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

by Jennifer Wright

Whether a civilization fares well during a crisis has a great deal to do with how the ordinary, nonscientist citizen responds. A lot of the measures taken against the plagues discussed in this book will seem stunningly obvious. You should not, for instance, decide diseased people are sinners and burn them at a literal or metaphorical stake, because it is both morally monstrous and entirely ineffective. Everyone would probably theoretically agree with this statement. But then a new plague crops up, and we make precisely the same mistakes we should have learned from three hundred years ago.

One of my great wishes is that people of the present will see those of the past as friendly (or irritating) acquaintances they can look to for advice.

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

When you arise in the morning, think of what a precious privilege it is to be alive—to breathe, to think, to enjoy, to love. —MARCUS AURELIUS

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

Although Galen was a great physician, he was not a terribly courageous man. Galen was a self-promoter above anything else. According to McLynn, he consistently claimed to be a self-made man, casually downplaying the fact that he came from an extremely wealthy family and had inherited numerous estates as well as a stellar list of contacts. He employed underhanded tactics to win debates, and he constantly aggrandized his own achievements. Personality-wise, you could think of him as the Donald Trump of ancient Rome. He was also something of a coward when it came to disease. Now, I don’t think cowardice is an abnormal reaction in life-or-death situations; it can be very similar to intelligent self-preservation. I fully expect that I would be weak and spineless in a plague. However, it’s not a great trait in a physician.

Before 1600, people would have difficulty differentiating any type of disease from another; any quickly spreading epidemic would simply be referred to as a plague.

In almost every plague throughout history, it takes a remarkably strong leader just to keep the bodies out of the streets.

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

Alexander became rich and famous. Of course he did. Charlatans preying upon people’s fear with false hope during plague times often do. (This is the “career advice for sociopaths” portion of the book.)

I have never in my research found an instance where a historian says, “Wow, we were on the right side of history for torturing Group X back then.”

Marcus Aurelius responded to the plague with the kind of calm collection I think all of us should strive for while, say, on the phone with Time Warner Cable. He immediately busied himself signing new laws to keep the city livable. For instance, he forbade people from turning their villas into giant tombs. He excused anyone from a court summons who had a funeral to attend, and common people who died of the plague were given burials at the public’s expense. A law was passed that you could not dig up bodies to use their graves for your own dead, which was apparently common enough to require legislation. All these laws were important, as undertakers were charging outrageous prices for the citizens’ increasing need for burials, and, again, the main responsibility of a plague-time ruler is to stop bodies piling up in the streets. (Both because it’s unsanitary and because it causes people to panic.)

Economic problems also loomed. The plague meant that expenses for the military kept increasing; some units required two times as many recruits as they had in the past. Meanwhile, the plague also caused significantly less governmental income to come in from estates, because if your populace is crippled by disease no one’s number one priority is making sure that their vineyards are superprofitable. The empire was forced into debt. Marcus Aurelius, in a surprising move, began selling off his imperial property in the Forum of Trajan. According to the fourth-century historian Eutropius, the emperor held an auction in the Forum of the Deified Trajan of imperial furnishings, and sold gold, crystal, and myrrhine drinking vessels, even royal vases, his wife’s silk and gold-embroidered clothing, even certain jewels … the sale went on for two months and such a quantity of gold was acquired that after he had carried through the remainder of the Marcomannic war in accordance with his intentions, he gave permission to buyers to return their purchases and get their money back, if they wanted. He did not cause trouble to anyone, whether he returned what he had bought or not.15 I can’t quite believe a ruler financed a war by having a crazy yard sale, but ancient Rome is surprising in many ways.

Sensible rulers like Marcus Aurelius are without doubt a godsend in times of plague. Rome was fortunate to be led by a man who was able to respond calmly to each crisis with a rational—if sometimes unexpected—solution. People speak often about Marcus Aurelius’s philosophical genius, his sense of morality, and his all-around greatness, and I’m sure all of that is true, but on a practical level the man was just an excellent problem solver.

When we are electing government officials, it is not stupid to ask yourself, “If a plague broke out, do I think this person could navigate the country through those times, on a spiritual level, but also on a pragmatic one? Would they be able to calmly solve one problem, and then another one, and then the next one? Or would bodies pile up in the streets?” Certainly, it would be better than asking yourself if you would enjoy drinking a beer with them.

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.

The takeaway from this story is that there is really only one thing we should collectively fear ending civilizations. It’s not licentious behavior. If the biggest problem in your civilization is people having sex, you are doing great. It isn’t even necessarily other countries attacking you because they hate you and all that you stand for. If you’ve got a big enough army you can fight them off. The real terror is plague. It’s waiting out there, somewhere, under the ice or in a jungle. If it strikes and it can’t be combatted effectively, it can take down an empire.

(Fun fact: you can’t kill someone by finely grinding up glass and mixing it in their food. Either they’d be able to detect it, or it would be too finely ground to kill them. I’m too smart for you, potential murderers who are after my history-book-writing fortune.)

Seemingly, medieval Christians remembered essentially nothing from the horrors of their own persecution in Rome because they did not hesitate to form large mobs and attack Jews.

First, your decision to travel to the plague-ridden fourteenth century is exceedingly ill-advised. I can only assume that in this fantasy you are a reporter for the Vice TV series.

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.

A very good sign that someone is not a charlatan is that they are doubtful of their own skills and do not demand huge sums of money for a magical cure they say only they can provide.

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. If you have been out hiking in a dry area like the American Southwest and find egg-shaped growths developing under your armpit, it is exceedingly important that you go to a doctor within twenty-four hours.

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.

Can human kindness and the support of your community cure disease? Not … generally. You will likely have better luck with antibiotics or vaccines.

And though they might not be as powerful as modern medicine, there is reason to believe that being treated with kindness and receiving the support of the community do help people recover from ailments. At least, they do if it is the sufferers’ state of mind that is affecting their health.

Can we recover from a disease just by knowing that the people in charge want us to get better? Surely, government authorities should always want everyone to be healthy. Even if you assume government officials are all abject sociopaths, having people dying en masse in your town is bad PR. 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.

Would they have preferred to live in a time without the Black Death? Yes. (This is not speculative. I called them all and asked.) But life went on in the face of death.

Between the conquistadores and the Spanish Inquisition, the Spaniards have a strong history of “doing unimaginably terrible stuff” through the sixteenth century.

My favorite story about the Spaniards’ horrific relationship to Amerindians comes from John Campbell’s An Account of the Spanish Settlements in America. In this eighteenth-century report Campbell relays how the Spaniards reached Cuba in the sixteenth century and committed “the most horrid barbarities ever to taint the page of history.” Before burning one native at the stake, a Spanish friar told him “that if he would embrace their religion he would go to heaven, but if not he would burn in hell forever.” The Cuban asked if there were any Spaniards in heaven. The friar responded that there were. The Cuban replied, “If it be so, I would rather be with the devils in hell.”5 Sick burn, Cuban guy. Nicely done—high five through time and space.

If you love thinking in metaphorical terms, you could consider your body as a house and the chicken pox virus as an unpleasant former bandmate who wants to crash in your guest room indefinitely. The smallpox virus, however, is Godzilla. If Godzilla was suddenly inside your house, authorities (your immune system) would probably freak out and might firebomb the whole thing in an attempt to get rid of him. Deadbeat chicken pox is uncomfortable, but authorities aren’t going to do much about it. He (chicken pox) is just going to live there, eating your food, having sex on your couch, and drinking your beer forever. You’ll probably forget he’s there after a while.

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.

Two points: (1) I am not defending Incan human sacrifice just because the feast sounds like fun and (2) a historical YA novel from the perspective of such a doomed teenager would be a very good premise. I will likely not sue you if you steal this idea. I will, however, expect to be invited to the book party, which must be as good as that feast in Cusco.

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

That’s not to say that smallpox wasn’t a scourge in Europe as well; it killed around four hundred thousand people—many of them children—each year in Europe well into the eighteenth century.24 But those surviving the disease developed immunity, and a small degree of immunity could be passed down through parents.

Despite what nineteenth-century romantic paintings would have you believe, a harem was like a sorority house located in hell.

Parents refusing to vaccinate their children are doing something akin to allowing their kids to run about in traffic because they are irrationally afraid of sidewalks or they believe being struck by an oncoming car might be good in the long run. And it’s not only their own children they are putting at risk. If you have children, they’re also putting your children at risk.

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.

Mary Mallon was an asymptomatic carrier of typhoid. Although she carried the bacteria inside her and could transmit it to others, she never suffered any of the symptoms herself. This is as close as someone can get to having a villainous superpower in real life.