Get Well Soon: History's Worst Plagues and the Heroes Who Fought Them

by Jennifer Wright

It does appear that we are living in a world where the word plague has shockingly little meaning for many.

Even now...

If conditions continue uninterrupted. We have been living in an age of improbable luck. We have experienced nearly thirty years without a disease—that we do not know how to combat—killing upward of thousands of otherwise healthy young people in those core countries.

The book feels prophetic.

Because when plagues erupt, some people behave amazingly well. They minimize the level of death and destruction around them. They are kind. They are courageous. They showcase the best of our nature. Other people behave like superstitious lunatics and add to the death toll.

Whether a civilization fares well during a crisis has a great deal to do with how the ordinary, nonscientist citizen responds.

The past does not exist under a bell jar. Moments, ideas, and tragedies of the past bleed into the present.

If moments from the past seep so seamlessly into the present, maybe moments from the present can help us relate to the past. After all, the past was no less ridiculous than the present. Both eras were made up of humans.

They had no idea they were living in the past. They all thought they were living in the present.

Knowing about pop culture doesn’t make you dumb; it makes you a person who is interested in the world you live in.

I feel validated!

I’m invested in this study of diseases because I think knowing how diseases have been combatted in the past will be helpful in the future. If you’re someone who intends on living into the future, I hope you will be, too.

The beginning of the final days of Rome wasn’t caused by heartwarming weddings between gay people. It began with a plague that erupted in the 160s. At that very time Romans were at the height of their power and their massive empire stretched from Scotland to Syria.

Ding! Ding! Ding!

pretending any historical age before proper indoor plumbing was a glorious epoch is a ludicrous delusion.

Agreed

Today, the Plague of Athens is usually thought to have been bubonic plague or possibly the ebola virus, whereas modern physicians suspect the Antonine plague was smallpox.

There’s debate today over whether the plague that led to Rome’s fall was typhus or measles or smallpox. I am on Team Smallpox!

“Even if we split the difference between the most impressive scholarly studies, we can’t get lower than a total mortality of 10 million.”

The philosophy is beautifully summarized by Marcus Aurelius in his Meditations: “Say to yourself in the early morning: I shall meet today inquisitive, ungrateful, violent, treacherous, envious, uncharitable men. All of these things have come upon them through ignorance of real good and ill. But, because I have seen the nature of what is good and right, I can neither be harmed by any of them, for no man will involve me in wrong, nor can I be angry with my kinsman or hate him; for we have come into the world to work together.”12 Stoics attempted to be guided by logic and reason rather than fleeting worldly pleasures. The practice of Stoicism supposedly allowed people to lead more peaceful, rational lives.

on the whole, Stoicism is straightforward and sensible, and the philosophy was popular. Certainly, it seems like it would be extremely useful in crisis situations. I like to think that, across the ages, the Roman people considered this endorsement of Stoicism, collectively shook their heads, and responded, “Nah.” As soon as the plague broke out, the population almost immediately abandoned calm, rational Stoicism in favor of believing in magic and killing Christians.

Society’s need for “bread and circuses” doesn’t go on hold when a plague surfaces. If anything, in uncertain and terrifying times people want more entertainment that allows them to escape reality.

Movies. Netflix. Sports.

So the Romans won in the end. But the Germanic tribes, by capturing hundreds of thousands of Romans and crossing the Danube, had dealt a decisive blow to any notion of Roman invulnerability, which was vital to the people of ancient Rome.

The first lesson of this book is that plagues don’t just affect a population’s health. If they are not quickly defeated by medicine, any significant outbreak of disease sends horrible ripples through every aspect of society.

Prince changed his name because of a contract dispute. Commodus changed his name because his brain was full of dumb ideas and positive reinforcement.

Thus the curtain rose on the Dark Ages, now euphemistically called the “Early Middle Ages” (which seems a lot like calling a mass unmarked grave an “early flower garden”).

The plague would kill somewhere between 20 and 50 million people in the fourteenth century, or approximately 30 percent of Europe’s population.

If you do a quick Google search on this topic, you will find that some hateful people still believe—today!—that the bubonic plague was deliberately spread by Jews poisoning wells. That rumor, though medically implausible, is apparently sufficiently compelling to continue to appeal to poorly informed people. So it is horrifying but not wholly unexpected that in February 1349, nine hundred Jews were burned to death in Strasbourg. A chronicler wrote: “They were led to their own cemetery into a house prepared for their burning and on their way were stripped naked by the crowd which ripped off their clothes.”12 In the same year, in Mainz, six thousand Jews were supposed to have been killed on a single day, and over twenty thousand were murdered in total.

Insane. But anti-semitism took many forms. At what point will witches be blamed?

Boccaccio’s novel The Decameron, which takes place in 1349, begins with a group of aristocrats bolting to the country to escape the plague. They do so not only “to preserve their lives” from the plague but to protect themselves from those given over to bestial behavior.

John Kelly explains the psychology of plague times in modern-day terms: “In plague, fear acts as a solvent on human relationships; it makes everyone an enemy and everyone an isolate. In plague every man becomes an island—a small, haunted island of suspicion, fear, and despair.”

Like Big Bird, but slightly less creepy

Masks to prevent droplets. And filled with orange peels, so they would treat patients, since they would not smell decay. Robes protect from fleas and pus. Staff for social distancing. This is not a bad idea at all. Though probably not around until after 1619. Maybe we should bring this back?

I am only eager to dispel the notion that Nostradamus was an otherworldly wizard because I think it overshadows the fact that he was a learned and progressive man, and those skills are as valuable as wizardry. They’re also skills humans can actually cultivate. His powers didn’t come from the heavens; they came from the fact that he was an avid reader, interested in the scientific advances of his own time, as well as the medical arts of the past.

But the bubonic plague never went away entirely. It still exists today. The World Health Organization reports that in 2013 there were 783 cases worldwide; 126 people died.35 About ten people contract the disease in the United States every year.

Regardless of the age we’re living in, many of us expect illnesses to be cured within our lifetimes. Sadly, that is not often the case. Nevertheless, we can take some heart. Practically no one dies of bubonic plague now. It was one of the human race’s most terrifying adversaries for many years, and we beat it, first with a bar of soap in the sixteenth century and then with antibiotics in the twentieth. Villani might hear that news and say, in a crotchety fashion, “Well, that’s no good to me, I’m dead.” Not everyone lives to see the end of a battle.

The Reverend in Footloose was right: Dancing kills.

Whenever someone begins pompously complaining that civilization is on a downhill slide, because people participate in harmless behaviors like taking selfies or watching reality television, a good response is to stare at them and respond, “You know, we used to burn people for being witches. That’s what people used to do in their spare time.”

Okay, the treatment worked because the problem was likely largely the result of a psychological disorder. But as much as their faith in the power of St. Vitus might have cured the dancers, it seems equally valid to say that the sufferers were—wait for it—cured by the power of friendship. Seriously. The people of Strasbourg were exceedingly, abnormally kind to those afflicted.

But it is rare, even today, that people suffering from diseases aren’t demonized. The U.S. government sponsors antismoking ads, which often imply that smokers deserve to get lung cancer because they didn’t quit smoking rather than putting those funds toward researching a cure for lung cancer, the actual enemy. Response to the AIDS crisis was delayed at least in part because those suffering were viewed by some as sinners. Clearly, those diseases take more than human kindness to cure, but there is never a situation where care and attentiveness by the community is a bad thing.

It’s perfectly possible to be smarter than everyone else and still be polite and even deferential—women have been doing it for centuries. Often people need the most tenderness when they are ill. Sometimes people actually need kindness to get well. Human kindness counts.

But if your definition of a big deal is the total destruction of a civilization, here is a plague for you. After being exposed to smallpox, the Aztec and Incan societies were devastated almost instantly. One year they were among the greatest civilizations in the world. The next year they basically didn’t exist.

Once again: Having a brilliant, beloved leader at the helm of a country when the land is in turmoil is one of the best situations people can hope for. That becomes apparent when that leader is dead.

Today, it’s estimated that smallpox killed around 90 percent of the native people of the Americas.16

But those surviving the disease developed immunity, and a small degree of immunity could be passed down through parents. Smallpox is thought to have originated with farm animals—especially cattle, but also horses and sheep—and then crossed species to infect humans. Europeans had a great deal of contact with those animals, whereas the Inca and Aztec people had none.

The devastation of smallpox in the Americas was not due to a vengeful God or a mysterious man bearing an evil box, but rather to the fact that Amerindians did not spend as much quality time with their domesticated llamas as Europeans did with their cows.

Isobel Grundy, Lady Mary Montagu’s biographer, notes, “Smallpox discourse was gendered, referring to men it spoke of the danger to life, referring to women, of the danger to beauty.”

A line in the 1696 play Love’s Last Shift reads: “I take more pains to preserve a public reputation / than any lady took after the Smallpox to recover her complexion.”30

Jenner called the technique vaccination, as vacca was the Latin word for “cow.” Cowpox vaccination was superior to smallpox variolation in that the vaccine from the less dangerous cowpox disease didn’t kill anybody but still provided immunity. This was the first building block on the road to safe vaccines, which have since been developed for many life-threatening diseases. Polio. Measles. Meningitis. Diphtheria. We’ve triumphed over them all.

Today you may have heard from a vocal minority of people who do not believe in vaccination. Many of those people distrust vaccines because in 1998 a gastroenterologist named Andrew Wakefield published a paper in the Lancet claiming there was a link between children receiving the vaccine for measles, mumps, and rubella (MMR) and children developing autism. Wakefield was a fraud. In 2010 he was stripped of his medical license. He was found to have conducted unethical experiments and accepted hundreds of thousands of dollars from lawyers attempting to sue the makers of MMR vaccines.34 Wakefield was also attempting to create a new measles vaccine and would have profited handsomely if the MMR vaccine was discredited. He preyed upon people’s fears and their concern for their children in order to obtain personal advantage. After an investigation by the intrepid Sunday Times journalist Brian Deer, it was found that the medical histories of all twelve children in Wakefield’s study had been misrepresented.35 In 2010 the editor of the Lancet issued the following retraction: “it was utterly clear, without any ambiguity at all, that the statements in the paper were utterly false.”

And for those who think, for instance, measles, which we vaccinate against, is an antiquated disease they don’t need to worry about, according to the World Health Organization it still kills nearly 115,000 people a year globally.

Think of what it might have been like when 30 to 90 percent of your friends and family died, because that was the world before vaccines. Ask the Aztecs and Incas whether or not they would have liked to have vaccines available to them. Oh, wait, you can’t, they’re dead. Vaccination is one of the best things that has happened to civilization. Empires toppled like sandcastles in the wake of diseases we do not give a second thought to today. If taking a moment to elaborate on that point will make this book unpopular with a large group of antivaxxers, that’s okay. This feels like a good hill to die on. It’s surely a better one than the Incas got.

The initial outbreak is estimated to have killed over one million Europeans,

The fact that we may never know how widespread the disease actually was has a lot to do with the reluctance of sufferers to admit they had syphilis or to suggest others had it. Claims about how many people and specifically which individuals had syphilis are still controversial.

Lincoln? Really?!

The neurologist Sigmund Freud suspected the mania of syphilis could have benefited Nietzsche’s work. Freud remarked: “It is the loosening process resulting from the paresis [syphilis-induced inflammation of the brain] that gave him the capacity for the quite extraordinary achievement of seeing through all layers and recognizing the instincts at the very base. In that way, he placed his paretic disposition at the service of science.”7

Silver linings we attribute to diseases—whether those linings are that syphilitics have moments of manic genius, or tuberculosis sufferers become angelically beautiful, or people with Alzheimer’s learn to live in the moment—are total bullshit. They do not lessen the horrors of the disease for anyone suffering from it. Instead they demean the very real suffering of victims and can make society less motivated to find a cure.

This is true of all illnesses.

The term mad hatters comes from the fact that nineteenth-century hat makers were often exposed to and indeed went mad from mercury fumes.