Pale Rider: The Spanish Flu of 1918 and How It Changed the World

by Laura Spinney

  Her question could not be asked now, because starting in the 1920s disease moved centre-stage in literature–and no longer (or not only) as a symbol, but in all its ignominious, banal, terrifying reality. She herself contributed to that shift, exploring psychiatric illness in Mrs Dalloway (1925). Ulysses (1922) is peppered with allusions to bodily functions, and malfunctions, while in Eugene O’Neill’s play The Straw (1919), which was inspired by his experiences in a TB sanatorium, disease doesn’t stand for hell–it is hell. ‘He sees life unsteadily and sees it black,’ a critic wrote of O’Neill in 1921.1

  What triggered this shift? Could it have been a virus that swept the globe in 1918, forcing infectious disease into human consciousness and highlighting the gap between the triumphant claims made for medicine and the dismal reality? The flu virus wasn’t the only germ causing misery at the time. There were others–notably, the twin curses of TB and venereal disease–but these were chronic, slow-burners. They didn’t come, cause devastation, and leave again, bringing in their wake a tsunami of lethargy and despair.

  The Russian flu pandemic of the 1890s, it has been argued, contributed to the fin de siècle mood of cynicism and ennui.2 It killed a million people; the Spanish flu killed at least fifty times as many. We don’t know how many of the survivors suffered from post-viral fatigue, but the numbers must have been very large. And they were unlikely to have forgotten the puzzling randomness with which the flu had struck–that lethal lottery. Psychologists have an expression to describe the mindset of people subjected to random terror: learned helplessness. They tell us it leads to depression.

  If you look hard, you can find traces of the Spanish flu in the writing of those who lived through it–heralds, perhaps, of the revolution to come. The disease left D. H. Lawrence with a weak heart and lungs, which he bequeathed to the gamekeeper, Mellors, in Lady Chatterley’s Lover (1928). Katherine Anne Porter wrote Pale Horse, Pale Rider (1939) after catching the flu in Denver, Colorado at the age of twenty-eight (her black hair fell out, and when it grew back, it was white), while on the other side of the world, Saneatsu Mushanoko¯ji–a member of the avant-garde Shirakaba or White Birch literary society in Japan–wrote a story about a young man returning from his travels in Europe, who learns that his girlfriend has died of influenza. Entitled Love and Death (1939) and still popular today, it describes a world full of happiness and light that suddenly turns black.

  In September 1918, T. S. Eliot published a poem entitled ‘Sweeney among the Nightingales’, in which he makes a possible reference to the Spanish flu:

  Gloomy Orion and the Dog

  Are veiled; and hushed the shrunken seas;

  The person in the Spanish cape

  Tries to sit on Sweeney’s knees

  By November, the flu had interrupted normal life in almost every town and village in Britain. Both Eliot and his wife Vivien caught the disease, which apparently exacerbated Vivien’s nervous condition to the extent that she found it impossible to sleep. She was living in Marlow, just outside London. He was in the capital itself, working on a vision of the desolate, haunted city that would become The Waste Land (1922)–itself possibly influenced by the strange atmosphere he imbibed at that time.

  Intriguingly, post-viral fatigue leaves more of a trace than the flu itself, as if writers had mistaken the disease for the metaphor, and been tricked into giving it a proper treatment. One of the bestselling European novels of the 1920s, that caught the imagination of a generation, was Michael Arlen’s The Green Hat (1924). Its protagonist, Iris Storm, is reckless, hedonistic and strangely detached from the world. She embodies many of the themes of the modern age: alienation, hypersensitivity, self-doubt. She was inspired by the heiress Nancy Cunard, who caught the flu in early 1919, developed pneumonia, and was dogged by depression throughout her long convalescence–the period in which Arlen knew her.

  Another detached loner from the period is Sam Spade, the private detective in Dashiell Hammett’s The Maltese Falcon (1929). Spade, the model for many later fictional detectives, finds a precursor in a little-known short story called ‘Holiday’ (1923), that the tubercular Hammett wrote after his own long and difficult recovery from the Spanish flu. It is about a tubercular soldier on day release from military hospital, a solitary man who lives only for the moment. In The Maltese Falcon, Spade recounts the parable of Flitcraft, a man who changes his life after nearly being killed by a falling beam: ‘He knew then that men died at haphazard like that, and lived only while blind chance spared them.’

  Modernism, which predated the war, provided the language that allowed artists and thinkers to explore the rich terrain that Woolf described. It liberated them from realism, from always being the outsider looking in, and in this it was influenced by psychoanalysis, which attached so much importance to dreams. Perhaps the lingering memory of those fever dreams contributed to this new fascination with the subconscious. The Polish composer Karol Szymanowski was staying in a Black Sea resort in the autumn of 1918, when he caught the Spanish flu and was inspired to write his opera King Roger. The ‘Sicilian drama’, as he called it, ‘sprang into my mind one sleepless, Spanish night’, after he and his cousin and librettist, Jarosław Iwaszkiewicz, had been strolling beside the azure sea. ‘It seems to me,’ Iwaszkiewicz wrote later, ‘that this same intangible element of the eternal ocean, calming yet disquieting at the same time, became cast into the music which was subsequently composed.’3 ‘There was no light, there might never be light again, compared as it must always be with the light she had seen beside the blue sea that lay so tranquilly along the shore of her paradise,’ wrote Porter in Pale Horse. ‘There are better dreams’ was Iris Storm’s mantra.

  But there was a newly black seam running through this exploration of the subconscious in the post-flu, post-war years. Sigmund Freud, the father of psychoanalysis himself, wrote an essay in 1920 entitled Beyond the Pleasure Principle, in which he introduced the concept of a death drive–Todestrieb–alongside that of the sex drive. At the time, he denied that the death from Spanish flu of his beloved daughter Sophie, pregnant with her third child, had influenced this development, but he later admitted that it may have played a role. ‘Can you remember a time so full of death as this present one?’ he wrote to his friend Ernest Jones, around the time of her demise, while to his widowed son-in-law, echoing Sam Spade, he wrote of ‘a senseless, brutal act of fate’.4 Psychoanalytic themes of sex and death permeated the first horror films, which were produced in the 1920s. Nosferatu (1922), directed by the German F. W. Murnau, was a retelling of the legend of Dracula, but with an additional subplot involving plague. The vampire is heading for Germany from his home in Transylvania, not far from the Black Sea, and spreading plague as he goes (ironically, the Spanish flu likely reached the Black Sea from Germany, brought by returning POWs).

  Irony replaced pathos and, in the hands of writers like Pirandello (Six Characters in Search of an Author, 1921) and later Samuel Beckett (Murphy, 1938), tipped into absurdity. Kafka had long had an eye for the random and meaningless, and the Spanish flu must have struck him as a particularly fine example of the genre. ‘Contracting fever as a subject in the Habsburg monarchy and re-emerging from it as a citizen of a Czech democracy was certainly eerie, though a bit comical, as well,’5 wrote his biographer. When, having recovered, he stepped out into the streets of Prague, he discovered that they were full of people who had only just been enemies–French, Italians, Russians. There was no longer a Franz Joseph train station–it had been renamed Nádraži Wilsonovo (Wilson Train Station)–but there was now an October 28th Street, marking Czechoslovakia’s birthday. And he wasn’t the only one who felt as if he’d vanished down a rabbit hole. Both Gustav Landauer, a socialist who had been itching to take part in the revolution in Germany, and the fill-in chancellor, Max von Baden, woke from their respective fevers to find they had missed it. The philosopher and leading Zionist Martin Buber fell ill just as Europe’s Jews looked to him for guidance in the matter of whether Palestine–which
had recently passed from Ottoman to British control–could really be the homeland they had dreamed of.

  Spanish writers and thinkers, whose identity had–against their will–become so tangled up with that of the flu, reacted to it in their own idiosyncratic way. Thanks to the operetta that had been on stage in Madrid when the spring wave had struck, and to deep-seated anxieties about the state of the nation, the disease had become inextricably linked in Spaniards’ minds to Don Juan, the incorrigible libertine who, with all his strengths and weaknesses, stood in some way for all that was Spanish. Traditionally, All Saints’ Day is marked in Spain by a performance of a version of the Don Juan myth, the play Don Juan Tenorio. By the time it came round in November 1918, however, Spaniards were in no mood for it. ‘This year Don Juan has come at an inopportune moment,’ wrote the critic José Escofet. ‘We won’t be able to attend’.6

  After the pandemic, a number of Spanish writers set out either to parody the don, or to analyse and reform him. The philosopher Miguel de Unamuno was among them, as was his friend Gregorio Marañón, an eminent doctor and intellectual who had been involved in managing the disaster. A eugenicist like many of his contemporaries, Marañón believed that Spaniards were ‘racially vigorous’ but disadvantaged by their environment, in particular by the unhappy lot of women and children. In order that the stock should fulfil its potential, he felt, the cult of Don Juan had to be demolished, along with the implicit licence it gave to male promiscuity. In 1924 he wrote an essay pointing to the rake’s lack of offspring, and suggesting that he may have been sterile, even effeminate. It was, arguably, the worst slur that could be levelled at one of the nineteenth century’s great Romantic heroes.

  More had died in the war than had died of flu, in Europe, but on every other continent, the opposite was true. If the pandemic contributed to a psychological shift in European literature, therefore, one might expect it to have done so to an even greater extent elsewhere. In Brazil, the departure of the Spanish flu marked a watershed moment. Doctors had been deeply unpopular in that country since Oswaldo Cruz had imposed a smallpox vaccination programme in 1904, but when cariocas saw that the flu was raging uncontrolled through Rio, they called for another well-known hygienist, Carlos Chagas–who was seen as Cruz’s spiritual son–to step in. As soon as he did, the epidemic began, serendipitously, to recede, and from then on Brazilians looked at doctors with new respect.7

  Brazil had been searching for a national identity ever since it had freed itself from its colonial masters in 1889, and doctors now gave it one. What defines a Brazilian, they said, is disease.8 Disease–rather than race or climate–is the one thing that unites all social classes in Brazil. They talked about brazilianisation by infection, of Brazil as an immense hospital, and these ideas percolated into literature–reinforced, perhaps, by the memory of those flu-themed parades in the 1919 Rio Carnival, when groups calling themselves ‘Midnight Tea’ and ‘Holy House’ sang bawdy songs about a ‘Spanish lady’.

  In 1928, the writer Mário de Andrade published Macunaíma, a fable about a young man who was born in the Brazilian jungle with magical powers. Black, roguish, sensual, tricky, the eponymous Macunaíma represents the Brazilian personality, and he repeats the catchphrase ‘Too little health and too many ants are the curses of Brazil.’ Some writers were suspicious of the predominantly white doctors, however, seeing ‘brazilianisation by infection’ as thinly disguised eugenics. If Brazilians were sick, came their riposte, it was because of deep inequalities at the heart of Brazilian society. And so a literary counter-current emerged, that drew attention to those inequalities. Among those who contributed to it was the mixed-race writer Afonso Henriques de Lima Barreto, whose novella Cemetery of the Living (1956) compared the psychiatric hospital in which it was set to a cemetery, or hell.

  The Spanish flu arrived in China at a time when the New Culture movement was challenging traditional Chinese values. It’s hard to single out one epidemic from the many that battered that country at the time, but collectively, one could argue, they fuelled the drive to modernise. New Culture poured scorn on traditional Chinese medicine, which they saw as emblematic of all that was wrong with Chinese society, and they urged those in power to embrace western scientific ideas. One of the leaders of the movement was a little-known writer called Lu Xun. He had had his own scarring experience with Chinese doctors, having grown up with an ailing, alcoholic father. Each time the doctor called, he charged an exorbitant fee and sent Lu to gather the ingredients of a cure. They included a pair of crickets, the doctor having stipulated that ‘They must be an original pair, from the same burrow.’ Lu’s father’s health continued to deteriorate until he died, leaving his fourteen-year-old son to support the entire family.9

  Lu studied western-style medicine in Japan, but later decided he could make a bigger difference with his pen. In 1919, he published a short story entitled ‘Medicine’, in which an elderly couple spend all their savings on a bread roll dipped in the blood of a recently executed criminal, believing that it will save their consumptive son–but he dies anyway: ‘“You there! Give me the money and you’ll get the goods!” A man dressed in black stood before Shuan, who shrank back from his cutting glare. One enormous hand was thrust out, opened, before him; the other held, between finger and thumb, a crimson steamed bun, dripping red.’10 Lu is now regarded as the father of modern Chinese literature.

  Finally there was India, the country that had borne the brunt of the Spanish flu in terms of the sheer number of Indians who had died. Disease was a major preoccupation in the writing that emerged in that country in the 1920s, where it dovetailed with ideas about the need to reform the caste system and throw off the yoke of British rule. In China, the modernisers were campaigning for the replacement of literary language (wenyan) by spoken language (pai-hua)–the equivalent of replacing Latin with French or English during the European Renaissance–so that ordinary people could have access to Chinese culture. In India, something similar happened. The new generation of writers set out to describe the harsh realities of peasant life in language that, for the first time, peasants could understand. The most important of them was Munshi Premchand. Barely known on the global stage, unlike the Nobel Prize-winning Tagore, Premchand was arguably better loved in India. In The Price of Milk (1934), for example, he told the tale of Mangal, an untouchable orphan whose father had died of plague and his mother of snakebite. Mangal lives under a tree in front of his landlord’s house, surviving on scraps. The landlord’s wife won’t touch him, for fear of pollution, even though Mangal’s mother wet-nursed her son. The discrepancy requires no explanation because, as a priest remarks, ‘Rajas and maharajas can eat what they want… Rules and restrictions are for ordinary people.’

  Premchand became the self-styled ‘chronicler of village life’ around 1918, when he was living in the United Provinces (Uttar Pradesh), where the Spanish flu claimed an estimated 2–3 million lives alone. Also living there at that time was the poet Nirala, ‘the strange one’, who lost his wife and many other members of his family to the flu. He later recalled seeing the River Ganges ‘swollen with dead bodies’. ‘This was the strangest time in my life. My family disappeared in the blink of an eye.’11

  These events, which took place when he was only twenty-two years old, left a deep impression on Nirala. A leading light in the Indian modernist movement, he had no patience with religious explanations of suffering that invoked karma or deeds done in previous lives. For him, the universe was a cruel place and there was no place in it for sentimentality. In 1921, he wrote a poem called ‘Beggar’, which arguably captured the mood, not only of Indian writers at that time, but of writers all over the world. It included the following lines:

  When their lips shrivel up from starving

  what recompense

  from the generous Lord of destinies?

  Well, they can drink their tears.

  PART EIGHT: Roscoe’s Legacy

  Electron micrograph of the recreated 1918 flu virus


  The 1995 film Outbreak tells the story of an outbreak of a fictional virus, Motaba, first in Zaire and then in a small town in America. Motaba resembles the real virus Ebola in that it causes a lethal haemorrhagic fever and–to begin with at least–it is transmitted by bodily fluids. At some point, however, it mutates and becomes airborne, like flu. To stop the virus spreading beyond the confines of the affected town, the president of the United States approves a plan to bomb that town. Thankfully, the plan is aborted.

  This horrifying scenario has not come to pass. Ebola kills around half of those it infects, but it is not airborne, so it spreads much less easily than flu. The most vicious flu on record, on the other hand–the Spanish flu–killed ‘only’ a few per cent of those who caught it. The scientific consultants on Outbreak nevertheless insisted that the scenario was feasible. One of them was David Morens, the epidemiologist who, with Jeffery Taubenberger, dubbed the Spanish flu ‘the mother of all pandemics’. He has even expressed the opinion that Outbreak’s scriptwriters could have gone further: ‘I don’t think they sensationalised it. If anything they toned it down.’1

  A report published in 2016 by the Commission on Creating a Global Health Risk Framework for the Future (GHRF)–an independent, international group of experts convened by the US National Academy of Medicine–estimated there to be a 20 per cent chance of four or more pandemics occurring over the next hundred years, and a high probability that at least one of them will be flu.2 Most experts consider it inevitable that there will be another flu pandemic. The only questions are when, how big, and what can we do to prepare ourselves? Lessons learned from the Spanish flu could help us to answer all three.