There's Something About Mary : Throughline When a cook who carried typhoid fever refused to stop working, despite showing no symptoms, the authorities forcibly quarantined her for nearly three decades. Perfect villain or just a woman scapegoated because of her background? What the story of Typhoid Mary tells us about journalism, the powers of the state, and the tension between personal responsibility and personal liberty.
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There's Something About Mary

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There's Something About Mary

There's Something About Mary

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(SOUNDBITE OF ARCHIVED RECORDING)

UNIDENTIFIED ACTOR #1: (As reporter) It is probable that Mary Mallon is a prisoner for life. And yet she has committed no crime, has never been accused of an immoral or wicked act and has never been a prisoner in any court.

RAMTIN ARABLOUEI, HOST:

It was in the middle of an outbreak. And though she had no symptoms - no fever, no chills, no rash - Mary Mallon had been classified as patient zero.

UNIDENTIFIED ACTOR #2: (as Mary Mallon) When I first came here, I was so nervous and almost prostrated with grief and trouble.

(SOUNDBITE OF MUSIC)

ARABLOUEI: So now she sat in an isolated cottage on an island surrounded by other infected people, confused about what was happening to her.

UNIDENTIFIED ACTOR #2: (As Mary Mallon) There was never any effort by the board authority to do anything for me excepting to cast me on the island and keep me a prisoner without being sick nor needing medical treatment.

RUND ABDELFATAH, HOST:

She became a sort of experiment - and felt like one.

UNIDENTIFIED ACTOR #2: (As Mary Mallon) Why should I be banished like a leper and compelled to live in solitary confinement?

ABDELFATAH: She didn't know if she'd ever make it off that island.

UNIDENTIFIED ACTOR #2: (As reporter) While Mary sees these unfortunate victims of various diseases come on the hospital boat and in due time return to their homes and friends, Mary stays on forever.

(SOUNDBITE OF MONTAGE)

UNIDENTIFIED REPORTER #1: The virus is very difficult to contain. Many experts studying the pandemic have said one reason for that is because of silent spreaders.

UNIDENTIFIED REPORTER #2: Across the country, tense moments caught on camera as more businesses enforce new rules to stop the spread of...

UNIDENTIFIED REPORTER #3: This person who had COVID-19 did not know they had...

UNIDENTIFIED REPORTER #4: To wear or not to wear one of these has in many quarters become a matter not just of health and safety but a matter of who do you believe.

UNIDENTIFIED PROTESTERS: Open up. Open up. Open up.

UNIDENTIFIED PERSON #1: I think you need to back away from me, sir.

UNIDENTIFIED PERSON #2: No, I got hydroxychloroquine. I'm fine.

UNIDENTIFIED PERSON #3: We live in a country of freedom. We don't live in a country where the government tells us how to take care of our health.

(SOUNDBITE OF MUSIC)

ABDELFATAH: You're listening to THROUGHLINE from NPR.

ARABLOUEI: Where we go back in time...

ABDELFATAH: To understand the present.

Hey. I'm Rund Abdelfatah.

ARABLOUEI: I'm Ramtin Arablouei.

ABDELFATAH: And on this episode, the story of Typhoid Mary.

ARABLOUEI: The COVID-19 pandemic has brought to the surface the underlying tension we all experience between our personal choices and the public good. I mean, we've all seen the videos of people shouting at each other over wearing masks in supermarkets and parks.

(SOUNDBITE OF MONTAGE)

UNIDENTIFIED PERSON #4: You are in violation of my [expletive] constitutional right...

UNIDENTIFIED PERSON #5: Either wear the mask or...

UNIDENTIFIED PERSON #6: And I'm not doing it 'cause I woke up in a free country.

ABDELFATAH: And what I see in these videos are people struggling with whether a person's right to decide to wear a mask - or not - is more important than the health of the people they encounter - basically, personal liberty versus personal responsibility to society - a dilemma as old as civilization itself.

ARABLOUEI: The thing is, today, that dilemma might be a matter of life and death. And it's only going to get more complicated as a potential vaccine for COVID-19 gets developed and becomes vital in ending the pandemic.

ABDELFATAH: We're seeing this play out now with how states are handling mask requirements. In California, for example, masks are now required to be worn by most people in public. But what happens when someone says - hey, I'm not sick. Why do I have to adhere to these strict rules? Or this is a free country; you can't make me do anything I don't want to do.

ARABLOUEI: So then how does the government react? How far can or should they go to enforce public health regulations?

ABDELFATAH: In this episode, we're going back more than a hundred years to tell the story of Mary Mallon, an Irish immigrant who refused to cooperate with public health officials for years and became the notorious Typhoid Mary.

(SOUNDBITE OF MUSIC)

RICK MISHLEVSKI: Hi, This is Rick Mishlevski (ph) calling from San Francisco, and you're listening to THROUGHLINE from NPR.

(SOUNDBITE OF MUSIC)

UNIDENTIFIED PERSON #7: Part 1 - Peaches and Cream.

ABDELFATAH: Oyster Bay is a small town on the northern shore of Long Island, just a short train ride from New York City. In the early 1900s, Oyster Bay was a popular vacation spot for New York's wealthy elite made famous by President Theodore Roosevelt, who had a home in the area.

ARABLOUEI: Each summer, families escaped the stench and sweat of the city for the cooler shores of seaside living.

ABDELFATAH: In the summer of 1906, the Charles Elliott Warren (ph) family rented a house in Oyster Bay, and Mrs. Warren was looking for some help.

SUSAN CAMPBELL BARTOLETTI: She had four children. She had five servants. She had all kinds of social parties she was giving, so she needed a cook and she wanted a good one.

ABDELFATAH: This is author Susan Campbell Bartoletti.

BARTOLETTI: She called up the employment agency in New York City, and they sent her Mary Mallon.

ABDELFATAH: Mary Mallon immigrated from Ireland when she was a teenager, alone with no money, and built a name for herself as a solid, reliable cook. And that summer, she traveled up to Oyster Bay to work with the Warren family. But not long after she got there, something strange happened.

BARTOLETTI: The 9-year-old daughter, Margaret Warren, became sick. It was soon discovered she had that very, very high fever. She had bouts of diarrhea. And then the spots occur on her abdomen. And they realized - oh, dear, this is typhoid fever.

ARABLOUEI: Typhoid fever is a bacterial infection that can range from mild flu-like symptoms to stomach pains, skin rashes and even internal bleeding. Though typhoid fever was fairly common in the early 1900s, few really understood what caused it. And there was no known cure. Consequently, doctors were left to treat symptoms with chemicals like turpentine, opium and ammonia. Nearly 10% of people infected died.

ABDELFATAH: This was the reality the Warren family faced when, mere weeks into their summer vacation, six of the 11 people in their household fell ill. Their newly hired cook, Mary, who didn't get sick by the way, stayed to help for a little bit. But she soon left Oyster Bay to begin working for a different family back in New York City.

ARABLOUEI: Luckily for the Warren family, no one died from the illness, and they eventually left their rented vacation house to return home. But the presence of typhoid fever posed a problem for the people who owned the house, the Thompson family.

BARTOLETTI: It had been a wedding present for Mrs. Thompson, and they rented it out. So they were really worried that no one would want to rent their house again if it was infected in some way. People were beginning to gossip about her house. And Mrs. Thompson was worried because if she couldn't figure out the cause, more than likely, the house would have to be burned down.

ARABLOUEI: At that time, typhoid fever was typically spread through contaminated water, a potential deadly consequence of things like back alley outhouses, clogged sewers or pipes that dumped waste into the same rivers and lakes meant to supply water. Typhoid was generally associated with overcrowded unsanitary conditions. So for it to surface in an affluent community like Oyster Bay was alarming.

ABDELFATAH: And so the Thompson family hired a man named George Soper to help them figure out where exactly the typhoid fever had come from.

BARTOLETTI: He is not a medical doctor. He has a Ph.D. in what would have been sanitary engineering.

ARABLOUEI: So tracking diseases wasn't exactly in the job description. But he had bigger ideas.

BARTOLETTI: He referred to himself as an epidemic fighter. You know, and that's - I love that he's like this superhero.

ABDELFATAH: He basically wanted to be the Dr. Fauci of his time and was eager to make a name for himself in the public health world. So he went to Oyster Bay, checked out the house and came up empty.

BARTOLETTI: There's nothing wrong with the house. But then he finds out that there was a new cook and this new cook was no longer there. And he asks, well, what did she make? One of the meals that she had made that everyone had enjoyed, including the servants, was homemade ice cream with fresh peaches.

ARABLOUEI: George realized that the bacteria that causes typhoid fever could have been passed in Mary's signature dish.

UNIDENTIFED ACTOR #3: (As George Soper) No better way could be found for a cook to cleanse her hands of microbes and infect a family.

ARABLOUEI: Now he needed to find her.

(SOUNDBITE OF MUSIC)

BARTOLETTI: And he begins to do something that today we call contact tracing.

ABDELFATAH: He started visiting other households where Mary had worked, interviewing people.

BARTOLETTI: And when he interviews the servants, he finds that they don't really want to talk about Mary. They're not going to be forthcoming with any information. But he does learn that there were 22 victims in all.

ABDELFATAH: Which led him to the theory that Mary was a healthy and asymptomatic carrier of typhoid fever.

BARTOLETTI: He believes he has found the first healthy carrier in the United States, and he really wanted to stake his career on this.

(SOUNDBITE OF MUSIC)

ARABLOUEI: At the time, the idea of germs, invisible microorganisms that got you sick, was virtually unknown to most people. So the idea that someone could be infecting other people with a deadly illness without knowing it, without showing symptoms themselves would have been unbelievable to an average citizen like Mary. But George Soper was a believer.

BARTOLETTI: He knew that germs could be passed. How could they be passed? They could be passed in the water system. They could be passed through the sewage system. They could be passed when people don't wash their hands after using the toilet. So he realized that this could be the situation with Mary - that perhaps she wasn't clean enough. Perhaps she was unwittingly, unknowingly passing these germs along.

(SOUNDBITE OF MUSIC)

ABDELFATAH: George eventually tracked down Mary to her current employer, a family on Park Avenue whose only daughter was dying from typhoid fever.

(SOUNDBITE OF KNOCKING)

BARTOLETTI: And so he shows up at her place of employment. And he tries to explain to her - he believes if he could just explain to her about how she could possibly be carrying this disease - that she doesn't wash her hands, that her fingers might still be dirty after using the toilet. Well, she becomes outraged.

ABDELFATAH: Think about that for a second. Mary's a professional cook. And Soper shows up, unannounced, and tells her she might be contaminating her food, making people sick - probably one of the most offensive things you can say to a cook.

BARTOLETTI: And so she's insulted. She has a clean kitchen. She is a clean cook. She's not sick. And when he presses her that he wants her to give him samples - he wants samples of blood, urine and stool - this was a pretty personal request. And so she becomes outraged. She grabs a carving fork, and she swears, and she attacks him. And he fled. (Laughter). He fled.

(SOUNDBITE OF MUSIC)

ABDELFATAH: When we come back, our epidemic fighter calls in backup to capture and test Mary Mallon.

(SOUNDBITE OF MUSIC)

BRETT: Hi. This is Brett from Stamford, Conn., and you are listening to THROUGHLINE from NPR.

(SOUNDBITE OF MUSIC)

UNIDENTIFIED PERSON #7: Part 2 - The Most Dangerous Woman in America.

(SOUNDBITE OF MUSIC)

ARABLOUEI: George Soper's job was technically done. The Thompson family hired him to investigate the source of the typhoid fever outbreak in their Oyster Bay home. He traced it to Mary, and that should have settled it. Mission accomplished.

ABDELFATAH: Not exactly. This was just the beginning of a self-driven determination to stop Mary in her tracks and, in effect, to halt any further spread of typhoid. Maybe it was in the name of public health. Maybe it was in the name of furthering his own career. Maybe it was both.

ARABLOUEI: Remember - George was a sanitary engineer. He had no authority over Mary or anyone for that matter. But if he could make a name for himself in the emerging infectious disease field, he'd be a pioneer.

ABDELFATAH: Beyond all that, Mary had dared to defy him. George wasn't used to women standing up to him, and he didn't like it.

BARTOLETTI: George Soper is looking at her from where he stood as this educated man who expected women to listen to him and others, probably, to listen to what he had to say because they certainly did when he was giving advice to the city about sanitation systems. And he just can't understand why, when he explains these things to Mary, she won't believe him.

ABDELFATAH: So he started building a case against her. He needed to convince others, especially the New York Health Department, that Mary was a serious public health threat.

BARTOLETTI: This is the beginning where George Soper begins to do what I call othering Mary because now he describes her as being - well, I would've called her athletic, but she was a little too heavy. She used rough language. And...

UNIDENTIFIED ACTOR #3: (As George Soper) Nothing was so distinctive about her as her walk, unless it was her mind. The two had a peculiarity in common. Those who knew her best said Mary walked more like a man than a woman and that her mind had a distinctly masculine character.

BARTOLETTI: He is making assumptions about gender and sexuality because, at this time, women were expected to be pious, pure, domestic and submissive. And she just wasn't checking those boxes for him. So therefore, she was emotional, she was irrational, and she wouldn't listen to him.

ABDELFATAH: Well - and it seems like, on top of all that - right? - she's this Irish immigrant woman. She's kind of unconventional for her time - very unconventional in some ways. And I imagine that she's kind of the perfect villain for George - like, that she just is very easy to scapegoat if you needed a scapegoat.

BARTOLETTI: Well, he wants to make a name for himself. And so in order to make a name for himself, he needs Mary to cooperate with him. He also dehumanizes her at this point because he now starts to call her a living culture tube, a chronic typhoid germ producer, as some sort of like half-human machine. And he uses this language in order to get the city department of health to allow him to go after her.

UNIDENTIFIED ACTOR #3: (As George Soper) She is a proved menace to the community. It was impossible to deal with her in a reasonable and peaceful way. And if the department meant to examine her, it must be prepared to use force - and plenty of it.

ARABLOUEI: It worked. With the city behind him, George made another attempt to confront Mary and get her tested. And this time, he had help.

BARTOLETTI: Dr. S. Josephine Baker.

ARABLOUEI: Not to be confused with the famous performer and civil rights activist, this Josephine Baker was a physician.

BARTOLETTI: Who has worked with women and has worked in the immigrant community.

ABDELFATAH: Since George had failed to get through to Mary, the New York Department of Health decided it might help for a woman to try and talk to her, so they sent Dr. Baker to Mary's doorstep. But they failed to mention that Mary had a tendency to get violent.

(SOUNDBITE OF MUSIC)

BARTOLETTI: So Baker just thinks she's going to show up and collect Mary and they're going to go down to the hospital - the Willard Parker Hospital.

ABDELFATAH: Wrong. Dr. Baker showed up at Mary's home and promptly got the door slammed in her face.

(SOUNDBITE OF DOOR SLAMMING)

ABDELFATAH: So she tried again the next day, this time with the police.

BARTOLETTI: Well, when she gets there (laughter), Mary reacts so violently that Baker falls backward into the police officer behind her and Mary charges out the door.

(SOUNDBITE OF FOOTSTEPS)

UNIDENTIFIED ACTOR #4: (As Dr. S. Josephine Baker) Mary had disappeared. Disappear is too matter-of-fact a word. She had completely vanished.

ABDELFATAH: They searched the property for clues and came across footprints in the snow-covered yard. The footprints led to a chair which had been pushed up against the fence. Bingo - Mary had scaled the fence and was most likely hiding out in the house next door. So Dr. Baker and the police scurried over to the neighbor's house and spent five hours looking up and down for Mary. Feeling utterly defeated, they interrogated every servant and maid in the home, who all denied having seen Mary.

BARTOLETTI: And finally, when they were just about ready to give up, one of the police officers sees a little bit of dress sticking out of a closet door. And in front of the door, all these ash cans have been piled. And they realize, oh, that looks familiar. Mary had been wearing that. And they discover her inside the closet.

ARABLOUEI: A hiding spot. She'd been aided by the very maids and servants who claimed they hadn't seen her at all.

BARTOLETTI: Now, you have the servants - this kind of class solidarity, you know, where they put the ash cans. They're helping her hide. And so when George Soper tries to make it sound as if she was some kind of outlier, some kind of loner, we find that this isn't true at all.

ABDELFATAH: Dr. Baker was actually impressed by the show of allyship from the other domestic workers, and said she, quote, "liked that loyalty." But that didn't stop her and the officers from pushing away the ash cans and pulling Mary out of the closet.

BARTOLETTI: Well, Mary is outraged.

UNIDENTIFIED ACTOR #4: (As Dr. S. Josephine Baker) She fought and struggled and cursed. I tried to explain to her that I only wanted the specimens and that she could go back home. She again refused, and I told the policeman to pick her up, put her in the ambulance. This we did, and the ride down to the hospital was quite a wild one.

BARTOLETTI: It takes four police officers to get her into the ambulance.

(SOUNDBITE OF HORSES TROTTING)

BARTOLETTI: And Dr. Baker sits on top of Mary all the way down to the hospital as the horse-drawn ambulance clatters down the street.

UNIDENTIFIED ACTOR #4: (As Dr. S. Josephine Baker) It was like being in a cage with an angry lion.

BARTOLETTI: She is now under arrest, really, because the New York City Department of Health had the power to do that. They could arrest her, and they could quarantine her.

UNIDENTIFIED PERSON #8: (Reading) She was locked up. It was not an attractive or particularly comfortable room, and there was no reason why a strong, active woman who felt herself to be in perfect health should be contented with it. And Mary Mallon was not.

BARTOLETTI: Her clothes are taken from her. She's given hospital outfit to wear, a white robe. And now everybody just waits.

ABDELFATAH: They had Mary, but what they really needed was her stool. And as a form of protest, one might say, she was holding it in.

BARTOLETTI: And at last, you know, Mary couldn't put it off any longer. She used the toilet. And now the hospital was able to get specimens from her. And they discover, yes, indeed, her body is harboring this bacteria that produces typhoid fever.

(SOUNDBITE OF MUSIC)

BARTOLETTI: She is now sent to the Riverside Hospital in North Brother Island, which is a 13-acre island in the middle of the East River between Bronx and Queens. And again, she doesn't understand. She feels that she's kidnapped.

ABDELFATAH: Which is pretty understandable - I mean, regardless of what the test results said, Mary didn't feel sick and, therefore, refused to believe she was sick. At that time, hardly anyone knew anything about this idea of a healthy carrier. Even the medical community had very little understanding of it.

ARABLOUEI: In fact, up until that point, there was no record of any healthy typhoid carriers in all of North America. So if Soper was right about Mary, she would be the first - patient zero. And Soper was right.

BARTOLETTI: The fact that there were bacteria in her body that caused this fever means that, yes, she did have it. She might have been too young to remember. She might have had such a mild case. But she absolutely had typhoid fever.

ARABLOUEI: What do you think made her so afraid of being apprehended? Like, what, in your opinion, is the causes of her resistance?

BARTOLETTI: I think of Mary's background, what she may have fled from in Ireland. We don't know what kind of life she had there. We don't know. But given that she was born in County Tyrone, stories of murderers and grave robbers who steal bodies and sell them to medical hospitals, you know, they're found in both Irish history as well as Irish folklore. And one of the most famous serial killers, who killed and sold bodies, was William Burke. And he was from County Tyrone.

ARABLOUEI: William Burke and his accomplice William Hare ran a deadly scheme in the late 1820s, where they got victims drunk, then smothered them to death and then sold their corpses to a doctor for dissection. Burke and Hare murdered at least 15 people before they were caught.

BARTOLETTI: And that happened within the lifetime of Mary's parents or grandparents, so she might have heard these stories. We don't know. But we do know that she obviously did not trust science. She did not trust medical science. And she wasn't going to trust any authorities who came after her.

ABDELFATAH: This begins to explain Mary's skepticism of the doctors. She felt vulnerable and violated, especially when they sent her to live in isolation at Riverside Hospital on an island.

BARTOLETTI: She really believed that they were trying to kidnap her to use her for medical experiments.

ABDELFATAH: Living alone in a cottage on what was nicknamed Quarantine Island, Mary's worst fears were coming true. Doctors started to turn routine checkups into experiments, trying out new drug therapies on her, hoping to find a cure.

BARTOLETTI: They were trying to disinfect her GI track. And the one drug was a combination of ammonia and formaldehyde. But the only real possibility for possibly curing her was to remove her gallbladder. And that's when Mary was very frightened, also, that she was being used as a medical experiment.

UNIDENTIFIED ACTOR #2: (As Mary Mallon) The supervising nurse asked me to have an operation performed. I also told her no. And she said the remark, would it not be better for you to have it done than remain here? I told her no.

(SOUNDBITE OF MUSIC)

BARTOLETTI: She continues to fight for her freedom, and she also continues to write threatening letter after threatening letter to George Soper and to Dr. Baker.

UNIDENTIFIED ACTOR #2: (As Mary Mallon) Why should I be banished like a leper and compelled to live in solitary confinement?

ARABLOUEI: When we come back, Mary makes headlines and fights like hell for her freedom.

(SOUNDBITE OF MUSIC)

CHLOE: Hi. This is Chloe (ph).

CHRIS: And this is Chris (ph) from Jersey City.

CHLOE AND CHRIS: And you're listening to THROUGHLINE from NPR.

CHRIS: Yay.

(SOUNDBITE OF MUSIC)

UNIDENTIFIED PERSON #7: Part Three - State-Controlled Fate.

ABDELFATAH: Two whole years of life pass by on Quarantine Island, where Mary was holed up against her will.

BARTOLETTI: Her story then makes the news. And you know, they didn't have HIPAA laws back then, and so her identity is known.

ARABLOUEI: Known for being the first officially traced carrier of typhoid fever, which inspired the infamous nickname Typhoid Mary.

BARTOLETTI: And it becomes fodder for William Randolph Hearst and Joseph Pulitzer and for their newspapers. And you can just imagine - these two men, they wanted to sell newspapers. You know, they are known for their yellow journalistic style. And so their newsboys would be hawking out on the streets.

UNIDENTIFIED ACTOR #5: (As Newsboy #1) Extra, extra, read all about it. Extra, extra, human typhoid germ.

UNIDENTIFIED ACTOR #6: (As Newsboy #2) Human fever factory, human...

BARTOLETTI: All these various headlines that would get people to sell the newspapers.

UNIDENTIFIED ACTOR #6: (As Newsboy #2) "Typhoid Mary - The Extraordinary Predicament of Mary Mallon, A Prisoner of New York's Quarantine Hospital."

BARTOLETTI: William Randolph Hearst - yes, he loved the sensationalist story, but he also championed the underdog. And it is believed that he hired the attorney by the name of George Francis O'Neill so that Mary could get her day in court.

ARABLOUEI: Just to reiterate here, the head of what would go on to become the largest media conglomerate of the time, William Randolph Hearst, may have actually funded Mary's legal battle against the state, arguing that she had been denied due process. Maybe he did it to root for the underdog, or maybe he did it for the sake of a good story. Either way...

BARTOLETTI: She gets her day in court, and that's two years after she was first quarantined. It took that long for her to get her day in court.

(SOUNDBITE OF MUSIC)

BARTOLETTI: One Sunday, right before she goes to court, she opened up the New York American. It was the Sunday edition, and she sees a two-page spread all about herself.

ABDELFATAH: It was 1909, so newspaper articles were more often accompanied by illustrations and engravings rather than photographs.

BARTOLETTI: The engravings - oh, they show Mary standing at a stove cracking skulls into a frying pan. I mean, they really are making her seem now as if she's a witch or a sorceress of some sort.

UNIDENTIFIED ACTOR #2: (As Mary Mallon) I have been, in fact, a peep show for everybody. Even the interns had to come see me and ask about the facts already known to the whole wide world. The tuberculosis men would say, there she is, the kidnapped woman.

BARTOLETTI: And so of course, there's a lot of hype around her trial.

UNIDENTIFIED ACTOR #1: (As reporter) Every effort has been made by the health authorities to cure the unfortunate woman but, so far, without success. There is nothing known to medical science which seems to reach a case like this. It is extremely unfortunate for the woman, but it is the plain duty of the health authorities to safeguard the public from such a menace.

(SOUNDBITE OF MUSIC)

ARABLOUEI: Mary lost her case and was sent back to North Brother Island. Then, in 1910, nearly three years after her initial arrest, New York City hired a new health commissioner. He took a more sympathetic approach to Mary's case and decided that she should be released. But there was a catch.

BARTOLETTI: She has to promise that she will not cook.

ARABLOUEI: The commissioner decided she should be free as long as she didn't put other people at risk.

BARTOLETTI: And so in writing, she promises she will not cook. And then she says - because of the disease for which it is possible I may cause - she has to add that in her own writing 'cause she still doesn't believe it.

ARABLOUEI: Even though Mary was still fully convinced she was never sick, she signed the affidavit. And with that, she was free.

ABDELFATAH: With some strings attached. Mary had to report to the health department each month. So she agreed to that, too, and then went back to New York City where she found work doing laundry.

ARABLOUEI: A year went by, then another and another.

BARTOLETTI: And then, suddenly Mary does not report, and nobody notices. And in November of 1914, there is a very tiny article in, like, the third section of the newspaper that mentions that Mary Mallon has disappeared. Nobody knows where she's gone.

Sometime after that, at the Sloane Hospital for Women, typhoid fever has broken out. And there are 25 cases.

ABDELFATAH: But nowhere in Sloane's records did it list the name Mary Mallon.

BARTOLETTI: Now the story depends who's telling it.

(SOUNDBITE OF MUSIC)

BARTOLETTI: George Soper says he got a call and he went to the hospital and he looked at Mary's handwriting. And he said, yes, this is definitely Mary.

ARABLOUEI: But it didn't add up. The cook at the hospital was named Mary Brown.

BARTOLETTI: Then Dr. Josephine Baker, if you listen to her, she takes credit for having gone to the hospital and figuring out it was Mary Mallon.

UNIDENTIFIED ACTOR #4: (As Dr. S. Josephine Baker) I went up there and went into the kitchen. Sure enough, there was Mary, earning her living in the hospital kitchen, spreading typhoid germs among mothers and babies and doctors and nurses, like a destroying angel.

BARTOLETTI: And then if you read the New York Sun, the New York Sun says it was the medical staff that figured it out. But in any case, Mary was working at that hospital under a pseudonym.

ABDELFATAH: Mary had broken all terms of her agreement. Not only had she stopped seeing her probation officer, she was working as a cook in a hospital and trying to fly under the radar using the name Mary Brown. In just three months working at Sloane, she spread typhoid to 25 people, killing two of them.

The reality is people had died from being exposed to her food. Right? And so there were consequences to her sort of continuing to evade testing and to basically deny that she could possibly have the disease. And so putting myself in her shoes - look, I understand why she felt so defensive. But on the flip side, that's a really dangerous thing for her to have done.

BARTOLETTI: Yeah, it was dangerous. She's refusing to go along with what the authorities are telling her, which is to the benefit of society to keep people safe. You know, so for her not to understand and choose not to understand, this is something that was very dangerous.

ARABLOUEI: So Mary realized they were after her again. And so she ran - again.

BARTOLETTI: And now the hunt begins for Mary. And she is found in a home. The police officers show up, and she locks herself into a room. And there were two dogs. And fortunately, the one police officer has brought with him a steak (laughter). And he tosses it to the dogs, and they go after the steak. And then he's able to capture Mary.

She was then arrested again after, you know, being found in the - out that she was working in the hospital - sentenced again to Riverside Hospital. And now she's resigned. She's going to stay there. She knows she's going to live her life out there.

ARABLOUEI: Mary returned to her private cottage on North Brother Island, where she stayed for a total of 26 years. She died of pneumonia in 1938 at the age of 69.

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ABDELFATAH: Mary was pretty stubborn in her resistance to getting testing. And of course, she had her reasons - right? - as you laid out. But I'm wondering, was there a failure of communicating with her on the part of, like, the authorities that contributed to her heightened fear, you know?

BARTOLETTI: Oh, I believe so. I think when George Soper appeared in that kitchen and accused her - he literally told her she wasn't washing her hands after using the toilet - she was insulted. And she was frightened because she didn't want to lose her work, her only means of employment. And I think that a lot of it is meeting a person where that person is. Maybe he needed to explain it to her differently. Maybe he shouldn't have gone in expecting her to understand, you know, right away what he was talking about. Maybe it frightened her. Maybe, you know, for someone to show up in your kitchen and say I need some urine and stool samples in the year 1906, that was a pretty personal request (laughter).

ARABLOUEI: Still, George Soper got credit, shared with Dr. Baker - which he wasn't very happy about - for tracking Mary down and stopping the spread. And this paved the road to a successful career, which ultimately led him to serve as the director of the American Cancer Society.

BARTOLETTI: Yeah, he absolutely got credit. He's the one who, you know, through the contact tracing found Mary Mallon. And so, yeah, he should get credit.

ARABLOUEI: This credit paved the way to published articles in highly respected medical journals that detailed Mary's story - of course, from Soper's perspective. Those articles then cemented him as the authority on the subject, making Soper the primary voice in the historical record, not Mary.

BARTOLETTI: You know, from Mary all we have is a six-page letter that she wrote. Those are the only words we have from Mary Mallon. We also have quotes from interviews that she had given to various newspapers. Other than that, what we have are accounts from Josephine Baker and accounts from George Soper. He brought his own prejudices and his own worldview and perhaps his own lack of trust. We talk about Mary's lack of trust, but his own lack of trust, you know, to how he treated Mary.

ARABLOUEI: Ultimately, Mary was traced to a total of around 50 typhoid cases and three deaths. This is tragic, no doubt, but George Soper himself later admitted that this was not as large a toll as other carriers who were discovered after Mary received a life sentence in quarantine.

BARTOLETTI: Even the court system were treating men differently. Mary, at the time, a woman living alone - she didn't have much recourse. You know, there was no unemployment. There was no welfare. There was no sort of assistance to help someone like her out. When the courts discovered men who were also healthy carriers, the court tended to be more lenient because - oh, you know, he has a family. He has four children. And I think that goes back to the expectation - what people expect of women, women being held to a different standard. You know, there were men at that time who infected people, including children. They were treated differently.

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ABDELFATAH: The story of Mary Mallon shows just how much public health efforts in the real world get linked to racial, gender and economic inequality. Often, the people who face the biggest risks from disease, then and now, are at the bottom of the social hierarchy.

ARABLOUEI: And this is one of the reasons that who sets and who follows public health directives remains such a complicated issue. People may not be able to heed warnings to stay home during lockdown because they have to go to work, or maybe years of systemic inequities mean that they just don't trust the authorities giving them information. And in some cases, people just don't want to be told what to do. So it becomes more difficult to just blanketly call people wrong or selfish for resisting public health regulations.

ABDELFATAH: And as the months of this pandemic go on and on, we're likely to see this tension between individual decisions and the greater good play out in different ways over and over again.

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ABDELFATAH: That's it for this week's show. I'm Rund Abdelfatah.

ARABLOUEI: I'm Ramtin Arablouei. And you've been listening to THROUGHLINE from NPR.

ABDELFATAH: This episode was produced by me.

ARABLOUEI: And me. And...

JAMIE YORK, BYLINE: Jamie York.

LAWRENCE WU, BYLINE: Lawrence Wu.

LAINE KAPLAN LEVENSON, BYLINE: Laine Kaplan Levenson.

JULIE CAINE, BYLINE: Julie Caine.

KIA MIAKKA NATISSE, BYLINE: Kia Miakka Natisse.

N'JERI EATON, BYLINE: N'Jeri Eaton.

ABDELFATAH: Fact checking for this episode was done by Kevin Volkl.

ARABLOUEI: Thanks also to Alex Curley (ph), Steve Tyson (ph), Austin Horn (ph), Collette Murphy (ph) and Camille Smiley (ph) for their voiceover work. Also thanks to Anya Grundmann and to our guest Susan Campbell Bartoletti, author of "Terrible Typhoid Mary: A True Story Of The Deadliest Cook In America." And a big shoutout out to our friends at NPR's Morning Edition for suggesting this episode.

ARABLOUEI: Our music was composed by Ramtin and his band, Drop Electric, which includes...

NAVID MARVI: Navid Marvi.

SHO FUJIWARA: Sho Fujiwara.

ANYA MIZANI: Anya Mizani.

ARABLOUEI: And one last thing - we wanted to ask something of teachers who are thinking about next school year and would maybe like to sneak in a summer assignment. Are there episodes of THROUGHLINE that you'd like your students to hear? Are there particular episodes that you found useful in teaching history that isn't in textbooks or doesn't get the treatment it deserves? If so, we'd love to hear from you. Please leave us a message at 872-588-8805. Again, the number is 872-588-8805. If you have an idea or like something on this show, please write us at throughline@npr.org, or find us on Twitter at @throughlinenpr.

ABDELFATAH: Thanks for listening.

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