Black Death at the Golden Gate
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Wyman’s resentment of Kinyoun built slowly over several years, and then cascaded down shortly after the Journal of the American Medical Association—a publication read by every doctor in the country and by the Marine Hospital Service officers posted at more than twenty ports overseas—published an issue in which it repeatedly referred to Kinyoun as the true Surgeon General and called Wyman unfit for his job. Though Kinyoun had never outwardly encouraged the attention, Wyman drew up a letter in early May of 1899 notifying him that he was to immediately report to a new station on the other side of the country. For the rest of his life, Wyman would take pains to avoid mentioning Kinyoun by name.
A hastily arranged farewell dinner was held in Kinyoun’s honor in an upstairs ballroom at Rauscher’s, a French restaurant then at the top of Washington’s social hierarchy. Fifty of the most lauded doctors in the country—a group that included George Sternberg, the sitting U.S. Army Surgeon General, and Z. T. Sowers, whose work championing the accurate labeling of drugs would lead to the creation of the Food and Drug Administration—listened while Professor George M. Kobe, soon to be dean of the Georgetown Medical School, reminded the group of Kinyoun’s genius. “No member of his corps has contributed more to the reputation of the Marine Hospital Service and helped to place it upon a higher scientific plane than Dr Kinyoun,” he said. In an understated dig at Wyman, who did not attend the ceremony, he added, “It seems a pity, therefore, that this modest, unassuming scientist should be divorced from a laboratory which has already accomplished so much and promised still more for the future usefulness of this branch of the public service.”
Kobe revealed to the men around him that Kinyoun had received the tempting offer of a full professorship at Rush Medical College in Chicago, yet turned it down because he felt that his first duty was to the public welfare of his country. “Men of this type are rare in the world, especially in these days of struggle for wealth and fame, when the accelerated speed of the race has quickened the pulse, stimulated the nerves and fired the ambition of men, until they overleap all limits of propriety,” he said. “It is not so with our honored guest, for he evidently belongs to the descendants of that noble band of patriots, ready to defend a principle with their lives, their fortune and their sacred honor.”
Before the month was over, Kinyoun, along with his pregnant wife and three young children, climbed aboard a train bound for San Francisco and a coast they had never before seen. They reached California twelve days later, following long stops in Denver and Salt Lake City to allow Lizzie to get some rest. Even with the unexpected delay, their new quarters at the Marine Hospital station in San Francisco were not ready when they arrived. The city itself seemed unwilling to greet them, consumed by a dense fog and chilly wind that felt like a closed door. A small earthquake that jolted the city the next day only confirmed the sense that California wanted nothing to do with them.
The Kinyoun family spent several days at the enormous Palace Hotel, which stretched across an entire city block at the corner of Market and Montgomery streets downtown and offered a level of elegance that prompted the steel magnate Andrew Carnegie to once proclaim, “There is no hotel building in the world greater than this.” Kinyoun, however, found the pageantry of the place an affront to his natural frugality, and shepherded his family toward the docks as soon as he received word that their new home was ready. The family boarded a private ferry for the thirty-minute trip to Angel Island, a hilly, star-shaped outpost that would be their home for the foreseeable future. There, on the largest island in the San Francisco Bay, Kinyoun took charge of the thirty-two-building complex that made up the most extensive quarantine station in the country, and which was responsible for inspecting all passengers and goods arriving through the Golden Gate.
Before leaving Washington, Kinyoun had extracted a promise from Wyman that he would be able to continue his laboratory research in California as time permitted. Upon arrival, however, he realized that would be impossible. The wharf where the ferryboat docked—and, indeed, the island’s only connection to the outside world—was so close to tumbling down that Kinyoun wondered if it was even possible to land. The station itself, meanwhile, was running dangerously short of water, holding so little reserve supplies that a malfunction of one of the hundreds of kerosene lamps required in the absence of electric light threatened to burn down the entire wooden complex. Microscopes and other laboratory equipment sat untouched in dirt-covered boxes. No working telephone or telegraph connected the island to the mainland, and the boats quarantine officers used to meet incoming vessels were so slow and top-heavy that they risked injury every time they went on patrol.
Every ship that appeared out of the fog stitched through the Golden Gate made the situation worse. Dozens of passengers on board a steamship from Hawaii might be discharged on the island at the same time as a crew of merchant sailors from Japan and the members of a Russian whaling party returning from Alaska, the jumble of languages and smells leaving Kinyoun all the more unmoored. The world arrived at his doorstop by the hour, united only by the fact that no one wanted to spend another minute waiting for inspections before they were allowed clear passage on to San Francisco. If he did need to treat a sick passenger, he had little to offer. The main hospital on the island was in shambles, with patients infected with communicable diseases sharing small rooms with men and women there for quarantine, a layout that practically begged for illness to spread. Every night, Kinyoun retreated to a small wooden barrack that served as his new home, where a cold wind from the bay seeped through the walls and left him perpetually worried that his children were about to fall sick. Worse yet, he did not know what else lay in store for him. Simply making a full tour of the island was rendered nearly impossible after a surprise summer rain washed the dirt roads away.
Adding to Kinyoun’s humiliation, he soon discovered that dozens of acres of the otherwise pristine and uninhabited island were covered in garbage, the only remaining evidence of the thousands of troops who had passed through quarantine after returning from the Philippines at the conclusion of the Spanish American War. The kind of scientific progress that had propelled his rise was now replaced by the opportunity to clean up trash, all the while literally marooned on an island on the other side of the continent from everyone and everything he considered important. “I heard a joke, which I consider quite a good one, on me a few days ago, and that was that rumor had reached San Francisco that I had been sent here by the Surgeon General to be buried,” Kinyoun wrote to a friend in Washington as he began work on bringing the station up to his standards. “Don’t you think that I have been rather a lively corpse, if that was the reason?”
In many ways, Kinyoun’s levity masked a rawness that had not diminished with age. With his thinning brown hair, stocky body and gold wire-rim glasses perched above a trim dark beard, Kinyoun looked more the part of a member of the Eastern elite than his life history would suggest. His unquestioning self-confidence had launched him from the humblest beginnings and now sustained him as he faced the indignity of his new surroundings.
It was not the first time that his personality had provoked scorn. At a time when there were few men or women in America that he considered his intellectual equals, he was accustomed to being right, and, like many researchers whose brilliance is most apparent in the laboratory, he lacked the social intelligence to smooth over disagreements. As a result, he often tangled even with those who liked him, flashing a stubbornness that frequently threatened to push his objectives further out of view. The sudden posting to San Francisco, which he considered a public rebuke by Wyman, only brought the darker aspects of his personality to the surface.
His willfulness had been fostered by a childhood marked by upheaval. He was born on the eve of the Civil War in the remote hill country of East Bend, North Carolina, into a wealthy family that owned slaves. When Joseph was five months old, his father, John, left his small medical practice to join the Confederate Army, in whose service he fought in thirteen successive battles
before resigning as a captain to work as a surgeon at a hospital in the rebel capital of Richmond, Virginia. He was among the thousands of men who surrendered to General Sherman in Durham, North Carolina, immediately following Lincoln’s assassination, and soon returned to East Bend, only to discover that his home had been burned down and nearly all of his farmland destroyed. After a brief stint in Texas, John Kinyoun resettled his family in the frontier town of Oak Township, Missouri, where he made his living splitting railroad ties for about a dollar a day.
The small town, nestled near the Kansas border, had been settled mostly by refugees from Southern states, and soon became a lawless place of vigilante justice among men who refused to let the Civil War die. There, Joseph Kinyoun spent his childhood in a small log cabin, where he devoured Greek and Roman classics and taught himself French, German and Spanish as an escape from the violence all around him. At the age of sixteen he began to study medicine under his father’s tutelage, a practice common at a time when most would-be physicians learned their craft in informal apprenticeships like blacksmiths. Under his father’s guidance, he learned how to diagnose common ailments, how to clean a wound and, most importantly, how to be quick with a knife when anesthesia was an indulgence. By the age of twenty-one, he was ready to move to New York City to study at Bellevue Hospital, one of the few places in the country that could offer formal research experience at a time when most hospitals were sparse, primitive wards.
In New York, Kinyoun took the first steps in his transformation from country doctor into one of the giants of the burgeoning era of medicine in which laboratory skills would prove to be more consequential than bedside manner. He took courses in microbiology, analytical chemistry and infectious diseases, becoming one of the first Americans to harness the power of the microscope to target bacteria, which had only recently been identified as the true cause of disease. He graduated from Bellevue in the spring of 1882 and returned home to practice medicine in Missouri.
The loss of his first patient that winter—a young girl suffering from diphtheria, among the deadliest of childhood diseases—left him so depressed that he nearly quit the field. He consoled himself by buying a microscope, which was then considered more a toy for the idle rich than a crucial tool for medicine, and immersed himself in the study of agricultural diseases like anthrax and chicken cholera, all the while supporting himself by tending to women in labor for the price of ten dollars per delivery. Within three years he was married to Susan Elizabeth Perry, the daughter of a prominent Missouri family who asked that everyone call her Lizzie, and ready to break out of a comfortable rural existence that offered few avenues for intellectual adventure.
He returned to New York in 1885 as a newly married man to study as one of the first students at a bacteriological research laboratory at Bellevue funded by Andrew Carnegie. It soon became clear that his timing could not have been better. “The word ‘bacteriology’ had appeared before 1886 but the subject had no existence anywhere much before that time,” noted William Thompson Sedgwick, one of the founders of the Harvard School of Public Health, in an early history of the field. A little more than two hundred years earlier, a Dutch tradesman and amateur scientist by the name of Anton van Leeuwenhoek had been the first to identify bacteria after experimenting with samples of lake water under an early microscope. Yet it would take more than a century for his discovery to find its application within medicine. With a previously unseen world now in view, the concept of disease began to morph from the medieval theory of miasma—the idea that so-called “bad air” spread infection—to pinpointing the exact bacilli that caused illness.
The new field of bacteriology focused more on cells than on the individual attributes of patients, and concerned itself chiefly with understanding how bacteria functioned in order to defeat it. Established doctors at the time considered this approach cold and unseemly, divorced from all the elements of humanity that made medicine feel so visceral, and remained unconvinced that laboratory work could offer anything that would alleviate a patient’s suffering. Those objections became moot after early bacteriologists discovered how to grow pure colonies of bacteria in a lab setting and develop weakened strains of disease as a form of vaccine, opening a new era in which science could target the specific cause of a deadly illness in hopes of eliminating its spread. The results—coming at a time in which unsanitary medical care and overcrowding doomed one in five children born in New York City to die before their first birthday, and in which only three out of four adults lived past the age of thirty—seemed otherworldly, as if Prometheus had returned and stolen another secret of the gods.
As the Carnegie Laboratory’s first bacteriology student, Kinyoun focused his research on cholera, an often fatal disease of the small intestine then uncommon in the United States, contracted from drinking infected water. He joined the Marine Hospital Service the following year, drawn by the chance to help fight disease on a scale he could scarcely imagine. With the advent of steamships and railroads, never before had the world seemed so small, and the Service, with its worldwide reach, offered the opportunity to save millions of lives. “The nations of the earth are more nearly related than ever before in the world’s history,” Surgeon General Wyman noted in a speech during Kinyoun’s first years in the Service. “All the world has become one neighborhood, as far as relates to distances. In no manner has this been better shown than in the warfare against contagion . . . [which is] bringing the nations together as one family in the struggle against these foes of mankind.”
Kinyoun soon set up the nation’s first federal bacteriology laboratory in a quarantine station in Staten Island. There, in a small ground-floor room lined with bookshelves nearly touching the ceiling, he spent nearly all his waking hours peering into microscopes, hoping to isolate disease-carrying bacteria. One month into his research, an Italian ship arrived in New York harbor reporting the suspicious deaths of eight passengers en route. With the cause of death vague and the city at risk of introduction of a deadly disease, Kinyoun obtained tissue samples from the dead. Within a few days, he was able to isolate the bacilli that caused cholera, making him the first person in the Western Hemisphere whose laboratory work resulted in the positive identification of the disease. His research skills allowed public health officials to take swift steps to prevent cholera from establishing a foothold in New York, and turned him into a minor hero inside the rapidly professionalizing circles of American medicine.
His glory was soon cut short by the death of his three-year-old daughter, Bettie, who contracted diphtheria and died despite Kinyoun’s frantic efforts to save her. Unable to go on working as before, he stepped down from his post as the head of the National Hygienic Laboratory and traveled to Europe, where he studied alongside pioneers in the field such as Louis Pasteur in Paris and Robert Koch in Berlin. With formal medical training still a rarity in the United States, Europe was at the time the center of research and drew countless ambitious young men and women from across the globe with its promise of discovery.
It was there, he would later say, that he fully understood that he stood at the start of a “new epoch.” He watched as researchers tested the first antitoxin to counteract diphtheria, all the while imagining Bettie’s face on every child injected with the experimental solution. He could only stand in wonder as dying children began to recover as if by magic. The effect was “so astounding that at first one is almost compelled to ask one’s self, ‘is this possible?’ ” Kinyoun wrote. Unable to trust what he was seeing, he conducted a study of hospital wards and laboratories to try to disprove what seemed like a miracle. Only then was he satisfied enough to trust it, writing a report back to Washington in which he admitted, “I have tried hard to find fault, to pick flaw in the statistics, but have signally failed. The work must stand for itself.”
He returned to the States with a renewed sense that all infectious disease could be prevented by laboratory research. By his posting to San Francisco in early June of 1899, Kinyoun had invented some of the wor
ld’s first disinfecting machines, prepared and tested the first smallpox serum in humans, developed new methods to fumigate railcars in order to prevent the spread of germs, and been called upon by Congress to investigate and remedy the poor ventilation of the House chambers. Yet as he spent the long afternoons of his first summer in the San Francisco Bay trying to get the Angel Island station in order, all that seemed nothing more than stories from a different person’s life.
His time was engulfed by the endless work of inspecting passengers and cargo, and any spare moment went to tackling one of the many projects that nagged at him. All the while, he forced himself to don the Service’s newest uniform, personally designed by Wyman, that featured gold epaulettes which left him feeling ridiculous and made it impossible to carry his youngest son, John, without the boy scratching his nose. “I do wish that they would have left the uniform alone,” he complained in a letter to a friend. “I sincerely hope that the man who advocated these latest changes is supremely happy and contented. I have not found anyone so far with whom I have talked that gladly welcomes the additions.”
Though it sat right across the bay, San Francisco remained a mystery to him. His work was so demanding that he only knew the city from the glimpses he got through the fog, finding himself so tired that he would find time to venture into the city at night only four times during his first year in California. The few hours he did spend in the city, however, left him cold, unable to reconcile what he saw as its blinding pursuit of profit with what he thought of as the higher purpose of life. Doctors and politicians who should have been his natural friends and allies went unmet, making his island home feel even more solitary. Physicians working at the Marine Hospital Service station in the Presidio district, meanwhile, remained indifferent to his attempts at friendship, the result of a lingering professional jealousy that the quarantine station at Angel Island did not fall under their jurisdiction. “The medical profession of San Francisco I know but little about,” Kinyoun admitted in a letter to a friend back home. “When evening came, we were all so tired that, farmer like, we went to bed with the chickens.”