by Black Death at the Golden Gate- The Race to Save America from the Bubonic Plague (retail) (epub)
Tom Shon, a fifty-one-year-old male actor and the roommate of Chu Ah Chon, seemed lost in a stupor of delirium when the commission doctors arrived at his apartment. Surprised that the man was still alive, Barker examined him. His skin was hot and dry to the touch and he winced when doctors put pressure on the enlarged glands in his groin. Though there were no buboes present, Barker told the man’s friends that a dose of the Haffkine serum was the only hope for his survival, though he cautioned that it might be too late. Shon’s friends refused the offer and he died the following morning. Tissues taken during a partial autopsy revealed plague.
Days later, the doctors descended into a cramped and filthy hovel at 921 Dupont Street. There they found Ng Ah Bock, a forty-five-year-old Chinese man who had been ill for two weeks with a high fever. Though friends present said that his mind no longer seemed anchored in reality, the man felt well enough to attempt a conversation as Barker began examining him and soon discovered a dark bubo bulging from his neck. The next day, Ng’s body was found outside a coffin shop on Sacramento Street, apparently dumped there by the men Baker had conversed with in the tiny shared apartment. An autopsy confirmed that he had died of bubonic plague.
Not all cases were as obvious. Fong Ah Fong, a twelve-year-old girl living at 747 Sacramento Street, showed no outward signs of plague when the doctors first examined her. The girl had been ill with a low fever for two weeks, her mother said, yet her temperature had not spiked and there was no evidence of inflammation in her glands. Suspecting that it was not plague and more likely a mild case of typhoid, the doctors asked her mother to contact them if the girl got worse. She died a few days later. Confused by the sudden decline, the commission members returned to the apartment to examine the body. Finding no buboes, they pressed her mother to allow them to conduct an autopsy, explaining that it was the only way they could determine if the girl had contracted the disease and where the infection had been hiding in her body.
The room suddenly filled with angry men and women, all violently objecting. Facing what he later called “an appalling outbreak of grief,” Barker promised to make only one small incision in the groin of the dead girl in order to capture a tissue sample, which confirmed that she had indeed died from plague. “In the face of the strong protest made by the friends, it seemed wise not to antagonize the Chinese too much, and so interfere with the progress of the whole investigation,” Barker later wrote in the commission’s official report, apologizing for what he called the limited anatomical evidence collected from victims.
Fong’s death marked the sixth case of plague the commission had identified in Chinatown within a single week and brought the official number of dead to twenty-six in ten months. Only two of the victims discovered by the commission developed buboes on their bodies, requiring Novy’s laboratory work for a true determination of the cause of death. “It is difficult to make a diagnosis of plague without bacteriological examination,” he later wrote. “In the absence of primary buboes, the unskilled observer will miss practically every case, and even the practitioner who has had much experience with plague may be deceived.”
While unanimous in their belief that plague was indeed endemic in Chinatown, the doctors nevertheless remained puzzled. In every other outbreak of the disease, plague had spread “like a great tidal wave with unusual force,” Novy wrote. Yet in San Francisco it remained constrained by some invisible hand, even if the true death toll was likely far higher than the official record. An unknown factor was saving the city from devastation, but none of the doctors could even guess at what it was. Their only hope was that the disease would continue its strange pattern until a sanitation campaign could fully eradicate it, sparing San Francisco from the devastation they had seen in India.
The commission members met privately with Governor Gage at the Palace Hotel. Plague was indeed spreading within the city, they told him, and they had witnessed it in victims before their deaths, a phenomenon that Gage considered impossible. The governor grew irate, accusing the men of infecting victims with plague themselves through their careless handling of germs. He demanded to know whether they had been influenced by Kinyoun, and raged even more when told that Kinyoun was not involved. Shortly before they left the meeting, the doctors told the governor that they were close to finishing a full report that would confirm the presence of the disease in San Francisco which they would send to Washington in the coming days.
Governor Gage immediately wired a letter of protest to the Treasury Department, which at the time oversaw all matters of public health, railing against the publication of an investigation he called “unjust” and “unfair.” Should the document make its way around Washington and into the hands of a reporter, Gage knew that the state’s economy—still dependent on its reputation as a mythical land apart from the ordinary concerns of the nation—would collapse. “Whatever differences of opinion may at this time exist as to the existence or non-existence of plague, no one can honestly be of the opinion that the disease is epidemic in San Francisco, nor can anybody seriously contend that ample protective and preventative measures cannot be taken in the premises without even spreading great or any alarm among the people and without disturbing our commercial affairs,” Gage wrote. He followed it up with a second telegram, in which he demanded a private meeting between the congressional representatives of the state and Surgeon General Wyman before the report was publicly released.
Gage did not know it, but he was not alone in his attempt to keep the truth from spreading. In Washington, Wyman was also intent on suppressing the news circulating among medical researchers that the disease had been confirmed in California. Worrying that a wire service reporter would pick up on the rumors and write an article that would be reprinted across the country, Wyman refused to talk about the commission’s findings with his subordinates, even though he trusted that plague was indeed in the city as they had described. He instead harbored a hope that with delay and denial he could “bring the Governor around to work with us,” he wrote in a private letter to a colleague, making the task of eradicating the disease easier. His greatest fear was that a copy of the full report would be published, further inflaming a man intent on making it impossible to conduct modern medicine in his state.
In San Francisco, Gage arranged a confidential meeting of the city’s power brokers. The editors of San Francisco’s largest papers, the president of the Pacific Mail Steamship Company, and attorneys for the Southern Pacific Railway—a group that collectively controlled the news that San Franciscans read, the goods that appeared on their docks and the trains that connected them with the nation—listened as Gage described the harm that publication of the commission’s report would pose to their futures. He had each man present promise to refrain from republishing or acknowledging any reports issued by the plague commission, even after they were released by the federal government.
Assured of a news blackout, Gage then assembled a delegation that immediately headed to Washington to press for the permanent suppression of the commission’s report and any federal mention of the plague in California. The group included the editors of the San Francisco Chronicle, the San Francisco Bulletin and the San Francisco Examiner, the chief counsel for the Southern Pacific Railway and the president of Union Iron Works, who happened to be a close friend of President McKinley. Unlike the secret pact among the newspapers to hide the news of plague, the men Gage picked boasted that they intended to rid the city of the federal health officers who had caused problems for too long. As he boarded the train for Washington, John P. Young, the editor of the Chronicle, announced that he would return with “Kinyoun’s scalp dangling from his belt.”
Surgeon General Wyman met with the California delegation and presented them with copies of the commission’s final report, which had yet to be published. It concluded that plague was not only in San Francisco, but had likely been in the city for at least two years. The doctors could point to no reason why the city had thus far been spared the epidemics that had wasted Bombay and
Hong Kong, yet they remained certain that it was only a matter of time. And San Francisco was not the only city at risk. The inability of health officers to forcefully confront the disease had most likely allowed it to expand to other large cities, including Sacramento and Los Angeles. If the disease was not confronted, the report declared, an epidemic could soon envelop the country.
The findings were plain, and sobering. Faced with hard evidence that the plague was not a hoax or the result of Kinyoun mishandling tissue, the California delegation abandoned its efforts to undermine the doctors who had served on the commission. While careful to maintain that they did not officially acknowledge the report’s findings, the delegation offered a bargain: the city and state would pay for a full sanitation campaign in Chinatown which would identify and treat plague victims and eliminate any trace of the disease, in exchange for the promise that the commission’s findings were never made public. After all, they argued, the only thing that could save lives now was the sort of sanitary response that Marine Health Service officials had long wanted but had never had the support of the city or state to conduct; why make the process more difficult by publishing a report that could lead to panic? Sensing that the deal offered a chance for his agency to save face in California, as well as quelling an open challenge to his agency’s federal authority, Wyman agreed, assuring the delegation that the commission’s report would not be published while he remained Surgeon General.
Left unsaid was that Kinyoun would never go along with such a plan. Before the meeting was over, Wyman told the men from California to consider Surgeon Joseph White, one of his senior agents, the officer now in charge of the Angel Island post. He then composed a telegram to Kinyoun informing him that he was being transferred to Detroit. There would be none of the public vindication that Kinyoun had desperately sought, but Wyman counseled him to put the duty of his office to save lives ahead of his pride. “The conferences have been harmonious, without personal or other accusations being made, and cooperation of all concerned is assured,” he wrote. “Public exigency requires personal feelings and any desire on part of Bureau [the Marine Health Service] or any others for public verification of statements made or position taken must be subordinated to maintain the present attitude of non-publication, even though outsiders may have published some facts not obtained through Bureau. The Department and the Bureau and its officers will maintain this attitude until further orders.”
Kinyoun considered it Wyman’s final betrayal. This time, however, Wyman’s duplicity had not only hurt him personally but harmed millions of unsuspecting men and women across the country who did not know that the Surgeon General was complicit in a plan to keep the truth from them. Kinyoun believed in a future where scientists like him had rendered the concept of infectious disease moot, sparing the lives of innocent people. Instead, he had to face a present in which politics mattered more than honesty, and ignorance proved more powerful than medicine. “All this goodwill wiped out at the insistence of a few politicians is not only humiliating to the officers of this service, but a calamity to the nation,” he wrote to a friend.
Despite Wyman’s best efforts, a copy of the commission’s report was leaked from the Marine Hospital Service and reached the Occidental Medical Times, which published it in full. The Sacramento Bee then revealed the secret meeting in Washington that had kept the Marine Hospital Service from publishing the report, calling it an “infamous compact.” Medical officials were shocked to read not only the details of how plague had established itself in a major city, but that San Francisco had thus far been successful in concealing it from its own citizens. With Wyman’s blessing, the federal government had intentionally helped California deceive the country, allowing thousands of Americans to travel to the state unaware that they were putting their families in danger. Their trust in California broken, health authorities in other states began preparing quarantine measures that they hoped would prevent plague from spilling across their borders. “I have but little conference in the California authorities, and unless I have a positive assurance from you that this State will be carefully protected by you from the disease I shall immediately order the most stringent quarantine regulations,” wrote Joseph D. Sayers, the governor of Texas, in a personal telegram to Wyman. “Please answer, by wire, immediately, as I will take no risk.”
Though his deception was now well known, Wyman refused to apologize. He had done what he considered necessary to coerce California into funding the costly cleanup campaign it needed, and that, and nothing else, was what would protect the country. “To secure this harmonious action and its continuance I have felt convinced of the necessity of not giving out for publication all the facts in the case,” Wyman wrote in a letter to state health authorities across the nation. In a gesture of openness, he enclosed with it one of Kinyoun’s reports on the spread of the epidemic in San Francisco that he had previously pulled from the weekly Public Health Reports bulletin. “By avoiding unnecessary publicity I feel that the actual necessary work has been and will be made possible and expedited,” Wyman wrote, not allowing himself to feel shame.
As he counted down his final days in San Francisco, Kinyoun vowed to make the most of them. He accepted invitations to appear at medical societies throughout the state, where he spoke at length about his experience fighting to be heard in a city that did not wish to acknowledge reality. In front of packed halls of doctors and public health officers who had never seen plague, he discussed how the disease presents itself in the body as a victim edges closer to death. He confessed that he did not understand why the city’s death toll was not much higher: in epidemics in Hong Kong and Sydney, it had taken no more than a year after the discovery of the first victims for the disease to show its full strength, and San Francisco was now already well past that point. The odd behavior of the disease, in which it appeared to select individual victims rather than flooding through a neighborhood, could change at any moment, he cautioned, and the city was still not prepared.
He grew the most animated when he returned to the harder truths he had learned. When he first arrived in California, he had expected that a city would always put its safety above its ambition, he said. Only now did he realize how naive that was. Any doctor who followed through on his public responsibility to report plague cases “must be prepared to be made a target by a subsidized press, to submit to all the lowest forms of persecution, simply because he has had no more sense than to do his duty and tell the truth,” Kinyoun told an audience of doctors in Sacramento.
He then quoted none other than Wyman, from an address the Surgeon General had made the year before regarding cities that attempted to suppress reports of cholera. “It is inconsistent with every known law of God, of every principle of sound policy, and of well doing among men that an individual or a city or state can successfully protect itself behind the flimsy barrier of a lie, particularly in dealing with the phenomena of nature,” Wyman had said. “If a case of cholera occurs in a city, and be hidden under the disguise of a simple intentional derangement, to avoid public clamor and injuries to the commerce and avenues of the state, the last hope of destroying the contagion is wiped away, and thousands of lives and the general ruin of industry must pay the penalty of a sordid, short-sighted, wretched policy.” Kinyoun left it up to his audience to determine whether a lie to cover up the plague was somehow better than a lie to mask cholera.
There was no reason to believe that the state would follow through on its compromise with Wyman, Kinyoun warned. The plague commission had found six confirmed cases in less than a week during its short investigation, but there had been no new victims identified since the deal was struck in Washington and the Gage administration had already started to suggest that it might not fund the cleanup effort as promised. Plague was in San Francisco, and, like all truths, would spread whether California’s doctors wanted to admit it or not. At the end of his speech, Kinyoun relayed a remark once made on the floor of the state senate by Senator Cutter, the man who had stated that K
inyoun should be hung for his attempt at quarantining the state. Only with Kinyoun’s removal, Senator Cutter said, could the people of San Francisco “sleep undisrupted, and by day follow their avocations without fear.” Now that the state appeared to get what Cutter had wished for, California was free “to enjoy bubonic plague to its full fruition,” Kinyoun said.
There was no disguising his bitterness. As he packed his belongings at Angel Island and prepared his family to move again, Kinyoun could only look back over the last year and a half with anger. He had once been a rising star who made his name by saving the lives of others; now he found himself once more headed to an inglorious posting, where none of his brilliance in the laboratory would matter, simply because he could not allow himself to play the game of politics if it meant watching people die and doing nothing. Even after his demotion, Kinyoun had continued to send reports to Washington estimating the spread of the disease. Wyman replied just once, telling him that all future communications should be sent via Joseph White.
Kinyoun considered resigning his post rather than appear comfortable with Wyman’s deceptions, but he was swayed by the pleas of fellow Marine Hospital officers. “Don’t do it, old man,” wrote Henry Rose Carter, who had played a key part in establishing that mosquitoes spread yellow fever and who remained one of Kinyoun’s closest friends. “You are one of the men who helped make this service . . . Believe me . . . Your life and good works will never be lost.”
With his future in the Marine Hospital Service ruined, Kinyoun’s sole consolation was the response of other medical professionals to his courage. “It is the well-studied plan of Dr. Wyman and in fact others to simply relegate me to oblivion, and because of the prominence which my laboratory work had been assuming in the past five or six years,” Kinyoun wrote to a friend. “It is most natural for a weak man, such as Dr. Wyman appears to be, to resent any such prominence of his subordinates, and therefore desires to regulate us to places where we cannot be so prominently before the public. There is one thing, however, that Dr. Wyman nor anyone else in the Marine Hospital Service can take from me, and that is my professional standing and character. The medical journals all over the United States have really been unstinted in their praise of the attitude which I assumed regarding the [plague], and my actions in carrying out the laws and regulations, and I have the unqualified confidence, you may say, of the whole profession in the United States. That is to me of more value than any word of praise which could emanate from Dr Wyman, or anyone connected with the Marine Hospital Service.”
