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

by Laura Spinney

  Mole understood that meaning comes with distance. The Spanish flu has been called the forgotten pandemic, but it isn’t forgotten. Our collective memory of it is simply a work in progress. A hundred years on, we have some distance on it, though Mole would probably carry on marching before he put down his viewing platform–until he reached the point at which the lines of perspective converge to produce an intelligible image.

  The lines of perspective never really converge, when it comes to history, so off Mole marches on his eternal quest, until he vanishes. Looking back the other way, to a distance of just under 700 years, we see the Black Death hove into view. In the mid-fourteenth century, the worst pandemic in human history killed an estimated 50 million people, though the numbers are even sketchier than for the Spanish flu, and may in reality have been far higher. The Black Death is certainly not forgotten, nor is it overshadowed in our minds by a war with which it coincided–the Hundred Years War–yet our collective memory of it took time to coalesce. Even in 1969, Philip Ziegler, the author of an excellent account of that plague, was able to write that ‘There are remarkably few full-length studies dealing with the Black Death as a whole or even in a country or group of countries.’ Some may have been lost, but of the six surviving studies that he considered most important, the earliest was published in 1853, 500 years after the event. The pandemic did not even acquire the name by which we know it until the sixteenth century. In the Middle Ages, it was known as the ‘Blue Death’.

  Wars and plagues are remembered differently. Collective memories for war seem to be born instantly, fully formed–though subject, of course, to endless embellishment and massage–and then to fade over time. Memories of cataclysmic pestilence build up more slowly, and once they have stabilised at some kind of equilibrium–determined, perhaps, by the scale of death involved–they are, in general, more resistant to erosion. The sixth-century Plague of Justinian is remembered better today than the eighth-century An Lushan Rebellion in China, though to the best of our knowledge, they killed comparable numbers.

  We find ourselves at an interesting point on the remembering/forgetting arc with respect to the twentieth century. The two world wars are still raw, we refer back to them obsessively and are firmly convinced that we will never forget them–though past experience suggests that they will gradually lose their lustre in our minds, or be obscured by other wars. Meanwhile the Spanish flu intrudes more and more into our historical consciousness, but it can’t shake the prefix ‘forgotten’.

  WorldCat, the world’s largest library catalogue, currently lists around 80,000 books on the First World War (in more than forty languages), and around 400 on the Spanish flu (in five languages). But those 400 books represent an exponential increase over what had been written on the subject twenty years ago. The range of academics who show an interest in it is now very broad, and it isn’t just academics. In the twenty-first century–a century in which writers have firmly embraced illness as a subject worthy of treatment, alongside love, jealousy and battle–the Spanish flu has finally penetrated popular culture, providing plot lines for novels, movies and TV dramas.1 In the popular British TV series Downton Abbey, for example, three main characters catch Spanish flu in April 1919, and one dies of it. In 1921, American sociologist James Thompson compared the fallout of the Black Death with that of the First World War.2 The Spanish flu would arguably have been a more natural reference for comparison with the other plague, and yet only two years after it, it didn’t occur to him to use it. Nor did the Spanish flu register on Ziegler’s historical radar when he cited Thompson’s paper nearly fifty years later. Such an oversight would not be possible today.

  Why does memory for a pandemic take time to develop? Perhaps one reason is that it’s not so easy to count the dead. They don’t wear uniforms, display exit wounds or fall down in a circumscribed arena. They die in large numbers in a short space of time, over a vast expanse of space, and many of them disappear into mass graves, not only before their disease has been diagnosed, but often before their lives have even been recorded. For most of the twentieth century, people thought the Spanish flu had killed around 20 million people, when the real number was two, three, possibly even five times that.

  And then, the Spanish flu is a difficult pandemic to pigeonhole. It killed horribly, and it killed many more of its victims than any other flu pandemic we know of, yet for around 90 per cent of those who caught it the experience was no worse than a dose of seasonal flu. As a result, people didn’t know how to think about it; they still don’t. At the time many mistook it for pneumonic plague–a disease that can be transmitted directly between people and that, unless treated, is almost always lethal. Today, they shudder at the thought of the hypothetical equivalent–airborne Ebola. But in general, the Spanish flu was far more mundane than either of those things. It was also very rapid, burning itself out in any given place before a siege mentality could set in. Epidemics of bubonic plague and AIDS, in contrast, linger in one locality for years.

  Memory is an active process. Details have to be rehearsed to be retained, but who wants to rehearse the details of a pandemic? A war has a victor (and to him, the spoils–the version that is handed down to posterity), but a pandemic has only vanquished. Until the nineteenth century, pandemics were considered acts of God and people accepted them fatalistically, but with the advent of germ theory, scientists realised that they could, in principle, prevent them. Their inability to do so in 1918 was humiliating, a reminder of earlier epochs when epidemics came without rhyme or reason, and there was nothing they could do to stop them. As one epidemiologist put it, ‘It was as if one of the old plagues had returned.’3

  At least one constituency, therefore–and a powerful one at that–had reason to pass over the Spanish flu in silence. The philosopher Walter Benjamin even argued that such public silences are essential to progress, because they allow us to leave behind the ruins of the past. So the Yupik of Bristol Bay made a pact–nallunguaq–not to speak about the pandemic that had shattered their ancient culture. When the story of the Spanish flu was told, it was told by those who got off most lightly: the white and well off. With very few exceptions, the ones who bore the brunt of it, those living in ghettoes or at the rim, have yet to tell their tale. Some, such as the minorities whose languages died with them, never will. But perhaps the victims did find a way to express themselves, after all–in strikes, protest and revolution.

  There is another reason why a pandemic memory might take time to mature. In 2015, psychologists Henry Roediger and Magdalena Abel of Washington University in St Louis, Missouri summed up a still thin body of research into collective memory when they wrote that its narrative structure ‘is rather simple and comprises only a small number of salient events referring to beginning, turning, and end points’.4 It helps, they added, if those events have heroic or mythical components. Wars slot easily into that structure, with their declarations and truces, their acts of outstanding bravery. A flu pandemic, on the other hand, has no clear beginning or end, and no obvious heroes. The French war ministry tried to create some, by awarding a special ‘epidemic medal’ to thousands of civilian and military personnel who had shown devotion in the fight against the disease, but it didn’t work. A war-memorabilia website notes that ‘Curiously, its place among the important decorations of that conflict is completely unknown.’5

  A different narrative structure is needed, and a new language. Piqued by their humiliation, scientists went on to furnish us with a vocabulary of flu–with concepts such as immune memory, genetic susceptibility and post-viral fatigue. Couched in this new language–not a poetic language, perhaps, but one that allowed you to make predictions, and to test them against the historical reports–disparate events began to appear connected, while other, once obvious links atrophied and died (no, it wasn’t the punishment of an angry god; yes, it was at least partly responsible for the subsequent wave of melancholy). The pandemic took on a radically new shape: the one we recognise today.

  Such
a narrative takes time to develop–around a hundred years, judging by the burst of interest in the last two decades–and until it does, all kinds of confusion arise. In Australia, the Spanish flu became telescoped in people’s minds with a 1900 outbreak of bubonic plague, in part because newspapers referred to both as ‘plague’, while in Japan it was eclipsed by another natural disaster, the Great Kanto¯ earthquake of 1923, which destroyed Tokyo. Many people thought the flu was the product of biowarfare, and the flu and the war were conflated or confounded in other ways too. The captains and lieutenants who died while serving with the British Army–Vera Brittain’s ‘lost generation’–numbered around 35,000.6 But six times as many Britons died of Spanish flu, and half of those were in the prime of life–young, fit men and women whose promise also lay ahead of them. They may therefore be considered more deserving of the label ‘lost generation’, though the flu orphans, and those who were in their mother’s womb in the autumn of 1918, may lay claim to it too, for different reasons.

  The death of Edmond Rostand illustrates this imaginative fusing of war and flu. On 10 November 1918, he was getting ready to leave his home in the Basque Country to celebrate the imminent armistice in Paris. At five in the afternoon the car arrived that was to take him and his mistress, Mary Marquet, to the station. While their luggage was being loaded, the pair sat close to the fire, watching the dying embers. They were wistful, even sombre: a dangerous disease was raging in Paris, major events were unfolding on the world stage. Suddenly they heard wings fluttering against a window. Rostand went to open it and a dove entered, staggering towards the hearth. He bent to pick it up, but as he cupped it in his hands, its wings grew slack. ‘Dead!’ he cried. Marquet, shocked, murmured that it was a bad omen, and three weeks later the celebrated creator of Cyrano de Bergerac died in Paris of the Spanish flu.7 It would be hard to think of a more fitting symbol of the twin dangers hanging over humanity at that moment than a sick dove.

  The 1918 pandemic is still emerging from the shadows of the First World War, but emerge it will, because of what we have already come to understand about it. The Spanish flu was an example of what today we would call, with appropriate avian overtones, a black-swan event. No European thought that black swans existed until a Dutch explorer discovered them in Australia in 1679, but as soon as he had, all Europeans realised that black swans had to exist, since other animals came in different colours. Likewise, though there had never been a flu pandemic like 1918 before, once 1918 had happened, scientists realised that it could happen again. Hence the reconstructed virus is maintained in high containment facilities where scientists study it in the hope of developing better vaccines; art historians pore over the self-portraits of famous survivors looking for traces of post-viral fatigue; and novelists try to put themselves inside the heads of those who lived through it, in an attempt to understand their fear. Like worker bees they are busy weaving threads between the millions of discrete tragedies to create a collective memory–a living photograph of the Spanish flu. Those threads will reinforce it in our consciousness, and help pull it free.

  Acknowledgements

  For the idea, thanks to Richard Frackowiak. For their invaluable help with the research and in some cases the translation, thanks to Robert Alexander, Séverine Allimann, Andrey Anin, Pierre Baudelicque, Annette Becker, Charles Linus Black, Elizabeth Brown, Ivana Bucalina, Marta Cerezo Guiu, Upendra Dave, Jean-René and François Dujarric de la Rivière, Mark Elgar, Thomas Fischer, Sofie Frackowiak, Paul French, John Garth, Douglas Gill, Anders Hallberg, Claude Hannoun, Jean-Frédéric Henchoz, Laura Jambrina, Peter Johnson, Andreas Jung, Bahri Karaçay, Ana Leal, Ahnie Litecky, Daniel Medin, Jürgen Müller, Sandy Rich, Inna Rikun, Nil Sari, Janice Shull, Maria Sistrom, Stéphanie Solinas, Tim Troll, Malvina Vlodova, Liliya Vukovich and the staff of the Gorky Research Library in Odessa, Jeanine Wine, Negar and Mohammad Yahaghi, and Patrick Zylberman. For their editorial advice, which made it a better book, thanks to Alex Bowler, Ana Fletcher, Janet Lizop, Michal Shavit and Jeffery Taubenberger. For their endless hospitality, thanks to Pamela and Gian Luigi Lenzi. For their grant, without which much of the research would have been impossible, thanks to the Society of Authors’ K. Blundell Trust and Authors’ Foundation. And for his wisdom, wit and kindness, a heartfelt tribute to David Miller, who died too soon and before this book saw the light of day.

  Laura Spinney is a science journalist and a literary novelist. She has published two novels in English, and her writing on science has appeared in National Geographic, Nature, The Economist, and The Telegraph, among others. Her oral history portrait of a European city, Rue Centrale, was published in 2013 in French and English.

  BY THE SAME AUTHOR

  The Doctor

  The Quick

  Rue Centrale: Portrait of a European City

  Illustration Credits

  The images used to introduce each of the ten sections of this book have been reproduced with kind permission from the following:

  Introduction: Bettmann / Contributor / Getty Images / Editorial #: 514877124. Part One: Popperfoto / Contributor / Getty Images / Editorial #: 79035213. Part Two: OHA 250: New Contributed Photographs Collection, Otis Historical Archives, National Museum of Health and Medicine (NCP 001603). Part Three: The Family, 1918, Schiele, Egon (1890–1918) / Osterreichische Galerie Belvedere, Vienna, Austria / Bridgeman Images. Part Four: Harris & Ewing collection, Prints & Photographs Division, Library of Congress, LC-DIG-hec-44028. Part Five: © IWM (Q 2381). Part Six: Institut Pasteur/Musée Pasteur. Part Seven: Charles Linus Black; Photographer: Sue Brown French. Part Eight: Photo credit: Cynthia Goldsmith; content provider(s) CDC / Dr Terrence Tumpey. Afterword: Bettmann / Contributor / Getty Images / Editorial #: 514865716.

  Notes

  INTRODUCTION: THE ELEPHANT IN THE ROOM

  1. The exact quote is: ‘The brevity of the influenza pandemic of August–September 1918 posed great problems to doctors at the time. They had no chance to try out different remedies or to learn anything about the disease before it was over. It has posed great problems to historians ever since.’ T. Ranger, ‘A historian’s foreword’, in H. Phillips and D. Killingray (eds.), The Spanish Influenza Pandemic of 1918–19: New Perspectives (New York: Routledge, 2003), pp. xx–xxi. This is also the source for Ranger’s comments on the need for a new style of narrative.

  2. J. Winter, Sites of Memory, Sites of Mourning: The Great War in European Cultural History (Cambridge: Cambridge University Press, 1995), p. 20.

  3. Ranger, in Phillips and Killingray (eds.), pp. xx–xxi. Ranger is thinking particularly of the female characters in the novels of Zimbabwean writer Yvonne Vera, whose surname was one of the names given to the Spanish flu in her country.

  4. L. Spinney, ‘History lessons’, New Scientist, 15 October 2016, pp. 38–41.

  PART ONE: THE UNWALLED CITY

  1. Coughs and sneezes

  1. N. D. Wolfe, C. P. Dunavan and J. Diamond, ‘Origins of major human infectious diseases’, Nature, 17 May 2007; 447(7142):279–83.

  2. Epicurus, Vatican Sayings.

  3. Book 25, The Fall of Syracuse.

  4. W. H. McNeill, Plagues and Peoples (Garden City: Anchor Press/Doubleday, 1976), p. 2.

  5. D. Killingray, ‘A new “Imperial Disease”: the influenza pandemic of 1918–19 and its impact on the British Empire’, paper for the annual conference of the Society for Social History of Medicine, Oxford, 1996.

  6. W. F. Ruddiman, Earth Transformed (New York: W. H. Freeman, 2013), ch. 21.

  7. C. W. Potter, ‘A history of influenza’, Journal of Applied Microbiology (2001), 91:572–9.

  8. Quick Facts: Munch’s The Scream (Art Institute of Chicago, 2013), http://www.artic.edu/aic/collections/exhibitions/Munch/resource/171.

  2. The monads of Leibniz

  1. P. de Kruif, Microbe Hunters (New York: Harcourt, Brace & Co., 1926), pp. 232–3.

  2. Ulysses, 2:332–7.

  3. Hippocrates. Ancient Medicine.

  4. T. M. Daniel, ‘The
history of tuberculosis’, Respiratory Medicine, 2006; 100:1862–70.

  5. S. Otsubo and J. R. Bartholomew, ‘Eugenics in Japan: some ironies of modernity, 1883–1945’, Science in Context, Autumn–Winter 1998; 11(3–4):545–65.

  6. G. D. Shanks, M. Waller and M. Smallman-Raynor, ‘Spatiotemporal patterns of pandemic influenza-related deaths in Allied naval forces during 1918’, Epidemiology & Infection, October 2013; 141(10):2205–12.

  7. J. Black and D. Black, ‘Plague in East Suffolk 1906–1918’, Journal of the Royal Society of Medicine, 2000; 93:540–3.

  8. A. D. Lanie et al., ‘Exploring the public understanding of basic genetic concepts’, Journal of Genetic Counseling, August 2004; 13(4):305–320.

  PART TWO: ANATOMY OF A PANDEMIC

  3. Ripples on a pond

  1. B. Echeverri, ‘Spanish influenza seen from Spain’, in Phillips and Killingray (eds.), p. 173.

  2. E. F. Willis, Herbert Hoover And The Russian Prisoners Of World War I: A Study In Diplomacy And Relief, 1918–1919 (Whitefish: Literary Licensing, LLC, 2011), p. 12.

  3. D. K. Patterson and G. F. Pyle, ‘The geography and mortality of the 1918 influenza pandemic’, Bulletin of the History of Medicine, Spring 1991; 65(1):4–21.

  4. R. Hayman, A Life of Jung (London: Bloomsbury, 1999). But Hayman gives no source for this story, and according to Thomas Fischer, director of the Foundation of the Works of C. G. Jung, there is no documentary evidence for it.

  5. E. Favre, L’Internement en Suisse des Prisonniers de Guerre Malades ou Blessés 1918–1919: Troisième Rapport (Berne: Bureau du Service de l’Internement, 1919), p. 146.

  6. My Life and Ethiopia’s Progress, 1892–1937: The Autobiography of Emperor Haile Selassie I, ed. E. Ullendorff (Oxford: Oxford University Press, 1976), p. 59.