With the possible modern exception of AIDS, no other disease has the moral taint of leprosy. Enlightened societies have rid themselves of at least the outward signs of personal condemnation for those with cancers, mental illnesses, even sexually transmitted diseases. But "leper" is still shorthand for an untouchable—someone so thoroughly contaminated, inside and out, that a healthy community will have nothing to do with him.

There's practically no such thing as an incurable leper anymore. Yet clinics for what is now called Hansen's disease still tend to go without signs, and patients give false names. The idea (stemming from a fatal mistranslation in the Bible) that lepers are uniquely cursed and marked by God for exile proved equally powerful for medical science and the popular press. When the territorial government of Hawaii established the Molokai leper colony in 1866, everyone agreed that the disease was aggressive, contagious, and invariably fatal, and many argued that all Christians should demand obedience to Old Testament laws concerning the unclean. John Tayman's crowded but often shocking history The Colony chronicles the tragic consequences of the decision to isolate all Hawaiian lepers on a peninsula facing a sheer cliff—a natural prison for civilization's ultimate outcasts.

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The book's first sections, covering the first few decades of the colony, are a jumbled heap of bureaucratic bungles, corrupt overseers, starving "settlers," and sadistic human experiments. With the arrival of the famous Father Damien, sent by the Catholic Church to minister to the nearly 700 exiles, and the near-simultaneous medical advances in the understanding of leprosy, Tayman finally has a single compelling figure fit for his narrative. But the cycle of do-gooders and whistleblowers, followed by neglect, exasperation, fraud, and human suffering, allows for fascinating variation, and Tayman invests the repeated stories of dashed hope and misunderstandings with palpable outrage. As the 20th century dawns and the U.S. government explores the possibility of a national leper colony (to solve what The Washington Post called "the leper problem in the United States"), the light of reason seems permanently obscured by ancient prejudice and fear. Yet Tayman ends on a note of hope—a community bond did form, against all odds, and long-term exiles chose to die peacefully on Molokai, a place ironically sanctified by human cruelty and ignorance.