Typhoid Mary

by Judith Walzer Leavitt

  The longest-running stage play of Mary Mallon’s story to date is Mark St. Germain’s 1989 Forgiving Typhoid Mary.33 Produced multiple times, and once starring Estelle Parsons in the title role, the play has achieved recognition and critical praise. Time Magazine named it “one of the ten best plays of 1991.”34 Two scenes frame the action: one, Mary’s memory of her loving relationship with a young girl in her care (who died from typhoid fever), and two, Mary’s cottage on North Brother Island during her first isolation in 1909 and 1910. There is a short epilogue that takes place in the 1930s. Two physicians, one a sympathetic man and the other an angry and dismissive woman, and a priest, who is scared but caring, interact with Mary. The basic outline of Mallon’s story unfolds during the play, and around it the playwright creates various responses to the problems posed by the healthy carrier, the most notable of which is, “What is to be done and who will be responsible?”

  The characters demonstrate a range of attitudes toward Mallon from complete rejection and blame to fear to understanding. In turn, they try sympathy, isolation, radical medical treatments, release from quarantine, and again isolation to solve the problem Mallon poses. The priest loses confidence in the Church’s ability to address such a thorny dilemma and ultimately leaves the priesthood. The male physician remains kindly but incapable of bringing about a lasting solution. The woman physician, whose job it is to obtain specimens and explain treatment procedures to Mary Mallon, is unable to let go of her rigid interpretation of what science demands until a touching scene toward the end of the play, which moves her toward understanding and warmth. Even so, she cannot bring herself to sit down and drink tea with Mary Mallon. Mallon herself evolves in the play from a dish-breaking, angry, resistant woman who only wants to get out of her confinement to one who gains insight, makes some concessions to the science she does not understand, and reveals a caring concern for the people who work with her. She slowly comes to terms with her complicity in the young girl’s death: “I killed her. I killed my little girl.” She understands why the doctor cannot sit down to tea. But despite her new insight, when they release her, she returns to her deadly cooking and demonstrates that she, too, cannot alone solve the problem her situation poses.

  St. Germain sets up the dilemma of what to do about Mary Mallon very much in the context of the 1980s and 1990s. As the program notes for the 1995 Minneapolis production advised, “The life of the infamous cook who contaminated New York in the early part of this century has vital importance today.” A post-show forum focused on “Rights and Responsibilities: The Dynamic Interface Between Individual and Public ‘Health.’ ”35 The play purposely leaves ambiguous how to reconcile Mallon’s right to freedom and her doctors’ need to protect the public’s health so that St. Germain can engage his audiences in using Mary Mallon’s early-twentieth-century story to think about what is, to him, an end-of-the-century problem.

  Carolyn Gage’s 1990 one-woman, one-act play, Cookin with Typhoid Mary, gives another present-day vivid meaning to Mary Mallon’s predicament. Gage transforms the view of Mallon as a public menace into a story that reveals the health department as the “real public enemy.” In the play, Mallon calls George Soper “that devil of a doctor” and a “nasty little pig-eyed bastard holdin’ his hat over his privates like he’s got somethin’ to be ashamed of.” A strong and belligerent Mary Mallon preparing potatoes in the Sloane Maternity Hospital kitchen has a clear analysis of her situation: “If you’re a woman and you’re Irish, they think they can say anything they like, and you’ve got to take it. Not this woman. Not Mary Mallon.” Gage’s cynical and knowing Mallon laughs, “Made me sign a paper that I’d never cook for a livin’ again. Now that was charitable of them, don’t you think? Maybe they was hopin’ I’d hire on as president of a bank.” In Gage’s mind, Mallon knows the health department did not do right by her and puts the blame back on the public officials. Gage speaks to a 1990s audience of women by presenting a resistant, strong-minded, foul-language version of Mary Mallon, democratically cooking potato stew for the masses, against a health department that protects the rich over the starving immigrants. Even as Gage strains against the common negative portrayals of Typhoid Mary, though, her own Mallon retains a nasty edge.36

  Gage has given us a powerful, victimized, and innocent Mary Mallon. The contrast to Gage’s characterization in John Steele Gordon’s 1994 article on Mallon in American Heritage shows the range of interpretations still available in the 1990s. While sympathetic, Gordon implies that Mary Mallon deserved considerable blame for her situation. He likens her case, that of a cook not allowed to invite anyone to dinner, to that of a poet or a painter whose artistic compositions will remain forever unseen. He admits that “she probably had no knowledge of the latest theories about typhoid.” But he cannot help wondering “if she did not, at some level at least, suspect something. Certainly the disease followed her about like an incubus.”37 In a radio interview, Gordon explained that Mary Mallon must have known she was a carrier of typhoid because she changed jobs so frequently, usually after typhoid fever broke out in the families for whom she had cooked. “It’s hard for me to imagine that she didn’t at least at some level understand that it must have been connected with her,” Gordon concluded.38

  Most recent renderings of Mary Mallon, especially the theatrical productions, try to cast her story in a positive or sympathetic frame. But the negative meaning of the phrase “Typhoid Mary” has continued to influence the tellings of her story. Indeed, the term has a life of its own and is increasingly called upon as an abstract referent. Sometimes the phrase is used in the popular press in directly analogous ways. For example, Jane E. Brody used it in her “Personal Health” column in the New York Times in an article on toxic shock syndrome. Brody noticed that it was very difficult to avoid the organism responsible because so many people carried the staphylococcal bacteria that produce the deadly toxin: “Most of these ‘Typhoid Marys,’ among them health care providers,” Brody wrote, “are immune to the toxin but can spread the organism to others who are susceptible.”39

  The transference of the phrase outside of medicine is more telling of how deeply into our culture it reaches. Typhoid Mary has a dictionary definition as a noun, “A person from whom something undesirable or deadly spreads to those nearby.” Or, “one that is by force of circumstances a center or focus from which something undesirable spreads.”40 The examples of how our language has adopted the symbol as part of the common lexicon are numerous. In the legal profession the term is applied to lawyers who move from one firm to another and in the process move to the opposite side of an active case. Such a lawyer becomes a “Typhoid Mary” because he or she can, because of previous knowledge, infect the new firm, which in turn might be disqualified from representation of their clients.41

  A New York Times columnist wrote that a Senate Committee asking Richard Nixon if he thought presidents might for national security reasons undertake illegal activities was “a little like asking Typhoid Mary for advice on communicable diseases.”42 A Wall Street Journal editor praising the Republican party in 1988 for making specific and detailed proposals in its election-year platform wrote that conversely, “The Democrats in Atlanta last month issued a 4,500-word manifesto that treated specifics like Typhoid Mary.”43 A Newsweek story about how American urban violence affected Japanese-American trade talks, quoted one Japanese student saying, “You’re like Typhoid Mary trying to cure the plague.”44 “Saturday Night Live” comedians joke, “I’m going to a banquet. It’s being catered by Typhoid Mary.”45 Arthur M. Schlesinger, Jr., advised President Clinton not to appease the money markets: “You don’t call on Typhoid Mary to stop a typhoid epidemic.”46

  Mystery readers encounter a character complaining about a police visit to another character who was in the hospital, “[They] wear surgical masks and stand back ten feet from his bed like he’s Typhoid Mary” while they interview him.47 A character in a Marge Piercy novel, noting the misfortunes surrounding his friend, laughs, “
A sick cleaning lady in your bed, a sick kitten and a sick sister? What are you, Typhoid Mary?”48 The term has relevance even on the newspaper sports page. When Dennis Rodman, the flamboyant and controversial National Basketball Association player, was in the news, a sports writer commented, “Madonna wanted to marry him, he says. Visualizing Rodman with Madonna is . . . like trying to picture the Elephant Man dating Typhoid Mary.”49 In a sign of our technological times, an advertisement in a computer magazine depicts “Typhoid Carol,” who, while processing the payroll and the mail, infected the communications network in her office with a computer virus.50 And, perhaps the best measure of how far into our culture the term has reached, the epithet is featured in a children’s jump-rope rhyme, part of which chants, “Typhoid Mary, What do you carry?”51

  Russell Baker’s New York Times Op Ed article on smoking and nonsmoking sections of restaurants encapsulated the term’s enduring cultural meaning. He commiserated with the people who, when they go out to dinner, had to answer “smoking” to the question of which section they prefer. “Of all the nasty punishments for smoking nowadays,” he wrote, “the worst must be the smoker’s sense of being a Typhoid Mary. Imagine a whole society hating you, isolating you from the good, strong, healthy people whose lives you imperil, you smoke-drenched swine!” Baker well understood the negative judgment carried in the phrase, and he took its meaning an additional step by adding an article in front of the term. Typhoid Mary at the end of the century is generic.52

  Mary Mallon was one among tens of thousands of Americans over the twentieth century who carried typhoid bacilli chronically within their bodies. She was one among thousands who refused to cooperate with authorities to follow set restrictions. She was one among many (possibly in the hundreds) who outright defied authorities by continuing to cook after being informed of their carrier status. Yet, as a culture, we still see Mary Mallon as unique. The retellings of her particular story indicate that she holds a special place in American life, worthy of recounting again and again. We do not, as a society, remember Alphonse Cotils or Tony Labella, who continued to cook food for others after being warned to stop. We do not remember Frederick Moersch, even though following his return to ice cream handling, he, like Mary Mallon, was isolated for years as a registered carrier. We do not remember other defiant carriers whose names are no longer recoverable. It is Mary Mallon’s story alone that carries meaning today. It is the image of “Typhoid Mary” that our culture retains; to this day, one woman carries the burden of all that healthy carriers represent.53

  Reflected in the media and the popular imagination, an initially benign descriptive term for a woman whose name was not known has become a widespread negative epithet. Typhoid Mary has a life of its own, no longer necessarily making a reference back to Mary Mallon and the specifics of her story.54 The phrase has become a general metaphor for contagion and the inadvertent or purposeful spread of disease or infection and, more broadly, evil.

  Marc L. Sherman, a California lawyer, has written a short story that demonstrates the use of the Typhoid Mary metaphor and dramatically illustrates the organizational theme of this book, that where you stand determines your perceptions and your understanding of what Mallon’s story means. Receiving a recent Pushcart Award nomination, a “Diptych” of parallel stories entitled, “Until the Pill Kicks In” and “Till Morning Comes” ran in parallel columns down the pages and simultaneously tracked two people’s perceptions of the same event. On the left side of the page, Sherman presented the woman’s story and on the right, the teenage boy’s.55 The woman, lying on one side of a bed, reviews her upwardly mobile life and marriage, which she has just left for a country house, slower pace, and, last night, a sexual encounter with the teenage boy who helped her move in. The boy lies on the other side of the bed, thinking of this, his first sexual experience. It worries him and causes him some disgust. He remembers the high school health class where he has just learned about AIDS and sexually transmitted diseases. His mind buzzes, “And didn’t this lady come from the city. She could be like that Typhoid Mary. Who knows with whom she has slept? Slut! Germs! . . . He’s really anxious now. Maybe she does it on purpose—to get back at men. . . . He could get sick.” He pictures his penis: “white, withered and flaccid, falling off while he climbs a rope in gym.” The two wait for morning.

  The Sherman story crystallizes the connections between Mary Mallon and the lasting legends of her created by our culture. Mary’s is not a simple story of evil or of conscious intent to harm, although it sometimes may be that, but it is a complex story of meanings imposed and multiple possible responses. It is a story of real people and experiences, of grief and hurt, of life and destruction of life. It never occurs to the young suburban woman in Marc Sherman’s story that she could be viewed as Typhoid Mary, yet that identity seems fearfully clear to the teenager on the other side of the bed. Danger lurks in the most unsuspecting places, and we are now a society on guard against it. Is there any way out? What should we do next?

  A “Square Deal” for Public Health

  CONCLUSION

  Throughout this book, I have reconstructed Mary Mallon’s story and shown how she appeared from different standpoints. While the various perspectives overlap, they also sometimes diverge in significant ways. There can be no one way to understand Mary Mallon and her place in the history of medicine and our culture. There is no single truth about her. Instead there are various stories about her and multiple productions of her different meanings. Together the various perspectives challenge us to recognize the compelling dilemmas faced by those who tried to protect the public’s health from the kind of dangers she posed. Just as point of view influences our comprehension and shapes our sympathy in fictional plots, history is also more richly understood through analysis that proceeds from different perspectives.1 Examining the contrasting perspectives on Mary Mallon and looking back at the debate about the control of healthy carriers of typhoid fever will not reveal ready-made solutions to our current public health problems, but the exercise does, I think, remind us of important approaches to consider and pitfalls to avoid as we seek answers to similar health dilemmas today.

  The story of how Mary Mallon became “Typhoid Mary” underscores the necessity of looking at public health problems from different stances. In her stories, a powerful negative image replaced the human being very early on—a negative image constructed by public health officials, medical writers, and the media, all of whom helped it become entrenched in American culture. In turn, the cultural meaning of the popular but stigmatizing phrase “Typhoid Mary” influenced the actual treatment of Mary Mallon, as well as her own responses to her situation. Scientists at the time accepted the medical perspective on healthy carriers in the new world of bacteriology and hoped for a world in which infectious diseases would no longer threaten human life. Health officials worried about how they were to carry out their job to protect the public’s health against preventable diseases in a world in which many doubted their words and their methods. The law tried to balance medical and social concerns, struggling with the dilemma in which it seemed necessary to sacrifice an individual’s civil liberty to a larger good. The media helped to construct a stylized Typhoid Mary who embodied the conflicts and the worries of a fearful public. Meanwhile, public actions were constantly influenced by the social and cultural values of a society that believed in limited roles for women, held stereotyped views of immigrants, and stigmatized the poor. Mary Mallon was caught in the middle of a web woven partly of her own actions but more strongly by science and society.

  Mary Mallon’s story has been used in medical textbooks primarily to illustrate the triumph of the new science of bacteriology in informing methods for public health protection. This is the story from the “winners’ ” point of view, and it has had a long historical appeal. But that telling differs from others; most significantly, it diverges from Mary Mallon’s own perceptions, the narrative of the “loser.” These contrasting perspectives, and the others explored
in this book, are what James C. Scott called a “community of discourse,” competing renditions of the same historical events, all of which are essential for understanding the past. Paul Farmer called such distinct points of view “positioned rhetoric” and demonstrated in his anthropological studies how multiple points of view are logically situated in particular historical contexts and necessary to construct a full remembrance of past events.2

  It should be obvious, here at the conclusion of this book, that our lines of sight on Mary Mallon are intertwined. Without considering our cultural biases, we cannot fully understand how the medical and public health communities saw this defiant immigrant Irish cook, nor begin to comprehend their actions toward her. Without considering turn-of-the-century enthusiasm for bringing scientific advances into a public arena, we cannot understand why the particular symbol of “Typhoid Mary” has embedded itself in our history as deeply as it has.

  Now that we have looked at several of the distinct but overlapping stories about Mary Mallon, I would like to join the various perspectives together again in a way that allows us to see how her example raises general issues that continue to concern public health today. The biggest questions raised by Mary Mallon’s case remain: Would it have been possible to protect the health of New Yorkers without taking away Mary Mallon’s liberty for twenty-six years? Is it possible, today, to protect the public from diseases such as drug-resistant tuberculosis and AIDS (and new ones that will yet emerge) without infringing on individuals’ rights and liberties? There are at least three issues basic to Mary Mallon’s story that present-day concerns echo and may help guide us in understanding the past as well as charting future paths. The three are: the identification and labeling of new categories of people who challenge the public’s health; the question of isolation and its potential threat to personal liberty; and the attribution of blame and responsibility for the spread of disease. All of these issues emphasize the interdependence of medicine and society; all, too, revolve around a basic conflict between individual rights and the public’s health.