I’m old enough to remember the TB van coming round for compulsory chest x-rays and I believe that I had one before the mobile Xray program concluded in 1976. Amongst the sunspots and wrinkles, my arm bears the fifty-year old scar of a BCG vaccine shot against TB. I remember the secondary-school rite of passage of lining up for the Mantoux test on the inside of your wrist, eyeing it anxiously to make sure that there was a bit of a reaction but not too much. Then the fear of lining up for the TB injection itself, which school rumours depicted as being huge and excruciatingly painful (neither rumour was true). I’ve read about the local uneasiness in my own suburb of Heidelberg about the TB Sanatorium at the Hospital for the Incurables (now the Austin) and for returned soldiers at Mont Park and Gresswell. TB is still the world’s deadliest disease, but in Australia public anxiety decreased to the point where the school-based BCG vaccination was discontinued in Victoria in 1984-5.
This was not the case in 1951, when Say No to Death was published. Tuberculosis had carved out its own literary space: think Thomas Mann’s The Magic Mountain, Novalis and his love for Sophie von Kuhn in Penelope Fitzgerald’s The Blue Flower, John Keats, Anne and Emily Bronte, Mimi in La Boheme – and probably many, many more. But in urban, post WWII Australia there was little romance or lyricism in TB. As this book shows, public health provision was under-funded with very uncertain outcomes, while private provision was overwhelmingly focussed on commercial profit-making considerations. People were afraid of TB, and there was blatant discrimination against sufferers in finding and keeping accommodation.
Jan lives in post-war Sydney with her older sister Doreen, both their parents having died. They live together in a small, basement level flat. When Jan goes to meet Bart’s ship returning to Sydney after a stint in occupation-era Japan after serving in WWII, her sister does not approve and she approves even less when Jan and Bart go off to a deserted beach shack for ten days together. This beach-shack holiday becomes a talisman for them both when Jan is diagnosed with tuberculosis. Despite his initial nonchalance about their relationship, he falls in love with Jan and is thrust into the role of carer in the small family.
I haven’t read a modern, urban (if you can call 70 years ago ‘modern’) TB story before. It reminded me a little of those cancer tear-jerkers that seemed popular in the 1980s (Molly dying in A Country Practice; the movie Sunshine) but there’s more critique of the medical system in this book than in purely emotion-based stories. Jan is not diagnosed for some time; the proprietor of the private hospital is a financial leech; there is much better care for returned soldiers who contract tuberculosis than for civilians; and if just a fraction of the money spent on war was directed to health funding, the public system wouldn’t have to be so threadbare and overworked.
Despite the gloomy subject matter, I ‘enjoyed’ this book. Cusack’s descriptions of landscape, especially at the sanatorium in the Blue Mountains, are evocative and she captures well the powerlessness of illness. She deals with betrayal, loyalty and trust, and I found myself worrying for the characters, as well as about them. Of course, it was a contemporary book when it was published, but I found it interesting as a piece of social history, despite the dated language. Somehow reading it during a time of pandemic, when we are again at the mercy of a disease, gave it an added poignancy as well.
My rating: 8/10? It’s dated, but I suspect that it will stick in my memory
Sourced from: my own bookshelves. I had read praise of it somewhere years ago, and when I saw it second-hand, I snapped it up.
Other reviews: Wad Holloway reviewed it as part of his Australian Women Writers Generation 3 series on his The Australian Legend website.
I have included this on the Australian Women Writer’s Challenge 2021
The Resident Judge of Port Phillip 
I remember being X-rayed before arrival in Australia, and my mother insisting that we have the vaccination on our legs so that the scar wouldn’t show.
And yes, those rumours at school about the size of the needle!
I nursed a couple of tuberculosis patients in the mid 1970s. That was such a long time ago …
Did you? Were they in a special ward or hospital, or was there less anxiety about contagion then?
They were in an isolation ward. There was a level of awareness rather than anxiety.
Pingback: Invasion Day, 2021 | theaustralianlegend
My grandmother had 6 children, four of them under 8. One day she disappeared and the four youngest children were split up amongst grandma’s siblings, all in North Melbourne or Carlton. Such was the shame attached to TB that no-one told her children where she was or when she would be returned to Melbourne.
Years later my father heard it was to a TB asylum in the country.
What a terribly sad situation. I just can’t imagine how your grandmother must have felt.
Pingback: Classics and Literary Round-up: January 2021 | Australian Women Writers Challenge Blog
Pingback: Six degrees of separation: from ‘What are you going through?’ by Sigrid Nunez to…. | The Resident Judge of Port Phillip
Pingback: Australian Women Writers Challenge 2021 | The Resident Judge of Port Phillip