Nathan Masters: Sunshine has always been part of the Southern California sales pitch.

Yet for one group, the region's blue skies were more than an attraction.

They were a lifeline.

In the late 1800s, tuberculosis was a leading killer, responsible for one in 7 U.S. deaths.

Treatment options were limited.

The most effective remedy-- fresh air and sunshine, commodities Southern California had in abundance.

Encouraged by the region's boosters, specialized hospitals called sanitariums or sanatoriums opened their doors on the outskirts of Los Angeles, and they served health seekers for decades, up until the 1940s, when the advent of modern antibiotics finally brought a cure.

Tuberculosis is often called the forgotten plague, but its imprint on L.A. is still visible today for those who know where to look.

[music] Announcer: This program was made possible in part by a grant from Anne Ray Foundation, a Margaret A. Cargill philanthropy; the Ralph M. Parsons Foundation; and the Los Angeles County Department of Arts and Culture and Creative Recovery LA.

Masters: When we think of the forces that shaped L.A., tuberculosis doesn't often come to mind.

But TB played a big role in Southern California's self-promotion.

To get a handle on that, I met up at the Occidental College Library with journalist Patt Morrison, whose postcard collection shows how sanitariums were wrapped up in L.A.'s booster package.

So, Patt, you have a box here of postcards that document a largely forgotten period of Southern California's past and kind of a dark period, although what's in here might not reflect that.

Morrison: It's a period that the city fathers and the local leaders at the time would just as soon forget, when Los Angeles and Southern California was part of what was called the Sanitarium Belt, when people with tuberculosis came here to get better.

And at some point they thought, "Yeah, we want tourists, but not sick tourists, especially not poor, sick tourists."

Masters: So, this is your personal collection, but someday it'll, it'll wind up right here at Occidental.

Morrison: It'll all be here.

And you can all come back later and look at them, because it illustrates very dramatically how Los Angeles sold itself as the center of health and sunshine.

Masters: Yeah.

Morrison: But then things went a little bit off the rails.

The first real tourist guide to Southern California, 150 years ago, had a chapter called "Southern California for Invalids."

So, already there was a sense that come to Southern California if you're sick and we're going to make you well, just because this place is a sunny paradise.

Masters: This was around 1875 when, really, the California tourism industry took off.

It was the moment where California was linked with the rest of the nation through-- Morrison: By the railroad.

Masters: Right.

Morrison: And then it was "Katy, bar the door."

Everybody came here to have a look.

We had an entire industry, as these postcards show, of sanitariums that were built in large part for wealthy, prosperous White tourists to come and get better.

They worked outdoors.

They lived outdoors.

There was no treatment for tuberculosis then.

There was only care and rest.

And that's what these cards sold.

Paradise Valley Sanitarium.

And look at them--they're playing croquet.

The grounds, beautiful, with the pergolas covered with flowers.

All of these homes are usually along the foothills.

That was where the Sanitarium Belt was, because you had sunlight, you had heat, you had warmth.

Masters: And they're postcards, right?

These are something you send when you're on vacation.

Morrison: Hey.

Yeah.

Look here.

I'm having a great time having tuberculosis in Southern California.

But they did make it look pleasurable, almost, that you could play tennis and be outdoors, and look at the rose-covered cottages and all of that.

Masters: There was the sense that the sunshine could cure it or could at least abate the symptoms.

Morrison: This was the great trick that Southern California and the Chamber of Commerce pulled.

In fact, two of the leading figures of the Chamber of Commerce in Los Angeles both came out here with tuberculosis and felt so much better after a time here that they decided they were going to promote this product.

And what was the product?

We didn't pay anything for it.

It was the sunshine.

It came right out of the sky.

And it drew so many people that it began to create this critical mass that made the Chamber of Commerce folks think, "Maybe we've oversold this."

Masters: Right, because a significant percentage of the population in Southern California were sick people.

Morrison: People write in certain memoirs of just running into the sick on the street, people who are hobbling and gasping and struggling.

You think this is not what they're trying to sell as the image of Southern California.

Masters: This, in some ways, is the birth of the California tourism industry.

Morrison: Exceptionally so.

People who were desperate were going to be spending money.

They would come here and they would spend money to do what it takes to make themselves better.

Not all of them succeeded.

Masters: Sadly, that is the California story, too, right?

That the reality doesn't always live up to the dream.

Morrison: And there was also a class level here, because we wanted people who could pay for their fancy resorts, which they called the TB sanitariums.

But people with very little money would come out, and the state and the city were concerned that they would be thrown on the public dollar.

The city would be responsible for their support.

And this was especially true when you had people of color.

Now, as then, the health and welfare of people of color didn't really concern the establishment until it started to affect White people.

And then it's, "Oh, well, those people of color, we have to isolate them."

It happened with the Latino community with smallpox, with tuberculosis, with the plague, that they were isolated and in a sense blamed for the conditions, blamed for the diseases, when in fact their conditions had been neglected for so long.

So, when we talk about people's hopes coming here, here's a postcard of a group of people on the Arizona desert.

And you know it's Arizona because there's a saguaro.

Right.

I think it's a real saguaro.

"A specific has at last been discovered for tuberculosis.

It is tuberclecide."

It says, "An internal remedy taken at home amid home comforts does not require a physician.

No hypodermics, no serums."

Sounds like the bleach cure for COVID.

Masters: It does.

It does.

Morrison: It goes on and on, and so, people came here with so much hope, and in some cases they were deliberately deceived, but so often because people didn't know what to do about TB, they tried everything.

Here's the Loma Linda Sanitarium, and in fact, the City of Hope in Duarte started because there was a Jewish hospital/sanitarium on Carroll Avenue in Angelino Heights that neighbors finally got all NIMBY about.

L.A. was starting to pass these zoning laws about having TB sanitariums within X hundred feet of a school or--those numbers begin to sound familiar, don't they?

Masters: They do.

They do.

Morrison: How much of it had to do with the patients and how much of it had to do with the fact that they were Jewish?

I think it's a mix.

But eventually, there were fundraisers, really impressive fundraisers.

The City of Hope in Duarte began as a kind of second sanitarium for Jewish patients and grew into the institution that we know today.

Masters: Now known as a cancer treatment hospital.

Morrison: TB is still around, and it's still a public health problem for communities that have had no care, who have been marginalized and have been ignored.

And that's where you see it devastating people the most.

Masters: Hmm.

These 4 by 6 cards are a window into a forgotten past, but they only show you so much.

To see what life was really like at a sanatorium, I had to see the biggest TB archive of them all-- the records of the Olive View Sanatorium in the San Fernando Valley.

I met up with historian Bill Deverell at the USC Libraries, where the collection now lives.

Thanks, Micaela.

Deverell: One of the things that was so exciting about the Olive View collection is they're not patient records.

That would be a complicated and difficult thing to do, ethically, morally, and otherwise, so, what is here is the world the patients developed.

So, the yearbooks they made, greeting cards that were exchanged between them, the Olive View newspaper that gives you insight into the daily life of these people.

The county officials were said, in the late 19-teens and early 1920s, when Olive View was getting going, were said to meet trains coming from other places into L.A. County and grab the tuberculars, who were indigent and poor and just looking to try to save their own lives, and bring them up here.

Masters: These people didn't have appointments to go to Olive View.

They were... Deverell: Probably mixed, yeah, probably mixed, but there is a hint of incarceration to this place.

But at the same time, if you get a sense of the public health physicians and administrators, they're deeply humanitarian.

So, it cuts both ways.

There's these little boys.

Masters: They're all TB patients.

Deverell: They've got to be all TB patients.

Yeah.

If they're sitting that close together, they're all TB patients.

Remarkable day-to-day photographs, both of clinical care but also everyday life.

There's some kind of show that's... Masters: A little puppet show.

Deverell: A puppet show.

Masters: Yeah, a marionette.

Deverell: Yeah, yeah.

Masters: This is golden.

Deverell: Total time capsule.

So, this one is called "Patient's Handbook.

Olive View Hospital.

Guide to Procedure and Policy."

So, lights out, visiting hours, rest periods.

There's a fair amount of control of their lives.

But they build these relationships as any human community would.

There's a U.S.

Postal Service outfit there.

There's schools, of course.

As I say, there's the farm.

Masters: It really is its own town.

Deverell: They're kind of marooned out there.

And so, they share this terrible thing in common.

But the friendships they build, the lifelong connections, the families that are created.

You know, it's, it's its own world.

And so, to get ahold of that and remind people about that medical history of Southern California and how important this was and how hopeful it was, it's important.

Masters: Like a lot of people who go through hard times, they manage to find the humor in it, too, here.

This is "Duel in the San."

And I see a nurse and a patient with syringes.

[Laughs] Deverell: Exactly.

And here's a little handmade book about daily life in there, and it says, "Personal hygiene.

Number one, keep clean-shaven at all times.

Why provide a feather bed for TB germs?"

So, you'd have to shave that beard, Nathan, because they don't want TB germs in there.

This is a famous book.

"Huber the Tuber, a Story of Tuberculosis."

So, it's a kid's book, published by the National Tuberculosis Association.

This is a rare book.

It's in beautiful shape.

Masters: Sorry.

What is this on the cover, though?

These are boys riding-- Deverell: They're riding the-- probably the tubers.

This just gives you an insight into how they tried to deal with it.

The patients are very interested in what the medical world is thinking about for TB, so, these are essentially a bridge.

Scientific findings.

Respiratory and pulmonary insights are important to the patients.

And then, everyday lives.

So, the patients will publish poetry.

Oh, there'll be jokes.

Little ditties, little word puns, then advertisements.

Masters: So, we're talking a lot about tuberculosis, but of course, there was another term bandied about in the day-- consumption.

Deverell: Right.

There's an odd distinction, often, along lines of class, and there is a reflex in the culture that the rich don't get tuberculosis.

That's a disease of the poor and of the streets.

The rich get consumption.

That can't quite be true.

And odds are they are exactly the same disease.

But what you call them also signifies or could signify your class position.

Masters: And consumption refers to the sense that the body is literally consuming itself.

You wa--you sort of waste... Deverell: You waste away from inside out.

Masters: And sometimes, consumption was glamorized or romanticized.

Deverell: Yeah, there's a wrinkle.

I think you've put your finger on it.

An often gendered wrinkle to this.

That wealthy women who faced consumption, they would take to their beds and think and produce literary thoughts and writings.

So, it's poignant, actually, and you do see it in the record.

These are all archivally preserved, acid-free, organized.

There's an order to these.

You see these identifiers are always in pencil.

Masters: Yeah.

Deverell: You know, pen is verboten.

Pen and Scotch tape.

No way.

Keep it out of here.

This is more of the "Olive View-Point."

You can tell the paper's pretty bad.

It's not really good paper.

It doesn't have a lot of cotton in it.

Masters: It wasn't printed on acid-free paper.

Deverell: No, no, no.

Masters: What was the actual process of rescuing this collection like?

You rolled up your sleeves and went there.

Deverell: We absolutely rolled up our sleeves.

Master: You personally, and your team.

Deverell: It's a wonderful tale.

It is a rescue.

I have to give credit to the folks out there at the Olive View Hospital, because they had protected the archive for, well, a good 70 years or thereabouts by shuttling it off to a facilities bunker.

Once we got that green light and we had the green light here at USC, then it's fun, because then you get a big truck and you go out with a team and you take the things you want, which was basically everything.

And also, just the process of seeing these boxes, which were not in these nice archival boxes then, of course.

They're in banker's boxes or shoe boxes or file cabinets.

And we had a job to do, which is, let's get this out of here and get it to USC.

There was a physician out there, the wonderful Dr. Salma Khamis, who was an anesthesiologist, but she trained herself as an historian of medicine, and she was utterly fascinated with the history of Olive View.

So, she's a key player in this, in the preservation.

The bunker was hot, a little too hot for archival preservation, but it was dry and it was dark, so, that helps for sure.

Masters: The people at Olive View saved this in 1935.

I mean, almost 90 years ago, somebody thought, "Oh, I'll set this aside."

Maybe they had no idea it would be here in 2023.

Deverell: I think they probably didn't, although who knows?

Maybe some facilities person or a physician or a patient thought, "You know, I want to make a record of this."

What I love about the "Olive View View-Point" is just the mixture of the social history texture, like who's coming to visit and how did the baseball team do last week?

Or, you know, is the pool being shut down for something or other?

With what are the doctors doing?

What's on the front line of possible cures?

Masters: What's especially important about this collection is that this is an entire, almost epoch of Los Angeles history that just doesn't exist anymore.

We don't have any way of knowing how big that was except through archives like this.

Deverell: You're right.

There are still people around who were children at Olive View, or their children, or their children's children.

So, we have the oral history and memory thread, but the documentary thread is thin.

So, having this is a real victory for scholarship and for our understanding of our region.

Masters: Although Olive View still serves L.A. County today as a general medical center, few remnants from its days as a TB sanitarium survive.

Thankfully, that's not the case at the Barlow Respiratory Hospital, founded in 1902 by Dr. W. Jarvis Barlow.

When he contracted tuberculosis as a young physician in New York, Dr. Barlow prescribed himself fresh air and sunshine and found it in L.A.'s bucolic Chavez Ravine.

L.A. history has gone through all these phases, where something's really important for a while, and then L.A. just moves on as if it never happened.

Tuberculosis is one of those.

But Barlow here is a living remnant of that.

Man: Yeah.

1902.

How many institutions are still in existence for all that amount of time?

It was built, started one pandemic, and this is our third, basically.

Masters: What goes on here now?

Man: Excellent question.

Back in the day, in 1902, when Dr. Barlow set up this place, there was no real treatment for TB.

So, the only way that you could really handle it was to be isolating the patients and exposing them to what we have in abundance, which is sun and fresh air.

Masters: Yeah.

Man: You know, back in the pre-smog days.

So, he built this organization here in Elysian Park adjacent to the city park, knowing that it was fairly remote, far away from what was the city at that point.

Masters: So, what was life like for a patient, you know, back in the early 20th century, when this was a TB treatment place?

Man: The patients were generally pretty young, in their 20s, 30s, and 40s.

They were your usual young adults who just happened to have an infectious disease that couldn't be spread around in the community.

I don't want to say they were prisoners, but they were more or less prisoners being treated as best could be treated at that point with fresh air, sunshine.

Masters: They were limited in what they could do in terms of recreation, right?

You're not going to go on a hike up through Elysian Park.

Man: No.

I mean, they had to stay on the 25 acres that we have here, but they did have occupational training of sorts.

We had animals.

They were trained in animal husbandry, where they take care of animals.

Masters: It's a way to pass-- Man: Exactly.

Masters: So, this is kind of amazing.

This is a sundial.

Man: Correct.

Masters: And, I mean, how appropriate for there to be a sundial here when sunshine was supposedly the medicine for tuberculosis.

Man: It makes great sense, doesn't it?

I mean, and this was here before basically anything was.

Masters: This was dedicated December 28th, 1905.

The hospital was only 3 years old when this was placed.

Man: Yeah.

Masters: These are grapevines, aren't they?

Man: They are.

I know the gardeners do an amazing job around this place.

At the end of World War I, the Red Cross funded building these 3 cottages.

The major patient population was returning soldiers who came back with tuberculosis from Europe.

You can only imagine soldiers returning from the war get stuck in a place like this.

They're going to want to get out.

I had heard that they would kind of sneak out from time to time into the community.

Masters: OK. Man: Hopefully, they were wearing masks or holding their breath.

Masters: Doctors like you had been treating patients for decades.

The same disease.

There's nothing they could really do about it.

Man: First, there was one drug that was fairly effective.

Streptomycin.

Then they gradually were introduced to better ones, ones that could be taken by pill instead of needing injection.

I can imagine what Dr. Barlow and his subsequent colleagues were thinking.

"OK, what are we going to do now?

You know, here's our organization that has become somewhat irrelevant."

Masters: Yeah.

Man: So, that's where they began to transition into taking care of other kinds of pulmonary disease.

Masters: They pivoted, to use the buzzword.

Man: Yeah.

Masters: A lot of these buildings date from the very early years of Barlow.

I mean, even that modern building that we were at.

1920s, I think, right?

Man: 1927.

Correct.

Masters: Why is it so important for Barlow to preserve this history?

Man: We recognize that beyond just the aesthetics of having the open space and the beautiful old restored buildings, that it does represent a significant amount of history for the city and particularly for this neighborhood.

Masters: Now we're heading towards these really old buildings, which-- Man: On the left side, we are about to encounter probably the most well-built and well-preserved shacks in Los Angeles.

Masters: But beloved.

Man: They're designated to be historic.

We're coming to a part of the site where you can start to get a sense of a little agricultural activity going on.

I guess chickens were the first, and then they introduced goats.

Bees.

Evidently, cows came into the picture, and rabbits and guinea pigs.

So, it did give these young, otherwise healthy tuberculosis sufferers something to do while they were stuck here on the 25-acre beautiful ground.

Masters: All this agricultural work, though, that was available to them, I mean, that really delivered on the promise that, that you saw in the sales pitch for, for California as the place to recover.

I mean, I was just looking at these postcards with Patt Morrison of all the sanitariums, and they're all depicted as these idyllic places, right?

The sunshine, of course.

But that was kind of the case here.

Man: It probably has as much to do with the fact that there's outdoor living is so readily accessible.

Being outdoors, you're less likely to become exposed or expose your loved ones to the disease that they don't want to be exposed to.

Fortunately, they had this place to fall back on when they needed us.

Masters: After touring the grounds, I just had to know more about how Barlow's residents lived out their days here.

So, I met up with physician Brenda Jones on the same porch where TB patients once enjoyed the fresh air of Chavez Ravine.

Dr. Jones is not only an expert in the clinical treatment of tuberculosis.

She's also immersed herself in the history of Barlow, and she shared some rare artifacts from the hospital's archive.

Jones: Dr. Barlow, in fact, had tuberculosis, and so, his doctor told him to, you know, go west to some sunshine and good weather.

I think he first went to Colorado, then ended up in San Diego and then Los Angeles, where he decided to practice, and founded Barlow.

He kind of did it initially for people with limited or moderate means.

A lot of times, people would come out to California that were very ill and they couldn't work, you know, if they had TB, so, they didn't really have any way of supporting themselves.

So, they really had to rely on family support.

And at that time, the government was not offering too much support.

Masters: So, you have these treasures from the Barlow archives that document that time before there were effective treatments.

I guess this is, what, a notebook from... Jones: Catherine Barlow.

Masters: It says, "Notes on Sanatorium.

Patients must pay their way.

Some who cannot afford are admitted.

The San--" short for sanitarium-- "is only for white collared class."

It sounds like the mission of the hospital kind of shifted a little bit from its early years.

Jones: I think that was true all over the United States, that as time went on, it was expensive.

You know, health care is expensive.

Masters: Right.

Jones: And a lot of times, patients that had late TB disease were very difficult to take care of.

There were less people coming in that had early stage disease that had more of a chance of cure than someone that had later disease.

Masters: So, it looks like this is from the mid-1940s.

Look at the employers here.

Lockheed Aircraft Corporation.

20th Century Fox Film Corporation.

You know, Universal Studios.

You know, it really was mostly white-collar-class people.

Jones: During that time.

Masters: During that time.

This book also gives admission and discharge dates.

And, I mean, some of these people were here for a long time.

This woman, Josephine Blake, was admitted in 1934 and wasn't discharged until 1941.

I mean, can you imagine, I mean, what it'd be like to be isolated from the rest of society for 7 years.

Let's see.

What else do we have here?

So, the Kodak logbook.

"These are Kodak views taken in and around Barlow Sanatorium.

They show the building, the work, and some of the play," the play, "of the patients."

Oh, these are some small black-and-white photos.

I guess these are just patients, right?

Jones: So, the nurses there.

Masters: These are the goats that Dr. Nelson was talking about here.

Ha ha.

Yeah.

Jones: First, people would have to have a rest cure.

You know, sometimes they were in bed for 24 hours a day.

But then they encouraged them to do some constructive things.

Masters: Oh, here they are, the croquet.

They must be playing croquet.

Oh, children.

What's the story there?

Jones: A lot of times, people were separated from their families, you know, when they had TB and they came to the sanatorium.

Masters: You know, when you're treating tuberculosis patients today, I mean, obviously, nobody's fortunate to have tuberculosis, but they're fortunate to have it in this time period where... Jones: Exactly.

I think it was, like, 1952 when INH, Isoniazid, became available and the Centers for Disease Control and Public Health Service did many trials, thousands of patients, to have the regimens that we have now for tuberculosis treatment.

We were able to get treatment down to 6 months now.

Um, you can take it at home, but at least for those that are treatable, you know, it is curable now.

So, all the sanatoriums pretty much closed or repurposed after the 1960s.

But there's still more work that needs to be done.

You know, we still need to get better TB vaccine, better diagnostics, and better, shorter treatments, of course.

Masters: Are there lessons from the, the history for, for today?

Jones: The importance of public health, for one thing, you know.

The importance of medical research also is there with COVID, with the vaccines, you know, that came about.

Those are things that we should all be, you know, grateful for, and a reminder how important it is to keep those things in place.

Once things cool down again, you know.

Masters: Archival collections such as these don't just animate the past, they also illuminate our present.

In the age of COVID-19, we know that contagious disease isn't merely an individual medical crisis, but a collective challenge.

The lessons from TB underscore that a united public health front can soften a pandemic's blow.

We can even see in these artifacts of history the origins of L.A.'s signature indoor-outdoor lifestyle.

Long after the last sanitarium shut its doors, Angelenos still seek healthier lives under sunny skies.

Announcer: This program was made possible in part by a grant from Anne Ray Foundation, a Margaret A. Cargill philanthropy; the Ralph M. Parsons Foundation; and the Los Angeles County Department of Arts and Culture and Creative Recovery LA.