THE SAD AND TRAGIC LIFE OF TYPHOID MARY

Janet Brooks

six came down with the high and ex- 2: -.-! :.::.::...,: !.: .,!.! j!:..:.l.:.! ., 1 ,,; tended fever characteristic of typhoid. Before the arrival of antibiotics, the mortality rate was at least 10%. Typhoid fever was first identified early in the 19th century, but it wasn't until the 1880s that Salmonella typhi was isolated. The bacteria was spread mainly by contaminated drinking water, and the incidence of typhoid fever decreased as clean wa- ter became more widely available. Still, in 1900 the fever claimed the lives of 20 000 Americans, often striking groups of people in a single location even though the drinking water was known to be pure. A 11 Mary Mallon ever wanted to schools, jobs, the military, profes- When Long Island public-health be was a good plain cook. Yet sional basketball leagues and even officials failed to identify the cause of one wintry New York afternoon in crossing some national borders, it is the Oyster Bay outbreak, the owner 1907, she found herself bundled probably useful to re-examine the of the house, concerned that no one against her will into the back of a case of Typhoid Mary, as Mallon was would rent it again, hired sanitary city ambulance and, subdued only by soon labelled. Her case shows how engineer George Soper of New the weight of the female doctor sit- an earlier age resolved the conflict York's Department of Health to in- ting on top of her, removed from her that arises when society's right to vestigate. employer's Park Avenue home. protect itself from unnecessary expo- The servants were Soper's prime History's most infamous typhoid sure to disease impinges on the lib- suspects, and particularly the cook. carrier had just been contained. Even erty of individual citizens. There was Mary Mallon had started working for though she had committed no crime, never any doubt in Mary Mallon's the Warren family just 3 weeks before Mary Mallon's life as a free woman mind that her life and liberty were the first member of the household was essentially over; turn-of-the-cen- unjustly sacrificed to a questionable became ill, and 3 weeks is the average tury health officials didn't have to greater good. incubation period for typhoid. worry about warnings, warrants or In the summer of 1906, before the When Soper checked files at the overly litigious lawyers. world had heard of Typhoid Mary, New York domestic-service agency As society grapples with contem- the disease struck a home in Oyster where the cook had been hired, he porary moral questions raised by the Bay on Long Island's north shore. It found that typhoid had struck most barring of HIV-infected people from had been rented by New York of the homes where she had previ- banker William Henry Warren. ously been employed shortly after Janet Brooks is a Canadian freelance writer living in Hong Among the four family members her arrival. Two cases had already Kong. and seven servants living in the house, been reported at the house on Park

.- For prescribing information see page 964 CAN MED ASSOC J * MAR. 15, 1996; 154 (6) 915 The authorities offered to release Mallon if she would agree to give up professional cooking or have her gall bladder removed, since it was believed to be the site of her chronic infection. She rejected both offers, and denied that she was responsible for anyone's sickness or death. She refused to recognize the authority of science or government to label her a menace to society.

Avenue where she was currently taining two interns, three policemen "I never had typhoid in my life, working. and Dr. Josephine Baker to the house and have always been healthy," Mal- Of course, Mallon wasn't sick. But on Park Avenue. As soon as she Ion told one reporter. "Why should I Soper knew that scientists in the opened the door, Mallon knew that be banished like a leper and com- budding field of epidemiology were they had come for her. She fled out a pelled to live in solitary confinement beginning to suspect that some peo- back entrance to a neighbour's house, with only a dog for a companion?" ple who were themselves healthy where the police located her after a After spending 2 years alone in could be chronic carriers of disease, 3-hour search. her bungalow, Mallon filed a writ of displaying no symptoms but shed- "She fought and struggled and habeas corpus to secure her release. ding bacteria constantly. cursed," said Baker, who eventually Her lawyer's argument that she had Soper went to see Mallon, then sat on Mallon to control her. "I told never been sick and could not there- about 40, although she never dis- the policeman to pick her up and put fore be a menace to society was re- closed her age, background or med- her in the ambulance. This we did, jected by the judge. He voiced sym- ical situation. If when Soper ap- and the ride down to the hospital pathy, but sent her back to North peared on her doorstep she had was a wild one." Brother Island. quietly acquiesced, acknowledged At the Willard Parker Hospital, it A year later, a new health com- that her cooking career was over and was confirmed that Mallon was shed- missioner agreed to release her if she agreed to find another line of work, ding Salmonella typhi; she was the first promised not to cook again. She she probably would never have healthy carrier of the bacteria to be failed to keep her word, but managed achieved immortality. Instead, when identified in North America. She had to elude authorities for 5 years. In Soper explained his findings, offered infected 22 people, including a little 1915, she was found cooking at the free medical care and asked her to girl who died. Sloan Maternity Hospital in New submit samples for testing, Mary Soper offered to release her if she York City, where 25 new cases of ty- Mallon picked up a rolling pin and would agree to give up professional phoid fever had recently been re- chased him out of her kitchen. cooking or have her gall bladder re- ported. Perhaps Mallon couldn't bear to moved, since it was believed to be Mallon was sent back to her bun- hear Soper's message. She was an in- the site of her chronic infection. galow on North Brother Island, telligent woman who read the New Mallon rejected both offers. She de- where she spent the rest of her life. York Times and Charles Dickens for nied that she was responsible for She died on Nov. 11, 1938, after pleasure, and must have wondered anyone's sickness or death and re- more than 26 years of enforced isola- why this awful disease kept following fused to recognize the authority of tion. In the end, she had passed the her from job to job. She never stayed science or government to label her a disease on to at least 51 people, 3 of at any position long. Although the menace to society. whom died. epithet 'Typhoid Mary" came to con- Since she would not cooperate, of- By the time she died New York note an uncaring disease spreader, ficials quarantined Typhoid Mary health officials had identified more Mallon often stayed to nurse the by now the press had given her that than 400 other healthy carriers of

stricken before moving on. One em- name - in what would become her Salmonella typhi, but no one else was ployer awarded her an extra month's permanent home, a one-room bunga- forcibly confined. pay for her sickroom efforts. low on the grounds of the Riverside Mary Mallon's intransigence had Soper informed the Board of Hospitable for Communicable Dis- temporarily made society's right to Health of his suspicions about Mal- eases, located on remote North protect itself more important than Ion, and it sent an ambulance con- Brother Island in the East River. the liberty of one person. M

prescribing information see page 939 -. 916916 CAN MED ASSOC JJ ** 15 MARS 1996; 154 (6)(6) For prescribing information see page 939 --->