A Rightful Place in History
Virginia Allen is one of the last ‘Black Angels,’ a group of Black nurses who helped cure tuberculosis
By Kari Jones
National Nurse magazine - Oct | Nov | Dec 2024 Issue
“At 16 years of age, I wasn’t sophisticated enough to even think about fear.”
Now 93, Virginia Allen smiles, recalling the day her parents gave her permission to leave her home in Detroit, Mich. to attend nursing school in New York City. Inspired by a respected aunt, Edna Sutton Ballard, she would become one of 300 “Black Angels,” the Black nursing staff caring for tuberculosis (TB) patients at Staten Island’s Sea View Hospital. Although she didn’t know it then, when Allen stepped onto the hospital grounds in 1947, she was also stepping forward into medical history.
Today’s nurses who worked through Covid know how terrifying it can be to care for highly contagious patients before the introduction of proven medical interventions. Between 1900 and 1950, when the only prescription for tuberculosis was rest, fresh air, and a healthy diet, TB killed more than 5.6 million people in the United States, including nurses infected on the job. Fueled by crowded and subpar living conditions, especially among the poorest and most marginalized people, TB claimed 10,000 lives annually in New York City alone before Sea View opened in 1913.
Author Maria Smilios chronicles the history of Sea View’s nurses in her book Black Angels. According to Smilios, while isolating sick patients away from the public ultimately cut infection rates, the sanatorium was not built on a foundation of care but, rather, of bigotry and greed. New York City officials were motivated to remove sick patients to Staten Island by the cost of labor loss when workers infected one another and died, and by contempt for immigrants, the Black population, and the lower classes, who contracted TB at higher rates due to the conditions of their everyday lives.
The hospital was initially staffed by white nurses, in an era when Black nurses were fighting discrimination in job and education opportunities, and a ban on joining most state nursing associations and the American Nurses Association (ANA). But by the late 20s, white nurses began leaving Sea View. With a dearth of nurses to do the stigmatized and dangerous work, Black nurses answered the call. Sutton Ballard left the Jim Crow south for Sea View in the early 30s, and in a later “nursing shortage,” fueled by unsafe working conditions and racism, Allen got the call that changed her life.
“It was exciting because I had never had a job before,” said Allen, who still remembers vividly, just like rewatching a favorite movie, her first weeks at Sea View. The all-Black education staff taught her everything: from how to take temperatures and bathe patients to specimen collection and proper isolation techniques.
“Those nurses were cracker jack,” said Allen, noting that the training she first got at Sea View carried forward into “every job I was ever involved in.” The Black Angels had given her a foundation for life.
Cure through community
In a recent keynote speech to the New York State Nurses Association (NYSNA)’s convention, Allen emphasized that “The advances in medicine are rarely the work of a single person. They are the result of many people coming together.”
It’s a truth she knows well. As she cared for child tuberculosis patients in the late 1940s and early 50s, many forms of collective action were inspiring positive change. Black nurses, banned from the ANA, had formed their own organization, the National Association of Colored Graduate Nurses (NACGN). By 1951, thanks to the NACGN nurses’ unrelenting advocacy, the number of nursing schools admitting Black candidates had jumped to 330 from 28, and the ANA had begun accepting Black nurses.
This era also saw scientists collectively build on each other’s advances toward a TB cure. By the time Allen arrived at Sea View, an experimental medication allowed some patients to recover. But regression was common, along with severe side effects. The world was still waiting for a miracle.
In 1952, another medication, isoniazid, began showing great promise in animals infected with TB. Only a human trial would tell if it was the long-awaited cure, and scientists and doctors decided Sea View was the perfect site for testing. Under the direction of doctors Edward Robitzek and Irving Selikoff, the Black Angels began working on the isoniazid trial, chronicling everything from patient swelling and bruising, to the most subtle changes in the tone of a patient’s voice and their mood.
“Dr. Robitzek and Selikoff would not have been able to perfect the drug had it not been for the nurses and their notes,” said Allen. “They would have been in a tunnel — blind — because they were only on the floors for a short time, observing the patients for maybe five to 10 minutes.”
Relying on the nurses’ observations, the doctors tweaked dosage and drug combinations, eventually finding a treatment that was 95 percent effective in ensuring recovery.
“It was joyous,” said Allen, whose child patients were too young for the initial trial, but who were given the medication as treatments were perfected, going on to lead regular lives. And just like that, the nurses who had fought so hard, for so many decades, to have a rightful place in the nursing workforce, proved that they also deserved a rightful place in medical history.
Full speed ahead
Allen is humble when asked how it feels to know she and her colleagues were instrumental in saving millions of lives.
“I wish we could have saved more,” she said, emphasizing that because isoniazid is not universally free, TB patients around the world are still dying. According to the World Health Organization, 1.25 million people died from tuberculosis in 2023.
Allen has a long career under her belt, and her time as a Black Angel is only one highlight. She earned her LPN while at Sea View, then went on to work at facilities such as Brooklyn Jewish Hospital and Staten Island University Hospital, where she precepted new nurses, including one memorable young nurse from 1986: NYSNA’s executive director Pat Kane, RN.
“I loved the young nurses because they had new, bright ideas,” said Allen, who today calls Kane and NYSNA/National Nurses United president Nancy Hagans, RN, friends. Hagans returns the praise, calling Allen a “living legend,” who “makes the nursing profession so proud.”
During her career, Allen said she has experienced racism, including from some doctors who “looked past her as if she wasn’t there” and never spoke a word to her. But she pressed on, following her desire for a challenge into union work. In the 1960s, after impressing SEIU 1199 founder Leon Davis, she became administrative organizer for 3,500 nursing home and hospital employees in Staten Island and Queens. She also studied labor relations at Cornell University, and she holds two honorary doctorate degrees from CUNY College Of Staten Island and Kentucky State College of Nursing, both in humane letters.
“We need a strong union voice to advocate for patients and our profession,” said Allen, who believes union strength keeps nurses from becoming “fragmented” and helps them bargain for crucial protections, including safe staffing. Allen says it’s important to ensure the medical field is always advancing, not regressing, citing concern with the current rollback on reproductive health care in the country, and with modern employers leaving nurses unprotected during Covid.
“I think during tuberculosis, we had more protections than nurses had during Covid. I couldn't believe it,” said Allen. But today’s nurses know, just as yesterday’s nurses did, that when public health and the profession are under attack, nurses standing in unbreakable solidarity can effectively fight back. The Black nurses of the early 20th century and the Covid-era nurses all used collective action to win change, saving millions of lives.
“We are all we have,” said Allen. “We have to love and care for each other.”
Kari Jones writes for National Nurses United.