The American Plague

by Molly Caldwell Crosby

  For the mosquito trials, Reed felt less certain about seeking volunteers. It was one thing to ask Cooke and the men to expose themselves to the filth Reed was certain could not transmit yellow fever; it was something else all together to ask men to volunteer for the same experiments that had killed Jesse Lazear and had almost taken James Carroll. The other doctors let it be known that Reed would need volunteers, and then they waited.

  Many of the doctors at Camp Columbia knew of John Moran’s situation. Having been honorably discharged from the army that July, Moran worked as a civilian clerk, hoping to save up enough money for medical school. An Irishman who had planned to join the cavalry at the onset of the Spanish-American War, his interest had turned instead to the Hospital Corps. As one contract surgeon told him, “Moran, any man with enough influence can become a captain, but not a doctor.”

  Moran was well liked, though considered a little green. When he first arrived in Cuba, the corpsmen made sure to teach the new Irishman some helpful Spanish phrases. “They were words,” he later wrote, “that I could not speak today in the presence of respectable, Spanish-speaking dames and expect to get away with it.”

  Moran received around $100 a month for his work as a field clerk under General Fitzhugh Lee and had been allowed to remain at Camp Columbia in spite of his civilian status so that he could save money for school. On his discharge papers, his character was described as “excellent,” his services, “honest and faithful.”

  Like many of the men at Camp Columbia, John Moran was also well acquainted with yellow jack. He arrived at work one morning to find the desk next to him empty, only to learn that the other clerk had just died of yellow fever. He had also heard the famous story of Major Peterson, which had shocked the military in Cuba and made the rounds in the American newspapers. When the handsome, young Peterson died of yellow fever, his wife feared that she too might have the fever. Just hours after his death, she pulled a revolver from her purse and shot herself. And, certainly, Moran had also been an admirer of Jesse Lazear, whose loss was still felt, poignantly, throughout the camp.

  One day, Dr. Roger P. Ames, a contract surgeon, approached Moran. He knew of Moran’s financial situation and had even suggested Moran consider his own alma mater, Tulane, once he had enough money saved. Ames brought up the subject casually—did Moran know that Major Reed was offering a bonus for men willing to volunteer for his new experiments? The $500 reward could certainly go a long way toward medical school, and he’d be doing Walter Reed a favor. “All right, Doc, I will sleep over it and let you know tomorrow.”

  “Neither of us,” Moran later wrote, “gave very much thought to a possible death lurking in the background.”

  That night, Moran talked it over with his roommate, Private John R. Kissinger. Moran decided not only to volunteer but to do so without monetary compensation. His mind was made up. Kissinger tried to dissuade Moran from forfeiting the money— especially since he needed it so badly for medical school. They continued to discuss it all through the night until the early hours of morning, when they decided to tell Reed that they would both volunteer. They wanted to tell him as soon as possible, before doubt weakened their resolve, but they thought it best to wait until Reed had dressed for the day and taken breakfast. Then, they made the short walk across camp toward the smell of coffee wafting from the officer’s quarters. Reed met the two men on his porch, “Good morning. What can I do for you?”

  In the tense silence, Reed looked at the two strangers—one a private, one dressed in civilian clothes—and waited for the tongue-tied men to speak. When they finally explained the reason for the visit, Moran wrote, “The Major’s surprise was complete and so reflected in his countenance. He never expected such rapid-fire action as confronted him, there and then, in the persons of two human guinea pigs.”

  Reed rubbed his palms, one over the other, and was about to answer the men when Kissinger blurted, “That is not all, Sir. We are volunteering without the bonus or money award which we understand you are offering.” Reed looked confused, even concerned.

  “That is correct, Major,” added Moran. “We are doing it for medical science.”

  Reed quietly told the men that he would gladly accept them for his experiments, and it was later famously recorded that Major Walter Reed touched his cap and said, “I take my hat off to you, gentlemen.” In another version, it was said that Reed remarked, “I salute you.” Both Moran and Kissinger denied that an officer would have said as much to enlisted men, but when Reed’s son, Lawrence, was asked about it years later, he said that it sounded exactly like something his father would have said. Actually, General Lawrence Reed added, “He would have said, ‘Gentlemen, I salute you.’ ”

  Reed would describe the moral courage displayed by Kissinger as unsurpassed in the annals of the army of the United States. And in a written recommendation for Moran, Reed would write, “A man who volunteered, as he did, without hope of any pecuniary reward, but solely in the interests of humanity and medical science, to enter a building purposely infected with yellow fever . . . should need no word of recommendation from any one.”

  Other volunteers for the experiments were acquired by less noble means. Agramonte, the only board member who could speak Spanish, was sent to the Immigration Station across the Bay of Havana for recruits. He hired roughly ten newly arrived immigrants at a time to work as day laborers at Camp Lazear. Straight off the boats, the immigrants were delighted to find easy work picking up stones in a field. They were given bountiful meals and tents to sleep in. Surely, they even observed with appreciation the folds of mosquito netting placed thoughtfully over their beds. They may or may not have noticed the casual, but persistent questioning that came from the officers in the camp: Where did their families originate, had they ever lived in Cuba or the tropics before, had they contracted any diseases—any fevers—since their recent arrival? Did they have a wife or children dependent upon them? If any of the immigrants were underage or had previously lived in the tropics, they were sent away from the camp immediately. At last, when the immigrants had grown comfortable to this life at Camp Lazear, the idea of the experiment was put before them. If the men agreed, they would receive $100 in gold and another $100 if they caught yellow fever, in which case they would be given the best possible care. “Needless to say,” wrote Agramonte, “no reference was made to any possible funeral expenses.”

  The board justified their means by arguing that Spanish immigrants in Cuba routinely expected to suffer a case of yellow fever—they would at least be paid for it this way. As crude as their methods seem to modern science, this was still during the height of vivisection. After all, two of the board members had infected themselves in the course of the last few months. What would make this experiment different, and set a precedent for all future human experiments, was the consent form. Most human experiments in the past had been conducted on unsuspecting patients or under false pretenses. Walter Reed insisted that these volunteers understand fully what they were risking and be compensated for it. Years later, Major Randolph Kean would proudly hang a copy of the bilingual consent form on his office wall.

  Once the consent form was signed, Moran and the Spanish volunteers went into isolation on November 20. Kissinger, who had been on the premises for a full month, did not need to be quarantined and was ready to begin the experiments immediately. Just as Lazear had done two months before, Reed set a glass tube against Kissinger’s skin and allowed the loaded mosquito to land and bite. Now, they would wait to see if and when Kissinger might develop the fever.

  Kissinger earned a sort of hero status around the camp. When he entered the mess hall one day, the soldiers rose from their seats and shouted, “Attention! Hero Kissinger is here!” They continued with the meal, occasionally asking someone to “Pass the hero the butter” or “Pass our hero the pickles.” One of the soldiers later wrote that Kissinger “was blushing a rosy red, and was so embarrassed he couldn’t eat. For he knew that this was the Army Way of hiding the real
sentiment we all felt by making a joke of our deep appreciation we would not express in words.”

  The days seemed slow going, the experiments uneventful. The men were not allowed to leave the isolated farm, and instead played poker and performed light duties around Camp Lazear, adhering to the old army saying, “If it’s there, pick it up; if you can’t move it, paint it; if it moves, salute it!”

  Moran continued to work as a clerk, this time for Reed. He spent four or five hours a day typing reports—with his two index fingers only—on the army’s standard Hammond typewriter. A perfectionist, Moran was even known to retype whole pages if he found an erase mark. Reed once tore up a whole page on yellow fever when he found an error, telling Moran that “perfection is next to impossible on a machine.”

  By the end of November, Kissinger, Moran and the other volunteers had all been bitten at one time or another, sometimes even twice, but there was not a single case of yellow fever among them. What the virus accomplished in nature with relative ease proved much more complicated in the lab. Like Finlay before them, their mistake lay in the simple matter of timing, and as one historian put it, their harvest would soon ripen with a vengeance.

  On December 5, Kissinger volunteered to be bitten for the third time, this time by five different mosquitoes. At least one of the loaded insects in the group had fed on a yellow fever patient in the first three days of fever. The virus slipped silently into his bloodstream, and three days later, on December 8, Kissinger came down with a sudden and strong chill. He shivered as his fever climbed almost immediately to 102.5. His head began to pound, and he felt as though his bones had literally been crushed. He would later describe his bout with yellow fever, “My spine felt twisted and my head swollen and my eyes felt as if they would pop out of my head, even the ends of my fingers felt as though they would snap off.” By the time his illness ended, Kissinger’s weight dropped to 118 pounds, and he would remain an invalid for the rest of his life, eventually becoming mentally ill. Years later, historian Philip S. Hench wrote that Kissinger “really ‘died’ physically and mentally when he took sick. Thereafter he has lived only one role—that of a yellow fever martyr and hero.”

  “The case is a beautiful one,” Reed wrote, “and will be seen by the Board of Havana experts today, all of whom, except Finlay, consider the theory a wild one!”

  Reed also wrote to Emilie: “Rejoice with me, sweetheart, as, aside from the antitoxin of diphtheria and Koch’s discovery of the tubercle bacillus, it will be regarded as the most important piece of work, scientifically, during the 19th century.”

  In the coming week, Reed produced three more cases of yellow fever among the volunteers.

  A haunted stigma began to surround Camp Lazear. A number of the Spanish volunteers fled, refusing any additional experiments. Rumors in Havana circulated that some soldiers had found an old limekiln filled with the bleached bones of Walter Reed’s yellow fever volunteers.

  To the three men living in the Infected Clothing Building, the news of Kissinger’s case only added to their claustrophobic sense of fear, which was already cloaked in isolation and filth. If Reed could produce yellow fever under such sanitary conditions, what chance did the three men enclosed in a tomb of germs have? The men barely slept at night and began to imagine fits of fever and chills.

  Just when they were at the psychological breaking point, a fresh box from a fatal case of yellow fever arrived. The box had been sealed shut for days, and when the men finally opened it, they ran out of the building into the dark, where one vomited uncontrollably. At last, on December 19, Cooke and his two volunteers were released from their twenty-night stay in Building No. 1, and the next group of volunteers entered. No cases of yellow fever ever developed from the Infected Clothing Building.

  By the end of these experiments, Reed had irrefutable proof that yellow fever could not be transmitted by “germs,” infected clothing or air. He had exposed his men to every type of filth for up to twenty days at a time, and not one had contracted the fever. It toppled once and for all the prevailing theory that yellow fever could be spread by filth.

  On December 21, John Moran entered Building No. 2, the Infected Mosquito Building. Much like its sister structure a few yards away, Building No. 2 had been carefully constructed by Reed. It was the same size and general make, but instead of one room, this building was split through the center with a finely woven wire screen, and the walls had not only been sealed, but also lined with cheesecloth. Again, like its sister structure, there were three cots, but these were outfitted with pristine, steamed sheets. Cot A stood on the “infected side” of the room, while cots B and C were located on the “safe side,” protected by a wall of wire that separated the two. The entire building had been thoroughly disinfected. Two other volunteers stayed on the “safe side” of the wire partition, where they would sleep for over two weeks—they were the experiment’s control group.

  Reed stood to one side of the screen, his face obscured by the metallic mesh, and watched as John Moran entered the room. Moran was fresh from a bath and wearing nothing but a night-shirt, which he removed before lying down on the cot. He rested on his back, his arms at his sides, and held the mirror Reed had given him. Moran could hear the whine of mosquitoes in the room. He lay very still as the insects began to sense carbon dioxide and flickered closer to the source. He watched his reflection in the hand mirror as the virulent mosquitoes landed on his face and fed. Over a series of similar trials that afternoon, Moran received fifteen swollen bites.

  On Christmas Day, four days after he entered the Infected Mosquito Building, John Moran awoke with a headache and a chill. He had made a wager with a fellow soldier that he would be present at lunch, and being an Irishman, he wasn’t going to give up so easily. Moran knew that eating heavy amounts of food during a case of yellow fever could have disastrous results, so he picked at his Christmas lunch, trying to hide how little he ate.

  “Guess you win,” admitted the soldier. “Damn it, you can’t kill an Irishman anyway.” The soldier reached into his pocket to retrieve the money.

  Moran looked up from his plate, “Well, I guess you won and lost.”

  The soldier’s smile faded, creases settling around his eyes and brow. “You don’t mean to tell me that you have it, Johnny?”

  By 3:00 that afternoon, when Reed arrived, Moran’s temperature was 103. Reed stood before him with a broad smile. “Moran, this is one of the happiest days of my life.”

  Moran’s temperature would continue to rise to 104 degrees, as he ate nothing but cracked ice and sipped strained watermelon juice for two weeks. During the course of his illness, he lost twenty pounds before making a full recovery.

  Though they occupied the same building, ate the same food and breathed the same air as John Moran, the volunteers from the “safe side” of the building never came in contact with mosquitoes. Neither man ever contracted yellow fever.

  In the week before Christmas, the atmosphere in Havana was festive, almost like a carnival. In spite of a toothache and no dentist available to treat it, Reed took part in the festivities. He walked the gaslit streets of Havana on the night of December 22, where porch fronts were studded with tropical flowers instead of evergreen boughs. Poinsettia bushes were in bloom, and candles lined windows and church doorways streaming wax down the stucco.

  Son music was played in taverns and cafes, the sound of the guitar and flute rising in the air with the beat of maracas like shifting sand beneath it.

  Reed crossed Parque Central in the heart of Havana, walking beneath the almond trees and iron lampposts. The triangular roof of the Tacón theater rose above the treetops. He waited for the horse-and-buggy traffic to slow before crossing the street at the Inglaterra Hotel, its neoclassical façade a perfect series of windows and wrought-iron balconies. Next door, between the Inglaterra and Hotel Telegrafo, he walked beneath white columns and archways to the doorway of a narrow building. Even from the street, he had heard the sound of cocktail-laced laughter and sm
elled the cigar smoke from the open, floor-to-ceiling windows. His dress shoes clapped against the tile as he climbed the narrow case of thirty-one stairs and entered the dining salon of Old Delmonico’s Restaurant. The room trembled with candlelight reflecting off crystal, the voices drowning out the music and street traffic below. The dinner was in honor of Carlos Finlay and his mosquito hypothesis; all of the speeches were given in Spanish. Juan Guitéras, the longtime yellow fever doctor who had served both on the 1879 Yellow Fever Commission and as the doctor treating Victor Vaughan at Siboney, was the master of ceremonies. He compared Finlay to Sir Patrick Manson, who first proposed that malaria could be spread by mosquitoes, and Reed to Ronald Ross, who had given the final proof. Carlos Finlay was given a bronze statuette in honor of his valuable work. He would also be nominated for the Nobel Prize in 1905, 1906, 1907, 1912, 1913, 1914 and 1915 for his work with yellow fever, though he would never win. And to this day, Carlos Finlay is Cuba’s most revered physician.

  At close to midnight, Finlay raised his glass: “Twenty years ago, guided by indications which I deemed certain, I sallied forth into an arid and unknown field; I discovered therein a stone, rough in appearance; I picked it up . . . polished and examined it carefully, arriving at the conclusion that we had discovered a rough diamond. But nobody would believe us, till years later there arrived a commission, composed of intelligent men, experts in the required kind of work, who in a short time extracted from the rough shell the stone to whose brilliance none can now be blind.”