Tuesday, March 3, 2020

The Cook Who Was Quarantined For 26 Years

Mary Mallon was born in (no kidding) Cookstown in County Tyrone of present-day Northern Ireland - about 45 miles around Lough Neagh west of Belfast - on September 23, 1869. In 1883 Mary escaped the poverty of Cookstown by herself to join her aunt and uncle in New York City, upon which she was employed as a cook for wealthy families.

Up to this point - and this point only - hers is a fairly traditional immigration story. Poor girl from Ireland moves to New York City in the 19th century and gets a job as a wealthy family's help. Standard stuff. Now it gets weird.

From 1900 to 1907 Mary worked for seven different families. Throughout the 19th and early 20th centuries, Typhoid was A Thing About Which To Be Worried. It's a bacterial infection that results in a high fever, vomiting, and diarrhea. You can get it from contaminated drinking water or mishandled food. Wash your hands often, and it's generally not an issue. However, in 1906, New York City alone endured over 3,400 cases of typhoid reported, with 639 deaths.

People who lived in the houses where Mallon worked tended to get sick. Typhoid Fever sick. Two dozen of them, in fact, in houses where Mallon served as a cook. By the time public health officials were able to trace the source of the typhoid outbreak back to the house, Mallon had moved on to a different house.

Enter George Soper. Soper got a degree from Rensselaer Polytechnic Institute in 1895, and was awarded a Ph. D. in sanitary engineering in 1899 from Columbia. Soper's specialty was investigating the origins of typhoid outbreaks. He had worked for the Boston Water Works and successfully investigated typhoid outbreaks in Ithaca, among other cities.

In Summer 1906, General William Henry Warren - a well-off New York banker - had rented the house of Mr. & Mrs. George Thompson in the Oyster Bay section of north-central Long Island. Oyster Bay is the home of the Seawanhaka Yacht Club - one of the oldest yacht clubs in the western hemisphere. It's that kind of place. Think: Gatsby. Notable people from Oyster Bay include Billy Joel, Sean Hannity, and John Gotti, Jr. Oyster Bay was the site of Theodore Roosevelt's "Summer White House." General Warren had his family and seven servants with him. One of those servants was Mary Mallon. Typhoid ran rampant throughout the house, causing severe illness to six people - first Warren's daughter, then two maids, and then Warren's wife. Then another daughter, then the gardener.

The Thompsons heard of Soper through some social connections and hired him to investigate the cause of the outbreak. If the Thompsons could find the cause and correct it, they could rent the house out again the following summer. Soper couldn't find anything. The closest he could come to an explanation surrounding the Thompson house was an "old Indian woman who lived on the beach had brought polluted shellfish," but he eventually ruled that out, as well.

Ultimately Soper settled on a theory he had read in some German papers that there are people who could be "carriers," or people who had the bacteria and weren't affected, but just straight up wrecked those who would be affected by the bacteria. This would be the first recorded instance of a carrier in the United States. Mary Mallon had infected feces. And sanitation wasn't exactly highly regarded at the time, and she was a cook...you see where this is headed.

Mallon loved to serve an ice cream dish with fresh sliced peaches. Soper knew this would have been an extremely easy way to transmit typhoid. Why? Because it wasn't cooked. Pretty much every other meal would have been heated to the point that it would have killed the bacteria. But Mary Mallon had left the employ of the Warrens in September 1906, six months before Soper was hired by the Thompsons. Soper found that Mallon had been hired by the Warrens through the well-known Mrs. Stricker's employment agency on 28th Street in Manhattan. Mallon kept to herself, so the other servants couldn't offer much in the way of information, other than that Mary Mallon "was not particularly clean."

Armed with this information, Soper discovered that seven of the households for which Mary worked from Long Island to Manhattan to Maine had experienced a typhoid outbreak. After leaving the Warrens, Mary was a cook for just over a month at a house in Tuxedo, NY, upstate a little bit. There was a typhoid outbreak. It took Soper four months to find Mary Mallon, which he did, working as a cook on Park Avenue. Soper:
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, out through the area and so to the sidewalk. I felt rather lucky to escape.

A subsequent interview didn't feature threats of violence, but Mary dismissed the idea of her being a typhoid carrier. Soper found that Mary Mallon was soon to leave her post on Park Avenue, and knew that finding her again would be extremely difficult, so he brought her case to the attention of Health Commissioner Thomas Darlington and NYC Health Department Medical Officer Dr. Hermann M. Biggs. They sent the police to bring her into custody. When they knocked on the door and tried to enter, Mary took off running out a window and over a fence. Ultimately, she was found hiding in the outside closet of a nearby house, and taken to Willard Parker Hospital (which was known for treating patients with communicable diseases) on East 16th Street along the East River for observation where she "provided" a fecal sample which tested positive for pure Bacillus typhosus. 

Due to her being deemed a flight risk, Mary was essentially arrested and placed into quarantine. It was 1907. The San Jose Evening News wrote:
The case is without parallel in medical records. Never has there been an instance, as the present, where a woman who never had typhoid fever should prove a veritable germ factory.

She was furious about her situation. She was perfectly healthy and, to her knowledge, had never gotten anyone sick, but she apparently refused to cooperate with Soper and the Department of Health. They transferred her to Riverside Hospital on North Brother Island, on the East River between The Bronx and Riker's Island. Riverside was another communicable diseases hospital (specializing in smallpox patients) founded in the 1850s.

At Riverside, Mary was given "a little bungalow" originally built for the superintendent of nurses. Soper noted that she had a living room, kitchen, and bathroom with gas, modern plumbing, and electricity, "pleasantly situated on the river bank, next to the church." Someone even cooked her food for her, which she ate alone. Soper seemed incredulous that a lawyer named George Francis O'Neill took up Mary's case after the William Randolph Hearst's New York American published a story about "Typhoid Mary" on June 20, 1909. Mary had been quarantined for two years.

Eight days later O'Neill - 34 years old and a former customs official who had been admitted to the bar two years earlier - filed a habeas corpus petition for Mary's release from prison. O'Neill argued a lack of due process in Mary's detention - she had not been accused of a crime and not given a hearing and had never engaged legal counsel. The case made it to the New York Supreme Court, which ruled:
The liberty secured by the Constitution of the United States to every person within its jurisdiction does not import an absolute right in each person to be, at all times and in all circumstances, wholly freed from restraint. There are manifold restraints to which every person is necessarily subject for the common good. 

Basically: Mary Mallon's freedom wasn't worth everyone around her getting typhoid. Despite her condition being a natural one, and one she couldn't necessarily control, and that her condition not actually a crime, Mary Mallon was a danger to society.

However, the Health Department Commissioner Ernst Lederle believed Mary had learned about how to properly manage her condition and released Mary on her pledge to not handle or cook food for anyone and appear before the Health Department every three months. She was not trained in any other occupation. As soon as she was released, Mary bounced. She changed her name and worked as a cook in restaurants, hotels, even sanitariums for five years. There were typhoid outbreaks throughout those five years, but due to the noms des cuisines (probably not correct French, but whatever) it's kind of impossible to know how many of those were due to Mary's poop-stained fingers.

The head OB/GYN at Sloane Hospital for Women in midtown Manhattan called Soper asking him to come to the hospital for a "matter of great importance." He had 20 cases of typhoid on his hands and a cook who the other workers called "Typhoid Mary." Could Soper come see if it was her? Soper did, identified her as Mary Mallon, and the Health Department was notified. This time she submitted to the Health Department without a struggle.

Mary stayed on North Brother Island for 23 years. She was allowed to occasionally leave and visit the City, but always came back. In 1932 she had a stroke and was paralyzed from the waist down, and passed away in November 1938. Mary Mallon was 69 years old, with a funeral at St. Luke's that only nine people attended, and was buried in The Bronx.

Throughout her career the number of typhoid cases directly attributed to her numbered 51, with three deaths as a result. The actual number is surely higher.