Fever by Mary Beth Keane

Mary Beth Keane presents a riveting fictional account of a young Irish woman known forever to history as "Typhoid Mary". Typhoid Mary was the name (among others) given to thirty-seven year old Mary Mallon who was one of the first people known to modern medical science as a healthy carrier of disease. Mary had never had typhoid herself, but carried in her gallbladder, Salmonella typhi, the strain of bacteria known to cause typhoid. Mary admitted to rarely washing her hands after using the bathroom and when cooking. The bacteria was transmitted to others through any uncooked food Mary Mallon prepared, causing them to become sick with typhoid.

At the time Mary lived, the early 20th century, scientists were just beginning to understand the role of micro-organisms, such as bacteria, in illness. It was not known that a person could be completely healthy yet make others sick by being a carrier of harmful bacteria. This was a relatively new discovery.

Mary's trouble began in 1906 when she worked as a cook for the Warren family at Oyster Bay, a place not known to suffer from typhoid outbreaks. Six people became ill from typhoid. Warren hired Dr. George Soper, a sanitation engineer, to try to find the cause of the outbreak in his home. Soper learned that the family had hired an Irish cook three weeks prior to the outbreak and soon discovered that many other outbreaks followed the employment of this same cook. He discovered the cook was Mary Mallon, an Irish immigrant. When Soper approached Mary, asking her to give stool and urine samples, she refused to believe him, was outraged by his request and refused. Eventually, after several attempts to obtain convince Mary that she was spreading illness wherever she went, Mary was arrested and sent to North Brother Island where her stool samples tested positive for the typhoid bacteria.

After several hearings, Mary was allowed to go free if she promised not to seek employment as a cook. She attempted to work as a laundress, but eventually returned to working as a cook and this led to her infecting more people with typhoid. In 1915, a major outbreak of typhoid at Sloane Hospital for Women resulted in Dr. Soper finally catching up with her and she was once again sent to North Brother Island where she remained for the rest of her life.

It's hard for us to understand Mary's behaviour today, but at the time, Soper's theory was very new and many people did not understand how a healthy person with no sign of disease could cause others to become ill. In addition, public health policies had no way yet of dealing with such a situation, so authorities were at a loss as to how to proceed. Mary was also well aware of the prejudices that existed at that time against immigrants, especially those from Ireland. She felt she was being unjustly targeted.

Keane does a wonderful job telling Mary's story from her perspective providing the reader with an account that is rich in detail and informative. Keane's portrayal of Mary allows us to see how she might have felt, how she might have viewed herself, and those who pursued her within the context of her own time. The novel is divided into five parts beginning with a prologue, Habeas Corpus, Liberty, His Banner Over Me Is Love, and an Epilogue.

The Prologue has Mary remembering working at the Kirkenbauer's in the summer of 1899 - the first time typhoid struck a house while she was employed. This incident is to haunt Mary for the remainder of her life, because of the little boy, Tobias, who dies from typhoid.

In Habeas Corpus tells the story of Mary's incarceration and her attempts to secure a release from quarantine. It is 1907 and Mary tells how she is tracked down and arrested, taken first to Willard Parker Hospital where she is asked to submit to gallbladder surgery. When she refuses, Mary is sent to North Brother Island to be quarantined. Eventually she is given her own little cottage and her meals are provided for her. She must provide samples of her urine and feces.

She writes her lover, Alfred Briehof, and asks him to find a lawyer to help her. However, Alfred isn't much help to her, writing to Mary only nine times in her first year on North Brother. In 1909, Mary does eventually get a lawyer, Francis O'Neill, who manages to get a hearing for Mary. O'Neill tells Mary that she should swear before the judges that she will not cook anymore and that this will allow her to be set free.

Mary and O'Neill prepare for the hearing while life goes on for Mary on North Brother. Interspersed are flashbacks of Mary remembering a time when she purchased the exact same hat as her wealthy employer, Mrs. Bowen, the time when the wealthy tried to organize a food collective, and when little Elizabeth Bowen became ill. Other flashbacks in this part of the book include her early life in Ireland as a poor orphan living with her grandmother, her arrival in New York where she lodges with her Aunt Kate and her husband, Paddy Brown, her first jobs as a laundress, and the first time she meets Alfred. The reader also learns about Mary and Alfred's tumultuous relationship that is further strained by his alcoholism and chronic unemployment.

At the hearing Mary manages to meet with Alfred, who misses her but seems distant. Mary is sent back to North Brother and she almost gives up. Eventually Alfred comes to visit her at North Brother and tells her that he is engaged to marry another woman, Liza Meany who is a widow. This is a very low point for Mary in her life.

Mary gains her freedom when a new Health Commissioner, Lederle is installed. She heads back to New York and finds employment as a laundress.

In Liberty, we learn more about Albert's life and how he tries unsuccessfully to straighten his life out. When he learns that Mary is set free he tries to see her but she won't have anything to do with him. This rejection affects Albert deeply, causing great hardship and suffering in his life.

In His Banner Over Me Is Love, Mary and Albert eventually find one another but the past cannot be rekindled. Their lives have been irreparably altered and yet the more things have changed, the more they are the same, with Mary basically supporting Albert by earning a living as a cook. This of course, has the expected result of her causing more outbreaks of typhoid and her eventual permanent incarceration.

The Epilogue sees Mary in her old age still struggling to deal with her situation and her conscience revisiting the Kirkenbauer incident and perhaps finally recognizing that she did in fact cause a child to die and that maybe she might have known this all along.

That the author did a great deal of research is evident in her writing. Keane provides vivid descriptions of life in New York City at the turn of the 20th century. It was a fetid, stinking mess, city streets full of rotting garbage, decaying horse carcasses, and overwhelmed with horse shit from the thousands of horses working the streets everyday. She also provides significant details about Mary Mallon and her life on North Brother, as well as the hearings to free Mary.

Fever attempts to give to Mary Mallon, what history has not and that is a measure of humanity. Keane encourages her reader to try to understand how Mary might have viewed her unusual situation, what she experienced as her life was turned upside down by something she didn't understand, in a time when prejudices ran strong against immigrants and those who had stepped outside of genteel society's parameters. Mary feels she is being singled out because she is a single working woman who lives with a man to whom she is not married. Mary notes how the wealthy, when looking for domestic help, don't inquire so much about their skills, but rather seem more focused on their religiosity.

"They all say they want a good cook, but what they want even more is a worthy project."

Mary did not want to be a project and was understandably humiliated and angered at such treatment.

Mary's lover, Albert Briehof was a genuinely unlikable character. Albert was a German immigrant who could not hold down a job, was an alcoholic and eventually a drug addict. He was unable to  commit to anything or anyone in life. Mary's attraction to him was both puzzling and annoying.  Her forced incarceration on North Brother ultimately destroyed their relationship, although Keane implies that it was already failing by the time she was sent to the island.

Fever will definitely appeal to fans of historical fiction and would make an excellent choice for a book club selection. There are plenty of themes and issues to explore for group discussion including the rights of patients with communicable diseases, the prejudice against Irish immigrants, the treatment of Mary Mallon, and social class distinctions in early 20th century America.

Nova ran a program called The Most Dangerous Woman in America in 2004 which was based on the book, Typhoid Mary: Captive to the Public's Health by Judith Walzer Leavitt. It provides excellent background into the unusual case of Mary Mallon.




Book Details:
Fever by Mary Beth Keane
New York: Scribner 2012
306 pp.