“Doc” Holliday: A Story of Tuberculosis, Pain, and Self-medication in the Wild West

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As many of our readers know, “Doc” Holliday was a professional gambler who worked the saloon and gambling halls of the cattle and mining towns of the Western Frontier between 1873 and 1887.1 What readers might not know was that Holliday also suffered from debilitating pain caused by chronic tuberculosis (TB) infection.1-8 Doc Holliday arguably was the most intriguing and colorful characters of the “Wild West” era, and a review of his life, health, and pain problems provides a unique educational opportunity. It might surprise you, but this icon teaches us a great deal about pain. He could be the poster child of the prototype patient who has a chronic disease, eventually develops intractable pain, and knows he has a short time to live. It’s rare that we have the opportunity to dissect and study the history of a pain patient from birth to death—Doc Holliday left us this gift.

To be a better pain practitioner, read about the instructive case of Doc Holliday. After studying his case, you will never approach a chronic pain patient quite the same way.

Just Who Was “Doc” Holliday?
John Henry Holliday was born August 14, 1851 into an aristocratic southern family in the tiny town of Griffin, Georgia.2 Holliday had a classical upbringing and was educated at the Valdosta Institute, a school for sons of southern gentlemen, in Valdosta, Georgia.2 Besides math and science, he was taught Greek, Latin, and French. When Holliday was a boy, his uncle John Stiles Holliday, MD, who was a physician, gave him an 1851 Colt revolver, which he learned to use expertly. When he was a teenager, Holliday moved into his uncle’s house, where a young Mulatto servant named Sophie Walton taught him and his brother how to play cards. She taught them games called “Up and Down the River” and “Put and Take,” which were similar to the card game Faro. She taught them how to count the cards in the deadwood (discard) pile and to remember which cards were yet unplayed. Holliday had an intensive competitive spirit, as well as a remarkable memory and mathematical ability.

Holliday attended the Pennsylvania College of Dental Surgery in his late teens, earning his degree on March 1, 1872.2 He practiced dentistry in Georgia before moving, in 1873, to Dallas, where he became a dental partner with Dr. John A. Seegar. Within his first year of dental practice, Holliday started frequenting gambling establishments and found that gambling was more profitable and exciting than dentistry. Holliday got the nickname “Doc” from his friends and acquaintances in the gambling saloons, who preferred to call him “Doc” rather than Dr. John Holliday.

Life as a Gambler
The life of a professional gambler in the Western Frontier was dangerous—losing players were often inebriated, took umbrage, and were ready to fight. Along the way, Holliday had developed a reputation as a deadly gunfighter. His long-term notoriety primarily stems from his participation in the gunfight at the OK Corral, which took place in Tombstone, Arizona, on October 26, 1881.1,5 Had it not been for this singular event, which lasted all of 30 seconds, Doc Holliday and Wyatt Earp likely would have died in obscurity. As it turned out, this gunfight has long captured the intrigue and fascination of the American public.1-8 Countless movies, books, articles, and songs have been written about it, which often makes telling fact from fiction difficult (see Fact from Fiction at the end of this article).1-12

Because so much has been written about Doc Holliday, much of it conflicting, it often is difficult to get a clear picture of his personal appearance, demeanor, and behavior.1-8 In his memoirs, Wyatt Earp described Holliday this way: “He was a dentist whom necessity had made a gambler, a gentleman whom disease had made a frontier vagabond, a philosopher whom life had made a caustic wit, a long, lean, ash-blond fellow nearly dead with consumption and at the same time the most skillful gambler and the nerviest, speediest, deadliest man with a six-gun I ever knew.”7

There is disagreement over which photos of “Doc” are legitimate.7 His true image has been dramatically altered in the many movies about him, so I have included a number of quotes by various persons in an attempt to capture the truth. Perhaps the best quote to separate fact from fiction is one by W.B. (Bat) Masterson, sheriff of Dodge City and Pueblo, Colorado, who personally knew Holliday. Considering Doc’s TB, Masterson described him as a physical “weakling who could not have whipped a healthy 15-year-old boy in a go-as-you-please fist fight.” Contrast this with the number of robust actors Hollywood chose to play Doc including Kirk Douglas, Jason Robards, Victor Mature, Caesar Romero, and Stacy Keach.

Just how much his pain and health problems influenced his temperament and behavior will always be a matter of debate, but it appeared to this author to be paramount in shaping his short life. There is remarkable consistency among “Doc’s” serious biographies regarding his health problems, which have allowed this author to medically analyze and report his case from a pain practice perspective.1-8

Doc’s Health and Pain History
Holliday’s health problems began at birth—he was born with a cleft lip and possibly a cleft palate.2 His lip was surgically repaired and the Holliday family took the time and effort to teach him to speak properly. Whether there was a genetic aspect to his birth defect will never be known, but it is commonly believed that genes and the environment play a role in the development of these orofascial clefts.

Figure 1. Image depicts two smooth, chromogenic colonies of Mycobacteria

The second major, but critical, event in Holliday’s life was the death of his mother Alice from TB in 1866 when he was 15.2 He had been very close to his mother, because during many of his formative years his father was away fighting for the South in the Civil War. At the age of 21, while practicing dentistry in Georgia, Holliday started to lose weight. He initially attributed this to his active schedule. About 6 months later in the summer of 1873, he developed a nagging cough that forced him to take some time off from his dental practice. When the cough did not subside, he sought out his uncle, Dr. John Stiles Holliday. Using a stethoscope and a bronchoscope he diagnosed Holliday with pulmonary TB,2 which at the time was commonly called “consumption” or “phthisis pulmonales.”13,14

First published on: December 1, 2012