Afsheen Zafar, FCPS
Islamic International Medical College, Rawalpindi, Pakistan (Spring 2016)
I had just put down my pen after the last patient left the room. She somehow reminded me of the Brontë sisters. She had been diagnosed with tuberculous axillary lymphadenitis after a biopsy but otherwise seemed to be in perfect health. Apparently she was not much disturbed by the diagnosis since tuberculosis (TB) could be treated. She had been fearful of Carcinoma breast because of a swelling on the outer side of her breast near her axilla. A relieved sigh and an under her breath “Thanks God” was her reaction to the report. I smiled and said, “Yes, TB is treatable,” but also felt a little bad about it. It’s still there even in apparently healthy looking patients. Here in Pakistan it is a diagnosis we make on a regular basis. It is still one of the most common infections in the world as almost one third of the world population is infected with it. There were 1.5 million TB related deaths worldwide in 2014.1 It is a well-known fact that physical ailments tax the patients’ emotional and mental capacities as well but this is not always true. Human nature can be very resilient and has not changed in the over one hundred and sixty years since Charlotte Brontë wrote Jane Eyre. I sometimes wonder how it must have felt to lose so many of her loved ones to a single disease and at the end succumb to it herself (Although Charlotte Bronte’s exact cause of death is disputed, her death certificate shows it to be “phthisis”2). During her time, one out of seven people suffered from the disease and many died young.3 Almost a century had to pass before effective treatment for tuberculosis would be found and the fear of it must have been dreadful, not less than the fear of cancer; yet, the strength that it must have produced in her is so evident through her life and novels, especially Jane Eyre.
Jane Eyre is Charlotte Brontë’s most celebrated novel. It is a novel full of imagination, hope, struggle and self-belief. It’s not just romanticism but carries in it the passion and strength of a young heart. Her passion is still relevant today and relevant to even those who live thousands of miles away and share none of her culture or living conditions. She looks at life in a way that defeats death and disease. Her portrayal of death and disease in her novel are unique in the sense that she does not choose to depress the reader with its description. Rather, the chapter in which her best friend Helen is dying of “consumption” starts with the description of spring around the Lowood school, so much so that you forget the typhus epidemic and marvel at nature’s beauty. Very few authors would have chosen to do that just before describing the loss of her only friend at school. We also get to see a glimpse of her views on tuberculosis when Helen describes the disease saying, “ ‘we all must die one day, and the illness which is removing me is not painful; it is gentle and gradual: my mind is at rest.’ ” While Jane thinks, ” ‘How sad to be lying now on a sick bed, and to be in danger of dying! This world is pleasant—it would be dreary to be called from it, and to have to go who knows where?’ ”
It brings a smile on my face; diseases affect bodies but cannot subdue hope so easily. We might not have beaten tuberculosis completely today but neither are we beaten by it. March 31, 2016 is Charlotte Bronte’s 161st death anniversary and March 24th is World TB Day. This year the WHO slogan for world TB Day is “Unite to End TB”.4 I hope we succeed in it and there is no one better to paint this hope than Brontë herself:
Life, believe, is not a dream
So dark as sages say;
Oft a little morning rain
Foretells a pleasant day.
Sometimes there are clouds of gloom,
But these are transient all;
If the shower will make the roses bloom,
O why lament its fall?
Life’s sunny hours flit by,
Enjoy them as they fly!
What though Death at times steps in,
And calls our Best away?
What though sorrow seems to win,
O’er hope, a heavy sway?
Yet Hope again elastic springs,
Unconquered, though she fell;
Still buoyant are her golden wings,
Still strong to bear us well.
The day of trial bear,
For gloriously, victoriously,
Can courage quell despair!5
1. Fact sheet N0 104. World Health Organization website. http://www.who.int/mediacentre/factsheets/fs104/en/. Reviewed March 2016. Accessed March 22, 2016.
2. Gezari J. The death of Charlotte Bronte. OUPblog. Oxford University Press’s Academic Insights for the Thinking World. http://blog.oup.com/2013/03/death-charlotte-bronte/. Published March 31st, 2013. Accessed March 22, 2016.
3. History of World TB Day. World TB Day. Centers for Disease Control and Prevention website. http://www.cdc.gov/tb/worldtbday/history.htm.
4. World TB Day 2016. Centers for Disease Control and Prevention website. http://www.cdc.gov/tb/worldtbday/. Reviewed and updated January 7, 2016. Accessed March 22, 2016.
5. “Life” is reprinted from “Poems by Currer, Ellis, and Acton Bell. Charlotte, Anne, and Emily Bronte. Philadelphia: Lea and Blanchard, 1848.” Accessed at http://www.poetry-archive.com/b/life.html.
Dr. Afsheen Zafar is a practicing surgeon and faculty member in the department of Surgery, Islamic International Medical College. Her postgraduate dissertation was on abdominal complications of tuberculosis. She has been an avid reader of the Brontë sisters’ novels since her college days.