Disease, Mortality, and Lessons from History

Monday Morning Musings

“Very few things happen at the right time, and the rest do not happen at all: the conscientious historian will correct these defects.”

–Herodotus, The History of Herodotus

“The forms of diseases are many and the healing of them is manifold.”

— Hippocrates

I’ve been thinking about the intersection of disease and history. Stay with me here–both subjects have been much in the news. The word “history” comes from the ancient Greek word meaning inquiry or investigation. Historians investigate a variety of materials, and then we evaluate, interpret them using the available facts (which often change over time), and chronicle them. History is not a science, but science has its history.

The current outbreaks of measles here in the United States and elsewhere can be examined through a historical lens, as well as through scientific ones. For example, my own history: I had the measles, chicken pox, and many other childhood diseases because I was born before there were vaccines. According to one report, there were 102 reported cases of measles in the United States, in fourteen different states, that are linked to one outbreak in California. (See this.) As a child, I did receive the oral polio vaccine. Due to the effectiveness of that and subsequent vaccines, polio has nearly been eradicated.

As of January 2015, no new cases of polio have been seen in Nigeria or Syria, where there were cases found last year, but the disease still exists in the wild in Pakistan. This is a disease that can be eradicated. What many people do not realize is that one case of a disease such as polio can cause an epidemic. According to the World Health Organization:

“Despite the progress achieved since 1988, as long as a single child remains infected with polio virus, children in all countries are at risk of contracting the disease. The polio virus can easily be imported into a polio-free country and can spread rapidly amongst unimmunized populations. Failure to eradicate polio could result in as many as 200, 000 new cases every year, within 10 years, all over the world.”

World Health Organization. 2014

Polio cannot be cured, but it can be prevented through proper vaccination.

Measles can also be eradicated. Many young doctors have never seen actual cases of the disease because the vaccine is so effective. One could divide history in the United States into a before vaccination for childhood illnesses and a post vaccinations period. Look back at family histories—how many children were lost to not only diseases such as polio and measles, but also scarlet fever, whooping cough, and others? Measles can cause severe complications, and the disease can also be fatal. There is NO scientific link between measles vaccines and autism. There is no debate about the efficacy of vaccines. Some children cannot be vaccinated because they have cancer, allergies, or auto-immune problems, but parents who choose not to vaccinate healthy children put not only their children at risk of getting the disease, but also help to spread the disease to others.

Epidemics have changed the course of human life and events. Most people probably know of the plague, the “Black Death” that occurred throughout the world in waves in the mid-fourteenth century–and killed millions of people. Fleas carry the plague bacterium. Many have theorized that rats harbored the plague-ridden fleas over decades, which caused the epidemics to break out in waves of plague throughout the mid-to-later part of the fourteenth century.

Some scientists now believe that Asian gerbils brought the disease to Europe. By examining tree rings, the scientists determined that weather conditions in Europe during plague outbreaks were not particularly conducive to rats. However, whenever the weather was favorable to gerbils and fleas in central Asia, the plague bacteria appeared a few years later in European harbor towns, and then spread across Europe. Of course, anyone who has ever had to deal with fleas brought in my pets or people, knows that they easily hop to new warm bodies, so carrier fleas once introduced into new locations, could jump to mice, rats, cats, dogs, livestock, and people. Rats are not off the hook, but the black plague of the fourteenth century may not have originated with them. (See an article about the study here.)

After the fourteenth century, the plague periodically reappeared. In England, the Great Plague of 1665 is perhaps the next most famous plague period, but there were others. I came across this story about plague graffiti left in churches. The article features a bit of graffiti: the names Cateryn, Jane and Amee Maddyngley that were inscribed on the wall of a church in Cambridgeshire after the plague of 1515 broke out in London and spread to the south and east.

Although it is sad to think of the deaths and the survivor who wrote the names of these three sisters, I had immediate questions. First, an observation–how cool is it that there is church graffiti survey! Then I wondered who had left the graffiti. And why? Was it simply a memorial? Was there more? Did the survivor feel guilty? Was it a brother? Of course, the other obvious thought was that he or she (but probably more likely he) was literate, and I wondered about literacy in this 16^th century English village. The article says the family was likely tenant farmers, which encompasses a great economic range. Perhaps the unknown graffiti artist attended one of the grammar schools that were established at this time. Because it’s unlikely that whoever left this graffiti left a record saying so, we will probably never know who inscribed these names, or most other church graffiti. But it is so interesting.

This is part of what makes the study of history fascinating and relevant. One can look at an event—the outbreak of plague in London in 1515–and from there follow all sorts of historical paths. It can lead to studies of epidemics, village life, family life, class, church history, agricultural history, and education, among others.

Recently in United States, some politicians have tried make the teaching of history in public schools fit their ideas of what should be taught, whether it is accurate or not. Some have attempted to rewrite or censor textbooks. Recently, Representative Daniel Fisher of Oklahoma introduced House Bill 1380 in the state to prohibit teaching the US History Advance Placement course there, unless it was changed to fit his ideas of what should be included in such a course. He and others who support him believe the AP US History course is not patriotic enough. Mr. Fisher lacks understanding of both the AP Course and US History. AP courses are designed to be similar to a first year college course. Students are expected to not merely memorize facts, but to investigate and analyze material, including a variety of primary texts. His version of required documents for US History included the Ten Commandments and the Magna Carta. The Ten Commandments should absolutely be studied—in a course on world culture or religions. The Magna Carta is important for a course in English history or government. Despite his desire to rewrite the past and influence the present, however, the United States is not and has never been a Christian nation, and “the Founding Fathers” were not all devout Christians. (See this.)

I agree that students—indeed all Americans—should be familiar with such documents as the Declaration of Independence and the Constitution, but how does it detract from the significance of these documents to know that many of the Founding Fathers, including George Washington and Thomas Jefferson were slaveholders? Good and bad things have happened in the United States, and students should be aware of them. They should know that along with fighting for freedom during World War II, the United States also interred thousands of Japanese Americans. This is part of our history. Political documents, like works of art, are richer for knowing and understanding the context in which they were created. The Founding Fathers did not live in a bubble. They had wives, families, servants, and slaves. They suffered from chronic diseases and were often in pain. It is also important to know about the lives of the less famous, and to understand the context into which both famous and unknown people lived their lives.*

If we are to understand the past—or at least to make educated guesses–then we need to know about more than kings and presidents, the wealthy and educated. To understand the past, we need to examine its rats, fleas, and dirt, along with its shining surfaces, palaces, and plantations. We need to appreciate the devastation of an epidemic, as well as the glory of gaining independence. We need to look at the graffiti and scribbles, as well as the portraits and treatises.

*******

Next week, my new Monday Morning Musings history blog post will return to more familiar and delicious territory. But so I don’t leave you without mentioning food, here’s a report of an exhibit that used cake to depict disease. Look if you dare!

Also, two wonderful historical novels that focus on plague in England: Connie Willis, Doomsday Book, which also involves time travel. It’s one of my favorite books. Geraldine Brooks’s novel, Year of Wonders: A Novel of the Plague, is based on a true story of a village in England that was struck by the plague in 1666. It is elegant and heartbreaking. I seem to remember reading it in one sitting, and crying.

*My World of the American Revolution: A Daily Life Encyclopedia (ABC-CLIO) should be out in September, at least that is what Amazon tells me!  It is full of information about things that Representative Fisher probably thinks are totally irrelevant.

What If?

“I shall be telling this with a sigh
Somewhere ages and ages hence:
Two roads diverged in a wood, and I,
I took the one less traveled by,
And that has made all the difference.”

—Robert Frost, “The Road Not Taken”

Readers of my blog may have noticed that several of my blog posts focus on time. That’s because I am fascinated by time–and by the past. (Probably good things for a historian.) I’ve always enjoyed stories about the past–and time travel—and as I grow older I’ve become more interested in my family’s past.

Recently I came across someone who disparaged what he termed “hypotheticals,” as if people don’t think about hypothetical situations all the time. “What if I had done this instead of that?”  “What if this happens? What will I do then?” Don’t most people carry on these soul-searching internal monologues?

 Or how about the middle-of-the-night wondering? “What if that shadow really is a monster?” Yep, been there, done that. 

We speculate how our lives might be altered if we had taken the other road. I wonder how my life might be different if my parents had not decided to divorce when they did, and my mother, sisters, and I moved to Havertown—where I met my future husband in our 9^th grade English class. Would he and I have met later? Would we have met at all? Perhaps I am the only one who thinks these types of thoughts, but I doubt it. The popularity of the movie It’s a Wonderful Life, Frank Capra’s classic 1946 film (and its many imitations), indicate that people enjoy speculating about how life would be if a person they know—or if they themselves—had never existed.

When a loved one dies, we experience a world that continues to exists, but with that person no longer in it. Yesterday I watched the Frontline documentary Never Forget to Lie, by Marian Marzynski,  about his experiences as child survivor of the Holocaust, and the experiences of other child survivors. It was incredibly moving, horrible, and thought provoking. I think it is common for Jews who did not experience the Holocaust to wonder how they would have survived. I know I have. Would any of my friends have helped my family and me? Yes, totally hypothetical, but don’t most people wonder about these type of things? After reading Anne Frank’s diary how can anyone not wonder what this talented young woman might have done or become if she hadn’t died in a concentration camp? We will never know.

I love reading historical novels, which are based on reality, but totally hypothetical. Robert Harris’s alternative history, Fatherland, takes place in a world in which Germany won World War II. In contrast, his novel Pompeii takes a historical event—the eruption of Mt. Vesuvius–and uses it as the basis for a mystery. We know that Vesuvius will erupt, but how will the hero escape? Or will he? Could anyone have done so? Connie Willis’s Doomsday Book has Oxford historians time-traveling back to the fourteenth-century–with disastrous results. In the brilliant and compelling City of Women, David R. Gillham tells the story of ordinary people who live in an extraordinary time and place, World War II Berlin. In reading about them–ordinary people with normal weaknesses and characters that are only truly tested as the war continues–I found it impossible not to wonder what I would have done in their situations. Yes, I do wonder what I would do if put in a fictional character’s situation. Because that’s what good fiction does. It transports us to other realms and makes us think about how we would react in various situations.

But hypothetical thinking—and dreaming—is important in real life, too. It is the human capacity to dream and speculate that make scientific discoveries—as well as great art—possible.  So I will continue to ponder the past. I will look back at roads taken and roads not traveled, and I will continue to wonder “what if?”

 

“If I could have convinced more slaves that they were slaves, I could have freed thousands more.”

—Harriet Tubman

          

I Wish Time’s Winged Chariot Made Pit Stops

“But at my back I always hear
Time’s winged chariot hurrying near”

-Andrew Marvell, “To His Coy Mistress”

I’ve been thinking a lot about time and task lately. Partly it’s because for the past few weeks I’ve been having trouble managing my time to get my tasks done. I suspect this is a common problem for people who work from home, especially writers, artists, and musicians. We spend our days (or nights) trying to fit our assignments, or tasks, around appointments, classes, and events that are scheduled at a particular time. The spigot of creativity and word flow gets turned off, and when it is turned back on, the gush has been reduced to a trickle.  There are times when I hear “Time’s winged chariot,” and I want to be seduced like Marvell’s mistress and surrender to the moment. Forget work. I want to read a novel.

Since ancient times, humans have been fascinated by time. We have tried to measure it through calendars (Go Mayas!), massive structures, such as Stonehenge, and small objects, such as hourglasses.

We try to capture time in photographs, videos, or words written in a blog post. But time cannot be captured; it is fleeting. It cannot be saved in a bottle, as singer-songwriter Jim Croce wished it could be. Time is like the bubbles produced by the child’s wand. We glimpse them for a moment as they hover and glimmer in the air, but they break and disappear when we try to catch them. They cannot be pinned down.

Sometimes time floats by like those bubbles. At other times it rushes by propelled by unseen currents. We see it pass. We see it in the aging faces of our parents, in the accomplishments of our children, in the physical changes in our own bodies, and we long to go back to revisit, to understand what happened.

Writers from H.G. Wells to Audrey Niffenegger have imagined worlds in which people could travel through time to see the past, or the future.  The novelist Connie Willis has written stories and novels that center around the time traveling adventures of historians and their students at Oxford University. As a historian, I have often wished I could go back in time to see if what I thought happened actually did.  However, my own time machine would have to be equipped with indoor plumbing, coffee, and chocolate, among other things.  I think it’s important to be upfront about my demands, even with the gods of time.

In the preindustrial world, daily life was not so tied to clocks.  Before factories and railroads, there was no need for time to be measured so precisely. Still, there was a seasonal and daily rhythm to life, and there were tasks to be done. Crops had to be planted and harvested according to the season. People and animals had to be fed, cows had to be milked, and children had to be cared for. There were court days and feast days and market days.  All of this, I imagine, made it just as difficult then, if not more so, for creative minds to find the time to produce works of art, literature, and music. And yet, they did.

I’ve been thinking about time, too, because I’m reading a novel called The Age of Miracles by Karen Thompson Walker (no review yet, since I haven’t finished the book). The premise is intriguing: the rotation of the Earth has slowed down. As a result the length of a day is no longer twenty-four hours. Daylight and darkness no longer fit “clock time.” Some people choose to live in “real time,” but most people attempt to remain on clock time, sleeping while it is light, going to school or work when it is dark, and watching the sunrise at noon.

None of this knowledge and reflection helps me to manage my own schedule.  Time’s winged chariot still whooshes by, and I still have deadlines.  Yes, it’s true. We can’t stop time, but we can pause to think about it.