If I Die Before I Wake

by Jean Little

  What is a “pandemic”? It is an epidemic which infects not just one city or even one province or state, but spreads throughout the world. Earlier such diseases were the Plague (sometimes called the Black Death) and cholera. HIV–AIDS is a pandemic that has spread across most of the globe and has killed millions of people throughout many countries, especially those in Africa.

  Polio was once a terrifying illness that killed or crippled thousands of people. In the past, measles and diphtheria were also responsible for thousands of deaths. We in the western world no longer fear these last three diseases so much, because vaccines have been developed which have brought them under control. Scientists are now working night and day in an effort to develop similar vaccines to counter the flu, in all its many variants.

  Why are we searching so desperately? Because all our current “miracle drugs” cannot defeat a deadly virus much better than medicines could in 1918. We have ways of fighting viruses, ways that our ancestors lacked. But they are still not sufficient.

  THE SPANISH FLU

  Despite its name, the Spanish Flu did not begin in Spain. There are several theories about how the word Spanish became associated with it, one being that reports of the disease first appeared in Spanish newspapers — Spain, being neutral in World War I, was less concerned about reporting deaths than the Allied or German press were.

  The first North American cases of the Spanish Flu epidemic were reported at Fort Riley, a military base in Kansas. Over 100 servicemen stationed there in March, 1918, began to show symptoms of having “colds,” and within weeks over 1000 soldiers were sick enough to be sent to hospital. Some of the sick were sent home — and carried the contagion with them. Others, who had not yet developed acute symptoms or were still in the incubation stage and therefore appeared healthy, were shipped overseas to fight. The Spanish Flu travelled with both groups. The virus had already begun to appear in soldiers in Europe and the British Isles — in May of 1918 over 10,000 sailors from the British fleet were sick.

  The contagion reached Canada during the summer of 1918, appearing among the civilian population in a college at Victoriaville, Quebec. Although the illness was reported in the press, nobody was unduly alarmed at first. It took longer then for people to travel from place to place — many people were born, raised and lived out their lives within a day’s journey of the town where they spent their childhoods. Quebec, which seems so close to Toronto today, was not close at all to people like Fee Macgregor and her family. Yet, late in September, a little girl from Jesse Ketchum School died in the Toronto General Hospital — Toronto’s first Spanish Flu fatality. Canadians, having endured a war that killed almost 60,000 of their young men, were about to experience the outbreak of a disease that would claim up to 50,000 civilians, who had believed themselves to be safe at home. Often the two groups overlapped. Some servicemen returning to Canada brought the contagion with them; some contracted it after they returned home, thinking themselves to be far from the Front and out of danger. Eighteen-year-old Alan McLeod, Canada’s youngest recipient of the Victoria Cross (the Commonwealth’s highest award for valour), survived the war but died from the flu soon after returning home a hero.

  As the death toll from the flu mounted across the country, complacency ended. Schools were quarantined. Public meetings were cancelled. Bowling alleys closed and public libraries shut their doors to the public. Even the Stanley Cup playoffs were cancelled.

  In Ontario, the government organized over 400 women to become Sisters of Service (S.O.S.). Other areas of the country launched similar appeals, and women responded. In Toronto, volunteers attended three lectures on how to help the sick, and then went to work. Besides actively nursing the desperately ill, there was a need for food to be taken to families who had nobody to prepare meals. There were thousands of gauze masks to be made and distributed. As Eileen Pettigrew explains in The Silent Enemy: Canada and the Deadly Flu of 1918, “Social barriers of the time were forgotten. Women who had never come closer to the mechanics of housekeeping than to instruct their cooks and chauffeurs, nursed people they didn’t know, changed beds, cooked, and did laundry.” Women across the country pitched in to help families where the flu had struck, at great risk to themselves.

  Soon overworked hospital staff were falling ill. Telephone operators became sick, too. In 1918, every phone call was put through by a living operator working at a switchboard. The operator would ask for the number you wanted and place the call for you. With fewer operators available, the public was asked to confine phone calls to emergencies only, because otherwise the whole system would be unable to manage. Many stores closed. Since most people did not yet have cars, and those available were sometimes appropriated for official business during wartime, people had to walk farther and carry home whatever was needed — unless they had a horse or a bicycle. It was another strain on already overtaxed people. The list of services that faltered under the strain is endless.

  THE FLU STRIKES

  The Spanish Flu began with back pain, coughing, fever — the same symptoms we associate with flu today. Some victims experienced profuse bleeding from the nose as well. If Spanish Flu victims did not recover within a few days, their breathing problems soon became desperate as pneumonia developed, filling sufferers’ lungs with phlegm or mucus and fluid. Eventually, there was no space for each new breath and people died, drowning in their own fluids. At the onset of the flu, doctors would see their patients grow flushed. If pneumonia developed, the flush darkened into a dark blue-grey. Some people even reported that their loved ones’ faces turned black before they died. Spanish Influenza did not drag on for weeks and weeks, giving families false hope. Usually, for those who died, it was all over within a week or ten days.

  Surprisingly, most of the people who died of the Spanish Flu were not the “usual” flu victims — frail elderly people or vulnerable children. Those did die, of course, but many Spanish Flu victims were adults between 20 and 50 years of age. This resulted in parents dying and children being suddenly orphaned.

  If you ask the members of your family who know about the past, many will tell you that someone related to you died in the Spanish Flu pandemic — perhaps your great-great-grandmother or a great-great-uncle or most of a family down the street were taken. If you are ever visiting an old graveyard, check dates on the headstones to see how many people died in 1918 or 1919, and what their ages were when they died.

  Not only adults died, though. Whole families perished, some almost overnight. As you read accounts of this disaster, people say, over and over again, “It was so quick. She was fine when we went to bed on Monday night and she was dead three days later.”

  Ironically, some people caught the Spanish Flu because they were so happy about the war ending that they rushed out into the crowds who thronged the streets of their town or city on Armistice Day, hugging and kissing each other because the Great War was over at last. Even some soldiers who had come home from the battlefields in Europe contracted the flu in exactly this way. The public had been so careful. They had stayed in quarantine. Many, especially in the western provinces where officials insisted on it, had worn masks. Everyone knew the danger. Yet, when news of the Armistice reached them, many threw caution to the wind and danced and sang and embraced each other — and some passed the infection on, literally from mouth to mouth.

  In 1918, doctors had few weapons to fight with. All that could be done was to keep the afflicted person as comfortable as possible, struggle to bring down their fever with cool water and drinks, give them drugs for pain … and pray they would be spared.

  Today we have some better methods for fighting the flu. We have flu shots — something that was unheard of when people across the world died of the Spanish Flu in 1918–1919. Vaccines can help keep us from catching the flu in the first place. There are now some antiviral drugs, which can help us get better faster. Antibiotics can help with other infections we might catch while our immune systems are battling flu. But there is still no “magic bullet�
� against the flu, and no guarantee that the strain of flu that hits in any year will be prevented by the vaccine.

  We also know the value of taking sensible precautions, such as the simple act of washing your hands (taking time to sing “Happy Birthday” through twice while you are about it, or if you hate singing that, try “Row, Row, Row Your Boat”). And use soap — flu bugs loathe soap.

  But our modern inventions have, in some ways, made us more vulnerable. Now, not only can we fly around the world with ease, so can each new strain of a flu virus, using us as its host.

  The story of the Spanish Flu is a frightening one, but if you find it too scary, remember that we understand the causes and spread of the flu in a way families in 1918 could not. They had no radios, few telephones, no television, no Internet. Today our scientists and doctors are working to develop a vaccine to stop the avian flu in its tracks. When SARS arrived in Toronto, 44 people died, but think what a difference that is from the 1200 who perished in the city when the Spanish Flu struck. We may not live in a safe world, but we do live in one that is alert to the danger of another pandemic.

  Images and Documents

  Image 1: Jesse Ketchum Public School, which the author attended when she was young. Toronto’s first fatality from the Spanish Flu was a little girl who also attended Jesse Ketchum.

  Image 2: A hospital ship carrying wounded soldiers back to Canada docks at Halifax, Nova Scotia. Unknown to some of the soldiers, they carried the flu with them.

  Image 3: Soldiers recuperate from their injuries in a hospital ward.

  Image 4: Over 400 Toronto women responded to the call to become Sisters of Service, risking their own lives to nurse those sick with the flu.

  Image 5: This poster was issued by the Provincial Board of Health in Alberta, to give citizens information about the influenza epidemic.

  Image 6: Employees of the Canadian Imperial Bank of Commerce in Calgary take extra precautions against the flu.

  Image 7: Alberta telephone operators wear masks to keep the flu at bay. Masks for sale in Calgary cost between 5¢ and 25¢.

  Image 8: Prairie farmers wore the masks too. In Grande Prairie, Alberta, there was a $50 fine for not wearing a mask.

  Image 9: When the armistice was announced in the early hours of November 11, 1918, people just wakened from sleep pulled coats over their pyjamas and took to the streets to celebrate. The headline reads: GERMANS ACCEPT THE ALLIES’ TERMS.

  Image 10: Both young and old took part in the victory celebrations. A young girl riding on the hood of a Ford wears a soldier’s cap.

  Image 11: Over 200,000 Torontonians took to the streets to watch the Armistice Day parade. Here, some children ride the running boards of a car while adults wave Union Jacks.

  Image 12: This ad for a child’s velocipede appeared in the 1927 Eaton’s Catalogue. In a 1918 ad a similar Canuck Velocipede sold for $3.85.

  Crossing the Bar

  Sunset and evening star,

  And one clear call for me!

  And may there be no moaning of the bar,

  When I put out to sea,

  But such a tide as moving seems asleep,

  Too full for sound and foam,

  When that which drew from out the boundless deep

  Turns again home.

  Twilight and evening bell,

  And after that the dark!

  And may there be no sadness of farewell,

  When I embark;

  For tho’ from out our bourne of Time and Place

  The flood may bear me far,

  I hope to see my Pilot face to face

  When I have crost the bar.

  — Alfred, Lord Tennyson

  Requiem

  Under the wide and starry sky,

  Dig the grave and let me lie.

  Glad did I live and gladly die,

  And I laid me down with a will.

  This be the verse you grave for me:

  Here he lies where he longed to be;

  Home is the sailor, home from sea,

  And the hunter home from the hill.

  — Robert Louis Stevenson

  Rules for the Macgregors’ Version of Pounce:

  Each player has his or her own deck of Flinch cards. Use the cards numbered from 1 (ace) to 13 — no face cards or jokers. Mark the back of each card in each person’s deck with a symbol such as a star or oval, so it’s different from other players’ decks.

  After shuffling his or her deck, each player counts off 13 cards for their Pounce Pile, which they place face-down, except for the top card, which is placed face-up to their left. Then they place 4 cards face-up beside the Pounce Pile, to their right.

  Play commences whenever the “chosen one” — the loser of the previous match — says “Go!”

  The object of the game is to play all the cards in your Pounce Pile, as quickly as possible. You begin by going through the cards in your hand and in your Pounce Pile, counting by threes and trying to use every third card. You can add this card to any of the 4 cards beside your Pounce Pile the same way you would play Solitaire, so long as it is next in number. That is, you can place a 5 on top of a 4, a 10 on top of a 9, and so on. If you turn up an ace, it counts as a 1 and you place it in the “common area” between the players.

  There is no taking turns; eveyone plays at once. All players can place a card on all piles, even another player’s pile and any of the common piles, until the 13 is placed on any pile. Once a 13 is played on the top, that player MUST turn the pile OVER!

  Once you’ve gone through your deck, always counting by threes, you begin again. And once your Pounce Pile is totally finished you yell “POUNCE” and all play stops IMMEDIATELY!

  To score, you separate all played cards by the design on the back of the cards, and then the players count their cards (identified by the different design on the back) and the scorekeeper records the tally. (Each card counts as 1 point towards your score, whether it is an ace or a 7.) Before you begin playing, all players decide on the total that they consider a winning amount, such as 100.

  The game can resemble a free-for-all as players reach across the table to slap down their cards on other players’ stacks before someone else can do so. It’s a fun game for anywhere from two to six players. (Jean Little herself recalls a game where twenty players were involved.)

  Note: Pounce is also known as Nerts, Racing Demon, Peanuts and Squeal, and there are interesting variations in the way the games are played. An Internet search on any of these names will bring up the rules for it.

  Image 13: Estimated deaths from the Spanish Flu, across Canada:

  British Columbia: No provincial statistics are available, but Vancouver alone had between 800–1,000 deaths

  Alberta: 33,000–38,000 cases, 3,300–4,000 deaths

  Saskatchewan: over 5,000 deaths

  Manitoba: No provincial statistics are available, but Winnipeg reported between 820–1,020 deaths

  Northwest Territories: No statistics are available

  Ontario: 300,000 cases, 8,705 recorded deaths

  Quebec: 535,700 cases, 13,880 deaths

  New Brunswick: 35,581 cases, 1,394 deaths

  Prince Edward Island: 101 deaths

  Nova Scotia: 1,600 deaths

  Newfoundland and Labrador: No firm statistics are available, but more than a third of the people along the Labrador coast died.

  Though the number of deaths totalled up to 50,000 in Canada, that was still less than half of one percent of the population. In the United States, the Spanish Flu killed an estimated 500,000–700,000 people.

  Acknowledgments

  Every effort has been made to trace ownership of visual and written material used in this book. Errors and omissions will be corrected in subsequent updates or editions.

  Grateful acknowledgment is made for permission to reprint the following:

  Cover portrait: Detail (colourized) from black and white photo, Waldren Studios Collection, Box 54, File 103, Dalhousie University Archives/image
40_098.

  Cover background: Detail (tinted) from Special Hospital Ward, Long Branch, Ont., 1918, Library and Archives Canada/PA-022917.

  Image 1: Old Jesse Ketchum School (Toronto, c. 1875) by Bernard Gloster, Toronto Public Library, T 12224, slide MTL 1472.

  Image 2: Hospital ship docking at Halifax, N.S., June 29, 1917, Library and Archives Canada, PA-023007.

  Image 3: Casualties just arrived. No. 1 Casualty Clearing Station. July, 1916, Library and Archives Canada, PA-000324.

  Image 4: Ad from The Toronto Daily Star, p. 20, October 15, 1918, Toronto Public Library.

  Image 5: Poster issued by the Provincial Board of Health, Glenbow Museum, NA-4548-5.

  Image 6: CIBC employees in Calgary, Alberta, Glenbow Museum, NA-964-22.

  Image 7: Telephone operators wearing masks, Glenbow Museum, NA-3452-2.

  Image 8: Men wearing masks during the Spanish influenza epidemic, Library and Archives Canada, PA-025025.

  Image 9: A Family Reads Armistice Day Headlines, City of Toronto Archives, Fonds 1244, Item 892.

  Image 10: Armistice Day Celebrations, City of Toronto Archives, Fonds 1244, Item 905.

  Image 11: Armistice Day, Bay and King Streets, City of Toronto Archives, Fonds 1244, Item 891.

  Image 12: Ad from the 1927 Eaton’s Catalogue.

  Rules for Pounce courtesy of Robin Little.

  Image 13: Map by Paul Heersink/Paperglyphs. Map data © 2002 Government of Canada with permission from Natural Resources Canada.