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

I enjoyed Steven Johnson's treatment of a famous cholera epidemic in Victorian London. I was skeptical at first a book-long treatment would hold my interest, like so many non-fiction books these days which are bloated with encyclopedia tangents and hung along a thin cord of a story. But Johnson's narrative skills are top notch and the book works well on a number of levels. On the surface it's a Sherlockian detective story, the mystery of what is causing the cholera and how its discovered. There were times I could hear the horse hoves on cobblestone, smell rank sewers and see black pools of sewage. Johnson sets the stage throughout and is a master at providing context in an atmospheric way that turns a seemingly dry topic into a lively show more trip back in time. It's also literary with many references to Dickens and other period excerpts. I also liked how Johnson looked at so many aspects from the biological to the sociological to the political - he can zoom out from the very small to the very large, from the specific "micro history" to the grand "big history" and bring it all together. Overall a well crafted story that is educational and entertaining popular history. show less

The “hero” of Steven Johnson's The Ghost Map, Dr. John Snow, I had already recently met in the pages of The Butchering Art: Joseph Lister's Quest To Transform the Grisly World of Victorian Medicine by Lindsey Fitzharris. The two books share accounts of the newly discovered use of chloroform and ether to anesthetize patients before surgeries and tooth extractions. Both describe Snow's concept of mapping the locations of cholera infections and deaths to discover the source and means of transmission of the disease. Both address the then-popular concept of miasma as an agent of infection (inasmuch as microbial life was unknown or disbelieved in the mid 1800s).

These points of commonality are merely part of Fitzharris's book but show more constitute the mainstream of Johnson's. In fact, Johnson hails Dr. Snow's mapping idea as the beginning of modern epidemiology. Then he goes further by crediting Snow's research, along with that of Henry Whitehead, a cleric who also sought to identify the source and means of transmission of the cholera bacterium, without knowing that it was a bacterium, of course, of enabling cities to exist.

True, one can trace developments from identifying polluted water as a source of disease to the construction of sewer systems to keep waste water separated from drinking water, and, yes, one can make the case that, without sources of clean water and hygienic disposal of waste water, humans could not live safely in concentrated masses, i.e., cities. However, I feel that Johnson attributes Snow and Whitehead with just a bit too much influence on the subsequent creation of city life.

Nonetheless, had The Ghost Map concluded with the story of the London cholera outbreak in 1854, it would have been an interestingly written retelling of the event, of the nascent debunking of “miasma” as a disease agent, and of the subsequent creation of an effective sewer system in 19th century London. However, the book includes a fairly lengthy epilogue which has little to do with the history of disease and of the discoveries that helped modernize both medicine and hygiene. Johnson appears to believe that the only hope for humankind is to live in the gray cement canyons and the sealed-window apartment warrens of congested cities. Optimistically, he concludes that, outside the sterile environments of man-made megalopolises, nature will be allowed to “do her thing” to keep Earth going despite the weight of human overpopulation, which he claims will actually be relieved by city dwelling. True, he does admit that nuclear war and terrorism may disrupt the security of cities and that mankind may have to learn with such things, but c'est la vie.

Had it not been for the 25 page soapbox epilogue and its sermon that humankind will survive only in the artificial environs of concrete, asphalt, steel, and glass, The Ghost Map may have eked out a four-star rating from me, not that this history has not been recounted elsewhere many times before but that this retelling is well done and is a fairly entertaining as well as informative history. However, to include what is in essence a final chapter that has little connection with what has come before and which presumes not only to predict humankind's future but also to presume to prescribe how that future should unfold appears to me to be unpardonably pretentious. With that, the fourth star disappeared. show less

This turned out to be a great companion piece to Sandra Hempel's "The Medical Detective" because combined, you really get the whole story. Like a sociological study, Johnson covers London's growth and city structure as a massive petri dish for disease, but also its people: "...epidemics create a kind of history from below: they can be world-changing, but the participants are almost inevitably ordinary folk...not thinking for a second about how their actions will be recorded for posterity..."

The first of these ordinary folks are the "recyclers" and waste collectors of society, among them are night-soil men and sewer-hunters. By simply existing, they were proof that one can literally slosh through human waste every day, but the "miasma" show more will not give you cholera. The second essential group of course are the victims. The miasma theory was standard, but John Snow was a highly observant man. He built his "waterborne theory" over many years of extensive research. Even before the infamous Broad Street outbreak, he learned that 12 ordinary people living in one slum building died from cholera, but the building across from it didn't. This was because, of course, they got their water from different sources. Snow also had to go against imperfect data! Snow's colleague, William Farr, attempted to record cholera deaths by elevation, the higher ground seemingly safer. But Snow went door to door and asked where they got their water. He mapped, recorded and pursued every lead. Turns out of course, the higher elevation had a cleaner water source. He was even stunned to find that clear water may still be deadly. Later, he found an unlikely ally in Rev Henry Whitehead, a member of the Broad Street community. The author ultimately gives credit to local assistance. Without it, John Snow wouldn't have been able to succeed as he did.

The author allowed you to appreciate Snow's efforts and how lucky some of us truly are to have access to clean water. You really can't take it for granted! show less

In 1854, cholera tore through a London Soho neighborhood with speed and impact far greater than previous outbreaks. Prevailing views on disease attributed the transmission of cholera to “miasma,” meaning there was something in the air, and that certain individuals would be more or less susceptible depending on their socioeconomic class and living arrangements. These beliefs, firmly entrenched in the medical establishment, hindered the authorities’ response to the outbreak. Enter John Snow, a neighborhood physician who had been studying cholera for years. Through door-to-door canvassing and painstaking documentation, Snow developed a new theory of water-borne bacteria, and then faced the daunting task of convincing the authorities show more to respond accordingly. His unlikely partnership with local curate Henry Whitehead was instrumental in making the case.

The Ghost Map was a fascinating account of a public health situation, the state of London’s infrastructure during that era, and the ways in which even the most knowledgeable people can fail to see their limits or accept new data points. I would have preferred the book had ended with its concluding chapter focused on Victorian London, and not the epilogue. This final section leaps forward to the 21st century and discusses the rise of urban living, the internet, and public health concerns at the time of publication (2006): annual flu vaccines and the H5N1 avian flu virus. This was doomed to obsolescence from the start, and I found myself wishing the author had stuck with the history. But his final sentences are spot on:

However profound the threats are that confront us today, they are solvable, if we acknowledge the underlying problem, if we listen to science and not superstition, if we keep a channel open for dissenting voices that might actually have real answers. The global challenges that we face are not necessarily an apocalyptic crisis of capitalism or mankind’s hubris finally clashing with the balanced spirit of Gaia. We have confronted equally appalling crises before. The only question is whether we can steer around these crises without killing ten million people, or more. So let’s get on with it.

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When I lived in London, we had an assessment to do any leisure activity that you would not have otherwise done. My class partner and I decided to go through her oddities of London book, which landed us in the Jon Snow pub. Ever since, I've been enamored by Jon Snow. His story is not just one of life-saving epidemiology, but also the triumph of good science (germ theory!) over bad (miasmists) and real science (...still germ theory) over social prejudice. Steven Johnson would also have you believe that this story is about urbanism and the way that population density results in vulnerability (I think. More on that later.) So, pretty much no matter what you're into, this is one of the coolest stories in Western history.

And Johnson just show more destroys it. I spent a lot of time thinking about how this went wrong. I read a lot of popular science, and there's some classical ways to mess it up: oversimplifying to the point of boredom, getting too bogged down in the details, getting attached to a pet theme, etc. Johnson does none of those. In fact, if I were to describe the content of the book, it would seem perfect. In addition to the science, Johnson explores how contemporary science and the politics therein reacted to this discovery and opposed it, how the friendship developed between the disparate Snow and Whitehead and how Whitehead's better social skills improved his ability to really test the hypothesis well. Those sorts of themes were key to my enjoyment of Johnson's the Invention of Air, which is one of the best history of science books I've ever read.

First, I thought there was something innately boring about the discussion of Victorian sewage*. But I'm the sort of person who loves pedantic details and I have enough medical training that I am unimpressed by extensive discussion of unmentionable topics. I think there was just no organization to what was happening. And as a result, every 25 pages or so, for no clear reason, Johnson would start repeating one of his key themes, not really apropos of anything but because it had been a long enough time since a central thesis that I think he forgot what he'd already said.

The other problem was that the backend of the book was a mess. After an extremely in-depth exploration of very specifically the broad street pump outbreak of cholera, Johnson tries to expand to discussing urbanism in general and his thoughts are completely discombobulated. Included within this chapter are: But urbanism is good for the environment even though no one used to believe that, and Johnson and his family certainly will live in a city and he loves cities and this is the global city, but urbanism is bad if there is terrorism and terrorism is relevant because it could be bioterrorism, but vaccines will work against bioterrorism and they won't work against conventional terrorism, so it'll probably be a bomb and also, there's this idea of mutually assured destruction but what if a lone actor gets their hands on a nuclear bomb? With about that degree of organization between thoughts.

All of this disorganization happening at the end of a reasonable chapter about how Jon Snow made a physical map to prove his point, which Johnson used as an opening to discuss how critical graphics are in science and then *did not include* said map. And yes, it's 2017 and I had a smart phone handy to google it, but come on.

*(This book is shockingly dry, given that its about a water pump.) show less

The Ghost Map is an extremely detailed and compelling account of a cholera outbreak in a neighborhood of London in 1854. Its detail is owed to the fact that a man living in the neighborhood, a scientist named John Snow, took it upon himself to survey the neighborhood house by house during the outbreak in an attempt to prove a theory he had hatched that cholera was a water-borne contagion. Thus, thanks to his records, we know that the well water for the neighborhood was probably contaminated on August 28th, 1854, and we know almost to a man who visited the neighborhood pump for water in the week the followed, since they almost all died. We also know who didn’t visit the pump that week, one of whom was an ornithologist named Gould, who show more was normally a regular pump-drinker but forewent the pleasure that week because he thought the water smelled a little off. It didn’t, but I couldn’t help, after reading this, glancing up at my beloved collection of Gould’s illustrations of tropical birds and feeling a little faint, some 150 years after the fact, at his near brush with certain death.

Thanks to Snow’s careful record keeping, plus a general British tendency to bureaucratize everything—and bureaucracy naturally means paperwork—Steven Johnson was able to rebuild the neighborhood around the outbreak almost to a house, along with careful, compassionate descriptions of everyone who lived there, what they did, how they survived (if they survived). And despite the scatological nature of the subject (cholera, I’m sorry to say, is transmitted fecal-oral) he creates for the reader a vivid image of Victorian London with the detail and beauty of a daguerreotype. full review show less

Cholera: not just something you perished from while playing Oregon Trail! Once thought to be caused by miasma/foul air, the 1854 cholera outbreak in London was a turning point in humanity's understanding of the disease and its spread. Intrepid physician John Snow fought an uphill battle against local authorities who were convinced cholera was spread by noxious sewer gases and could not be persuaded otherwise...until Snow drew up a map of victims' homes and their relationship with the Broad Street water pump.

I was surprised to find this book about a devastating, feared and deadly disease to be so enjoyable. I learned a great deal about not only cholera, but also 19th-century urban sanitation, medicine and municipal infrastructure. The show more final chapters revealed some fascinating things with respect to urban vs. city dwelling and, having now come through the other side of the global COVID-19 epidemic, were freakily prescient regarding potential future viruses. I love that there is now a pub named "John Snow" right next to location of Broad Street pump. Highly recommended for fans of narrative nonfiction. show less