Lore - Episode 86: Under Siege

Episode Date: May 14, 2018

Our bodies are a fortress, and every day, they suffer through attacks from the outside. Over the centuries, we’re become very good at protecting ourselves from illness and disease, but all of those efforts assume everyone around us will be responsible. Illness, though, has often been misused—sometimes maliciously and other times through sheer ignorance—and the results have been horrifying. Learn more about your ad-choices at https://www.iheartpodcastnetwork.com Access premium content!: https://www.lorepodcast.com/support See omnystudio.com/listener for privacy information.

In 2014, archaeologists working along Hadrian's Wall in Northern England found something amazing. There at the bottom of a mud-filled pit of garbage was a perfectly intact 2,000-year-old toilet seat. Historians had already learned a lot about Roman toilets over the years, but this was the first time an actual seat had been discovered. It was carefully carved from a single piece of wood and had a shape that would be instantly recognizable to any of us today. That narrow, sea-shaped curve that sits between the toilet itself and the person using it, it's become part of the universal language of sanitation, along with pipes and running water, all of which are tools designed to keep us clean. The rise of major civilizations has always

tended to run parallel to their access to fresh water. The Romans are a prime example of this. Their massive network of 11 aqueducts, which delivered roughly 300 million gallons of water to them each day, allowed them to grow and flourish as a culture. Without fresh water, we might not have had the Romans at all. History is littered with our mistakes, though. Poor conditions led to an outbreak of typhoid fever in Athens around 430 BCE, killing a quarter of the city's population. The plague of Justinian raged across the Byzantine Empire for almost two centuries, and by the time it was finished in 750 AD, half of Europe was dead. 600 years later, the plague returned to claim millions more.

Over the centuries, humans have proven the old adage that cleanliness is next to godliness. That being clean is the best way to stay healthy and fight disease. When we do it right, a society can be transformed, elevating the quality of living to a whole new level. When we fail, though, bad things can happen. And sometimes, as history has shown us, those bad things have been intentional. I'm Aaron Mankey, and this is Lore. The city of Fiodosia, once called Kaffa, is an ancient seaport on the eastern side of Crimea, the peninsula that juts down from the north into the middle of the Black Sea.

It was founded nearly 800 years ago by Italian merchants from Genoa who were given permission to settle there by the Mongol Empire, the biggest kingdom the world had seen up until that moment. By the early 1300s, though, relations had soured between them. The Mongol rulers felt that the Genoans were a bit deceitful and disloyal, and after years of tension, they sent forces to reclaim Kaffa for themselves. In 1343, a Mongol army laid siege to the port city, but although they outnumbered the Genoans, the fighting was frustratingly slow. And then, the plague arrived. While the Genoans watched from inside their walls, their attackers began to die off.

It was one of the first waves of the Black Death, that notorious disease that scientists call Yersinia pestis, to reach the edges of the west. Most historians think it had followed the Mongols west from Lake Yizikul, one of the main stopping points on the ancient trade route known as the Silk Road. When it finally caught up with the Mongol forces at Kaffa in 1346, it decimated them. But in that desperate hour, they tried something new. They gathered up hundreds of bodies of plague victims, loaded them into their catapults, and launched them into the city. The best contemporary account is a memoir by the Italian Gabriel de Mussi. This is what he wrote in 1348.

What seemed like mountains of dead were thrown into the city, and the Christians could not hide or flee or escape from them, although they dumped as many of the bodies as they could in the sea. And soon, the rotting corpses tainted the air and poisoned the water supply, and the stench was so overwhelming that hardly one in several thousand was in a position to flee. Today, historians and microbiologists considered the siege of Kaffa to be one of the earliest examples of biological warfare. It was a shift in the way people thought about disease. And while Kaffa didn't fall to the Mongols that day, the plague was pushed by humans into one of the busiest port cities in the ancient world. From there, it would eventually spread west,

taking the lives of close to 100 million people over the next five years. It might have been one of the first uses of disease as a weapon, but it sadly wouldn't be the last. A few centuries later in North America, it was the Europeans' turn to give it a try. In 1758, after four years of conflict known as the French and Indian War, the British came to an agreement with the Native American tribes who lived in what would become Ohio and Western Pennsylvania. The British promised to leave the area if the Native Americans broke ties with their French allies. After a number of tribes followed through with their promise, the British changed their minds, provoking a siege of Fort Pitt right there in modern-day

Pittsburgh. As part of their strategy, the British took items that had been exposed to the smallpox virus and gave them to the Native Americans as Trojan horse gifts. The outbreak that followed is said to have killed at least 100 Native Americans and left their forces too sick to maintain the siege, but it was worse than that because, like the plague in Kaffa, the spread of smallpox reached beyond Fort Pitt, eventually killing Native Americans all across the region. In 1940, Japanese forces bombed a city in northern China with fleas infected with smallpox. And while their efforts weren't the most effective, historians believe upwards of 400,000 people were infected in the resulting outbreak. Two years later, the Japanese tried

again farther south, but some of their ceramic smallpox bombs inadvertently fell on their own troops, infecting close to 10,000 of them. Disease is powerful because it's invisible. The people of Kaffa only saw bodies, but the real weapon lay inside them. As we've learned more about how diseases work, it's opened up new ways to abuse that power, because the human body will always be at risk of a siege from the outside, which is why we've gotten very good at defending ourselves. But that's not always been enough. That's because our defense hinges on the assumption that the person who is sick knows that they are, that they're aware and responsible and will do anything to protect others. But what if they aren't? What if they were fully aware of the risk

they pose to the people around them, but they couldn't care less? The results, as history is about to show us, can be devastating. We don't know a lot about her early life, but a few details have stuck around. We know she was born in Cookstown, a poor village in the northern part of Ireland in 1869, and we know that she boarded a ship at the age of 14 and came to America. The 1880s and 1890s were massive years for immigration. That's when my own family arrived at Ellis Island in New York, and I bet a lot of you have a similar story. Mary came for a better life and a chance to start fresh and work towards something bigger. After arriving, though, she vanished from the public record.

Then, 16 years later, she resurfaced. She was 31 years old by then, all grown up and out on her own. Over the years between 1900 and her youth in Ireland, she had become a good dependable cook and had begun offering her services to some of the wealthy families of New York. The first job that we know about, the one that she took in 1900, was for a family in a village just up the coast from Staten Island, overlooking Long Island Sound. For a number of decades, it had been the summer destination for families wanting to get out of New York City, but some also moved there full-time. To Mary, that meant a lot of potential employers. She settled in with that family sometime in early August of 1900, and for a while,

things seemed to be going well. Then, a couple of weeks later, a guest arrived to stay with the family, and shortly after, he became sick. And not just sick, this guest had typhoid fever. Typhoid fever had been around for thousands of years. It's the disease responsible for the plague of Athens I mentioned earlier, and it's difficult to find a military conflict since then that doesn't see a few cases. That's because military camps, for a very long while, were on sanitary places, and typhoid fever is spread through contaminated food and water. But science has a way of conquering things over time, and in 1880, they managed to identify the bacteria that caused the illness. In 1896, just four years before the house guest became sick,

the first ever typhoid fever vaccine was introduced, but it was rolled out slowly. Too slowly, in fact, in 1900, over 35,000 Americans died from the disease, which meant that, while people were hopeful, they were also still very nervous. So, when this guest became ill, Mary packed up and left before she herself could do the same. That's okay though, because there were lots of other big families around, in equally big houses, and many of them would need a cook. Mary managed to escape the illness and find a new job, so life went on. In 1901, while working for another family, one of the housekeepers became ill. Again, it was typhoid fever, and again,

fearing for her own safety, Mary left. After that, she caught wind of a job in Maine and traveled north in 1902 to cook for the Drayton family there. Two weeks after her arrival, though, one of the children became sick. Within a month, seven of the nine family members were in bed, horribly ill. The culprit? Typhoid fever, of course. But Mary was helpful and brave. She stayed on longer than she would have liked, risking her own health to help the family out. The father, Mr. Drayton, was so glad for her help that he gave her a large bonus as she was leaving. After that, it was more and more of the same. Mary bounced from house to house, cooking for a while and then leaving out of fear. In 1904, while she was working in a house at Sands Point,

four of the servants she worked with on a daily basis became sick. I have to think Mary was beginning to panic. There was an outbreak of typhoid fever happening. The evidence was all around her, it seemed, and I can't blame her for running away. It's also important to point out New York City did seem to be experiencing a sharp uptick in cases of typhoid fever. In 1899, there had been only 2,000 confirmed cases of the disease, but by 1905, that number had doubled to over 4,000, ultimately claiming more than 600 lives that year. The risk was real, and Mary, like a lot of other people in New York City, felt threatened and unsafe, so she continued to run.

Everything Mary experienced reinforced this, too. There was an outbreak taking place around her, and I mean that literally. Everywhere she went, people would get sick. Maybe she noticed and forced herself to ignore it, or perhaps she was honestly clueless and unaware. That didn't matter, though, because others were about to catch on, and once they did, they wouldn't allow Mary to run any longer. Her past, it seems, was catching up with her. In the summer of 1906, Mary landed a job at the summer house of a wealthy banker named Charles Henry Warren. Like a lot of her previous employers, the Warrens had rented a large house overlooking the waters of Long Island Sound. It was summer. The ocean was blue,

and life must have seemed good and full of joy. For a while, at least. In August of that year, six of the people in the house, a mixture of family and staff, all came down with typhoid fever. It happened so quickly and infected so many people at once that the owner of the house, a businessman named George Thompson, panicked. He feared that the health department would condemn his profitable rental property and burn it to the ground, so he asked a nearby hospital to send someone out to investigate the cause. The trouble was, they couldn't find a source. They were able to map out the spread of the disease through the household, but when they followed it all the way back to the first person to get sick,

that was it. They were stuck. So, Thompson sent a message to the Department of Health asking for someone more qualified and skilled in this sort of situation. What they sent him was a sanitary engineer. Now, sanitary engineers had already been around for decades at this time. They were civil engineers tasked with keeping the water supply as clean as possible, but in the late 1880s, an MIT professor named William Sedgwick took the field to a whole new level, setting it on a trajectory that's led to our modern water filtration plants. Basically, we have Sedgwick to thank for those clear sewage-free glasses of water that we drink every day. In the 1890s, though, the field was just getting started, and sanitary engineers

in New York City were pulling double duty as both scientists in charge of keeping water clean, and also detectives going out into the city to track down the real sources of new epidemics. And that's the sort of person George Soper was and why he was sent to the Warren household. What he discovered there was frightening. Each and every one of the people in the house infected with typhoid fever had contracted it from a single source, a food prepared by the cook. You see, Soper was a well-read scientist, going so far as to have European medical papers translated so that he could learn from advancements overseas. And one of the new ideas he had encountered was this idea of an asymptomatic carrier, people who are infected with the disease

but show none of the symptoms. The trouble was, Mary had already run, so by the time Soper figured out who he needed to talk to, the cook had vanished into the wind. Now remember, this was 1906, so tracking people down was a lot harder than it is today. He couldn't just pick up the phone and call her, which is why the detective part of his training was necessary. All Soper had to go on was her full name, Mary Mallon, but there was also the agency that had placed her in the Warren household. Starting there, managed to get a list of all the places she had worked at prior to 1906, and out of those eight families, seven of them had experienced a typhoid fever outbreak.

There had even been fatalities, which was one reason Soper wanted to work so fast. Mary Mallon was a walking incubation chamber for typhoid, and she didn't know it. Thankfully, the employment agency was also able to give Soper the address of Mary's new job, but by the time he found out about it, one of the children in the house was close to death, so he traveled to the house in hopes of seeing Mary for himself. Obviously, he had a lot to discuss with her. You have to understand just how driven George Soper was. He'd managed to track the source of an outbreak to a new type of patient, one that didn't actually look or feel sick, and this was huge for two reasons.

First, if it was true, it would open up a whole new way of approaching the work of public health officials, potentially bringing an end to the constant outbreaks they fought like firefighters. Second, though, it meant that if Mary wasn't stopped immediately, things could get very bad, very quickly. When he knocked on the door in March of 1907, and Mary actually answered, all of his excitement became uncontainable. She invited him into the kitchen and asked what his business was, but rather than explain the situation slowly and clearly, he immediately asked for samples of her urine and feces. Shocked and offended, Mary picked up a rolling pin and chased Soper out the front door. George Soper was persistent, though. After tracking down the man

she was living with at the time in a room above a tavern, he sat outside the door one evening, waiting for her to return home. But when she did, he made a better second attempt at his request, but Mary was still put off, and she screamed at him until he was forced to leave. With no other choice left, Soper paid a visit to the local Department of Health and told them the situation. On March 20th of 1907, they sent an ambulance to Mary's Park Avenue location with a team of police officers, medical interns, and a physician named Dr. Josephine Baker. They had instructions to bring Mary in, whether she wanted to or not. Mary, however, was not about to go quietly.

I don't know if the police had to knock the front door down, or if it was already unlocked. What I do know is when they arrived and Dr. Josephine Baker knocked on the door, Mary opened it up, took one look at the collection of medical professionals on her doorstep, and then slammed it shut. After that, she vanished into the depths of the house. It was a high stakes game of hide and seek, one where actual lives were at risk and the pressure was beyond intense. They tore the place apart looking for her, but after the better part of three hours, they came up empty. Mary Mallon had somehow slipped away. That's when one of the officers stepped outside the back door. The fenced-in yard was tiny and

cramped, but he did notice a chair sitting in the grass beside the fence, a kitchen chair. He alerted the others, and soon they were all climbing over into a neighbor's yard, which is where they found the hem of Mary's dress sticking out of the door of a small shed. Dr. Baker would later describe the capture of Mary to George Soper. She fought and struggled and cursed, she told him. I told the police to pick her up and put her in the ambulance. This we did, and the ride down to the hospital was a wild one. And she should know. Dr. Baker apparently had to sit on Mary the entire way in an effort to

keep her from thrashing about. She later told reporters that it was like being in a cage with an angry lion, but they'd captured their suspect, and that was all that mattered. Mary was tested for typhoid fever multiple times through urine and stool samples, and almost all of those tests came back positive. She was exactly what George Soper had thought she was, an asymptomatic carrier of a deadly disease. To keep the general public safe, she was transported to Riverside Hospital on North Brother Island in the middle of the East River. That was 1907. Nearly three years later in 1910, she was still there, still captive, still in isolation. They had explained to her how she carried the disease without knowing it,

and how, because of that, she had infected nearly a dozen families. People had died, they told her, but they also thought they knew how to help her. All they had to do was remove her gallbladder, and she would be a safe and normal member of society once again. Mary, however, refused. She refused to believe she was sick. She refused to allow them to operate. She refused to admit that she might be responsible for an outbreak of a deadly disease. And so for three years, she lay in a hospital bed, just waiting. I imagine that her release from captivity was a complete shock to her. In February of 1910, the new commissioner of the health department decided that enough was enough. If Mary would swear

to never work as a cook ever again, he would agree to let her go free. Mary pledged to follow his instructions, left the hospital, and vanished. She tried her hand at running a boarding house, but it turns out she wasn't very good at that. She missed the good pay that came with being a cook. But Mary Mallon wasn't allowed to do that anymore. So she did the only thing she could think of. She changed her name and got a new job as a cook. And she did this for five more years. In 1915, our old friend George Soper received a message from Sloan Maternity Hospital in New York City. They had 25 patients who had come down with typhoid fever, and they believed that they had identified the suspect, a woman who cooked for them, a woman named Mary.

When the authorities arrived to take her into custody this time, Mary didn't fight back. All told, Mary Mallon spent about 26 years in captivity because of her illness. It was one of those real-life examples of that old Star Trek notion of the needs of the many outweighing the needs of the few. However cruel it might have been. Mary was a Trojan horse of disease, and during her few years as a cook in the city, she had infected dozens and killed at least three. As barbaric as it sounds to us today, the Department of Health at the time felt that if she couldn't be cured, she had to be kept. But it wasn't all darkness and isolation for Mary.

During her second stay on North Brother Island, the hospital staff there actually gave her a job in the on-site lab. It paid well too. They gave her a small cottage outside the main building, and every now and then she was even allowed to go into the city to shop and see old friends. They say she read a lot in her spare time. Mary had a stroke in 1932. A deliveryman found her on the floor of her cottage unable to get up, so she was moved into the hospital and taken care of there. She lived another six years before passing away in November of 1938. She was just 69 years old. The threat of infectious disease will always horrify us.

The fear is similar to being in a crowded room, and someone shouting that there is an invisible killer among the people there. Panic and chaos would take over in a heartbeat, and every single person would become George Costanza shoving their way to the door without a second thought for the others around them. Like that ancient fortress of Kaffa, our bodies are under siege every day by invisible forces, and if we ever need proof of that, we needn't look further than Mary Malin. Dr. Josephine Baker's boss, a man named Walter Bensel, referred to Mary as a living fever factory. She just didn't know it. If you dig around the internet enough, you're probably going to read that the staff of the

hospital performed an autopsy on Mary's body after she died. Those stories say that the medical examiner removed her gallbladder and found it to be teeming with the bacteria that causes typhoid fever. But according to George Soper himself, those stories are lies. In an article written a year after her death for the Bulletin of the New York Academy of Medicine, Soper explicitly wrote, There was no autopsy. There was barely even a funeral. Soper records that only nine people attended her services at St. Luke's, and none of them were staff from the hospital. After a tragic lonely life, Mary Malin received an equally tragic and lonely send-off. He doesn't come out and say it, but there's a sadness in between

Soper's words. To him, she was remarkable. For decades after, Mary was used as the literal poster child for infectious disease. They called her typhoid Mary, and cartoons would usually show her cooking a meal. In one of the better-known examples, Mary is sprinkling little skulls into a frying pan. Thanks to her, the world became more aware of how careful we need to be about the food we put in our bodies and who prepares it. Her story isn't without flaws, though. There are deep ethical questions about the way the entire situation was handled. Somehow, in 1907, the forced captivity and isolation of a human being was presented to the public as a good idea. Mary, though, had a different opinion. She claimed it was discrimination, that she was only treated

this way because she was Irish and lower class. Before her death in 1938, another 400 asymptomatic patients were discovered in New York City, but none of them were forcibly confined like Mary. Judith Walzer Leavitt, a professor of medical history at the University of Wisconsin, presents the best balance I've read on this topic. Wherever we position ourselves, she writes, as individuals and as a society, we must come to terms with the fundamental issue that whether we think of them as guilty or innocent, people who seem healthy can indeed carry disease and, under some conditions, may menace the health of those around them. Optimally, we search for responses that are humane to the sufferers

and, at the same time, protect those who are still healthy. I'm not saying it's an easy topic to nail down. On one hand, if a contagious plague broke out in our community, any of us would fight for our family's ability to stay away from those who were infected. On the other hand, though, all of those patients deserve to be treated humanely. At the end of the day, it's all hypothetical for most of us. We don't have to make those choices right now, but Mary lived them each and every day. She fought for her freedom and lost. Sure, some people think the authorities did the right thing, but others disagree. What they can all agree on, I suppose, is that people were afraid.

And we still are, nearly a century later, with bacteria adapting to resist modern antibiotics, and each season of the flu seemingly worse than the last. It's difficult not to ask the same hypothetical questions George Soper and Mary Mallon were forced to face. What would you deserve if you were sick? What would you deserve if you weren't and wanted to keep it that way? The answers to those two questions stand on opposite sides of the debate, and both of them have valid points. It might be overly optimistic of me, but let's hope we never have to pick sides. Mary Mallon spent most of her 26 years of captivity living on North Brother Island

in the middle of the East River. It's easy to think of that place as a disposable prop in a larger story, but what most people don't know is just how tragic of a past that island actually has. If you'll join me, I want to give you a brief tour of that dark place that was so much more than just a prison for Typhoid Mary. Stick around after the break to learn more. Europeans have been visiting New York City for almost 500 years. Of course, in 1524 there was no city, and the places we know today as Staten Island, Queens, the Bronx, Manhattan, and Brooklyn were all inhabited by the Native American tribe known as the Algonquins,

but not North Brother Island. In fact, even though the Dutch laid claim to the small 20-acre island way back in 1614, no one actually inhabited the place until 1885. That's when Riverside Hospital, Mary Mallon's unwanted home, was built as a way of isolating and treating people suffering from smallpox. Then, in June of 1904, tragedy struck. Over 1,300 members of a local church climbed on board the General Slocum, a side-wheel steamboat that had been operating in the East River for a little over a decade. They boarded the ship on June 15th with plans to travel to a picnic site known as Locust Grove, but they never made it. The fire broke out in the lamproom and quickly spread throughout the ship.

The captain called his crew to action, but there was nothing they could do. All of the fire hoses and life preservers had been left unchecked in the sun for years and just fell apart in their hands. They were trapped on a burning ship in the middle of a river. The ship finally came to a stop just off the coast of North Brother Island, but it was too late. Over 1,000 passengers were dead, the biggest loss of human lives in the history of New York City, a tragedy that would stay on the records until September 11th, 2001. Hundreds of bodies washed up on the shore of the island, and while they were eventually collected and given a proper burial, some people think they left a bit of themselves behind,

a darkness that has haunted the island ever since, and they point to the decades that followed as proof. Riverside Hospital continued to play host to the sick, although over the years that sickness of the moment always seemed to change. Smallpox gave way to typhoid fever, and then tuberculosis. They even built a brand new wing for those TB patients, but an antibiotic was discovered almost immediately. After the hospital closed, the building was briefly used as college housing for World War II veterans taking classes at local schools, but by the early 1950s, everyone was gone. There was an attempt to use the island as a rehab center for troubled youth in the early 60s,

but even that seems to have failed. Today, the island is home to wildlife, empty buildings, and, according to some, the ghosts of the past. Visitors to the island have reported unusual experiences that left them feeling unsettled and afraid. Some have heard voices or felt invisible hands touch them as they walk the halls of the old buildings. Others have seen shadows that move or clouds of unnatural mist. It's enough to keep most people away. Mary Mallon, it seems, was a woman of the islands. The green beauty of Ireland and the bustle of New York City contrasts starkly with her final years on that much darker patch of land. I can't help but assume she was haunted by all sorts of demons. Most, I'm sure,

were personal. Her anger and frustration, her loneliness and fear, but perhaps a few of them were already there before she arrived. And if the stories are true, they've never left. This episode of Lore was written and produced by me, Aaron Mankey, with music by Chad Lawson and research help from Marsette Crockett and Carl Nellis. If you're new around here, this is my friendly reminder that Lore is a lot more than just a bi-weekly audio story. There's an ongoing book series from Penguin Random House, a television show available on Amazon Prime, a membership site with extra episodes, and so much more. You can learn all about everything over in one place, theworldoflore.com slash now. And if you don't want to miss out on anything new

that's happening and you're a social media sort of person, you're welcome to follow the show on Twitter, Facebook, and Instagram. Just search for Lore podcast, all one word, and then click that follow button. And when you do, say hi. I like it when people say hi. And as always, thanks for listening. I'll see you next time.