A House Divided

13 mins read

“Every kingdom divided against itself will be ruined, and every city or household divided against itself will not stand.”  (Matthew 12:25)

During the nineteenth century, medical researchers discovered that microscopic, living organisms they referred to as germs, were the cause of many diseases.  Germs include bacteria, fungi, protozoa, and (as identified in the 20th century), viruses.  Nonetheless, the medical establishment was skeptical that something as small as germs could be the cause of cholera, typhoid fever, diphtheria, smallpox, and malaria, to name just a few of the diseases that have ravaged mankind for millennia.  And it took many years to convince doctors that knowledge about what caused these diseases could help prevent and cure them. 

However, by the beginning of the twentieth century germ theory was well established as were ways to treat germ borne diseases.  For example, inoculation worked to prevent certain diseases such as smallpox.  Hygiene, such as hand washing, using sterile dressings, wearing masks and gloves, and sanitizing medical equipment reduced infections that occurred when treating patients.  Ultimately development of antibiotics provided a direct way to fight bacteria borne disease.  Researchers also found they could prevent the spread of some diseases across large populations through sanitation, such as treating water and sewerage to kill bacteria and protozoa.  That’s why chlorine and fluoride is added to public water systems. Thus was the beginning of the public health movement in the developed world.  

Given this progress, it came as a surprise when a number of wealthy families experienced outbreaks of typhoid fever in the early 1900s.  Although typhoid fever had not been eradicated in the United States, wealthy Americans tended to have access to public sanitation making it much less likely they would contact typhoid fever, let alone that it would spread to almost every member of the household, family and staff included.  When the New York City Public Health Department started tracking the disease across these households they found an interesting pattern: one person, a cook by the name of Mary Mallon, had worked for all of the families.  When confronted, Mallon refused to provide urine and stool samples.  Eventually, Mallon, who the press dubbed Typhoid Mary, was arrested and placed in quarantine, where she could be studied to determine if she was the carrier.

Researchers found that Mallon was an asymptomatic carrier of the bacteria that causes typhoid fever.  The bacteria were isolated in her gallbladder and doctors offered to remove it, but she refused.  She also admitted that she seldom washed her hands.  After three years in quarantine, Mallon was released, after promising not to work as a cook and promising to maintain her hygiene including hand washing.  However, Mallon was not good to her word and she went back to work as a cook, including working in a hospital.  And once again, in each setting, Mallon caused typhoid fever outbreaks.  Because she changed her name when she changed jobs, it took public health authorities several years to track her down.  This time, to protect the public, she was ordered by the court to remain in quarantine and thus spent the rest of her life at Riverside Hospital in New York, until her death in 1938.  It is believed that between 1900 and 1915, Mallon infected between 50 and 100 people resulting in at least three deaths.

Mallon’s story is a stark reminder of the responsibility each of us has in preventing the spread of disease.  Unfortunately, in response to COVID19, too many Americans are acting like Typhoid Mary, thinking more about what they want for themselves, rather than the needs of all members of our society. 

President Abraham Lincoln used the biblical phrase about a “house divided” to describe the impact of slavery on our nation.  However, the truth is, since its inception, the United States has always been a house divided and is even more divided in our current political climate.  When the founding fathers were drafting the U.S. Constitution, they were concerned about the scope of government; they understood that when people gather together to create a democratic and representative government, there would be times that the needs of society would override individual rights.  At the same time they wanted to ensure that individual civil liberties were maintained.  Ultimately, when things are working correctly, we balance individual rights with societal needs, understanding that each approach has its advantages and disadvantages.  For example, most Americans agree to drive at the posted speed because the roads are safer when we all drive within those limits.

When I was writing The Case for Universal Health Care, I wanted to better understand why so many conservatives oppose it; after all, universal health care costs less than what most Americans currently pay for health insurance and it ensures everyone has access to treatment.  I found that at its simplest, conservatives believe that the rights of the individual take priority over the needs of society, whereas liberals believe situations determine when the individual or society’s rights and needs take priority.  For conservatives, individuals are ultimately responsible for their success or failure.  While believing that is true, liberals also recognize that individuals do not work and live in isolation; society and the environment society creates can insist or impede an individual’s endeavors.

For example, when first lady Hillary Clinton used the African phrase “It takes a village to raise a child”, liberals understood it to mean child rearing does not occur in isolation.  Raising a physically, mentally, and emotionally healthy child requires a healthy community with social, educational, and religious supports.  Conversely, conservatives branded her a communist who want the government to raise our children instead of an intact, heterosexual family.  Similarly, liberals believe assuring access to health care is a social responsibility, whereas conservatives brand universal health care as socialism.

Unfortunately, over the past forty years, the Republican Party has tried to tip the balance ever further right of center.  As a result, Republicans have advocated policies that strengthen individual rights over the needs of society as a whole.  And the emphasis on individualism is extremely problematic as our nation faces the COVID19 pandemic.  Whereas, we should be a united country, we are a house divided making combating the disease much more difficult.  For example, egged on by Donald Trump, reinforced by conservative media such as Fox News and Breitbart News, preyed upon by wacko televangelists such as Kenneth Copeland, and supported by Republican governors, thousands of Americans have taken to the streets to protest governors’ orders to shelter in place to reduce the spread of COVID19.  Conservative media has convinced many that the pandemic is not real, rather it is a political conspiracy, and government actions taken to protect the population from spread of the disease amounts to communism.  Although they represent an exceedingly small minority of Americans, these protestors have received a lot of media attention which threatens to undermine the productive efforts our health care system has taken to fight the spread of the disease.  Consider the protestors as the Typhoid Marys of the COVID19 pandemic.

Donald Trump was correct when he referred to combating the pandemic as the same as fighting a war.  However, when we fought WWII, we were a united people.  In his fireside radio chats, Franklin Roosevelt extolled the merits of making sacrifices for the war effort and the betterment of the country.  In contrast, Trump said he would take a bipartisan approach to solve the pandemic and then the very next day criticized the actions of Democratic governors who complained about the Federal government’s slowness in getting virus testing kits out to the states.  We are a house divided at a time when we need to be united.  We are a house divided because of a partisan president, a partisan Republican party, and partisan conservatives who think only about their individual wants rather than their responsibilities as members of society.

A friend of mine recently wrote a letter to the editor and I think she described the problem very succinctly:

“I don’t know exactly how so many people missed learning the Preamble to the Constitution, or the Gettysburg Address, or even JFK’s inaugural speech, but here’s a reminder of what democracy looks like: It looks like, ‘We, the people,” not me.  It looks like a system that is, “of the people, for the people, and by the people,” not, “of me.”  It looks like doing all you can for our collective country, not, me.  It looks like, “providing for the common defense,” not, me and only my defense to do whatever I please regardless of the consequences to others.  The protesters have completely twisted versions of liberty and government.  Well, they have the right to assemble, so I have no problem with their doing so.  However, they don’t have the right to endanger others.”

David Colton, Ph.D. is the author of The Case for Universal Health Care (Clarity Press, 2019) and blogs about UHC at: www.universalhealthcarenow.com 


  1. Timmreck, Thomas C. (1998).  An Introduction to Epidemiology. Jones and Bartlett, Publishers.  Entry for Mary Mallon: https://en.wikipedia.org/wiki/Mary_Mallon
  2. As of 2018, about half of all children were being raised in nontraditional intact families: https://ifstudies.org/blog/1-in-2-a-new-estimate-of-the-share-of-children-being-raised-by-married-parents
  3. https://www.youtube.com/watch?v=ZMkyDS5ULts
  4. https://www.youtube.com/watch?v=pvDXtJBwXAM
  5. https://www.newsleader.com/story/opinion/readers/2020/04/22/our-nation-built-notion-we-rather-than-me/3005251001/

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David Colton, Ph.D., is a retired health care administrator and adjunct professor of health care administration at Mary Baldwin University, Staunton, VA. Research interests, publications, and conference presentations have focused on quality improvement and cultural change in behavioral health care organizations. He is the author of The Case for Universal Health Care (Clarity Press, 2019) and maintains a blog on the subject at www.universalhealthcarenow.com.

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