The Cook Who Killed: Typhoid Mary's Deadly Legacy

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What happens when healthcare professionals face a critical pediatric emergency and systemic resistance simultaneously? Our episode opens with a gripping medical mishap submitted by a nurse who found themselves racing against time to save a 4-year-old hemorrhaging after a routine tonsillectomy. When the child began swallowing blood and showing signs of deterioration, this nurse's persistent advocacy ultimately proved life-saving, despite repeatedly being dismissed by other providers. The case highlights the vital importance of speaking up in healthcare settings and trusting clinical instincts—even when faced with opposition from those higher in the medical hierarchy.

We then journey back to the early 20th century to examine one of medical history's most fascinating figures: Mary Mallon, better known as "Typhoid Mary." Born in poverty in Ireland and later working as a cook for wealthy New York families, Mary became America's first identified healthy carrier of typhoid fever. Despite never feeling ill herself, she unwittingly spread the disease through her cooking, particularly her famous peach ice cream made with raw, unpasteurized ingredients. When sanitary engineer George Soper connected multiple typhoid outbreaks to Mary's employment history, she refused to believe she could be responsible, leading to a forced quarantine that would ultimately span 26 years of her life.

Have you ever wondered how you might react if your freedom was restricted for the greater good? Share your thoughts with us and subscribe to hear more medical stories that challenge our understanding of health, ethics, and human rights.

Wired (Sept. 23, 1869: Here Comes Typhoid Mary) provides a richly detailed narrative focusing on her forced quarantines, her return to cooking under an alias, the resulting outbreaks, and her eventual permanent isolation.
WIRED

Time (Refusing Quarantine: Why Typhoid Mary Did It) offers a thoughtful look into the tension between public health imperatives and individual rights, exploring Mallon's denial of her carrier status and the ethical dilemmas her case posed.
TIME

Gavi’s article, “The tragedy of Typhoid Mary,” emphasizes her confinement and how she was treated less like a patient and more like a public menace—inviting reflection on possible injustices in her treatment.
Gavi

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Episode Transcript

Speaker 1 (00:00):
Go Jenna.

Speaker 2 (00:06):
How are you?
I'm over here.
How are you?

Speaker 1 (00:11):
Yay Good, Are you enjoying the remnants of summer?
Because I hate to say it, but Imean I don't want to be Debbie
Downer here, but like school'sstarting soon.

Speaker 2 (00:24):
So today was the first day.
I was like I have to practicegetting up early and my friend
is a teacher and so I had seenon her social media like that.
She was like tomorrow I have toget up early and I was like I
actually need to practice thattoo, because I should have
started a long time ago and Ihaven't.
So we both were like, okay, 545, and let's be having coffee by

(00:49):
six.
So we did that.

Speaker 1 (00:53):
Oh, that's early, Do you always get up?

Speaker 2 (00:54):
that early?
Oh, I get up.
I actually have to get upearlier than that when I do go
to work because I live so faraway from work.

Speaker 1 (01:00):
That is early, okay.
How'd it go then, tired?
We're past your bedtime now, itbeing almost seven o'clock yeah
this is going to be about.

Speaker 2 (01:11):
I actually was pretty impressed with myself.
I've really had a lot of energy.

Speaker 1 (01:18):
I'm proud of you.

Speaker 2 (01:18):
It was good.
I am very tired now, but it wasgood.
It was good.
I'm proud of you.

Speaker 1 (01:25):
You got this.
Thank you, you got this really.

Speaker 2 (01:27):
Yeah.
I think it will be good to likeget back in a routine and like
see the kiddos.
Obviously I love my job, solike looking forward to that,
but I do think like the firstweek back is going to be a huge
like slap of reality, of likehere's a schedule but honestly,

(01:47):
you're sporting a beautifulgolden tan, so I'm jealous like
I feel like I lost my tan thelast few weeks because it's been
so hot.
I haven't oh well, apparently,but I guess it's still more than
your fluorescent light bulbhospital life thank you so much

(02:07):
for pointing that out, you cowthat's the tan.

Speaker 1 (02:10):
I always sported too yeah, listen, I have a left arm
driver's tan, because my armthat's on the like window, so
when I'm driving is my left armand so that turns really nice
golden brown and then the restof me is just pasty, pasty as

(02:31):
heck you look good, I agree.
Also, never again am I notgoing to get myself a pool, an
above ground pool, for thesummer, because that was my only
excuse to go outside.
So now I am super pasty white,except for my left arm.

Speaker 2 (02:45):
It's not happening again you didn't go sit in your
little floaty chair thing no,you know it got slimy because,
yeah, and tried to wash it offand then it's like, okay, I
gotta go freaking, turn on thehose, fill it up.

Speaker 1 (03:00):
The water's ice cold yeah yeah, at least for with a
pool, when I mean it is a lot ofwork for a pool, but I enjoyed
the work because it's basicallywalking around in a circle
creating a little like tornadoof water to catch all the bugs
and leaves and stuff and thatwas like half the thing I
enjoyed about being in the pool.

(03:22):
I had had like a purpose, okaynext year she's getting a pool
back.

Speaker 2 (03:26):
Yeah.

Speaker 1 (03:27):
Next year, girls, I'm getting my pool, so any whoozle
.
Do I have any corrections fromlast week?

Speaker 2 (03:36):
Probably not because it was worse.
I was going to say I don'tthink so, but then I also am
sitting here like I don'tremember what my case was.
So Hep C guys.

Speaker 1 (03:48):
Yeah, the guy that was addicted to fentanyl.
Yeah, ass Asshat of a guy.
No, I don't her up because wewere fortunate enough to get a
really in-depth medical mishap,which is not a funny, it's

(04:13):
actually rather a very importantbut also kind of deep dive into
what's wrong with our medicalsystem.
Medical mishap from a writer.
So I'm going to start with thatand then we can talk about
something a little morelighthearted, although it's not
terribly lighthearted, but it'sa lot more lighthearted.

(04:34):
Typhoid Mary.
So for Typhoid Mary, ourresources will be listed in the
show notes, but I mean she's soubiquitous, so I mean there's so
many documentaries and podcastsand articles about her books,
about her, that I felt kind ofpressed upon to come up with

(04:54):
some things that listeners maynot have known about her.
So let's hope I can reveal acouple of those things.

Speaker 2 (05:01):
I then reassured her that I know nothing about
typhoid Mary, so hopefully,maybe someone else is in the
same boat as me and this will beall new and exciting Not
exciting, of course, but youknow, yeah, it sounds like some
things are a little funny.
So, that's an important case.

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Okay, as I said, the resourcesfor this show will be on our
show notes and I don't reallyhave any trigger warnings.
But I'm going to go straight tothe medical mishap.

(07:18):
Let's do it so, yeah, so thetitle of this email was
tonsillectomies can go bad andthe email starts hello, amanda
and Jenna, I'm a day onelistener.
Oh, yay, thank you.
I appreciate all you both do toeducate the public about
medical issues and crimes.
I'm writing to you about myexperiences and prefer to be

(07:40):
anonymous.
We get that.

Speaker 2 (07:42):
And we got it.
Thank you, yes, thank you.

Speaker 1 (07:45):
So from here on out, anonymous refers to themselves
as the writer.
So it starts out.
The writer usually workedovernights, from seven at night
to 730 in the morning, but thisday, due to staffing, the writer
went in at three o'clock in theafternoon.
Upon arrival, a new patientimmediately arrived by a private

(08:07):
car and it says parenthesesparents drove, end parentheses.
The patient was a four-year-oldmale who was experiencing
severe bouts of hematomesis,which means vomiting blood.
Most commonly, when patientssay they're vomiting blood,
they're not actually vomitingblood.
It's more often irritation onthe back of their throat from
persistent vomiting which cancause inflammation and some

(08:30):
blood-tinged vomiting.
But this patient proceeded atthat moment to have a bout of
emesis or vomiting, which wasindeed wine-colored, which
supported the statement from theparents that the patient was in
fact vomiting blood, whichsupported the statement from the
parents that the patient was infact vomiting blood.
The parents indicated to thewriter that the patient was
three days post-op bilateraltonsillectomy, which is a very

(08:53):
common procedure.
That was me saying that was avery common procedure.
The writer then got thepatient's chart pulled up and
noticed that they had been tothe emergency room already today
, that same day, four times thatday in fact this indicated to
the writer the major problemoccurred Either there was a

(09:14):
significant lack of education tothe parents about what to
expect and when to return formedical treatment, or a severe
disservice was done by the staffat the facility, or a severe
disservice was done by the staffat the facility.
The patient was not receivingthe necessary care.
The writer also noticed thatthe previous four times the
patient had been seen was by thesame provider for four times.

(09:35):
The writer asked the patient'sfamily if he could excuse
himself to read over some of thedocumentation to determine what
was going on, and that he wouldbe at a computer with an
eyesight of the patient so hecould continue to observe them.
The patient was stable, so thewriter went to research the
patient's history.
The writer determined that thepatient was post-op day three

(09:59):
from a tonsillectomy.
The patient experienced mildbleeding but early in the day
the patient had eaten bread fromPanera Bread, which we all know
is.
This is Jenna.
It can be a little crunchy, yeah, a little bit crunchy crusty.
So the Panera Bread appeared,which is that rustic crusty
bread appeared to irritate thesurgical sites, so the patient

(10:22):
then presented to the emergencyroom due to significant bleeding
resulting in vomiting.
Unfortunately, the facilitywhere the writer worked did not
have current coverage for an ENTyour nose and throat physician.
The writer attempted to reachout to the provider who
performed the surgery but wasadvised that there was no one on

(10:42):
call.
Since it was a weekend, thewriter requested to speak to the
head of the department.
Since this was clearly an ENTemergency period, the head of
ENT did contact the writer andthe writer was advised that,
since no one was on call, no onewould be addressing the issue
and that the writer should notattempt to contact them anymore.

(11:05):
The writer then continued tolook through the patient's chart
and saw that the provider inthe emergency room had reached
out to an ENT physician at alarger facility owned by the
same system.
It was advised that they shouldsee the patient as an
outpatient.
The writer also noted that theemergency room provider did
reach out to the ENT at theparent facility and was advised

(11:28):
each time that it was not anemergency and there was nothing
that needed to be done at thistime.
The writer went on to talk tothe patient and the family again
and perform basic care, as inputting in an IV fluid
resuscitation, offeringanti-emetics and pain control.
The writer clarified all theinformation with the family and

(11:50):
confirmed that this was accurate.
The provider then arrived atthe bedside and the writer, the
nurse and the doctor conversedwith the patient's parents.
It was quickly determined atthis point they would need to
transport the patient directlyto the parent facility because
it had been approximately 30minutes since the writer entered

(12:12):
the room to perform care andtalk with the patient's family.
The patient was no longerheaving or vomiting, so that was
an improvement period.
The writer did, however, noticethat the child slash patient
seemed more lethargic and pale.
This was determined to be aresult of the combination of
blood loss and the excitementfrom the day by parents,

(12:33):
providers and the writer to beof no significance.
The parent facility acceptedthe patient and staff awaited
ambulance transport and staffawaited ambulance transport.
The writer returned to check onthe patient 10 minutes later.
The patient still appearedlethargic, but not more so than
previously.
The patient maintained theiroxygen saturation and didn't

(12:53):
vomit anymore.
Nor did there appear to be anynew bleeding.
And then the email saysparentheses of note the patient

(13:15):
was determined by the writer tohave between a class 3 or class
4 in the Malampati scale, whichmeans that tonsils are not able
to be visualized when looking inthe throat end parentheses.
So the writer spoke with theparents, who felt that the
patient was doing okay.
But the parents were obviouslyconcerned about the patient, so
they spent about 10 minutesspeaking with the parents until
the parents felt better.
The writer did notice an odorof blood and by close
observation the writer noticedthe patient appeared to be

(13:36):
swallowing.
This led the writer to believethe patient was still bleeding,
it was just not being visualized.
So the writer didn't want toalarm the parents and went to
speak immediately to theprovider, who stated that they
would look.
They returned and stated ohwell, it doesn't appear to be
bleeding currently.
So the writer made a mentalnote to monitor the patient even

(13:56):
more closely than already hadbeen done.
Because of what the writer feltwere clear signs of
decompensation, the writerreturned to the room to check on
the patient and infused somemore fluid.
Approximately 10 minutes laterthe writer again noticed a
strong odor of blood and againit was noted that the patient
appeared to be swallowing.

(14:16):
The writer inquired at thistime whether the parents felt
that the patient was exhibitingthose signs as well, and the
patient's mother did reportswallowing, but the provider
said it's likely leaking a bit,not to be concerned.
The writer, upon completingtasks and offering the patient
some stickers, went to theprovider to again express their

(14:38):
extreme concern that the patientwas bleeding more than
previously thought.
The provider advised that theparent facilities, ear, nose and
throat department had alreadyaccepted them and there was
nothing more to be done.
Roughly seven minutes passedand the writer went to check on
the patient again.
And again the writer noticedswallowing and the overwhelming
smell of blood.

(14:58):
I mean, can you imagine?

Speaker 2 (15:01):
So it's that metallic smell right, yeah, yeah, well,
I mean, I imagine, yeah.

Speaker 1 (15:08):
So the writer went to speak to the provider again and
stated that it was necessary todo some other sort of
intervention.
I mean, we're supposed tocultivate it this is me speaking
outside of the email but we'resupposed to cultivate a culture
of safety where people feel safeto speak up, regardless of
their role, and have, you know,their concerns addressed at

(15:31):
least right.

Speaker 2 (15:32):
So well done for this , so I imagine this person is
just feeling like they'rescreaming in a brick wall at
this point.

Speaker 1 (15:37):
Yeah, after speaking with the provider.
The provider agreed with theassessment of the writer,
finally, which the writer is theprimary nurse.
So it was determined that theprovider agreed with the
assessment of the writer,finally, which the writer is the
primary nurse.
So it was determined that thebest course of action would be
to transport the patient via airtransport or helicopter versus
ground transport.
So the writer went to informthe patient's family and

(15:58):
reassure the parents that thiswas a good thing.
Writer also reassured thepatient that it would get to fly
in the clouds like birds, towhich the patient smiled Sounds
like such a good nurse.
The helicopter was launched andestimated to be 40 minutes to
touchdown.
The rider continued to check onthe patient regularly and
continued to alert the providerto bleeding, to which the

(16:20):
provider thanked the rider, andcontinued to wait until the
helicopter arrived.
33 later, the writer wasinformed that the helicopter was
diverted to the field becausethere was another child that
needed help who had been runover by a large farm appliance.
Oh my god jesus.
The writer went to inform thepatient's parents about what

(16:43):
happened and advised thatanother helicopter had been
launched, but this was an hourand 30 minutes away.
This had been three minutessince the last time the writer
checked on the patient.
The writer immediately noticedthat while the patient was
lethargic, they were now passingout.
The writer immediately began toassess the patient and it was
apparent the patient seemed tobe slightly more pale and

(17:06):
altered and confused.
The writer then had a patientcare tech bring a forehead O2
device to help prevent theclient from removing the device
and their saturations were foundto be 87%, which is low but
suspicious that the patient'ssymptoms did not support the
current saturations low, butsuspicious that the patient's

(17:27):
symptoms did not support thecurrent saturations.
The writer then spoke withparents of the patient and
stated that the writer wouldonce again go to the provider
and advocate heavily for thepatient's care.
The writer spoke to theprovider and the provider and
writer went into the room.
The provider talked to theparents and advised at this time
it would probably be best tointubate.
The patient's parents agreedand it was decided that standard

(17:48):
intubation which intubation notbeing done due to respiratory
distress or failure or trauma oranother significant emergency
was a big deal.
So the provider then left theroom to get the supplies.
The patient's mother then statedto the writer he's not okay.
The writer responded to thepatient's mother I know he isn't
, I'm fighting for him At thismoment.

(18:10):
The patient sat up and lookedat the writer with an expression
the writer would describe asfear and then projectile vomited
a significant volume ofmerlot-colored blood, about 400
milliliters, and then passed outin the writer's arm.
The patient was now suddenlywhite, as opposed to pale like
white as a piece of paper, andcompletely hypotonic.

(18:33):
The writer immediately advisedthe mother to hit the staph
assist button on the wall anddrop the bed down into a lying
position.
While attempting to find apulse, the writer ripped the
patient's shirt off, appliedcardiac monitoring patches and
called for an ECG.
At this point, other staffstarted to arrive and the rider
instructed the RN to grab thepediatric crash cart and another

(18:55):
to grab the pediatric airwaycart.
The rider then advised apatient care technician to grab
as many suction canisters asthey could get a hold of.
The writer then instructedanother patient care tech to
grab all of the NG andrespiratory suction tubing they
could find for pediatricpatients and a blood pressure
cuff that was appropriate forthe size of the child.

(19:17):
The patient's heart rate wasnow found to be 160 and climbing
to a steady pace the patient's160 and climbing to a steady
pace.
The patient's oxygensaturations were also dropping
at a steady rate and with itcurrently being 73%.
The patient's blood pressurewas found to be 37 systolic and
13 diastolic.
This was so low, but it must betaken into account.

(19:40):
The patient was a four-year-oldchild who was small for his age.
The patient stopped breathingat this point.
The writer immediately orderedsomeone to grab the pediatric
bag from the crash cart.
But the crash cart, however,only had an infant bag.
So a provider grabbed the bagand started to resuscitate the
patient at 60 to 70 times aminute to compensate for the

(20:01):
lack of volume within the smallbag.
Respiratory therapy was calledat this point by the staff to
assist alarm and separately fourtimes in the emergency
department was advised, but theysaid they were busy and would
respond when they were done.
The writer then pushed the codeblue button to indicate an
emergency so that therespiratory therapists and

(20:23):
pharmacists would need to reactper protocol.
The writer placed two additionallarge-bore IVs A 20-gauge was
the largest the patient's veincould support and started the
patient on rapid fluid bolus.
The writer then held thepatient as the provider
intubated.
The writer pushed down on thepatient's tongue to visualize
the tonsilsils and it wasimmediately apparent that this

(20:45):
was a gross hemorrhage situation.
The writer advised anothernurse to call the blood bank and
prepare supplies for the rapidtransfusion protocol of O
negative blood type until typeand screen could be determined.
The respiratory therapist thenarrived and observed for several
minutes and stated well, lookslike everything's under control,

(21:08):
and then excused themselvesfrom the patient's room.
The writer then asked anotherperson please get them
suctioning supplies.
This instant the individual'sreturn was supplies.
The writer began to suctionlarge volumes of blood from the
patient's throat.
It was apparent that thepatient also had a large volume
of blood in his stomach andlungs.
The writer also noted that thepatient had an asymmetrical

(21:31):
chest rise.
They immediately reported thisto the provider who advised the
writer that they disagreed.
The writer proceeded to listenand then advised the
endotracheal tube was likely notin the proper place because no
air movement could be heard onthe left side At this point.
Portable x-ray arrived toverify the tube placement.
The writer advised that theywould hold the patient and apply

(21:53):
lead to them for protectionagainst radiation.
I'm sorry, apply a lead.
Maybe A lead, a lead?
Is it a lead, a lead?
Okay, I'm thinking of that leadvest.

Speaker 2 (22:06):
A lead.
Yeah, yeah, yeah.

Speaker 1 (22:07):
Lead vest.

Speaker 2 (22:08):
Sorry, I just heard my husband cough in the living
room and I was like I hope youknow to cut that out.

Speaker 1 (22:13):
So if anyone hears that, siri, Upon completion of
the x-ray it was immediatelyapparent that the patient was
right main stem intubated andthat the patient now had a left
side pneumothorax.
The tube was quickly pulledback and confirmed to be at the
carina, which helpedsignificantly with the

(22:34):
oxygenation problem.
It was determined this waslikely a tonsillar arterial
bleed.
The general and trauma surgeonwere both consulted and advised
they could not perform anysurgical interventions on the
patient.
The writer advised the nurse tocall the patient's ear, nose
and throat physician and theywere advised that, since the

(22:54):
patient was in an emergency room, that we should be able to
handle the situation.
Another provider assisted bysoaking sterile gauze in
tranexamic acid and attempted todirectly pack the patient's
directly now very apparentbleeding open wounds where the
tonsils were.
This had limited successbecause of the location, the

(23:16):
size of the patient's mouthbeing a small 40-year-old child
and the amount of bleeding thatwas happening.
At the same time the bloodarrived and the patient's heart
rate was around 209 beats perminute.
Oh, my goodness.
The patient was given two unitsof blood through manual
pressure infusion by squeezingblood bags with your hands to
force the blood in as fast aspossible, and then an infusion

(23:39):
was set.
The rate of the infusion wasprecisely set to be as close to
the rate of bleeding as possible.
The risk was that raising bloodpressure too much or even to
normal would result in furtherdamage and further hemorrhage,
which could ultimately result inthe patient's death.
But too little would result ina deficit and eventually a loss

(24:01):
of life due to blood volume loss.
I can't imagine being in thissituation, Can you, oh my?

Speaker 2 (24:07):
goodness no.

Speaker 1 (24:10):
The writer requested an order to apply small doses of
PRN phenylephrine as necessaryfor blood pressure maintenance,
which was granted.
The phenylephrine comes in adose of 100 micrograms per
milliliter, with a total syringeof 1 milligram to 10
milliliters.
The dose that was recommendedto give the patient at intervals

(24:32):
was 0.1 milliliters, whichwould be 10 micrograms of
phenylephrine.
The writer immediately askedthe pharmacist to put this in a
different syringe.
The provider stated not toworry, just give 0.1 milliliters
.
Another nurse stated it wouldbe incredibly unsafe to the ease
at which a much larger dosecould be given and the

(24:54):
phenylephrine would not beadministered unless it was in a
one milliliter syringe.
So this was done and a properdose was administered.
Since the patient wasnon-responsive, there were no
meds given before intubation thewriter requested that the
patient be given a dose ofsomething because the patient
was in pain that one can stillfeel pain when unconscious and

(25:26):
then all present could visualizethat the patient was not
ventilating well, in other wordsthey were bucking the
ventilator and that sedation atthis point was required.
The provider then agreed andordered 2.5 milligrams of Versed
to be administered.
The writer did administer saidmedication and the patient did
cooperate better with theventilator at that point.
The writer then placed theorogastric tube and hooked it to

(25:49):
suction, in which immediatelylarge volumes of blood were
suctioned out At 500 milliliters.
However, the suction stopped.
The writer attempted variousmethods to clear but ultimately
made the decision to remove thetube and place a new one.
Upon removal it was apparentwhat the problem was.
The tube was clogged with largeblood clots.

(26:11):
After the third clot, thewriter made the decision not to
replace.
Instead, they took a tube fordeep respiratory suctioning and
fed the said tube into thepatient's stomach.
The writer then could suctionand manually pull out the clots
and repeat decompressing theabdomen.
At this point the canister wasswitched because it was full of

(26:32):
900 milliliters of blood.
The writer then requested theprovider put in an order for
additional Versed.
The provider advised that, perthe patient's electronic medical
records, they had alreadyreceived the dose seven minutes
ago.
The writer stated the patientwas still in pain, as apparent
by them crying, and at thispoint it was just cruel not to

(26:53):
treat the pain in some way.
The provider stated they didn'twant to harm the patient and no
order would be given.
The writer reminded theprovider that the patient was
fully intubated, that even largedoses of midazolam or ketamine
would cause no ill effects andno loss of airway, since a tube
was already there to maintainthe airway, and that both the

(27:16):
midazolam and ketamine havecontinuously been proven not to
lower blood pressure, and infact ketamine can slightly raise
blood pressure.
The writer also reminded theprovider that propofol, while a
sedative, does in no way treatpain and has been commonly shown
that patients under sedationwith propofol only still feel
pain.
The ethics of such being arguedthat if the patient is sedated

(27:38):
and doesn't remember, does itcount as being in pain or still
in question.
But the writer didn't want thepatient or the patient's parents
to have any more trauma.
I mean, he's four after all.
It was agreed then and an orderwas placed for ketamine and
midazolam infusion.
At this point the helicopterdid arrive and the patient was

(27:59):
transported to the parentfacility and immediately taken
to surgery.
They were in surgery for 32minutes.
During that time their tonsilswere cauterized, stopped the
bleeding and a total of 600milliliters of blood products
were evacuated from the abdomenand the lungs.
Oh, my goodness.

Speaker 2 (28:17):
Wow, can you even imagine if that was your day at
work?

Speaker 1 (28:22):
I mean, this makes my worst day seem like.
Yeah, walking the park, Noteven just like a day at work.

Speaker 2 (28:28):
This is like one part of your work day, right?
We love a nurse.

Speaker 1 (28:33):
We do love a nurse, but also a feisty nurse.
That's like I don't care whoI'm standing up to.
I am going to speak my truthfor the patient's best interest.
That's what we need.
Yeah for sure, and I know thatthere seemed to be a bit of
resistance initially, but I dolike the fact that you know the

(28:54):
physicians in this story notstory this case eventually did
pay attention.
They could see reason and andthey weren't.

Speaker 2 (29:02):
Their egos weren't above, over and above the safety
of the patient ultimatelyalthough it does kind of kill me
that the head of the entdepartment or whatever was like
yeah, no, I said no, so stopcalling, which I'm.
I guess if there's no coverageand no one's on call, then
there's nothing you can do aboutthat.

(29:22):
But if it's clearly an ENTemergency, like if I was that
person, I'd be like feelpersonally responsible if I
didn't go in.
But that sucks and like, no,there's no work life balance.

Speaker 1 (29:33):
So, like I get it, because the organization isn't
hiring enough of them, right,yeah, how could you, how could
you, how would your conscienceallow that to happen?
But I also wonder if they get alot of false alarms like people
going oh, I'm sure you're likeit's so rare.
You know that people have thesehemorrhages and I know one of

(29:58):
our ENTs where I work.
He was phrasing his tonsilsurgeries in a different way and
I was like what is this?
And he's like, oh well,basically he doesn't take them
out, he just scrapes them downbecause there's a lot less risk
of hemorrhage.
He goes hemorrhages are reallyrare but like, why even do that?
So you can do like these Iforget what it's called, I

(30:20):
should have looked it up butlike you can do like these
little tonsil scrapes where youdon't take the whole tonsil out,
and I think that's amazing.
That's what's nice about.
You know, we have some younger,like recent grads, like they're
coming with all the fresh stuff, you know, the fresh knowledge.
That's really cool but, yeah,scary.

Speaker 2 (30:46):
I mean that's really cool, so but, yeah, scary.
I mean yeah, oh, well done.
Also, I happen to know likewhere both these facilities are,
just because I know the writerand I'm just like, by the time
the damn helicopter gotredirected to a different
emergency and the estimated timethat it would be till the
helicopter got there, plus theinitial eta of when it would get
there, it's like Jesus Christ,I could have driven there and
back in that amount of time.

Speaker 1 (31:06):
I know oh my God For that family too who are just
like this is our child, like Iget that another child needed
help, but like how hard thatmust be.

Speaker 2 (31:17):
Watching your child go through that and like how
child be yeah, more hurt thanare they gonna die?
Because, yeah, my goodness butin, in, I'm thinking too, like
with my comment of, like I couldhave driven there and back by
now, but like, thank god thatdidn't happen to your child
while you were transporting inyour private car.
And, oh my god, stock thefucking carts with the

(31:40):
appropriate stuff, right?

Speaker 1 (31:42):
yes, stock your carts .
And also, god bless nurses.
Can I just say, shout out to mysister who's a nurse.
Shout out to this writer,anonymous thank you for writing
in like this is a really rareinside glimpse of, because, you
know, obviously in ourprofessional lives we have have
to, you know, gloss up the goodand limit the bad, but just to

(32:07):
know what it's like like behindthe scenes.
It's like a backdoor glimpse atwhat actually is happening, and
it took this writer a lot ofstrength and a lot of courage to
stand up, and a lot ofknowledge too.
A lot of courage to stand upand a lot of knowledge too, to
stand up to yeah, withoutresearch about these medications
to the provider.

Speaker 2 (32:26):
Yeah, well, actually research, yeah.

Speaker 1 (32:29):
I mean I'm glad that the providers weren't such God
complex heroes that theycouldn't learn from these
situations, because, yeah, andI'm also thinking too like Sorry
, I interrupted, no, go no.

Speaker 2 (32:42):
Learn from these situations because yeah.
And I'm also thinking too likesorry, I interrupted, no.
I'm thinking too like the er isalways busy because most often
it's misused, right like youdon't really need to go to the
er, um.
And so then thinking like, oh,over there and cube four, this
lady's gonna be so pissed.
I haven't checked on her yet,but it's like.
This is what I'm doing in theother room like this.
This is an actual emergency.

Speaker 1 (33:00):
I always feel guilty if I end up in the OR because
I'm like what if somebody was areal problem?

Speaker 2 (33:09):
I only go there like that's why you just got to wait
longer.

Speaker 1 (33:13):
I know, I know I went in for my spider bite because
there wasn't an urgent care andthey told you it was good you
went in.
Yeah, I know, but I was onlunch and I was like, if I can
just sneak up there, but I hateto take up, which also speaks to
like hospital culture.

Speaker 2 (33:28):
Right like I can't take off work because these
patients are going to get in, soon my lunch I'll try and get
this looked at that's not goodeither my cellulite is looked at
before my leg has to getamputated.

Speaker 1 (33:40):
Do you know that it's like scarred now, but the whole
top of my foot is so painfulstill.

Speaker 2 (33:47):
Isn't that weird, that damn spider That'll teach
me to garden, anyway, for yoursix raspberries.

Speaker 1 (33:55):
Yeah, anyway, thank you, dear nurse friend, and if
you know them personally, Amanda, please tell them.
Thank you for sharing.
That's very eye-opening andthey're rare privilege to be
able to see behind the scenes.

Speaker 2 (34:13):
You know, should I do our little chart note now?
I'm like we're already at 37minutes.
Should we even do a chart note?
Maybe not.
I think let's a chart note,Maybe not.
I think let's save it for yournext one Just get into Mary,
let's save it.

Speaker 1 (34:29):
Let's get into Mary, it looks like you have part of
your case done for next time.
What is the chart note?
Yeah, 1869, ireland, let's gothere.
Old timey, yes, yes.
Mary Mellon was born inCookstown, country Tyrone.
This was one of the poorestregions of Ireland.

(34:50):
Life in County Tyrone and theyears that Mary spent growing up
there were harsh, were harsh.
Every year.
There would have been times offamine and she would have grown
up eating primarily potatoes,which I don't want to flippantly
say it's not a bad thing, butlike they probably don't have
sour cream chives.

Speaker 2 (35:09):
I was going to say, yeah, they're not like loaded
mashers, I'm sure.

Speaker 1 (35:12):
There's probably not bacon bits on these potatoes.
So she immigrated to America in1883 alone as a teenager.
How brave is that, can youimagine?
No, she moved in with her auntand uncle in New York City and
then they died.
So yeah, she described herselflater as alone in America.

(35:37):
Mary worked her way up from thedepths of laundry as a
seamstress cleaning, hauling andperforming all the usual lower
echelon tasks.
At some point she learned howto cook well and ended up being
able to run a kitchen.
She began to be hired again andagain by good families because
skilled cooks were in highdemand and the cook was on the

(36:00):
highest rung of the peckingorder amongst servants.
So picture this it's asweltering August afternoon in
1906.
The servants in the sprawlingLong Island Long Island summer
home of the Warren family arewilting in the heat.
But in the kitchen, mary Mallon, the new cook, is cool as a

(36:22):
cucumber.
She's making her specialtypeach ice cream.
Now here's the thing In 1906,making ice cream meant no
cooking whatsoever.
You turned raw cream, sugar andfruit together over ice.
There was no pasteurization, noheat to kill bacteria, which
means that whatever was inMary's hands was going straight

(36:43):
into those peaches.
Gross Guests rave.
This is the best peach icecream we've ever had, mary.
She smiles quietly proud, butwithin days half the household
is violently ill.
Public health investigatorslater realized that this one

(37:04):
dessert, this light, summery andjust sweet enough to mask its
microbial hitchhikers, mighthave been her deadliest dish of
all.
In this luxurious vacation homein Oyster Bay, long Island, the
youngest girl in the Warrenfamily, named Margaret, lay
gravely ill.
Her father, charles Warren, wasthe Vanderbilt's family banker.

(37:26):
So Margaret had the best carethe money could buy, but there
was no cure.
All anyone could do to help herwas attempt to bring her fever
under control.
But then six more members ofthe family fell ill After
Margaret two maids became ill,then the mother, another
daughter and finally thegardener.
Charles was confounded andgrief-stricken.

(37:47):
How could a disease that onlyaffects poor people, the slums,
affect his wealthy?

Speaker 2 (37:52):
family.

Speaker 1 (37:55):
In such an exclusive seaside resort.
No less, Even Teddy Rooseveltwas known to summer there.

Speaker 2 (38:02):
Well, by God, I bet they just have a little fence up
.
No germs here, I know.

Speaker 1 (38:10):
At the turn of the 20th century, the most densely
populated neighborhood in theworld was New York City's Lower
East Side.
It was even more crowded thanCalcutta, india, with few
connections to city water orsewers, and the residents lacked
access to basic sanitation.
Infectious diseases likesmallpox, diphtheria,

(38:30):
tuberculosis and typhoid feverkilled thousands of people every
year.
In New York City alone, therewas an estimated 4,000 cases of
typhoid fever every year.
The symptoms of typhoid aresevere and include headaches,
diarrhea and high fevers whichoften lead to delirium.
Since antibiotics had yet to beinvented, 10% of people who

(38:52):
contracted typhoid back thenwould die from the disease.
Disease Louis Pasteur, 27th ofDecember 1822 to 28th of
September 1895, was a Frenchchemist, pharmacist and
microbiologist renowned for hisdiscoveries of the principles of
vaccination, microbialfermentation and pasteurization,

(39:19):
the last of which was namedafter him.
His chemistry research led toremarkable breakthroughs in
understanding the causes andprevention of diseases, laying
the foundations of hygiene,public health and much of modern
medicine.
Pasteur's works are creditedwith saving millions of lives
through the development ofvaccines for rabies and anthrax.

(39:41):
I have to giggle because I justfinished.
I'm re-watching the Office likebinging that in the background
while I do stuff.
Every couple of years, I'llredo it again.
And there's this whole episode.
Do you watch the Office?
Not like you?
No, okay.
Well, there's a whole episodeon like rabies.

(40:01):
Dwight trapped Meredith's headin a bag with a bat.
She got bitten.
Oh, my God, and so like thenwhen Michael Scott ran her over
with his car he was like, well,it's a good thing she went to
the hospital, because she neverwent to the hospital for rabies
and she had to get her rabiesvaccines.

(40:21):
And then they did a whole likewalk for the rabies cure, but
there's already a cure forrabies.
So anyway, it was just verytimely because it happened at
the same time I was researchingthis, anyway.
So yeah, pasteur he wascredited for the development of
vaccines for rabies and anthrax.
Pasteur he was credited for thedevelopment of vaccines for

(40:42):
rabies and anthrax.
He's regarded as one of thefounders of modern bacteriology
and has been honored as thefather of bacteriology and the
father of microbiology.
Pasteur is credited withproving that typhoid fever was
caused by salmonella and thetyphi bacteria grow in the
intestinal tract where they'reshed in the feces.
So this was an exciting timefor science the concept that

(41:04):
tiny microbes that were visibleonly under a microscope were yet
responsible for such tangibleand devastating diseases.
It was mind-blowing at the time.
So 1906, oyster Bay outbreak Sixpeople are sick in a summer
home.
Cue the wild witch hunt.
Who was the dirty scoundrel whobrought blight upon such a

(41:26):
privileged place?
Could it be the lady on thebeach selling shellfish?
Was it bad dairy from the localfarm by contaminated food or
drink?
Investigators began byinspecting the plumbing in the
house.
They added dye to the toilet todetermine if it contaminated
the drinking water, and this wasmind-blowing to me.

(41:49):
Can you imagine how horrifyingthat would be if you see that
you put dye in your bathroom andit came out of the tap that you
drink water from?
So I'm not going to lie, I didtry this.
Oh my God, with food coloring,I mean, one can't be too sure.
I put food dye in the toiletbowl and then flushed a few

(42:10):
times and then ran upstairs tocheck my drinking faucet.
I mean, I do have a filter, butI can't.
It was clear.
It was clear, we're all good.
So, happily, the Oyster Bayvictims' health improved, but
doubt and fear were rampant, notto mention that the family who

(42:37):
owned the house that the Warrensrented from were concerned that
they wouldn't be able to renttheir home out again because
they were basically famous forbeing in the typhoid house.
So, especially since that wasthe only place that the typhoid
had been contracted, there werenobody else in that beachfront
community that had actuallycontracted the disease.
So enter George Soper, a37-year-old freelance sanitary
engineer.
I mean, how sexy is that?
Don't you want to just date himright away?

(42:59):
Wow, he's a sanitary engineer.
He started his investigation byreviewing the results of the
previous investigation.
He was eager to figure out howto trace the disease outbreak
and better understand howdiseases like typhoid were being
spread, since the priorinvestigation had been fairly
thorough but yet fruitless, hebegan questioning the people of

(43:21):
the Warren household morethoroughly.
He asked them if there wasanyone he hadn't yet spoken to
in the household.
And then the staff remembered acook who had been employed
during this season but no longerworked there.
Semper knew that it takes up tothree weeks after exposure to
become ill with the disease, sothis was the incubation period.
That was his first clue.

(43:41):
The family had hired a cook onAugust 4th, which was three
weeks before the family becamesick.
It stood to reason that theperson who brought the typhoid
bacillus into the house camefrom them Sober, figured out
that the bacteria got into theperson's, got onto the person's
hands from the bathroom and thenonto the food.

(44:02):
Particularly, I know right,particularly wash your hands
people particularly uncookedfood, so I don't know.
Ice cream with fresh peaches,can you imagine?
She's like mulching thesepeaches with her derby hyphoid
hands, oh god.
And then putting it inunpasteurized milk and letting

(44:22):
it sit out.
Boy, oh boy, oh boy.
It's amazing these peopledidn't die, but anyway.
So he traces the illness toMary Mallon and sets out to find
her.
The employment agency thatplaced her with the Hortons
didn't know where she was, butthey directed her him to some of
the previous places that hademployed her.

(44:42):
Soper wasn't ready for what hediscovered upon reaching out to
those families.
Over a 10-year period sheworked for eight families.
Six of these families hadepidemics of typhoid.
But how is this possible?
Had Mary been spreading typhoidbacteria for years without ever
appearing to be sick?
Because, remember, they don'tknow that you can be a carrier

(45:05):
without being ill.
So Soper remembered reading apaper written four years before
that by German scientist RobertKoch.
Koch found a baker who wasn'till but who spread typhoid germs
.
This was a healthy carrier ofthe disease.
Could this be the same casewith Mary Mallon?
Soper felt that he was ontosomething cutting edge.

(45:26):
If he were right, the cookwould be the first American
identified as a healthy carrierof typhoid fever.
This would be a significantdiscovery and make Soper famous.
Soper was fascinated andexcited.
He saw this as an opportunityto be the detective to solve
this significant scientificpuzzle.
To prove his case, soper neededblood samples from the cook.

(45:47):
On March 19, 2007, he learnedthat Mary was working for a
family on Park Avenue.
Here was his chance.
Typhoid had already takenresidence in a chambermaid in
the household who had just beentaken to the hospital.
The family's only child was illand in critical condition.
Mary was helping to nurse thegirl.
Later Soper recounted hismeeting with Mary Mallon for the

(46:09):
first time.
My name is Dr George Soper.
I've been looking for you forquite a while.
I was hired to track you down.
To track me down, asked Mary.
Yes, miss Mallon, and itappears you're the unwilling
cause of the typhoid feveroutbreak at Oyster Bay last year
.
I must get specimens from youof your urine, feces and blood

(46:32):
to confirm my suspicion.
Mary replied I have never beensick.
A day in my life I've never hadtyphoid.
I have never been sick a day inmy life I've never had typhoid.
Miss Mallon, you contain withinyour body typhoid fever germs.
When you visit the bathroom.
These germs can transfer toyour fingers and then transmit
them to the food.
Barry replied Are yousuggesting that I don't wash my

(46:56):
hands?
Rude Soap reclaims that themeeting ended poorly when Mary
reached down, picked up a meatfork and threatened to stab him
with it.
She showed a bit of her Irishtemper and that's what Soper
thought, was it?

(47:21):
He thought well, it was only amild request.
It was a reasonable scientificrequest, but it was seen by
Mary's exact opposite.
Later she went on to say thatSoper didn't mention the
families she'd worked for whodidn't contract typhoid.
Nor did he mention the familywith whom she frequently lived
with in the Bronx when she wasout of work and shared a room

(47:42):
with the children, and nobodycame down with typhoid there.
Mary Mallon had no reason tobelieve that she could have
transmitted typhoid fever toanyone.
The concept that if you're sickwith a particular disease, you
can pass it on to someone elsewas new at the time.
Why would you believe, all of asudden, a group of white men
scientists telling you thatinvisible germs that you can't

(48:04):
even see, that you've never evenheard of, are causing diseases
that you have seen for decadesand decades?
Like most people of her time,mary didn't understand how
diseases were caused andtransmitted.
In the 19th century there was astigma that disease somehow came
from filth, and filth was seenas a moral reflection of one's
community.

(48:24):
The filthier your community,the more likely it is that it
will create miasmas.
People thought that illnesscame from mysterious sewer gases
called miasma.
Miasmas were like evil spiritsand thought to be concentrated
in the tenements overflowingwith immigrants.
With the population doublingevery decade, city services were
unable to cope.

(48:45):
Imagine this is a city of150,000 to 200,000 horses that
were being used for thepopulation's primary source of
transportation at the time.
Basic public health informationshows that each horse gives off
about 25 pounds of manure a day.
So if you multiply that by200,000 horses, 365 days a year,

(49:07):
during a period in which thecity may or may not be able to
pick up that manure, can youimagine how filthy and stinky
New York City was.
Gross, filthy and stinky NewYork.

Speaker 2 (49:17):
City was.

Speaker 1 (49:19):
Gross.
Oh.
Add to that the uncollectedgarbage, overflowing sewage and
conditions that became even moreunbearable and rife with
disease.
In 1895, the city established adepartment of sanitation,
citing the phrase cleanliness isnext to godliness.
They recruited an army ofstreet cleaners that were known

(49:40):
as the White Wings.
These guys would parade downFifth Avenue in an almost
military-like exercise, and thiswas the time when George Soper
found himself on the cuttingedge of a new science.
Utilizing his background insanitary science, ever
emboldened by the prospect ofimminent fame and the public's
belief in endorsement ofbacteriology, soper continued

(50:03):
his investigation of mary mellon.
He discovered that mary wasspending her evenings at a
rooming house on third avenuebelow 33rd street with a
disreputable looking man namedbreyhoff.
Breyhoff had a room on the topfloor and soper's sources shared
that mary would often take himfood.
As he kept to his room duringthe day, breyhoff spent his days
at the local saloon on thecorner and Soper befriended him

(50:26):
there.
Eventually, this man took himto see his room.
Soper described it ashorrifyingly squalid, infected,
an evil apartment with amenacing mangy looking, probably
dangerous dog.
The way he tells it.
It's evident like classism isat play here.
Although he believed in thescience of bacteriology.

(50:48):
He also believed thatimmigrants were a source of
infection and danger, somethingwe can relate to in this
political day and age.
Unfortunately, eventually,soper was able to get Breithoff
to tell him when Mary would bevisiting the apartment next.
Soper alone didn't have theauthority to force Mary to

(51:08):
cooperate with his requests.
So then enter Dr Herman Biggs,new York City's health
commissioner.
Biggs was committed to wipingout disease, using scientific
tools to promote and protectpublic health.
He gave workers the right tomarch into tenements to
vaccinate people and confine theinfected to their houses.

(51:29):
Can you imagine if thathappened during COVID?
Oh my God.
Like public health officialsmarching in your house to
vaccinate you against your will.
Like my goodness.
He encouraged the use of forceto quarantine those who wouldn't
comply.
So this was the power that theyfelt was needed to confront
Mary Mallon.

(51:50):
Dr Herman Biggs is the reasonshe was taken into custody the
first time and that herspecimens were taken against her
will.
Sopranos' assistant confrontedMary one night, insisting that
she provide samples of her bodyfluids.
He assured her that he did notthink her transmission of the
disease was intentional, butthat it was her moral and public
responsibility to provide hersamples.

(52:12):
Mary understandably objectedand protested.
She said I nursed those peoplewho were sick in those
households.
I never had typhoid, so how canI give it to them?
They insisted that she comealong with them.
And again she objected,apparently swearing and chasing
Soper with a carving fork, againbefore fleeing.
They literally had to chase herdown on foot to catch her, and

(52:36):
then she was taken to WillardParker Hospital, an infectious
disease facility for people withlow income.
She was quarantined on NorthBrother Island for three years.
Lab scientists took her samplesand placed them in an incubator
to see what bacteria would grow, took her samples and placed
them in an incubator to see whatbacteria would grow, and they

(52:59):
grew typhoid bacilli.
George Soper was gratified toknow that his suspicions were
correct and that she was anasymptomatic carrier of typhoid
fever.
And now he had proof.
In most cases of typhoid fever,the body is engaged in a
microbial battle where thebacteria and the immune system
are at war, and as the bacteriaprevail the patient dies.
But in the case of healthycarriers, there's no clear
winner.
The immune system protects thebody from infection, but still

(53:26):
bacteria continue to live withinthe body without causing
symptoms and remain ascontagious as someone who is
symptomatic with the disease.
So Soper was eager to learn more.
When was she exposed to typhoid?
How often did she pass it on?
Of course she didn't want tospeak to him, but he tried to
reason with her and offered toget her out of there if she
would only just cooperate withhim and answer his questions.
He even offered to write abouther case and give her all the

(53:47):
profits.
She turned down the deal.
So now health officials wereleft in a quandary.
What did they do with her?
I mean, they can't let herreturn to cooking.
So they sent her to aquarantine island no trial, no
representation, no due process,just plucked off the street and
planted in a plague island foras long as the government saw
fit.
North Brother Island sits inthe East River, a few hundred

(54:09):
yards offshore from the SouthBronx.
Most patients there were sickwith TB at the time.
Needless to say, it was a scaryplace to go, and Mary spent
three whole years there.
She was confined to a smallcottage on the island and I'm
sure she felt that this was aform of cruel imprisonment.
She later described herexperiences as when I came here

(54:30):
I was so nervous I was almostprostrated with grief and
trouble.
My eyes began to twitch and myleft eye became paralyzed and
would not move.
It remained in this conditionfor six months.
Some public health officialsbelieve that her quarantine was
unjustified.
Dr Milton Rossino, director ofthe National Hygienic Laboratory
in Washington, and otherprominent scientists objected to

(54:51):
her incarceration.
They were aware of the NationalHygienic Laboratory in
Washington, and other prominentscientists objected to her
incarceration.
They were aware of the dangersposed by an asymptomatic carrier
.
Yet they maintained that allthat was needed to afford Mary
her civil liberties was toretrain her for a different line
of work or she wouldn't be adanger to anyone.
It was not pill battle, as theDepartment of Health was

(55:12):
determined not to let her go,but instead wanted to try and
cure her with experimental drugsand procedures.
Some of the medications weredangerous and Mary purported
they would have killed her ifshe continued to take them.
Health officials told Mary thatremoving her gallbladder would
cure her.
They assured her that they'dhad the best surgeon operate on

(55:32):
her.
Mary refused, claiming thatthere was had the best surgeon
operate on her.
Mary refused, claiming thatthere was nothing wrong with her
gallbladder, as if you'd know,but anyway, as if they'd know If
she had undergone the surgery,there was a chance she might
have survived, but the rates ofinfection were higher there.
So Mary's kept on North BrotherIsland and waged a steady battle
by writing letter after letterto Biggs and Soper begging for

(55:53):
her freedom.
Why should I be banished like aleper and compelled to live in
solitary confinement A few yearsof my life and I will be insane
?
During her quarantine on NorthBrother Island, boaters in the
East River sometimes tried toglimpse the most dangerous woman
in America.
She was aware of her notorietyand reportedly resented being

(56:15):
gawked at like a zoo exhibit.
Some papers depicted her withskulls, floating in frying pans
or wearing an apron patternedwith crossbones.
She became such a cultural iconof contagion that typhoid Mary
is now a permanent phrase inEnglish for anyone who spreads
trouble or disease is now apermanent phrase in English for
anyone who spreads trouble ordisease.
Two years pass and Mary'sdesperate to regain her freedom,

(56:36):
stating as there is God inheaven, I will get justice
somehow sometime.
In June 1909, mary and a youngIrish lawyer named George
O'Neill filed suit in the NewYork Supreme Court demanding her
release.
Her argument wasstraightforward I have never
been sick.
Therefore, I can't transmitsickness to anyone else.
I've never gotten my day incourt.

(56:58):
There's been no due process.
A few days later, publisherWilliam Randolph Hearst tells
Mary's story in his New Yorknewspapers.
This time her identity isrevealed, but she earns the
unfortunate moniker of TyphoidMary.
The story included an articleby William Park, head of the

(57:22):
city's bacteriological lab.
He wrote that new screeningprocedures uncovered at least 50
healthy carriers of typhoidfever, and yet only Mary was in
quarantine.
He wanted to say that the other49 are mingling with people in
New York was in quarantine.
He wanted to say that the other49 are mingling with people in
New York.
Since Mary only transmittedtyphoid when she cooked her
people, she should be allowed toleave to pursue other vocations
.
In July 1909, mary left NorthBrother Island to plead her case

(57:45):
before the New York SupremeCourt.
The Department of Health arguedstrongly that there was
scientific proof that she was acarrier and she was a danger to
society.
But Mary went to court withsome ammunition of her own,
using her boyfriend Breyhoff asa courier.
She had been sending specimensto Ferguson Laboratory in
Manhattan for months.
The results of these labsdirectly contradicted the health

(58:07):
department's reports, whichstated that no bacteria were
present in the samples.
She sent Health Department'sreports which stated that no
bacteria were present in thesamples she sent.
She said there are two kinds ofjustice in America and all the
water in the ocean wouldn'tclear me of this charge in the
eyes of the Health Department.
They want to make it a showing.
They want to get credit forprotecting the rich and I am the
victim.

(58:28):
This led some public healthofficials to be outraged at
Mary's continued incarceration.
Even Charlie Taplin declaredit's a discredit to public
health work in New York.
Adding to the pressure on theDepartment of Health to find a
better solution to the Maryproblem, they even suggested she
move to another state so thatshe would be another state's

(58:49):
problem.
But Mary refused, stating I'vebeen told that all I have to do
is to leave the state and liveunder another name and I can
have my freedom.
But I will not do this.
I will either be cleared orI'll die where I am now.
In 1910, the tide of publicopinion changed, as did Mary's
fortune.
New York City hired a newhealth commissioner named Ernst

(59:11):
Letterly.
Letterly was uncomfortable withthe humanitarian and civil
liberty implications of Mary'sconfinement.
He released her on thecondition that she report in
regularly and agree never towork as a cook again.
He even found her a job as alaundress, which was the bottom
of the domestic ladder, andhorrendous work that paid close

(59:32):
to nothing.
Mary's boyfriend died soonafter her release and there she
was on her own, barely able toscrape together a living.
The New York City HealthDepartment continued to track
her, but in 1914, they losttrack of her, and they had
bigger problems by that time,because 3% of the people who
contracted typhoid fever becamecarriers after they recovered,

(59:55):
which meant that there werethousands of people like Mary in
New York and it was impossibleto track them all.
So therefore the Department ofHealth focused on those who
posed the most significant riskthe food handlers.
So they passed a resolutionthat required anyone handling
food in New York City to betested regularly and issued
cards so that they would beknown to the health department.
They were given instructionsabout what they should and

(01:00:18):
shouldn't do and they weresupposed to report back
periodically to the healthdepartment for checkups.
This understandably yielded avery low return for healthy
carriers and was extremelyexpensive.
But low-paying laundry workdoesn't cut it.
So Mary took cooking jobs underfake names and outbreaks

(01:00:39):
started popping up again.
In March 1915, the city'sprestigious Sloan Maternity
Hospital experienced an outbreakof typhoid.
25 doctors, nurses and staffmembers succumbed to the disease
and two died from it.
The hospital called Dr GeorgeSoper and when he arrived he was
told that he had a typhoidepidemic on his hands.
Servants at the hospitaljokingly referred to the

(01:01:02):
hospital cook as Typhoid Mary.
He went to talk to the cook,whose name was Mrs Brown, but
she wasn't working that day.
So he was handed a letter fromwhich he immediately recognized
Mary Malone's handwriting whenhe showed up to the hospital a
day later and reported thekitchen.
Sure enough, there she was, maryMalone earning her a living in

(01:01:24):
the hospital kitchen, spreadingtyphoid like she'd always done
before.
What a destructive angel thatshe was, yep.
So Department of Healthemployees traced her living
quarters to a place in Queensand when she didn't answer the
doorbell they used a ladder toget to the second floor and
break in.
And she went without a struggle.
No carving fork this time,thank goodness.

(01:01:45):
So she was sent again back toBrothers Island, but even in
enforced isolation she waspermitted to live with her pet
fox terrier dog, which was oneof the few companions she had in
her final decades.
Some accounts say she doted onhim obsessively.
The Department of Healthoccasionally allowed Mary to
take the ferry into New YorkCity on a day trip to visit

(01:02:08):
friends, but she would alwaysreturn on time.
Over the years, the Departmentof Health developed a more
flexible approach to healthycarriers of the disease.
Food handlers were retrained orpaid to stop working, but even
those who were uncooperativewere not punished in the same
manner as Mary Mallon was.
Eventually, mary was hired as alab technician at Riverside

(01:02:28):
Hospital in 1932.
Ironically, although notallowed to cook for people, she
was ultimately given work in theisland's laboratory where she
washed bottles, prepared medicalequipment and assisted in
autopsy.
So I guess they're already dead.
Mary suffered a stroke whichleft her partially paralyzed and
she died in 1938 after 26 yearsof captivity on North Brother

(01:02:51):
Island.
She was 69 years old when shedied.
Her possessions reportedlyincluded her beloved cooking
tools, which she kept fordecades, almost like a chef's
version of a security blanket.
Her autopsy found typhoidbacteria still in her
gallbladder.
She was buried in St Raymond'sCemetery in the Bronx and her

(01:03:12):
grave remained unmarked foryears.
Official records attribute 51infections and three deaths to
her.
However, historians believethat the actual number was much
higher potentially over 100,because many of the cases were
not traced or recorded.
Mary never accepted that shewas the cause of their deaths.
Ten years after her death,antibiotics were developed that

(01:03:36):
could treat the disease and curehealthy carriers like Mary.
Still, new and even more deadlydiseases continue to arise,
confronting us with the issuesthat Mary Mallon raised a
century ago.
As a society, we need to becautious and careful about how
we protect public health, butalso maintain the rights of
individuals who are ill.

Speaker 2 (01:03:58):
Oh, wow, wow, Poor Mary.

Speaker 1 (01:04:04):
She was so spicy though I mean I love that, but
like I can get where she'd belike if it's not known that you
can be a carrier, ill, she'd belike I can get where she'd be
like if it's not known that youcan be a carrier?

Speaker 2 (01:04:16):
I know I'm not sick.

Speaker 1 (01:04:17):
Quit picking on me.
I like to cook.
Leave me alone.
I'm doing a peach ice creamthing.
Yeah, quit punishing me.

Speaker 2 (01:04:25):
People love my cooking, yeah, also just so
interesting how like thingsunfolded over the centuries and
how we know the things we knownow, like an asymptomatic
carrier.
There was a time where no oneknew what that was.

Speaker 1 (01:04:41):
Can you imagine marching in and forcing
vaccination on people?
Just asking people to getvaccinated was a big deal during
COVID.
Yeah, oh, that's crazy.
So, yeah, there's a fine linebetween public health and
individual rights.
I'm not claiming to have allthe answers, but, like I just
feel sorry for her because theydidn't know at the time.

(01:05:02):
She just happened to be thefirst, but she was one of
thousands, yeah, yeah, and shewas the one who had to pay for
it.
She wasn't ever given.
Yeah, and she was the one whohad to pay for it.
She wasn't ever given.

Speaker 2 (01:05:12):
But I'm also like.
Well, I mean, she did get sentto be a launderer, which was
apparently the bottom of thechain.

Speaker 1 (01:05:21):
But I'm like Mary, you could have also just got a
different job.
Yeah, it's harder to feel sorryfor her when she had a chance
and they're like you can go livein another state and be there.

Speaker 2 (01:05:31):
They're like listen.

Speaker 1 (01:05:32):
California's a great place.
Just go.
Even Pennsylvania, that's rightnext door.
Just go somewhere else.
Why don't?

Speaker 2 (01:05:38):
you go spread over there.

Speaker 1 (01:05:40):
She's so stubborn, she's so convinced that she
wasn't a problem Literallyanywhere.

Speaker 2 (01:05:45):
So, bless her heart, just chasing everyone with her
fork.

Speaker 1 (01:05:50):
No man.
So, Amanda, what can ourlisteners expect to hear next
week?

Speaker 2 (01:05:57):
Yeah, I'm not sure yet for sure.
Oh, a surprise.
I'm in the same boat as always,still working on books.
Still not sure.
Might be a surprise to all ofus.
I love that for us, okay, sojust keep you on the seat of
your pants there.
So since I don't have ourregular script here, let me pull

(01:06:18):
one up so I can sign you off.

Speaker 1 (01:06:21):
Yeah, sorry I skipped a bunch of stuff so I wouldn't
keep our listeners for too long,but okay, I got this okay.

Speaker 2 (01:06:30):
So, guys, until next, don't miss a beat.
Subscribe or following doctorin the truth wherever you enjoy
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trust.
After all, it's a delicatething.
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(01:06:53):
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Don't forget to download, rateand review so we can be sure to
bring you more content next week.
Until then, stay safe and staysuspicious be, suspicious, okay,

(01:07:17):
goodbye.