The Most Dangerous Woman in AmericaPBS Airdate: October 12, 2004 MARY MALLON ("Typhoid Mary," Dramatization*): Where we going? JOSEPHINE BAKER (New York City Public Health Doctor, 1907, Dramatization*): Mary, it is our obligation to take you in. MARY MALLON: I can't... NARRATOR: At the dawn of the 20th century, there is no hiding from New York City's newly powerful Department of Health. JOSEPHINE BAKER: There is very little that a Board of Health cannot do in the way of interfering with personal and property rights for the protection of public health. NARRATOR: And with good reason. The city's slums are overflowing with poor immigrants. Conditions are horrific. Infectious disease is out of control. DAVID ROSNER (Columbia University): Children were dying of intestinal diseases, of diarrheas. Tuberculosis, whooping cough and diphtheria were endemic. NARRATOR: But not here—Oyster Bay, Long Island, is another world altogether, a place upper crust New Yorkers go to escape the city. But suddenly this privileged enclave becomes vulnerable. A deadly disease, typhoid fever, strikes the household of a wealthy banker. How it got here is a mystery that confounds the experts. GEORGE SOPER (Civil Engineer, 1907, Dramatization*): I was disappointed. Try as I would, I could not find anything wrong. NARRATOR: Only within the last twenty years have health officials come to understand that disease is caused by invisible microbes or germs. This knowledge will lead them to an unsuspecting Irish immigrant, a servant named Mary Mallon. ANTHONY BOURDAIN (Chef and Author, Typhoid Mary: An Urban Historical): They called her—I love this phrase— "She is a human culture tube," you know, this, this pestilential entity that must be stopped. MARY MALLON: Get out of my kitchen. GEORGE SOPER: Miss Mallon, please. MARY MALLON: Get out of my kitchen! NARRATOR: They call her "Typhoid Mary." Her story will make history and raise challenging questions we still face today. MARY MALLON: Keep going. JUDITH WALZER LEAVITT (Author, Typhoid Mary: Captive to the Public's Health): It is the prime dilemma in public health: how do you protect the health of the masses of the people if it is jeopardized by an individual whose liberty you are thinking of taking away? MARY MALLON: No, no, no! I am an innocent human being. The contention that I am a perpetual menace in the spread of typhoid germs is not true. NARRATOR: An innocent victim or a murderous villain? The tragic story of The Most Dangerous Woman in America, right now, on NOVA. Major funding for NOVA is provided by the Park Foundation, dedicated to education and quality television. And by... Science: it's given us the framework to help make wireless communications clear. Sprint is proud to support NOVA. This program has been made possible by the National Endowment for the Humanities, expanding America's understanding, for more than 30 years, of who we were, who we are and who we will be; and by the National Library of Medicine. Major funding for NOVA is also provided by the Corporation for Public Broadcasting, and by PBS viewers like you. Thank you. NARRATOR: August, 1906: in this luxurious vacation home in Oyster Bay, Long Island, a young girl, Margaret Warren, is gravely ill with typhoid fever. She has the best care, but without a cure, all anyone can do is try to bring down her fever. This is the last thing Charles Warren, banker to the Vanderbilts, expected when he rented a house for his family in this exclusive seaside resort. JUDITH WALZER LEAVITT: This was a family that brought servants with them and came to summer out on the island. And this individual family...no one else in Oyster Bay but this individual family was struck by typhoid fever, and six members of the household came down with the disease. NARRATOR: Typhoid fever is extremely contagious. First the youngest daughter became ill, then two maids, the mother, another daughter, and finally, the gardener. How could a disease of the slums strike this wealthy community? ANTHONY BOURDAIN: It wasn't the sort of area that one would expect to see typhoid, which was often associated with crowded, poor neighborhoods. NARRATOR: At the turn of the 20th century, the most crowded neighborhood in the world is New York City's Lower East Side. It's even more crowded than Calcutta. With few connections to city water or sewers, the tenements lack even basic sanitation. Infectious diseases like smallpox, diphtheria, tuberculosis and typhoid fever kill thousands each year. JUDITH WALZER LEAVITT: Typhoid fever was a fairly common visitor in New York City and in other urban areas, especially in the 19th century and in the early part of the 20th century. In New York City alone there were about 4,000 new cases of typhoid fever every year. NARRATOR: The symptoms of typhoid can be severe: weeks of fever, headache, diarrhea and delirium. One out of 10 dies of the disease. BARRON LERNER (Columbia University): When people had typhoid fever in the early 20th century and there were no antibiotics, doctors had to just treat the symptoms. NARRATOR: But the cause of the disease is no longer a mystery. Thirty years earlier scientist Louis Pasteur electrified the world by proving that bacteria, microbes invisible to the naked eye, cause disease. Typhoid fever comes from salmonella typhi, bacteria that grow in the intestinal tract and are shed in the feces. In 1892, New York City set up the country's first bacteriology laboratory devoted to public health. BARRON LERNER: The new science, the new bacteriology, was tremendously exciting. This focused on, "What can we see under the microscope? What can we do once we diagnose people with specific diseases? What can we do to prevent this from being spread to other people?" NARRATOR: In Oyster Bay, where even President Teddy Roosevelt summers, the threat of a typhoid epidemic is terrifying. ANTHONY BOURDAIN: Everybody started looking around for an explanation. They started looking for the usual suspects, you know, "Let's find the dirty, the poor, uh, you know, maybe some bad dairy, the lady on the beach who sells shellfish, it's got to be one of them." NARRATOR: Experts are called in to investigate. They know typhoid fever is caused by contaminated food or drink. They suspect the plumbing in the house and put dye in the toilet to see if it contaminates the drinking water. It doesn't. They check the local shellfish to see if the bay is polluted with sewage. It isn't. They examine the milk supply in case it is contaminated. It, too, is free of bacteria. The source of the outbreak remains a mystery. Though the Oyster Bay victims recover, a cloud of disease hangs over the house. JUDITH WALZER LEAVITT: The family who owned the house, the Thompsons, were afraid if they didn't get to the bottom of this, they would never be able to rent their house again. NARRATOR: That winter, the Thompsons learn about a freelance civil engineer known for his ability to track down the source of disease. Thirty-seven-year-old George Soper is confident and ambitious. GEORGE SOPER: By 1907, I had had a good deal of experience with typhoid fever. As an undergraduate, I had the temerity to move typhoid patients and their families out of a house that had a long history of communicable diseases and, with the consent of the owner, burn it to the ground. JUDITH WALZER LEAVITT: George Soper was somebody who got his teeth into a problem and would not let go. He wanted to find the cause. He was not going to give up until he did, and so he was obsessed. NARRATOR: Soper begins by reviewing the results of the earlier investigation. BARRON LERNER: It's detective work, and Soper was excited about the ability, now, to trace diseases, to trace the disease outbreaks and to really understand how diseases like typhoid were being spread. GEORGE SOPER: The first investigators had done their work thoroughly. Try as I would, I could not find anything wrong. So I turned my attention to the people in the house. This gave the key to the situation. JUDITH WALZER LEAVITT: Finally, he asked the question of one of the members of the household, "Who else was in this house that I didn't yet talk to?" And one of them remembered that they'd had a cook that summer that was no longer with the family. NARRATOR: Knowing it takes up to three weeks after exposure to become sick with the disease, Soper uncovers his first clue. GEORGE SOPER: I found that the family had changed cooks on August 4th, about three weeks before the epidemic broke out. All the patients were infected after the new cook's arrival. BARRON LERNER: The way that a cook who was infected with the typhoid bacillus would transmit the disease is that there would probably be some typhoid bacillus that they got onto their hands while they were in the bathroom. ANTHONY BOURDAIN: To prevent the transmission of typhoid, a lot of brushing and scrubbing was involved, meaning under the nails, no jewelry. I mean we're talking a vigorous and abrasive scrubbing. NARRATOR: Soper also knows the bacteria can survive on uncooked food only. GEORGE SOPER: On a certain Sunday there was a dessert, which she prepared, and of which everybody present was extremely fond: this was ice cream with fresh peaches cut up in it. I suppose no better way could be found for a cook to clean her hands of microbes and infect a family. NARRATOR: The cook is a 37-year old Irish immigrant who works for wealthy families in New York. MARY MALLON: Before God, and in the eyes of decent men, my name is Mary Mallon, and I have lived a decent and upright life. NARRATOR: Soper sets out to find the cook. The employment agency that placed her with the Warren's does not know where she is but directs him to some of her previous employers. What he discovers astounds him. GEORGE SOPER: In 10 years, she is known to have worked for eight families, and in six of these, typhoid had occurred. NARRATOR: How is this possible? Has Mary been spreading typhoid bacteria for years without ever appearing to be sick? Soper remembers reading a paper written four years earlier by German scientist Robert Koch. Koch had found a baker who was not ill but who spread typhoid germs, a so-called "healthy" carrier of disease. Could this be the case with Mary Mallon? ANTHONY BOURDAIN: Soper had read that literature and thought he was on the cutting edge of, you know, of medical science and history. NARRATOR: If Soper is right, the cook would be the first American identified as a healthy carrier of typhoid fever. It would be a major discovery and make his career. JUDITH WALZER LEAVITT: I think Soper is very excited by this possibility. He sees it as a scientific puzzle—that he is the detective, for he's going to sleuth out and win the prize. NARRATOR: To prove his case, Soper needs specimens from the cook. In March, 1907, he learns Mary is working for a family on Park Avenue. Typhoid too is already in residence. A chambermaid has just been taken to the hospital and the family's only child is in critical condition. Mary helps nurse the girl. MARY MALLON: There you go, my darling. Oh, I know. Just hold on there. Just hold on. GEORGE SOPER: It was at this house that I had my first interview with Mary. I supposed she would be glad to know the truth. I thought I could count on her cooperation. NARRATOR: Soper's account of their meeting is almost theatrical. GEORGE SOPER: Miss Mary Mallon? MARY MALLON: I'm Mary Mallon. GEORGE SOPER: Miss Mallon, my name is Dr. George Soper. I have been looking for you for quite awhile. I was hired to track you down. MARY MALLON: To track me down? GEORGE SOPER: Yes, Miss Mallon. It appears that you are the unwitting cause of the typhoid fever outbreak at Oyster Bay last summer. MARY MALLON: Are you mad? GEORGE SOPER: It is imperative that I get specimens from you of urine, feces and blood to confirm my suspicions. MARY MALLON: I've never been sick a day in my life. I've never had typhoid. GEORGE SOPER: Miss Mallon, you contain, within your body, typhoid fever germs. When you visit the toilet, these germs get on your fingers. You then transmit these germs to the food. MARY MALLON: Are you suggesting that I don't wash my hands? GEORGE SOPER: No, Miss Mallon. ANTHONY BOURDAIN: Soper claims that the meeting ended badly when Mary reached down and picked up a meat fork and threatened to, well, stab him with it. MARY MALLON: Get out of my kitchen. GEORGE SOPER: Miss Mallon, please. MARY MALLON: Get out of my kitchen, and don't come back again. GEORGE SOPER: Miss Mallon, try and be reasonable. MARY MALLON: Keep going. I don't want to see you back here again! Keep going! ANTHONY BOURDAIN: I think that he makes her sound a lot more fearsome than she was simply to explain the fact that, you know, he, well, she scared the hell out of him. JUDITH WALZER LEAVITT: He unleashed a violent temper in her, by what he thought was a mild request, reasonable request, a scientific request. And she sees it as the exact opposite of that. MARY MALLON: Soper did not mention the families where I have worked where there was no typhoid. He did not see fit to mention the family I always lived with in the Bronx when I was out of work, and where I shared a room with the children without giving them typhoid. JUDITH WALZER LEAVITT: Mary Mallon had no reason to think that she could have communicated typhoid fever to anybody. The concept that if you are sick with a particular disease, you can give it to somebody else is fairly new. BARRON LERNER: Why would you believe, all of a sudden, a group of scientists telling you that invisible germs that you can't even see, that you've never heard of before, are causing all these diseases that you've seen for decades and decades? NARRATOR: Like most people of her time, Mary Mallon does not understand the cause of disease. DAVID ROSNER: In the 19th century, you had this idea about disease, that somehow it came from filth. And filth was somehow a moral statement about your community. So the filthier your community, the more subject you were to having what were called "miasmas" arise. ANTHONY BOURDAIN: People thought that illness came from mysterious sewer, sewer gases, miasmas, you know. We're not far away from evil spirits. NARRATOR: Miasmas and the filth that caused them were thought to be concentrated in the tenements overflowing with immigrants. With the population doubling every decade, city services were unable to cope. DAVID ROSNER: It's a city that's being traversed by 150 to 200,000 horses. And, of course, you know, basic public health fact Number 1 is that each horse gives off about 25 pounds of manure a day, times 200,000 horses, times 365 days in which the manure may or may not be picked up. So the city was really filthy. NARRATOR: Uncollected garbage, animal carcasses, back alley privies, clogged sewers and household waste made conditions unbearable. Cleaning up the city became a moral crusade. In 1895, a Department of Sanitation was created proclaiming, "Cleanliness is next to Godliness." It recruited an army of street cleaners, the White Wings. DAVID ROSNER: There were parades of these guys. These guys would march down Fifth Avenue. It's almost like a military exercise. NARRATOR: At the same time, public health is shifting its focus from brooms to bacteriology. George Soper is part of that change. DAVID ROSNER: George Soper was on the cutting edge of the new science, but he's coming from an older field, an older field of sanitation, that he's, in some sense, trying to leave behind. Having Mary Mallon deemed a typhoid carrier would lead to a new kind of respect, a new credibility in the science of bacteriology. GEORGE SOPER: I discovered that Mary was spending the evenings at a rooming house, on Third Avenue below 33rd Street, with a disreputable looking man named Briehof, who had a room on the top floor, and to whom she was taking food. He kept his headquarters during the day in a saloon on the corner. I got to be well acquainted with him. He took me to see the room. I should not care to see another like it. ANTHONY BOURDAIN: Soper describes it as a horrifyingly squalid, fetid, evil apartment with a, you know, menacing, mangy looking, probably dangerous dog. You know, Briehof is this degenerate, you know, alcoholic. This is class war—with all its prejudices—at its purest. DAVID ROSNER: The new generation of public health people had a kind of condescension to the poor. You have this kind of mix of a belief in bacteriology, a belief that there are germs there, and embedded in that is a belief that the immigrant is kind of a source of real infection and danger. ANTHONY BOURDAIN: Soper made some arrangement with Briehof, the boyfriend. He somehow turned Briehof. He got Briehof to tell him when Mary was going to be visiting the apartment next. GEORGE SOPER: Good Evening, Miss Mallon. MARY MALLON: What are you doing here? GEORGE SOPER: Miss Mallon, this is my assistant, Dr. Hoobler. We've come with the hope that you will cooperate and come with us. MARY MALLON: I've already told you. I'm doing nothing for you. GEORGE SOPER: Miss Mallon, I believe that you are making people sick. I believe that you are the cause of the typhoid outbreaks in several of the families you've worked for. Now, nobody is claiming that you've done this intentionally, but we need to have these specimens so that we can understand this illness and help you. MARY MALLON: I've nursed those people that were sick in those households and I've never had typhoid, so how could I give it to them? GEORGE SOPER: Miss Mallon, please come with us and we can be certain. MARY MALLON: I can't believe that you followed me. You followed me in the street. You've come to my place of work, and now you've come to my home. How did you fi -? Take your assistant with you and go. ANTHONY BOURDAIN: His interpersonal skills were not as good as his epidemiological skills. He tracked her down, and maybe he should have left the interview portion of the case to someone else. MARY MALLON: Go. Both of you. Get out of here now. Go. Get out. Go. And don't...get out of here and don't come back. Go on. Get out. JUDITH WALZER LEAVITT: She threw him out again, swearing apparently the whole way, and also protesting her innocence, still thinking, "Why is this man harassing me?" MARY MALLON: I have never had typhoid fever in my life and have always been healthy. The contention that I am a perpetual menace in the spread of typhoid germs is not true. HASIA DINER (New York University): These Irish immigrant women were tough. I mean, they had lived a life of such deprivation in Ireland. They came into a society that vilified them, that associated them with every negative stereotype: stupid, drunken, dirty, that they were unfit for participation in the American sort of mainstream. They had to be tough. NARRATOR: Mary Mallon was born in 1869, in County Tyrone, one of the poorest regions of Ireland. HASIA DINER: Life in County Tyrone in the years Mary was growing up was really harsh. Every year there would have been times of famine. She would have grown up eating primarily potatoes. There were no plates, no forks. It was a very grim existence. JUDITH WALZER LEAVITT: She came to this country in 1883, alone, as a teenager. She moved in with her aunt and uncle in New York City. Her aunt and uncle then died, and she always described herself later as "alone in America." ANTHONY BOURDAIN: She probably put in her time on a laundry, seamstress work, cleaning, hauling coal, all the usual lower echelon tasks. So it was quite a climb. She at some point had had to learn how to cook well, how to run a kitchen well, and apparently was good at what she did. She was hired again and again by very good families. HASIA DINER: Cook was the highest rung of the pecking order among servants. And she was often not just cook, but she was really the kind of manager of the entire enterprise, and would have been the most trusted member of the staff. NARRATOR: Mary's employers are unaware that their cook may have brought typhoid fever into their home. GEORGE SOPER: I felt a good deal of responsibility for the case. Under suitable conditions, Mary might start a great epidemic. NARRATOR: But Soper alone does not have the authority to force Mary to cooperate. Typhoid fever, smallpox, influenza, diphtheria, tuberculosis, the man leading the charge against these scourges is Hermann Biggs, the New York City Health Commissioner. Biggs is committed to wiping out disease using science and the tools of public health. In this crusade, workers have the right to march into tenements to vaccinate people, confine the infected to their houses, and use force to quarantine those who will not comply on islands in New York Harbor. This is the power needed to confront Mary Mallon. GEORGE SOPER: I laid the facts concerning Mary's history before Dr. Hermann Biggs, with the suggestion that the woman be taken into custody and her specimens examined. JOSEPHINE BAKER: Dr. Soper asked to have an inspector sent to get specimens from Mary. I was the inspector assigned this seemingly simple task. NARRATOR: Trained as a physician, Dr. S. Josephine Baker is one of the Department of Health's roving inspectors. ANTHONY BOURDAIN: You know, of all the things that people did in the story of Mary Mallon, picking a woman seemed like a really smart, sensible, human move. JUDITH WALZER LEAVITT: Baker came from a fairly well off family. She was very committed to the poor and to improving the health of the poor. However, she had nothing kind to say about the people that she worked among. And yet, there she was committing her life to them. JOSEPHINE BAKER: The heat, the smells, the squalor, made Hell's Kitchen something not to be believed. Its residents were largely Irish, incredibly shiftless, wholly lacking in any ambition, and dirty to an unbelievable degree. I climbed stair after stair, knocked on door after door, met drunk after drunk, filthy mother after filthy mother, and dying baby after dying baby. NARRATOR: In the home where Mary Mallon works, the daughter dies of typhoid fever. Mary must be taken in for testing. JOSEPHINE BAKER: I stationed one policeman in the front of the house, another on the nearest side street, had an ambulance waiting around the corner, and with a third policeman at my elbow, I knocked at the servants' entrance. Miss Mallon, the Health Department has sent me to take you with us. MARY MALLON: I'm going nowhere. JOSEPHINE BAKER: Oh? Officer... ANTHONY BOURDAIN: Mary sees her, brandishes a fork again, supposedly. Mary goes on the lam, tries to get away, with police searching everywhere. JOSEPHINE BAKER: Has Mary Mallon come through here? The rest of the servants denied knowing anything about her or where she was. Even in my distress, I liked that loyalty. She's disappeared. We went through every nook and cranny. It was utter defeat. Then one of the policemen with me caught sight of a tiny scrap of blue calico caught in a door in a back hallway. Several ash cans were heaped up in front of it. Mary, I am... MARY MALLON: No! JOSEPHINE BAKER: ...under instructions to bring you in to take samples from you. MARY MALLON: I am going nowhere with you! JOSEPHINE BAKER: Now, Mary, you have typhoid germs in your body. MARY MALLON: I've got no germs. JOSEPHINE BAKER: We will not hurt you. JUDITH WALZER LEAVITT: They pull Mary Mallon out, scratching and screaming and yelling. MARY MALLON: No! Let me go! I'm not... JUDITH WALZER LEAVITT: And it takes the five police officers to get her into the ambulance. And Josephine Baker sits on her in the ambulance the whole way to Willard Parker Hospital, where they're going to take her. JOSEPHINE BAKER: It was like being in a cage with an angry lion. NARRATOR: Mary is taken to Willard Parker Hospital, an infectious disease facility for the poor. JUDITH WALZER LEAVITT: There is a photograph of Mary Mallon in bed at Willard Parker Hospital, and she is in a room with a lot of other people. Who knows if they have typhoid fever or something else, or why she is in bed, since she's not sick. DAVID ROSNER: Being brought to Willard Parker was, in some sense, a statement about Mary's worth that she would have understood very clearly. She would have said, "Oh, my God," you know? "How dare they?" I mean, this is, this was a real, kind of, insult to her. MARY MALLON: I have committed no crime, and I am treated like an outcast, a criminal. It is unjust, outrageous, uncivilized. And it is incredible that in a Christian community a defenseless woman can be treated in this manner. NARRATOR: At New York City's pioneering Bacteriology Laboratory, scientists test Mary's specimens using the most advanced tools and techniques. Samples are placed in an incubator to see if bacteria grow. The results are unambiguous. JOSEPHINE BAKER: The hospital's laboratory speedily proved that Mary was as dangerous as Dr. Soper had suspected. Her stools were a living culture of typhoid bacilli. JUDITH WALZER LEAVITT: George Soper knew all along, from his work, that she could carry typhoid fever. This was proof that she did carry typhoid fever. NARRATOR: Soper has made a major breakthrough in the battle against disease, proving that Mary harbors the bacteria even though she insists she has never had typhoid fever. BARRON LERNER: Mary Mallon did have typhoid fever. But she had a very, very mild case of the disease. And she never knew she had typhoid fever or was that sick at all. In fact, she probably just thought she had a cold or the flu. NARRATOR: In most cases of typhoid fever, the body is host to a microbial battle where there is a clear winner. If the bacteria win, the patient dies; if the immune system wins, the typhoid bacteria die. But in the case of a healthy carrier, there is no clear winner. The immune system protects the body from infection, but the bacteria continue to live. Mary, with no symptoms at all, is as contagious as someone sick with the disease. JUDITH WALZER LEAVITT: The press gets a hold of the story immediately, in 1907, but they don't get very much of it. The health department is clearly trying to keep a lid on the fact that they are holding, against her will, a healthy 37-year-old woman. NARRATOR: Still, the story makes front page news. To protect Mary's identity the Department of Health gives the newspaper a false name. But Mary cannot escape a visit from George Soper. He is anxious to learn when she was exposed to typhoid and how often she has passed it on. JUDITH WALZER LEAVITT: She, of course, immediately sees him and sees red. She doesn't want him there, and she's not talking to him. But he's talking to her, and he has learned a little bit, presumably from their first encounters, and he's trying to be reasonable. GEORGE SOPER: "Mary," I said, "I've come to talk with you and see if, between us, we cannot get you out of here. You would not be where you are now if you had not been so obstinate. So throw off your wrong-headed idea and be reasonable. Answer my questions and I will do everything I can to get you out. I will write a book about your case; I will guarantee that you will get all the profits." ANTHONY BOURDAIN: This is fairly forward thinking. I mean, these days, you walk out of a burning building and there's somebody offering you a book deal right away, and a film deal. You know, maybe he was ahead of his time here. And he even offered her 100 percent, which is quite reasonable. I...on the other hand, I can certainly understand why she turned down the deal. JUDITH WALZER LEAVITT: She gets up, marches into the toilet, slams the door, and doesn't come out until he's gone. GEORGE SOPER: The door slammed. There was no need of my waiting. NARRATOR: What should health officials do? They can't let Mary return to cooking, but how can they stop her? Typically, poor people with infectious diseases are sent to a quarantine island, and that's what they do with Mary. ANTHONY BOURDAIN: Without trial, without representation, without any kind of due process, the law allowed you to be plucked off the street and deposited on a plague island for as long as they felt like keeping you there. KEVIN CAHILL (New York City Board of Health, 1981-1993): Civil liberties have to sometimes be bent for the public good. And I think that, while it may be perceived as a conflict, most serious people in public health and, I think, in the country, would understand that depriving an individual of her freedom for, hopefully, a brief period of time, that's a legitimate step to take. NARRATOR: North Brother Island sits in the East River, a few hundred yards offshore from the South Bronx. This is the site of the City's largest quarantine facility, Riverside Hospital. Most of the patients are sick with tuberculosis. They must stay here until they recover or die. BARRON LERNER: North Brother Island was a scary place to go to. Here are hundreds of patients, very sick with infectious diseases, and then Mary Mallon, who everybody admits is perfectly healthy, is sent out there. NARRATOR: Mary is confined to a small cottage on the island. DAVID ROSNER: She was being cut off from everyone and everything she was familiar with, so it was really imprisonment. I don't think she would have seen it as anything other than a form of imprisonment. MARY MALLON: When I came here I was so nervous, I was almost prostrated with grief and trouble. My eyes began to twitch, my left eye became paralyzed, would not move. It remained in this condition for six months. NARRATOR: Not everyone in public health believes Mary's quarantine is justified. Dr. Milton Rosenau, Director of the national Hygienic Laboratory in Washington, and other prominent scientists object to her incarceration. JUDITH WALZER LEAVITT: They understood her dangers—they accepted that she was a healthy carrier—and yet they said, "All you have to do is retrain her for another job where she's not cooking, and then she won't be a danger to anybody." NARRATOR: But the Department of Health is determined not to let Mary go. Instead, doctors try to cure her with experimental drugs and procedures. MARY MALLON: I took urotropin for about three months, all told. If I should have continued it, it would have killed me, for it was very severe. At first I would not take it, for I am a little afraid of these people, and I have good right. JOSEPHINE BAKER: She never listened to reason. When they suggested removing her gallbladder, the probable focus of infection, she was convinced afresh that this was a pretext for killing her. NARRATOR: Mary's doctors have a hunch, incorrect as it turns out, that removing the gallbladder will cure her. MARY MALLON: They said they'd have the best surgeon in town to do the cutting. But I said, "No, no knife will be put on me. I've nothing the matter with my gallbladder." JUDITH WALZER LEAVITT: I think Mary Mallon may have made a very good choice there. If she had had surgery, she probably would have survived, but the rates of infections and other problems were higher, and there is a chance she might have died from routine gallbladder surgery. NARRATOR: Mary is kept on North Brother Island, but wages a steady battle. She writes letter after letter to Biggs, Soper and Baker pleading for her freedom. MARY MALLON: Why should I be banished like a leper and compelled to live in solitary confinement. A few years of this life and I will be insane. NARRATOR: Two years go by. Mary is even more desperate to regain her freedom. MARY MALLON: Will I submit quietly to staying here a prisoner all my life? No! As there is a God in Heaven I will get justice, somehow, sometime. NARRATOR: In June, 1909, Mary and a young Irish lawyer, George O'Neill, file suit in the New York Supreme Court demanding her release. JUDITH WALZER LEAVITT: Her argument was very simple: I've never been sick, therefore I can't transmit sickness to anybody else. And I've never gotten my day in court. There has been no due process. NARRATOR: A few days later, publisher William Randolph Hearst tells Mary's story in his New York American. He may even be financing her legal case to sell newspapers. This time her identity is revealed but Typhoid Mary is the name that sticks. The story includes an article by William Park, head of the city's bacteriological lab. He writes that new screening procedures have uncovered at least 50 healthy carriers of typhoid fever; only Mary is in quarantine. JUDITH WALZER LEAVITT: The health department knows, and the reason they haven't isolated the other 49 is because walking around the city streets, mingling with people in New York, was not at all dangerous. Mary Mallon only transmitted typhoid fever when she cooked for people. NARRATOR: July, 1909: Mary Mallon leaves North Brother Island, for the first time in two years, to plead her case before the New York Supreme Court. The Department of Health defends its position. JUDITH WALZER LEAVITT: The health department argued very strongly that there was proof in the laboratory that she was a carrier and therefore dangerous to the public health, a menace to the public health. And they argued that point alone. NARRATOR: Mary goes into court with some ammunition of her own. Using her boyfriend Briehof as a courier, she has been sending specimens for months to the Ferguson Laboratory in Manhattan. The results contradict the Health Department's. MARY MALLON: The Health Department report always comes back stating that typhus bacilli have been found. But my specialist, who is the head of his profession, reports that he has found none. NARRATOR: Occasionally the specimens of a healthy carrier do not contain bacteria, which may explain Mary's results. In any event, the court rules against her. BARRON LERNER: Historically, courts have almost always sided with public health departments—be it typhoid fever, be it tuberculosis, be it other infectious diseases—because the fear of the spread of infectious diseases is so dramatic. KEVIN CAHILL: I absolutely think that the public health authorities were justified in quarantining her. The public has the right to be protected from people who can destroy their lives and end up killing them. JUDITH WALZER LEAVITT: We see it today, certainly, with multidrug-resistant tuberculosis, with HIV/AIDS, now with SARS. Uh, you see where individuals are being quarantined, isolated, whose liberty is taken away in the name of protecting the public health. Well, Mary Mallon gives us an example of that at an extreme level, because she was healthy. She wasn't even sick. MARY MALLON: There are two kinds of justice in America, and all the water in the ocean wouldn't clear me of this charge in the eyes of the health department. They want to make a showing. They want to get credit for protecting the rich, and I am the victim. NARRATOR: Several leading public health officials are outraged at Mary's continued incarceration. Charles Chapin in Rhode Island declares it "a discredit on public health work." In New York, the Department of Health is feeling the pressure. ANTHONY BOURDAIN: There were numerous attempts to find a way to let all involved weasel out. There were a number of approaches to Mary. "Well, don't you want to go stay with your sister in Connecticut?" And she would say, "But I don't have a sister in Connecticut." I think the idea there was, you know, "If we can just unload her on another state..." MARY MALLON: What I have been told that all I have to do is to leave the state and live under another name and I can have my freedom, but I will not do this. I will either be cleared or I will die where I am now. NARRATOR: In 1910, Mary's fortune changes. New York City hires a new Health Commissioner, Ernst Lederle. ANTHONY BOURDAIN: Lederle strikes me as a sympathetic character. I think he was uncomfortable with the civil liberties implications, the political implications, the humanitarian implications, the medical implications. He was uncomfortable with the situation. NARRATOR: Lederle releases Mary. She must report in regularly and can never again work as a cook. He even finds her a job at the bottom of the domestic ladder. HASIA DINER: Laundresses were just about the worst paid members of the female working class. It was a horrendous work and paid close to nothing. NARRATOR: Mary's boyfriend, Briehof, dies soon after her release; she is on her own, barely able to make a living. JUDITH WALZER LEAVITT: The Health Department has her on file and knows where she's living and knows when she moves in 1910, in 1911, in 1912, in 1913. In 1914, they admit they've lost track of her. NARRATOR: By that time, health officials have a bigger problem on their hands. They have come to realize that at least 3 percent of people who get typhoid fever become carriers after they recover. BARRON LERNER: That was an enormous number of people. It would range in the thousands and thousands in a city like New York. You basically have to go to everyone who had typhoid fever and check their stools after they got better. NARRATOR: That's impossible, so the Department of Health focuses on those who pose the greatest risk, food handlers. JUDITH WALZER LEAVITT: The health department passed a resolution, and it became the law of the land, that anybody who handled food in New York City had to be tested, and had to be tested regularly. BARRON LERNER: They were given cards, so they were known to the health department, and then they were given instructions about what they should and shouldn't do. And they were supposed to report back periodically to the health department to get checked on. JUDITH WALZER LEAVITT: They caught very few healthy carriers that way, and it was a very expensive program, as you can imagine all the food handlers there are in New York City. NARRATOR: Most healthy carriers escape detection unless they cause an outbreak. In March, 1915, typhoid fever strikes the city's prestigious Sloane Maternity Hospital. Twenty-five doctors, nurses and staff come down with the disease; two die. The hospital calls in George Soper. GEORGE SOPER: Dr. Cragin telephoned me asking that I come at once to Sloane Hospital. When I arrived he told me he had a typhoid epidemic on his hands. The other servants had jokingly nicknamed the cook "Typhoid Mary." She called herself Mrs. Brown. She was out at the moment, but would I recognize her handwriting? He handed me a letter, from which I saw at once that it was indeed Mary Mallon. JOSEPHINE BAKER: I went up there and went into the kitchen. Sure enough, there was Mary, earning her living in the hospital kitchen, spreading typhoid germs among mothers and babies and doctors and nurses, like a destroying angel. HASIA DINER: My sympathy begins to erode a bit for her. And I think, "What is going through her mind? How can she go back and start cooking? Is she either so dense that she didn't get it, or is she so spiteful that she's going to show the Americans, or she's going to show the employer class that they can't keep her down?" KEVIN CAHILL: I don't think she was ever an evil person. She didn't intentionally go out to hurt people. She just was incapable of understanding that her carrier state was the cause of deaths of people and the illness of people. NARRATOR: Department of Health officers trace Mary to a house in Queens. JUDITH WALZER LEAVITT: She doesn't answer the doorbell so they use a step ladder to get up to the second floor. There are dogs barking. They bring up meat to give to the dogs and quiet them down. And they break into the house. ANTHONY BOURDAIN: This time, she goes without a struggle. I think she understood "the jig's up," you know? "This was basically my last shot. I'm not getting out of this." NARRATOR: There is no sympathy now for the woman whose name is synonymous with disease. BARRON LERNER: The second time that Mary Mallon was quarantined, the arguments for doing so have become much more compelling. She's sort of failed the test of working with the public health officials, and she's sent back to the island, this time with more justification. ANTHONY BOURDAIN: By the time she hit North Brother the second time, there was no fight left in her. Everything that she had was gone. NARRATOR: One of the women here, the second from the left, is thought to be Mary Mallon. Adjusting to life on North Brother Island, Mary even makes friends with some of the doctors and nurses. KEVIN CAHILL: My father was the Medical Director of the Riverside Hospital there, and he knew Mary Mallon very well. He was one of the few people that Mary got along with. He was a first-generation Irish person. I think he could identify, maybe more than Hermann Biggs or George Soper, with what makes an Irish immigrant tick. NARRATOR: Three years after her return, the Department of Health occasionally allows Mary to take the ferry into New York. ANTHONY BOURDAIN: They would let her leave, take day trips to visit friends, and she would always return on time. I don't think there was anything else for her out there. NARRATOR: While Mary is in quarantine, the Department of Health develops a more flexible approach to healthy carriers. Food handlers are sometimes retrained or paid to stop working. Even uncooperative carriers are not punished the way Mary Mallon is. BARRON LERNER: Mary Mallon got singled out, I think. The Public Health Department, in the face of her resisting this new authority of science, I think, got vengeful in their desire to show, to teach her a lesson. NARRATOR: On the island, Mary is tested regularly for typhoid. She is still a carrier. Eventually she is given a job as a lab technician at Riverside Hospital. In 1932, her supervisor poses here with Mary at age 62. JUDITH WALZER LEAVITT: The photograph that we have of Mary Mallon from late in her life shows a woman who's gained weight, who has suffered some minor strokes. You can see one of her hand is in a fist. She does not look very attractive in that picture. She doesn't look very happy. NARRATOR: After 26 years on North Brother Island, Mary Mallon died in 1938. She was 69 years old. She had given 47 people typhoid fever; three of them died. Mary never accepted she was the cause. By that time, typhoid fever was on the wane, the result of better sanitation. It would be another 10 years before antibiotics would be used to treat the disease and cure healthy carriers like Mary. But new and even more deadly diseases continue to arise, confronting us with the issues that Mary Mallon first raised a century ago. BARRON LERNER: Today it might be Ebola virus, HIV, and most recently SARS. But we always have to, as a society, be very careful about how we will use public health powers and not trample on the rights of the individuals who are sick. NARRATOR: Though Mary Mallon is long forgotten, "Typhoid Mary" is not. She remains a potent symbol of our fear of disease and of the dilemma over how far we should go to protect ourselves. DAVID ROSNER: We now assume that Typhoid Mary is actually a perpetrator of evil, and I think that's probably a pretty sad legacy for her. MARY MALLON: I lived a decent and upright life until I was seized, locked up and rechristened Typhoid Mary. Before God, and in the eyes of decent men, my name is Mary Mallon. Quarantine is as important now as it was in Mary Mallon's day. On NOVA's Web site, trace the history of quarantine from ancient to modern times, including the power states have today to isolate you. Find it on pbs.org. To order this program on VHS or DVD, or the book Typhoid Mary: Captive to the Public's Health, please call 1-800-255-9424. NOVA is a production of WGBH/Boston. Major funding for NOVA is provided by the Park Foundation, dedicated to education and quality television. Science: it's given us the framework to help make wireless communications clear. Sprint is proud to support NOVA. And by... This program has been made possible by the National Endowment for the Humanities, expanding America's understanding, for more than 30 years, of who we were, who we are and who we will be; and by the National Library of Medicine. Major funding for NOVA is also provided by the Corporation for Public Broadcasting, and by PBS viewers like you. Thank you. * The dramatizations of Mary Mallon's, George Soper's, and Josephine Baker's remarks are their own words as recorded in their writings or reported in newspaper articles and interviews. PRODUCTION CREDITSThe Most Dangerous Woman in America
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Senior Executive Producer In Memory of Laura LeMarr (1959-2004) A film by Nancy Porter Productions, Inc. for NOVA in association with WGBH/Boston © 2004 Nancy Porter Productions, Inc. and WGBH Educational Foundation. All rights reserved Any views, findings, conclusions, or recommendations expressed in this program do not necessarily represent those of the National Endowment for the Humanities. |
The Most Dangerous Woman in America
In Her Own Words 
Typhoid Mary: 
History of Quarantine 
Disease Detective  |
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© | Created September 2006 |
