I hadn’t really thought about it until someone pointed it out, but those bird-like plague masks aren’t Medieval, they’re early modern. The early modern era ended in 1815.
That was the way Western medicine responded to outbreaks of infectious disease when North America was a shifting patchwork of colonies controlled by France, Britain, and Spain.
Fifty years after that engraving was made, my first relative to arrive in North America (that I know of) arrived in Brooklyn, in a spot marked by a plaque that’s practically under the Verranzano Bridge.
In trying to imagine what it was like before modern medicine, my first vision is one of terror of the unknown. I imagine a population living in terror — stalked by the horrors of infectious disease, minor accidents leading to deadly infections, and untreatable chronic illnesses causing ongoing suffering.
I imagine they were aware of how helpless they were when it came to the treatment of illness. I imagine the shock and awe of witnesses to miraculous healings performed by saints.
However, as Quackery: A Brief History of the Worst Ways to Cure Everything taught me, that’s not how it seemed at the time.
How much have things changed in the past 299 years?
The actuarial tables documented in The Price for Their Pound of Flesh demonstrate that life did not seem like an endless, unpredictable gauntlet of cruelties. No matter how extreme the horrors and suffering, life was no less predictable than it is today.
I keep thinking about what we have in common with the homo sapiens who have lived before us. From the point when our ancestors reached the density sufficient for epidemic diseases until around 50 years ago, everyone who lived did so with cycles of epidemic disease.
Not that they ever actually stopped, but for a few decades Western medicine declared itself triumphant over them.
Concepts like the number needed to treat hint at the idea that we’re still guessing more often than not.
There was an article in The New York Times (and a paywall free version in People) suggesting that the 1918 flu pandemic and the novel coronavirus pandemic are following similar trajectories, despite the facts that in 1918 there were no antibiotics to treat secondary infections like pnemonia and IV rehydration wasn’t widespread.
In 1918 they attributed influenza to a bacteria. They tested for this bacteria and misattributed influenza outbreaks to cholera, typhoid, and other infections that seem, to me, very obviously different from the flu. They created and distributed a vaccine for this bacteria as a miracle cure.
People did all sorts of things to prevent and treat the flu. Scientists and historians still debate what worked and what didn’t, because we just don’t know.
I find it comforting to realize how little control any of us have. One of the nicest things about spending time in the Rockies was the ever present reminder that the world is so much bigger than any of us. Looming over every suburban street are huge hunks of rock, pieces of the Earth’s mantle jutting up, remnants of a great act of violence…or majesty.
Sure, there are plenty of people racing up to the peak of every mountain to pose for photos as if they’ve conquered the mountain.
The rescue helicopters whirring above me and the roads knocked out by landslides suggest the mountains remain unconquered, even a short distance from downtown.
I think of the kneejerk, accusatory response people have to hearing someone’s been diagnosed with lung cancer — “Did they smoke?”
I think of my parents’ friends who got laid off right before they were eligible for retirement. Who did all the right things and still didn’t get the pension and security they worked so hard for.
I think of the story of a 19th century housewife who took every possible precaution to protect her family from cholera, told in The Gospel of Germs, and still died of it.
We want life to make sense. We want life to be within our control.
I’m happy to wear a mask, to wash my hands, to follow the rest of the guidelines. My circumstances make this easy, so I’m saved the conundrums many of you face.
But I wear my mask knowing that it adjusts my risk factors and the likelihood of my potentially spreading the virus.
We’re all actuaries now, calculating the risk factors for every potential action. Actuarial tables are accurate only when you zoom out so that individual lives transform into statistics.