Very, Very, Very Dreadful

by Albert Marrin

  To make matters worse, American officials often placed limits on the number of mourners who could attend a funeral and how long it might last. Chicago health authorities ruled: “No one except adult relatives and friends not to exceed 10 persons in addition to the undertaker, undertaker’s assistants, minister and necessary drivers shall be permitted to attend any funeral.” No exceptions allowed, so don’t ask.37

  Influenza was an equal opportunity killer. It was no respecter of sex or race, education or wealth; anyone was a potential victim. Newspapers carried weekly lists titled “Prominent People Who Have Died of Influenza.” Among these were athlete George Freeth Jr., the “Father of Modern Surfing”; writer Randolph Bourne; composer Charles Tomlinson Griffes; silent film actor Harold Lockwood; and educator Ella Flagg Young. Survivors included cartoonist Walt Disney, painter Georgia O’Keeffe, silent-film star Mary Pickford, and Pulitzer Prize–winning author Katherine Anne Porter. Pale Horse, Pale Rider, Porter’s account of her illness told in the form of a novel, is at once sensitive and chilling.38

  Almost 4,000 people died in Boston as a result of the flu epidemic of 1918 during its first weeks. Credit 59

  Assistant Secretary of the Navy Franklin D. Roosevelt had a close shave. FDR, as everyone called him, had gone to France in September to inspect U.S. bases. Though he stayed in a top Paris hotel, he could not escape the fact that influenza made Parisians sad and nervous. On the return voyage from Brest, he fell critically ill with the flu, but he survived. Had he died in 1918, it would have changed the course of world history. Elected president in 1932, FDR saw America through its worst economic crisis, the Great Depression, as well as the Second World War.

  The pandemic harmed the U.S. economy. High absenteeism affected every industry. Miners’ illnesses and deaths cut coal production by half in certain areas. In Pennsylvania, production in a major mine fell from 1,100 tons to 200 tons a day. Such a shock to coal supplies had the same impact as a severe oil shortage would today. Coal powered the steam engines that drove factory machines. Influenza and coal shortages hit the steel industry, which made the metal used for everything from safety pins to battleships. Ford Motor Company, the world’s leading manufacturer of cars and trucks, had steel shortages and over 2,000 workers down with flu at its plants in Detroit. Despite heroic efforts, munitions factories were forced to reduce their output of bullets and artillery shells. Philadelphia’s shipyard at Hog Island, the world’s largest, delayed production and repairs because of the lack of steel and its flu-reduced workforce.39

  A cartoon depicting influenza’s devastating impact on American manufacturing. (1918) Credit 60

  Federal, state, and local governments limped along as best they could. In Washington, D.C., flu struck suddenly and killed swiftly. One afternoon, a young woman called an emergency number about her three roommates. Two were dead and one was dying, so could someone please come? She herself felt perfectly fine. Shortly afterward, the police arrived and found four bodies. Influenza also felled hundreds of police officers and firefighters, raising fears that the nation’s capital would dissolve in chaos. This possibility gave the fire chief nightmares. “The whole city’d burn to the ground if a fire ever got started,” he groaned. Every government department had to make do without key people. Flu even forced the U.S. Supreme Court to adjourn. Justice Oliver Wendell Holmes called its quarters in the Capitol “this crowded and infected place.” In courts across the nation, jurors rebelled, refusing to stay together in the same room.40

  Children ready for school during the 1918 flu pandemic. Credit 61

  AMERICA’S CHILDREN

  Influenza robbed countless youngsters of normal childhoods. For them, attending school had been a regular part of life. The pandemic, however, forced local authorities to decide whether to keep public schools open; private schools decided this for themselves. Most officials played it safe, ordering district schools closed for a few days, weeks, or months. Yet three major cities—New York, Chicago, and New Haven, Connecticut—kept their public schools open throughout the pandemic. Their reasons for doing so were much the same; we will focus on New York because it had the nation’s largest number of pupils.41

  The city’s schools served nearly one million children, of whom three out of four lived in crowded, run-down tenements. At first, health officials wanted to follow the rest of the country, closing schools until the crisis passed. However, Dr. Sara Josephine Baker (1873–1945), head of the Bureau of Child Hygiene, argued for keeping them open. She asked the health commissioner, Dr. Royal S. Copeland, a simple question: “If you have a system where you could examine one-fifth of the population of the city every morning, and control every person who showed any symptom of influenza, what would it be worth to you?” Startled by Baker’s question, Copeland replied, “Well, that would be almost priceless.” Like Baker, he decided “children are better off in school, under supervision, than playing about in the streets.” New York’s public schools stayed open.42

  Sara Josephine Baker, an American physician notable for making contributions to public health, especially among the immigrant communities of New York City. (1925) Credit 62

  Baker was a bundle of energy. Thanks to her wit and will, schools became havens from influenza. They already offered a clean environment, visited by doctors and nurses for routine medical inspections. Now children were forbidden to gather outside before the school day began. Instead, monitors hurried them straight to their classrooms, where teachers checked for telltale symptoms: runny noses, red eyes, sneezing, coughing. Children with any of these symptoms were immediately sent to the nurse’s office for further examination. A school secretary took a sick child either home to be put to bed or directly to a hospital emergency room. Schools also emphasized good hygiene as a way to prevent disease. As for influenza, each class had to have its “Daily Gargle”—cleansing mouths and throats with salt water as the eagle-eyed teacher looked on.43 (Gargling, however, is useless against flu viruses.)

  Baker’s program was an amazing success. It had beaten the odds. When the pandemic finally passed, Dr. Copeland reported: “The number of cases of influenza among children of school age was so small as to be negligible. There was no evidence at all, in this age group [six to fifteen], that there had been any epidemic of influenza in the city.” New York’s children were lucky—mostly. Elsewhere, things were decidedly different.44

  Years after the flu pandemic, schoolchildren were still taught to gargle as a precaution, despite its ineffectiveness. (1935) Credit 63

  For young survivors of the pandemic, life would never be the same. Like shell-shocked soldiers, they bore emotional scars.

  These children had similar experiences and shared similar feelings—of anxiety, of terror, of despair. Parents could not hide their own feelings, try as they might. Youngsters might not know exactly what was happening, but parents could not help sending nonverbal signals. “I knew my parents were worried,” recalled William Maxwell of Lincoln, Illinois, who later became an editor at the New Yorker magazine. “I paid less attention to their words than to the sound of their voices. When they discussed it, I heard anxiety.”45

  Fear became so strong that one could almost touch it. For Bill Sardo, son of a Washington, D.C., funeral director, fear was a living presence. “From the moment I got up in the morning to when I went to bed at night, I felt a constant sense of fear,” he recalled as an adult. “We were afraid to kiss each other, to eat with each other, to have contact of any kind….Fear tore people apart.” Don Tonkel of Goldsboro, North Carolina, said, “[I] felt like I was walking on eggshells….I remember I was actually afraid to breathe. People were afraid to talk to each other. It was like—don’t breathe in my face, don’t even look at me, because you might have the germs that will kill me.”46

  There was plenty to be afraid of. Death seemed to lurk everywhere. Kenneth Crotty of Framingham, Massachusetts, was eleven when the “great flu” reached his block. “It was scary,” he said years later, “because every mo
rning when you got up, you asked, ‘Who died during the night?’ You know death was there all the time.” In New Haven, Connecticut, John Delano knocked every morning on the door of his friends’ house, but no one ever answered. Finally, John’s mother told him that “God had taken them. My friends had gone to Heaven.”47

  Terrible experiences forced some youngsters to mature quickly. Francis Russell, later an author and journalist, was seven years old when the pandemic struck. The boy lived with his family on top of Dorchester Hill, from which he could see Boston and the troopships in Boston Harbor. To support the war effort, Francis bought thrift stamps at twenty-five cents each, and he ate peaches to save the pits, which were made into charcoal for gas masks. Every day, too, he watched funeral processions pass by and saw coffins pile up under a large tent at a local cemetery. Francis and two friends became curious. What, exactly, happened to those coffins? they wondered. One day they sneaked into the cemetery, hid on the slope of a low hill, and watched a funeral in progress. A gravedigger saw them and chased them away.

  It was getting dark, and as Francis walked home alone, he had a sudden insight—one that changed the way he saw the world. For the first time, the youngster became aware of time. Not the time to go to bed or to wake up or to eat, but the eternal rush of time. It left him shaken, but wise beyond his years. He explained later: “I knew then that life was not a perpetual present, and that even tomorrow would be part of the past, and that for all the days and years to come, I too must one day die. I pushed the relentless thought aside, knowing even as I did so that I should never again be wholly free of it.” Whoever they were, whatever they wished, mortal humans shared the same fate.48

  Many children had to grow up faster than Francis Russell, whose parents survived. When a father, the family’s breadwinner, died, someone had to put food on the table. Often widows did double duty as mothers and breadwinners. If they could not, their children had to go to work. Melvin Frank, for example, was stunned when influenza took his father. The loss sent him “reeling,” he said. “My world had tumbled in.” Suddenly, at age twelve, he became “the man of the family.” A week after his father’s funeral, Melvin found a job, his childhood and school days over.49

  Losing one’s mother could be an even worse blow. The devil virus was especially adept at killing pregnant women. Mattie Varner, a midwife in Atlanta, Georgia, felt helpless because her clients “were dying just like leaves off them trees.” Varner did not exaggerate. Among mothers-to-be, as many as 71 percent of those infected by the virus died. Some died while giving birth to live babies; others miscarried or delivered dead infants.50

  Young children had great difficulty coping with a mother’s loss. When William Maxwell was ten, influenza took his mother, and he discovered he was living in a dangerous world. “The shine went out of everything,” he later told an interviewer. “I realized, for the first time and forever, that we were not safe. We were not beyond harm.”51

  Yet Maxwell was lucky; he still had his father. Orphans had no parents. Some became homeless, surviving by their wits and luck. In Minneapolis, Minnesota, police officers found a hundred children, some sick, all malnourished, living on the streets. Many wound up in orphanages, though a few were adopted or placed in foster homes. Families also passed orphans from relative to relative. Mary McCarthy, later a famous writer, was six when influenza claimed both her parents. Though taken in by a wealthy aunt, she and her three younger brothers felt scorned and deserted, unwanted and helpless. “It was thought,” she recalled bitterly, “that we should know we were orphans and fitted for a different destiny than our well-tended cousins.”52

  HEROES, HEROINES, AND ORDINARY FOLKS

  As a young Mary McCarthy learned, the pandemic showed men and women at their worst and at their best. A person’s basic character did not change under its pressure. Faced with such horror, people revealed their real selves, only in exaggerated form. The selfish became more selfish. The callous remained cold-hearted. The cowardly gave in to hysteria, cringed, and whined in self-pity. The brave and dutiful, by their actions, became almost holy.

  There was enough selfishness and cowardice to go around. “Not one of the neighbors would come in and help,” a survivor recalled. Sometimes landlords evicted tenants just because they were unlucky enough to have the flu. Cowardice, however, might also have a silver lining. Despite the ability to hide their identity by wearing gauze masks, Chicago muggers feared flu more than they feared jail. One young woman calmly walked home from her job late at night; if a stranger approached, she began coughing violently.53

  More often than not, however, Americans tried to help each other. This was especially true within the medical profession. As in wartime Europe, the needs of the military came first. When Congress declared war on Germany in April 1917, just 776 out of America’s 140,000 physicians were serving in the armed forces. When the war ended in November 1918, more than 38,000 of them had enlisted.54

  A civilian public health official described the wartime doctor shortage: “There were sections of the country that were absolutely stripped of physicians.” Frantic officials in state capitals tried to fill the gaps any way they could. Calls went out to nursing homes for retired physicians to volunteer during the emergency. One old-timer was eighty-five years old, another had a wooden leg, and another had a drug addiction. Medical students left their lecture halls for hospital wards. In addition, 173 New Orleans dentists volunteered, though the devil virus never attacked teeth.55

  Physicians did the best they could, given what they knew about influenza, which was next to nothing. Day in and day out, they worked under terrific pressure. Patients cried, “Doctor! Doctor! Do something, give us something, Doctor!” But doctors had nothing useful to give, except massive doses of aspirin.56

  Despite their hard work, physicians had little to show for their efforts. Their frustration grew, and with it anguish. In the small Arkansas town of Central, for instance, Lillie Ladd remembered how a visiting doctor broke down in front of her husband, Melvin. The doctor was exhausted and could offer no hope to a stricken family member. “This is my twenty-fifth case,” he groaned, “and I’ve lost the first twenty-four.” Besides, physicians were human beings, not gods. For many weeks, the Journal of the American Medical Association printed page after page of short obituaries, in small type, of doctors who died of influenza.57

  The disease put American hospitals under severe strain, too. The flood of patients used up supplies faster than they could be replaced. Across the country, hospitals reported shortages of basic items: gowns, pajamas, slippers, gauze masks, towels, blankets, sheets, and pillowcases. Flu patients occupied many, if not most, hospital beds. Things got so bad in New York’s Bellevue Hospital that nurses put three to a bed in the children’s ward. At another hospital, a nurse, Carla Morrissey, recalled walking into a forty-one-bed ward. She described conditions like those my father found in Siberia when he came down with influenza. Not only were all the beds occupied, “but there were boys laying on the floors and on the stretchers waiting for that boy in a bed to die.”58

  A recruitment poster seeking student nurses. Because of their ability to provide “tender loving care” as well as perform administrative duties, nurses were often in higher demand than doctors during the pandemic. (c. 1917–1919) Credit 64

  Nurses were in greater demand than doctors. When authorities in Bath, Maine, telegraphed a Boston hospital pleading for two doctors, the return message read: “Can send all the doctors you want but not one nurse.”59

  At first glance, this seems not to make sense; after all, doctors had to study for years and pass rigorous examinations before getting their licenses to practice medicine. However, despite all their knowledge, they knew nothing of the true cause of influenza, much less how to cure it. Ditto for nurses. But nurses provided vital supportive care; they called it TLC—tender loving care. Nurses did the hundreds of small things, from fluffing pillows to speaking calmly, that made patients comfortable, hopefully keeping the
m alive until the infection passed. TLC, as historian Alfred W. Crosby rightly says, “was the miracle drug of 1918.”60

  Until the mid-1800s, nurses were considered ignorant people unfit for any other type of work. Often they were “fallen women,” sinners whom judges asked to choose between nursing and jail. This negative view changed thanks to the pioneering work of Florence Nightingale in England and Clara Barton, founder of the American Red Cross. Both trained “lady nurses,” demanding knowledge, efficiency, “good character,” and “sound morals.” By 1918, nursing had come into its own as a profession.

  When the United States joined the Allies, it had 98,162 highly trained “graduate nurses.” Of these, roughly 16,000 would enlist, serving at army camps at home and with the AEF in France.61

  Civilian nurses worked every bit as hard as their military sisters. The pandemic became the supreme test of their ability and character. Routinely, big-city nurses worked twelve-hour shifts in flu wards. One, Dorothy Deming, described a typical shift in New York’s Presbyterian Hospital: “Almost overnight the hospital was inundated….Wards emptied hastily of patients convalescing from other ailments…and only emergency operations were performed. Cots appeared down the center of wards….Victims came on stretchers…their faces and nails as blue as huckleberries.”62