Flesh and Blood Read online

  Billy remained wonderfully raw and hard and irreverent and funny till the day he died. I like to think that his only son, Ritchie, gave him some respite from the toxin he’d endured. Ritchie Routledge grew to be a successful singer and guitarist in a hit band called the Crying Shames – a member of that wonderful Merseybeat generation – a glorious, bright, brash burst of Liverpool song that took the world by storm before the ships sailed away and the factories closed.

  If Billy hadn’t survived Batu Lintang then Ritchie’s music would never have existed. His would be a beautiful sound we’d never know. So Billy’s hunger and defiance were a gift to those who followed, and a tribute to those who didn’t make it. His hatred was redeemed by sacrifice: a grim, grinning skeleton that endured so that the ones who followed might sing a gentler song. The tooth-smashed love song of ‘bastards like us’.

  *

  I’m back in 1868. Back at Teresa McGann’s sad, simple death certificate.

  How did her mother cope with what she witnessed? How did she rise the next day and go on? How did she consummate her renewed hope and passion with Owen – time and time again, rolling on that filthy bed at night with the coughs of her children close at hand? What was the motivating force that sprang from the hungers of the family that bore me? Just then I see it. Next to Owen’s name on the certificate. The father’s occupation, hidden by the official’s careless pencil mark.

  ‘Musician.’

  Owen was a musician! The first artist of any kind recorded on my family tree. Not a docker, not a labourer, not a tinker. A musician. Of the lowliest sort, I’m sure – a cheap fiddler or tin whistle beggar, playing for farthings on the street or in the bar. But a musician all the same. This meant that there was music in that hovel, not simply silence. Owen was a grinning, dancing skeleton, playing his joyous, raucous, toothless reels until the kind and clever ones that followed him could play a gentler song. There was music in their bed at night – passion like a melody, despite the filth. His music was a motivating force beyond passivity. A sound like Billy’s skeletal laughter. The sound of something beyond mute suffering. The sound of a feverish hope that propelled a family forward into the unknown, despite all dangers and obstacles. The sound of a directed desire.

  The sound was love. The passion of being alive despite the horror. A defiant song for all those who’d come after. A redeeming sacrifice for his descendants. A focused hunger to succeed beyond starvation.

  The love song of bastards like us.

  2

  PESTILENCE

  Pestilence n.

  1. An infectious epidemic disease that is virulent and devastating.

  2. An entity that is morally destructive or pernicious.

  MEDICINE

  Epidemic infection has been ripping families and societies apart since the very earliest civilisations, and many of these ancient pestilences are still with us today. Infectious disease is a medical disorder caused by a microorganism – a bacterium, virus, parasite or fungus – entering the body and disrupting its normal function. The characteristic of these diseases is that they are transmitted from one person to another. As human civilisation first became established, people began to live together in larger, denser, more interconnected settlements. This enabled infectious disease to establish quickly through close contact, and then spread widely through trade or conflict with others.

  These pestilences could sometimes be so terrifying to our forebears that a dark sentience, divine provenance or moral cause was ascribed to them. Pestilence even appears as one of the Bible’s Four Horsemen of the Apocalypse, those mythical harbingers of our final moral judgement. Pestilence wasn’t simply an affliction to our ancestors; it could also be an indicator, a verdict or retribution for some greater malady within the character of the sufferer and their kin.

  One such pestilence was leprosy. Leprosy is an acutely disfiguring bacterial infection with a long history of public fear and prejudice. In many societies, it was believed to be a punishment from God – a curse for the failings of the sufferer. Lepers were isolated in colonies, stoned and shunned by the healthy, and forced to differentiate themselves as an alien group. The Old Testament’s Book of Leviticus gave specific directions for their treatment:

  Anyone with such a defiling disease must wear torn clothes, let their hair be unkempt, cover the lower part of their face and cry out, ‘Unclean! Unclean!’

  We can all be grateful that a trip to the doctor now involves a more useful approach to the treatment of infectious disease than instructions on hairstyle and a light stoning. Yet even recent history has shown that public fear of infection can fuse itself in language and attitude to the nature of the people who suffer from it. In a sense, the pathogen and the person become one – or, in the case of typhus fever, an infection can even grow to embody a whole race.

  Typhus fever is spread through lice that have been infected by a bacterium called Rickettsia prowazekii. As these blood-sucking lice feed on a human host they excrete the bacteria onto the skin. If the human scratches this bite, then the infected faeces are rubbed into the microscopic wound, transmitting the typhus. The faeces can also dry to a dust and then be inhaled as an airborne pathogen. The onset of typhus fever is rapid: headaches, rash, delirium, muscle spasm. After five days, a livid rash appears on the chest and limbs. After a fortnight the death rate is between 25 and 40 per cent. Typhus fever is a disease of close confinement, grinding poverty and an inability to keep clean. It was a common feature of the Irish famine, and was carried with the emigrants to the slums of Liverpool, where it became known simply as ‘the Irish fever’. A pathogen had become fused in language to a people.

  Infectious diseases can be as distinctive as the populations they infect. Each has its own unique method of transmission, deadliness and rate of infection. Scientists have devised a scale for the infectiousness of a pathogen called its basic reproduction number – or R0(pronounced ‘r naught’). This is an approximate measure of how many unprotected people are likely to become infected by contact with a single person carrying this disease. An airborne pathogen like measles is highly contagious, with an R0 of 12–18 – meaning that a single infected schoolchild might infect eighteen of their unvaccinated classmates. Yet deaths from measles are relatively rare. A disease like Ebola, spread only by bodily fluids, has an R0 of just 1.5–2.5, yet it will kill about half of those it infects. The danger from a pestilence is therefore greatest when a pathogen is both easily transmitted and highly deadly – as was the case with one of the most infamous of all the historical plagues: smallpox.

  Smallpox is caused by the variola virus. Infection occurs when a person inhales droplets of the breath of a sufferer, or if their infected bodily fluids manage to find their way into healthy mouths and noses. With an R0 of about 7, it’s not the most contagious of infections – and contagion depends upon prolonged close contact with someone who has it. Yet if the conditions are right – cramped housing and dense urban populations – it can spread like a bushfire. Once infected, the incubation period is long – about a fortnight. At first there are flu-like symptoms and the body temperature rises. Then there’s nausea and vomiting. A few days later, red spots appear in the mouth and throat and on the tongue. When these spots burst, the virus spreads on the infected saliva. Within another two days, a signature rash of spots or macules begins to develop on the skin of the forehead and face, spreading to the body and extremities over the following days. In the most common variant of the disease, the rash develops into deeplying, hard pustules that cover the entire face and trunk, and leak a vile fluid. These pustules finally subside into scabs that, when they fall off, leave the sufferer horribly pockmarked, and possibly blind. That’s if they live. The death rate for smallpox is at least 30 per cent and as much as 80 per cent amongst children.

  Smallpox is an ancient scourge. Evidence of smallpox has been found on the mummified body of Pharaoh Ramesses V of Egypt, more than three thousand years old. Traders were believed to have brought the disease from
India during the first millennium, BCE. From India it spread to China, and returning crusaders were thought to have carried smallpox to Europe in the eleventh and twelfth centuries.

  Though deadly and feared, there was a defence against it. Smallpox enjoys the privilege of being the first disease to be treated with vaccination. Edward Jenner famously inoculated a small child by infecting him with the closely related but nonfatal cowpox in 1796. Yet evidence for smallpox vaccination goes back much further, to tenth-century China. The traditional method, called variolation, was a simple one: a patient’s skin would be cut or scratched open and material from an active smallpox macule would be inserted into it. The patient developed mild symptoms of smallpox but recovered, and thereafter was immune. Yet it was risky: introducing active smallpox to a healthy body could prove fatal in a significant minority of cases, and also risk spreading the full-blown disease to others. Jenner’s cowpox method was safer, as the introduced infection was not, in itself, a fatal one, yet would still inoculate against its deadly cousin.

  Smallpox enjoys another unique distinction in the history of medicine. It’s the first infectious disease that humans have ever managed to wipe from the planet. It was finally declared eradicated in 1980 following a global campaign by the World Health Organization. This amazing feat was achieved by a crucial alliance of medical science with wider human qualities of collective organisation, education and knowledge sharing.

  Right up to the 1960s, smallpox had remained endemic in Africa and Asia. Mass vaccination programmes had been effective in many parts of the world, yet they were costly in time and resources, and not always efficient in targeting those people most in need. A new strategy of ‘containment and surveillance’ was devised, led by American epidemiologist Donald Henderson. Every time there was a smallpox outbreak, a medical team would travel to the scene, vaccinate and isolate all those who were ill, and then trace and vaccinate everyone who had come into contact with them. At the same time, they educated local populations in risk areas about how to spot the disease, and offered rewards for any confirmed sightings. In this way Henderson and his team turned the blunt instrument of mass vaccination into a kind of ‘whack-a-mole’, seeking and destroying smallpox wherever it reared its head. Eventually the disease was whacked into extinction. The last natural smallpox case was in Somalia in 1977 – a young hospital cook called Ali Maow Maalin.

  The word ‘natural’ is important here. Although smallpox no longer exists ‘in the wild’, it endures as a dangerous pathogen in laboratories in the United States and Russia. These supplies have been retained for military purposes, as well as for research. This has led to isolated outbreaks due to accidental exposure, thankfully controlled thus far. Smallpox is even more dangerous to us now, as the population has ceased to be vaccinated against the disease. Despite periodic appeals to destroy these dangerous stocks for safety reasons, the two superpowers have so far refused to do so – each mistrusting the other, and fearing that the pathogen could be weaponised against them.

  The smallpox pathogen has avoided complete eradication not by the failings of medicine, but by that same ancient fear of ‘the other’ which turns an infectious disease into mistrust of an alien tribe considered incurably pestilent. Significantly, just two years before Ali Maow Maalin contracted smallpox, the soon-to-be President of the United States, Ronald Reagan, compared Communism to a dangerous pathogen: ‘Mankind has survived all manner of evil diseases and plagues – but can it survive Communism?’

  Pestilence is therefore like a beast with two heads. The first is the physical infection that assaults our bodies – killing families, disfiguring flesh, decimating communities. The second is a malady of the collective mind – a ghetto into which a disease can cast the infected, encouraged by the biblical stones thrown by those in society who most fear it. A physical infection may be treatable with medical science or prevented by the sanitary improvements of social progress. Yet cultural pestilence is the more subtle and enduring pathogen; one more likely to persist according to prejudice and expediency than to vanish completely.

  Pestilence isn’t just something we can catch, but something we can become. A way for others to define us, and a means by which we may ultimately come to define ourselves.

  HISTORY

  The Survivors: The McGann family, 1871–1900

  When I last left my McGann forebears, it was the evening of Sunday 2 April 1871. They were huddled in a tiny dwelling in Clay Street, Liverpool: pauper immigrants from Ireland who had subsisted in an overcrowded and insanitary dockland neighbourhood since their arrival from Roscommon nearly a decade before. Owen – forty-eight years old; his wife Susan, forty; their children, James, Eugene, Sarah and Mary. They’d already lost two children to hunger since they’d arrived. They were soon to lose another.

  The reason I can be so specific about time, place and people is that the evidence comes from the United Kingdom census, the once-a-decade population survey that’s existed in Britain since 1841, and whose careful preservation provides genealogists with unique insight into a specific British neighbourhood. There was an interesting detail to the McGanns’ address on the 1871 census. They lived at ‘2 in 4ct’ Clay Street, whereas a nearby neighbour simply resided at 4 Clay Street. Other families could be found at ‘5 in 4ct’, ‘3 in 4ct’, etc. What was going on with the street numbering?

  The answer, I discovered, was socially significant. The abbreviation ‘ct’ stood for ‘court’. Every few numbers along each street, the numbering would expand to embrace a particular court containing several sub-addresses, crammed with Irish families. These court dwellings were a feature of slum housing in Liverpool at the time and up to half of the city’s population were housed in them by the middle of the nineteenth century. The McGanns were court dwellers.

  A court was accessed from the main street by a low, unlit passageway, which opened out after a few metres into a narrow courtyard containing anything from four to a dozen or more houses that faced each other across the tiny space. Families were squeezed into single rooms or sub-let cellars in these houses, and most courts were ‘blind’ – meaning that the only entrance and exit was by way of the narrow passageway to the street. At one end of these courts was a single water tap; at the other end were the public toilets – foul closets that a hundred residents or more had to share. They were little better than open sewers. There were no conveniences, water or gas within the houses, and each dwelling backed directly onto the wall of the next court, so that the only access to light and ventilation was from the insanitary and foul-smelling courtyard.

  In 1883, the Liverpool Daily Post newspaper set up a special commission to investigate these housing conditions. Its anonymous commissioners explored the very streets the McGanns were living in and reported on what they found:

  Here resides a population which is a people in itself, ceaselessly ravaged by fever, plagued by the blankest, most appalling poverty, cut off from every grace and comfort in life, born, living, and dying amid squalid surroundings, of which those who have seen them can form a very inadequate conception.

  They called their report ‘Squalid Liverpool’ and descriptions of the courts featured widely in their account:

  The passage entrance … is strewn with refuse matter – animal and vegetable – so that one has to pick a careful way in order not to become bedaubed. In all this dirt and stench little children play about and roll over, perfectly regardless of the consequences.

  They ventured into the court dwellings to describe the kind of single-room conditions that Owen’s family were living in:

  The room is perhaps eight or nine feet square. Into the boards is ground the dirt of years. The window does not open at all, and if the inhabitants desire to dilute the foul air of the room with a little of the foul air of the court they have to remove the sash bodily … on the floor a few sacks of vile appearance and smell were arranged in the form of a bed.

  And yet, in all of these houses, they found the people universally friendly, polite
and approachable:

  The house doors are nearly always open. You may go in if you like, no one will object. You will meet with nothing but civility. Your commissioners in all their visits never received a harsh word from young or old, men or women.

  Filthy but polite. Squalid but friendly. Dens of sickness with their doors flung open in welcome. Owen playing his merry reels on a tin whistle while the lice crawl on his children’s heads. As the commissioners’ investigations continue, the impression gathers that the residents’ relaxed disposition is regarded as a symptom and not a virtue. These were not only paupers by circumstance, but by social propensity. The commissioners remark upon the ease with which a householder will lie about most things, ignore personal hygiene, drink to excess, yet exude a passive contentment with their lot:

  ‘Like all the rest, they inhabit filthy houses, and appear perfectly contented with their dirty surroundings.’

  To the commissioners, these people were smiling incubators of infection, rolling over contentedly in their own dirt and stench like pigs in a sty. ‘A people in itself’. An alien, infected tribe.

  Certainly infected. If one wished to incubate a fatal disease, you couldn’t imagine a more suitable environment than the crowded, filthy courts these commissioners described. Reports like ‘Squalid Liverpool’ were responses to the constant threat of epidemic facing the respectable citizens of prosperous Liverpool with regard to the Irish paupers in their midst. These slum dwellers were a breeding ground for pestilence, and had been for decades.

  Sanitary conditions had been dire in Liverpool since before the Irish famine in the 1840s. Previous influxes of emigration had led to overcrowding and epidemic in the shabby backstreets of the docks. But now a new legion of the starving and diseased had arrived to swell the courts and cellars to bursting. So urgent was the problem that a law was passed in Parliament dedicated to the city’s hygiene: the 1846 Liverpool Sanitary Act. I’m sure there are many who can claim that their ancestors were poor – but how many can say that the local nature of their family’s poverty was so bad that it led to government legislation?