A Pox Upon Thee

Tucson author Jennifer Lee Carrell revives smallpox.

One of the great fears of our paranoid times is that someone will break into a heavily-guarded freezer in Atlanta or Moscow, steal the last few samples of the smallpox virus, and set the killer free in a world ill-equipped to fight a disease that was eradicated in 1977.

Writer Jennifer Lee Carrell has already brought smallpox back to life in The Speckled Monster, an account of how two amateurs in the 1720s fought modern medicine's first battles against the deadliest, most terrifying disease the world has ever known. They led the charge by paying serious attention to the folk wisdom of such outsiders as Turkish women and African slaves--and by experimenting on their own children.

Carrell, a regular contributor to Smithsonian magazine, was covering the fine arts for the Arizona Daily Star when a publisher injected her with a significant advance to write a book about smallpox. This was in November 2001, when America was newly obsessed with terrorism, including bioterrorism. Carrell's agent had shopped the book proposal around for only 10 days before the first offer came in; then, after a week-long auction, Carrell suddenly found herself with enough money to quit the Star and spend the next 10 months researching and writing her book, which has just been published by Dutton.

"It was astonishing to me to think that this old story was of interest to people because of current events," Carrell says. "It's perverse and terrible that we have to be afraid of smallpox now because we've eradicated it from nature. That's what makes it so effective as a weapon--because it's gone from normal life, hardly anybody is vaccinated against it anymore."

The Speckled Monster is nonfiction, but Carrell has taken a novelist's approach to the story, creating dialog and poking through the thoughts and dreams of people who have been dead at least 2 1/2 centuries. "I wouldn't have done that if my goal were to write an academic history," she says, "but my publisher wanted me to take the fragments of history and bring them alive. This seemed the best way to do that."

Interestingly, Carrell's Harvard dissertation--she also has degrees from Oxford and Stanford--was on how people expected to find truth in narrative as modern fiction began to emerge in the late Middle Ages and early Renaissance.

For The Speckled Monster, Carrell says, she had to fabricate very little dialog for one of her main characters, Lady Mary Wortley Montagu. Once a beauty, she was badly scarred by a near-fatal case of smallpox, but went on to become as central a figure in London's aristocratic-literary circles as a woman could be in the early 18th century. She was a poet, pamphleteer, diarist and voluminous letter-writer. "Most of Lady Mary's dialog in the book is either verbatim or closely paraphrased from conversations she reported in her letters," Carrell maintains. "After all the research I did, I felt I knew her voice very well."

Her second main character, Zabdiel Boylston, posed more of a problem. Boylston was a well-known physician/surgeon/pharmacist in early Boston, but because he learned his skills through apprenticeships rather than formal education, he was denigrated by the "real" doctors who were starting to arrive in Massachusetts in the early 1720s. Boylston, too, was a smallpox survivor--the disease was by no means invariably fatal, even though, as Carrell writes, it killed "more people than the Black Death and all the bloody wars of the 20th century put together." Unlike Lady Mary, Boylston left few of his own words behind, aside from an account of the smallpox inoculations in which he was involved. "But what he did leave is so marked by a particular voice that it wasn't too hard to bring him back through dialog," Carrell says.

Both figures were catalysts in the first widespread use of inoculation in the West, employing smallpox to fight itself. Lady Mary learned of inoculation on a trip to Turkey, and Boylston investigated it by interviewing slaves from Africa. The medical establishment wanted little to do with theories developed by ignorant heathens and publicized at home by amateurs. Yet Boylston and Lady Mary did help promulgate the new, controversial and sometimes fatal practices, partly by offering their own children as early subjects.

"It wasn't just controversial; it was explosive," says Carrell. "There were riots in the streets over this. The intensity of the fear is hard for us to comprehend. This was 140 years before germ theory, so that fear had a great level of ignorance and superstition in it."

Despite the ignorance, it was easier then for an individual like Boylston to make an impact on public-health issues. "Science was at such a basic level that you didn't need fancy labs to try new things against viruses," Carrell says. "Inoculation, vaccination, antibiotics--all three major breakthroughs in immunology have come by accident, not because of bureaucratic support of research and control of disease."

Even if the last smallpox viruses remain safely in the deep freeze, our medical bureaucracy may not protect us from some new disease that could be just as devastating. "We're on the edge of a problem," Carrell says. "There's already an epidemic decimating Africa and South Asia--AIDS. But AIDS works so slowly that it doesn't rouse our fight-or-flight instincts like fast-acting diseases do. With SARS, you see what havoc a quick-acting disease can wreak in a globalized world. That's what we need to be worried about now: emerging infectious diseases. We're in an arms race against the bugs, and our old weapons, our antibiotics, are becoming antiquated."

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