David McCullough Library E-book Box Set

by David McCullough

  Philippe Bunau-Varilla, meantime, had returned to Paris and resumed his duties as publisher of he Matin. Three days after ratification of the treaty by the Senate he had submitted his resignation as envoy extraordinary, asking that in lieu of salary for his services the money be withheld by the new republic for the erection of a monument at Panama City to Ferdinand de Lesseps. His replacement, the new Panamanian ambassador to Washington, was former Governor Obaldía.

  The Frenchman’s final official act had been performed on a bright February morning in Washington when he and John Hay formally exchanged the ratified treaties and bid each other farewell. It was, he wrote later, a deeply moving moment for both of them. And in his vaulting literary fashion he recalled a rush of private thoughts–

  of all those heroes, my comrades in the deadly battle, worthy grandsons of those Gauls who conquered the Ancient World, worthy sons of those Frenchmen who conquered the Modern World, who fell in the struggle against Nature . . . of the shameful league of all the passions, of all the hatreds, of all the jealousies, of all the cowardices, of all the ignorances, to crucify this great Idea . . . of my solitary work, when I went preaching the Truth on the highways . . . of the untold number of stupidities I had had to destroy, of prejudices I had had to disarm, of insults I had had to submit to, of interests I had had to frustrate, of conspiracies I had had to thwart, in order to celebrate the Victory of Truth over Error and mark at last the hour of the Resurrection of the Panama Canal.

  At the moment, however, looking at Hay, he had said only, “It seems to me as if we had together made something great.” The actual delivery of the canal works at Panama occurred early on the morning of May 4, 1904, and to the Panamanians, who adored ceremony and celebration, who remembered Cathedral Plaza festooned with palm branches and French flags, who remembered parades and banquets and Ferdinand de Lesseps prancing on horseback, it was a terrible disappointment and most unbecoming to the occasion. At 7:30 A. M. Lieutenant Mark Brooke met with half a dozen American officials and a duly authorized representative of the Compagnie Nouvelle at the company headquarters on the plaza, the old Grand Hotel. On being handed the keys to the storehouses and to the Ancon hospital, Lieutenant Brooke swiftly signed the receipt of the property and read aloud a brief proclamation. The transaction occupied no more than a few minutes. Scarcely anyone other than those present was aware of the event. Lieutenant Brooke had not even thought to invite President Amador.

  Having shaken hands with the Panamanians and the French officials, the young officer raised the Stars and Stripes to the top of the hotel flagpole.

  BOOK THREE

  The Builders

  1904–1914

  15

  The Imperturbable Dr. Gorgas

  The world requires at least ten years to understand a new idea, however important or simple it may be.

  –SIR RONALD ROSS

  I

  “It is all unspeakably loathsome,” concluded a New York reporter who was among the earliest to arrive at Colon. That his countrymen could and would build the mighty ship canal, he, like his countrymen, took as a matter of course. Any contrary view would have placed him among an all but indistinguishable minority. Having tamed a continent, having achieved industrial supremacy, having embarked upon the great adventure of world leadership, the American people–some 80,000,000 strong–would now triumph where the French had failed so ignobly. “There is nothing in the nature of the work . . . to daunt an American,” the reporter insisted. “I have made three excursions over the canal route . . . and while I do not pretend to speak expertly of the engineering aspects of the problem, I should say that the building of the canal will be a comparatively easy task for knowing, enterprising and energetic Americans.”

  Still, Colón was troubling. The Negroes lived in the most appalling fashion in rotting shanties propped on stilts in a swamp, “a morass, a vast expanse of black water covered with green scum.” There was no plumbing, not one sewer. The stench was like nothing in his experience; the nights were made “hideous” by the interminable din of thousands of frogs.

  He described the poisonous mists rising over the Chagres River, mists quite visible from Colón in the early morning; and not wishing to appear ignorant of advanced medical theory, he wrote also of the mosquitoes. What conceivable chance, he asked, was there to make so vile a place safe for white men?

  The article appeared in the New York Tribune the first week in February 1904, three months before Lieutenant Brooke raised the flag over the old French administration building, and three weeks before the President emphasized comparable concern to the chairman of his new Isthmian Canal Commission. “As you know, I feel that the sanitary and hygienic problems . . . on the Isthmus are those which are literally of the first importance, coming even before the engineering . . .” Roosevelt declared.

  The tragic experience of the French was never far from mind. But more immediate and vivid was the memory of Cuba in 1898, when thirteen times the number of American troops killed by the enemy had died of yellow fever, malaria, and typhoid fever. For Roosevelt personally, Cuba had been an unforgettable lesson in the havoc disease could bring down on an expeditionary force. Cuba had been primarily the fault of bad or indifferent leadership in the field and “not too many gleams of good sense” in Washington. It was Roosevelt, following the capture of Santiago, who with Leonard Wood wrote the famous roundrobin letter to General Shafter, saying that the army must be moved at once or else perish of malaria. His own brigade, he said in a second letter, was “ripe for dying like rotten sheep.”

  To head the new commission, he had turned again to old John G. Walker, who, as time would tell, was an unfortunate choice; he was as ill-suited for his responsibilities as had been the Secretary of war in 1898, Russell Alger, the cause of much of the anguish in Cuba. But the difficulties of mounting the task at Panama were compounded still more by the unwieldly composition of the commission itself, a matter over which Roosevelt had no say. The Spooner Act required that there be seven members, at least four of whom must be “learned and skilled in the science of engineering,” and of those four, two must be military officers (one Army, one Navy). All seven were to have equal authority.

  Walker was the Navy man; for the Army there was General George W. Davis, “a fine old plains warrior” who had been a vice-president of the defunct Nicaragua Canal Construction Company. The civilian engineers were Professor William H. Burr (from the prior Walker Commission), Benjamin M. Harrod, Carl E. Grunsky, and William Barclay Parsons. The seventh member, Frank J. Hecker, was a businessman. On the surface it was a distinguished body. But none of them had ever organized a gigantic construction project. None was accustomed to handling problems of supply, labor, or overall planning on a scale even approaching what was now called for.

  Nor had any of them had the least medical training. Congress had looked upon the canal as a problem of engineering construction exclusively. The presence on the commission of a physician or of someone experienced in sanitation had not been deemed essential, so none had been named.

  That a sanitary officer was assigned to serve under the commission was due primarily to the insistence of Dr. William Henry Welch, of Johns Hopkins, who, during a personal call at the White House, had urged Roosevelt to tackle the sources of disease prior to every other effort on the Isthmus. Welch, one of the celebrated “big four” (Welch, Osier, Kelley, and Halsted) at the Johns Hopkins Medical School, went to the White House with a delegation of prominent physicians, plus, significantly, the chief of the Bureau of Entomology at the Department of Agriculture, Leland O. Howard. “We passed through a room crowded with persons waiting to see the President,” Welch recalled, “and I felt that he must begrudge every minute we occupied . . .” But Roosevelt afterward told Walker to find the very best medical man in the country to take charge of the hospitals and sanitary work at Panama, and although he did not tell Walker who that man should be, Walker was instructed not to make the appointment before consulting with Welch.
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br />   The result was the naming of an Army doctor, a former student of Welch’s, Colonel William Crawford Gorgas, who since the death of Walter Reed (of appendicitis in 1902) was known in professional circles as the outstanding authority on tropical disease. Gorgas was forty-nine years old, a courtly, white-haired man whose humorous eyes and “sunny” Alabama manner concealed a marvelous tenacity. Everyone had a good word for him. He was the son of the Confederate general Josiah Gorgas, the career soldier from Pennsylvania who became Jefferson Davis’ chief of ordnance; and so, for political purposes, the appointment helped offset a preponderance of Yankees on the commission.

  The seven had been chosen rather hastily–too hastily, Roosevelt later conceded–during the last week of February. On March 4, he sent seven telegrams announcing the appointments and giving each recipient four days to drop what he was doing and convene at the White House. (Walker and General Davis were already in Washington; Burr and Parsons in New York, Hecker in Detroit, Harrod in New Orleans, Grunsky in San Francisco.) He was not interested in their politics, Roosevelt said at their first meeting. They had been picked solely on their reputations for integrity and ability. He had nothing to offer concerning the details of the work. “What this nation will insist upon is that the results be achieved.”

  The commission set up headquarters in the Star Building on 14th Street and the position of chief engineer was offered to a Chicago railroad official named John Findley Wallace, an offer he accepted with the understanding that the job required residence on the Isthmus. His salary was to be $25,000 a year, which was more than that of any other government employee in 1904, with the exception of the President, and $10,000 more than he, Wallace, was receiving as general manager of the Illinois Central. William Gorgas’ annual income as an Army colonel was $4,000.

  On May 9 came the executive order placing the commission under the direct supervision of the new Secretary of War, William Howard Taft.* The commission thus had full authority to proceed with the canal.

  So six months following the Panama revolution, everything seemed set to go. To the Yale professors who still challenged the legality of his part in the revolution, the Harvard man in the White House responded with another of those spontaneous, eminently quotable retorts for which he had such a gift, wholly avoiding the issue but greatly pleasing the country: “Tell them that I am going to make the dirt fly!”

  To William Gorgas there was no real problem about what had to be done at Panama. Nor does he appear to have had any doubt that he could succeed, his assumption being that full support would be forth-coming from the office in the Star Building. He would concentrate on yellow fever first. Malaria was the larger, more serious threat in his judgment, but an outbreak of yellow fever could result in panic and yellow fever was his specialty. Though the means by which both diseases are transmitted had become known, only yellow fever had been eradicated in any one plague spot as a result of such knowledge– in Havana in 1901–and he had been the man chiefly responsible.

  The carrier of yellow fever, it had been determined, was the small, quiet, silvery household mosquito known as Stegomyia fasciata, exactly as the Cuban physician Carlos Finlay had announced years earlier. As is presently known there are no fewer than 2,500 different species of mosquito (rather than 800-odd, as Finlay believed), and these belong to three important genera: Culex, Anopheles, and Aëdes. The Culex group includes the ordinary gray household mosquito found in northern latitudes (Culex pipiens pipiens). The Anopheles are the only known carriers of malaria and also transmit encephalitis, or sleeping sickness. The Aëdes aegypti is Stegomyia fasciata, as it was then called, the yellow-fever mosquito.

  Credit for finding the cause of malaria, one of the greatest medical discoveries of all time, belonged to the English physician Ronald Ross, who had addressed himself to the problem alone in a remote field hospital in Secunderabad, India. Though malaria was a worldwide killer, flourishing in a broad zone on both sides of the equator, its greatest toll in human life was in Asia, and in India it was the arch destroyer, taking possibly a million lives a year. Ross, once the indifferent student, amateur poet and musician, had figured out the pattern by which the disease is spread, a pattern that seemed simple enough only after he had explained it. In the summer of 1897 he dissected under a microscope an Anopheles mosquito after it had fed on a malaria patient. In the insect’s stomach he saw the same circular cells that the French physician Laveran had discovered in Algeria in 1880, the malaria parasite Plasmodium falciparum. Besides, he determined that the cells were growing.

  In his notebook that night he wrote a poem describing the moment. It was to be his only published verse, the last stanza of which became famous:

  I know this little thing

  A myriad men will save.

  O Death, where is thy sting?

  Thy victory, O Grave?

  Not until the following year, however, was he able at last to prove the mosquito theory by locating the mosquito’s salivary gland and determining that the expanding parasite within the mosquito’s stomach eventually penetrates all parts of the mosquito’s body, including that gland. “The door is unlocked,” he wrote in an exultant letter to England, “and I am walking in and collecting the treasures.”

  The solution was this: Anopheles, comparatively large, brown mosquitoes with little black dots on their wings, transmitted malaria only after having bitten someone already infected with the disease. The mosquito drew the blood containing the parasite, the parasite multiplied in the stomach of the mosquito, then moved to the salivary gland whence the parasite was delivered to the bloodstream of whomever the mosquito bit next. The insect was not the source, in other words, only the agent of conveyance. But this particular insect was the only means of conveyance. Furthermore, it could cause damage only when there was infected blood to feed on, when there were people about who were sick with malaria. So the way to stamp out malaria was not simply to get rid of the Anopheles mosquito, but to make it as difficult as possible for the Anopheles mosquito to get at anyone who had the disease.

  The idea of preventing malarial epidemics by exterminating the Anopheles was first put forth in a letter addressed by Ross to the government of India on February 18, 1901. The following year Ross published a small book, Mosquito Brigades, explaining how such a campaign should be organized. By then, however, Gorgas and his Army doctors had demonstrated at Havana what almost no one had believed possible. In 1901, in one of the worst fever cities on earth, they had eliminated yellow fever in less than eight months and very nearly got rid of malaria. There had been nothing comparable in medical or military history to their war on mosquitoes.

  Gorgas had played no part in determining the cause of yellow fever. As it happens, he had been one of the last of the Army doctors in Cuba to accept the mosquito theory. Like Ross he had even come to the practice of medicine itself without noticeable interest or enthusiasm and most of his professional life had been spent at “hitching post” forts, as far removed as Secunderabad from the salient discoveries and innovations that had so dramatically transformed medical science during the last part of the nineteenth century. In 1880, the year Gorgas finished his training at Bellevue, the germ theory of disease was still a subject of debate; from 1880 to 1900–the years that marked the emergence of Pasteur, Koch, Lister, the founding of Johns Hopkins– Gorgas was at such places as Fort Brown, Texas, or Fort Randall, South Dakota, attending to routine duty. Fort Randall, set in a boundless prairie, was seventy-five miles from the nearest railroad.

  Gorgas became a doctor because of a boyhood determination to have a military career. As a child in Richmond he had seen Lee and Jackson confer with his father in the front parlor, and in the final winter of the war, as ragged Confederate troops filled the streets, he insisted, at age ten, on going barefoot. He received a bachelor of arts degree from the struggling little University of the South at Sewanee, Tennessee, where his father had been made president, but still determined to be a soldier, much against his father’s wishes, h
e tried for an appointment to West Point. When West Point turned him down, he chose medicine because it was the only way left to get into the Army.

  Classmates at the Bellevue Medical College in New York would remember “Billy” Gorgas as a devout Christian, a careless speller, too poor to go home for vacations, the most likable man in the class, and “imperturbable.” It was at Bellevue that he encountered Dr. Welch, then in his late twenties, and after receiving his degree in June 1879 Gorgas spent another year as an intern at Bellevue Hospital.

  His father, meantime, learning that his ambition remained unchanged, protested that the life of an Army doctor “would not be a life to look forward to as a permanent thing. It is not in the army that the sphere of a doctor is ennobling.”

  To Gorgas later it would seem that the pattern of his life had a large, definable purpose, perhaps God-willed. It was as if every important turn had been designed to prepare him for one historic task. He was not a person to dwell overly on questions of cosmic destiny. Rather, genuine modesty was an important part of his considerable charm. “I am not much of a doctor,” he once remarked to a gathering of prominent physicians, “that is, I am not experienced in the care of the sick, and I am not very much of a military man, although I have been in the army service practically all my professional life.” But while he seemed incapable of taking himself seriously, he was intensely serious about his work and what it could mean to his fellow mortals.

  To him the years at frontier outposts had been supremely invigorating. He had grown physically rugged, accustomed to riding out hardships and boredom of a kind to defeat other men. He learned discipline, acquired an unequivocating devotion to duty. His wife would recall nights when, wrapped in buffalo robes, he would set off in a sleigh in the midst of a North Dakota blizzard to deliver an Indian baby in a cabin sometimes thirty miles away. “Life like this was more than an education in medicine,” she would write.