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I chose to read “Extraordinary and Even Arbitrary Powers” because I was looking to compare and contrast the dialogue of quarantine and public health policies with my own research. I have been looking into federal and state responses to the Yellow Fever Outbreak in the Mississippi River Valley of 1878 and found striking parallels as well as contrasts between the two.
At Mary Mallon’s time, state and national health boards were still in their early formation stages (more so in the South than the North). But a lot still remained unclear about jurisdiction, funding, and research roles of the boards. It was a time of anxiety in the public health world and policy makers, businessmen, and health officials alike were still sorting out their place in the field. New York’s board, however, as Leavitt writes, had been frontrunner in forming policies since it gained legitimate authority in 1866. She writes, “The local board soon became the nation’s leader in terms of defining municipal programs to promote health and prevent disease, and its accomplishments were adopted as models across the country” (40).
And yet, one of the most established boards in the country couldn’t quite figure out what to do with little Mary Mallon. After the yellow fever outbreak in Memphis, state and federal officials blamed the poor sanitation conditions for the epidemic. However, New York was doing fairly well in that regards. They needed to find another way to take action, so they put Mary Mallon in quarantine? “Why was quarantine the first response of the New York officials instead of last resort?” (47)
John wrote that “Mary Mallon’s capture and subsequent isolation can be viewed as a manifestation of the belief that it was possible for humankind to conquer disease” and I agree with that to a certain extent. However, there was also just a sense that people did not know what to do with her. And this raises a whole host of ethical questions that Leavitt discusses in this chapter, “Was it necessary to restrain even one person’s individual liberty in order to achieve health?” (69) And yet, there are records that officials believed that their capturing of Mallon was reasonable. And while I agree with Molly when she wrote, “The real disaster, was not the outbreak of typhoid, but Mary’s treatment and the public’s reaction to it”, there was no protocol for dealing with cases like silent-carriers. What is our value criteria for dealing with such sensitive subjects like quarantine? Public officials didn’t really have a good rubric back then – and even today we are still having similar discussions about the spread of HIV and tuberculosis. What is “good” quarantine?