Mary and Carrie and baby Grace and Ma had all had scarlet fever. The Nelsons across the creek had had it too, so there had been no one to help Pa and Laura. The doctor had come every day; Pa did not know how he could pay the bill. Far worst of all, the fever had settled in Mary’s eyes, and Mary was blind.

Those are among the first words of “By the Shores of Silver Lake,” by Laura Ingalls Wilder, and they are haunting ones. Generations of children who had grown to know Mary in the first books of the “Little House” series read them with the same sense of shock — Mary, the annoying, bossy, well-behaved sisterly nemesis to the wild “half pint” Laura, blind?

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We young readers knew that Mary and Laura were real people. They listened to Pa fiddle and did churned butter and sat for hours in the wagon. They brought in the cows and waded in the creek. And now for Mary, in just a few simple words, everything had changed, which meant anything could change that quickly.

The literary and life lessons of that change remain the same, but for a decade, Dr. Beth A. Tarini wondered about the cause. “When I was a medical student doing my pediatric rotation,” she says, “I asked my supervising doctor ‘So, scarlet fever can make you go blind, right?’ and she said no. I argued— ‘Mary Ingalls was a real person. And it said in the book that scarlet fever made her go blind.’ But clinically, it didn’t make sense.”



Dr. Tarini was curious enough to do some research at the time as a medical student, but she set her work aside for years. When she returned to it, she enlisted the help of numerous sources including two doctors, Carrie L. Byington and Jerome I. Finkelstein, along with Sarah S. Allexan, the Herbert Hoover Presidential Library and Museum, the Ingalls family historian Bill Anderson and the South Dakota Historical Society, to publish “Blindness in Walnut Grove: How Did Mary Ingalls Lose Her Sight” in the journal of the American Academy of Pediatrics.

Their conclusion? Mary’s blindness at age 14, in 1879, was likely caused by viral meningoencephalitis.

Why call it scarlet fever in the book? The authors suggest that scarlet fever may have seemed simpler or more familiar to either the author or to her editors:

After revisions by Laura and her daughter Rose, Laura’s memoirs were transformed into the Little House novels. We presume that during those revisions, they decided to attribute Mary’s blindness to scarlet fever, perhaps to make the story understandable for children. Alternatively, Laura’s editors may have thought readers were more familiar with scarlet fever than brain fever or meningoencephalitis. For example, scarlet fever is featured prominently in other 19th century novels such as Frankenstein and Little Women.

Beyond being an interesting literary curiosity, why does it matter why Mary lost her sight?

“When I’m in clinic,” Dr. Tarini said, “and I tell parents their child has scarlet fever, I see their eyes widen. In my mind, it’s no different than a strep throat with a rash, but the specter of history colors their reaction.” Those emotional words describing Mary’s lost vision still carry weight with the parents who read and remember “By the Shores of Silver Lake” and all the books that came before and after it.

“We’re taught to find out what’s wrong and give a patient a diagnosis,” Dr. Tarini continued, “but that’s only one of the things the patient needs. If I say ‘scarlet fever’ and a mother is thinking, ‘Mary Ingalls’ then if I don’t know to pull that out, I’m not doing my job.” It matters to pediatricians if it matters to their patients.

I had scarlet fever as a child. I thought I was gravely ill, and I studied the rash on my hands with fascination. I thought I might be shut up for weeks in the dark, like J.D. in “The Great Brain,” who had measles, although I hadn’t yet read “Little Women” and didn’t expect to share Beth’s fate. I practiced walking with my eyes shut in case I became blind.

When I mentioned all this to my mother years later (I said nothing at the time — which should remind us, again, that our children have rich inner lives about which we know nothing), she shrugged. “It was just scarlatina,” she said. Scarlatina— the same thing as scarlet fever, actually, but a much less threatening name.

How Mary lost her sight is little more than a historical curiosity today. But our memory of it says something about who we are, and how our culture and our own history comes with us into the doctor’s office. “Blindness in Walnut Grove” is a nice reminder that the best doctors look beyond the diagnosis and the prescription sheet to consider what other worries their patients might have.

I found myself re-captured by the real stories of Laura and Mary in writing this. To read more about Mary’s life, visit the website of the Museum of the American Printing House for the Blind.