Radiolab – "Patient Zero (Updated)"

Podcast: Radiolab (WNYC Studios)
Hosts: Jad Abumrad, Robert Krulwich
Date: November 13, 2014
Episode Theme:
Exploring the origins—the "patient zero"—of epidemics (disease and otherwise): focusing on the archetype of the first case, tracing the path from a single individual (or idea) to vast movements, epidemics, or social phenomena. This episode journeys from Typhoid Mary to the origins of HIV/AIDS, contemporary Ebola outbreaks, and even the cultural “patient zero” of the high five.

I. Introduction: The Fascination with Beginnings

• Radiolab dives into the seductive idea of patient zero: that finding the source of something—be it an epidemic or a trend—will yield insight, containment, or understanding.
• “Patient Zero, the first cause.” – David Quammen (05:47)
• The episode mixes investigative journalism, science, and history, threading stories from the physically quarantined to cultural contagion.

II. The Story of Typhoid Mary (Mary Mallon) (02:33–16:22)

A. Outbreak in Oyster Bay (~1906)

• A wealthy family falls ill with typhoid; a sanitary engineer, George Soper, is summoned.
• Outbreaks are linked over several years and locations—all employ the same cook: Mary Mallon.

B. Discovery of the First "Healthy Carrier"

• Key Insight: Typhoid Mary was the first documented healthy carrier in North America—a person carrying and spreading disease without symptoms.
• “She was actually the first documented case in North America of a healthy carrier…” – Robert Krulwich (07:34)
• Soper confronts Mary, asking for samples. She refuses, chases him away with a serving fork.

C. Capture and Quarantine

• The health department sends Dr. S. Josephine Baker (and eventually police). Mary hides, is found, dragged out kicking and screaming, and tested.
• Confirmed as a typhoid carrier, she’s isolated on North Brother Island—a quasi-prison, with a view of the city she can’t enter.
• “Any place that you’re not free to leave becomes like a prison.” – Carl Zimmer (10:59)
• Her experience includes fluctuating (intermittent) test results. She sues the city and loses.

D. Legal and Ethical Dilemma

• Questions arise about civil liberties vs. public health. Hundreds of other healthy carriers are identified; only Mary is subjected to lifelong isolation.
• “I think it was more about making people feel safe than actually making them safe.” – Robert Krulwich (15:36)

E. Aftermath and Legacy

• Mary is released on the promise never to cook again, but eventually resumes cooking—causing new outbreaks. She is re-institutionalized and spends her life in isolation.

III. Patient Zero and the HIV/AIDS Pandemic (20:09–47:25)

A. The Origin Myth: Gaétan Dugas ("Patient Zero")

• Early 1980s: CDC’s cluster study maps sexual contacts between AIDS cases.
• One member, labeled “Patient O” (for “Out of California” in the CDC study), is misinterpreted as “Patient Zero.” This myth is propagated in media and Randy Shilts’s And the Band Played On.
• Dugas is wrongly villainized as the origin, “the central victim and victimizer.” (22:40)

B. Disproving the Myth: Scientific Evidence & Viral Genetics

• Advances in genetic analysis—known as the “molecular clock”—reveal HIV entered the U.S. around 1966, years before Dugas was sexually active.
• “So you could measure how different they are and...know that it would take a certain amount of time for them to get that different.” – Jad Abumrad (27:19)
• The real early cases are traced to earlier decades, including individuals in the 1950s and 60s.
• HIV’s origins are traced from the US to Haiti, then to Kinshasa (DR Congo), and ultimately southeastern Cameroon.

C. Tracing to the Real Patient Zero: The “Cut Hunter”

• 1908 (approximate): Scientists hypothesize that a hunter in southeastern Cameroon, while butchering a chimpanzee, contracts Simian Immunodeficiency Virus (SIV)—the ancestor of HIV—from chimp blood.
• Chimpanzees in a small region of Cameroon are pinpointed as the primary source: “An area probably only of 100 square miles” – David Rosner (33:06)
• Large-scale colonial change (railways, cities) facilitates the virus’ jump from the forest to global urban centers.

D. Even Deeper Origins: Chimp Zero & Viral Recombination

• The virus in chimps itself is a hybrid—arising from two monkey viruses within the same chimp, recombined in a “blue moon after a blue moon after a blue moon” event (43:14).
• Viral “spillover” from animal to human is a constant process, not a one-off.

E. On Spillovers and Ongoing Threats

• Nathan Wolfe discusses “viral chatter”—new retroviruses constantly leap from animals to humans.
• “The real question is, how do we stop patient zeros?” – Jad Abumrad (46:10)
• Tools such as digital surveillance and rapid-response epidemiology may mitigate the next pandemic.

IV. Update: Ebola Spillover (2014) (47:54–57:06)

A. Contextualizing the 2014 Ebola Outbreak

• David Quammen (author of Spillover) discusses the similarities with HIV’s emergence.
• Ebola's known outbreaks date back to 1976; the 2014 outbreak is unprecedented in size due to its emergence in denser populations and proximity to international travel.
• “Ebola burns too hot… it just destroys the body.” – Soren Wheeler (50:33)

B. The Challenge of Containment and Mutation

• Direct contact is required for transmission, but increased case counts mean more opportunities for mutation.
• “As the case count gets higher, it has more opportunities to mutate, and therefore more opportunities to adapt.” – David Rosner (56:21)
• Emphasis on stopping the epidemic at its source before mutation creates broader threat.

V. Cultural Contagion: The High Five Origin Story (59:40–73:47)

A. The Search for the High Five’s Patient Zero

• A modern example of “patient zero” outside disease: the origin of the high five.
• Reporter John Moallam debunks the viral but apocryphal story that credits basketball player Lamont Sleets.

B. The Real Origin: Glenn Burke and Dusty Baker

• Evidence points to Glenn Burke (LA Dodgers) and Dusty Baker’s celebratory high five on October 5, 1977.
• “He said, ‘Think about the feeling you get when you give someone the high five. I had that feeling before everybody else did.’” – Glenn Burke (68:32)
• Burke, a charismatic but marginalized gay player, is effectively erased by bigotry—his career ends early, and he dies young of AIDS-related complications.

C. The Complications of Tracing Origins

• Multiple competing origin stories: women’s volleyball, NCAA basketball, even a French film from 1955.
• “Every time we look for the original of anything… we find more than one.” – David Quammen (73:31)
• Sometimes, we choose narrative over strict truth: “Let’s just go with the best high five. Forget the first. The best.” – Jad Abumrad (73:47)

VI. Notable Quotes & Memorable Moments

• Typhoid Mary’s Defiance:
  “How dare you. I’m not a sick person.” – David Rosner as Mary Mallon (07:11)

• On the Patient Zero Myth:
  “He was not Patient Zero. Not even close.” – Jad Abumrad (24:55)

• Viral Recombination in Chimps:
  “These two viruses will end up inside the same cell in the same chimp at the same time, literally.” – Nathan Wolfe (41:51)

• The Human Cost of Stigma:
  “This is Glenn Burke, the faggot.” – Billy Martin, as recounted by Carl Zimmer (66:49)

• On Origins & Narratives:
  “Every time we look for the original of anything… we find more than one.” – David Quammen (73:31) “Let’s just go with the best high five. Forget the first. The best.” – Jad Abumrad (73:47)

VII. Key Timestamps

| Timestamp | Segment / Topic | |--------------|----------------------------------------------| | 02:33–16:22 | Typhoid Mary: carrier, quarantine, and legacy| | 20:09–47:25 | HIV/AIDS: Dugas myth, molecular tracing | | 47:54–57:06 | Ebola update: spillover, mutation risks | | 59:40–73:47 | High five: searching for cultural patient zero|

VIII. Episode Tone & Style

• Candid, investigative, and often reflective—mixing humor (“back to the peaches”), empathy, and awe.
• Frequently voiced in playful, spontaneous conversation, but always grounded in deep research and expert insight.

IX. Final Takeaways

• Tracing origins is as much about understanding ourselves—our fears, our desire for certainty—as it is about science.
• The quest for “patient zero” often yields ambiguity—whether in pandemics or pop culture.
• Societal responses to blame and stigma (from Typhoid Mary to HIV to Glenn Burke) have profound and lasting consequences.
• Vigilance, humility, and empathy remain vital, whether facing disease or chasing the origins of an idea.

Recommended Further Reading:

• Spillover by David Quammen
• A Planet of Viruses by Carl Zimmer
• The Viral Storm by Nathan Wolfe