Nursing Book Club

Black Death at the Golden Gate by David K. Randall and The Mosquito: A Human History of the Deadliest Predator by Timothy C. Windegard

Two books about the politics of epidemics

As we confront the spread of the coronavirus, I decided to investigate two recent nonfiction books about contagious disease, and the social and political implications of public health during an epidemic.

The first is Black Death at the Golden Gate, by journalist David K. Randall. This gripping true story begins in 1899, when a bookkeeper named Yuk Hoy arrived in Honolulu from China with a fever and the black spots of bubonic plague. His Chinese doctor, Li Khai Fai, was all too familiar with the symptoms, having seen the plague kill 10 million people in China in only five years before spreading to India, Australia, Scotland and North Africa to kill 5 million more.

Li had hoped that the oceans would be a barrier against further spread of the disease, but the arrival of this dying Chinese man proved those hopes were in vain. Six months after Yuk Hoy’s death, a ship arrived in San Francisco with a lifeless passenger who had also shown the first signs of plague.

The rest of this page-turning story is about the race to contain the disease before it spread beyond the harbor of the West’s largest city to the rest of the continental United States. This crisis left politicians debating who was to blame and calling for quarantines of ethnic groups they held responsible.

Vital public health information was deliberately withheld out of fear of the possible economic impact of limiting incoming shipping and rail traffic up and down the coast. Lives were lost and many careers were ended before it was all over.

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Randall is an entertaining storyteller who takes dry facts and makes them come alive. Although Black Death at the Golden Gate is nonfiction, it reads like a good historical novel. I also found myself thinking a lot about how these events would play out in today’s political climate.

Tiny and Deadly

In The Mosquito: A Human History of the Deadliest Predator, author Timothy C. Windegard presents an expansive view of these tiny menaces to public health. Today, mosquitoes are well-known as vectors of potentially fatal illnesses, of which malaria is only the best known.

However, Windegard demonstrates that mosquito-borne epidemics have been a problem throughout human history. He begins by describing mysterious epidemics of earlier eras, like the Plague of Athens (430 BCE), which “ripped apart the cohesion and foundation not only of the Athenian military but also Athenian society.”

Winegard doesn’t limit his history to any one era or continent. He paints a vivid portrait of the importance mosquitoes have played as carriers of disease in colonial America, India and South America, among others. These tiny insects have decimated whole armies and changed the shape of cultures, economies and even human biology.

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A particularly interesting focus is on evolutionary responses like sickle cell trait, which poses significant health risks of its own, but can confer significant immunity to mosquito-transmitted diseases even in someone who inherits the gene from only one parent.

Winegard’s knowledge of this subject is exhaustive, peppered with fascinating examples. One that I especially liked was the story of NFL football player Ryan Clark. Jr, who became ill while playing in Denver’s Mile High Stadium and suffered a near-death experience with organ necrosis. He later learned that he had sickle cell trait, which made playing in a high-altitude stadium that much more difficult and dangerous.

The development of more effective insect repellants has given humanity some defense against the mosquito menace, but malaria still kills half a million people a year. Widespread business and leisure travel provides new opportunities for disease to spread and climate change is increasing the mosquito range.

If another author sits down 50 or 100 years from now to write a sequel to this book, it may well conclude that mosquitoes are once again winning this ancient war.

Black Death at the Golden Gate: The Race to Save America from the Bubonic Plague by David K. Randall (W.W. Norton and Co., 2019)

The Mosquito: A Human History of Our Deadliest Predator by Timothy C. Winegard (Dutton, 2019)

CHRISTINE CONTILLO, RN, BSN, PHN, is a public health nurse with more than 40 years of experience, ranging from infants to geriatrics. She enjoys volunteering for medical missions.

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