Symptoms of the Self: Tuberculosis and the Making of the Modern Stage

Symptoms of the Self: Tuberculosis and the Making of the Modern Stage already has garnered glowing reviews and won the Canadian Association for Theatre Research’s 2023 Ann Saddlemyer Award for the best book contributing to “the field of drama, theatre, and performance studies in what is now known as Canada.” In short, it is a terrific book. The primary reason for bringing this monograph to the attention of O’Neillians is its last chapter, which addresses American theater from 1912 until 1977, devoting about a dozen pages to O’Neill. Scholars who are curious only about Roberta Barker’s analysis of tuberculosis in The Straw and Long Day’s Journey Into Night, with a nod to Beyond the Horizon, could turn just to that final chapter, which stands independently enough to be useful. However, the book offers such a rich understanding of the role of tuberculosis in nineteenth-century transatlantic culture and theater that it is worth a full read.Organized in roughly chronological order, the book follows the development of portraying tuberculosis on French, British, and American stages. Barker’s study is the most wide-ranging yet to trace what she calls the “consumptive repertoire” beginning in Paris around 1830 (3). The introduction asks the overarching question: “How did pulmonary tuberculosis become the theatrical and cinematic illness par excellence?” (2). First, it is important to remember the prevalence of that disease, which accounted for 25 percent of deaths in France toward the end of the nineteenth century (4). Working from the contemporary stance that foregrounds the experience of illness as a cultural performance, Barker notes that during most of the nineteenth century consumption was thought to result from personal traits, such as excessive emotionality. She then classifies the consumptive theatrical repertoire as sentimental rather than melodramatic or tragic, as it unfailingly sought to evoke and manipulate strong emotions.The body of Symptoms of the Self is divided into three parts: “Consumptive Poetics,” “Sentimental Transmissions,” and “The Sentimental Survival.” The first section is devoted to French theater, with chapter 1 examining vaudeville and Alexandre Dumas père’s drama, which reflected the medical stance that tuberculosis was triggered by unhappiness. The second chapter analyzes two of the most famous renderings of consumption, La Vie de Bohème and La Dame aux Camélias, which Barker reads as associating the disease with overwork. Section II addresses the transatlantic spread of the consumptive repertoire, with the third chapter discussing how La Dame aux Camélias influenced British and American theater. Chapter 4 delves into portrayal of the consumptive child in Uncle Tom’s Cabin and East Lynne, which Barker links to the then-current medical theory that consumption was hereditary. The fifth chapter takes up the connection between the consumptive repertoire and national identity during the latter half of the nineteenth century. It deals with such works as Tom Taylor’s An Unequal Match, Augustin Daly’s Horizon, and Edmond Rostand’s L’Aiglon. The final section expands into the twentieth century, illustrating the persistence of consumptive stage tropes. At the turn of the century, realists employed the consumptive type to criticize contemporary society, as shown in chapter 6 through analyses of François de Curel’s La Nouvelle Idole and George Bernard Shaw’s The Doctor’s Dilemma. The last chapter treats later works by Tennessee Williams and Charles Ludlam in addition to O’Neill, indicating the lasting effects of the repertoire. In an afterword, Barker notes that she finished drafting the monograph during the COVID-19 lockdown, a global event reminding Anglophone scholars that while tuberculosis may seem to belong to the past, 10 million people worldwide contracted the disease in 2018 (211).As many readers know, a frail, pale-countenanced performer who coughs into a blood-stained handkerchief while leaning on stage properties for support became nineteenth-century shorthand not only for debilitating illness but also for an untimely death. Barker does an admirable job of analyzing every aspect of the consumptive repertoire. She interprets the handkerchief, for example, as revealing interiority while concealing the disease, as the character attempts to protect others from the pain. The classic consumptive personality supposedly was susceptible to disease because of heightened sensibility but also grew in sensitivity because of the disease. Barker argues for a more rounded understanding of consumptive protagonists. For example, Mimi in La Vie de Bohème and Marguerite in La Dame aux Camélias are not simply punished for their sensuality but illustrate the “challenges that assail the woman who depends upon her body for her livelihood” (54). Consumptive children, such as Eva St. Clare in Uncle Tom’s Cabin, are read as emblems of their parents’ flaws, especially those passed down through the mother. Barker sees this naturalist emphasis on heredity in the consumptive repertoire as “a legacy from, rather than a reaction against, the sentimental stage” (126). Barker explores such psychological conclusions beyond character types, extending to notions of national morality: Britons and Americans feared that attending French drama would lead to adopting French vices.One might assume that everything suddenly changed when Robert Koch identified the tubercle bacillus in 1882, contradicting theories of causation based in emotionality and/or heredity. However, drama was slow to reflect the advancement in medical thought, Barker shows; presenting a consumptive character as preternaturally sensitive and artistically gifted extended into the twentieth century. Shaw, for instance, exploited that stereotype in The Doctor’s Dilemma, as he often subverted audience expectations to provoke thought about social issues. Medicine evolved while public perception clung to fallacies.The 180 pages that trace the representation of tuberculosis on the nineteenth-century transatlantic stage provide a full foundation for O’Neillians to appreciate the last chapter, addressing Long Day’s Journey, The Straw, and Beyond the Horizon as well as Charles Ludlam’s Camille and Tennessee Williams’s Kingdom of Earth and Vieux Carré. As the full twentieth-century cultural context is beyond the book’s scope, Barker asserts that these plays reflect the female and male consumptive types of the previous period. It becomes evident that the artistic, fragile, sensitive, self-sacrificing characters of these realistic plays are rooted in sentimentalism. As Barker argues, “At the heart of O’Neill’s emergent American naturalism, the stage consumptive’s affective capital—and the constructions of interiorized, tormented selfhood upon which it depended—lived on” (187). She describes how medical treatment eventually evolved once the bacterial nature of tuberculosis was identified: sanitoria emphasized fresh air, exercise, and healthy food, but still linked the disease to heightened emotion. O’Neill’s sanitorium stay, she notes, was a “school of interiority” where he “was resurrected as a writer who could translate his suffering into art” (187). Edmund from Long Day’s Journey, of course, garners the most attention of O’Neill’s consumptive characters; for example, Barker points out how the belief in hereditary consumption surfaces when James attributes Edmund’s physical frailty and nervous energy to Mary.As a specialist in dramatic literature, I admit that not all books of theater history appeal to me, but Barker’s work is thoroughly engaging. It situates the particulars of each play in the zeitgeist regarding tuberculosis, both the popular (mis)conceptions and medical thought. From a medical humanities viewpoint, Symptoms of the Self is a fascinating look at how diagnosis and treatment evolved and how that evolution appeared on stage. This volume contributes not only to theater history but also to general scholarship about tuberculosis as a social phenomenon. As Barker points out, Meredith Conti’s Playing Sick: Performances of Illness in the Age of Victorian Medicine (2018) examines portrayals of consumption, but among multiple illnesses performed in nineteenth-century Anglophone theater. Barker expands to consider the entire transatlantic repertoire, rather than limiting to English-language drama, and to fully treat some less-than-stellar works that critics tend to dismiss. In doing so, she weaves a rich tapestry of close reading, theater history, and cultural analysis that provides valuable context for studying O’Neill’s work.