Hello and welcome to our second discussion of Fever by Mary Beth Keane. This time we're focusing on social issues — personal freedom vs. public health, nationality, gender, and socioeconomic status. Some details regarding the discussion and how it will work: Please join the discussion by leaving a comment here on the blog. I'll be responding to your comments directly IN the comments, so please do check back once in a while to see how the discussion is going this week. Please feel free to respond to other commenters as well.
Like Carole mentioned last week, this time around we've got an added bonus to participating in the book discussion. We have put together a “book lovers' surprise package” to be given to one lucky Fever reader! Just leave a comment on any of our book discussion blog posts. Your name will be placed in a hat EACH time you make a comment — so the more you share, express your opinions, and comment, the more chances you have to win the prize. The winner will be revealed as part of our wrap-up post on February 25.
The following questions are simply meant as a way to start the discussion. I don't want this to feel like high school where good books can be analyzed to the point that you no longer enjoy them, so please feel free to answer any questions you wish and ignore those you don't, or offer your general opinions and comments about the social issues covered in Fever. We value all of them and thank you for your input!
1. The story of Mary Mallon exemplifies a conflict between personal liberty and public health. Because there are always two sides (or more) to the story discuss whether you think Mary's case was handled well, and consider how it might have been dealt with today.
2. In early twentieth-century New York, class and background dictated a person's prospects. Do you think Mary was discriminated against because she was a poor Irish immigrant woman? How does Mary handle these situations? Are there any instances when Mary uses her identity to an advantage?
3. During Mary’s imprisonment, other healthy typhoid carriers are discovered and allowed to continue their lives as long as they take precautions to not spread the disease. So why is Mary kept imprisoned? Is it because she was the first? Because she refuses to admit her guilt and cooperate? Because she is a poor, unmarried, Irish woman at the dawn of the twentieth century or are there other reasons?
4. After her first release from North Brother Island, Mary abides by her promise not to cook. But as time passes she is eventually drawn back to her profession, first at the bakery and then at the hospital. How does she justify her decisions despite the risk to others? Do you think she believes she is responsible for passing typhoid fever through her cooking?
Be sure and check in with Kym next Tuesday for her discussion of the historical fiction aspects of Fever; characters and events — what (and who) was based on historical fact and what was fabricated/fictionalized. I'll be back here on February 25 with a summary of Fever.
Oh boy, these are such great questions!
ReplyDelete1. I am thinking about the people we are putting in quarantine on military bases now due to the coronavirus and it seems that public safety has to win every time. Some of it is common sense to me, but I think Mary exacerbated her situation with her attitude.
2. Perhaps her status helped the authorities justify their treatment of her but she seemed determined to not believe what anyone told her. I don't think her temperament helped her situation, but I absolutely think that her being a woman was a huge strike against her.
3. I found this absolutely maddening, and their reasoning that they were the "male of the house" made me want to scream. But, again - I don't think Mary did anything to improve her situation with her attitude.
4. I don't think Mary ever believed that she was a carrier. I think she felt they were just trying to control her and blame her. Sadly, that kind of ignorance (refusal to see what is proven) is still alive and well today!
And great answers, Kat!
DeleteIn 2020 we have a clear understanding of germ theory, how many diseases are spread, and public health departments and laws governing public health, so it's a bit easier. There are many asymptomatic carriers of typhoid fever in the US, but because they never test negative for the bacteria, they are simply not allowed to work in sensitive occupations or situations by law. I agree that Mary's attitude was a big factor, along with the prejudice against her as an Irish woman. I understand that it would have been difficult for Mary or almost anyone to understand what George Soper was accusing her of, but when she (the fictional Mary in the book) justified her actions by saying "people die anyway", I no longer felt any sympathy for her.
That last line... AMEN! Mary really had no redeeming qualities at all in this book!
Delete1. Like Kat, I think that in recent weeks we're seeing a present-day example of this dilemma playing out. I think that there is a balance or compromise to be made. While public health is a very real and sometimes very urgent concern, quarantine does not have to be imprisonment. I know Mary's situation is very different from coronavirus in that she never ceased to be able to pass it on to others, but it seems like they could have made her confinement a bit more comfortable and given her a bit more dignity.
ReplyDelete2. I think Mary's position as a woman and an immigrant most definitely played a role in her treatment, and she had two strikes against her already in any argument. I also think there was some moral superiority at play here; perhaps if she'd been married with children, they would have looked at her with a bit more pity and kindness. But she is an unmarried woman living with a man to whom she is not married, with no children, who earns her own keep. To the men of the time, that was threatening.
3. Much of my answer to your second question bleeds into my answer to this one. I think sexism and a patriarchal society played a huge role, and her personality only clashed with the authorities more and made things worse. It's hard to parse out which factor played the biggest role in her incarceration; I think she was just very unlucky to have all of them in one package.
4. Whether or not Mary understood that she was a carrier and how she was passing the disease on to others was my biggest question as I read the book. I think Keane hints at Mary's understanding (when she first returns to cooking, she at first refuses to do anything that isn't actually heated/cooked), but there's enough ambiguity that I was never completely sure. I think part of the issue is that even the experts weren't entirely sure about how the disease was transmitted at the time, so it seems unlikely that a poor woman with no education would fully understand it. But, as Kat noted, even if she had, it's possible she'd still refuse to believe the truth in front of her. Certainly we see that kind of denial in the face of scientific fact today -- look at how many anti-vaxxers there are out there!
Like I replied to Kat, public health departments take care of many of these issues today because so much is known and scientifically proven. But as you said, coronavirus is a present-day example of how it might have felt to Mary and others in the early twentieth century. So much is not known about coronavirus, such as incubation period and how it is spread, that we are forced to adopt a willy-nilly, hope for the best approach. I hadn't thought about scientific denial in this day and age, but you are completely right about anti-vaxxers. They have greatly endangered public health!
DeleteThese really are great questions. I think that Mary's case was handled poorly, but it is difficult to know if the outcome would have changed. I know from working in health care that a kind and explanatory approach works best when trying to educate people. At least they are more inclined to listen and consider what you say if you approach them in a low key manner. Having said this, I worked with drug-resistant TB patients for several years, and I came to realize quickly that people act on their own motivations and not yours even when the info is critical. (Just as an aside, I had to run them out of the men's bathroom occasionally to give them their meds because they were busy shooting craps.) Soper's aggressive and punitive handling of the situation from the beginning set up a hostile relationship that was impossible to overcome for either of them. Once you make someone fear and hate you, the relationship usually does not improve. I think the situation is likely to be approached in a better way today, but not necessarily. It depends on the person in charge.
ReplyDeleteMary was most definitely discriminated against due to her gender and her socioeconomic class. Women and the poor, and immigrants still are, but it can be somewhat less obvious these days. I cannot think of an instance where she used this to her advantage, but please point it out to me if she did. She handled them like she handled most things in her life when confronted in a negative manner. She became obstinate and angry. I think Mary learned this behavior in order to survive from an early age, and as we all know, the hardest thing to change is your own behavior.
I think Mary was imprisoned primarily for her resistance to authority (people are still punished more vigorously for showing resistance to authority), and because she was a cook. Her background of Irish immigrant female certainly was part of the decision.
Mary probably started cooking again because it was the only avenue she could see to a reasonable life economically. She was also led in that direction because she was an excellent cook, she was proud of her skills, and she was encouraged by others to do so. It would be very difficult to believe that you were the cause of disease when many of the people you cooked for never got sick, especially if you were uneducated and ignorant of the issues.
Thanks for your thoughts based on experience, Becky! Surely a kind and explanatory approach works best, but I'm sure you're right that people act on their own motivations, even when their own health is at stake. Poor Mary did have the cards stacked against her by being female, poor, unmarried, Irish, and an asymptomatic carrier with a proud and determined streak. I felt some pity towards her and her pitiable circumstances, at least until she justified any responsibility for deaths she might have caused by stating "those people were going to die anyway."
DeleteAll good questions Bonny! Like others, I struggled to determine whether Mary really understood her role in passing on the germs, or did she just ignore that? She was strongly impacted by the death of the little boy, but not so much by others AND there were so many others for whom she cooked who did not get sick. I do believe the fact that she was a woman and an immigrant factored into the way she was treated (as well as factoring in to where she was able to live, work, etc.), but that was also the way it was back then. It wasn’t just Mary – it was ANY woman and/or ANY immigrant who was not treated as well as a MAN (American). And, yes, the present day situation with the Coronavirus is playing out very similarly. It is interesting to see how folks are treated in different parts of the world.
ReplyDeleteYou make a good point, Vera — that it wasn't just Mary, it was ANY poor, unmarried, immigrant woman who was not treated as well as a man. I wondered why she didn't seem to feel any sorrow for the other deaths aside from the little Kirkenbauer boy. There is an exchange near the end where one of the doctors says "Before it was carelessness. This time its criminal." "I know that," she said, and when she said it she realized she wasn't just being agreeable; she did know. And that it had been a risk worth taking was something they would never be able to understand." Mary Beth Keane is writing those words for Mary Mallon, but I don't understand.
DeleteGood questions! 1. When handling an outbreak of infectious disease, public safety always comes first, as it did with the TB outbreaks in the 1990s. I think it is difficult to compare Mary's case to the current outbreak of the novel coronavirus virus because we know so much more about infectious disease transmission than we did a century ago. 2. Both her class and gender worked against her. It was commonly believed that diseases such as typhoid occurred only among the poor. In fact, many physicians were non-compliant with basic infection control measures such as handwashing because they believed they were not "dirty" and could not spread germs. Sadly, this continued to be a problem right up to the HIV/AIDS epidemic...I know because I had to provide extensive training to our medical staff at that time. 3.& 4. I think Mary's initial imprisonment was because the medical community didn't understand the concept of an asymptomatic carrier. As they learned about other carriers, they released her with the requirement that she stop cooking for others. Here is where being a single, poor, Irish woman worked against her. I believe she lacked understanding of how she could spread disease without being sick herself. But, she was proud of being a cook and had no other way of making a decent living, so it made sense for her to go back to cooking. If she had received education about her condition and re-training for another job, maybe the outcome would have been different, but those services weren't offered to those of Mary's class in those days. At that time it was expected that patients follow "doctor's orders" without question, especially if one was female.
ReplyDeleteGood points, Debbie! In so many ways, Mary was a victim of her gender, socioeconomic, and immigrant status, but like you said, public safety always comes first. I must admit that I am shocked you had to provide extensive training to the medical staff on proper handwashing at the time of the HIV/AIDS epidemic. But I probably should not be. Just this morning I read an article hypothesizing that proper handwashing by travelers in key airports throughout the world could help slow this coronavirus epidemic. The researchers found that only 70% of people wash their hands after using the bathroom, and of that 70%, only 50% do it correctly.
DeleteYou make a really good point I hadn't thought of, Debbie -- that she went back to cooking because it was the only thing she was good at that she could make a living doing.
DeleteBut, she did work in a laundry for awhile. Maybe not the money she would make cooking...but she could find other work.
DeleteShe did, but she hated it. I can't say I blame her for wanting to earn a living doing something rewarding and enjoyable.
DeleteProper hand washing was always a topic in the OR that was never ending! Not so much the surgical hand scrubbing that was a full five minutes, but the non-surgical hand washing, (after using rest room, before and post eating, having respiratory infects-colds,etc.). The latest and greatest consences on the topic (before retirement) was, to sing 'Happy Birthday' 3x starting after lathering hands with soap and before rinsing. How's that for high tech
ReplyDeletescience? I must admit though, I still do it today and never use antibacterial soap at home. I am rarely sick with colds or other infections.
I don't think Mary was a stupid women and if she had a doctor or public health nurse explain to 'her understanding' how this disease moved through the public and her being a carrier, I think with that knowledge , Mary may have stopped cooking.However, I do not think doctors would of considered Mary capable of understanding the little science behind the spread of germs at that time in history. Let's face it, doctors (men) didn't understand that much about germ contamination, look at their hand washing and sterile techniques...scary! Also, I agree with Debbie, doctors were not to be questioned, particulary by women!
Re-training wasn't a 'thing' back then, especially for women.
Interesting and good to know! I was a med. tech. in the lab., and when I was training back in the dark ages we were taught to sing Happy Birthday x2!
DeleteI think you raise a good point that I hadn't considered — that if Mary had received some basic, kinder and gentler education then it's possible she might have cooperated. We'll never really know for sure, but she must have felt victimized by the doctors, authorities, and press. It was surely portrayed as an adversarial relationship in the book. And I never considered the idea that doctors weren't to be questioned, but I'm sure that was the case 100 years ago, it was true in the 1970s, and is still somewhat true!
What a great discussion of this (sometimes maddening) book! As I read, I kept trying to put myself into Mary's head . . . at that time, in that place. NYCity was a stew of germs. The field of "germ science" was only just beginning. Mary had no safety net. She was a very good - and in demand - cook, and she was proud of her profession. She had never been sick with typhoid herself, and she cooked for many people who never got sick. Being accused of being a typhoid carrier - and being quarantined for such a long period of time - must have been confusing and maddening for her. I'm sure I would have been livid in that situation myself! She seemed to agree to the conditions of her release (not working as a cook) for quite a long time -- and then, once she began again (as a "baker" . . . not a "cook"), the floodgates opened for her. She was desperate to earn a better living. I felt like . . . yes, she did understand what they were explaining to her about being a carrier. But she was desperate and had few options. As for the men identified as carriers -- and allowed to remain out in the world? It's hard enough for women still in 2020. Can you imagine what it would have been like at the turn of the 20th century? It didn't surprise me at all that they treated male typhoid carriers differently than Mary!
ReplyDelete(And I was taught to sing Happy Birthday 2X, too.) ;-)
There is an exchange near the end where one of the doctors says "Before it was carelessness. This time its criminal." "I know that," she said, and when she said it she realized she wasn't just being agreeable; she did know. And that it had been a risk worth taking was something they would never be able to understand." Mary Beth Keane is writing those words for Mary Mallon, and implied that she had come to understand her medical status and what that meant, yet she still didn't write any words of remorse for Mary. I'm looking forward to your discussion of historical fiction next week!
DeleteOkay now you've done it. I want to read it now that I know more. Or is this a true story and podcast would tell me a bit?
ReplyDeleteMary Mallon was a real person, also known as Typhoid Mary because she spread typhoid fever working as a cook and was identified as the first asymptomatic carrier. It is a true story, but this book, Fever by Mary Beth Keane, is a fictionalized account of the story.
DeleteInteresting discussion. My view of Mary is that she was an intelligent strong woman but not well educated. She lived in a time when the science of germs wasn't well developed and understood. She was also treated differently because she was poor, an immigrant, a woman, and an unmarried woman in a relationship with a man. The only option and way to survive was to use her iron clad will to resist. I wonder if women had been in professional positions of power if the response would have been any different. Of course women were not in any positions of power at that time.
ReplyDeleteIndividual freedom versus public safety (common good) is an interesting concept and one that is challenging to discuss. In some ways, this story is not so puzzling because we live in a country where individual freedom is cherished but often the individual rights of some are more highly regarded than others. How to decide issues of public safety, common good and when one outweighs the other is complicated. This reminds me of the discussion around significant health issues/exposure in the early intervention program where I worked. Several times we faced providing equitable services while staying safe and without compromising anyone's rights. It took some very thoughtful lengthly conversations and staff training. As far as this author presented the story, thoughtful response was lacking. Mary was a health hazard but was the response to her was not thoughtful nor respectful.
I hadn't thought about how much we value individual freedom in this country, and how individual rights of some are more highly regarded than others. From a public health standpoint today, the public always comes first. I think the Health Department may have been trying to do that in Mary's case, but their judgements certainly weren't equitable, and like you said, not at all thoughtful nor respectful.
DeleteLOVE all the thoughtful and well-stated comments here! I have all the sympathy for Mary as a victim of social and racial prejudice, and gah! she made things so hard on herself. We have made tremendous progress in managing contagious diseases but all of that rests on folks buying into and going along with the rules. Coronovirus is our latest test ... that wasn't news when I read the book. I just read that my city (Atlanta GA - home of the Center for Disease Control) has been questioning folks ... some 200+!
ReplyDeleteI was just reading what is known about this coronavirus on the CDC website, and it doesn't seem to be much! The method of spread, incubation period, even symptoms aren't completely known, so I can get a faint glimmer of how Mary Mallon and others living 100 years ago might have felt when presented with germ theory and the very beginnings of public health. Now public health rules are backed by enforcable laws, and individual freedom can't always win out.
DeleteGreat discussion here. I'm not finished with the book yet (~70%) But two things that have not been mentioned:
ReplyDelete1. When Mary was being held in isolation on the island, they were effectively using her as a human research project. So in addition to the fact that she was in quarantine, they were also invading her body to learn more about the disease. Since WWII we have guidelines for the use of human subjects in research. But they are just guidelines and have been stretched to the limit in recent years with some of the genetic research/experiments: https://en.wikipedia.org/wiki/He_Jiankui_affair
2. Mary seems to feel that George Soper is exploiting her situation to make a name for himself, which is entirely possible. I read another nonfiction book that included Soper (can't recall which one....may have been: https://www.goodreads.com/book/show/28363846-bellevue ) and he certainly was a man aware of his public image.
The final thing that caught my interest was the role of the press in Mary's situation. It was how she learned about the other carriers and other important communication regarding her situation. It was also the press that gave her the moniker Typhoid Mary which is still in use today.
They did test Mary often while she was quarantined, but I saw that more as being done to determine if/when she would be free of Salmonella typhii and no longer able to infect others. The same type of testing is done today by public health departments with the requirement of six consecutive negative tests before the patient can be cleared:
DeleteFecal or gallbladder carrier: 6 consecutive negative feces and urine specimens submitted at 1-month or greater intervals beginning at least 7 days after completion of therapy.
Urinary or kidney carrier: 6 consecutive negative urine specimens submitted at 1-month or greater intervals beginning at least 7 days after completion of therapy.
Carriers cannot be released from supervision until cleared according to public health law.
I read some of George Soper's publications and can certainly believe that he was a man aware of his public image. He had done a lot of research on typhoid prior to his pursuit of Mary, but good detailed information about him has been hard for me to find.
I agree that the press certainly played a role in Mary's situation, reporting with quite a bit of hyperbole (just like the present day)!
I can't add much to this terrific discussion. I agree that Mary was a difficult subject for sure and was quite frustrated by her stubbornness. The timing of the read is particularly good as we wait and watch what happens with our ever growing and not quite understood Coronovirus. Thank-you for your thoughtful questions and for doing this!
ReplyDeleteMary was almost a perfect intersection of poor hygiene, fierce stubbornness, and the really bad luck of being an asymptomatic carrier of typhoid. Between reading this book, the "regular" flu virus, and this coronavirus, I'm being especially careful to wash my hands thoroughly!
DeleteI'm not certain Mary was confined while others remained free just because she was a poor, female immigrant. The difference between Mary and the dairy farmer, for instance, was that he agreed to be hands-off in his operation while Mary refused to quit cooking. So while things could have been handled better, I believe Mary was appropriately quarantined for the public good. The part that made absolutely NO sense to me was not being allowed to contact Alfred or her friends. That was strictly punitive.
ReplyDeleteAs I wrote on Carole's post last week, I can sympathize with Mary's initial and (even) continued resistance to complying with what had to seem like an unfounded accusation. She had a skill that earned a living and that she enjoyed. It wouldn't be hard to convince yourself that "the experts" were wrong when there was so much evidence to the contrary (e.g., so many did not get sick, she'd never been sick, etc.). Although I generally am compliant when authority speaks -- always wear your seat belt, protect our planet, don't let your dog eat chocolate -- I can also conveniently dismiss it -- have that second glass of wine, choose butter, be lax about sunscreen sometimes. The public should be protected against selfish carelessness, but that isn't so black and white when you are the one being restricted. That's where Mary was, I believe.
I agree that there wasn't even a question about releasing Mary, especially after she eventually went back to cooking after the first time she was released. Public health had to be protected over the individual. I really like your analogy about being compliant. I'm a rule-follower when it comes to seat belts, don't drive dunk, don't rob banks, etc., but can very easily dismiss or ignore rules concerning healthy eating, get more exercise, don't sit and knit when you have work to do on plenty of occasions.
Delete