There’s a story written on the heart of every epidemiologist (whether out of reverence or forced repetition, I won’t say). The story goes like this. In 1854, a physician named John Snow took it upon himself to investigate an outbreak of cholera in the Soho district of London. The prevailing theory of the time supposed that cholera was caused by miasma, or bad air. This actually seems quite sensible, given how poor public sanitation was at that time.
But in any case, Snow had his doubts, so he took it upon himself to go door to door. He inquired at each household whether they had experienced cholera, and from which well they drew their drinking water. Snow tallied the location of each case on a map, alongside the location of public wells. His visualization showed a clear clustering of cases around a particular well, on Broad Street. Legend has it that he convinced city officials to smash the well’s handle off with a sledgehammer, but I think we can safely assume that’s an exaggeration.
Veracity of the details aside, John Snow not only contributed to the identification of contaminated water as a source of cholera, he also launched the field of epidemiology. His story endures today as an example of the power of “shoe leather epidemiology.” With a pad of paper, some basic statistics, and a good pair of walking shoes, we can take on any outbreak, decimate infant mortality, eliminate rubella. The elegance of using those simple methods to improve the health of whole populations is part of what drew me to epidemiology.
Meanwhile...the internet happened. And mobile phones. Email, smart phones, wearable sensors, satellite imagery, omniscient meteorology. These are all things of presumable relevance to public health that have not made it into practice. Modern physicians use old-fashioned stethoscopes to listen to hearts and lungs, but they also use magnetic resonance imaging, computed tomography, ultrasonography. There’s not much equivalent to robotic laparoscopy in your local public health department. The world has moved on without us.
That’s not meant as an indictment of the profession. Epidemiologists eradicated smallpox just fine, thankyouverymuch, and hopefully guinea worm and polio aren’t far behind. But think how much further we could be, how much better we could do, if we harness the advancements that have brought us GPS and digital music. Or even better, what if we made whole new technological advancements for ourselves?
These are things I want for epidemiology. And since I’m extremely ill equipped to do it myself, I’m tagging you in, reader. I’ll teach you to code, and then I’ll get out of the way and let you handle the rest. Deal?
Good. Let's get started.
P.S. You can also find my Episkills blog and community site over at www.episkills.com