What Killed Jane Austen?: And Other Medical Mysteries

by George Biro

  So she was kept incarcerated in the hospital for three years; brooding, malevolent, a study in suppressed anger. She worked in the laundry, retaining all the while those typhoid tombstones in her gall bladder, while at the same time honing to perfection a heart rending derring-do story for which her countryfolk are supposed to be famous. The upshot was that Mary Mallon was released after promising with all the vehemence she could muster, which was considerable, that she would stick to the copper rather than the casserole and report to the Health Department every three months.

  She promptly disappeared, seemingly from the face of the earth. In fact she did what probably any upright, downright and forthright person would have done. She changed her name to Mrs Brown, and her job, surprise, surprise, back to cook.

  For five more years Mary plied her deadly culinary art round New York city, while unsuspecting trenchermen wolfed her typhoid-ridden gobbets. In 1915 there was a serious outbreak in the Sloane Hospital for Women, where she was working. In a moment of ingenuous banter another cook called her Typhoid Mary, whereupon to everyone’s surprise she fled. The police were notified and she was caught on Long Island. Rather disappointingly, she went like a lamb.

  She was returned to the Riverside Hospital and given a life sentence of custodial care. By now the stuffing had been knocked out of her, even though the potent gall stones remained, and she went over to the enemy, so to speak, by becoming a worker in the hospital laboratory. The management even built her a small cottage in the grounds and she gave tea parties there. To accept an invitation no doubt meant playing rock-bun roulette, and perhaps was held as a kind of threat to the more obstructive patients.

  Mary had a stroke in 1932 and died in 1938, not, as you may suppose, of the long-term complications of typhoid, but of bronchopneumonia. You will be relieved to know that she secreted the typhoid bacillus to the end.

  When Mary Mallon died her score card was marked and the certainties came to ten outbreaks of typhoid fever which involved fifty-three cases and caused three deaths. Besides that she was almost certainly responsible for the 1904 outbreak at Ithaca in upstate New York when there were 1,400 cases. On top of these there were very many likely but unattributable episodes stretching back some thirty years.

  Typhoid Mary touched scores of lives with her unique brand of ice cream; she terrorised dozens of policemen, insulted numerous public-health workers, and put the breeze up countless doctors. So spare her a passing thought as you abstractly drink your sparkling tap water, for it was by her polluting its likes that she accomplished much more in her lifetime than most of us are likely to do in ours.

  (JL)

  Painters dial R for death

  Doctors learned about radium the same way they did about X-rays: by trial and error (Catherine Caulfield)

  In 1898 Marie and Pierre Curie announced their discovery of a new element. Radium fever swept the world.

  In the United States, in 1915, Dr Sabin von Sochocky developed a luminous paint that he called ‘Undark’. Next he founded the US Radium Corporation. His plant in New Jersey was only two blocks from Thomas Edison’s laboratory, where Edison’s assistant had received the radiation that later killed him. Should von Sochocky have read that as a warning?

  US Radium’s staff painted numerals onto watch dials and made crucifixes that glowed in the dark. The workers were women and girls, some only 12 years old. They used very fine brushes, which they brought to a point by pressing them between their lips. Sometimes, for fun, they painted their teeth or fingernails to glow in the dark.

  In 1916 the medical journal Radium declared: ‘Radium has absolutely no toxic effects, it being accepted as harmoniously by the human system as is sunlight by the plant.’

  The First World War stimulated the demand for luminous dials on all sorts of instruments. By 1920, America had over 2,000 dial painters. But within four years, nine had died, reportedly of phosphorus poisoning, stomach ulcer, syphilis, anaemia, and cancer of the jaw. Many others had severe problems with their jaws and teeth.

  Dr Theodore Blum, a dentist-doctor, reported a patient with an infected jaw ‘caused by some radioactive substance used in the manufacturing, of luminous watch dials’.

  In 1925 Dr Frederick Hoffman, statistician to Prudential Life Insurance, blamed radium poisoning. Working with him was Dr von Sochocky, who had resigned from his own company. By now, von Sochocky’s own breath was more radioactive than that of his dial painters.

  A team from the Harvard School of Public Health found the US Radium work area spattered with radium paint. In a dark room, the ‘hair, faces, hands, arms, necks, dresses, underclothes … of the dial painters were luminous’, according to Caulfield.

  All 22 workers tested had abnormal blood tests. The team concluded that all workers were exposed to excess radiation, both externally and internally. The deaths and illnesses, the Harvard team said, were ‘due to radium’. The company threatened to sue if the team published its report.

  Dr Harrison Martland, medical examiner for Essex County, home of US Radium, saw two dial painters with high radioactivity levels just before their deaths.

  Researchers found that the optimists were wrong: radium does not pass straight through the body, but settles in bones, where it can cause cancer and damage the bone marrow.

  Dial painters were not the only ones at risk.

  Doctors were using radioactive substances for a hotchpotch of real and imaginary conditions: schizophrenia, rheumatism, high blood pressure, irregular periods, depression, poor sex drive and even debutante’s fatigue!

  In early 1925 US Radium’s own chemist, Edwin Lehman, was well; within a month, he was dead of acute anaemia. Unlike the dial painters, he had not swallowed any paint, but had breathed in the radium.

  Martland pressed for complete protective measures for workers using radioactive substances: in manufacturing plants, laboratories, hospitals and offices. But the lawyers still blamed poor hygiene and held up the publication of his report.

  From 1925 on, the company was seldom out of the courts or the news.

  In 1927 five former US Radium dial painters (the papers dubbed them ‘The Five Women Doomed to Die’) filed a case. Because workers’ compensation in New Jersey did not cover radium poisoning, each woman sought damages of $250,000. One had endured 20 operations on her jaw, and had paralysed legs from spinal-cord damage. Two had to be carried into court; one could not even raise her hand to take the oath.

  Defence lawyers invoked the two-year statute of limitations. Despite the media outcry, the court agreed; the women appealed. Legal wrangling held up the case for over a year, while the women faced painful deaths.

  Well-wishers around the world sent prayers and advice. From France, Marie Curie suggested raw calf’s liver. She herself was to die within a few years of radium-induced anaemia.

  In May 1928, the women won permission to sue in the Supreme Court. But how long would that take? Suddenly a mediator appeared; within five days, he negotiated a settlement.

  The company, ‘Actuated solely by humanitarian considerations’, gave each woman $10,000 and a yearly pension of $600, plus medical expenses.

  Less than six months later, Dr Sabin von Sochocky himself died of aplastic anaemia. Radium had eaten away at his hands, mouth and jaw. Martland wrote: ‘He … gave all that was in him to help and comfort others suffering from this disease.’

  It is sobering to consider that the painful deaths of these early victims led to safer working conditions for the makers of the atomic bomb, which in turn devastated the people of Hiroshima and Nagasaki.

  (GB)

  Wittenoom: the asbestos tragedy goes on and on

  Peter Garrett and Midnight Oil have a song about it; Rolf Harris worked there. But it was Lang Hancock who, in the late 1930s launched blue asbestos mining at Wittenoom in the remote north of Western Australia.

  Then the Second World War boosted world demand for this popular, versatile material; it could insulate pipes in submarines and filter noxious gas
es in gas masks.

  In 1943 Hancock formed Australian Blue Asbestos Ltd, later bought out by CSR (Colonial Sugar Refineries).

  Dr Eric Saint became Government Medical Officer for the whole of north-west Australia. Even from the air and 30 kilometres away, he could see the blue-grey asbestos dust over Wittenoom.

  The offices alone had dust readings that would have been illegal down a mine. Thousands of tons of milling residue (tailings still containing asbestos) formed the roads and even coated the school playground. It was everywhere; dust levels were six to eight times the levels then considered ‘safe’.

  Inhaling asbestos particles causes asbestosis, a thickening or fibrosis of the lung tissue. In turn, this thickening blocks the flow of oxygen into the lungs and makes people breathless. One sufferer has compared it to ‘having your lungs slowly filled with wet concrete’.

  If asbestos levels are high enough, asbestosis may follow even fairly brief exposure, though it may not become apparent for many years after initial exposure. Malignant tumours that often follow asbestosis include lung cancer and mesothelioma.

  Already workers were getting sick. From 1948 Dr Saint tried to convince the mine manager of the dangers, and then wrote to the Head of Public Health in Perth, predicting ‘in a year or two, ABA will produce the richest and most lethal crop of asbestosis’.

  Why did this message to the health department fall on deaf ears? Because some public servant wrote on the letter that Dr Saint was misinformed, and that no action was needed.

  From 1959 Dr James McNulty was the local public health officer, but his best efforts were just as fruitless.

  Only the Mines Department could order the company to clean up the mine, or close it down altogether. Dr McNulty kept warning the managers, and pressing his own chiefs, who in turn warned the Mines Department, but according to journalist and author Ben Hills, ‘not a single prosecution was ever launched, no effective demands were ever made for safe ventilation … the operation was never shut down for a single day’.

  Dr McNulty’s efforts with the men were just as frustrating:

  ‘I must have told more than 100 of them: “you are sick, it is the asbestos, you must leave the mine”. I don’t think a single one of them ever took my advice.’

  Residents accused him of destroying their town, and taking away their top incomes. The union wanted jobs at any price and pushed for an extra 20 cents an hour dust allowance!

  In 1966 the Wittenoom mine and mill were shut down—not from guilt or remorse, but because the quarry was no longer economically viable. Not for another decade did the full health impact begin to emerge.

  It was not only those in the mine or the mill who suffered. In 1950 Joan Joosten had moved to the nearby township of Wittenoom Gorge, as her husband was foreman at the mill. She worked as a secretary in the office; even there, dust hung in the air and clogged the flyscreens. The boss told Joan not to worry, as the dust was ‘clean’. During her three years working for the mining company, she never had a chest X-ray.

  Some 25 years later, Joan was getting tired, losing weight and had pains in the arms and chest; she had malignant mesothelioma. Joan battled her growth, and battled the company as well. Her husband sold his sandwich bar to look after her and pay legal costs.

  But in 1979 Justice Wallace in the Supreme Court dismissed their case: ‘I do not condemn as negligence that which, in my opinion, was a sad misadventure.’

  This verdict seems to have overlooked all the evidence already available well before Joan came to Wittenoom in 1950. In 1931, Britain legislated to control dust levels in asbestos textile factories. In 1935, there were reports of lung cancer in patients with asbestosis.

  The tragedy was quite predictable; the evidence was right there. Doctors knew the score; managers who cared to look knew the score. But the public took longer to find out.

  Though Joan was going downhill, the Joostens appealed. In March 1980, a few hours before the hearing of the appeal, Joan died. Her memorial is the Joan Joosten Centre, headquarters of the Asbestos Diseases Society of Australia.

  Sadly, Joan Joosten is one of many—even by 1978, some 40 people had died of diseases related to the asbestos mining at Wittenoom.

  Rusting sheds now mark Wittenoom. In late 1996 about 30 people still lived in the township.

  The story is far from over. New cases of malignant mesothelioma are expected to rise to a peak around the year 2010. Of 6,912 former employees at Wittenoom, the number predicted to get asbestosis, mesothelioma or lung cancer is almost 2,000. Even children of Wittenoom workers have developed asbestos diseases.

  As Ben Hills wrote, ‘[Wittenoom] will go down in the history of this poisoned planet alongside Chernobyl, Bhopal and Minamata.’

  (GB)

  Syphilis in Tuskegee, Alabama

  On 19 May 1997 Bill Clinton, President of the United States, apologised to survivors of a racist medical experiment that began in 1932 and ran for 40 years.

  In July 1972, some 25 years before Clinton’s apology, the American media were enjoying an abundance of news, scandals and controversy.

  After Senator Thomas Eagleton (running mate to George McGovern) revealed his past history of depression requiring hospital admissions and shock treatment, the public outcry forced him to withdraw as candidate for vice-president.

  Officials of the US Public Health Service (PHS) welcomed the Eagleton controversy since it diverted heat from the medical scandal that broke on the very same day.

  For 40 years from 1932, the PHS had been following, but not treating, 412 poor black sharecroppers who had advanced syphilis and who lived around the county seat of Tuskegee in Macon County, Alabama. According to James H. Jones, this was ‘the longest nontherapeutic experiment on human beings in medical history’.

  Why would reputable doctors take part in such an inhumane experiment?

  Remarkably, there was a precedent. Between 1891 and 1910, doctors at the Oslo Clinic in Norway had followed, but not treated, several hundred people with syphilis. Their report appeared in a leading German journal in 1929.

  One reason, though certainly no justification, for the American study was to confirm the common belief that syphilis in black people is very different from syphilis in whites.

  The Alabama subjects were not only black and poor; most were also illiterate. The PHS doctors, who were mostly white, had offered them free check-ups, free treatment for minor ailments, hot meals on clinic days, and burial stipends for their survivors.

  When pressed by the media, PHS officials couldn’t even find an experimental protocol. The experiment had just grown; it had included regular examinations, blood tests and above all, autopsies.

  Dr J. Williams served as an intern at Andrews Hospital in Alabama’s Tuskegee Institute. He said that despite official assurances about informed consent: ‘The people … were not told what was being done.’

  A survivor, Charles Pollard, said: ‘They come around from time to time and check me over and they say: “Charlie, you’ve got bad blood” … they never mentioned syphilis to me.’

  Worst of all, the men believed that PHS doctors were treating them for their ‘bad blood’. An official letter offered ‘your last chance to get a second examination … and after it … you will be given a special treatment’.

  This was not treatment at all; it was a lumbar puncture (needle in the back to draw a sample of cerebrospinal fluid for testing). But to convince the men that this was treatment, the doctors called it a ‘spinal shot’. Most men had side-effects from their lumbar puncture; over 40 years later, one said: ‘I never have got over that shit.’

  Dr Reginald James—who was not involved with the experiments—worked in Macon County from 1939 to 1941. When he found a man with syphilis, Eunice Rivers, the black nurse who kept track of the men, would warn him off: ‘He’s under experiment and not to be treated.’

  If Dr James insisted on treating such patients, they never returned, since they knew they would lose their benefits. Moreover, they
believed they were already having full treatment.

  Belonging to ‘Miss Rivers’ Lodge’ made them feel special.

  How could they know that they were pawns in a deadly experiment?

  PHS spokesmen defended themselves by pointing out that the experiment had been the subject of many medical conferences and journal articles. How could 100,000 medical readers fail to ask questions?

  Moreover, PHS doctors convinced their private colleagues not to treat the experimental subjects for their syphilis. Instead, as the men fell ill, their doctors should just refer them to the hospital to ensure that they came to autopsy. Undeterred by blindness, paralysis, dementia and early death in some of their patients, the private doctors readily agreed to all this.

  Once the story broke, The Atlanta Constitution newspaper condemned the ‘moral astigmatism that saw these black sufferers simply as subjects in an experiment, not as human beings’.

  One citizen called the experiment ‘but another act of genocide by whites … that again exposed the nature of whitey: a savage barbarian and a devil’.

  Another asked: ‘How in the name of God can we look others in the eye and say “This is a decent country”?’

  Though he worked for the VD division of the Atlanta Centre for Disease Control, Dr Donald Printz said: ‘A literal death sentence was passed on some of those people.’

  But Dr John Heller, who had directed the VD division between 1943 and 1948, bluntly told reporters there had been nothing unethical or unscientific.

  Some other doctors were just as blind. Dr R.H. Kampmeir of the Vanderbilt University admitted that many patients with syphilis would die if not treated: ‘This is not surprising. No one has ever implied that syphilis is a benign infection.’

  Apologists claimed that, in 1932, the available treatments (mercury, arsenic and bismuth) were worse than the disease. They said the drugs were painful, slow to act, toxic, and sometimes even fatal.