The Forgotten Plague (2015)

The Forgotten Plague is a documentary film which premiered on US television (PBS) in 2015. It is an episode in the long-running series American Experience. Here is some basic information about it:

** Written, produced and directed by Chana Gazit
** Consultants: Sheila Rothman & Nancy Tomes

** Narrated by Michael Murphy

** Run time: 54 minutes

Tuberculosis is one of the most deadly diseases in the world. It has been around for centuries, killing millions all over the world. In the past, doctors were powerless against it. The disease was not understood. Until the 1940s, there was no cure. This film is the story of tuberculosis from ca. 1850 until today.

THE WITNESSES

Several witness were interviewed for the film. They can be divided into two categories.

# 1. Victims who survived the disease:

** Sherwood Davies
** Whitney Seymour, Jr

** John Stoeckle

** Joanne Curtis

# 2. Authors, scholars and scientists:

** Mary Hotaling, resident of Saranac Lake, local historian
** Andrea Cooper, immunologist

** Andrea Barrett, author

** Peter Pringle, author

** Vivian Schatz, wife of Albert Schatz

** Nancy Tomes, professor of history

** Sheila Rothman, professor of public health

THE PERSPECTIVE

Tuberculosis was and is a global problem, but in this film the focus is almost exclusively on the US. However, we have to remember that this is an episode in the series American Experience and that the subtitle is Tuberculosis in America. When we do this, I think we can accept the limited perspective.

The film is divided into two parts:

** In the first part – about two thirds of the time – the focus is on one person: Dr Edward Livingston Trudeau (1848-1915).

** In the second part – about one third of the time – the focus is on two persons: microbiologist Selman Waksman (1888-1973) and his research assistant Albert Schatz (1920-2005).

PART ONE

In 1873, Trudeau was diagnosed with tuberculosis. His doctor assumed he did not have long to live, but recommended that he should leave the big city and go to some remote place in order to get some fresh air. Trudeau chose the Adirondack Mountains, which was at the time one of the most isolated places in the US. Amazingly, his health began to improve.

When he returned to New York City, his health began to deteriorate again. He felt there was a connection between the climate and his health. In 1876 moved his family to the village of Saranac Lake in the Adirondack Mountains, and this is where he remained for the rest of his life.

In 1882, Trudeau read about the discovery made by the German doctor Robert Koch (1843-1910): the bacteria which cause tuberculosis had been identified. At first, the scientific community was not impressed by his discovery. But later, it was recognised that he was right. In 1905 he received the Nobel Prize for this discovery.

While many were sceptical, Trudeau believed in Koch. And two years later he successfully replicated Koch’s experiments in his own lab. The identification of the bacteria was an important step forward, but it did not mean that there was a cure for this disease.

All that doctors could do at that time was to recommend rest, fresh air and healthy food. Trudeau established a sanatorium in his village and soon the idea spread to other parts of the US. One third of Trudeau’s patients recovered, but two thirds did not. When Trudeau died in 1915, there was still no cure for the dreaded disease.

PART TWO

In the early 1940s, the discovery of penicillin opened up a new way of treating dangerous diseases, but it did not work on tuberculosis. At Rutgers University, microbiologist Selman Waksman decided to try something else: he studied the bacteria in the earth.

In 1943, Waksman assigned the project to his research assistant Albert Schatz. After a few months, Schatz made a great discovery: he found an antibiotic that could defeat tuberculosis. Waksman and Schatz named it streptomycin. In 1944 the drug was tested on several patients and it worked! Finally, it seemed, there was a way to cure the dreaded disease.

Before long, they realised that they had celebrated too early. There were disappointments, there were relapses. Waksman and Schatz realised they had to create more drugs. They developed a cocktail of different drugs and this worked much better.

Patients began to recover. It was a miracle. The disease could be cured. The number of cases in the US dropped sharply. In 1954, Trudeau’s sanatorium at Saranac Lake closed, when its last patient left the building.

But, as we are told at the end of the film, this story does not have a happy ending: in the 1980s, tuberculosis began to return as a result of the AIDS epidemic. Since then, drug resistant tuberculosis has become more common. Today, there are thousands of cases in the US and nine million cases world-wide.

POSITIVE AND NEGATIVE

The Forgotten Plague is a moving film about an important topic. The witnesses are well-chosen. The survivors give the film a human aspect, while the scholars cover scientific aspects. It is easy to say something positive about this film.

As stated above, I will not complain about the limited perspective, because the subtitle is Tuberculosis in America. The producers of the film do what they promise to do. But I do have one negative comment. I do not complain because there is a mistake; I complain because there is an omission.

The producers never mention the controversy between Waksman and Schatz, even though they have the witnesses they need to cover this issue: they have Vivian Schatz, the widow of Schatz, who lived through it; and they have Peter Pringle, who wrote a book about it. But they still shy away from it.

I understand the producers do not want to get side-tracked, but even if they did not wish to cover the issue in detail, I think they could and should have mentioned it briefly. Just enough to let the viewers know that there is something more to this story than they can say in this film.

THE CONTROVERSY

Since the issue is totally excluded from the film, I will add a few words about it here. Schatz made the discovery (as we are told in the film), and once he did, Waksman joined him for further experiments (as we are told in the film).

This was big news. When the press showed up at the university, they talked to Waksman. At first, he would also mention Schatz, but soon the name Schatz began to disappear from interviews and Waksman pretended he had made the discovery himself. This was annoying for Schatz, but he let it slide.

Waksman had asked Schatz to sign over his rights to royalties for the product and he had agreed to this, because he wanted everybody in the world to have easy access to the drug. Waksman claimed he had done the same thing. But later Schatz discovered that this was not true.

Waksman had made a secret deal which gave royalties to him and the university, but not to Schatz. And this was too much for Schatz; in 1950 he sued Waksman for the money he never got. The case was an embarrassment for the university, so it was quickly settled out of court: while Schatz was paid some money, 40 per cent of this went to his lawyer. But there was one important result: Schatz was recognised as co-discoverer of streptomycin.

Two years later - in 1952 - the controversy flared up again, when the Nobel Committee in Sweden announced that it was going to offer Waksman the Nobel Prize for the discovery of streptomycin. Schatz protested to the committee. He suggested he and Waksman should share the honour. But his idea was rejected. The committee said Schatz was just a young research assistant and he could not claim any part of the honour. Waksman went to Sweden to receive the prize. In his acceptance speech he never mentioned Schatz by name.

The scientific community turned against Schatz, because he had dared to sue his professor, even though he was right. When he applied for a job, he was turned down. He was regarded as a trouble-maker. He had to go abroad and teach at a university in Chile for several years. Only later was he able to continue his career in the US.

In the 1980s, when British scholar Milton Wainwright came to Rutgers University in order to do research for a book, he discovered the truth: the famous professor had taken credit for a discovery that had been made by his young research assistant. And worse: Waksman had received the Nobel Prize for a discovery he never made.

Some members of staff at Rutgers University realized that Schatz had been wronged and they decided to act. In 1994, fifty years after the initial testing of the product, Schatz was awarded the Rutgers University Medal, the university’s highest honour.

Fortunately, Schatz lived long enough to get official recognition for his discovery, but for many years he was the victim of an injustice. Waksman had been his mentor. Schatz was deeply disappointed to find out that his mentor betrayed him in order to promote his own career and his standing in the scientific community.

The Waksman-Schatz controversy is a symptom of a general problem in the world of science: who gets credit for what? Can the professor take credit for work that has been done by his or her research assistants? There is a moral problem here. And not only that. It is also about jobs and money. The scholar who gets the credit will get the better job as well as more funding for future projects.

In many cases, the research assistant will be afraid to complain; if you do this, you will be branded as a trouble-maker and the professor may win anyway. Many will shut up and let it go. You might think this situation has changed in the age of the internet, when anybody can report anything, but apparently this is not the case. If you search the internet, you can find similar cases that are current, and not only from the past.

CONCLUSION

As stated above, The Forgotten Plague is a moving film. It covers an important topic and does so quite well. But I cannot ignore the flaw that I have mentioned here.

The producers have two witnesses who know a lot about the controversy. Without having any proof, I am quite sure both of them talked about this issue when they were interviewed. But the producers decided to exclude it from the film. Not even one word about a controversy, which is a symbol of a general problem, which deserves to be covered.

If you ask me, it was a most unfortunate decision to exclude it. I have to take off one star. Therefore I think the film deserves a rating of four stars.

PS # 1. For more information, see the following books (two of them are written by witnesses in the film):

** The Gospel of Germs by Nancy Tomes (1998, 1999)

** Living in the Shadow of Death by Sheila Rothman (1994, 1995)

** The Forgotten Plague by Frank Ryan (1993, 1996)

** Invincible Microbe: Tuberculosis and the Never-Ending Search for a Cure by Jim Murphy & Alison Blank (2012, 2015)

PS # 2. Regarding the question of credit, see the following books (one of them is written by a witness in the film):

** Miracle Cure: The Story of Antibiotics by Milton Wainwright (1990)

** Experiment Eleven: Deceit & Betrayal in the Discovery of the Cure for Tuberculosis by Peter Pringle (2012, 2013)

** Prize Fight: The Race & the Rivalry to be the First in Science by Morton Meyers (2012, 2013)

PS # 3. The following articles are available online:

** Veronique Mistiaen, “Time, and the great healer,” The Guardian, 2 November 2002

** Milton Wainwright, “Albert Schatz,” The Independent, 16 August 2012

** Anonymous Academic, “My professor demands to be listed as an author on many of my papers,” The Guardian, 5 June 2015

PS # 4. American Experience is a television program produced by PBS. The first episode was aired in 1988. The number of episodes differs from one season to the next, but the program is still running today. The topic under review here (tuberculosis in America) is season 26 episode 6 from 2015.

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