At a time when germ theory was still transforming everyday medical practice, these interventions mattered.

They also required people to change habits.

That could be harder than prescribing medicine.

Susan had to convince communities that small daily behaviors could save lives.

The work was relentless.

Her own health began to suffer.

She experienced chronic pain, hearing problems, and illness during her career.

At times she was forced to reduce or leave formal government service.

Yet stepping away from the government position did not mean abandoning medicine.

She continued treating patients privately.