What It Was Really Like Being A Plague Doctor

The mention of a plague doctor conjures up images of an unsettling figure in dark robes, sporting a long, beaked mask under a hat ... right? That's actually just part of the story.

Even though that iconic plague doctor costume has become synonymous with the Black Death and the terror of medieval disease — and cures — no medieval plague doctor actually wore it. That costume didn't come until later outbreaks of the plague, and don't worry, there were plenty of disease-filled years left by the time it was invented. Live Science says early plague doctors — those working during the Plague of Justinian, for example, and the Black Death of the 1300s — didn't even have the scant protection that famous beaked mask would have given.

So, why on Earth would anyone want to become a plague doctor? Who were these people? And what was it really like, tending to the sick and fighting a seemingly insurmountable disease that was everywhere? What kind of person becomes a doctor like that ... and just watches their patients die, often quickly and miserably?

When a doctor found a community that was in need of a plague doctor, it wasn't just a matter of moving in and setting up shop. According to The Medieval City, plague doctors would enter into a contract with the town or city that was hiring them, and negotiations were rarely straightforward. While communities knew they needed a plague doctor, they didn't want to put much further strain on already tough times. But plague doctors also needed contracts that made it worthwhile, and oftentimes, they got them.

Let's take one (of many) existing plague doctor contracts. In 1479, Pavia struck up a contract with Giovanni de Ventura. On top of 30 florins per month, he also got living expenses, two months' salary in advance, a completely furnished house, and another month's pay after his services were no longer needed. He also negotiated for "all and everything which is necessary for his life," which included things like food. And that? That was a huge deal, considering that widespread famine usually came with the plague.

That's not a bad deal, but there's one other thing: Many plague doctors who headed into cities and towns were looking for somewhere to set up a practice. Contracts — like Ventura's — sometimes also gave citizenship to a plague doctor who fulfilled his contract and survived the plague. That could have been life-changing: He would have had a place to live, money set aside, and a community to stay in if he chose.

Medieval plague doctors had a horribly depressing job, and the struggle to find something that worked was real. Many mixed potions, powders, and tonics and then gave them to their patients in an attempt to create a cure, and sometimes, they just ended up killing people faster.

According to the Ancient History Encyclopedia, plague doctors might offer their wealthiest customers a powder made from ground unicorn horn. (It wasn't really, but that's never stopped anyone before.) Other options for the very wealthy or the merchant class might involve grinding emeralds into a powder, mixing them with food or a drink, and serving that up along with a dose of mercury and/or arsenic, which, yes, was deadly. Plague doctors also had something called theriac in their arsenal, which was a complicated syrup made from up to 80 different ingredients ... and opium. 

Later plague doctors would have also been very familiar with mixing up a common treatment called Four Thieves Vinegar. The Farmers' Almanac says lore suggests the name — and the drink — came from a group of 18th-century thieves who robbed the homes of plague victims and drank their tonic to protect themselves from the plague. And it may have worked: Some of the components weren't just antibacterial but repelled the insects that were causing the plague. There were various recipes, but basically it was a tonic of herbs — variously including things like wormwood, sage, rosemary, camphor, and clove — left to steep in white wine vinegar.

Being a plague doctor didn't just mean someone spent all of their time tending to the sick and the dying: They were also sort of the accountants and attorneys of the plague.

According to Doctor's Review, a large part of a plague doctor's job was keeping detailed records about who died. They were responsible for keeping logbooks, recording the names of the dead and when they died.

Sometimes, they were tasked with other things, too. As one of the few people who might be brave enough to head into a house filled with people dying of the plague, they were often asked to hold onto important documents and to witness the wills and final wishes of the dying. They were also expected to testify on behalf of their patients if matters came to that, and, needless to say, there were plenty of unscrupulous plague doctors who took full advantage of their dying clients and grieving families. 

Plague doctors were paid by the community that hired them, not by individual families or clients ... and here's where things can get a little shady: Some of the contracts plague doctors signed were designed to protect the community, too. Take the agreement between Pavia and Master Giovanni de Ventura, signed in 1479. It specified that he was not allowed to ask patients for payment ... but also said that he was allowed to accept it if it was offered freely. There's a lot of wiggle room there.

In the 17th century, plague doctors got an upgrade to their wardrobe that came thanks to a physician named Charles de Lorme, who was the doctor of a handful of royals, including King Louis XIII.

National Geographic says that he — and his contemporaries — believed in something called the miasma theory, which stated that the plague spread through poisoned air. That's where the masks came in: That long beak was filled with herbs thought to help purify the air and keep the doctor healthy. The beak was filled with all kinds of herbs and flowers, including mint, cloves, camphor, dried roses or carnations, myrrh, and other pungent herbs. The stronger the smell, the better it was thought to work, and sometimes, those herbs and flowers were set on fire and allowed to smolder away. And here's the thing: While it's unclear just how useful the getup was, The Public Domain Review says that it's entirely possible that the heavy leather, ankle-length robe might have provided some very real protection against plague-causing factors, like sneezes.

Also handy? The wand or cane that was a part of the costume, too. While the mask made communication difficult, the wand was used to give instructions, take the pulse of a patient, or keep people away, should they wander too close. Once that distinctive costume was created, plague doctors were often required by law — and the contracts they signed with their communities — to wear it.

One of the heaviest weapons in the world's fight against the plague was quarantine, and according to History, entire cities have been using quarantine measures since the 14th century. The very first large-scale quarantine order was issued in what's now Dubrovnik in 1377, when it was ordered that no one was allowed to come into the city without spending a month in one of the surrounding areas set up to deal with outsiders.

That 30-day quarantine period was called a trentino, but more popular was the 40-day stretch called quarantino. That's where we get the word "quarantine" from today, and it's possible the time frame was extended to a standard 40 days because of the religious significance.

While city officials were allowed to declare longer (or sometimes shorter) periods of quarantine, plague doctors were also given the authority to lengthen or shorten the amount of time a person spent in quarantine. Did it help? Yes, in several ways: It didn't just help contain the disease, but the idea of having laws put in place to obey gave people a sense of agency and helped prevent a descent into anarchy and panic.