I think I was 12 when I encountered Berton Roueché. I encountered his work (considerably abridged) in the science-class version of My Weekly Reader that we received in 7th grade science. Rather than listen to the class (because who does that in 7th grade?) I read an article about a family whose members, after dinner, showed up at the local hospital with a range of frightening symptoms: blurred vision, hemispheric paralysis of the face, increasing trouble breathing, paralysis and–in a couple of cases–death. A sudden onslaught of something like this causes public health officials to sit up and take notice (as they did) lest this be a contagion and only the tip of the iceburg. In the end, they determined that home-canned mushrooms (with a ride-along by botulism) had been the culprit.* The fact that I remember this 58 years later gives you an idea of the impact the article had on me.
From 1946 Roueché began a column for The New Yorker: Annals of Medicine. Each column featured a medical mystery: what made that family so sick that several of them died? How did eleven homeless men turn up in hospitals all over New York City all in the same week, all horribly sick, and all sky blue? How did an HVAC technician who never went near livestock come down with anthrax?
These mysteries and many others were solved by public health officials, doctors who combined the shoe leather and deduction of Hollywood gumshoes with science. And because the series started in the 1940s, in the movie in my head the doctors all look like a combination of Robert Mitchum and Richard Widmark, hats pushed back on their heads, ties askew, sleeves rolled up, bent over typewriters or medical records, working to solve mysteries and make sure that threats to the public are contained.
For example (and I’m working from memory here) there’s a case where a few people from different neighborhoods in Manhattan show up with typhoid. Typhoid is borne by fecal contamination–usually from apparently healthy people who don’t know they’re carriers (or a few who do: Typhoid Mary Mallon was a carrier, working as a cook. Her employers kept getting sick and Mary kept moving on from one household to another, until finally she was identified as the source. She refused to believe it, continued to work as a cook–even attacking the doctors who went to talk to her–and finally she was forcibly quarantined as a menace to public health. Mary Mallon is a whole post on her own). Because of the way typhoid is communicated, you don’t generally see one case here, one case there, with no apparent link between them. After a lot of shoe leather and asking questions the public health officials determined what had happened: a known carrier (blameless) lived in a building with bad plumbing. There was a fruit and vegetable stand on the first floor. Pipes leaked just enough so that a few apples were contaminated. People from the neighborhood–and in one case from far outside the neighborhood–bought an apple and came down with typhoid. The canvassing and legwork and deduction this took is both mind-boggling and inspiring.
Aside from the fascination of these stories (some of which were used, decades later, as the source for episodes of House M.D.) and a healthy regard for proper hand-washing, safety equipment, and home canning protocol, Berton Roueché’s essays inspired in me a life-long admiration for the professionals who work in public health. The first answer isn’t always right: as a matter of fact, I can recall at least one essay where the doctor telling the story admits that he thought he was pretty smart about figuring something out–only to realize that he hadn’t in fact figured it out at all, and had to go back to the beginning. That, I realized (sitting there in 7th grade science class) is what science is: looking for answers and, if a promising one doesn’t work, looking for the one that will solve the mystery.
A couple of years ago, as you may recall, Public Health officials had a moment in the sun–immediately followed by a lot of abuse from people who didn’t like the news they were giving. Representatives of the CDC and other Public Health organizations made mis-steps–largely because in the first year or so of the pandemic there were others breathing down their backs insisting that the news they give be Happy! News! that would distract people from body bags and long COVID. Even so, doctors and scientists and technicians were working the problem, using tools much more sophisticated than those used by the scientists Roueché wrote about. But the impulse, the chore, was the same: to solve the problem, to limit the damage, to make sure that the health of the public is being safeguarded.
What’s not to love?
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* You can bet that, among other things, my home canning protocol since then has been as spotless as I can make it.
Well, botulism was the obvious answer for the first case, but what was it that turned all those men sky blue?
Lemme see if I can remember the details: All eleven of them had been eating breakfast at a low-rent Bowery chophouse. This was just after WW II, when saltpeter, used for pickling (sodium nitrate), was replaced with a short term substitute (sodium nitrite, which is toxic). The restaurant had a big canister of sodium nitrite in the kitchen, and one day the canister was swapped with the canister of standard salt (sodium chloride), and the day’s batch of oatmeal (5 gallons worth) was prepared with the sodium nitrite. Even then, the amount of sodium nitrite would have been just below toxic level… except that a couple of the salt cellars on the tables had also been filled with sodium nitrite. And because the eleven homeless guys were alcoholics with diminished taste, they added additional salt to their oatmeal, pushing it well over the toxicity level.
One of the symptoms of sodium nitrite poisoning turns out to be bluish color in the lips and skin. And because of their alcoholism and general debilitation these men became very sick–it wasn’t just a bluish tint to the skin, but serious blueness all over.
See why I love this stuff?
It is fascinating.
Nitrate/nitrite? What difference could a single letter make? Ha!