Not many remember the name of Mary Mallon.
If not for tragic circumstances, a strange
immunity, and her position at the center of
an outbreak of disease, it's likely that she
would have faded into obscurity as just another
ordinary immigrant who gave up her homeland
for the promise of America in the mid-1880s.
Mallon was just a teenager when she left Ireland
and headed west, landing in New York City
in 1883 or 1884.
She had connections there, at least, an aunt
and uncle she lived with until she found her
feet.
If that was all there was to the story, history
wouldn't remember her.
She would have been one of millions of Irish
who emigrated to the US in the 19th century,
a time when an estimated 50 percent of the
country's population picked up roots to try
to make a better life elsewhere.
But Mallon was carrying a deadly disease with
her, and marked her as Typhoid Mary.
But there's more to her story than just a
gory nickname, and remembering her as just
as a carrier of disease doesn't quite do her
credit.
TITLE: What is typhoid fever, anyway?
Since typhoid fever is one of those olde-timey
diseases that isn't talked about much in the
modern, industrialized world, this conversation
deserves a short foreword on what exactly
the disease is.
It's caused by the bacteria Salmonella typhi,
and most of the time, it's passed from one
person to the next through food or water that's
been contaminated.
In some cases, being in close contact with
someone that's infected can spread the disease,
too.
Symptoms can take up to a week to develop,
and they're generally unpleasant.
The infected have to contend with a wide range
of disease markers, including fatigue, muscle
aches, abdominal pains, swelling, and sweating,
ranging all the way up to fever and extreme
gastrointestinal distress.
Without treatment, the disease can progress
to delirium and the so-called typhoid state:
laying there, too exhausted to move, eyes
half-open.
It's at that stage when other complications
can develop: some might start suffering from
hallucinations and paranoid psychosis; others
might develop inflammation of the heart, pancreas,
or brain.
The most serious complication is intestinal
bleeding, which, in some cases, can lead to
holes in the intestines.
Typhoid is treatable today, but even modern
vaccinations aren't 100 percent effective.
The cause of typhoid was confirmed in 1880,
after years of attempts to document exactly
how contained instances of disease can turn
into epidemics.
Typhoid had about a 10 percent fatality rate
at the turn of the 20th century, and the first
vaccine wasn't developed until 1911.
That's five years after Mary Mallon was hired
to cook for a well-to-do New York banker named
Charles Henry Warren and his family.
TITLE: Typhoid Summer
Not much is known about Mallon's early life
in Ireland, or her first years in the US.
She was born in County Tyrone — one of the
poorest areas of Northern Ireland — on September
23, 1869, and left her homeland for the US
when she was only 14 or 15 years old.
There was nothing unusual about her; in fact,
she followed the normal route of settling
in with family members who had made the crossing
before her, then finding work as a domestic
servant.
Things started to change in 1900, when one
of her employers discovered she was a talented
cook.
They put her to work in the kitchens, and
it was a move that changed her life, and the
lives of those who employed her.
Mallon worked for eight families in the years
between 1900 and 1907, and where she went,
typhoid fever often followed.
At the time, typhoid was an illness associated
with crowded and poor urban communities with
nonexistent sanitation and little access to
fresh drinking water.
Mallon, however, was working for some of the
most affluent families in the city, which
were not exactly the sort of families that
tended not to suffer from afflictions like
typhoid.
Doctors did notice they were unusual victims,
but remained baffled by the outbreak of illness
in homes where there seemed to be no logical
explanation for it.
Mallon’s peers became sick at seven of the
eight jobs she held in those years.
At least 22 individuals fell ill, and at least
one died.
There's nothing that indicates Mallon initially
had any idea the illnesses were connected
to her in any way, and she continued to cook
for various families.
Because she did move around a bit, and because
she never left a forwarding address, it took
a while before anyone could connect the dots.
In the summer of 1906, Mallon was hired to
be a summer cook for Charles Henry Warren
and his family.
They had rented a house on Long Island and
in August, one of his daughters took ill.
It was, of course, Typhoid, and it wasn't
long before her sister, mother, a gardener,
and two maids were also sick.
The owner of the house was George Thompson,
and he was understandably worried; no one
would want to vacation there if it gained
a reputation as a place where an entire family
could fall mysteriously ill.
They were afraid the area water source was
contaminated, and knew they had to find out
exactly what happened before they could rent
the property again.
Thompson looked for and found a professional
to get to the bottom of things.
He hired New York City Department of Health
sanitary engineer George Soper to find the
source of infection, and he knew exactly what
to look for, as he had specialized in the
study of typhoid outbreaks.
At first, Soper thought the freshwater clams
that had been served to the family were a
likely source, but not everyone who developed
typhoid had eaten them.
Eventually, he honed in on Mallon as another
potential source for the disease.
His theory was quickly confirmed.
Mallon moved on from the Warren family and
showed up next as a cook in a home on Manhattan's
Park Avenue.
That's where Soper followed her, and when
he met her.
TITLE: Confronting Typhoid Mary
In order to confirm Mary Mallon was, indeed,
a carrier of typhoid, Soper knew he needed
to have her bodily fluids tested for presence
of the bacteria.
It's hard to imagine just how awkward that
conversation had to be; when Soper introduced
himself to her and asked her to provide samples,
well, he described the encounter like this:
"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.
It did not take Mary long to react to this
suggestion.
She seized a carving fork and advanced in
my direction.
I passed rapidly down the long narrow hall,
through the tall, iron gate, and so to the
sidewalk.
I felt rather lucky to escape."
Now, with the benefit of hindsight, it's easy
to vilify Mallon.
We know she was a carrier of Typhoid, but
she almost certainly did not.
She had never developed the disease herself,
and she did, at one point, voluntarily subject
herself to testing for the bacteria.
The chemist who performed the tests — who
was a respected professional — declared
she was free of any sign of disease.
It's suspected the tests were performed when
she was in a period of remission, which certainly
didn't make things any easier on either her
or Soper.
Just imagine: a stranger appears out of nowhere
and accuses you of being responsible for spreading
disease and sickness everywhere you've worked.
You are, allegedly, responsible for deaths,
despite the fact that you feel fine and have
never been sick.
At one point, a doctor has even told you that
you're fine.
It's no wonder that Mallon was less than willing
to submit to more tests, amid rumors that
would put her entire livelihood on the line.
There is another element at work here, too,
that may have attributed to Mallon's violent
outbursts when confronted.
The late 1800s was a time when the Irish were
emigrating to the US in droves, fleeing oppression
and starvation in their homeland.
Some made the journey on so-called "coffin
ships," packed with desperate immigrants and
so filled with disease and death that an estimated
25 percent died before they completed their
journey.
Their bodies ended up at the bottom of the
Atlantic.
Those that did reach America's shores were
starving and destitute by the time they got
there, and there were a lot of them.
Anti-Irish and anti-Catholic sentiment was
strong, and while there were some groups who
offered charity to the refuges, there were
more that whispered of a secret plot orchestrated
by the Vatican to instill Catholicism in America
as the dominant religion.
The Irish were condemned for supposedly taking
jobs from Americans and gallivanting as drunken
criminals.
Politicians who railed about the Irish nuisance
were preaching loudly from their pulpits to
a public that was more than happy to listen.
Homes and churches were burnt, and mob violence
took lives.
It was only in the 1880s that some politicians
began to see the large numbers of Irish as
valuable allies, but signs of "No Irish Need
Apply" were still fresh in everyone's memory.
For Mallon, it very well could have felt that
this was just one more way her new home was
persecuting her for the accent she kept throughout
her entire life.
Soper couldn’t give up, though, as he was
sure he was right.
Still, Soper knew he was right and couldn't
walk away.
He discovered exactly what it was that Mallon
had served to get everyone sick: ice cream
with fresh peaches.
Heat may have destroyed the bacteria in other
foods, but the uncooked peaches and Mallon's
unwashed hands were the perfect way for disease
to spread.
In 1906, there were 3,467 reported cases of
typhoid, and 639 of them were deadly.
The actual number of cases was probably much
higher, and if Typhoid Mary was spreading
it everywhere she went, it was only a matter
of time before the city had a potential outbreak
on its hands.
At the time, Soper was familiar with the idea
that people infected with disease could pass
bacteria on to others through various bodily
fluids.
But since Mallon wasn't sick and never had
been, this was completely different from anything
he'd seen before.
By the time Soper caught up to her at her
new job in Manhattan, there were already instances
of typhoid in the household she was cooking
for; one servant was infected, and the family's
only daughter was dying.
So, he followed her to the boarding house
she was living in and confronted her again,
with no more luck than the last time.
After he was turned down for fluid donations
a second time, Soper requested help from the
New York City Health Department.
He gave them a warning: in this case, they
needed to be prepared to use force.
The Health Department gave her one more chance
to peacefully agree to submit to testing,
and sent Dr. S. Josephine Baker to see her.
When she still refused to cooperate, they
sent the police.
Mallon tried to flee, but was eventually found,
forced into an ambulance, and taken to the
Willard Parker Hospital in what Dr. Baker
described as a "wild" ride, one where Dr.
Baker was forced to sit on her the entire
way to help restrain her.
She wrote, "...it was like being in a cage
with an angry lion," and it was no wonder
she struggled.
Police had carried her into the ambulance
after a five-hour chase, and Mallon was convinced
she had done nothing wrong.
TITLE: Mary Mallon enters into medical history
Once Mallon was transferred to the care of
a hospital, her bodily fluids were tested
repeatedly — three times a week, from March
to November — for traces of the bacteria
that causes typhoid.
Most of the tests confirmed the Typhoid bacteria
was there, but there were still some tests
that came back negative, which explains why
she might have had a clean test prior to Soper's
intervention.
It wasn't long before Soper found himself
sympathizing with Mallon.
She hadn't infected people on purpose, after
all, but she was still dangerous.
And now, she was being held in a small, uncomfortable
hospital room, under lock and key, while she
herself was of perfectly sound mind and body.
He tried talking to her, getting her to cooperate,
even suggesting she could have her gallbladder
removed, as it was a nonessential organ that
was probably the source of the infection.
But she refused to talk to him.
She stayed in custody for a full two years
before she sued for her release.
Mallon argued in court that she had never
been sick, but the courts viewed the findings
of the medical research far more compelling,
and refused to release her.
That was, they said, largely because they
didn't want to bear any responsibility, should
anyone else get sick or die from contact with
her.
It was another eleven months before Mallon
made a deal with the Health Department: she
could go free as long as she checked in with
them every three months, and never cooked
or handled food for others again.
Mallon agreed, was released, and promptly
disappeared.
Here's where things get a little dicey.
Mallon did spend some time working in other
professions, and she did get jobs in places
like laundries, where she would have been
no danger.
But she found it almost impossible to support
herself, and the temptation to return to cooking
— which paid a lot more — was too high.
So she went back in the kitchen, where she
continued to cook and continued to infect
a lot of people.
Soper was officially off the case, but he
continued to keep an eye on her.
She popped up cooking under the pseudonyms
Mrs. Brown and Marie Breshof, finding work
in a fancy hotel and a sanitorium, both in
New Jersey, along with a hotel in Southampton
and a restaurant on Broadway.
It's impossible to tell just how many cases
Mallon caused, but there were a lot.
It was during this period that the press had
officially christened her Typhoid Mary.
But here's the thing.
There's no real evidence that suggests Mallon
ever truly believed that she was the cause
of all these instances of typhoid fever at
the time she was first arrested and diagnosed.
She was the very first example of a completely
asymptomatic patient ever studied.
If the medical community didn't understand
the mechanics of what was going on, how was
Mallon supposed to?
It's also suggested that there was another
massive oversight in Mallon’s case.
When she was released, she was told not to
cook, and to take extra care when it came
to hygiene.
But she was never given any sort of specific
instruction on how to properly disinfect herself
and keep the bacteria off her hands, and she
was never given any kind of retraining or
direction on other ways she could support
herself.
There was no welfare system or aid available.
Mallon assumed authorities were simply trying
to label her a scapegoat for the outbreaks;
she didn't seem to think she was actually
doing any harm when she returned to cooking.
TITLE: The Question of Confinement
Mallon was initially released in 1910, and
it wasn't until five years later that a man
named Dr. Edward B. Cragin approached Soper.
He was an obstetrician at the Sloane Hospital
for Women, a facility that had recently had
more than 20 people fall ill to typhoid.
He had a suspect and a sample of her handwriting,
and asked Soper if he could identify their
cook.
He could.
It was Mallon.
Soper advised him to reach out to the Health
Department, and he did.
Mallon was arrested and sent to quarantine
on North Brother Island, an island in the
East River that was home to a hospital and
quarantine facility built in 1885.
It was home to patients suffering from illnesses
like tuberculosis, smallpox, yellow fever,
and, of course, typhoid.
Mallon would live among them until her death
in 1938.
Instead of feeling relief, Soper painted a
heartbreaking picture of a woman who no longer
fought against her own confinement.
He wrote:
"...she had been advertised to the world as
a dangerous person and had been treated worse
than a criminal, and yet she had not been
guilty of the least violence toward anybody."
Mallon seemed resigned to her lot in life,
finally admitting to herself that there was
a wave of typhoid that swept along behind
her wherever she went.
She was not the same person when she was apprehended
the second time, and there was little left
of what Soper described as her "almost pathological
anger."
She settled into her confinement willingly
enough, and they gave her a job in the laboratory,
where she ran medical tests.
They even gave her permission to visit the
mainland, where she regularly headed into
the city.
She always came back.
If she seemed resigned to her later confinement,
it was a resignation she hadn't felt in her
younger years.
Most of what we know of Mallon is through
the writings of Soper and other medical professionals,
although there are a few of her letters that
have survived.
In one, she describes being so distraught
over being arrested and confined to a hospital
for the first time, that she developed an
eye twitch that led to the paralysis of one
eye — a condition which went untreated.
When she was given medication, she complained
that she didn't need it: it was mainly used
to treat kidney issues, and she didn't suffer
from those.
She wrote of doctors that told her she needed
to have her gallbladder removed, then admitted
to her that the surgery might not make a difference.
And she wrote: "I'm a little afraid of the
people…
I have been in fact a peep show for everybody.
Even the interns had to come to see me and
ask about the facts already known to the whole
wide world.
The tuberculosis men would say, "There she
is, the kidnapped woman."
Dr. Park has had me illustrated in Chicago.
I wonder how the said Dr. William Park would
like to be insulted and put in the Journal
and call him or his wife Typhoid William Park."
It brings up an important question: did Mallon
deserve to be vilified to such an extreme
extent?
Should she have been advertised as cracking
skulls into a frying pan, as at least one
illustration showed her doing?
Or was she simply a victim of typhoid in her
own way, too?
TITLE: Unraveling the Mystery of Contagion
Mary Mallon was credited with directing spreading
typhoid to at least 50 people, and three of
them died.
She's even been named as the Patient Zero
who likely started a typhoid outbreak in 1907,
one that ultimately escalated to around 3,000
cases.
Even though she's the one most infamous when
it comes to healthy people who have had the
potential to spread a deadly disease, she
was far from the only one.
By the time she died, more than 400 others
had been identified in New York alone.
In fact, somewhere between one and six percent
of those infected with the type of salmonella
that causes typhoid become healthy carriers,
and it's a huge problem the medical world
hasn't known too much about until recently.
It wasn't until 2013 that studies done by
Stanford University School of Medicine researcher
Denise Monack yielded some insight into demonstrating
the mechanisms by which bacteria might infect
a person without making them ill.
Figuring out the mechanics of just how it
all works could lead to the development of
a treatment that would block typhoid's ability
to hitch a ride in a seemingly healthy host,
just as it did to Mallon.
Today, there are a lot like her out there.
Typhoid impacts around 16 million people a
year across the globe, and even on the low
end, that's 160,000 people capable of spreading
infection just like Mallon did.
Typhoid Mary died alone.
Soper wrote about her death after he was fairly
certain he had tracked down her sister, though
he could never conclusively prove their relation.
On Christmas morning in 1932, she was discovered
on the floor of her cottage, paralyzed from
a stroke.
She was moved to the hospital, where she lived
until her death on November 11, 1938.
Afterwards, there were advertisements taken
out in several newspapers for the span of
a month, appealing for relatives to come forward
to claim the little money she left behind.
No one ever did.
Only nine people attended her funeral, and
no one followed her to witness her burial
at St. Raymond's Cemetery in the Bronx.
There's a bit of rumor surrounding her death
as well.
An autopsy was said to have turned up a high
concentration of bacteria in her gallbladder.
If she had agreed to the operation to remove
it, would she have been cured?
It's entirely possible, the rumor implies,
but it's not that clear-cut a case of regret.
Some researchers — including Soper — say
there never was an autopsy, and the tale is
retold to help justify her imprisonment.
Which is true?
It's impossible to say.
