Published December 2007

Count Your 21st Century Blessings

By Gary M. Goodman (page 88)

Fascinating book on London cholera epidemic should be confirmation on the important role played by modern sanitation professionals.

What reads like a mystery, teaches like a technical paper and to whose true story we as pumpers owe our livelihood? Answer: The Ghost Map: The Story of London’s Most Terrifying Epidemic — and How It Changed Science, Cities, and the Modern World, by Steven Johnson (2006/ Riverhead Books).

It is difficult to imagine what life was like 150 years ago, especially in an area 30 miles in circumference housing over 2 million people. Livestock and families lived under the same roof, the air constantly smelled of rotting garbage and manure, and humans were dying by the hundreds daily from unknown causes.

This wasn’t some Third World country; it was London, the modern, progressive and largest city on earth, hub of world trade and birthplace of the industrial revolution. And the conditions were ripe for the worst cholera epidemic in history.

Two Londoners, one a reclusive surgeon and the other an amiable minister, collaborated to find the common link to a rapid death from “rice water disease,’’ which was caused by contaminated water from the unseen V. cholera microbe (microscopes were just being invented). It would take another 10 years before their theory was proven correct, and 20 years before municipal sewers were constructed. But they were the founders of our modern sanitation industry, and to whom mankind owes a great debt.

I highly recommend reading The Ghost Map to my fellow liquid waste industry professionals.

Gary M. Goodman is president of SepticPROS, Prineville, Ore. He submitted this review as a tribute to the liquid waste hauling industry.

From the Publisher: Science-based page turner explains birth of sanitation

A lethal epidemic breaks out in the largest city of the Western world. Its source is unidentified, and there are no known treatments. Panicked residents shut themselves up in their homes or flee the city, only to carry the contagion elsewhere. It is a nightmare scenario, evoking modern fears of bird flu and biological terrorism.

The most intense outbreak of cholera to strike Victorian London was stopped in its tracks by two brave and brilliant young men who defied conventional wisdom, saved countless lives, and made vital contributions to the fields of epidemiology, city planning, and information management whose implications are still unfolding today.

Steven Johnson, the bestselling author of Everything Bad Is Good for You and Mind Wide Open, chronicles the achievements of Dr. John Snow and the Rev. Henry Whitehead — and explores how the example might lead us to rise to the lethal challenges of our own time — in The Ghost Map: The Story of London’s Most Terrifying Epidemic — and How It Changed Science, Cities, and the Modern World.

Johnson’s tale begins on Aug. 28, 1854, with a sick baby girl in the part of the Soho neighborhood known as Golden Square. Her mother soaks the baby’s diapers in a pail of water, which she dumps in an overflowing cesspool at the front of her house. Just a few feet away is a well called the Broad Street pump that provides drinking water for almost a thousand people. Within a few days, scores are dead and hundreds more are violently ill. London has seen cholera outbreaks before, which have killed upwards of 50,000 people, but none has spread so fast or so virulently.

Snow, a pioneer in anesthesiology, had seen this pattern before. He was certain that cholera spread by water, a theory he advanced at the time of the last great cholera epidemic in 1849. But London’s leading doctors and public health authorities were convinced that it is an airborne disease, caused by the foul air or “miasmas” resulting from the city’s unsanitary conditions.

London at that time was home to 2.4 million people with a primitive sewer system, few toilets, and no central public water supply — a city drowning in its own filth. Johnson makes the case that the battle between man and microbe would determine whether great cities exploding across the industrialized world would remain habitable.

Outbreak traced

Over the course of 10 tense days, Dr. Snow traced the source of the outbreak to the Broad Street pump. He persuaded local officials to close the pump, and the epidemic came to an end. Yet London’s public health authorities remained unconvinced.

Ironically, one of Snow’s original opponents becomes his greatest ally. For days, the Rev. Henry Whitehead watched his parishioners die, and resolved to do everything he could to prevent another outbreak. Although highly skeptical at first of Snow’s theory, he confirms its correctness through relentless legwork and in-depth interviews. Ultimately, Whitehead provides a critical piece of the puzzle by identifying the very first case of cholera in the infant girl.

A few months later, Snow plots the deaths from the epidemic onto a map of London — the “ghost map” — that shows graphically how close they were to the Broad Street pump. The map remains one of the most famous documents in the history of science.

London’s cholera epidemics led to the construction of modern sewer and water systems, which became models for other cities.

According to Johnson, a similar effort will be needed to deal with the enormous challenges posed by the exploding urban centers of the Third World, as well as the looming specters of biological terrorism, avian flu, global warming, and other crises. Nevertheless, he is confident that the world has the means to successfully meet new demands, including recent developments in biomedical research and information technology. In other words, we not only have a rapidly growing arsenal of medical techniques to defeat deadly epidemics, whether natural or manmade, but new ways of detecting them using the Internet and other means. Indeed, Johnson contends that within a few decades, lethal epidemics may well be consigned to history.