London, 1854. The cobblestone streets are littered with derelict workhouses as the remarkable, putrid smell of rotting garbage and feces pervades the heavy air. Smog and pollution are rampant, and Parliament is at its wits end regarding the ongoing health crisis. Meanwhile, on Broad Street, just north of Piccadilly Circus, one of the worst outbreaks of cholera in the modern era is soon to break out. The overwhelming scientific consensus of the day points toward the foul-smelling air itself as the source of disease, following the medieval disease theory called miasma. Yet, two men, one a scientist and the other a local minister, decide to investigate deeper as they inch ever-closer to discovering the true source of the ravaging disease: a contaminated water pump in the heart of the city.

In his book, The Ghost Map: The Story of London’s Most Terrifying Epidemic- and How it Changed Science, Cities, and the Modern World, bestselling author Steven Johnson breathes life into this narrative as he traces the intricacies of this event and its implication for our own city-planning aspirations. Following the multidisciplinary thinking of London physician John Snow, Johnson recounts how Snow examined water samples under a microscope, drawing up a map that revealed a correlation between the cases of cholera and the walking distance between the pumps. Furthermore, he narrates the struggle that Snow encountered in opposition to the General Board of Health, which ardently held onto the disease theory of miasma. Johnson also includes the contributions of local minister Henry Whitehead, who, unlike Snow, had a localized knowledge of the residents of Golden Square, leading him to identify the source of the cholera contamination, namely a sick infant’s discarded diaper that had infiltrated the well. Furthermore, Johnson also dives into the context of Victorian London’s infrastructure, illuminating the ways in which waste was managed and the role of population density on epidemiology. By effectively utilizing his primary sources, as well as adding a bit of imaginary flair into the inner thoughts of these men, Johnson uses the 1854 Golden Square cholera outbreak to make a compelling narrative about the ever-evolving role of science and medicine in mid 19th century London.

The strongest aspect of this work is its compelling and entrancing narrative structure. This is an incredibly well-written book, as  Johnson weaves primary documents with his own imagination in order to complete a compelling narrative of the Broad Street outbreak. The book, especially in the first half, reads as a type of medical detective thriller, bidding  us to walk along the gritty, dirty streets of mid-19th century London, in all of its spectacular urban dirge. Also note that this book is not for the squeamish, as Johnson vividly describes the biomechanics of cholera, how it spreads (via excrement), and how citizens treated the disease (often with undesirable outcomes.) Furthermore, Johnson provides the reader with a map in the front of the book, to which I constantly referred. This simple addition helped me to visualize the streets and the proximity of the pumps, the importance of city planning and waste management and aided in highlighting the geographical nature of the epidemic. Finally, it is worth commending that Johnson refuses to rest in the “great man” theory of history that plagues many popular books within the history of science. In fact, he explicitly writes that “Great breakthroughs are closer to what happens in a floodplain: a dozen separate tributaries converge, and the rising waters lift the genius high enough that he or she can see around the conceptual obstructions of the age” (149). Thus, in several ways, Johnson rightly emphasizes the role of collaboration in scientific discourse, rather than leaning on the hackneyed trope of the lone genius who overcame the superstition of his age (though Johnson is not entirely clear of logical positivism and scientistic thinking, as I’ll address later.)

On the other hand, the book has a few fundamental issues. I found that the first half of the book is drastically more engaging than the latter, as he unnecessarily stretches the narrative out in order to fill pages. As the book progresses, Johnson begins to take the reader on wild tangents, meandering through various topics such as the development of telecommunications, location-tracking software, and the threat of nuclear annihilation. For example, in the Epilogue, Johnson makes an argument in regards to the ecological benefits of urban living, making the case that “the primary solutions [to global warming and our dependence on fossil fuels] may well prove to be to encourage people to move to metropolitan areas. A warmer planet is still a city planet, for better or for worse” (239).  Furthermore, he adds that the primary reason that people live in cities, including “the squatter classes of Sao Paulo,” is because they actively choose to live there due to cities being “centers of opportunity, tolerance, wealth creation, social networking, health, population control, and creativity” (237). This passage strikes me as overly-optimistic (and a bit tone deaf) towards the nature of city living outside of the author’s home of Brooklyn, preferring to Romantically believe that favelas are the result of an opportunistic, progressive mindset rather than an increasingly unequal distribution of wealth and gentrification within Sao Paulo. This scientistic, naive optimistic vein is further found in the final pages, where he writes that science, rather than superstition, holds the key to solving the world’s problems, which he explicitly states does not include an apocalyptic crisis of capitalism (256). While these subjects are tangentially related to the subject matter at hand, they seemed a bit odd and out of place in an otherwise tight and compelling narrative.

Overall, this book serves an an intriguing look into the ways in which city planning, infrastructure, and determined, unquenchable curiosity can be catalysts for social change. Johnson’s writing is strongest when he is describing the primary narrative that drives the book, turning an otherwise mildly interesting history book footnote into a compelling, disease-driven detective novel. While some of his conclusions (especially in the Epilogue) are a bit far-fetched and tangential to the overall narrative, this work still serves as a worthy addition and relatively quick read for anyone interested in the evolution of science, medicine, and city-planning within Victorian London.