The Great Trouble (20 page)

But the words Jake had spoken that morning the Great Trouble began came back to me: “Ain’t we all riverfinders? Put on this earth to try to get by, one day at a time. We’re all we’ve got under this sky. We need to play fair and take care of one another.”

We had done that as best we could: Dr. Snow, Rev. Whitehead, Florrie, and me.

Thumbless Jake. I wondered what would happen to
him. It would be nice to think he could find his way back to Hazel and his children, though somehow I didn’t think so. He’d had such trouble in his life.

But then again, so had all of us that summer when the Great Trouble had come to Broad Street.

And somehow, we had survived.

Many readers ask where I get my ideas. My inspiration often comes from what I read, and that’s certainly true for
The Great Trouble
. Several years ago I came upon a book by Steven Johnson called
The Ghost Map: The Story of London’s Most Terrifying Epidemic—and How It Changed Science, Cities, and the Modern World
.

Replica of the Broad Street pump outside the John Snow, a pub on what is now Broadwick Street, London
Photograph by Deborah Hopkinson

The Ghost Map
tells the true story of Dr. John Snow and the Broad Street cholera epidemic of 1854. While
The
Great Trouble
is historical fiction, the story mirrors the progress of the epidemic during those late-summer days so long ago, when 616 residents died. Some of the action is compressed into fewer days (see the timeline for a summary of actual events), and I’ve given my fictional characters Eel and Florrie major roles in solving the mystery.

The real Dr. Snow created the now-famous map that revealed that deaths from cholera, sometimes called the blue death, were clustered around the Broad Street pump. By interviewing residents (including the sons of Susannah Eley, who died in her home several miles away after drinking the water), Dr. Snow was able to demonstrate a link between drinking from the Broad Street well and getting the disease.

Thanks to Dr. Snow’s testimony at the committee meeting on September 7, the pump handle was removed on September 8. In his book, Steven Johnson calls that day “a turning point”—an important moment in the history of public health, when action was taken to protect citizens based on scientific theory.

The investigations didn’t stop then. Later that fall, Dr. Snow and Rev. Henry Whitehead were asked to join the St. James Cholera Inquiry Committee to continue to study the epidemic. Rev. Whitehead, who had no medical training, disagreed with Dr. Snow’s theory at first. But as he talked to families, he became convinced that Dr. Snow was right.

It was also Henry Whitehead who discovered that baby
Frances (Fanny) Lewis was the index case that started the epidemic. This led to an excavation of the cesspool at 40 Broad Street in the spring of 1855. In his report of May 1, the surveyor, Jehoshaphat York, noted that the bricks lining the cesspool were decayed. The Broad Street well was less than three feet away, and the surrounding soil was saturated with human waste. In other words, when Sarah Lewis emptied her baby’s diapers into the cesspool, the cholera bacteria seeped through bricks and soil to contaminate the water in the well.

As in our story, after little Frances Lewis died on Saturday, September 2, the epidemic naturally waned because no new contamination of the well was taking place. But her father, Constable Thomas Lewis, fell ill on Friday, September 8, the very day the pump handle was removed. Had the well not been closed, the epidemic would undoubtedly have killed more people because Mrs. Lewis had begun emptying her husband’s waste into the cesspool. When no new epidemics struck the neighborhood, the pump handle was eventually restored in September 1855.

Dr. John Snow is known today as a pioneer both in public health and in the field of anesthesiology. But until I read
The Ghost Map
, I hadn’t heard of him. My journey to find out more took me to books, websites, museums, and libraries, including the Wellcome Library in London, which specializes in the history of medicine.

Finally, I found myself standing on Broadwick Street,
which used to be called Broad Street. There’s a replica of the pump there, and a pink slab of granite nearby marks where it once stood. In 2011, as it must have been in 1854, the street was the center of a bustling neighborhood. I couldn’t help reaching down to touch the stone as I imagined what it had been like to live then. And that is how this book came to be.

The Great Trouble
includes both fictional characters and historical figures. Eel, Henry, Florrie, Fisheye Bill Tyler, the Griggs family, Abel Cooper, Nasty Ned, and Thumbless Jake are fictional. Historical figures include Dr. John Snow, Rev. Henry Whitehead, William Farr, and Dr. Snow’s housekeeper, Jane Weatherburn.

I have also used the names of some actual Soho residents. The brothers John and Edward Huggins really were the owners of the Lion Brewery, though I have no reason to think they were not both perfectly nice gentlemen. Their nephew Hugzie is fictional.

People who lived at 40 Broad Street included a tailor, “Mr. G.,” who became the fictional Mr. Griggs. Constable Thomas Lewis and his wife, Sarah, also lived at that address, along with a son, an infant daughter named Frances, and a daughter named Annie, who in a later census was listed as an embroiderer. (Thus she became Annie Ribbons in my book.) Susannah Eley, who lived in Hampstead, was
the widow of a munitions factory owner. Knowing of her fondness for water from the Broad Street well, her sons had a bottle delivered to her daily.

Additional information about major historical figures in the story is included in the following sections.

Dr. John Snow (1813–1858)

John Snow was born in York, the eldest of nine children. His father, William, began as an unskilled laborer and was eventually able to purchase a farm. John’s parents wanted to give their children a primary education, so John went to school until the age of fourteen.

In 1827, he was apprenticed to William Hardcastle, a family friend who was a surgeon apothecary in Newcastle upon Tyne, a coal-mining town. It was there, in 1831, that John first became acquainted with cholera. He moved to London to continue his medical training in 1836 and set up his practice in the city two years later.

In 1846, the London dentist James Robinson became the first doctor in England to demonstrate ether. Gases like
ether and chloroform were important because they allowed people to undergo surgical and dental procedures without pain. John Snow began doing his own research on anesthesia and often experimented on guinea pigs, mice, frogs, and other animal subjects. He also designed an inhaler and began assisting dentists and surgeons. He became so well known for his skill that he gave chloroform to Queen Victoria when she gave birth to Prince Leopold in 1853.

At the same time, Dr. Snow was researching cholera. By 1854, when the Broad Street epidemic occurred, he was studying the relationship between cholera outbreaks and London’s water supply.

Even after the success of the Broad Street investigation in 1854, not everyone in the field of public health agreed with Dr. Snow’s theory on cholera. It was not until 1866, partly thanks to Henry Whitehead, that Dr. Snow’s conviction that cholera was a waterborne disease was fully accepted. Unfortunately, John Snow was not there to see that development. He suffered what was apparently a stroke and died on June 16, 1858. He was only forty-five. Today he is remembered for his pioneering research in anesthesia and epidemiology.

Rev. Henry Whitehead (1825–1896)

Henry Whitehead is an unlikely hero in the history of cholera. He had no medical or public health training. He was born in Ramsgate, where his father was the headmaster of a school. Whitehead attended the University of Oxford, receiving his degree in 1850. His first assignment in London was as assistant curate at St. Luke’s Church on Berwick Street. Just shy of thirty when the cholera epidemic broke out, he was a familiar and comforting figure to the families of the neighborhood.

Rev. Whitehead remained unconvinced by Dr. John Snow’s theory until the two of them were thrown together on the St. James Cholera Inquiry Committee. In January 1855, after reading the monograph about the Broad Street epidemic that Dr. Snow had prepared and gathering information from the residents, Rev. Whitehead came to believe that Dr. Snow was right.

In 1865 and 1866, when cholera again broke out, Rev. Whitehead published articles reminding the public of Dr. Snow’s earlier work. In 1874, when he left London for a
position in Brampton, a farewell dinner was held in his honor. During his speech, he called his old friend “as great a benefactor in my opinion to the human race as has appeared in the present century.”

Dr. William Farr (1807–1883)

William Farr was born into a large family in the village of Shropshire. It was his good fortune to attract the attention of a local benefactor, Joseph Pryce, who paid for his education. When Pryce died in 1828, he left William money, which the young man used to pursue medical training. William became interested in medical statistics, urging that physicians record the exact reason for a person’s death. In 1838, he joined the General Register Office for England and Wales, where he was responsible for the collection of medical statistics. He stayed with the office until his retirement in 1880.

Dr. Farr came late to believing that contaminated water, not miasma, caused the spread of cholera. It was not until the cholera epidemic of 1866, eight years after Dr. John
Snow’s death, that he fully supported Dr. Snow’s theory. Today Dr. Farr is remembered for developing a national vital statistics system, which provided data to public health officials and served as an example to other countries.

The Great Trouble
takes place in Victorian London. Queen Victoria ruled Great Britain from 1837 until her death in 1901; to date, hers is the longest reign of any British monarch and the longest of any female monarch in history. This period has become known as the Victorian era.