The Case of Typhoid Mary

For four years now, any talk of allowing society to function in the event of a pandemic has called forth cliches about Typhoid Mary. It’s remarkable how this real event, a paradigmatic case of awesome and egregious powers of public health, in which a poor Irish immigrant was scapegoated for typhoid infections in New York, still survives – fully 100 years later. 

Even otherwise scrupulous scholars I knew have tossed out her name expecting it to end all discussion of the necessity of lockdowns. 

It’s time we examine the case. Typhoid Mary was a real person, Mary Mallon (1869-1938). By all accounts an excellent chef who had served many families and had outstanding skills. She was never symptomatic for typhoid. She was healthy and well. But when there was an outbreak at a home she served, she was hunted down, her stool tested positive, and then she was quarantined in New York as an asymptomatic carrier (1907-1910). 

Legal pushback led her to be released three years later on the condition that she check in and never cook again. She defied both conditions and so was hunted down yet again. This time medical authorities demanded to remove her gallbladder which she refused to permit. She ended up spending a total of 26 years in solitary confinement before she died (1915-1938). 

There is in fact a large literature on the case. The best are Famous and Difficult Patients: Amusing Medical Anecdotes from Typhoid Mary to FDR, by Richard Gordon (St. Martin’s Press, 1997); Typhoid Mary: Captive To The Public’s Health, by, Judith Walzer Leavitt (Beacon Press, 1996); Typhoid Mary: The Notorious Life and Legacy of the Cook Who Caused a Typhoid Outbreak in New York, by Charles Editors (2020) and many more but above all, Typhoid Mary, by Anthony Bourdain (Bloomsberry, 2005), which is a brilliant, engaging, and deeply sympathetic book. For a quick overview, there are many articles online. 

All are fascinating and in agreement that Mary likely (probably) spread typhoid, along with many hundreds of others in New York who were never hunted and jailed. She never felt sick. She frequently tested negative and deeply distrusted the authorities that hunted her down. The man who started the whole bit was a lawyer/investigator named George Soper who ended up writing an article and book that caused her to forever live with the moniker. This book became a bestseller and Soper himself became a famous and beloved disease sleuth. 

The public was so enthralled with the case that New York kids would skip rope to the line: “Mary Mary, what do you carry?” She tried to sue but her case was rejected by the New York Supreme Court. She was not allowed to see an eye doctor even though her eyelid was paralyzed. She was forced to take unproven treatments that threatened to destroy her kidneys. 

No question that tagging her as public enemy number one was a reflection of prevailing bias against Irish immigrants who were seen as dirty and lower class. She was lower class but she wasn’t dirty. I’ve read much about her and find myself not entirely convinced that she was a source of sickness in every case in which she was blamed. The germ in question was spread primarily through water mixed with fecal matter so fixing that problem causes the issue to go away, as people later learned. In addition, the regime of test, track, and trace is notoriously error-prone and plays very much into the hands of the public’s desire to stigmatize the diseased and otherize infection no matter what.

Due to public hatred and unrelenting attacks, Mary very likely eventually came to believe that she was a source but, at some point, she didn’t care much, which is what happens when a whole country blames you alone for disease and the authorities jail you and threaten to cut you open. 

In other words, she was treated like an animal, not a patient, and then later experimented upon with random untested treatments. Meanwhile hundreds of carriers of the said bug were out and about, while the water supply remained the main culprit. 

Typhoid was ultimately conquered not by jails but by sanitation, hygiene, and antibiotics. Mary was blamed for infecting hundreds but only 3-5 died from cases she was accused of spreading (however inadvertently). Again, maybe. 

The point was that she was declared guilty regardless, largely because of her class, her national origin, and ethnicity. She was an easy target, even though typhoid carriers were everywhere. Meanwhile, Salmonella typhi (the source of Typhoid) continued to be a problem until later fixed. Much later typhoid victims were easily treated with antibiotics and the disease prevented with vaccination and, even more importantly, hygiene.  

What’s striking is how the case, which is so clearly an instance of public frenzy together with public health authoritarianism and brazen brutality, is so frequently cited as an example of how, of course, we must lock people down when there is a virus out and about. In reality, her case has aroused a century of questions about the power of the state to grab people out of their daily lives and imprison them without trial on the claim that they are disease spreaders. 

To say that such powers can be abused is an understatement, as we well know in these post-lockdown times. People who have studied the case of Mary Mallon nearly always come around to having great sympathy for her. These were times when modern medical knowledge was advancing but so was the expectation that the rich whom she served would not be subject to the usual sicknesses that snagged the poor. 

She alone among hundreds and thousands of likely carriers in the region was shamed and ruined for a disease she didn’t believe she had and did not intentionally spread. Meanwhile, there were no similar efforts undertaken to hunt down and capture other spreaders of Salmonella typhi. 

Again, what did this actually achieve in terms of public health? Did the 30 years of involuntary captivity of this woman save lives? There is no way to know, but certainly people continued to die from the disease after her imprisonment, until good treatments came along. Meanwhile, public health authorities had their archetype of a disease carrier to justify their enormous power. 

Eventually, Mary came to accept her plight and became a strong adherent of her Catholic faith, and died a peaceful death. Anthony Bourdain offers a deeply touching account of visiting her grave at St. Raymond’s Cemetery, Bronx, New York. 

In 1973, I bought my first chef’s knife, a high-carbon Sabatier with a polished wooden handle. I was so proud of it – and I’ve held onto it all these years, remembering how it felt in my hand when I first unwrapped it, the way the handle rested against my palm, the feel of the blade, the sharpness of the edge. It’s old now, and stained, and the handle is cracked slightly in spots. I long ago gave up using it or trying to maintain it. But it is a beloved object. Something a fellow cook would appreciate, I hoped – a once fine hunk of quality French steel – a magical fetish, a beloved piece of my personal history. And a sign of respect, I hoped, an indicator that somebody, somewhere, even long after her troubles and her dying, took her seriously, understood, if only a little bit, the difficulty of her life as a cook. It’s the kind of gift I would like to receive, one that I would understand. 

I looked around the graveyard, making sure that no one else was watching, leaned over and with my hands, pulled back the grass at the base of her stone. I slipped my knife down there, covered it up the way it had looked before and left it for her. It was the least I could do. 

A gift. Cook to cook.