In the late summer of 1854, cholera struck a densely crowded poor neighborhood in London’s Soho district. Within days, hundreds were dead, and dozens more had fled the area for other parts of London or the surrounding countryside. In terms of the sheer speed with which it ran through the neighborhood and the concentration of deaths in a small area, it was the worst epidemic in London’s history. But by the end of it, events had been set in motion that would change the faces of science, medicine, sociology and urban planning. Those changes are still reverberating today, more than a century-and-a-half later.
Brooklyn-based journalist and author Steven Johnson brilliantly lays out the complex set of circumstances that led to the cholera outbreak, and uses novelistic techniques to tell the narrative of two men — a surgeon and a pastor — whose efforts eventually convinced the skeptical doctors, scientists, journalists and bureaucrats of the day that the disease was spread by water. That in turn led to some of the first public health laws in history and to massive public-works projects to protect the municipal water supply.
This is one of the best books of popular science and history I’ve read, ever. It combines conscientious research with a clear and concise writing style and a compelling narrative arc to arouse and keep the reader’s interest. It uses all the tricks in the arsenal of the journalist, historian and social scientist, without ever seeming to preach or try to persuade one to believe anything not supported by facts.
“This is a story with four protagonists: a deadly bacterium, a vast city, and two gifted but very different men,” Johnson states in a brief prologue. “It is the story of a map that lies at the intersection of all those different vectors, a map created to help make sense of an experience that defied human understanding. It is also a case study in how change happens in human society, the turbulent way in which wrong or ineffectual ideas are overthrown by better ones. More than anything else, though, it is an argument for seeing that terrible week as one of the defining moments in the invention of modern life.”
The two men are John Snow, a polymath physician, surgeon and scientist, and Henry Whitehead, the vicar of St. Luke’s parish.
The book’s chapters coincide with the days of the epidemic, although there are many diversions down historic and scientific paths. In the opening chapters, Johnson shows how and where the epidemic began, then quickly moves on to paint a picture of Victorian London, particularly the horrifically filthy and squalid conditions in which a large proportion of its 3 million inhabitants lived. He traces the history of cholera and explains its life cycle and its deadly effect on the humans it infects. He makes a convincing case that epidemic cholera was a natural consequence of urbanization that outpaced infrastructure.
Johnson also explores the state of medical science of the time, which firmly believed that plagues were caused by agents in the air. Bad smells caused disease, they believed; and the author goes to great lengths to show how difficult it was for an independent-minded scientist like Snow to persuade them that it was the water, not the air, that was killing Londoners.
That’s where the titular map comes in. It wasn’t actually drawn until months after the outbreak had passed — after Snow had persuaded a reluctant local board of health to remove the handle from the pump on the infected well. The map, which clearly showed the distribution of fatal cases was directly related to the well, eventually became the tool that persuaded city officials to construct an adequate sewer system, and to make sure that the city’s water supply and sewage remained separate.
In the book’s final chapters, Johnson extrapolates from the London cholera outbreak to the challenges facing the 21st century, particularly conventional, nuclear and biological terrorism. He begins with a tribute to cities as the true expression of modern life, the place where cultures and ideas mix and foment and bring about change. He makes Snow a stand-in for a modern expert or government official, and Whitehead for the blogger or person on the street, with intimate knowledge of what’s happening on the ground. He believes that modern information technology can bring together local “experts” with urban planners, bureaucrats and other governmental officials, to create local solutions to today’s macro problems.
The final chapters, in which these conclusions are developed, lack the narrative power of the bulk of Ghost Map. But they’re worth considering, and with the preceding two-thirds of this excellent book, Johnson has earned our attention.
(Riverhead, 2006)
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