To his dismay, Mary did not see Soper as the answer to some long-troubling question about the series of odd and unpleasant coincidences that had long followed her. He stood an accuser, and she reacted thus, and her reaction seems to have come as a complete surprise to him.
Here, at this first meeting between pursuer and pursued, is where things began to go terribly wrong – at least for Mary Mallon and any future she might have had. What was said here, and how it was said, would set the tone for everything that happened after.
Chapter Two
Typhoid Sucks
Typhoid: Until the mid-nineteenth century, no one even knew what it was. All that was known for sure was that lots of people were dying from it – and had been dying from it for a long, long time.
As far back as 1607, in Jamestown, Virginia, where typhoid would retroactively be credited with wiping out 6,000 settlers, officials knew something was devastatingly wrong. But people died of so many things in those years: typhus (a different disease entirely – spread by fleas and lice), cholera, yellow fever, smallpox, measles, throat distemper, influenza, scarlet fever, as well as typhoid – most of them indistinguishable from each other in eras marked by unwashed, undernourished, maltreated, and poorly housed folks who tended to die young anyway. Against a backdrop of frequent epidemics, famines, plagues, abject poverty, and rudimentary to nonexistent health care, it is no surprise that it took so long to even give the thing a name.
But in 1880, only twenty-six years before Mary Mallon went to work in Oyster Bay for the Warren family, a man named Karl Erberth isolated the particular organism associated with typhoid fever, identified it, and allowed future doctors to at least differentiate between typhoid and all the other microbes that were likely to kill you before you hit middle age. Erberth’s discovery was the first step down the road to a vaccine (as opposed to a cure).
Even so, typhoid continued to be a serious problem – not the least for the military. In the war against South Africa, Britain lost an incredible 13,000 troops to the disease, a staggering body count, especially when weighed against total battlefield losses of only 8,000.
As recently as 1948, there was virtually nothing a doctor could do against typhoid, other than put the patient to bed and hope for the best. There was by then a vaccine extant, but that was like shutting the barn door long after the mad cow had wandered off to do his business. As late as the midteens, medical practitioners were still not certain that the vaccine even worked (it did). Antibiotics had not yet been discovered. So before 1948, it must have been pretty terrifying to recognize the all-too-familiar symptoms of typhoid. And they were familiar: outbreaks in 1865 and 1885 had decimated residents of major American cities. An earlier incident, when heavy rains flooded Lake Michigan, commingling sewage with drinking water, had left an estimated 90,000 dead of cholera and typhoid, so people tended to take outbreaks very seriously. In New York State alone in 1906, there had been over 3,000 cases reported, with more than 600 fatalities.
First came a sudden and prolonged high fever – brain-boiling temperatures that could reach 104 to 105 degrees. Powerful headaches followed, accompanied by gut-roiling nausea and the disappearance of appetite. Victims often developed a bad cough, hoarseness, rampaging diarrhea or constipation. Frequently adding to their discomfort and misery were skin rashes, inflammation, and tenderness in the abdomen. Until antibiotics hit the market in the late 1940s, about 10 per cent of typhoid sufferers died from the disease. Even after antibiotics, about 1 per cent still never recovered and eventually succumbed. As late as 1997, there were 17 million cases of typhoid reported worldwide, with about 600,000 deaths resulting.
Even today, in underdeveloped countries like Vietnam and Mexico, where antibiotics at first seemed to be working wonders, 75 per cent of typhoid cases are now said to be drug-resistant.
Typhoid is an infectious disease caused by a bacillus called salmonella typhi. Simply put, typhoid fever is transmitted by food and water that has been contaminated with human feces or urine. Polluted water is the most common source of infection. When water from toilets and outhouses drains into water used for bathing and drinking, you start seeing cases of typhoid. Shellfish such as clams, mussels, and oysters which have been taken from contaminated beds can give you typhoid. Likewise, dairy products which have had close encounters with sewage, can be – and have been – linked with the spread of the disease.
And, of course, people can give you typhoid, as long as the bacteria exists in their systems. For most people sick with typhoid, this means that for the week prior to their being bedridden (during which time they probably have not yet been diagnosed), until about a week after, they are infectious. Many (about 10 per cent) will continue to exude bacteria in their stools for about three months, and about 2 to 5 per cent will become permanent carriers, the bacteria settling comfortably into their gallbladders and digestive tracts like rent-controlled pensioners. This last statistic is important, because the beleaguered Mary Mallon was believed to be one of these unfortunate few – a carrier for life, a one-woman bacteria manufacturing machine, an endless supply of very bad things.
If you want your city, town, or prefecture to remain free of typhoid, experts recommend that you endeavor mightily to protect and chlorinate the water supply – basically keeping it sewage-free. It is suggested that human waste be disposed of in a safe and sanitary manner and that latrines be kept fly-proof. And you don’t want typhoid carriers handling your food. Particularly raw food.
In Mary’s time, especially in the years she was coming up and learning her trade, indoor plumbing was a fairly recent development – and in rural areas, decidedly rare. Even the idea of bathing regularly was a new, and pretty bold, concept.
Our colonial forefathers, many of whom proudly boasted of bathing only once a year, must have stank like musk-oxen, and the sanitary, or more accurately, the unsanitary grooming habits of generations of Americans and Europeans explains a lot about their behavior and accouterments. (That the French would take the lead in perfume manufacture should come as no surprise.) High collars, make-up, wigs, beauty marks – many of the fashion choices of much earlier days were developed as much for fashion as to cover up dirt-streaked and smallpox-scarred necks, syphilis-ravaged faces, unspeakably greasy and unpleasant hair, and rank odor. Not too much earlier than Mary’s time, the ‘Sunday bath’ was considered the height of sartorial extravagance, something to boast about. As the turn of the century approached, people still didn’t much like to bathe. They didn’t, for the most part, like water. Water, it was believed, admittedly with some reason, made you sick. It gave you typhoid, cholera, fevers – all sorts of bad and mysterious stuff. Better to grease yourself up and sew yourself into your long-johns for the winter, as many frontiersmen did, than risk getting chilled and possibly ill. Better to do your business in a chamber pot, then hurl it out the window; bury it in the garden, or in the privy. Next to the well.
In the most elemental language, to prevent typhoid, modern health care professionals strongly suggest persons who prepare food for others use scrupulous care when washing their hands after using the bathroom.
It is one thing to have typhoid bacteria wriggling around inside your alimentary canal. It is another to transfer those bacteria to another human being. Not washing your hands after a bowel movement is a good way to start. Using those same hands to prepare food which remains uncooked – like, say, salad, or peach ice cream – would be better. Who among us really washes their hands in such a way as to satisfy the requirements of food handling? Dr. John Marr of the New York State Health Department states flatly, ‘I don’t know anyone who washes their hands 100 per cent after going to the bathroom.’
If you are the kind of person for whom washing your hands after a bathroom visit is an ordeal – and you allow your fingernails to grow to fashionable length – you can look forward to a real career in disease spreading. One has only to ask a health inspector to demonstrate, for instance, the proper method of hand washing for a manicu
red kitchen worker, then watch the professional mime furiously the scrubbing (with brush) of the undersides of the nails, top to bottom, finishing with an impressive hands-up doctor-style flourish, to get a cold chill down your spine. You’ll never eat a Caesar salad again.
Chapter Three
The Conversation
When informed that the woman he had been pursuing over the last months was indeed working only a few feet away from where he now stood in the anteway of the opulent Park Avenue home, Dr. Soper could hardly contain himself.
But his enthusiasm, his bad judgment and his zeal worked against him. His first approach was clumsy:
I had my first talk with Mary in the kitchen of (the) house. I suppose it was an unusual kind of interview, particularly when the place is taken into consideration. I was as diplomatic as possible, but I had to say I suspected her of making people sick and that I wanted specimens of her urine, feces and blood.
Soper tries to make excuses for getting ahead of himself, but after all, to his mind, Mary was a killer, at least of a kind, and he felt he had no other choice but to act with dispatch.
Showing up at a cook’s place of work and attempting to interrogate her on such a sensitive subject in front of the other household employees and the housemistress was probably not a good idea. Demanding samples of ‘urine, feces and blood’ proved hardly an ideal icebreaker when attempting dialogue, especially given the fact that he and Mary had never been formally introduced.
In any event, Mary balked in a most emphatic way at Soper’s suggestion that she give up her bodily fluids.
She seized a carving fork and advanced in my direction. I passed rapidly down the long, narrow hall, through the tall iron gate, out through the area, and so to the sidewalk. I felt rather lucky to escape. I confessed to myself that I had made a bad start. Apparently Mary did not understand that I wanted to help her.
Soper’s own accounts, given at various times in speeches, newspaper articles, and papers published in medical journals, vary as to how much was said at this first meeting. An early telling has him resuming the discussion – presumably at fork-point – outside the house on Park Avenue.
She upbraided me for connecting her with outbreaks of typhoid fever in every household she had worked in . . . The circumstances connected with the case were most pathetic. In the face of all this, Mary refused to submit herself to an examination and would not divulge a single fact about her past life, her relatives, her friends, in fact, she refused to say a thing to assist me.
In another recounting (and Soper dined out on this story quite a lot), he added that Mary denied ever having typhoid fever, asserting that she could not possibly be the cause of it – either at her current employer’s home or anywhere else.
Whatever words passed between them during that initial exchange, the outcome was clear. Dr. Soper went away empty-handed, and Mary Mallon went away angry, frightened, paranoid, and suspicious.
The result of that first meeting between hunter and prey was that Mary was put on the defensive. Her hackles went up and she fully staked out her position. Not guilty. Period! To get her to climb down from that particular tree would be difficult if not impossible. Soper was disappointed. Whether he knew it or not, he’d blown it. However cognizant of his own failing as interrogator he might have been, he was also, to his discredit, personally offended. It seems to have come to him as a complete surprise that the rudely ambushed cook had responded neither favorably nor agreeably to his suggestions, and this confused Soper and made him somewhat indignant.
It mattered not that I told her if she would answer my questions and give me the specimens, I would see that she got good medical attention, in case that was called for, and without cost to her.
As a matter of fact, I did not need the specimens in order to prove that Mary was a focus of typhoid germs. My epidemiological evidence had proved that. (!) Laboriously, I had worked out every one of seven outbreaks and I was positive that Mary had produced them all. I felt a good deal of responsibility about the case.
Soper was bitter that the subject of his interest was not eager to accept his offer of free ‘good medical attention’. That ‘medical attention’ of any kind might have a bad connotation for her, might have sounded attractive to her only if she deemed herself sick or was feeling physical pain (she wasn’t), does not appear to have occurred to him. He came away from the encounter with his position as entrenched as Mary’s. She was now, in his opinion, a ‘proven menace to society’.
Under suitable conditions, Mary might precipitate a great epidemic. You can well imagine what havoc she would have wrought if her work had taken her to poor families, where sanitation and cleanliness are put in the background.
Already painting himself as a savior of peoples from all walks of life – both rich and poor – Soper returned a few days later to take up where he had left off, but Mary would have none of it.
It is a measure of the completeness of her denial that she had returned to work. Many would have been in the wind after the initial encounter. But Mary continued to work at the house on Park Avenue. That her employers did not immediately throw her out into the street is curious as well, signifying great indulgence on their part – or remarkable cooking prowess on Mary’s.
One night, after Mary finished work, George Soper, waiting for her in hiding, followed her through the streets, shadowing her to her destination, a seedy rooming house at Thirty-third Street and Third Avenue, under the rumbling elevated train tracks and around the corner from the Willow Tree Inn and Sig Klein’s Fat Men’s Shop, where she appeared to be sharing rooms with a man called Breihof.
One imagines the sanitary engineer turned private dick, lurking under the Third Avenue el, spying on Mary from the shadows as she entered the rooming house. The excitement, the thrill of the chase, of sneaking around, must have been electrifying. A far cry from gazing at bacteria under a microscope, or comparing columns of statistics.
She was spending her evenings with a disreputable looking man who had a room on the top floor and to whom she was taking food. His headquarters during the day was in a saloon on the corner.
Unsatisfied with mere surveillance, Soper enlarged his portfolio of skills by now becoming a clandestine operative, a spymaster, and an agent runner of sorts. Taking note of Breihof’s affection for alcohol and his limited means, the doctor-turned-case-officer entered the saloon and befriended him, plying the man with free booze while engaging him in conversation.
I got well acquainted with him. He took me to see (his) room. I should not care to see another like it. It was a place of dirt and disorder.
There was a large dog in residence, a beast of whom, Breihof confided, Mary was quite fond. The neat doctor remained in the doorway of the tawdry walk-up apartment, unsure where, or if, he could sit down. The eager-to-please, vulnerable Breihof stood there uncomfortably, revealing to the outsider his pathetic kingdom.
Breihof had turned. He’d been bought for the price of a few drinks. He cannot have been entirely comfortable with that. It was a poignant moment, for Mr. Breihof is the only known love in Mary’s life. We do not know if she was ever married. We know nothing of her early experiences with men, or with love, or even her feelings about men in general. Though she was a church-going Irish Catholic woman living in less-than-enlightened times, she seems to have been living comfortably in sin with the unimpressive Mr. Breihof. It is known that later in her life, she used his name – or variants of it like Bresof (as an alias), identifying herself in some way as his de facto wife. More than likely, it was she who paid the rent on the Thirty-third Street rooms – as Breihof had no visible means of support. And she appears to have loved him, looked after him, forgiven him his weakness for drink, and his less-than-rock-solid loyalty.
As Soper later reported.
I made an arrangement with Mary’s friend to meet her in this room; and taking an old assistant, Dr. B. Raymond Hoobler, later head of the Children’s Hospital in Detroit, I waited one evening for Mary a
t the top of the stairs.
How did he know when she was due to arrive? Because Breihof had set her up. Probably in exchange for money or drink or both.
Soper continues:
Mary was angry at the unexpected sight of me, and although I recited some well-considered speeches committed to memory in advance to make sure she understood what I meant, and that I meant her no harm, I could do nothing with her.
She denied she knew anything about typhoid. She had never had it nor produced it. There had been no more typhoid where she was than anywhere else.
There was typhoid fever everywhere. Nobody had ever accused her of causing any cases or had any occasion to do so. Such a thing had never been heard of. She was in perfect health and there was no sign or symptom of any disease about her. And she would not allow anybody to accuse her. Again I saw I was making no headway, so Doctor Hoobler and I left, followed by a volley of imprecations from the head of the stairs.
Already a fiercely private person, Mary was mortified at this latest intrusion. Her horror and embarrassment at finding Soper and associate, with their insinuations and accusations, at Breihof’s door must have been shattering.
Mary knew a few things with terrible certainty at this point. She knew how serious Soper was – the degree of trouble she was in – and the apparent inescapability of it. He’d identified her secret companion, been inside her squalid little love-nest or refuge, unmasked her – surely to his satisfaction – as a common slut. This could only have been a hideous affront. This man, who wasn’t a medical doctor but let her believe that he was, continued to insist that she was dirty, unclean, sick (a charge that can only have been bolstered by Breihof’s maddeningly unclean personal habits). It was one of many humiliations to come. Worst of all, this charlatan had gotten her man to betray her, to set her up, to talk about her behind her back and allow the loathsome Soper into the room. It was an awful betrayal – and that the hapless and hopeless Breihof remained her friend and ally after this incident can only have reinforced her assessment of his weakness and her hatred of Soper for exploiting it.