“Consumption, Was It?”: The Tuberculosis Epidemic and Joyce’s “The Dead”

The courtship of Nora Barnacle and Michael Bodkin ended in 1903 when Bodkin was restricted to bed rest in Galway for his steadily worsening case of tuberculosis. Not long after his confinement, Nora Barnacle left the West of Ireland for Dublin, where she would meet James Joyce. According to what has become a staple of Joycean legend, Michael Bodkin’s death from tuberculosis was hastened by the last visit he paid to Nora: ignoring his doctor’s orders, he went out in pouring rain to sing farewell to her beneath an apple tree, fatally aggravating his illness.¹ Years later, when Joyce learned of their sad and striking parting, he became “characteristically jealous” of Nora’s past involvement with another man—galled especially in Bodkin’s case by what he felt to be a “rivalry with a dead man buried in the little cemetery at Rahoon.”²

In “The Dead,” the final story of Dubliners, Joyce famously rehearses a corresponding rivalry between Gabriel Conroy and Michael Furey, a boy who died of tuberculosis in Galway after singing farewell in the rain to a young woman named Gretta, whom Gabriel later marries. This similarity admits “The Dead” to compelling autobiographical interpretations, which Richard Ellman’s biography of Joyce helpfully explicates.³ Joyce’s use of tuberculosis’s etiology as a model for the narrative structure of “The Dead” also suggests a broader historical and epidemiological context in which the story participates. Joyce harnesses TB’s peculiar etiology and cultural meanings in early twentieth-century Ireland to tell a tragic love story parallel to one he knew from his own life.

When Joyce published Dubliners in 1914, tuberculosis had long been the leading cause of premature death in Ireland.⁴ The disease reached its peak mortality rate in the year after Michael Bodkin’s death, when it claimed 13,000 lives.⁵ In spite of this staggering statistic, tuberculosis received far less attention in Ireland than the more dramatic nineteenth-century epidemics of smallpox, typhus, and cholera, which accompanied the social and economic crises of the famine years.⁶ The effects of tuberculosis were less pronounced; the epidemic nature of the disease in late nineteenth-century Ireland was only noticed retrospectively upon the publication of mortality statistics in the early twentieth century.⁷ Diarmaid Ferriter suggests that by the time tuberculosis was finally recognized as an epidemic in Ireland, it also was gaining renown as “the Irish disease”—partly because when tuberculosis was at its peak in Ireland it had for years been on the decline in Scotland, Wales, and England.⁸ Thus, as Joyce began composing “The Dead” in Rome, tuberculosis, like the Famine before it, was acquiring international acceptance as a particularly Irish tragedy.⁹ Kevin Whelan has thoroughly catalogued the ways in which Joyce treats the Irish Famine in “The Dead.”¹⁰ But the tuberculosis epidemic’s significant presence in the story has not yet received the critical attention it invites. The complicated epidemiology and cultural history of tuberculosis in Ireland help to explain some of the literary functions the epidemic takes on in Joyce’s story.

By 1882, Robert Koch’s experiments in Germany had shown that tuberculosis—often known as “consumption”—is caused by a bacterium that infects different parts of the body, and most commonly the lungs.¹¹ Until this time, however, the causes were generally unknown or misunderstood, which made way for numerous and variable disease treatments founded on folk medicine, superstition, or mere quackery. Often, these treatments reinforced class, racial, and national stereotypes and perpetuated the prejudices underpinning them.¹² While various diseases of the late nineteenth and early twentieth centuries (such as cholera, smallpox, and typhus) prevailed among the lower classes, tuberculosis was a disease that primarily affected younger members of the working poor. In 1906, the majority of Irish tuberculosis victims were between the ages of 15 and 45. That year the disease killed 1,355 people between the ages of 15–20; 1,660 people aged 20–25; and 2,821 between the ages of 25–30.¹³ This fact of Ireland...