Isabel Gillard, Circe’s Island: A Young Woman’s Memories of Tuberculosis Treatment in the 1950s (Glasgow: Unbound Press, 2010), pp. 140, £7.99, paperback, ISBN: 978-0-9558360-5-3.

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Isabel Gillard was twenty and a literature student at Edinburgh University when, in 1950, she was hospitalised for over a year in the city’s Royal Victoria Hospital for Tuberculosis. This is her personal recollection of that time which she describes as ‘a determined hanging on, a waiting for an upturn in fortune.’ By the early 1950s, tuberculosis in the Western world was theoretically coming under control. Drug treatments such as streptomycin, PAS (para-aminosalicylic acid), and isoniazid were widely available, although TB specialists were slow to relinquish the unpleasant ‘technical’ procedures that kept patients incarcerated in sanatoria and specialist hospitals – artificial pneumothorax, phrenic nerve crush, lobectomy, and thoracoplasty; ‘in the case of thoracoplasty operations, a general anaesthetic was not always suitable and this meant that the still-conscious patient could hear pieces of his or her own ribs being thrown into an enamel bucket under the operating table’ (p. 60). Like many people with tuberculosis, Isabel experienced extremes of kindness and cruelty in an environment designed to bully patients into obedience and acceptance of a restricted life beyond the sanatorium walls. To this end, a certain Dr E was fond of telling the young girls that although they might look like rosy apples on the outside they were, nevertheless, rotten to the core. It is fortunate that youth is invariably optimistic, but from my own work with TB survivors, the wounded carry these poisoned barbs like shrapnel, into old age. This, then, is a multi-layered tale set in a marginalised community – a tale of personalities; friends made and lost; freezing, snow-covered beds in the name of ‘fresh air’ treatment; balmy nights in three-sided wooden chalets under September stars; eggs boiled in jugs beneath running bath water; separation from lovers and children; interrupted education; tears, fears, pain and the inevitable merry-go-round of emotions associated with check-ups, X-rays, blood tests and bronchoscopies. Isabel and her ward companions were undoubtedly luckier than most British sanatorium patients in being confined in the Royal Victoria Hospital, a pioneering institution founded at the turn of the twentieth century by Sir Robert Philip (1857–1939) who was studying in Koch’s Vienna laboratory at the time the TB bacillus was discovered. The ‘Edinburgh System’ was adopted by local authorities in the UK when, in 1911, they took over responsibility for the treatment of tuberculosis. But if some new treatment for TB appeared in the media, Philip (who became Professor of Tuberculosis at Edinburgh University in 1919) always claimed that he was already using it in Edinburgh. As Isabel was returning to her university studies, (Sir) John Crofton (1912–2009), who has written a foreword and appendix to this book, was succeeding to the Edinburgh chair of tuberculosis. It was Crofton and his colleagues who devised the triple therapy – streptomycin, PAS and isoniazid – that became the gold standard of tuberculosis treatment, reducing the increasing incidence of TB by fifty-nine per cent within three years. Memoirs like this are extremely important for welding the patient experience to the history of a disease. That many such testimonies are disturbing should not surprise us since many ex-TB patients have been disturbed, both by medical and social treatments. Isabel Gillard is reflective, even self-indulgent at times, but you forgive her because she teetered back from the brink and has survived in good health for sixty years. Nevertheless, as a critical reviewer I was irked by a reference to Lady Mary Wortley Montague introducing cowpox vaccine into Britain (p. 72), and I was confused by the story of John, a fellow patient who had donated a kidney (c.1950) to his consumptive older brother (p. 65). The first kidney transplant in the UK was, indeed, carried out in Edinburgh, but this was in 1960, between twin brothers.