Contagion — Irresponsible behaviors can make deadly infections of past our grim future

Andrew Speaker, the 31-year-old Atlanta lawyer with a bad case of wanderlust and a worse case of tuberculosis, isn't just a media sensation. He's also the personification of a time machine, returning us to a not-so-distant era when diseases that we now casually assume are treatable claimed thousands of lives. And that grim part of our past could become our future.

Speaker got plenty of press as he was ordered into federal quarantine, having crisscrossed the Atlantic on commercial flights while infected with extensively drug-resistant tuberculosis (XDR-TB). But what hasn't garnered nearly enough attention is a sober consideration of just how deadly tuberculosis can be. The rising worldwide number of XDR-TB cases like Speaker's may herald the end of a glorious 60-year holiday from many common and highly contagious diseases such as polio, measles and cholera that once routinely ravaged vast swaths of humanity.

For those who consider tuberculosis a thing of the distant past, let me tell you a story. In 1913, Eugene O'Neill, the future playwright and winner of the Nobel and Pulitzer prizes, was confined for five months to a TB sanatorium. His family considered the initial diagnosis practically a death sentence — tuberculosis was then the leading cause of death for Americans ages 20 to 45. Under a regimen of rest, fresh air and exercise, with a diet rich in fat and protein, O'Neill recovered. A young woman he fell in love with there was not so fortunate. Emaciated, pale and weak, she entered her last bloody round of violent coughing 18 months later. Writing about her death, O'Neill described tuberculosis as a cruel game of drawing straws, with more short straws than long ones.

The ancient Greeks had a wonderful word to describe tuberculosis' ravages: PHTHISIS, which describes a living body that shrivels with intense heat as if placed on a flame. The Romans used the Latin word CONSUMERE, to eat up or devour; indeed, when O'Neill's TB was diagnosed, the disease was still referred to as "consumption." This is precisely what untreated (or untreatable) tuberculosis does. It consumes with a passionate and incisive energy; it slowly, inexorably devours the very structure of the lungs and other critical organs, with the single goal of conquering its host — but not until its progeny have had the opportunity to travel to and settle in the lungs of another human, to start the horrific process all over again.