The Grubby Underbelly of the Richest and Most Powerful

An article from NPR today has caught my attention, not surprisingly because it's reminded me of something I've read.

A Twist On Charles Dickens: He Was A Public Health Pioneer Too

I learned from the exhibit and from Dickens scholars that this bane of high school students was not just a Man of Science, but a committed and effective public health activist with a strong eye for general medicine as well.

On display at the museum is an original copy of a weekly journal established and edited by Dickens in 1850 called Household Words, a two-penny weekly of the time. Dickens scholar Tony Williams has gone through hundreds of issues and his list of medical and health topics it covered is, well, Dickensian in length:

"Public health issues, sanitation, housing, slums." And more: "Hospital development, medical schools, proposals for health insurance, the problems facing new entrants to the medical profession, education for the disabled child."

Not done yet! "Compulsory vaccination, water pollution and food adulteration, the need for restrictions on the sale of poisons, the care of fighting men brought back from overseas conflicts, the spread of disease and how to prevent it; what we would now call repetitive stress syndrome for workers using the newly-invented sewing machine; homeopathy, epilepsy, lead poisoning."

And Dickens practiced epidemiology in the journals, and elsewhere. An article Dickens commissioned and edited compared mortality rates in a London slum to those in a specially designed housing project for the poor. The mortality rate in the slum was five to six times higher. In May of 1863 he gave a speech alerting the public to what had only been appreciated by a handful of epidemiologists at the time – that premature death was far more common in the poor than the rich.

Williams counted 125 articles on public health, sanitation and water, another 289 on medical care, nursing, hospitals, surgery and doctors, plus several hundred more on social conditions, poverty, psychiatry and mental health. . . . 

The book it brings to mind is Terry Pratchett's Dodger. Here's what I wrote for my review:

The thing I find particularly hard about reviewing Terry Pratchett is trying to come up with anything I might say that would capture the deft, clever, articulate writing that characterizes his books. Nothing seems to do it justice and I end up feeling he's best left representing himself. He simply has a magical way with words.

This story he calls a "historical fantasy," although the only fantastical elements are the way he's slightly fictionalized some of the characters and their interactions in early Victorian London. The protagonist is a young man named Dodger who has encounters with a journalist named Charlie Dickens, a barber named Sweeney Todd, politicians Robert Peel and Benjamin Disraeli, and many others names familiar from history. It's a nice blending of fact and story that captures the atmosphere of a time and era.

I'm waffling between four and five stars on this one. It's not as overtly humorous as much of Pratchett's other fare, with a little more emphasis on the adventure and suspense and a little less commentary on the foibles of the human creature. But I tipped the scales up because I sense he wrote this with a bit of a mission in mind; when I read this and similar stories set in that era (even the recent movie adaptation of Les Miserables), I see ominous similarities to some current political trends, and I think he meant this book as a beneficial reminder and lesson. That earns a bonus from me.

In particular, the article has me thinking of something Pratchett wrote as part of his end notes:

Transposed:

Dodger is set broadly in the first quarter of Queen Victoria's reign; in those days disenfranchised people were flooding into London and the other big cities, and life in London for the poor, and most of the people were poor, was harsh in the extreme. Traditionally, nobody very much bothered about those in poverty at all, but as a decade advanced, there were those among the better off who thought that their plight should be known to everybody. One of those, of course, was Charles Dickens, but not so well known was his friend Henry Mayhew. What Dickens did surreptitiously, showing the reality of things via the medium of the novel, Henry Mayhew and his confederates did simply by facts, lots and lots of facts, piling statistics on statistics. Mayhew himself walked around the streets chatting to little orphan girls selling flowers, street vendors, old ladies, workers of all sorts including prostitutes; and he exposed, by degrees, the grubby underbelly of the richest and most powerful city in the world.

The massive work known as London Labour and the London Poor ought to be in every library if only to show you that if you think things are bad now, they were oh so much worse not all that long ago.

Readers may have heard of the movie Gangs of New York; well, London was worse and getting ever more so every time fresh hopefuls arrived to try their luck in the big city. Mayhew's work has been shortened, rearranged, and occasionally printed in smaller volumes. The original, however, is not heavy going. And if you like fantasy, in a very strange way fantasy is there with realistic dirt and grime all over it.

And so, it is to Henry Mayhew that I dedicate this book.

Dodger is a made-up character, as are many of the people he meets, although they are from types working, living, and dying in London at that time.