Beth’s Books: Fever Season

Whoops! I didn’t mean to let this many days go by without an entry, but I’ve been battling a cold as well as dealing with lots of wintry weather (piss off, Polar Vortex), so I’ve just been hunkering down and doing some reading.

Today I finished Fever Season by Jeannette Keith, a book about the 1878 yellow fever outbreak in Memphis (as of this posting, the book is only $1.99 for Kindle). Anyone who has been reading my blog for a while knows that I’m fascinated by how disease affects history, and this book didn’t disappoint. Some infectious disease books are about the hunt for the microbial culprit; this is more about the psychological and social effects on the city. (For the record, I like both types of books.) This doesn’t go into any lengthy scientific explanations of the virus or its epidemiology, so it would be easily understandable for a layperson.

Many aspects of dealing with an epidemic are addressed. Sanitation, quarantine, food and water supplies, care for the sick, burial of the dead...so many people were dying each day that individual graves and funerals simply weren’t possible, and mass graves had to be dug. In a Victorian society that placed great emphasis on proper burial and mourning, this was an additional psychological blow.

At the time of this epidemic, the cause of yellow fever and the way it was spread was not known. (It’s a virus spread by mosquitoes.) Much ado was made about proper sanitation and how filthy the city was at the time. Efforts at sanitation and a new sewer system after the outbreak didn’t address the cause of yellow fever, but it certainly would have an impact on general public health and helped to make Memphis an important southern city once again.

One thing I found especially fascinating was the social and racial aspects of post-Civil War Memphis. Black citizens and troops helped to maintain order and were credited with being a big part of keeping things together. Memphis was not a segregated city at this time, and black and white relief workers ate and worked side by side. It wasn’t until the early 1900s that the Jim Crow laws came into being and segregation was instituted in Memphis. Histories of the epidemic written by whites eliminated the important role that blacks played in dealing with this outbreak. It was as though they wanted to deny reality. I guess some things never change! (I’m thinking of that Duck guy saying that he was around blacks when he was growing up, and they were happy and singing songs.)

The book throws in some fairly gory details of the disease (One tell-tale symptom is black vomit, or vomito negro, which consists of digested blood—yellow fever is a hemorrhagic virus, like Ebola. When that starts, the patient isn’t long for this world. One nurse wrote about how a patient’s bed looked like someone had tossed black ink all over it. That’s going to stick with me for a while.), but the main focus is the social and psychological devastation the epidemic brought to the city. It’s hard to imagine the impact that massive die-offs of family, friends, and neighbors would have, even today. Our epidemiology and quarantine capabilities are much better now, but an extremely virulent and transmissible agent would still be hard to contain.

Yellow fever, AKA Yellow Jack, still occurs in Africa and South America.

They call me Mellow Yellow

I've had this book for a while and finally got around to reading it.

I've written before about how one of my favorite subjects is infectious disease and its effects on history. It has had a profound effect, from the obvious (the massive die-off of the native population due to smallpox when the Europeans arrived contributed to the Europeans' easy land grab of the Americas) to the sublime (powdered wigs, heavy face powder, and faux beauty marks of the 1700's, all designed to hide signs of mercury poisoning from syphilis treatments and syphilitic lesions). I love books like this, and The American Plague by Molly Caldwell Crosby focused on the 1878 yellow fever outbreak that stunted that city's growth as an expanding post-Civil War metropolis. At that time, Memphis was poised to become a major city in the South, but the massive deaths and frantic desertion of the city due to the epidemic brought that growth to a shrieking halt.

In that regard, that part of the book was interesting. I also enjoyed the tale of Walter Reed and his Yellow Fever Board that did research in Cuba at the turn of the 20th century. At that time, human experimentation was common, and not only among volunteers. A few members of the research team chose to infect themselves with yellow fever in order to study the transmission of the disease. That seems barbarous and inconceivable now, but such experiments were common in that era.

However, I was horribly disappointed in this book. I've read numerous books on the subject of disease and its effect on history, or on the threat of emerging diseases, and most were written by doctors or research scientists. Ms. Crosby's biography states that she has a graduate degree in nonfiction writing from Johns Hopkins. She's not a bad writer, but I found her endless adjectival descriptions a little much. There was much about how incoming storms looked, or the yellow color the fever's victims develop, or anecdotes about family outings in Cuba. (Maybe that's why last night I had a dream in which I was sitting outside and thought about the “blueberry pie sky.” Interesting phrase, but who really writes that way? She actually described one victim as having “eyes like sunflowers.” What a horrid, hyperbolic description!)

Maybe this would be an interesting read for someone who has a casual interest, but I wanted much, much more. Where were the descriptions of the virus itself, its virulence factors, and speculations from scientists about why the Memphis outbreak was so severe? Why not more narrative from Reed and his team about figuring out that the mosquito was the vector? Towards the end of the book, there was a jarringly out of place short chapter that spoke of a case in the States in 2002. There was no follow-up, no description of the CDC's inevitable and full involvement, and nothing but vague, ominous cautions about how viruses have taught us one thing throughout history: "that their will and ability to survive may be stronger than ours." Really? That's the one major thing that viruses have taught us? Nothing about DNA, RNA, transmission, vectors, immune response...just that their will to survive is stronger than ours? I call bullshit on that, by the way. Viruses have no will. They are not sentient organisms. They are packets of protein. They simply exist, and they exist by replication in humans. They have no ill will towards us; they merely do what they must in order to survive.

Another thing that bugged me was that when Crosby wrote about Reed and his team in Cuba, she began talking about the yellow fever virus...but this was well before any researchers knew that yellow fever was caused by a virus. The prevailing thought at the time was that it was a bacterium. I found it very out of place to read about these researchers thinking of yellow fever as a virus when they had no real idea yet what what actually causing it.

I know I'm a hard taskmaster when it comes to books about microbiology and infectious disease. I want details, I want analysis, I want to hear about research. I won't go so far as to say that non-scientists shouldn't write about such subjects; I thought Richard Preston did a great job with The Hot Zone. But I will say that Ms. Crosby should find a subject other than science. I found this book boring and uninformative and very unrewarding. Oh, and about 40 pages was devoted to detailed notes about her sources. It's one thing to provide a bibliography. I don't need a detailed description of where you found every single thing you wrote about in the book. I skimmed over all of that, but I might have missed how she was sipping an iced coffee at a charming little sidewalk cafe when she read one of Reed’s letters to his wife. Seriously…WAY too much background!

If anything, this book made me resolve to consider my words more, and to try to use adjectives, descriptions, and metaphors judiciously. I'm sure Ms. Crosby had several courses in creative writing during her college studies. If such courses teach you to write like that, I think I'll pass. If anything else, it made me think that if she can get a book like this published, I could certainly get one published, too.