He was dying. And after caring for his brother eight years earlier—comforting him until his last gasp—he knew how this would end. But if consumption would soon kill him, leaving behind his beloved wife, two babies and a happiness and stability he could only have imagined, he wanted to spend his last days in the mountains and the forest. In his 1915 autobiography, Dr. Edward Livingston Trudeau wrote that such surroundings “seemed to meet a longing I had for rest and the peace of the great wilderness.” Weak and feverish, Trudeau endured the trip from his home in New York City to the remote, rugged northern Adirondacks. He was jostled and slammed in a horse-drawn wagon the last 42 miles from Au Sable Forks to Paul Smith’s hotel, where he was carried like a sleepy child to his room.
After three months at Paul Smith’s place, the young doctor—sunburned, 15 pounds heavier and in improved health—returned to his family. His time in the outdoors seemed to have arrested the ravages of tuberculosis, a disease then synonymous with death.
Edward Trudeau photograph courtesy of the Historic Saranac Lake Collection
Soon, Trudeau and his family were boarding in a simple clapboard house in Saranac Lake, at that time just a settlement of a half-dozen guides’ shanties. To prolong his life, wrote Edward, he and his wife, Lottie, “decided to face the terrors of an Adirondack winter, entirely cut off from all connection with the outside world.”
From that decision—made almost 150 years ago—rose a community. There, Edward went on to build a laboratory to research Mycobacterium tuberculosis. And he convinced generous friends to help him create the first fresh-air sanitarium in North America, transforming a tiny, far-flung hamlet into a sprawling, world-renowned health resort.
Today, Saranac Lake, with a year-round population of more than 5,000, is the biggest village in the Adirondack Park. It has a college, hospital, ski hill and thousands of homes squeezed together on hills and along shorelines. And what’s remarkable all these years after Trudeau first arrived is how Saranac Lakers embrace their town’s past, one built on a disease.
But this place’s history isn’t just about suffering, says Historic Saranac Lake executive director Amy Catania. Yes, “there was sadness—a lot of people died here—but there are also inspiring stories of resilience and people finding new occupations and falling in love.”
Historic Saranac Lake is the organization behind the restoration of Edward Trudeau’s Saranac Laboratory for the Study of Tuberculosis, the boxy brick building at 89 Church Street. From this museum, Catania and her staff offer tours of the lab and, through photographs and other artifacts, illuminate the days when the sick came to convalesce under Trudeau’s care, taking his prescription of rest, good hygiene and fresh North Country air to boost the immune system. In 1884 he established the Adirondack Cottage Sanitarium. Today old “cure cottages” still dominate the village’s architecture—at last official count there were 900—and though antibiotics* eliminated the need for Trudeau’s sanitarium a half century ago, there’s still reverence for its long-ago patients, lined up on cots, cocooned in blankets on porches.
Sitting in the museum’s John Black Room library, adjacent to the lab, Catania says that “we’re dealing with COVID in a similar way as people dealt with TB back in the day … what it was, how it was transmitted, the fear, the stigma. You look at issues in public health today,” and our conversations, as in Edward Trudeau’s time, “involve income inequality, racial discrimination, access to healthcare and how that affects peoples’ outcomes.”
Historic Saranac Lake has long chronicled Trudeau, his practices and patients, but there are so many more stories to tell and people want to hear them, says Catania. Visitors come to Saranac Lake to honor and understand what this place meant to their parents or grandparents—people who maybe “worked in the industry here or recovered their health here or met a spouse here, or settled down here. That Saranac Lake gave them their lives back is hugely important to these peoples’ descendants.”
Historic Saranac Lake is in the process of restoring Edward Trudeau’s home next door to the laboratory. Both the lab and house were built in 1894, after Trudeau’s original home burned to the ground. When the property came on the market, “the history was too strong to not jump in and make it work,” says Catania. The expansion will allow for more exhibits, a research room, housing for its collections, science activities and event space. Fundraising has been promising—almost three million dollars so far—“because there’s a community character that people want to preserve.” In minutes, Catania expects a fifth-grade class from Saranac Lake’s Petrova Elementary School to arrive for a tour of the lab and then Pine Ridge Cemetery. “We want the next generation to connect and identify with the place where they grew up … or they aren’t going to come back.”
Just then there’s a great shuffling upstairs. The fifth-graders have arrived.
Edward Trudeau’s autobiography, written the year before he died at age 67, reads like a book of acknowledgments—hundreds of pages that intertwine the doctor’s personal life with the generous people he met along the way. He was known as “the beloved physician”—a relentlessly optimistic and empathetic practitioner. Catania says that comes through in the letters he wrote to his patients and the letters patients wrote to him. Trudeau knew what they were going through. He’d lost his brother, an experience that, he wrote, “nearly broke my heart, and I have never ceased to feel its influence.” He and his wife lost their baby, Henry, then their 16-year-old daughter, Chatte, who died from TB—“she suffered so constantly.” And the Trudeaus’ son Ned, fresh from Yale, newly married and ready to start his own medical career, died suddenly from a blood clot brought on by pneumonia. “My wife and I passed through days of dazed suffering, which even now it is hard to dwell upon and from which we have never recovered.”
Edward also knew the physical agony of TB—it had incapacitated him throughout his life. In the most famous photographs of the doctor, he’s in his lab, bent over beakers or peering into a microscope. Did he see heartbreak when tubercle bacilli revealed itself on his slides?
Trudeau had famous, wealthy patients, including writer Robert Louis Stevenson, but he worked to give everyone care. He wrote that on the days he opened his doors for “office hours … my waiting room, the piazza, and even the lawn” were crowded with patients. “I usually managed to see all of them and give them some sort of advice as to their cases and their mode of life.” After these marathon stretches, he was “numb with mental and physical exhaustion.”
The doctor’s selflessness must have been an inspiration. Among the wealthy with whom he crossed paths, either at Paul Smith’s, on his travels or in Saranac Lake, Trudeau was never shy to ask for “subscriptions” for his sanitarium or for a chapel or some other structure or service that he believed would improve people’s lives. He was rarely turned down.
And so brick by brick, Saranac Lake was built on generosity.
Edward’s son Francis became a doctor. Francis’s son Frank became a doctor. They administered to the sick in Saranac Lake and, in 1964, a decade after the sanitarium closed, Frank founded Trudeau Institute, an independent research lab to carry on his grandfather’s work.
Garry Trudeau in the 1950s. Photograph courtesy of Garry Trudeau
When he was in high school in the 1960s, Frank’s son, Garry, spent a summer working at the lab. But, says Garry, the family business “didn’t take. At one point I threw the institute’s new Zeiss electron microscope out of alignment, and they had to fly in a team from Düsseldorf to fix it.” The idea of a career in medicine “never came up again.” Instead, Garry became a Pulitzer Prize–winning cartoonist and creator of the cartoon strip Doonesbury.
Garry continues the Trudeau legacy of making Saranac Lake a better place. About a decade ago, after visiting with veterans at Walter Reed Medical Center, in Washington DC, he channeled his great-grandfather’s vision of healing in the North Woods, and brainstormed a program for soldiers returning home with physical and mental struggles. Today, Homeward Bound Adirondacks offers free retreats for veterans, and it recently broke ground on a permanent retreat center. For many years Garry served on Trudeau Institute’s board of directors, and he’s Honorary Chair of the Campaign for Historic Saranac Lake’s Trudeau Building expansion.
Despite living elsewhere most of his life, this place is part of who he is.
“Saranac Lake was magical,” he says. “I could not have wished for a more perfect childhood. We were all free-range kids, lightly parented and mostly left on our own to roam the woods, build treehouses and burn out our gloves on the rope tows at Pisgah. I left earlier than I would have preferred—my parents wanted me to attend a downstate school where my uncle taught—but I always considered Saranac my hometown.”
Growing up here means embracing Winter Carnival, a festival that had its beginnings when Edward Trudeau and friends gathered for skating parties at Pontiac Bay. Through time it morphed into a multi-day, town-wide event, with performances, races, a parade and an elaborate palace made with ice cut from Lake Flower. Years ago, says Garry, during one of the carnival’s benefit shows put on by the Rotary Club, “my father and his friends pranced out on stage in a cancan line, all of them clad in stockings and heels and ruffled petticoats. The audience roared with laughter, but I had a hard time processing it. Dad was ordinarily so dignified that seeing him in cross-dressing mode just fried my young brain.”
Now, as in the past, the carnival “raises spirits during a dark, frigid time of year,” says Garry. “It brings business into town, and as a tradition of long standing, is a tremendous source of local pride.”
Another tremendous source of local pride has been Garry Trudeau and his willingness to create a cartoon for the carnival’s annual fundraising buttons. For 41 years he’s made one to fit the theme of each carnival. This February it’ll be “Totally ’80s.”
Tuberculosis still kills people—in 2020, 1.5 million lost their lives to the disease. It is treatable and curable, but in developing countries it infects more than 10 million people a year, many of whom can’t access care or complete what can be a lengthy treatment. At Trudeau Institute, scientists are working on developing shorter courses of TB treatment as well as drugs that target drug-resistant strains. The institute’s director, Dr. Atsuo Kuki, says, “The eradication of tuberculosis remains one of the greatest challenges we face.”
Trudeau’s scientists are also researching novel coronavirus, influenza and tick-borne illnesses; since the COVID-19 outbreak, the institute has helped develop and test vaccines. Kuki says that “part of the scientific push for the next generation of vaccines will be to focus on protection against multiple coronaviruses.”
Almost 60 years ago, when Trudeau Institute was constructed, “Little Red,” the first of the cure cottages at Edward’s sanitarium, and a statue of the doctor himself, were moved to the institute’s campus on Lower Saranac Lake. Those who understand the past know how even the smallest things—a tiny cottage with a tiny porch; a sickly, diminutive doctor—can symbolize hope. Trudeau Institute’s mission is “to safeguard human health by combatting 21st-century health threats,” says Kuki. “It’s a mission that draws directly from our history, when Edward Livingston Trudeau faced down the greatest threat of his time.”
All of that, of course, continues to impact a place that means so much to so many. Edward Trudeau would be astounded by what’s grown from that early guides’ settlement. He transformed Saranac Lake into what it is today, and, through his generosity, a vision for the kind of community it could be. At the end of his life, Edward wrote that “tuberculosis looms up as an ever-present and relentless foe. It robbed me of my dear ones … it shattered my health … and relegated me to a remote region, where ever since I have witnessed its withering blight laid upon those about me, and stood at the death-beds of many of its victims whom I had learned to love.” And yet, wrote the good doctor, the struggle “brought me experiences and left me recollections which I never could have known otherwise…. While struggling to save others, it has enabled me to make the best friends a man ever had.”
Visit Historic Saranac Lake’s Wiki site for thousands of pages on the village’s history; read A Rare Romance in Medicine by Mary Hotaling to learn more about Dr. Edward Livingston Trudeau; and see www.saranaclakewintercarnival.com for this year’s winter carnival schedule.
*This article has been changed to correct an error in the print version. Penicillin is not effective against tuberculosis, but other antibiotics are.
