The Ghost Map

I find infectious disease fascinating. Not having it, mind you (thought I should clarify that), but transmission, history, properties, effects, the investigation process to determine origin and develop strategies to fight it - essentially, working for the CDC is on the short list of 'Occupations I Wish I'd Had'. This fascination expresses itself in what is probably an unseemly interest in biological disaster movies (I've seen Outbreak more than once – ‘nuff said), documentaries about same and lucky for me, there is a plethora of books on the topic. Thanks to having consumed The Hot Zone and Virus Hunter, in addition to numerous articles and television programs several years ago, I know an alarming amount about Ebola, even being able to discuss the determining characteristics of the filovirus, as well as the details of the outbreaks specific to Ebola Marburg, Reston and Zaire.

After spending months in a haze of undemanding entertainment B.H. (Before Humira), I've become increasingly thirsty for something that exercises my brain ever since I 'woke up'. To that end, I've decided to always have a non-fiction book on the go - I dip in and out of them in between various forms of fiction. Which is a very lengthy way of saying that I've just finished reading The Ghost Map by Steven Johnson, an account of the pivotal 1854 cholera break in London during which a doctor named John Snow discovered how cholera is transmitted.

I like history and I find the Victorian age intriguing. Through reading about the era, I picked up on the fact that Victorian London was a very dirty due to the polluting effects of coalfires, but I’d never really thought of the storage (yes, storage!) and disposal of human waste. Now I know more. And boy, oh boy, must it have stunk. The book starts with a fascinating description of all the various occupations involved in some way with the process originating in Elizabethan times and continued in the more population dense industrial times of the 19th century. There were some truly disgusting jobs. Like nightsoilmen (who came to your house and emptied your cesspool) and bonepickers (quite literally what the name implies, these were people who travelled immense distances in a workday, looking through refuse for rags and bones they could sell – all kinds of good information here). Captivating and educational though this first part of the book is, orienting you to the conditions and squalor of the city, I highly recommend that you don’t read that bit in any immediate proximity to a meal. I’m not squeamish, but it made me nauseous (I’m pretty sure reading it on audiobook 'enhanced' the experience, although the narrator is amazing). Based on the description, it’s a miracle the human race survived industrialization.

The Ghost Map further describes the transition from agrarian society to the high population density cities and shows how infectious disease such as cholera changed to becoming utterly devastating - at the time, you could leave for the weekend and come back to see 10% of your neighbours being wheeled away in deathcarts due to an outbreak. We also spend quite some time hanging out in the small intestine, as well as taking a tour of the predominant theories of disease transmission at the time, the main one being the belief that “smell is disease”, in other words that smell is held within a miasma of infectious agents and therefore the main strategy to combat and prevent infection was to get rid of the smell. One of the brilliant applications of this theory involved pumping the city’s sewage into the Thames. Right where various water companies pumped in their water to distribute back to their customers. Yum.

Long story short, the book details the 1854 epidemic from “patient zero” to the end, following the people involved, be they victims or investigators and specifically focusing on John Snow, who through his research discovered that the contagion originated from a pump on Broad Street, which was then shut down, effectively ending the epidemic. Johnson calls it “the triumph of rogue science” (I can’t tell you how much that phrase tickled me) and it was the turning point in steering the development of epidemiology, public health, cartography and sanitation to the models used today. The book is an almost organic description of the empirical process, an education in how science works – it certainly felt organic, considering how much time is spent in the small intestine – and entertains while it educates. So much non-fiction is badly written (see Hot Zone, which although gripping is only gripping due to the subject matter, while I found myself repeatedly wishing for a better writer), but this reads like a fast-paced thriller – the pacing’s excellent and the writing is very, very good. It was a joy to read.

Highly recommended for geeks, history buffs and mystery lovers alike.