Wednesday 21 March 2018

Medical metaphors: Boris Johnson may regret sadistic nurse comments about Hilary Clinton

Boris may regret his comments about a pouty-lipped sadistic nurse, and Maurice Gueret tracks down our Typhoid Mary

Britain's Foreign Secretary Boris Johnson. Photo: Reuters/Andrew Matthews/Pool
Britain's Foreign Secretary Boris Johnson. Photo: Reuters/Andrew Matthews/Pool
Dr Maurice Gueret

It has been a busy summer on the playing fields, packed tight with football fervour and Olympic endeavour. For those who prefer their sport to be bloody and political, the comings and goings at Number 10 Downing Street have sated the appetite. I have long been fascinated by the way medical metaphors creep into public discourse. Britain's new Foreign Secretary, Boris Johnson, may need more than diplomatic skills should the Clintons reclaim the White House. Boris once wrote affectionately about Hillary's "dyed blonde hair and pouty lips, and a steely blue stare like a sadistic nurse in a mental hospital". It will be interesting to see how Boris's 'special relationship' with his new North Atlantic ally fares in the months ahead.

The man who scuppered Boris's prime-ministerial ambitions has also been framed with a medical metaphor. Michael Gove lost friends and prospects when he stabbed Boris front and back following the Brexit vote. Gove now cuts a lonely, isolated figure on the House of Commons benches, with one commentator describing him as the Typhoid Mary of Westminster. Everyone has heard of Typhoid Mary, but few know that she was also Tyrone Mary.

Born Mary Mallon in Cookstown in 1869, she emigrated to the United States in her mid teens to lodge with an aunt and uncle. She worked in various domestic-service jobs around New York before settling as a cook. In 1906, she was working at the Long Island summer house of a wealthy New York banker, when 11 of his guests came down with typhoid fever. Initially, the outbreak was blamed on seafood, but a hired investigator later came up with the novel theory that Mary was a 'healthy carrier' of the salmonella typhi bug. She rebuffed all efforts to obtain blood, urine and stool samples by the investigator, a Mr Sober, so he set about tracing her previous employers. He found she had served in eight families, and seven of them had experienced typhoid.

After a cat-and-mouse chase, public health authorities had Mary arrested and tested. Her stools contained the typhoid bacterium, so she was moved to an isolation facility on North Brother island. She was quarantined there for two years and released on condition that she find a job that didn't involve a kitchen. Mary changed her surname to Brown and went to work as a cook in a Manhattan maternity hospital. Death and diarrhoea followed in her wake. There were 25 cases of typhoid among staff at the hospital in 1915, two of them fatal. Mary was tracked down and re-arrested. She spent the rest of her days back in her cabin on the same Quarantine Island. With only her dog for company, Mary said she knew how lepers felt. On Christmas Day 1932, she suffered a devastating stroke that stopped her walking. Typhoid Mary died six years later and she is buried in the only Roman Catholic cemetery in the Bronx.

* It's almost four months since we filled in the 2016 Census, and to be honest, I found the form to be a very strange document. It asks all sorts of intimate questions about septic tanks, who you live with, your faith and the time you go to work. But nobody is asked to record their height, boast about their new car, pop up on to a weighing scales or state their ability to speak French or Russian. The health section is particularly vague. There is one odd question about how you rate "your health in general". It can be very good, very bad or somewhere in between. But there are no instructions as to how to fill this in. A young lad up all night with a toothache might incline towards very bad, while a dying man levitating on a lake of morphine may rate things as very good indeed. There are questions about "long-lasting conditions and difficulties", but the options are very sparse indeed. One question is "Do you have a difficulty with pain, breathing or any other chronic illness or condition?" The notes explain that chronic means six months or longer, or something that recurs. Those who suffer from eczema, ingrown toenails, dandruff and haemorrhoids would be well within their rights to say 'yes' to having a chronic condition. If we want to retrieve health data from a population census, things could be greatly improved with a bit of thought. We could make it an optional section, where individuals have complete freedom of choice about what they wish to disclose. Or it could be anonymised, and posted back separately from the return made at the doorstep.

* The human height study published this summer received plenty of column inches in the newspapers. The authors tells us that tall people live longer, are better educated and earn more than diminutive colleagues. I grew up in a household that celebrated lankiness. A quarter of a century of childhood growth was recorded every month on the back of a pantry wall. This new global study has some high points. Men and women are growing taller in every country over the last 100 years, and men are maintaining their advantage, upping the gender gap to four-and-a-half inches today. Tall wives are best found in eastern Europe, with the lasses of Latvia, Estonia and the Czech Republic best able to peer down on their contemporaries. If it's a tall husband you are after, then the Netherlands is the place to go. William Shakespeare once mocked the alcohol drinking abilities of "swag-bellied Hollanders" but the average Dutchman born between 1975 and 2000 holds his head high at six feet. Ireland is holding its own and better, rising from a top 40 position a century ago to a top 20 position for both men and women now. That can only be the milk.

Dr Maurice Gueret is editor of the 'Irish Medical Directory'

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