THE REAL LIVEJOURNAL IDOL SEASON 10, WEEK 9 -- THE TROLLEY PROBLEM
THE MALLON CONUNDRUM
[Section 1169]
The Board of Health shall use all reasonable means for ascertaining the existence and cause of disease or peril to life or health, and for averting the same, throughout the city.
[Section 1170]
Said Board may remove or cause to be removed to [a] proper place to be by it designated, any person sick with any contagious, pestilential or infectious disease; shall have exclusive charge and control of the hospitals for the treatment of such cases.
-- The Greater New York Charter, enacted in 1897
NOVEMBER 1906
George Soper, Ph. D., frowned slightly as he looked over the blueprints for his client's Oyster Bay summer home. “I'm not sure exactly what it is you expect me to do for you, Mr. Warren.”
The wealthy New York banker harrumphed impatiently. “I thought I made my expectations quite clear: I want you to unequivocally determine the cause of the Typhoid Fever outbreak which struck my family and neighbors this past summer, and perform whatever work is necessary to ensure the incident does not occur again! I have been told that as a sanitary engineer you are second-to-none... and after seeing half my family hospitalized and one of my neighbors die from the disease, I do not want to experience that sort of Hell ever again. So do whatever you have to do to make this property safe for people to inhabit again; cost is no object.”
Dr. Soper pursed his lips. “To be honest, if these plans are accurate then I don't see what more can be done to improve the sanitary conditions here - Your sump tank is positioned well away from your water lines, so even if the tank had sprung a leak it should not have contaminated anything.” The engineer glanced upward. “Did the county health inspectors test your drinking water?”
Warren practically spat the words in frustration: “Yes, and they said that they found no trace of the Typhus bacillus in our water, or our milk for that matter... but that means that they have no idea as to how my family and friends got infected in the first place!”
Dr. Soper scratched his head thoughtfully. “Well, I can re-run those tests, but I know the local inspector and he's a competent fellow... so if he says there was no sign of Typhus in your water or milk, then he's probably right.” Soper sighed quietly. “So if the source wasn't the water or food, then it must have been a person; someone ill with the disease must have come here and it spread from them.”
The financier shook his head. “We had no guests visit us before the outbreak... and once my family started falling ill with typhoid fever symptoms, the other members of the household and our neighbors took all appropriate measures to minimize their exposure to the bedridden victims... yet the disease still spread like wildfire.”
“Hmmm...” Soper cocked his head as he mulled this over. “In theory, it's possible for someone to carry the Typhus bacterium and not show any symptoms themselves, due to a partial immunity, and such an individual could pass the disease on to those around them.” Soper glanced up. “I'll need to personally interview all the people who were here during the outbreak, both your family and members of your household staff.”
Warren nodded. “I can arrange that... with the exception of Mary, of course.”
Dr. Soper raised his eyebrows. “Mary?”
“Our cook. She left us shortly after the outbreak started, apparently for fear of getting sick, and she was quickly hired by one of my neighbors. I can't say that I especially blame her for fleeing this plague house, though from what I heard she didn't have any better luck at my neighbor's, as he and his family came down with Typhus themselves a short while later.”
A hypothesis began to form in Dr. Soper's mind. “And where can I find your neighbor, and this 'Mary'...”
When Dr. Soper interviewed the neighbor family, he found that their cook, a plump 40-ish Irishwoman named Mary Mallon, had left the household shortly after the Typhoid Fever outbreak started there, and had been hired by yet another nearby family... who, in turn, had been struck down by Typhoid Fever shortly after Mary had started cooking for them. Once the newest outbreak started, Mary left without a forwarding address... but she would not remain hidden for long.
March 1907
Dr. Soper rang the bell of the elegant Park Avenue townhouse and shifted his weight from foot-to-foot as he waited for the door to open. A genteel butler ushered him into the parlor, where the master of the house, Walter Bowen, stepped forward to greet him. “To what do we owe this visit, Dr. Soper?”
Soper smiled gently. “As I explained in my note, I specialize in investigating cases of Typhoid Fever and determining their causes. It's my understanding that at least one member of your household has been struck down with the disease?”
Bowen grimaced. “Yes, about half my family is bedridden right now, and my daughter... may not survive.” The man shuddered visibly. “A few of my neighbors have also been sickened, so I had just assumed that it was something that was 'going around'.”
Dr. Soper inhaled sharply. “I have... reason to suspect that there may be a more direct link between the outbreaks you mentioned. I would very much like to look around your home and interview your staff, if I may.”
The family patriarch nodded somberly. “If you think it will help, then please proceed as you see fit...”
Soper stood. “In that case, sir... could you please direct me to your kitchen? I think I'd like to start there...”
The woman was tall, plump, handsome rather than pretty... and carving up a chicken with expert skill when he entered the room. Dr. Soper waited until she set the boning knife down before he gently called her name. “Mary?”
“Aye?” She had a rich Gaelic brogue which 25 years in the US had barely softened. “An' who might ye be?”
“My name is Doctor Soper, and I'm an expert on Typhoid Fever--”
“Ach! Ye should be seein' to the little one upstairs, then.” She reached for another chicken and the boning knife. “I've no need for yer services; I'm as fit as a horse!”
“Actually, I'm here to talk to you about the Warren family, and their neighbors in Oyster Bay... and all the other cases of Typhoid Fever that you've 'witnessed' in your career...” Mary froze in place when she heard these words, and she gazed warily up at the medical man as he continued speaking. “I've uncovered much your work history, Mary, and I've seen a very unpleasant pattern, repeated over and over. Surely you must have noticed it yourself?”
Mary shook her head slowly. “I dunno what ye mean.”
Dr. Soper spoke as gently as he could manage. “So many of your employers have gotten ill with Typhoid within a month of them hiring you, Mary. Did you really think that was mere coincidence?”
The lady's face flushed beet red. “Are ye tryin' to tell me that I'm accursed?”
Soper smiled wryly. “Not in the way you mean... but in a sense, I think you are 'cursed', and I'd like to try to help free you from your curse.”
Mary's eyes became narrow, wary slits. “What the divil do ye mean?”
“I think... you've been making those around you sick, without meaning to. Without realizing it.”
Mary went white as a sheet... then she started screaming. “I'VE NEVER BEEN SICK A DAY IN ME LIFE! HOW DARE YE SUGGEST SUCH A THING?!”
Dr. Soper tried to calm the woman without success. “We can run certain medical tests to determine the truth, and if I'm correct there may be a surgical solution--”
Mary picked up the boning knife and began advancing toward the medico, swiping the air before her. “YE TRY TO CUT ME OPEN, I'LL GUT YE LIKE A FISH, I WILL!”
Dr. Soper wisely decided that discretion was the better part of valor and beat a hasty retreat all the way to the sidewalk... and resolved to bring backup with him on his next visit...
… but things did not fair any better on their next encounter. Dr. Soper and the police officer who had accompanied him tried to speak to Miss Mallon in the privacy of her home, but she would have none of them.
“Git out of me house, ye pair o' worthless bastards!” Soper and his police escort each took a step back in response to Mary's apopectic rage. “I never want to see either of yer ugly faces ever again!”
Soper tried sending colleagues to speak in his stead, including Dr. Sara Josephine Baker, who was a well-known advocate for immigrants... but Mary would listen to none of them. The Irishwoman insisted that she was innocent, and that the government was persecuting her without cause. However, after several failed attempts to get her to submit to the medical tests peacably, Doctor Soper managed to convince the authorities at the New York City Board of Health to take Mary Mallon into custody by force. Her feces, urine and blood were tested... and were all found to contain the Typhus bacillus. The medical authorities were now convinced that Mary Mallon was the source of multiple outbreaks of Typhoid Fever over the previous decade.
But Mary herself remained unconvinced...
MARCH 1908
“LIES! IT'S ALL LIES!”
Dr. Soper tried to reason with the woman one last time. “Mary, as best as we can tell there's a colony of the Typhus bacillus in your gall bladder. It may not be making you sick, but the germs end up all over your hands whenever you use the privy... which get transferred to the food you prepare, which sickens those who eat it--”
“It's sheerest nonsense! Yer sayin' I got little animuls livin' inside me, animuls so small nobody can see 'em, and these animuls make everyone around me sick but leave me alone! Yer daft if ye'd think I'd believe that!”
“Mary, listen! If we remove your gall bladder, the problem should go away! I will pay for the operation myself-”
“YER NAY CUTTIN' ME OPEN, YE BUTCHER, AN' THAT'S FINAL!”
And so, invoking Sections 1169 and 1170 of the Greater New York Charter, The New York City Board of Health declared Mary Mallon (aka “Typhoid Mary”) a public health risk, and for the next two years they confined her against her will at the medical facility on North Brother Island in the East River.
With the support of American millionaire William Randolph Hearst, in 1909 Mary sued to be released from confinement, but the courts initially ruled in favor of the Board of Health, and so it appeared that Mary would spend the rest of her life in custody...
FEBRUARY, 1910
“Miss Mallon?” The civil servant looked the woman up and down. “My name is Jones, and I'm from the Department of Health.”
Mary gazed back with undisguised hatred. “Aye? Come to see the beast in her cage? D'ye wanna check me teeth?”
The man's expression didn't waver in the slightest. “Actually, Miss Mallon... I'm here to offer you a way out of your cage.”
The woman bristled. “I tole ye before: I will not be cut open-”
“No surgery, Miss Mallon.” Jones pulled some papers from his briefcase. “Our new Commissioner at the Board of Health has reviewed your case and determined that you would not be a threat to the public safety as long as you're not involved in food preparation. So... As long as you are willing to swear to never work as a cook again... we can arrange to have you released within a week or two.”
Mary warily looked the man over. “Ye... yer pullin' me leg!”
“I assure you I am not.” The man laid a document and a pen before the Irishwoman. “You sign this affidavit, in which you swear before Almighty God to never work as a cook again, and we can start the process to get you out of here.”
Mary took her time reading the document... but the language was plain and simple, and exactly as Jones had described: The Department of Health would release her on the sole condition that she never work as a cook again.
Mary took a deep breath. “I suppose... I could be a laundress...” She picked up the pen and signed her name.
Jones smiled and nodded as he put the document back in his briefcase. “I always enjoy situations where everyone wins...”
JANUARY 1915
“How many dead?”
“Just two, but the count's so low only because they were already in a hospital. 25 people were sickened in total.”
The lead investigator nodded sardonically. “Typhoid fever at a maternity hospital! What is this world coming to?”
“I have no idea. Still, let's figure out how it happened. I guess we should start with the hospital kitchen.”
The two men entered the work space and approached the first employee they found. “You're the new hire, Mrs... Brown, is it?”
“Aye?” The tall, plump, middle-aged woman seemed unusually nervous as she turned to face the investigators. “An' how may I help ye, gentlemen?”
After the incident at Sloane Maternity Hospital, The New York City Board of Health interned Mary Mallon on North Brother Island for the rest of her life. She passed on November 11, 1938, at age 69.
It should be noted that Mary Mallon (aka “Typhoid Mary”) was never put on trial, much less convicted of a crime... but she was essentially incarcerated for 26 years against her will, because she was considered to be a threat to the public health. Arguments are still held in Law School classes to this day as to whether the way she was treated was legally, ethically or medically correct... and if not, how her situation could have been handled better with the medical limitations of her era. In my opinion, at least, the jury's still out...
This post is an entry in The Real LiveJournal Idol (therealljidol) for Season 10, Week 9. It is based on the prompt "The Trolley Problem", and is a slightly fictionalized account of the life of Mary Mallon, who was branded in the press as "Typhoid Mary" in the early 20th Century.