<i>The Ghost Map</i>, by Steven Johnson, is very close to a perfect book. The book describes the birth of modern epidemiology as it arose in response to a virulent outbreak of cholera in a particular 1854 London neighborhood. If you, unlike me, are not horribly enthralled by cholera or nerdily swoon at epidemiology, this has the potential to be a very dry read. And, in fact, going into this book I already knew the story of this particular outbreak of cholera because I’d read about it in much less gripping books about Victorian medicine. What makes <i>The Ghost Map</i> different, and what makes it the kind of book that I now want to thrust into the unsuspecting hands of everyone I know, is that it does a remarkable job contextualizing the outbreak such that you, as a modern reader who likely has no direct experience of cholera, understands the absolute terror the Londoners felt in this outbreak. You feel the visceral urgency that comes with that terror, the awful need to unravel what the horrible riddle that was cholera.

Much of the book follows Dr. Jon Snow, who is an interesting historical figure in his own right. A pioneer of anesthesiology, Jon Snow also had a fascination with cholera. It was he who, without the aid of developed germ theory, deduced that cholera must be waterborne and traced the outbreak back to a particular water pump on Broad Street. <i>The Ghost Map</i> has shades of narrative non-fiction, just enough to draw Jon Snow and the other players as real people, complete people with thoughts and tragic flaws and beating hearts. The book never tips fully over into narrative non-fiction, restraining itself enough that it does not speak for these historical figures, which I appreciated.

But to say that this is a book about Jon Snow’s prodigious scientific contributions is to give it short shrift. The real strength of the book is that it takes this single narrative thread—Jon Snow’s proto-epidemiological investigations into the 1854 cholera outbreak—and locates it in a myriad of nested lenses. This narrative thread is explored from the lens of the microbial cholera itself, describing cholera’s life cycle and the way cholera adapted to the new context of a dense and dirty human metropolis. This narrative thread is explored from the sociological lens of why Snow’s waterborne theory had to fight so hard to gain traction against the classist and Social Darwinist competing miasmatic theory of cholera transmission. Ultimately, the unifying element of the book is that Stevenson frames the 1854 cholera outbreak in terms of waste recycling—he starts the book with descriptions of the London underclasses who survived by compiling and moving and disposing of the mountains of human waste that Victorian London produced. He frames microbes as creatures whose waste products ultimately gave rise to multicellular creatures like ourselves. It is a fascinating, cyclical framing device that allows the reader to understand just how smoothly all the pieces fit together.

If you are interested in medicine, or the human body, or biological systems, or cityscapes, or Victorian England or just really good non-fiction I cannot recommend this book enough.

The Ghost Map is a historical book about the SoHo outbreak of cholera in 1854. This book is 332 pages, easy to read, and engaging. The author is Steven Johnson. Steven Johnson is the host of the series “How We Got to Now.” This show explores innovations through time to explain how we got to modern times. Examples are: clean, cold, sound, glass, etc.

This book weaves science and history together into an interesting story. I liked how it was about two different scientists who had two different views of how cholera spread. One scientist, Henry Whitehead, thought it spread by air. Another scientist, John Snow, thought it spread by water.

The cholera outbreak happened because there were leaky sewers that let human waste leak into the underground water reservoirs that the Broad St. pump was connected to. The sewers were brand new. They were installed about a year before the outbreak. The “dirty water” from the Bridal St. pump and the Canary St. pump was actually better than the Broad St. pump "clean water."

John Snow discovered this by mapping out the deaths in his little town of SoHo where the outbreak was. The people with their own private wells didn’t experience illness or death.

John Snow also asked residents who had deaths outside of the zone where they got their water from, and most of them said they walked the extra distance to Broad St. because it looked cleaner. Notably, the people that worked at the brewery didn’t experience illness or death even though they were a block away from the pump. They drank beer not water. These people proved that the illness couldn't be from a cloud of cholera-infected gas.

They didn’t fix the sewers until two years later when they realized human waste leaks were the cause. Once the scientists believed John Snow’s theory about water spreading cholera, they went looking for a reason and discovered human waste was the cause. They found a leak really close to the Broad St. pump. The Broad St. pump handle was removed and people stopped getting sick. There was difference in people getting sick and dying within three days. Only people who had stocked up on Broad St. water continued to get sick, but those who didn’t stopped getting sick. Within two weeks the deaths stopped.

I think Steven Johnson achieved his goal in making this book interesting, enough that I read it all at once. I liked how he took a big event and made a story by talking about the people involved.

-Linus, Age 9

The springboard for Steven Johnson's book, The Ghost Map, is the 1854 London cholera epidemic, but the pool that he dives into from this jumping off point is both deep and broad.

The cholera epidemic of 1854 is fascinating in and of itself, and many aficionados of medical history will recall that it was the setting of one of the most dramatic moments in public health history: an epidemic was brought to a halt by the simple removal of the pump handle on the Broad Street well that supplied the stricken London neighborhood. The ferocity of an epidemic that swept entire families away in two or three days is presented in horrifying detail, but this book is far more fascinating than just another plague story. Johnson's credentials in science writing are solid and impressive, having written for Wired, Slate, and Discover Magazine, as well as having published several books. In Ghost Map, he flexes his literary muscle with potent effect. Johnson's mind is a "big tent" mind, and The Ghost Map is a three ring circus of intellectual ferment, with the final product being far more thought-provoking and informative than a "bug versus human, human conquers bug" tale.

Johnson is a fan of scalable levels of knowing, and is never satisfied with a simple listing of dates, times, and names. Think rather this way: bacteria (such as the vibrio cholerae) evolved early on. More complex unicellular organisms came later, but actually incorporated bacteria inside their cell membranes to provide certain functions (such as mitochondria). These more complex cellular organisms became multi-cellular. Multi-cellular organisms eventually (in the plant and animal world) developed organs. Humans eventually came on the scene, composed of cells, organs, neuro and hormonal networks, and consciousness. Humans began to live together, forming simple gatherings, then hamlets, villages, towns, cities, and mega-cities. As cities and mega-cities evolved, their function clearly demonstrated yet another scaled up level of organization: cities/mega-cities began to function like organisms...or maybe ARE organisms. Cities combine into states/nations, and up the scale we go to the Margulis/Lovelock Gaia concept, and even beyond. All to say that starting with the tiny little organism that causes fatal illness in the untreated victim, vibrio cholerae, Johnson takes the reader on eye-popping, cerebrum stretching exploration of where we humans have been, and where we might be going. The author never lets the reader forget the overlapping and interweaving levels of effects and influences that all the above organisms and quasi-organisms have upon one another. Two million people inhabited London in 1854, with population densities sometimes exceeding 400 people per acre. States Johnson "that perplexity gave rise to an intuitive sense that the city itself was best understood as a creature with its own distinct form of volition, greater than the sum of its parts, a monster, a diseased body."

The title, The Ghost Map, is a prelude to Johnson's fascination with the ability of maps to organize knowledge into ever more comprehensible patterns, patterns that vastly supersede in sophistication and utility the simple specification of geographic location. Johnson's discussion of this topic alone would have satisfied me that I got my money's worth out of this excellent book, but the importance of maps is only one topic among many that would have made me feel equally satisfied. Dive into this pool of ideas ready to have more than a few take-your-breath-away moments.

It seems like I am not alone in these sentiments, at least among the critical reviewers of this book. Much of the Conclusion, and certainly all the Epilogue is such a non-sequester in style, content, but primarily in the quality of thought from what preceded it. The last 50 pages seem like a rambling "cut and paste" add-on.

Johnson is a polymath in his own right, and has mastered the diverse aspects of the outbreak of cholera in the Soho section of London, in 1954, and has written a compelling story. It is the London of the time of Charles Dickens, whom Johnson has read and routinely quotes. His descriptions of the significant part of the population that dealt in "recycling" and human wastes (and these people would have formed one of the larger cities in England at the time) were most memorable; Dickeneque in their own right. He provides an excellent clinical description of the action of cholera on the human body. The "drama" of the story centers around the action of two very different men, the scientist Dr. John Snow, and the social worker pastor Henry Whitehead, who combined their different outlooks and skills, to prove that the vector that carried cholera was water; which was totally contradictory to the received ideas of the time. Establishment thought considered it to be the "miasma," the fetid air, the bad smells that transmitted the disease. Johnson gives an impressive biological explanation why human reactions to smells would cloud their judgment; much contradictory evidence, such as the fact that the laborers who worked in the fetid atmosphere of the sewers all day were not particularly susceptible to the disease, was simply ignored. Johnson laces his account with some droll humor, for example, praising the advantage of cities so that it gave consumers an opportunity to concern themselves with "new technologies.... and celebrity gossip"(!) Considerable emphasis is given to the impact of "the Ghost Map," which is a graphical representation of where the deaths occurred, and how this helped "sell" the theory that the water from the one well, at 40 Broad Street, which had been contaminated with cholera from the diapers of Victim #1, or as they say in epidemiology, the "index case," was the source of the disease. And yes, despite some reviewer comments, the Ghost Map is in the book, in several places, even with a "ghost" shading.

But even with the first 200 pages I had some problems. The gas/liquid/solid energy metaphor of the three states of water compared to the three developmental states of human society: hunter-gather/farmer/city dweller is completely muddled, and the energy levels are actually the reverse of what is indicated (p 94). The Ghost Map was in the book, but it certainly would have been useful to have a Voronoi diagram also. And when he cites Marcel Proust and his Madeleine-inspired reveries (p 128) he missed a marvelous opportunity to compare Dr. Snow's work with Marcel's father, Dr. Achille Adrien Proust, who was an epidemiologist who devoted much of his life to fighting cholera, and is largely responsible for developing the "cordon sanitaire" technique. There is also the problem, particularly prominent at the publisher, Penguin, (Love and Consequences: A Memoir of Hope and Survival fame) of not taking the time to run the manuscript through spell-check. The editing, particularly towards the end was shoddy - saying the same thing about the 1918 flu epidemic, thrice, in three pages. Despite these shortcomings, I would have given the book 5-stars if he had stopped around page 200.

The last 50 pages should have been prefaced with that classic cover from the "New Yorker," that shows the world in wildly distorted proportion, with Manhattan consuming about 80% of it, Jersey as a distant shore, San Francisco a remote dot, and all of China a smaller and more remote one still. Johnson is an unabashed New Yorker, (and yes, as the cliché has it, it is a great place to visit, but...) and he apparently believes that the world would be a better place if we all lived like they do in the Big Apple. "We are now, as a species, dependent on dense urban living as a survival strategy" (p 236). Pleeeze. Some of us in the "fly-over zone" would demur. Johnson asserts with the aplomb and certainty of Edwin Chadwick, one of the chief miasmaists who propounded the "All Smell is Disease" dogma.

As a few other reviewers have commented, it is rather ironic that there are large dollops of miasma-theory supporter thought processes behind Johnson's statements made in the final pages. All the contradictory evidence is set aside when "I (heart) NYC." Is New York really the greenest city in the United States, aside from an article in - no surprise here- "The New Yorker"? Density as an engine of wealth creation? How many trillion did Wall Street just vaporize? Density leads to population reduction? Or is it increased income levels that makes the "human" Social Security of many children no longer necessary? And then the long ramble about terrorist threats was sophomoric, at best, with nary a thought as to how to reduce or eliminate these threats. It is not that terrorism, fossil fuel depletion, or the threat of a new epidemic are not real issues to be considered in rationale discourse, but how could you NOT mention America's, and even New York's massive reliance on foreign capital, and foreigners to supply us the necessities of life, while so many able Americans are unemployed as being the central issue that must be resolved: an equitable distribution of the wealth of society. I just finished reading Thoreau's Walden, and what a stunning contrast.

Overall, the last section should be dropped, or re-worked, with much more critical thought, including some input from beyond the Hudson River, and perhaps made into its own stand-alone book. Combining the excellent portions of the book, with a shoddy ending: 3-stars.

Medicine meets sociology in this mapping of a deadly disease and how the persistence of two men against false ideas helped find a long ranging solution. Highly recommend!

The Ghost Map, a book about a specific turning point in human history as well as a "public health thriller" and psycho-sociological exploration of the nature of urban culture, takes its title from the artifact that survives in a British archive as a reminder of the nearly forgotten key players who solved the mystery of cholera and stemmed the 1854 London epidemic. Though it makes a rather late appearance in this oddly affecting narrative, it is an apt title for the story and lessons it imparts.

The faint of heart should know, this is a book about an intensely populated city that in 1854 did not know how to dispose of its human waste and about a disease that is transmitted by ingestion of infected human fecal matter. And yet, it is a highly readable amalgam of detective narrative, Victorian history and psychology, epidemiology, public health history, a sociological consideration of the human impulse to create cities and the survival of cities despite the vulnerability of dense populations. In September of 1854, cholera outbreaks were certainly not unheard of, but this one was ripping mercilessly through the Soho/Golden Square neighborhood. The prevailing authorities insisted that "bad air" brought on the epidemics. Physician John Snow had a different idea, and hit upon the biology and transmission of the cholera molecule as he carefully collected data in the face of the scourge. He knew it was traveling through a water supply infected with fecal matter, and tracked his findings on the map of the title. Skeptical at first, the Reverend Henry Whitehead joined Snow, sharing his knowledge of his parishioners to track down ground zero. Snow finally convinced the authorities to close a public water pump and the outbreak was staunched. Snow's proof of what was a radical concept, however, would not become accepted science for another ten years.

In the end, Johnson makes this more than a history lesson, moving onto a meditation about urban life. He often quotes Charles Dickens and Jane Jacobs. As a New Yorker committed to urban living in the early 21st century, he expresses a heightened sensitivity to the threat of terrorists and weapons of mass destruction but insists on the sustainability of cities. This went to press before Katrina, before the economic boom went bust, before Haiti and Chili suffered devastating earthquakes, all of which would have informed his narrative but probably would not have undone his vision.

The title refers to a document that John Snow, a physician, devised after the outbreak of bubonic plague in London in the 1840s. Its purpose was to help him locate the local source of the deadly virus. That information is best revealed within the riveting narrative during which empirical thinkers such as Knox were opposed by advocates of the miasma theory (i.e. that contamination is atmospheric), thoroughly discussed in Chapter 7, "All Smell Is Disease."

Steven Johnson tells a great story and, like all other great stories, this one also has a cast of memorable characters (notably Knox, Henry Whitehead, William Farr, Benjamin Hall, and Edwin Chadwick), a sequence of highly dramatic plot developments (as well as subtle ones, equally significant), conflicts that create escalating tension and increased reader interest, and eventually a climax at which time this reader (at least) felt exhausted, unkempt, and somewhat toxic.

Of special interest to me is how skillfully portrays the setting less as a metropolitan area, within which more than two million people and countless livestock are crammed, than as "a natural organic process," a living organism, an alien creature, indeed a monster. As I read the material that focuses on the human devastation, I was reminded of the whatever-it-is in the film, Predator.

Victims of the plague proceeded from a "healthy, functioning human being to a shrunken, blue-skinned cadaver in a matter of days" after Vibrio cholerae is ingested, finds its way to the small intestine, and "launches a two-pronged attack." Residents in the Broad Street area tended to be either dead or not dead yet. What was it like? "Imagine if every time you experienced a slight upset stomach you knew there was an entirely reasonable chance you'd be dead in forty-eight hours...Imagine living with that sword of Damocles hovering above your head - every stomach pain or watery stool a potential harbinger of imminent doom."

Credit Johnson with creating a multi-disciplinary narrative (a page-turner, really) during which his reader is provided with relevant elements of history (including biography), sociology, economics, medical science, and law. Meanwhile, the outbreak "shed light on the poverty and despair of inner-city life, illuminating everyday suffering with the bright light of extraordinary despair. Whitehead had the story half right: the terrifying visibility of the outbreak did in fact sow the seeds of a cure. But it was not divine providence that drove the process. It was destiny."

For a book to be inspired by another book is not unusual, but for a book to be inspired by an illustration is quite rare. That's the case here.

I first learned about this story in Edward Tufte's book, The Visual Display of Quantitative Information, back in the 1990s. Steven Johnson read the same story and map and wrote this remarkable book.

We all know about the Black Death, the Plague, and how it ravaged Europe in the Middle Ages, but few know about the cholera epidemic of 1854 in London, which was even more virulent but shorter. Two men, working independently and together, figured out what was happening and why and intervened to help stop the spread.

This book tells the story and reads like a novel.

The new afterward, written in 2023, discusses the COVID pandemic, with comparisons and contrasts to the 1854 colera outbreak, a marvelous capstone to the book.

Highly recommended.

Fora de série. Utilizei muitas informações num livro que escreví(Doenças que mudaram a História).

Étude tout simplement brillante. L'auteur nous offre une plongée passionnante dans la quête du docteur Snow pour comprendre les modalités de diffusion du choléra ainsi que tous ses efforts, accompagné du révérend Whitehead, pour convaincre les différents (et nombreux) acteurs politiques locaux du bien-fondé de sa théorie. Enfin, ce livre est aussi l'occasion de voir naître la première carte géographique s'appuyant sur le big-data.

I loved this book which was as much a story about London during an epidemic. It has much detail - from the theory of the discovery of the first person who got the plague - how it spread and, interestingly, who didn't become ill and why. Interesting book in these times of Ebola in Africa and possibly spreading to the rest of the world.

Such a stroke of genius to plot death on a map and recognized patterns that indicated the source of disease.While others were convinced the disease was carried in the air, Snow recognised it to be water born... Super story

Excelente perspectiva histórico-científica del Londres del siglo XIX... Es recorrer Londres en su época de consolidación como la ciudad esplendor de un imperio en apogeo...