The Ghost Map: The Story of London's Most Terrifying Epidemic - and How It Changed Science, Cities, and the Modern World

This is how great intellectual breakthroughs usually happen in practice. It is rarely the isolated genius having a eureka moment alone in the lab. Nor is it merely a question of building on precedent, of standing on the shoulders of giants, in Newton's famous phrase. Great breakthroughs are closer to what happens in a flood plain: a dozen separate tributaries converge, and the rising waters lift the genius high enough that he or she can see around the conceptual obstructions of the age.

How could so many intelligent people be so grievously wrong for such an extended period of time? How could they ignore so much overwhelming evidence that contradicted their most basic theories? These questions, too, deserve their own discipline: the sociology of error.

But epidemics create a kind of history from below: they can be world-changing, but the participants are almost inevitably ordinary folk, following their established routines, not thinking for a second about how their actions will be recorded for posterity.

The first is to embrace—as a matter of philosophy and public policy—the insights of science, in particular the fields that descend from the great Darwinian revolution that began only a matter of years after Snow’s death: genetics, evolutionary theory, environmental science. Our safety depends on being able to predict the evolutionary path that viruses and bacteria will take in the coming decades, just as safety in Snow’s day depended on the rational application of the scientific method to public-health matters. Superstition, then and now, is not just a threat to the truth. It’s also a threat to national security.

But Engels and Dickens suggested a new twist: that the advance of civilization produced barbarity as an unavoidable waste product, as essential to its metabolism as the gleaming spires and cultivated thought of polite society. The barbarians weren’t storming the gates.

The history of knowledge conventionally focuses on breakthrough ideas and conceptual leaps. But the blind spots on the map, the dark continents of error and prejudice, carry their own mystery as well. How could so many intelligent people be so grievously wrong for such an extended period of time? How could they ignore so much overwhelming evidence that contradicted their most basic theories? These questions, too, deserve their own discipline—the sociology of error.

Superstition, then and now, is not just a threat to the truth. It’s also a threat to national security.

As Lynn Margulis writes: “All the world’s bacteria essentially have access to a single gene pool and hence to the adaptive mechanisms of the entire bacterial kingdom. The speed of recombination over that of mutation is superior: it could take eukaryotic organisms a million years to adjust to a change on a worldwide scale that bacteria can accommodate in a few years.

Over generations, the gene pool of the first farmers became increasingly dominated by individuals who could drink beer on a regular basis. Most of the world’s population today is made up of descendants of those early beer drinkers, and we have largely inherited their genetic tolerance for alcohol.

Broad Street marked the first time in history when a reasonable person might have surveyed the state of urban life and come to the conclusion that cities would someday become great conquerers of disease. Until then, it looked like a losing battle all the way.

All nucleated organisms generate excess calcium as a waste product. Since at least the Cambrian times, organisms have accumulated those calcium reserves, and put them to good use: building shells, teeth, skeletons. Your ability to walk upright is due to evolution’s knack for recycling its toxic waste.

Right now we’re in an arms race with the microbes, because, effectively, we’re operating on the same scale that they are. The viruses are both our enemy and our arms manufacturer.

The timing of Thomas Lewis’ illness suggests one chilling alternative history. The Broad Street outbreak had subsided in part because the only viable route between the well and the neighborhood’s small intestines had run through the cesspool at 40 Broad. When baby Lewis died, the connection had died with it. But when her husband fell ill, Sarah Lewis began emptying the buckets of soiled water in the cesspool all over again. If Snow had not persuaded the Board of Governors to remove the handle when he did, the disease might have torn through the neighborhood all over again, the well water restocked with a fresh supply of V. cholerae. And so Snow’s intervention did not just help bring the outbreak to a close. It also prevented a second attack.

In the long run, the map was a triumph of marketing as much as empirical science. It helped a good idea find a wide audience.

DR. JOHN SNOW—This well-known physician died at noon on the 16th instant, at his house in Sackville-street, from an attack of apoplexy. His researches on chloroform and other anaesthetics were appreciated by the profession.

The contamination of drinking water in dense urban settlements did not merely affect the number of V. cholerae circulating through the small intestines of mankind. It also greatly increased the lethality of the bacteria. This is an evolutionary principle that has long been observed in populations of disease-spreading microbes. Bacteria and viruses evolve at much faster rates than humans do, for several reasons. For one, bacterial life cycles are incredibly fast: a single bacterium can produce a million offspring in a matter of hours. Each new generation opens up new possibilities for genetic innovation, either by new combinations of existing genes or by random mutations. Human genetic change is several orders of magnitude slower; we have to go through a whole fifteen-year process of maturation before we can even think about passing our genes to a new generation.

Dense urban environments may do away with nature altogether—there are many vibrantly healthy neighborhoods in Paris or Manhattan that lack even a single tree—but they also perform the crucial service of reducing mankind’s environmental footprint. Compare the sewage system of a midsized city like Portland, Oregon, with the kind of waste management resources that would be required to support the same population dispersed across the countryside. Portland’s 500,000 inhabitants require two sewage treatment plants, connected by 2,000 miles of pipes. A rural population would require more than 100,000 septic tanks, and 7,000 miles of pipe. The rural waste system would be several times more expensive than the urban version.

as the historian Tom Standage observes, they were “among the first to recognize the importance of trademarks and advertising, of slogans, logos…. Since the remedies themselves usually cost very little to make, it made sense to spend money on marketing.

There’s a reason why the world’s wealthiest people—people with near-infinite options vis-à-vis the choice of where to make their home—consistently choose to live in the densest areas on the planet. Ultimately, they live in these spaces for the same reason that the squatter classes of São Paulo do: because cities are where the action is. Cities are centers of opportunity, tolerance, wealth creation, social networking, health, population control, and creativity.

The wealthiest cities of the world will follow Venice’s lead and simply try to engineer their way around the problem. The poorest cities will follow New Orleans’ lead—at least so far—and just move to other nearby cities. Either way the poplation stays urban.

In other words, a serious crisis of nonrenewable energy resources is likely to accelerate the urbanization trend, not derail it.

And so this is why the whole world has suddenly taken an interest in whether Thai poultry workers get their flu shots: because the world wants to ensure that H5N1 stays as far away as possible from ordinary flu viruses.

Cities were suddenly populated by a class of consumers, free to worry about other pressing matters: new technologies, new modes of commerce, politics, professional sports, celebrity gossip. That

And of course, if they do recognize that they are living through a historical crisis, it’s often too late—because, like it or not, the primary way that ordinary people create this distinct genre of history is by dying.

This is not mere sentimentality. The triumph of twentieth-century metropolitan life is, in a real sense, the triumph of one image over the other: the dark ritual of deadly epidemics replaced by the convivial exchanges of strangers from different backgrounds sharing ideas on the sidewalk.

2Do not mistake these multiple trends--the energy flows of metropolitan growth, the new taste for tea, the nascent, half-formed awareness of mass behavior--for mere historical background. The clash of microbe and man that played out on Broad Street for ten days in 1854 was itself partly a consequence of each of these trends, though the chains of cause and effect played out on different scales of experience, both temporal and spatial. You can tell the story of the Broad Street outbreak on the scale of a few human human lives, people drinking water from the a pump, getting sick and dying over a few weeks, but in telling the story that way, you limit its perspective, limits its ability to convey a fair account of what really happened. Once you get to the why, the story has to widen and tighten at the same time: to the long duree of urban development, or the microscopic tight focus of bacterial life cycles, These are causes, too.

It is a great testimony to the connectedness of life on earth that the fates of the largest and the tiniest life should be so closely dependent on each other.

And so it was with the Broad Street well that the decision to remove the pump handle turned out to be more significant than the short-term effects of that decision [Cholera outbreak abated.] . . . .But the pump handle stands for more than that local redemption. It marks a turning point in the battle between urban man and V. cholerae, because for the first time a public institution had made an informed intervention into a cholera outbreak based on a scientifically sound theory of the disease. . . . For the first time, the V. cholerae's growing dominion over the city would be challenged by reason, not superstition.

Early risers strolling along the Thames would see the toshers wading through the muck of low tide, dressed almost comically in flowing velveteen coats, their oversized pockets filled with stray bits of copper recovered from the water’s edge. The toshers walked with a lantern strapped to their chest to help them see in the predawn gloom, and carried an eight-foot-long pole that they used to test the ground in front of them, and to pull themselves out when they stumbled into a quagmire. The pole and the eerie glow of the lantern through the robes gave them the look of ragged wizards, scouring the foul river’s edge for magic coins.

If we're going to survive as a planet with more than 6 billion people without destroying the complex balance of our natural ecosystems, the best way to do it is to crowd as many of those humans into metropolitan spaces and return the rest of the planet to Mother Nature.