Carville: Remembering Leprosy in America

From 1894 to 1999, Carville, Louisiana, was the site of the only in-patient facility in the contiguous United States for treating Hansen’s disease, historically known as leprosy. Because of the high incidence of Hansen’s disease in southern Louisiana, locating the facility in a former plantation between New Orleans and Baton Rouge made sense. The patients there, in quarantine until the 1960s, constituted a community that was rich in narratives and traditions resulting from the intersection of their common malady with the usual benchmarks of life. In all, they narrate “a story of survival and a quest for dignity” (p. 4).

The first chapter of Marcia Gaudet’s Carville: Remembering Leprosy in America introduces the history of the disease, both in scientific terms and in the popular consciousness, and presents Carville as a treatment center and a community. Chapter 2, “An Exile in My Own Country: The Unspeakable Trauma of Entering Carville,” relates memories of the emotional devastation accompanying diagnosis and then analyzes both how the patients chose to voice those memories in personal narratives and how they managed to reconstruct viable identities in their new situation and new home. Much of the documentation comes from detailed and eloquent biographies published by three patients and from interviews conducted by Gaudet. Throughout the book, she sensitively balances well-chosen extended quotations with synthesis and discussion.

The borders of Carville—and of the community it contained—were semipermeable. Chapter 3, “Through the Hole in the Fence: Personal Narratives of Absconding from Carville,” examines the long-term equilibrium between the strict regulations concerning confinement and the lax enforcement of those regulations. Patients slipped out now and again, sometimes for fun, sometimes for serious tasks like getting married (Louisiana required a blood test, while Mississippi did not), and always to explore the boundaries of their lives. Tellers of these stories relate justifications for fleeing, details of passage to the outside, and returns to Carville (voluntary or not). These personal escape narratives allowed patients to assert some limited, but psychologically critical control of their fate. Their common stigma inspired escape and then also return: patients would grow weary of hiding the truth or would need medical attention. Punishments were just harsh enough to assure that “escaping” would remain infrequent yet lenient enough to allow some possibility of respite, thus balancing sanity and physical health.

The fourth chapter, “‘Talking it Slant’: Personal Narratives, Tall Tales, and the Reality of Leprosy,” feels a bit crowded. Gaudet explores disease as a multivalent metaphor, and then she cites casual vernacular uses of the word “leper” to illustrate the crudity of the stigma and the patients’ frequent need to creatively temper the truth. Teenagers who slipped out of Carville to attend football games often simply lied about where they were from. One patient managed to tell a saloon audience on the outside that he was a leper in a way that almost guaranteed being disbelieved; this is the only narrative closely examined in the chapter. In contrast to the brevity of chapter 4, the sixth one is a bit overlong. “‘Under the Pecans’: History and Memory in the Graveyard at Carville” focuses on gravestone inscriptions in the hospital’s two cemeteries. Many quarantines continued in death, since permission for burial elsewhere was elusive. Just as patients in the early eras of Carville received new names on arrival, these pseudonyms appeared on the stones. To protect their families from discrimination back home, those early markers were inscribed simply with initials, a first name, or a patient’s number.

Chapter 5, “The World Turned Downside Up: Mardi Gras at Carville,” is my favorite. There, Gaudet narrates a real twist on festival identity transformation: “The carnivalesque world upside-down is challenged, decentered, reversed upon itself when the carnival inversion includes those who historically have been the ultimate Others” (p. 118). Set apart in daily life, the citizens of Carville became “normal” when fantastically masked and costumed. They were able to participate in a delightful, gaudy pseudo-anonymity for a few hours, building up to this with weeks or even months of anticipatory labor. A tradition including thousands of people, which was still a modest minority of the citizenry, Mardi Gras participation is an avid (and expensive!) hobby for its self-appointed culture bearers. But at Carville, nearly everyone was passionately involved; the permanently stigmatized were happy to join a broad community of the annually abnormal.

This book is short but elegantly conceived and written, and it will be useful in the classroom. Illustrating and analyzing Carville’s subspecies of common folklore genres, most chapters are self-contained. Gaudet’s Carville is an immediate classic, a wonderful combination of scholarship and compassion.