One of the guiding lights of public health policy in the United States was a Russian Jewish immigrant who came to this country with plans of being a lawyer and a social advocate.
Theodore Bernard Sachs was born on May 2, 1868, a son of a prosperous merchant and owner of the largest department store in Cherkov, Russia. The younger of an educated family, including a sister who earned a medical degree in Switzerland, Sachs studied law at the Imperial University of Odessa, became active in student revolutionary activities and graduated as an advocate. Under terms of his ensuing military conscription, Sachs was offered a commission as captain on the condition that he convert to the Greek Catholic faith. Sachs declined and decided to take his chances on immigration to the United States, instead.
The 21 year old Sachs moved into the Chicago home of his aunt Sarah and set up a law practice with the firm of Moses, Rosenthal & Kennedy after taking a year of study to get comfortable with English, a struggle that would prove difficult to overcome.
“Discouraged at his inability to speak English as fluently as he thought necessary,” wrote the Chicago Jewish Sentinel in its coverage of his suicide in 1916, “he decided to give up his ambition to be a lawyer and became a physician instead. He never succeeded in modifying his pronounced accent and, sensitive as he was, he worried over this defect.”
Thus, Sachs abandoned his law career for medical school at the College of Physicians and Surgeons, later the University of Illinois College of Medicine, supporting himself with odd jobs, including but not limited to working part time at Hart, Schaffner and Marx. During his internship at Michael Reese Hospital in Chicago, Sachs met Lena Louise Wilson, a nurse who would change his life.
Louise and Theodore grew fond of each other as she helped him in establishing his private practice in a modest office at Halsted and 12th Streets, specializing in the disease of the lungs. Tuberculosis, consumption, or “the white plague” was taking a large toll in the industrialized urban communities at the turn of the century and the medical field was struggling in its treatment of the disease. Assisting Dr. Sachs in his new practice, Louise succumbed to tuberculosis, whereupon Sachs gave up his office and brought Louise to a tuberculosis sanitarium in Denver, Colorado. According to the Sentinel’s account, Sachs remained with Louise in Denver for three years. He first devoted himself to Louise, who recovered, and the two then in turn devoted their lives together to researching and treating the disease. Theodore qualified for citizenship in 1896 and he and Louise were married on January 4, 1900.
Sachs had published a study charting four dense blocks on Chicago’s west side where nearly every household was stricken with tuberculosis and Sachs presented the results of the study before the International Tuberculosis Congress in Washington, DC, in 1908. The study was widely regarded as setting a standard for both the study of tuberculosis, as well as a model social survey in what would become the science of sociology.
In the summer of 1911, Sachs organized the factory committee of the Chicago Tuberculosis Institute, the first organized effort to campaign for workers healthcare, reaching roughly a quarter million workers. Sachs also chaired of a number of committees of the National Association for the Study and Prevention of Tuberculosis whose work revolutionized the standards for treatment of tuberculosis. Facilities were often neglected to the point where the committees found hundreds of patients to only one physician and a handful of nurses, no real staff and patients who were able to walk did much of the maintenance work around the institutions. The committees required one physician to 50 patients and one nurse to 8 bed-patients, installation of well-equipped laboratories and staff requirements so that patients were not required to work, except in the course of their therapeutic treatment.
Sachs served as medical director of the Edward Tuberculosis Sanitorium in Naperville, Illinois, was appointed by Chicago Mayor William Busse as director of the Municipal Tuberculosis Sanitarium in what is the city’s North Park Village today, and reappointed to the position by Mayor Carter H. Harrison in 1912. Meanwhile, Sachs founded the Winfield Tuberculosis Sanitorium as a part of the Chicago Tuberculosis Institute and a constituent institution of the Associated Jewish Charities in 1909. The Sanitorium officially opened on February 7, 1910, and Sachs served as its physician-in-chief until August 7, 1912.
With the coming of Mayor William Hale “Big Bill” Thompson in 1915, the new administration had taken its time establishing its approach to the office of the city’s health commission as the fate of Dr. Sachs’ position remained unclear. While Sachs was eventually reappointed as director of the Municipal Tuberculosis Sanitarium, reports emerged about the city’s new commissioner of health Dr. John Dill Robertson forcing political appointees into service of the sanitarium and “political methods into the administration of its affairs,” according to an account in the Proceedings of the Institute of Medicine of Chicago, and were met by the commission and its allies with accusations of financial shortcomings of the Tuberculosis Institute.
“The heat of the summer and the worry began to drain Dr. Sach’s vitality,” wrote the editors of the Sentinel, “and last August, in a confidential talk in his private sanitarium at Naperville, he spoke of his deep despondency, referring to the fact that he had no social life and that he had no children and said that his whole life was wrapped up in his ‘child,’ the municipal sanitarium, and that if this was taken away from him, life itself meant little to him.”
In historical retrospect, it is less clear if Dr. Sachs is a martyred figure so much as simply and sadly tragic. When Dr. Sachs took his life in the library of Edward Tuberculosis Sanitorium in Naperville with a fatal dose of morphine, the man certainly assumed martyrdom on a tidal wave of anger and grief by the community, through local press and civic organizations and directed at the mayor and the health commissioner. “The city was prostrated last Monday when the morning papers carried the headlines that Dr. Sachs had committed suicide some time last Saturday night or Sunday morning,” wrote the editors of the Sentinel.
The Chicago Tuberculosis Institute’s business manager Frank E. Wing testified before the Chicago City Council on May 18, 1916, about the events that led to Dr. Sachs’ downfall. “It is not true,” Wing said, as reported by the Chicago Tribune, “that Dr. Sachs resigned because of Mayor Thompson’s statement that his appointment was the worst he ever made. Before that remark was made he spoke to me several times of resigning. Reaction resulting from the mayor’s statement may have led him to resign just when he did, but that was not the cause of the resignation. The real cause was the constant and recurring disagreements with Health Commissioner Robertson.”
From Wing’s testimony, The Tribune reported that Sachs was gravely concerned with the incoming Thompson administration. “More than a year ago, before the mayoralty election,” Wing continued, “Dr. Sachs had many misgivings as to his future on the board. He speculated on many occasions on the likelihood of his opportunity to serve the city being taken away from him. He often wondered who the next health commissioner would be. He was concerned over his own appointment. It was his temperament to worry over such things.”
Lena Louise Sachs was compelled to accept an offer of a salaried position in the Edward Sanitarium. “I have not much to leave to you except my unsullied name,” Sachs wrote to his wife in his suicide note, published in the Proceedings of the Institute of Medicine of Chicago, and listing the accounts left to him. “This will take care of you and mother…. Please bury me at Naperville, if possible. Services non-sectarian.”
The pain of Dr. Sachs’ struggle emerged in the 1927 Chicago Mayoral Election between the incumbent Mayor William Everett Dever and former Mayor William Hale “Big Bill” Thompson, as reported by the Chicago Tribune on April 2, 1927:
At the Herzl school, Independence boulevard and Lawndale avenue, last night Mayor Dever found 3,500 Jews called together and reminded them today is the eleventh anniversary of the suicide of Dr. Theodore B. Sachs, who, as head of the Municipal Tuberculosis sanitarium, had protested in vain against Thompson methods. The audience had been reminded that there is a Hebrew prayer that every Jew anywhere in the world is accustomed to say on the anniversary of the death of a loved one. Those present were urged to say the prayer today and ask friends and acquaintances throughout Chicago to do the same. Mayor Dever called Dr. Sachs’ death “an instance of the tragedy of bad government.”
Thompson prevailed in the election over Dever.
This story "The Tragic Socialist Russian Jewish Immigrant At The Root of Our Public Health Debate" was written by Barry Dredze.