On some level, the nuclear problem may turn out to be one that we never solve, and the ultimate question will turn out to be how often a rogue nation or terrorist cell manages to get its hands on one of these devices. Perhaps urban nuclear explosions will turn out to be like hundred-year storms: a bomb goes off once a century, millions die, the planet shudders in horror, and slowly goes about its business. If that’s the pace, then as horrible as such a catastrophe would be, the long-term sense of urban sustainability would likely remain intact. But if the trends of asymmetric warfare continue, and the suicide bombers start detonating suitcase nukes every ten years—at that point, all bets are off.
AND SO OUR CONVERSION TO A CITY-PLANET IS BY NO means irreversible. The very forces that propelled the urban revolution in the first place—the scale and connectedness of dense urban living—could be turned against us. Rogue viruses or weapons could once again turn urban areas into sites of mass death and terror. But if we are to keep alive the model of sustainable metropolitan life that Snow and Whitehead helped make possible 150 years ago, it is incumbent on us to do, at the very least, two things. The first is to embrace—as a matter of philosophy and public policy—the insights of science, in particular the fields that descend from the great Darwinian revolution that began only a matter of years after Snow’s death: genetics, evolutionary theory, environmental science. Our safety depends on being able to predict the evolutionary path that viruses and bacteria will take in the coming decades, just as safety in Snow’s day depended on the rational application of the scientific method to public-health matters. Superstition, then and now, is not just a threat to the truth. It’s also a threat to national security.
The second is to commit ourselves anew to the kinds of public-health systems that developed in the wake of the Broad Street outbreak, both in the developed world and the developing: clean water supplies, sanitary waste-removal and recycling systems, early vaccination programs, disease detection and mapping programs. Cholera demonstrated that the nineteenth-century world was more connected than ever before; that local public-health problems could quickly reverberate around the globe. In an age of megacities and jet travel, that connectedness is even more pronounced, for better and for worse.
In many ways the story of the past few years is not an uplifting one, where these two objectives are concerned. Intelligent design “theory” continues to challenge the Darwinian model, in the courts and in public opinion; the United States appears to be spending more time and money proposing new nuclear weapons than eliminating the ones we have; public-health spending is down per capita; as I write, Angola is suffering through the worst outbreak of cholera in a decade.
But if our current prospects seem bleak, we need only think of Snow and Whitehead on the streets of London so many years ago. The scourge of cholera then seemed intractable, too, and superstition seemed destined to rule the day. But in the end, or at least as close to the end as we’ve gotten so far, the forces of reason won out. The pump handle was removed; the map was drawn; the miasma theory was put to rest; the sewers were built; the water ran clean. This is the ultimate solace that the Broad Street outbreak offers us in our current predicament, with all its unique challenges. However profound the threats are that confront us today, they are solvable, if we acknowledge the underlying problem, if we listen to science and not superstition, if we keep a channel open for dissenting voices that might actually have real answers. The global challenges that we face are not necessarily an apocalyptic crisis of capitalism or mankind’s hubris finally clashing with the balanced spirit of Gaia. We have confronted equally appalling crises before. The only question is whether we can steer around these crises without killing ten million people, or more. So let’s get on with it.
AUTHOR’S NOTE
THIS BOOK IS A HISTORICAL NARRATIVE OF THE EVENTS OF September 1854 in London based on the many surviving eyewitness accounts and the exhaustive investigations by the authorities in the months after the outbreak subsided. Any direct dialogue quoted in the text comes from those firsthand accounts, and where ambiguities exist about names or the timing of events, I have made a note of it in the text or in the endnotes. The one literary convention that I have adopted is to attribute thoughts to some of the individuals at specific points in the narrative. In each case, the historical record is clear that the thought did occur to them at some point during the outbreak and its aftermath; I have simply made an educated guess as to when exactly the thoughts first came to mind.
ACKNOWLEDGMENTS
It occurred to me somewhere in the middle of writing The Ghost Map that this was a book I’d been preparing for almost twenty years, ever since I decided to do my undergraduate thesis on the way cultures respond to epidemics. In grad school a few years later, my primary focus was the metropolitan novel in Victorian society, specifically the imaginative challenge that confronted anyone who tried to represent the overwhelming experience that was London in that period. To the professors and friends who guided me then—Robert Scholes, Neil Lazarus, Franco Moretti, Steven Marcus, and the late Edward Said—thank you for steering me toward Broad Street with such intelligence and patience.
I’m indebted to a number of people who read the manuscript and improved the book immensely with their thoughts and corrections: Carl Zimmer, Paul Miller, Howard Brody, Nigel Paneth, Peter Vinten-Johansen, and Tom Koch. A number of scholars were kind enough to comment on specific sections of the manuscript, or to answer my questions about the material: Sherwin Nuland, Steven Pinker, Ralph Frerichs, John Mekalanos, Sallie Patel, and Stewart Brand. My research assistant, Ivan Askwith, was once again an invaluable collaborator, as was Russell Davies, who came through with some last-minute additions from the streets (and libraries) of London. Whatever errors remain are mine alone.
I’m grateful to the many libraries whose resources I drew on in my research: those of Harvard, MIT, and NYU, and the New York Public Library. I am particularly indebted to two London institutions: the Wellcome Library for the History and Understanding of Medicine and, of course, the peerless British Library—even the remote newspaper reading rooms in Colindale. My editors at Wired and Discover—Steve Petranek, Dave Grogan, Chris Anderson, Ted Greenwald, Chris Baker, Mark Robinson, and Rob Levine—helped me explore, over the past few years, a number of the themes addressed in the closing chapters here. I’m also grateful for the friends who have made London such a wonderful place to visit, and who inspired me to write a book about the city in the first place: Hugh Warrender, Richard Rogers, Ruthie Rogers, Roo Rogers, Brian Eno, Helen Conford, and Stefan McGrath.
At Riverhead, I’m grateful for the support from the publicity team—Kim Marsar, Matthew Venzon, and Julia Fleischaker—who helped me survive the madness of Everything Bad’s media frenzy while I was writing this book. Thanks to Larissa Dooley for being on top of a million different threads at the same time. And thanks to my fearless editor, Sean McDonald, who sets some kind of record by being the first editor to make it through two books of mine. As for my agent, Lydia Wills—I got all gushy in the last acknowledgments and it’s really gone to her head since then, so I’m not mentioning her at all this time around.
But as always, the acknowledgments begin and end with my wife, Alexa—the closest of readers—and our three boys: Clay, Rowan, and the latest addition, born not five days ago as I write, Dean.
Brooklyn
July 2006
APPENDIX:
NOTES ON FURTHER READING
THERE ARE TWO INDISPENSABLE RESOURCES FOR UNDERstanding the life and work of John Snow. The first is the exhaustive Web archive devoted to all things Snow, maintained by the UCLA epidemiology professor Ralph Frerichs. The site, accessible at www.ph.ucla.edu/epi/snow.html, has everything from annotated reproductions of various maps of the period to a multimedia tour of the Broad Street outbreak to a complete digital collection of Snow’s writing. The second is Cholera, Chloroform, and the Science of Medicine, written by a multidisciplinary team of scholars (Peter Vinten-Johansen and o
thers) from Michigan State University. The book is both a biography of Snow himself and a clear and insightful survey of the intellectual landscape he traveled during the course of his life. Both resources were essential to the writing of this book, and I highly recommend them for anyone interested in exploring John Snow’s work in more detail.
For readers interested in the map itself, and in Snow’s legacy as an information designer, Edward Tufte’s account is by now the canonical one, though his initial telling of the story—in his 1983 book The Visual Display of Quantitative Information—was factually wrong on several fronts, as he acknowledged in his subsequent work, Visual Explanations, which offered a more nuanced account of the Broad Street outbreak (and which managed to reproduce Snow’s map itself, instead of the secondhand copy that ran in the first book). Tom Koch’s brilliant Cartographies of Disease offers a comprehensive look at Snow’s place in the specific tradition of disease mapping.
There are innumerable portraits of Victorian London, but Henry Mayhew’s London Labour and the London Poor is still the most riveting and thorough account of the city’s vast underclass, rivaled only by Engels’ London chapters from The Condition of the English Working Class. Among the contemporary accounts, Liza Picard’s Victorian London, Roy Porter’s London: A Social History, and Peter Ackroyd’s London: A Biography are all worth reading. On the future of cities, I recommend Stewart Brand’s essay “City Planet” and Richard Rogers’ Cities for a Small Planet. The best account of the psychological and cultural impact of urbanization remains Raymond Williams’ masterly The Country and the City. Stephen Halliday’s The Great Stink tells the amazing story of Joseph Bazalgette’s battle to build London’s sewer system. For a modern look at waste management, I recommend William Rathje and Cullen Murphy’s Rubbish: The Archaeology of Garbage. Readers interested in the social history of beverages—including tea, coffee, and spirits—will want to read Tom Standage’s A History of the World in Six Glasses.
On the scale of bacteria, the seminal work in the field remains Lynn Margulis and Dorion Sagan’s mind-opening Microcosmos. Though it doesn’t deal directly with cholera, Carl Zimmer’s Parasite Rex is also a fascinating exploration of our microscopic fellow-travelers. For a unnerving look at the failure of modern public-health infrastructure, see Laurie Garrett’s Betrayal of Trust.
The story of the Broad Street outbreak itself has been sketched in numerous books, usually with significant distortions. Many accounts assume that Snow created the map during the outbreak, or that he developed the waterborne theory from his investigations at Broad Street. Henry Whitehead is often ignored altogether. And so the best sources for understanding the outbreak are still John Snow and Henry Whitehead themselves. Their various published accounts of the events are available online at the UCLA site, and at a special John Snow archive hosted by Michigan State University.
NOTES
page 2 Beside them fluttered the mud-larks Mayhew, p. 150.
page 2 Above the river, in the streets “The pure collected is used by leather-dressers and tanners, and more especially by those engaged in the manufacture of morocco and kid leather from the skins of old and young goats, of which skins great numbers are imported, and of the roans and lambskins which are the sham morocco and kids of the ‘slop’ leather trade, and are used by the better class of shoemakers, bookbinders, and glovers, for the inferior requirements of their business. Pure is also used by tanners, as is pigeon’s dung, for the tanning of the thinner kinds of leather, such as calf-skins, for which purpose it is placed in pits with an admixture of lime and bark. In the manufacture of moroccos and roans the pure is rubbed by the hands of the workman into the skin he is dressing. This is done to ‘purify’ the leather, I was told by an intelligent leatherdresser, and from that term the word ‘pure’ has originated. The dung has astringent as well as highly alkaline, or, to use the expression of my informant, ‘scouring,’ qualities. When the pure has been rubbed into the flesh and grain of the skin (the ‘flesh’ being originally the interior, and the ‘grain’ the exterior part of the cuticle), and the skin, thus purified, has been hung up to be dried, the dung removes, as it were, all such moisture as, if allowed to remain, would tend to make the leather unsound or imperfectly dressed.” Mayhew, p. 143.
page 2 “What world does a dead man belong to?” Dickens 1997, p. 7.
page 3 “It usually takes the bone-picker” Mayhew, p. 139.
page 4 “the most disagreeable in the whole range of manufacture” Mayhew, p. 143.
page 5 “The removal of the refuse of a large town” Mayhew, p. 159. “Now the removal of the refuse of London is no slight task, consisting, as it does, of the cleansing of 1,750 miles of streets and roads; of collecting the dust from 300,000 dust-bins; of emptying (according to the returns of the Board of Health) the same number of cesspools, and sweeping near upon 3,000,000 chimneys.” Mayhew, p. 162.
page 5 the Colosseum served as a de facto quarry Rathje and Murphy, p. 192.
page 7 But if the bacteria disappeared overnight “In fact, so significant are bacteria and their evolution that the fundamental division in forms of life on Earth is not that between plants and animals, as is commonly assumed, but between prokaryotes—organisms composed of cells with no nucleus, that is, bacteria—and eukaryotes—all the other life forms. In their first two billion years on Earth, prokaryotes continuously transformed the Earth’s surface and atmosphere. They invented all of life’s essential, miniaturized chemical systems—achievements that so far humanity has not approached. This ancient high biotechnology led to the development of fermentation, photosynthesis, oxygen breathing, and the removal of nitrogen gas from the air. It also led to worldwide crises of starvation, pollution, and extinction long before the dawn of larger forms of life.” Margulis, p. 28.
page 8 No extended description of London Punch (27, September 2, 1854, p. 102) even captured the stench of the metropolis in verse:
In every street is a yawning sewer;
In every court is a gutter impure;
The river runs stinking, and all its brink
Is a fringe of every delectable stink:
Bone-boilers and gas-workers and gut-makers there
Are poisoning earth and polluting air.
But touch them who dares; prevent them who can;
What is the Health to the Wealth of man?
page 9 drowned in human shit Halliday 1999, p. 119.
page 10 “I found whole areas of the cellars” Halliday 1999, p. 40.
page 10 “a heap of dung” Picard, p. 60.
page 10 “We then journeyed on to London-street” Mayhew, London Morning Chronicle, September 24, 1849.
page 11 The visitors no doubt marveled Halliday 1999, p. 42.
page 13 “The corpses [of the poor]” Engels, p. 55.
page 13 “up to my knees in human flesh” Picard, p. 297.
page 14 “a hemmed-in churchyard” Dickens 1996, p. 165.
page 14 “There is no document of civilization” Benjamin, p. 256.
page 16 Eventually, the city’s inexorable drive Summers, pp. 15–17.
page 17 Another Blake brother opened a bakery Summers, p. 121.
page 17 “In that quarter of London” Charles Dickens, Nicholas Nickleby (London: Penguin, 1999), pp. 162–63.
page 18 “[The flat] has two rooms” Quoted in Summers, p. 91.
page 21 Sometime in the late 1840s Vinten-Johansen et al., p. 283.
page 22 Plagues and political unrest The radical democrat James Kay-Shuttleworth described cholera as an opportunity to explore “the abodes of poverty… the close alleys, the crowded courts, the over-peopled habitations of wretchedness, where pauperism and disease congregate round the source of social discontent and political disorder in the centre of our large towns, and behold with alarm, in the hotbed of pestilence, ills that fester in secret, at the very heart of society.” Quoted in Vinten-Johansen et al., p. 170.
page 26 “Mind you, the man” Rawnsley, p. 4.
p
age 26 “One does not realize” Rawnsley, p. 32.
pages 27–28 In some cases, cows were lifted Picard, p. 2.
page 28 defining the region that the “gentleman” Rawnsley, p. 34.
page 28 forced to perform arduous labor Workhouses had existed in one form or another for centuries, but the Poor Law Amendment Act of 1834 had greatly increased their number, and the severity of the “punishment” they dealt out to the pauper classes of the day. “Under the new Act, the threat of the Union workhouse was intended… as a deterrent to the able-bodied pauper. This was a principle enshrined in the revival of the ‘workhouse test’—poor relief would only be granted to those desperate enough to face entering the repugnant conditions of the workhouse. If an able-bodied man entered the workhouse, his whole family had to enter with him. Life inside the workhouse was… to be as off-putting as possible. Men, women, children, the infirm, and the able-bodied were housed separately and given very basic and monotonous food such as gruel, or bread and cheese. All inmates had to wear the rough workhouse uniform and sleep in communal dormitories. Supervised baths were given once a week. The able-bodied were given hard work such as stone-breaking or picking apart old ropes.… The elderly and infirm sat around in the day-rooms or sick-wards with little opportunity for visitors. Parents were… allowed limited contact with their children—perhaps for an hour or so a week on Sunday afternoon.” See http://www.workhouses.org.uk/.
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