacks in the South was loathsome, she graduated nursing school but found no work until she responded to a recruitment notice from Sea View in 1929. Readers who can tolerate the author's docudrama fictionalization will gnash their teeth at what follows. Always short-staffed, the hospital's nurses worked exhausting 12-hour shifts. Therapy was drawn-out, gruesome, painful, and ineffective. Smilios digresses regularly to describe treatment of Black nurses as well as the efforts of researchers working on anti-TB drugs. Inevitably, many were tested at Sea View. Progress fighting both TB and racism was slow. However, by the 1950s, TB became curable, TB hospitals vanished, and nursing organizations dropped their all-white policies. Vivid accounts of medical and racial progress with a mostly happy ending.

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October 2, 2023
In her evocative debut, essayist Smilios tells the story of the Black nurses at Staten Island’s Seaview Hospital, which, during its heyday in the 1940s and ’50s, was the largest tuberculosis sanitarium run by a city government in the U.S. She focuses on the Black Southern nurses who were recruited to work there starting in 1929 after a mass resignation of white nurses due to poor working conditions and fear of the disease (at the time, tuberculosis killed one in seven people). Smilios profiles individual nurses, some of whom worked in the ward for more than 20 years, against a detailed historical backdrop, including the Great Migration of African Americans from the South to the North and the work done by the National Association of Colored Graduate Nurses to garner respect and professional opportunities for its members. After WWII, the narrative shifts to the discovery of the antibiotic isoniazid and its trial as a cure for tuberculosis at Seaview, which was administered by the hospital’s Black nurses. Smilios’s narrative is sympathetically told in rich if sometimes flowery prose. (In one passage set in the surgery theater, Smilios describes “lungs whose surface resembled the moon, full of craters and rims” and the stench from corpses rising “like an invisible dark matter.”) Historical fiction aficionados will want to take a look.

Starred review from September 1, 2023
In a note to readers at the end of this immensely rewarding history, Smilios recounts how she stumbled upon the surprising story of Sea View Hospital in Staten Island. An editor in the field of biomedical sciences, she was not expecting to find that the cure for tuberculosis was discovered in New York nor that the hospital where it occurred, though seriously degraded, was still standing. Struck by the fact that there was no archive documenting Sea View's accomplishment, she found herself talking to one of the nurses who worked there as the disease still raged. That conversation led her to another revelation, that for decades the Sea View nursing staff was overwhelmingly African American. This confluence of histories, encompassing public health, urban development, race, class, and social upheaval was too significant for Smilios to pass up, no matter how difficult the research might prove to be. She blends all of the threads she followed into a big blistering narrative that takes readers into the lives of an exceptional group of individuals whose personal stories are as compelling as the disease they confronted was deadly. Informative, enthralling, and sometimes appalling, this is American history at its best.

COPYRIGHT(2023) Booklist, ALL RIGHTS RESERVED.