I had long been familiar with the epithet “Typhoid Mary” but knew nothing about the real Mary Mallon until I happened to see a TV documentary about her case. She ended up inspiring my novel, Fever.
Mary Mallon was a cook living in the US at the turn of the last century when it was discovered that she was a "healthy" carrier of typhoid, and had allegedly infected several households where she had worked. Pursued by medical experts, Mary already had several strikes against her: she was an unmarried woman in her late thirties; she was a servant; she was an Irish Catholic; she was an immigrant.
Former employers described her as proud, and while pride might have been admirable had Mary been born higher, in an uneducated servant it presented as insolence. She seemed satisfied in her work as a cook, and that was another strike against her. Here was a woman who didn’t quite fit the mould of what a woman should be.
Though the experts admitted that Mary posed no danger as long as she wasn’t preparing food, they forced her into quarantine. There were other healthy carriers found after Mary was discovered, several of whom were linked to far more cases than her, and at least two of them went back into food service after being made aware of their carrier status. Yet no other carrier was placed in permanent quarantine as Mary was, and it’s impossible not to wonder whether that’s because those other carriers were American-born men, the heads of their households. She was demonised for who she was as much as for the disease lurking within her body.
The more I read, the more vivid Mary became and I began to understand that the implications of her case went beyond the struggle between an individual’s rights and protection of the public as a whole. For me, her story struck at the heart of human nature: how we judge and interpret one another, how we rationalise and obfuscate, how we – past and present – are constantly casting about for ways to survive.
Over the course of the last century, the question of whether protecting the public’s health trumps individual rights has taken many forms. In 1985 a US poll concluded that most Americans favoured quarantine of AIDS patients, and some even supported using tattoos to mark those who tested positive for HIV.
And recently we’ve seen the involuntary quarantine of people with drug-resistant tuberculosis. Russian-born US immigrant Robert Daniels was diagnosed with a drug-resistant strain of TB and placed in isolation in 2007 after walking outside without a mask. For almost one year he was kept in a room without windows, without a television, was not permitted exercise and was not allowed to shower. Only when the American Civil Libertires Union took up his cause was he moved to a hospital with more humane conditions.
In Mary’s day, the media made special note of her personal appearance: whether she was “neat,” and “attractive”. Despite the fact that she could have had no way of knowing her carrier status – the concept was unheard of beyond certain medical circles – her culpability depended on how well she fit into the social mores of the time.
What little I read about Robert Daniels during the course of my research also made sure to mention those characteristics that made him stand apart from his neighbours in Arizona: he was Russian, and he had a history of drinking and drug abuse. Though those details should have been irrelevant when it came to how he was treated, it seems to me that we still use that “fitting in” standard to decide whether to condemn or exonerate.
While there is no doubt that containing certain highly contagious diseases presents a real ethical dilemma, it seems to me that the detail we keep forgetting, in Mary’s day and now, is that having a disease is not a crime, and does not make a criminal of the person carrying or suffering from that disease.
We need to begin the discussion with sympathy, and move from there.
Fever by Mary Beth Keane is published by Simon & Schuster.