There's a difference between being quarantined and being ordered — in New York State, these days, that amounts to being asked, really — to stay at home to slow the spread of disease.
One is an involuntary loss of freedom, with forced confinement to one place and one place only. The other, comparatively, is a disruption that, as months drag by during this COVID-19 pandemic, becomes harder and harder to accept.
The saga of Mary Mallon, who became known as Typhoid Mary, illustrates the difference between quarantine and a stay-at-home order.
Although the circumstances are wildly different, we, like Mallon, are caught up in an iteration of that same conflict between public health and individual rights.
Mallon was an asymptomatic carrier of the bacteria that spread typhoid fever.
"She was really a brand new idea, as well as a reality at that time," said Judith Walzer Leavitt, professor emerita at the University of Wisconsin and an expert in medical history, the history of science and gender and women's studies.
"She was healthy, she didn't show any signs of the disease, and of course, at that time, the only understanding of disease was transmission through germs of someone who was sick, giving it to someone who wasn't sick," Leavitt said in a telephone interview.
Mallon, to the day she died. never accepted the fact that she could pass disease onto others.
The popular version of her story begins in Oyster Bay, in 1906, when she worked in a home that a New York City banker, Charles Henry Warren, had rented for the summer.
When six in the household of 11 family members and servants came down with typhoid fever, the home's New York City owners — worried that the outbreak could impact future rentals — hired an investigator.
That investigator ultimately tagged Mallon as a carrier, after tracking typhoid fever outbreaks to other households where she had worked.
At one point, he located Mallon, telling her she was spreading disease and death and demanding that she provide blood, urine and fecal samples.
She tossed him out of the house where she was working.
When the investigator returned a second time, with New York City's health inspector, Mallon was arrested by police and forced to provide samples for lab analysis.
When the analysis came back positive, Mallon, then in her late 30s, was placed in health department custody and, in 1907, moved to an isolation cottage of a hospital located on an island in the East River.
She stayed there for three years, until, under a new health official, she was released — on the condition that she never work as a cook again.
But Mallon, under an alias, ultimately found work as a cook — which paid more than other household jobs — in a maternity hospital, where an outbreak of 25 new typhoid fever cases occurred.
With that, she was arrested again, and ordered back to North Brother Island, now a bird sanctuary located near Rikers Island, where she lived out the rest of her life.
"Before God, and in the eyes of decent men, my name is Mary Mallon," she was quoted as saying, when her case made tabloid headlines, "I lived a decent and upright life until I was seized, locked up … and re-christened Typhoid Mary."
Leavitt spent 10 years researching Mallon's story for her 1996 book, "Typhoid Mary, Captive to the Public's Health." Early on, Leavitt raises a question: "How far have Americans been willing to go to protect the public's health?"
In Mallon's case, officials went so far as to quarantine the Irish immigrant, a formidable woman who had zero compunction about standing up for her rights. As Leavitt notes, Mallon not only wasn't the sole carrier of the disease — but she alone ended up being defined, and so publicly vilified, for it.
"The more I learned about her, and what happened to her, the more I understood it as an individual tragedy, from her standpoint, of being snatched from her life and being put on an island of loneliness," Leavitt said.
Why did Mallon go back to cooking after she was found to be a carrier of the disease, which also spread through unsanitary water systems?
"I don't think she was being resistant; I think that in all of that time, Mary truly never believed that she was sick," Leavitt said.
Today, Leavitt sees the same tension between public health and individual rights playing out again — just as it did even during the flu pandemic of 1918, and more recently during outbreaks of HIV, SARS and Ebola.
"The length that this country has gone to protect the public health has increased over time, but the bottom line is that we are willing to impinge on people's personal freedom in order to protect the larger society," Leavitt said.
"Public health is a very important value in America, but equally important is individual liberty and our right to freedom, even though those rights get distributed unequally in our society," she said.
One of the many lessons of Mallon's story is, "we have to get away from the notion that those who are sick are somehow deserving of being sick, that some people are more expendable than others," Leavitt said.
Mallon lived during a golden age for the science of bacteriology, Leavitt writes. The knowledge gained during that time impacted public health policy, which, in turn, led to the construction of sanitary water systems in much of the nation.
Like many of us, Leavitt, 79, is keeping close to home these days.
"I think that on some level, I understood that what we're now experiencing could happen at this scale," she said. "But on the other hand, it is hard to live through something that I had really experienced only in theory."
With that, she feels for Mallon.
"It's understanding how it feels not to see your family, not to be able to talk to people that you know," said Leavitt. "At a personal level, I hadn't experienced that before."