Get Well Soon

by Jennifer Wright

  Maybe I’m a bohemian crank too, but I don’t think there is anyone in this book more heroic than Father Damien. He never confused the disease with the person suffering from it. He served as a role model to countless future heroes and heroines, most notably Mother Teresa, who specifically asked if he could be the saint for her congregation in 1984. At that time, he had not yet been canonized, as it was said that he had not performed miracles. Mother Teresa wrote to the pope claiming that she believed his two miracles were, first, “the removal of fear from the hearts of the lepers to acknowledge the disease and proclaim it and ask for medicine—and the birth of the hope of being cured.” And second, the miraculous transformation of the community on Molokai to exhibit “greater concern, less fear, and readiness to help.”55

  However you feel about religion—because I do not want to get too truly he followed in the footsteps of Christ here—Damien is proof that kindness and love and compassion can be stronger forces than fear, even the fear of death. That’s a good thing because we’re all going to die. None of us can beat death. And so, perhaps, like Damien, we can go out into the world bravely and make it better for the time we are alive.

  Individuals can change global perspectives on, well, just about anything. Before Damien’s intercession people considered lepers barely human. I don’t think Mother Teresa is overstating her case when she says that he performed a miracle in making people less afraid and more eager to fight against the miseries of the world.

  In all likelihood, nobody reading this chapter is going to contract leprosy. A lot of the credit for that goes to Damien. He may not have found a cure—because not everyone’s role is “being a doctor”—but his bravery raised awareness and inspired others to work for one. Not all of us can be expected to live up to Damien’s legacy, and not everyone needs to. There are lots of ways to help people on a smaller scale and without endangering your own health. But Damien is a reminder that you don’t have to be a genius or a brilliant scientist or a doctor to help in this war against disease: you just have to be someone who gives a damn about your fellow man.

  Typhoid

  War is not an adventure.

  War is disease. Like typhoid.

  —ANTOINE DE SAINT-EXUPÉRY

  If you take nothing else away from this book, I hope it’s that sick people are not villains. They are unwell. It’s impossible to say this enough. They should be sympathized with, instead of being declared sinners or degenerates or so many of the other negative labels society chooses to use. Diseases are villains and should be hunted down and combatted accordingly. Separating the disease from the diseased seems crucial if we are to be decent and compassionate people.

  But having a disease doesn’t necessarily make someone a good person. In certain cases diseased people do seem to lapse into villainy, and there’s no more interesting example of this phenomenon than the story of Mary Mallon.

  Mary Mallon’s life in the United States was flourishing in 1907, perhaps going even better than her fellow Irish immigrants could have hoped for during that time period. She had come to America as a teenager, and by the time she was thirty-seven, her superb cooking skills had earned her employment with an upper-crust family living on Park Avenue in New York City. She was earning around $45 a month. That would equate to $1,180 today, which may seem low but was a good salary for a cook at the time.1

  Now, you might ask, especially if you are reading this chapter on your lunch break, what were Mary Mallon’s specialties?

  Desserts.

  If you were a wealthy person in the late nineteenth/early twentieth century, desserts centered on ice cream. It had become especially popular following the publication of Agnes Marshall’s two cookbooks about ice cream in 1885 and 1894.2

  Mary Mallon was known for her peach melba, which is basically vanilla ice cream with peaches and raspberry sauce. It looks like a very healthy sundae with no sprinkles (because sprinkles were not invented until the 1930s). The summer of 1906 was a great time for peaches, according to the Long Islander newspaper, which reported “the largest and finest peaches that have been shown in town this season.”3 So Mary would have had the means to make a great deal of her specialty on a regular basis.

  All of this could have been wonderful. Mary Mallon’s story could be a nice account of an immigrant who made good in America by virtue of her cooking skills. It could be adapted by the Hallmark Channel, and people would watch it on National Ice Cream Day (the third Sunday in July). The close-up shots of Victorian/Edwardian ice cream would be delightful.

  Unfortunately for Mary, her employers, and the producers at Hallmark, she was not well. Her body was teeming with Salmonella typhii, the bacteria that result in typhoid fever.4 If people are infected with Salmonella typhii, their feces or, more rarely, their urine will contain the bacteria. That means that if they don’t clean their hands thoroughly before preparing food, they might pass the bacteria on to the diners. Typhoid can also be spread by drinking water that’s been contaminated by the bacteria. Even eating shellfish from a polluted body of water could pass on the disease. At the turn of the century, if untreated, the disease resulted in death about 60 percent of the time. Today, antibiotics reduce the risk of fatality to almost zero.5

  That said, typhoid fever is still prevalent in many periphery countries, and the Centers for Disease Control and Prevention (CDC) suggests that if you’re in one of those locales you should “boil it (water), cook it (food), peel it (fruit), or forget it.” Vaccinations are also available. If you’re traveling to a country where typhoid fever is still present, you should get a vaccination so your feeble little core country immune system does not experience the extremely high fever (generally around 103 or 104 degrees, compared to the fever from the flu, which usually tops out at 101 degrees), headaches, muscle weakness, and diarrhea associated with the disease.

  If you do not worry very much about contracting typhoid fever in your daily life, well, neither did wealthy people at the turn of the century. It was a disease associated with the urban poor, who, especially prior to the Tenement House Act of 1901, often lived in overcrowded and unsanitary conditions.

  But the rich could contract typhoid if their food was handled by someone shedding Salmonella typhii bacteria. A cook could transfer those germs to the food easily. An investigator would later say, “I suppose no better way could be found for a cook to cleanse her hands of microbes and infect a family.”6 That wouldn’t be so bad if the food was cooked. Cooking, as the CDC points out, will kill the bacteria. But on uncooked food—like ice cream—germs could slide into your intestines and thrive in their warm, moist environment. In the course of a day, a single bacterium cell can multiply into 8 million cells. They’re just like beautiful little sea monkeys that way.

  So would you hire a cook who appeared to have typhoid fever? Not unless you had a death wish. No one would hire a woman who was visibly ill to prepare their food. A woman who was ill with a temperature of 104 degrees probably wouldn’t be able to prepare food to begin with. As long as everyone knew who made the food, and that person wasn’t ill, everyone should be fine. Right?

  Nope!

  Here’s the twist: Mary Mallon was an asymptomatic carrier of typhoid. Although she carried the bacteria inside her and could transmit it to others, she never suffered any of the symptoms herself. This is as close as someone can get to having a villainous superpower in real life.

  But Mary didn’t know she was spreading the disease. Yet considering the extent to which everyone around her contracted typhoid, she must have suspected she was at least very unlucky. Mary left a trail of illness wherever she went. The basic timeline of her employment goes like this:7

  Summer 1900, Mamaroneck, New York: Mary worked for a family for three years and killed only one person. He was a visitor who became sick with typhoid about ten days after he arrived.

  Winter, 1901–02, New York City: Mary infected a family’s laundress during her eleven-month tenure.

  Summer 1902, Dark Harbor, Maine:
When Mary worked for the family of J. Coleman Drayton, seven of the nine members of the household (four members of the family, five servants) became ill, which led doctors to believe that … the footman did it. Really. As in a murder mystery where the characters think the butler is too obvious a suspect.

  Summer 1904, Sands Point, New York: Four servants became sick. Doctors assumed that the laundress must have brought the disease.

  Summer 1906, Oyster Bay, New York: Six of the eleven people in the Charles Henry Warren household became infected (three family members and three servants). This time people suspected the water supply might have been contaminated, and that the workers cleaning the water tank might have carried in the contagion on their boots.

  Autumn 1906, Tuxedo Park, New York: A laundress became ill shortly after Mary arrived at the home of George Kessler.

  Winter 1907, New York City: Mary began working at the Park Avenue home of Walter Brown. Two months after she was hired a maid became ill with typhoid, then the family’s daughter contracted it and died.

  Mary infected a total of twenty-two people. Is twenty-two a plague? No, of course not! It is approximately “an awful lot of people to have for Thanksgiving, too many, really” or “a manageable classroom size.” The particular strain of the disease spread by Mary Mallon was not so widespread as to qualify as a plague. Indeed, in wealthy areas like Oyster Bay there seemed to be no other cases of infection beyond those in the house Mary occupied.8

  That is not to say that, overall, typhoid itself isn’t a plague. It still affects approximately 21.5 million people a year worldwide according to the CDC. The disease as it affected Mary and the people who came into contact with her is just one fascinating case of a much larger issue. But it’s still the most fun to look at, as the outbreak surrounding Mary Mallon ties to some serious early twentieth-century sleuthing and tabloid journalism. And Sherlock Holmes–style investigating and sensational reporting were the best things about the 1900s. Those things and the nontyphoid ice cream.

  The Sherlock Holmes figure in this case was a sanitation engineer named George A. Soper. The outbreak might never have been traced if the owners of the house in Oyster Bay—who had rented it to the Warrens in the summer of 1906—weren’t concerned that they wouldn’t be able to rent their house again. Accordingly, they were more diligent in investigating the root of the disease than the other affected families. They had every water source that might be contaminated tested. All of those tests came back negative. Stymied, they hired Soper, who had successfully investigated several typhoid outbreaks in the past.

  Soper did not immediately think, Probably the perfectly healthy cook caused the typhoid outbreak because no one at the time would consider that possibility. He initially assumed the Warrens became ill because they were eating contaminated clams, which they routinely bought from a woman who lived in a tent and who found her catch in areas filled with sewage. But then he realized, “If clams had been responsible for the outbreak it did not seem clear why the fever should have been confined to this house. Soft clams form a very common article of diet among the native inhabitants of Oyster Bay.”9

  Apparently, everyone on Long Island ate probably polluted clams, which is awful. Well, for everyone except the tent woman, who was doing a brisk business with her sewage catch.

  Soper knew that the first person in the Warren house who became sick fell ill on August 27, so he began looking for any significant changes to the family’s situation just before then. He found that they had hired their new cook, Mary Mallon, on August 4, three weeks earlier. Soper understandably wanted to question her—perhaps to see if she had been serving anything more horrifying than clams fished out of sewage—but she had left the family three weeks after the typhoid outbreak. He began researching her employment history and found the unusually high instance of typhoid in each of the places she had worked.

  By early March 1907 he found Mary at her new employer’s Park Avenue address. He asked the healthy—indeed, robust—Mary to provide specimens so he could test to see if she had typhoid fever. The request honestly didn’t entail all that much. Soper just needed to see if bacteria showed up in her urine, blood, or stool. On the whole, the process would have likely been less invasive than your annual physical. But Mary was not having it. And why should she? She was in perfect health, and the idea of being an asymptomatic carrier was barely known within the medical community in 1907. She refused and forced Soper from the house, furiously brandishing a carving fork at him. Not deterred, Soper returned with a medical colleague, and, again, Mary sent them away.10

  So on March 11, 1907, Soper appealed to the New York Health Department. He explained that he had not been able to get Mary’s consent to an examination, but that he believed “the cook was a competent cause of typhoid and a menace to the public health.”11 The department responded by sending an inspector named Dr. Sara Josephine Baker to visit Mary. Perhaps it assumed the two might get along better because Dr. Baker was a woman. It might have also thought, given that Baker had decided to become a doctor after her father and brother died of typhoid (despite her family’s protestations that such a career choice was an “unheard of, harebrained and unwomanly scheme”),12 that she would be able to convey to Mary the importance of protecting other people from typhoid.

  When Dr. Baker arrived, Mary attempted to stab her in the neck, again with her trusty carving fork. Dr. Baker leaped back into the hallway. She later wrote, “I learned afterward that Soper had reason to suspect that Mary might make trouble, but I knew nothing of that.”13 Mary fled. Dr. Baker called the police, who helped her search the house. They found Mary in one of the closets. Given that it took five hours to find her, one can only assume none of them were great at playing hide-and-seek as children. When Mary was discovered, Dr. Baker wrote, “She came out fighting and swearing, both of which she could do with appalling efficiency and vigor.”14

  That Mary. She had spunk!

  The police subdued her and took her to the Willard Parker Hospital.15 Dr. Baker claimed, “I sat on her all the way to the hospital. It was like being in a cage with an angry lion.”16 She would later state, “The hardest dollars I ever earned were those as a $100 a month Health Department employee when I was sent to get Mary Mallon.”17

  When Mary was finally tested at the hospital, doctors found that her stool was filled with typhoid bacteria. Her blood also tested positive for the disease.18

  In an effort to isolate Mary, the health department moved her to a home on the Riverside Hospital grounds on North Brother Island, a small island in New York City’s East River. Here, it suddenly becomes clear why Mary fought being taken away. She would be a virtual prisoner for the next three years. On North Brother Island Mary claimed that she was treated “like a leper” and that she had to live in an isolated house with only a dog for a companion.19 Her abode was said to be either a “shack,” a “pig-sty [with] a bad stench,” or “a lonely little hut,” depending upon the source.20 None of those sounds good. While she was there she submitted 163 cultures, of which three-quarters tested positive for typhoid.21 The fact that she definitely carried typhoid may have made the examiners feel justified in their treatment of Mary, but it did nothing to assuage her unhappiness. Later she would recall, “When I first came here I was so nervous and almost prostrated with grief and trouble. My eyes began to twitch, and the left eyelid became paralyzed and would not move. It remained in that condition for six months.”22 Despite the fact that there was an eye specialist on the island, he never visited Mary. She occupied some of her time writing letters to Soper and Dr. Baker, threatening to kill them when she got out, to which Dr. Baker noted, “I could not blame her for feeling that way.”23 Soper remarked, “She could write an excellent letter.”24

  In 1909 reporters at the New York American told the story of her situation, describing Mary Mallon as “Typhoid Mary.” They wrote: “It is probable that Mary Mallon is a prisoner for life. And yet she has committed no crime, has never been accused of an immoral or w
icked act, and has never been a prisoner in any court, nor has she been sentenced to imprisonment by any judge.”25 Totally true. Mary was quick to respond. In June 1909 she wrote a letter to the editor of the New York American, which was never published, explaining her frustration: “In reply to Dr. Park of the Board of Health I will state that I am not segregated with the typhoid patients. There is nobody on this island that has typhoid. There was never any effort by the Board authority to do anything for me excepting to cast me on the island and keep me a prisoner without being sick nor needing medical treatment.”26

  Were the doctors trying to cure her? Well, kind of. In addition to taking a ton of samples of her bodily functions, Mary claimed:

  [An authority] went to that doctor, and he said, “I cannot let that woman go, and all the people that she gave the typhoid to and so many deaths occurred in the families she was with.” Dr. Studdiford said to this man, “Go and ask Mary Mallon and enveigle her to have an operation performed to have her gallbladder removed. I’ll have the best surgeon in town to do the cutting.” I said, “No. No knife will be put on me. I’ve nothing the matter with my gallbladder.” Dr. Wilson asked me the very same question. I also told him no. Then he replied, “It might not do you any good.” Also the supervising nurse asked me to have an operation performed. I also told her no, and she made the remark, “Would it not be better for you to have it done than remain here?” I told her no.27