While no concrete evidence has been found to confirm these theories, historians such as Alfred Crosby suggested a more plausible explanation, namely that Spanish flu derived directly from the war itself, a man-made catastrophe created by a deadly combination of the poison gas and decomposing corpses created in No Man’s Land:
Wherever his armies met in Europe, man was creating chemical and biological cesspools in which any kind of disease might spawn. Never before had such quantities of explosives been expended, never before had so many men lived in such filth for so long, never before had so many human corpses been left to rot above ground, and never before had anything so fiendish as mustard gas been released into the atmosphere in large amounts.54
Victor Vaughan’s response to the epidemic at Camp Devens was chilling. ‘If the epidemic continues its mathematical rate of acceleration, civilization could easily disappear from the face of the earth,’55 he feared.
CHAPTER EIGHT
LIKE FIGHTING WITH A GHOST
I had a little bird
And its name was Enza
I opened the window and
In-flew-enza
THIS WAS THE rhyme the third-grade girls sang as they jumped rope in Miss Sykes’ class in Dorchester, Boston. ‘To our confident immortality, influenza seemed no threat at all, one more incident in the excitement of the war’s climax,’ recalled Francis Russell, just seven years old when Spanish flu hit Massachusetts. Like the children in Thomas Gray’s poem, the little victims played, heedless of their impending doom.1
Initially, doctors and civic authorities were confident that the epidemic would be contained. On 13 September 1918, Surgeon General Rupert Blue of the United States Public Health Service (USPHS) gave a press interview, issuing guidance on how to recognize Spanish flu and recommending bed rest, good food, quinine and aspirin for patients.2 The following day, the Public Health Service of Massachusetts telegraphed the national headquarters of the Red Cross for fifteen nurses to be rushed to Boston.3 There were similar calls from elsewhere in New England in the following days. Despite these efforts the mortality rates increased day by day. On 26 September, 123 Bostonians died of influenza and 33 of pneumonia.4 Overall, 50,000 cases were reported in Massachusetts. Governor Calvin Coolidge telegrammed President Wilson, the Mayor of Toronto, and the governors of Vermont, Maine and Rhode Island with the news that ‘Our doctors and nurses are being thoroughly mobilized and worked to limit … Many cases receive no attention whatever.’5 Coolidge did not ask New Hampshire or Connecticut for assistance, ‘because he knew they were nearly as badly off as Massachusetts’.6
By this point, Spanish flu had appeared at navy bases as far away from Boston as Louisiana, Puget Sound and San Francisco Bay, and in twenty army camps from Massachusetts to Georgia and as far west as Camp Lewis, Washington. Despite this sinister development, the city authorities insisted there was no cause for alarm. The Boston Globe proclaimed that the doctors had the Spanish flu ‘pretty well in hand’7 despite the fact that the Navy announced 163 new cases the same afternoon, with a Rear Admiral protesting that there was ‘no reason to be alarmed’.8
Francis Russell’s school in Dorchester, Boston, lay on the route to the New Calvary cemetery and from his classroom window Francis had a ringside view of the funerals. As the coffins piled up, the landowner, John ‘Pigeye’ Mulvey, pitched a circus tent alongside the chapel to hide them.
‘The tent lay there white and billowing, like some grotesque autumn carnival among the withered leaves, with the somber line of vehicles trailing through New Calvary gate,’ Francis recalled.9 Caskets, buried too shallow, were rising out of the ground. From his classroom, as they followed the morning routine of multiplication tables,
We could hear the carriages passing outside, the clop of horses’ hooves in the wet leaves … The plague stretched out its fingertips towards Miss Sykes. Trying as best she could to conceal it from us, she became sharp and tense-voiced. The rattle of the hacks had broken her nerve. In the afternoon the sun’s rays would strike against the glass of a passing carriage, and reflect waveringly across the ceiling of our room, and we, distracted by light and sound, would crane toward the row of windows. ‘Eyes front!’ she would shriek at us. For the fear was on her.10
All the schools in Boston were closed in the first week of October 1918, as the authorities finally took action to stem the onslaught of the epidemic. This was a blessing as far as Francis was concerned:
For us it was pure joy in that abounding weather to be free of the third grade and the Palmer Method and the multiplication tables and Miss Sykes and her harmonica. The early mornings turned frosty, blackening the marigolds, but the afternoons were warm and sun-drenched and golden, heavy with cricket sounds, light as milkweed down. By Collins’ Pond the witch hazel was in bloom, the lemon-yellow filaments crisscrossed against the bare branches, on the Hill, on such bright days, we lost ourselves in the immediacy of the timeless present, as free to wander as any coma of milkweed.11
Francis’s idyllic memories of the fall contrast vividly with the grim reality of life in Massachusetts during the epidemic. When a Roman Catholic nurse on duty in Boston was asked why she had returned so late, she had replied: ‘Well, the Mother had died, and there were four sick children in two rooms, and the man was fighting with his mother-in-law and throwing a pitcher at her head.’12 ‘The whole city is stricken,’ wrote a nurse in Gloucester, Massachusetts. ‘We were taken quite unawares.’13
Meanwhile, six-year-old John Delano was growing up in the Italian immigrant community in New Haven, Connecticut. ‘Life to me was just lots of Italians living together. We all knew each other, we were always visiting, passing food around. We were just one big happy family. For every little affair – baptisms, birthdays, Communion – we had a party. It was always parties, parties, parties.’14
But Spanish flu soon changed all this. John lived down the block from an undertaker, and he began to witness coffins piling up on the sidewalk outside the morgue. As the piles of coffins rose, he and friends played on them, jumping from one to another: ‘We thought – boy, this is great. It’s like climbing the pyramids. Then one day, I slipped and fell and broke my nose on one of the coffins. My mother was very upset. She said, didn’t I realize there were people in those boxes? People who had died? I couldn’t understand that. Why had all these people died?’15
In Brockton, Massachusetts, 8,000 people, 20 per cent of the city’s population, fell ill. Mayor William L. Gleason conducted an efficient holding operation, employing Boy Scouts to send messages and run errands, but despite this the infection spread. The chair of Brockton’s Board of Health told one nurse that combating Spanish flu was like ‘fighting with a ghost’.16 One morning a young woman arrived at Brockton Hospital suffering from Spanish flu. Her lungs were already full of blood, and she was seven months pregnant.
‘The baby was born prematurely and died at birth, but I did not dare tell the mother it had died,’ recalled her nurse.17
‘She kept begging me to see her baby … I assured her that he was fine and beautiful and she would hold him as soon as she was stronger. She had such a lovely look on her face as she talked about her son, and how happy her husband would be. It was an effort for her to talk as her lungs were filling … She died late that afternoon. I put the baby into her arms and fixed them so that they seemed only to be sleeping. And so the husband saw them when he came.’18
Young Francis Russell and his classmates, left to their own devices, made the most of their new-found freedom. One afternoon, Francis and his friend Eliot Dodds followed another boy, Everett Nudd, down towards the New Calvary cemetery. ‘Want to come along?’ Eliot asked. ‘Want to come watch funerals? I do it every day.’19 Francis had never attended a funeral, although he had seen many through his classroom windows, and he found himself unable to turn back.
We wandered down the main path past the brown and gray stone monuments, past carved crosses and sacred hearts and triumphant stone angels with impassive granite
wings. Then the path ended at a dump, and Everett turned right through a thicket of ground oak and speckled alder, holding up his hand in warning. A funeral was going on directly below us. Around the raw earth of an open grave a group of mourners was huddled together like a flock of bedraggled starlings. The fumed oak coffin had been set beside the grave, and a priest in a biretta stood at its head, even as we looked down, making the sign of the cross over it. Then the others began to file past and some of them stopped to pick up a bit of earth which they scattered on the coffin. Just behind them two workmen appeared with ropes fastened in a sling. A heavy-built man with white hair and florid features stopped at the grave’s edge, shook the damp clay from his fingers, then glanced up to see us peering through the alder bushes. ‘Get out of here, you!’ he shouted, his face turning scarlet. ‘Get out!’20
The boys hid behind the bushes; Francis was desperate to get away but Everett tugged on Francis’s shirt to make him stay. They had stumbled across a horrific sight. Exhausted gravediggers, hopelessly trying to keep up with the backlog, were dumping the corpses out of the coffins and re-using them. As the boys emerged beside another open grave,
A grave digger just climbed out and stood with his shovel beside him, lighting his pipe. He was an old Italian with a drooping mustache, wearing a shapeless felt hat with a turned-down brim. The grave digger started at us with shrewd, uncomprehending eyes, then took his pipe out of his mouth and spat again. ‘Ah, you boys-a go-onna home,’ he said thickly. ‘You no playa here. Go-onna home.’21
Francis ran away home, but was never able to forget the experience:
Seeing the lights, thinking of the afternoon, in that bare instant I became aware of time. I knew then that life was not a perpetual present, and that even tomorrow would be part of the past, and that for all my days and years to come I too must one day die. I pushed the relentless thought aside, knowing even as I did … I should never again be wholly free of it.22
John Delano, too, had his first taste of mortality at the hands of the Spanish Lady.
One day, my three best buddies didn’t come out of their houses in the morning. I realized no one in our neighborhood was visiting each other. No one was passing around food, talking on the street. Everyone was staying inside. Still, every morning, I went to my buddies’ houses. I knocked on the door and waited for them to come out and play.23
One morning, John knocked on the doors of his friends’ houses and waited for someone to come out. But nobody did. ‘I didn’t know what was happening. Finally, my mother told me God had taken them. My friends had gone to Heaven.’24
Down in New York, conditions were not as bad as they might have been. Despite its role as the most important embarkation port in the United States, New York did not suffer as gravely as other American cities during the Spanish flu pandemic. As we shall see in a subsequent chapter, that melancholy distinction fell to Philadelphia. However, New York could not escape the onslaught entirely. As a major port, it was subject to the disease brought on board from foreign craft and from its own returning servicemen. Also, Spanish flu was airborne: if it had not come to New York via global military transportation, it reached New Yorkers a dozen other ways: on the breath of returning soldiers reunited with their families; from civilians travelling back and forth the length and breadth of the country; and from civilians and military personnel gathering together for recruitment drives. On 12 October, President Wilson led 25,000 cheering New Yorkers down the ‘Avenue of the Allies’25 in a supreme example of ‘stark raving patriotism’.26 That same week, 2,100 New Yorkers died of influenza.27
On 19 September, the USS Leviathan returned to New York from Brest, France. Among her passengers was Assistant Secretary of the Navy Franklin Delano Roosevelt, who had developed influenza on the way home from an exhausting fact-finding mission to France. Eleanor Roosevelt received word through the Navy Department that Roosevelt had double pneumonia and they were to meet him on arrival with a doctor and an ambulance. According to Eleanor, ‘the flu had been raging in Brest and Franklin and his party had attended a funeral in the rain. The ship on which they returned was a floating hospital. Men and officers died on the way home and were buried at sea.’28 Among the passengers was Prince Axel of Denmark and his entourage, coming to the United States for a visit. ‘When they felt the ’flu coming on they consulted no doctor but took to their berths with a quart of whisky [sic] each. In the course of a day or two, whether because of the efficacy of the whisky or because of their own resistance, they were practically recovered.’29
Roosevelt was so weak that he had to be carried off on a stretcher when the ship docked. ‘An ambulance drove him to his mother’s house, and four Navy orderlies carried him inside.’30 It took Roosevelt a month to recover.
The Spanish Lady embraced the future president of the United States as enthusiastically as she flung her arms around the poor Chinese sailors who ended up sick in New York. Twenty-five Chinese sailors, suffering with flu, were taken from their ship to the Municipal Lodging House, which had been turned into an emergency hospital. To their horror, they were greeted by white masked figures in white robes, who spoke no Chinese. An interpreter had been found, but fled the scene when Spanish flu was mentioned. Fearing that they would be robbed, the sailors refused to take their clothes off, and afraid they would be poisoned, they refused to eat. Victims of mutual incomprehension, seventeen out of twenty-five sailors died.31
But the official mood remained buoyant. At the end of September 1918, the Journal of the American Medical Association claimed that Spanish influenza might sound unusual but this ‘should not cause any greater importance to be attached to it, nor arouse any greater fear than would influenza without the new name’. The journal also maintained that Spanish flu had ‘practically disappeared from the Allied troops’.32
Despite these claims, Bellevue Hospital, Manhattan, was swiftly overwhelmed with patients. People were dying in beds, on stretchers and in the corridors. In the paediatric wards, children were packed three to a bed. After the laundresses had panicked and fled from the basements, there was no clean linen to be had. Cleanliness, routine and discipline, the bedrock of hospital life, had disappeared.
Dorothy Deming, a student nurse during the pandemic, recalled: ‘There were no more formal “doctors’ rounds,” neither for the attending physicians nor for the medical students. Doctors came and went at all hours, calling for a nurse only when giving an order or needing help. It was quite usual to see a haggard doctor come in long after midnight to make a last examination of his patient before staggering home to bed.’33
Another nurse was shocked by the difference between general nursing and the scenes which she encountered on a daily basis:
Until the epidemic, death had seemed kindly, coming to the very old, the incurably suffering or striking suddenly without the knowledge of its victims. Now, we saw death clutch cruelly and ruthlessly at vigorous, well-muscled young women in the prime of life. Flu dulled their resistance, choked their lungs, swamped their hearts … There was nothing but sadness and horror to this senseless waste of human life.
Many a morning after working hard over a patient, Dorothy [another Dorothy, Deming’s friend] and I bore the grim task of trying to find words of comfort for dazed parents, husbands and children. One dawn – a glorious morning with rose-colored clouds above the gray buildings across the street – after a particularly sad death, I knew the tears I had been shedding inwardly must find outlet. I rushed to the linen closet, always our place of refuge, and there ahead of me was Dorothy, sobbing her heart out.34
Dorothy Deming took some consolation from the fact that she was ‘doing her bit’ for the war effort, a vital consideration at the time. It seemed to Dorothy that nursing in these conditions was the equivalent of being under fire, like ‘our brothers in the Argonne’.35 Despite this iron resolve, the noise coming from the wards was so loud that Dorothy could only sleep with the help of an eye mask fashioned from a black silk stocking, and her ears plugged wit
h cotton wool.36
At Columbia Presbyterian Hospital in Washington Heights, Dr Albert Lamb recognized the fact that he was dealing with an unprecedented new disease, describing his incoming patients in graphic terms: ‘They’re blue as huckleberries and spitting blood.’37 The by-now familiar stigmata of Spanish flu were adding a note of horror to the familiar symptoms of influenza: torrential nosebleeds, explosive haemorrhaging, air-hunger and cyanosis. Every hospital ward was a vision of hell.
But despite this horrific evidence, New York Public Health Commissioner Royal S. Copeland refused to take rudimentary measures such as closing schools and theatres, claiming that the epidemic was widespread but not serious. ‘I’m keeping my theaters in as good condition as my wife keeps our home,’38 he told reporters. ‘And I can vouch that is perfectly sanitary.’39 On the same day that Copeland made this speech, 354 New Yorkers died of influenza.40
The Spanish Lady made orphans of over 600 New York children. Among these was a little Jewish boy from Brooklyn named Michael Wind.
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