Fighting for Life

by S. Josephine Baker

  “How unfortunate it is,” she said, rolling it out like a preacher in a pulpit, “that, at the moment of our entrance into the world, we have to be chastised.” Then having uttered that profound and really eloquently expressed sentiment, she fell back into an alcoholic slumber that lasted twenty-four hours.

  CHAPTER IV

  THE GIBSON GIRL WAS A GREAT HELP TO ME when I started work in the public health field. It is difficult to realize today how curious it seemed then that a woman should hold my position. A little later, when I was assistant to Dr. Darlington, the Commissioner of Health, they made me print my name on the letterheads as “Dr. S. J. Baker” to disguise the presence of a woman in a responsible executive post. The Gibson Girl played a part in the situation because, most fortunately for me, she had persuaded me and the world in general into accepting shirtwaists and tailored suits as a conventional feminine costume. I liked the effect and still do. But its convenience came in because, if I was to be the only woman executive in the New York City Department of Health, I badly needed protective coloring. As it was, I could so dress that, when a masculine colleague of mine looked around the office in a rather critical state of mind, no feminine furbelows would catch his eye and give him an excuse to become irritated by the presence of a woman where, according to him, no woman had a right to be. My man-tailored suits and shirtwaists and stiff collars and four-in-hand ties were a trifle expensive, but they more than paid their way as buffers. They were also very little trouble. I could order a suit and another dozen shirtwaists and collars with hardly a tenth of the time and energy that buying a single new frock would have required. And I had no time or energy to spare because, in the process of convincing myself that my work must be a success and equal to the best that might be done by a man in that man-made world, I invariably took home a brief case full of trouble every night and worked at it until the small hours of the morning. Dr. Mary Walker wore trousers to startle men into recognizing that a woman was demanding men’s rights. I wore a standard costume—almost a uniform—because the last thing I wanted was to be conspicuously feminine when working with men. It all seems very strange now, for today women can be ultra-feminine and thus add attractiveness and charm to the work they are doing.

  At home, of course, I kept a certain amount of conventional and thoroughly feminine attire for those rare occasions when I could allow myself a social holiday. And yet, I am sure that there are today a great number of my old-time friends who never saw me dressed in any other way, for I wore that costume in my daily work for over twenty-five years. When Commissioner Darlington gave a tea at the Plaza Hotel one day, I appeared in something rather frivolous for me. Several of the secretaries and clerks were there all dressed in their best. As I came in, I stopped for a word with two of the secretaries standing near the door. “Well, how’s the party?” I asked. “Very nice,” said one of them; “but to tell you the truth, doctor, we only came because we wanted to see whether you would wear a tailored suit and a stiff collar.”

  It seems queer too to think back those few years to the time when the world at large seemed genuinely convinced that women were not altogether bright. There are still probably many men who feel doubtful about taking orders from a woman, but women are now so generally accepted in the business and professional worlds that individually they get an opportunity of proving their worth before patronizing generalities begin to crop out. I had been at the head of the Bureau of Child Hygiene several years, I remember, when one day Dr. Alonzo Blauvelt started complaining to me about the appointment of some women doctors as medical inspectors. Women were all right in their way, he told me grievedly, but there was no getting around the fact that they were not trained to work in groups; they had no sense of cooperation, no idea of how to get the most out of their subordinates, no ability to take responsibility. I listened awhile, and then my sense of humor got the best of me. I laughed and said, “Now wait a minute, doctor. What kind of a creature do you think you are talking to now?” His jaw dropped and he blushed purple. “Good Lord,” he said, “I’d entirely forgotten that you were a woman.”

  The modern young woman in the workaday world is a calm and efficient person who can take routine off the shoulders of her chief so that he can ponder matters of major policy and take two hours and a half over his lunch. There are thousands of her in the world of public and private management. At that time, a young woman in public life was as rare as a woman aviator and I had to take my job in male terms. And during those first few years I was a glorified jack-of-all-trades. There were the years in Dr. Bensel’s office when I was sent out on unusual and always exciting assignments; the two years that I spent as an assistant to Dr. Herman M. Biggs, where Dr. William Studdiford and I had an opportunity of working out many public-health ideas. This was a rare experience. It gave me a background of the entire field of public health that made me decide then and there that it was a career. The rare wisdom of Dr. Biggs, coupled as it was with kindliness and humanity, has left a memory that I shall always cherish. I learned a great deal in those days: a range of information that ran from glanders in horses to tuberculosis in man. We planned a campaign for the control of mid-wives that I later had a chance to put into effect, and the first glimmer of an idea of what might be done to reduce infant mortality on a large scale came to me then. I can never be too grateful for those two years as a student of Dr. Biggs’.

  Then I was assigned to the office of Dr. Darlington and given the official title of “Assistant to the Commissioner of Health.” And during nearly all of these years I was what might be called a “trouble shooter.” Anything which did not fit into the assignments of the regular staff of inspectors fell to me. It was a fine idea. For one thing, it kept life from anything like monotony. And for another, it showed me that this field of public health was far removed from anything that had been comprised in my conventional medical training. Not that medicine was not an essential background—that was clear enough—but the mass attack instead of individual care began to come to the front. We were dealing with the problems of a community, and the individual became important only when he contributed to the problem as a whole.

  And so the odds and ends of experience began to take form in my eyes. There was a great deal that was rather rough. Invading Bowery lodging-houses, the ten-cents-a-night kind, for instance, to vaccinate the patrons against small-pox in the very early hours of the morning. It had to be done between midnight and six since the Bowery floaters were up and away by the time dawn broke and that was the only time to find them in any numbers. Few of them were nature’s noblemen, so I always had a Health Department policeman by my side when I marched in; the usual picture being a huge, airless room in a decrepit old building that shook every time the elevated went by, filled with fully dressed men sleeping in musty blankets. The policeman would wake a man up and tell him to put out his arm. Then I would vaccinate him and pass on to the next. They were usually too far gone from bad whiskey to know very much about what was going on.

  Things were exciting in another way when New York developed a spectacular and tragic epidemic of cerebro-spinal meningitis and I became the temporary Department expert on the subject; not by merit, but because I happened to be the only member of the staff who had ever had much experience with this peculiarly horrible disease which then killed the majority of its victims and left the remainder maimed for life. Meningitis epidemics are fairly rare. While this one lasted I was dashing frantically all over New York, taking cultures, making spinal punctures, diagnosing and supervising cases and, in view of the patients’ fearful sufferings, almost wishing that they would all be lucky enough to die. Noise and nuisance inspection were also thrown my way, which acquainted me with the perversities of insanitary plumbing—or no plumbing at all—smoke hazards and the filth of the overcrowded tenements that bred nuisances.

  Since then New York has apparently decided to let the smoke nuisance get completely out of hand. In Dr. Darlington’s administration, however, a black cloud pouring out of a
chimney of a factory or an office building meant not only that the owner or operator was liable to arrest but that his employees must be taught how to stoke the furnaces so that this smoke could be prevented. New York had a clear atmosphere in those days; the smoke nuisance was controlled. Why it has been allowed to come back and why the health authorities are quiescent about this filthy nuisance, is one of the things that puzzle me today. As for noise, we had no noise at all in the modern sense. The screeching taxi-horn and the shouting radio had not yet been developed. But there were plenty of complaints, and in the intervals of writing pamphlets on rabies and the prevention of sunstroke and inspecting swimming pools and becoming the first editor of the Health Department’s new Monthly Bulletin for the medical profession, I was assigned to nearly every variety of sanitary inspection.

  There can hardly be an obscure corner of Manhattan Island into which I have not poked my official nose at one time or another. Sanitary conditions in New York City thirty years ago were far better than they had been in the fifties when chickens and pigs were running at large in the streets and the tenement houses, but by present-day standards conditions were pretty bad—just about as Jacob Riis described them in How the Other Half Lives. The lower east side of the city has been cleared out and cleaned up today; streets have been broadened and living-conditions improved to such an extent that it seems almost like a new world to me now. But thirty years ago the average tenement house that I visited was an ancient scandal, usually made up in the type of “railroad flats” of from two to four or five rooms in a continuous row with no hallway. Sometimes there would be one family to a room and too often there were boarders. Never a bathroom: that was unheard of. The better places had inside toilets; one to each floor. The older ones had outdoor privies in the backyard or court. The indoor privies were so filthy that I think the people with outdoor privies had slightly the better of it; at least these latter were cleaned out at night by a crew from the Department of Health. You might often find one room used as living-quarters by ten or a dozen people, taking it in shifts with some on night and some on day work. And a large section of the west side of the city was the same; all unutterably filthy and hopeless, particularly Hell’s Kitchen. I grew to know this latter district well.

  It was curious to see how conditions varied, depending upon the particular foreign colony you chanced to meet. The Germans were the cleanest; that was axiomatic. The Italians came next; not only would the front room of an Italian family usually be moderately clean but there would have been some pathetic attempt at brightening the place up with paper flowers, religious pictures and a fancy bedspread. It always amazed me to go into the big colored district, which was between Tenth Avenue and the river in the upper West Fifties then, instead of in Harlem as it is today. That district contained the densest population in town, with one block housing over six thousand people, but they managed to stay decent in spite of that inhuman handicap. The houses were clean in a sad poverty-stricken fashion and the children were kept so clean that I often wondered how it was done; they were always cheerful people too and I liked to work with them. The Irish and the Russian Jews vied for the distinction of living in the most lurid squalor. The Irish did it, as I already knew, out of a mixture of discouragement and apparent shiftlessness, but they were happy people too and soon pulled themselves up out of the ruck. They had an ambition that could survive almost anything. The Russian Jews did it out of thrift. Practically every Russian Jewish family had chosen one son who was to be supported through medical or law school as a way of raising the family fortune and prestige, and every penny that could be spared beyond the barest necessities of life was hoarded for that purpose. While Isador was being educated the whole family worked like mad under sweat-shop conditions and skimped incredibly on food, clothes and rent, not to mention soap and sunlight. Then when the chosen son started making money, they moved out and followed his rising fortunes uptown; first to Lexington Avenue, then to the Bronx, then to Riverside Drive and sometimes finally to Park Avenue or the upper East Fifties or Sixties. That was as regular a progression as spring, summer, autumn, winter. But again, I liked them too. They had not the gaiety of the Italians or the colored people but their ambition did get my respect.

  The self-sufficiency of these Little Italys and these Little Ghettoes was incredible. The men went around a bit; they had to go to different parts of the town to work at their jobs. But the women ate, slept, cooked, washed and minded the baby strictly at home and did all the family buying at the pushcart in the immediate neighborhood. They had no curiosity and it never occurred to them to go outside of that necessary circle. In the years when the Health Department held Better Baby Contests, I went down on the East Side in a Department car to get a mother and her baby who were to be presented with a prize at a ceremony in Central Park. The mother stepped into the car remarking that she had never ridden in one before, which was understandable in 1910. But then she startled me by asking if perhaps she might be able to see a tree in this place to which she was going. She had been born and brought up under the approach to the Brooklyn Bridge and then moved, when she was married, to a tenement not far distant, evidently living all her life in shade so thick that not even the ailanthus trees, which will grow almost anywhere in New York’s slum districts, could take root in her various backyards. Yet it was not that trees were inaccessible; there was a park full of trees only a few blocks from her street. It was just that she had never had any practical occasion to go that far away from home, so she never had.

  The Italians were the cheeriest group as a rule. A call on an Italian family for any purpose whatever generally required you to have a drink with them; usually of some exotic Italian cordial. No matter how destitute they were, the father would always reach in somewhere and produce a dubious looking bottle. In fact there were often several bottles and father would demonstrate both his hospitality and his steadiness of hand by pouring you a pousse-café. Once a day that was a welcome lightener of the day’s labors. But when you were working steadily in Italian neighborhoods, with a dozen or fifteen stops, you might as well have been a young gentleman paying New Year’s calls back in Poughkeepsie. All of these first-generation immigrant families were a great relief because they never showed any surprise at having a woman doctor appear. They were used to midwives in their native lands and, after all, this was a strange and new country and there was always their innate courtesy in accepting anything they found in their new homes. They called me “doc” in all innocence of either disrespect or irony, just because an Italian cannot help cutting syllables off English words.

  Towards the end of this period, it was my fate to take an active—rather too active, in fact—part in the story of Mary Mallon. Typhoid Mary, who came to have no other name, to the public at least, died on November 11, 1938, at the Riverside Hospital of the Department of Health on North Brother Island. She was seventy years old and since 1907 had been virtually a prisoner of the city. The germ of typhoid fever had been isolated in 1884 and several years later Dr. Robert Koch, a great bacteriologist, discovered during an outbreak of typhoid fever in Strassburg, Germany, that a woman who was running a bake shop in that town might be the source of the infection. She had had typhoid fever many years before and tests showed that her body still gave off the germs of typhoid. In 1904 this news came to America. Dr. George A. Soper, an eminent sanitarian, determined to find the truth of this. Starting with an epidemic of typhoid fever occurring in Mamaroneck in 1900, he had been following the trend of these numerous cases. He came upon a curious sequence of outbreaks in private families in different communities. In each family he found that the same woman was the cook, leaving shortly after the outbreak occurred to go on to her next place where, inevitably, typhoid occurred shortly afterward. She was finally located in a house on Park Avenue where several members of the family already were coming down with typhoid fever. Dr. Soper, at that time a sanitary engineer in the Department of Health, asked to have an inspector sent to get certain specimens from Mary
. I was the inspector assigned to this seemingly simple task.

  I learned afterward that Dr. Soper had reason to suspect that Mary might make trouble. But I knew nothing of that and, after all, I was just to get specimens of her blood and urine. When I first interviewed her, Mary was busy at her job in the kitchen of a prosperous Park Avenue household. It was the traditional brownstone-front house in the Sixties. Mary was a clean, neat, obviously self-respecting Irishwoman with a firm mouth and her hair done in a tight knot at the back of her head. Using as much routine tact as possible, I told her what I wanted. Her jaw set and her eyes glinted and she said “No.” She said it in a way that left little room for persuasion or argument. Obviously here was another case of that blind, panicky distrust of doctors and all their works which crops up so often among the uneducated—and among the educated too, for that matter.

  That night I received a telephone call from Dr. Bensel, my superior officer, telling me to be at the corner of Park Avenue and Sixty-seventh Street the next morning at 7:30 where I would find an ambulance and three policemen. We were to go to this house, get the blood and urine specimens and, if Mary resisted, we were to take her to the Willard Parker Hospital, by force if necessary. Of course I was there at the appointed time. Leaving the ambulance at the corner, I placed one policeman around the corner, another in front of the house and with the remaining one I went to the basement door. Mary was on the lookout and peered out, a long kitchen fork in her hand like a rapier. As she lunged at me with the fork, I stepped back, recoiled on the policeman and so confused matters that, by the time we got through the door, Mary had disappeared. “Disappear” is too matter-of-fact a word; she had completely vanished. In a three-hour search we discovered only one clue: a chair set by the high fence between this house and the adjoining one with footprints in the snow leading to it. So, much to the bewilderment of its occupants, we searched that house too; but still no Mary. The rest of the servants denied knowing anything about her or where she was; even in my distress, I liked that loyalty. Further search seemed useless. I went over to Third Avenue and telephoned Dr. Bensel that Mary could not be found. Dr. Bensel was laconic. “I expect you to get the specimens or to take Mary to the hospital.” And then he rang off. On my discouraged way back to the house, I commandeered two more policemen whom I found by the way. And then we started in again. For another two hours we went through every closet and nook and cranny in those two houses. It was utter defeat. I was trying to decide how I would face Dr. Bensel, when one of the policemen caught sight of a tiny scrap of blue calico caught in the door of the areaway closet under the high outside stairway leading to the front door. A dozen filled ashcans were heaped up in front of this door; another evidence of class solidarity. The ashcans were removed and the door opened and there was Mary. Once the door was opened she wasted no time. She came out fighting and swearing, both of which she could do with appalling efficiency and vigor. I made another effort to talk to her sensibly and asked her again to let me have the specimens, but it was of no use. By that time she was convinced that the law was wantonly persecuting her, when she had done nothing wrong. She knew she had never had typhoid fever; she was maniacal in her integrity. There was nothing I could do but take her with us. The policemen lifted her into the ambulance and I literally sat on her all the way to the hospital; it was like being in a cage with an angry lion.