Consumed in the City: Observing Tuberculosis at Century's End

Consumed in the City: Observing Tuberculosis at Century's End

Consumed in the City: Observing Tuberculosis at Century's End

Consumed in the City: Observing Tuberculosis at Century's End

Synopsis

As a public health field worker assigned to control tuberculosis in New York and Chicago in the 1990s, Paul Draus encountered the horrible effects of tuberculosis resurgence in urban areas, and the intersections of disease, blight, and poverty.Consumed in the Citygrows out of his experiences and offers a persuasive case for thinking about-and treating-tuberculosis as an inseparable component of the scourges of poverty, homelessness, AIDS, and drug abuse. It is impossible, Draus argues, to treat and eliminate tuberculosis without also treating the social ills that underlie the new epidemic. Paul Draus begins by describing his own on-the-job training as a field worker, then places the resurgence of tuberculosis into historical and sociological perspective. He vividly describes his experiences in hospital rooms, clinics, jails, housing projects, urban streets, and other social settings where tuberculosis is often encountered and treated. Using case studies, he demonstrates how social problems affect the success or failure of actual treatment. Finally, Draus suggests how a reformed public health agenda could help institute the changes required to defeat a deadly new epidemic. At once a personal account and a concrete plan for rethinking the role of public health,Consumed in the Citymarks a significant intervention in the way we think about the entangled crises of urban dislocation, poverty, and disease. Author note:Paul Drausis a research scientist at the Center for Interventions, Treatment and Addictions Research in the Department of Community Health at the Wright State University School of Medicine.

Excerpt

The first question to answer: What am I doing here?

It is the last day of September, two years before the end of the twentieth century. I am sitting on a milk crate cushioned by a dirty old jacket, under a tree in an empty lot at the corner of First Street and Jefferson Avenue on the West Side of Chicago (these are disguised names, so don’t try to find them). I have been stopping by here every morning lately, usually between 8 and 8:30. This morning there are four guys out here, not including myself and Hank, who sits in his old red Chevy a few yards away, sipping wine from a plastic cup and listening to dusties on the radio. Lewie, kj, Montgomery, and a guy named Fred whom I have never met before, are sitting in a circle on plastic barrels and milk crates, splitting a bottle of malt liquor in a paper bag between them. Lewie gives up his seat for me and shows me a car stereo that he is trying to sell; it is an ac Delco with auto reverse cassette, a big blocky thing that wouldn’t even fit in my Toyota’s dashboard. They say they found it stashed somewhere and ask if I want to buy it. I find it interesting, would actually like to have a big fat car stereo like that, but I have no place for it, and besides, I have no money on me. “Sorry,” I say, though I am not really sorry.

Later a guy with a shaved head and a gold bracelet walks up and shakes my hand; he looks familiar, but I wait a moment and he reminds me who he is: “I’m Duck,” he says, “we met over by Billy.”

Yes, Billy. Billy is an acquaintance of mine, and a true neighborhood character. We were just discussing him, as a matter of fact, perched on the barrels and crates, before Duck walked up. I told them that Billy was in a nursing home in Joliet, some fifty miles south of the city, where I stopped to see him last Friday and brought him some hot sauce as a belated birthday present. the guys on the corner had been wondering where he’s been ever since the hot August day when the ambulance took him away. He had a seizure in the parking lot across Jefferson Street. “How is he doing?” they want to know, and I tell them he can walk, but not very well, he tends to run into walls, so he uses a wheelchair which he pulls along with his feet.

“He scoots himself around, huh?” asks Lewie, imagining the sight.

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