Suffering in the Land of Sunshine: A Los Angeles Illness Narrative (review)

In the early 1900s, my husband’s great-grandfather moved his entire family across the country from Milwaukee to Los Angeles. He, like many others, sought a tuberculosis cure in the “land of sunshine.” Undoubtedly, his declining health, his deep concern for his family’s survival, and the promise of a better climate must have driven this Russian immigrant to journey west so soon after settling in America. But why did he choose this particular southern California city? In her book, Emily K. Abel illustrates how medical, social, and political factors combined to make this growing city both a haven for health seekers and a place whose leaders and residents had mixed feelings about welcoming all who sought comfort there. At the center of her story is Charles Dwight Willard—a transplant from Chicago, a journalist, a novelist, a city booster, and a near invalid whose experiences Abel uses to personalize her account.

As Abel explains in the introduction, focusing the narrative on Willard was serendipitous. Amid her research for a related book, she found Willard’s rich cache of papers and correspondence at the Huntington Library. His frequent letters home to his parents and siblings, his dark stories and biting editorials, and his interactions with noted figures in local, state, and national politics made him a good candidate for a historical study. Moreover, his opinionated prose made him the perfect protagonist. Abel quotes from his writings frequently to outline his personal and professional life in California. We gain a detailed understanding of Willard’s struggle not only to support himself and, eventually, his small family, but also to achieve a position of status in the bust and boom cycles of this early city. Each achievement, however, is dulled by the threat of a hemorrhage or other health setback. Abel captures Willard’s daily physical and emotional challenges, paying particular attention to the female caregivers—family members, hired servants, and boarders—who alleviated his suffering. As in her previous work, Hearts of Wisdom, she examines the obligations and rewards of lay nursing.

Readers will quickly appreciate that Willard is a complex figure worth further investigation. At the outset of his career, he wrote of the health benefits of southern California. Using agricultural metaphors, he promoted the moderate climate as a place in which all things would thrive. However, as his own physical condition deteriorated, he was increasingly outspoken in his condemnation of policies designed to accommodate or welcome those with consumption to the area. Taking great pains to hide his own progressively declining health, he publicly condemned specific at-risk populations and condemned plans to improve or increase facilities for the ill.

The pace of the narrative slows at times, as we learn of the day-to-day trials of Willard’s illness. It shines brightest, however, when Abel combines this careful accounting with her artful contextualization of Willard’s life amid the changing late-nineteenth-century California landscape, contemporary medical theories of consumption, and local political debates playing out in the newspapers and institutions Willard fought to join. The secondary literature to which Abel points is not exhaustive, but it provides a starting point for readers interested in the history of health and disease.

Suffering in the Land of Sunshine is a rich case study that should be read alongside Abel’s recent book, Tuberculosis and the Politics of Exclusion,¹ for a complete understanding of how chronic illness deeply affects the individual, family, community, and nation. Particularly through the voluminous writings of Charles Willard, Abel presents questions that help us reconsider the past and may help us rethink our current public health policies and, if not more important, our attitudes toward the sick.