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Public support plummeted and opinion turned against Mary Mallon in 1915 because
of her conscious return to cooking when people believed she should have learned
her lesson. "The chance was given to her five years ago to live in freedom,"
editorialized the New York Tribune, and "she deliberately elected to
throw it away." Historians have since that time been no more lenient in their
assessment of Mallon's informed return to cooking. In 1994, Robert J. T. Joy
put it directly: "Consider that Mallon disappeared for five years, and used
several aliases and went straight back to cooking! ... Now, as far as I am
concerned, this verges on assault with the possibility of second degree murder.
Mallon knows she carries typhoid, knows she should not cook—and does
so."
To be sure, Mary Mallon was not entirely blameless when she knowingly returned
to cooking in 1915, but the blame must be more broadly shared. Much of what
Mallon did can be explained by events greater than herself and beyond her
control. It is only in the full context of her life and the actions of the
health officials and the media that we can understand the personal position of
Mary Mallon and people like her—people whom society accuses of
endangering the health of others—and can hope to formulate policies that
will address their individual needs while still permitting governments to do
what they are obligated to do, act to protect the public's health.
Mary's straits
Mallon was not a free agent in 1914, when she returned to cooking. Consider her
circumstances. She had been abruptly, even violently, wrenched from her life, a
life in which she found various satisfactions and from which she earned a
decent living. She was physically separated from all that was familiar to her
and isolated on an island. She was labeled a monster and a freak. [For more on
the quarantine of Mary Mallon, aka "Typhoid Mary," see In Her Own Words.]
She was not permitted to work at a job that had sustained her, but she was not
retrained for any comparable work. If Ernst J. Lederle, the New York City
Health Commissioner who had released her in 1910, helped her find a job in a
laundry, it did not provide the wages or job satisfaction to which she had
previously become accustomed. Nor did it provide the social amenities, as
limited as they were, of domestic work in the homes of New York's upper class.
The health department, for all of Lederle's words of obligation to help her in
1910, did not provide her with long-term gainful employment.
Neither did health officials, who precipitously locked Mallon up, succeed in
convincing Mallon that her danger to the health of people for whom she cooked
was real and lifelong. The medical arguments that carried weight among the
elite at the time and have become more broadly convincing since did not
resonate with her. There was no welfare system to support her. There was no
viable "safety net," practical or intellectual, for an unemployed middle-aged
Irish immigrant single woman.
Hard choices
So she did what many other healthy carriers since have done: returned to work
to support herself. And the health department responded by doing what it felt
it had to do when faced with a now very public uncooperative typhoid carrier:
returned her to isolation. New York health officials did not isolate all the
recalcitrant carriers it identified; many who had disobeyed health department
guidelines were out in the streets during the years Mallon remained on North
Brother Island, the East River islet where she was quarantined. But officials
had reason to act as they did. And so did Mary Mallon.
Health officials chose not to deal with their first identified
healthy carrier in a flexible way.
In other words, there were choices for both the health officials and Mary
Mallon, and judgment, when we make it, should take this full context into
account. Events could have evolved in a different pattern. If tempers had not
been raised to fever pitch in 1907, when Mallon was first quarantined on North
Brother Island, and positions not solidified, various compromises and
possibilities would have been available for education, training, and
employment, all of which might have led to decreasing the potential of
Mallon's typhoid transmission.
Health officials, who certainly held the reins of power most tightly, chose not
to deal with their first identified healthy carrier in a flexible way. They
chose to make an object lesson of her case. But it was a choice. If they had
shown some personal respect for how difficult it was for Mary Mallon to cope
with what happened to her, it is conceivable that she would have responded in
kind and come to respect their position. As it happened, neither side
considered the other, and communication was stopped short.
Proper treatment
How can we address the problem that is now, still, again, before us?
Shall we insist on locking up the people who are sick or who are at risk of
becoming sick because they threaten the health of those around them? Our own
situation in large part determines how we think about these questions and
informs our various responses to this public health dilemma. We can view people
who carry disease as if they consciously bring sickness and death to
others—like the demon breaking skulls into the skillet, as a 1909
newspaper illustration depicted Mary Mallon [see image at right above]. We can view
such people as inadvertent carriers of disease, as innocent victims of
something uncontrollable in their own bodies. We can see disease carriers as
instruments of others' evil, as victims of society's or science's
perversity.
Wherever we position ourselves, 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. We can blame, fear,
reject, sympathize, and understand: withal, we must decide what to do.
Optimally, we search for responses that are humane to the sufferers and at the
same time protect those who are still healthy.
The conflict between competing priorities of civil liberties and public health
will not disappear, but we can work toward developing public health guidelines
that recognize and respect the situation and point of view of individual
sufferers. People who can endanger the health of others would be more likely to
cooperate with officials trying to stem the spread of disease if their economic
security were maintained and if they could be convinced that health policies
would treat them fairly. Equitable policies applied with the knowledge of
history should produce very few captives to the public's health.
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Mary Mallon (wearing glasses)
photographed with bacteriologist Emma Sherman on North Brother Island in 1931
or 1932, over 15 years after she had been quarantined there permanently.
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An old file card detailing results from
tests on stool specimens from Mary Mallon gives a capsule history of her
capture and quarantine.
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Part of the New York American article of June 20, 1909, which first identified
Mary Mallon as "Typhoid Mary."
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Judith Walzer Leavitt is a professor of medical history and women's studies at
the University of Wisconsin, Madison. She is the author of Typhoid Mary:
Captive to the Public's Health (Beacon Press, 1996), on which the NOVA
program "The Most Dangerous Woman in America" was based and from which this
article was adapted with kind permission of the author and publisher.