“History does not repeat itself. But, it does rhyme”
-Mark Twain
“Cooks work sick. They always have. Most jobs, you don’t work, you don’t get paid. You wake up with a sniffle and a runny nose, a sore throat? You soldier on … it’s a point of pride, working through pain and illness.”
-Anthony Bourdain
In 1869, Cookstown, in present day Northern Ireland, was poor even by Irish standards. It had a population of only a few hundred. A new textile mill promised better jobs for the mostly subsistence farmers but it was not finished yet.
Mary Mallon was born here on September 23, 1869. Little is known of her early life in Cookstown but, like many in the country, she was very poor. She decided to immigrate in America which promised a chance to work and get ahead in life. She had an Aunt in America. She would go and live with her. So she traveled alone to obtain passage across the Atlantic. How she managed to purchase a ticket even in steerage is unknown. The journey would take weeks.
She was only fourteen years old.
She could not read or write. Despite being an attractive young lady, she never married. How she would make a living in the new world was uncertain. She did know how to cook. Wealthy families in the New York area would often hire immigrants to do household management. There were openings for cooks. She was a single woman in a country that offered few opportunities for advancement. If she wanted to live here, she had to work in order to survive.
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Typhoid fever has been known to man for centuries. It is a bacterial disease caused by Salmonella Typhi. The infection is acquired through exposure to water contaminated with feces and poor hygiene.
When outbreaks occur, it typically was in undeveloped areas where sanitation was poor such as slums or military camps. During the American Civil War an estimated 80,000 men died of the disease. Some 6,000 of the Jamestown settlers succumbed to the fever. It took the life of Henry V, England’s greatest King, as well as thousands of others over the years. The first recorded outbreak was in 430 BC in Greece where 1/3 of the city of Athens died.
Although people have long suspected contaminated wells as the cause, it was not until 1880 that the Typhoid bacillus was identified and determined to be the cause of the scourge. The germ theory of disease had now become commonly accepted as the cause of many disorders. However, we still did not know what to do about it yet. Treatments lagged behind these discoveries although a primitive vaccine was used by the military in 1896.
After exposure it takes a week to a month to show symptoms. Then a fever starts that can be quite high. Headache, malaise, cough, bloody noses, and abdominal pain follows. As the infection progresses the patient’s fever becomes so severe that it becomes difficult to walk. A delirium sets in. The liver and the spleen swells and patients become vulnerable to pneumonia. Diarrhea can occur and in some cases the disease causes ulcerations in the colon leading to rupture and death.
About 80% of patients will survive. However 20% will die horribly. (With modern antibiotics this is rare) To give a sense of perspective, Coronavirus infection, depending on studies, has a mortality rate of 2-5%.
A small number of patients will carry the bacteria and remain asymptomatic. The bacteria colonizes on gallstones in the gallbladder. The asymptomatic carrier patient is still infectious and can transmit to disease. Removal of the gallbladder, a cholecystectomy, can be curative.
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In the summer of 1906 a Wall Street Banker named Charles Warren rented a house on the beach at Oyster Bay Long Island. It was meant to be a family vacation with long afternoons at the beach and dinners with the family in the evenings presented by servants. One of those servants was a single woman with a thick Irish brogue. She was, now 35 year old Mary Mallon. Mary had been working as an itinerant cook going from family to family for years.
On the evening of August 27th, one of Warren’s daughters developed fever, coughing , and stomach pains. A doctor was called and diagnosed the girl with Typhoid Fever. This was not a completely unusual circumstance. Typhoid fever outbreaks in cities were not uncommon. With improved sanitation, the infection was occurring less frequently. It was not common to see it in a wealthy area, but not unheard of either.
Then something odd happened.
The house suffered an outbreak of the fever. Six of eleven people in the house came down with Typhoid.
Mary left the house by then, needing work, and moved on to cook for another family.
The owner of the house , Mr George Thompson , had a problem. It was clear the source of the infection was in the house but where? If he could not find the source, he would never be able to rent the house again and he would lose money.
He hired a private Sanitation Engineer named George Soper who had experience with other Typhoid outbreaks. After an investigation of the house, he began to suspect the cook.
He researched her employment history and found between 1900-1907 she had worked for seven different families. In those home 22 cases of Typhoid appeared. One person died.
Soper suspected Mary was a “Carrier” of the disease. A carrier is a person who can infect others but does not have the disease. In 1907, he visited the home of Walter Bower where Mary was working as a cook. Can you imagine the conversation?
Soper gently said, “We suspect you are carrying the bacteria that causes Typhoid Fever”
“I’m not sick’” Mary responded.
“I know, but you can still transmit the disease and not have symptoms”
(pause)
“Bollocks!”
“We think it’s true”
“How would you know?”
(Pause)
“Well, we will need some of your stool”
“….beg pardon?”
According to the story, Mary then grabbed a meat skewer from the kitchen and threatened Soper with it to get him to leave. He left but, found out where she lived. He went to her house, this time with a doctor and tried to persuade her again. She refused to cooperate yelling expletives at Soper as she chased them from her porch.
She was fired from her job. But, quickly moved on to another one.
Soper went to the heath department who agreed she needed to give a test. He returned to her home again this time with five policemen. A fight ensued and she stabbed one of the officers and ran away. They found her in a neighbor’s closet.
Against her will she was taken via an ambulance to a local hospital. She protested vigorously that she has never been sick and her rights were being violated. She was compelled to give a sample and the test came back positive for the Typhoid bacteria. From the hospital she was taken to an isolation cottage and was kept there against her will for two years.
There were no charges, no trial, no crime committed. Yet Mary was incarcerated. In 1909 a lawyer filed a writ of habeus corpus on Mary’s behalf. The city argued she was a danger to society because she was spreading a deadly disease.
The press got wind of the story and she was dubbed “Typhoid Mary”.
Mary told the court, "This contention that I am a perpetual menace in the spread of typhoid germs is not true. My own doctors say I have no typhoid germs. I am an innocent human being. I have committed no crime and I am treated like an outcast--a criminal. It is unjust, outrageous, uncivilized. It seems incredible that in a Christian community a defenseless woman can be treated in this manner.”
Mary lost her case and her freedom to the city. The court ruled she was a danger to the public. She was returned to isolation. She was offered a cholecystectomy but she refused. She may have had good reason too because 12 to 20% of patients did not survive the operation in those days.
A year later a different Public Health Commissioner was elected. He felt it was wrong to keep a woman in isolation, presumably for the rest of her life, when she has committed no crime. Mary continued to be steadfast in her belief that she never infected anyone and has never been sick. He agreed to release her as long as she agreed not to work as a cook. She agreed to the terms and was released.
She lied.
She tried to get work as a seamstress, but it did not pay as well as a cook. So she went back to work under an assumed name as a cook.
Five years later there was an outbreak in a maternity hospital. Twenty-five patients and staff became severely ill. Two died. In the kitchen there was a new cook named Mary Brown.
It was Mary Mallon.
She was arrested and returned to her isolation where she would remain for the remainder of her 23 years. She died of complications from a stroke in November 1938.
This is the cottage today where she died.
An autopsy was performed and her gallbladder was full of the Typhoid bacillus.
Mary was presumed to have infected fifty-one people and was resonsible for three deaths. The actual number may be higher. However, she was not the most lethal carrier of the Typhoid germ. That honor goes to a New yorker named Tony labella. He was a food worker and reportedly caused two outbreaks. One hundred people were infected and Five died.
Today we have a good vaccine for Typhoid Fever.
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Mark Twain observed, “History does not repeat itself. But, it does rhyme”.
When we look at the protests around the country regarding isolation and the pandemic we see complaints that Mary argued all those years ago.
“My rights are being violated!” “I see nothing wrong and feel fine!” “I have to work to live!” “They are lying to us!”
In America we enjoy the notion that we are free to come and go as we please. If you work hard you can make a decent wage and your family will thrive. We believe we are free to chart our own destiny as long as we commit no crimes and as long as we do not hurt other people.
There’s the rub.
As long as we don’t hurt other people.
If we protest the closures we are advocating two different arguments.
The first is we attack the information we are being given. The science is wrong or overstating the issue and scaring people. We must challenge the information and return our freedoms. We want things to 'go back to normal'.
Where do you get your information? We also have to believe something. The best available evidence clearly says we are in the middle of a deadly pandemic. A healthy skepticism is great. Outright denial of reality is foolishness. People will die because of a denial of facts.
If we had responded earlier to the warning signs and tested better, we might have avoided the hard lockdown we are now enduring. But, we did not heed the signs. We fell into a deep hole and now have to climb back out. It is too late for the easier path now.
As of today over 1 million people are infected in the US, more than any other country.
60,474 people are dead.
This number is higher than all the American losses in the decade long Vietnam War.
The second reason to protest is a belief that your individual rights are more important than the greater public health. It is tyranny, you cry, to deny your God given right a chance to work and earn a living just because someone might get sick. I should have the right to do what I want with my own body regardless of the consequences.
Is this true?
If you go to a hair salon and spread the infection to others is that your right?
If you ignore public health guidelines, get sick, and overwhelm our hospitals because of your behavior, is that a right also?
Who will come and get you when the pandemic knocks on your door? Is it your fellow protesters or first responders who place their lives at risk because of your carelessness?
Protesters are faced with making an immoral choice or arguing the science isn’t true. Many choose the latter approach. Attack the source of the information. Stab it with a meat skewer?
Mary tried both arguements. She was told she caused infection and the death of people. She denied the science and argued for her personal rights instead.
Was she right?
Should we have kept Mary locked up for her life? No, I don’t think so.
In order to allow her to enjoy her freedom and rights she needed to be a responsible citizen. She needed to accept what the doctors were telling her and try to not infect others. Instead, she lied, pursued her own agenda, and people suffered because of her.
The same is true for the protesters. I agree that we cannot stay locked down forever, but to deny the science of this virus is the greater error. Coronavirus can and will kill people. More have died in the last several weeks than all of the soldiers in Vietnam. This is not a hoax. The facts are real and represent a clear and present danger.
We have to open up. But, we have to open up responsibly.
I do not know how worried Mary was to make a living. I imagine she was very desperate. Women in her time, especially unmarried ones, had very limited resources and means to make a living. I imagine she felt forced to make her choices.
I imagine many today are very worried as well. Choices are limited. It is a very dark tunnel we are in right now.
To leave the tunnel we need to be responsible citizens. We do have rights. and our freedoms are being limited. However, we don’t have the right burn down the house no matter how much we may desire to light the match.
Mary Mallon is a cautionary tale of how we respond.
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