David McCullough Library E-book Box Set

by David McCullough

  The initial question was which particular species of Anopheles to go after. “It was not known how many different species of Anopheles existed,” wrote Joseph Le Prince, one of Gorgas’ advance guard, “nor was it definitely known which of them were the important malaria carriers.” To Le Prince, who had also been Gorgas’ right hand at Havana, it was evident that “much investigative or pioneer work” was still called for.

  We had no means of determining how seasonal changes would affect propagation, and the available data were unreliable. It was generally believed at that time that all mosquitoes traveled more or less with gentle air currents, but there was no positive knowledge of habits of flight, and the length of flight of Anopheles . . . was yet to be determined. It was not known if or how topography affected the distribution of species, whether Anopheles larvae thriving in small collections of water held by plants were of . . . importance, or whether certain species were confined to fixed geographical limits.

  So while detailed information was being gathered and put on file concerning the whereabouts of Stegomyia larvae in Panama City, Anopheles larvae and pupae were being carefully taken from puddles and swamps along the canal line, scooped up in white-enameled dippers, poured into wide-mouthed jars, and carried back to a makeshift laboratory at Ancon Hospital. Live adult Anopheles collected in villages along the railroad could not survive the return trip, it was found, unless carefully protected from direct sunlight, rain, and strong air currents–an observation that was to have considerable subsequent value.

  This preliminary survey disclosed the presence of Anopheles breeding grounds in or near every existing settlement, every abandoned camp built by the French. At a work camp at Culebra, a village of roughly five hundred Jamaicans, Gorgas found that every child he examined had a greatly enlarged spleen, a sign of chronic malarial infection. Every adult he talked to spoke of attacks of chills and fever within the preceding six months. On a hill above this same village a detachment of United States Marines was encamped, half of whom already had malaria. “The condition,” he wrote, “is very much the same as if these four or five hundred natives had smallpox, and our Marines had never been vaccinated.”

  No one even tried to approximate the numbers of Anopheles present at any given point. Within the hospital compound itself their presence was phenomenal. On the panel of a single doorway one dutiful assistant counted fifty-four. Like Stegomyia, the Anopheles were easily recognized by their resting stance. In contrast to the common northern mosquito, which stands with proboscis and head crooked at right angles to its body, Stegomyia and Anopheles kept proboscis, head, and body on a straight line, but at an angle to the resting surface. When feeding on an arm or wrist, an Anopheles looked as though it were standing on its head.

  To determine the time of day or night when the Anopheles would take blood, the men stretched out on cots in one of the wards, each man with a supply of pillboxes and a pocket watch. Every time a mosquito bit, or tried to, it was captured, put in a pillbox, and the date and hour were recorded on the box. The Anopheles, it was learned, would attack a human at rest at any hour, though the night hours were by far the worst. The life span of the insect seemed to be about a month and in that time the female required a meal of blood every two to three nights. Her bite did not cause any appreciable swelling, nor was the itch especially bothersome. Often a person was not even aware of being bitten by an Anopheles.

  After a month or so, with only a few exceptions, all the small American force, Gorgas as well, had been down with malaria.

  Time was the pressing concern. For although there were but one or two yellow-fever cases, and none serious, at the moment, that condition would change rapidly as soon as new human material became available for the Stegomyia fasciata– and thus the disease–to feed on. Gorgas’ analogy to explain the violent wave effect of yellow fever– the apparent absence of the disease followed by a sudden, vicious outbreak–was the exhausted fire wherein concealed embers lay in wait for fresh supplies of fuel. The arrival of several thousand nonimmunes would be equivalent to heaping on dry kindling: nothing much would happen at first; then the disease would catch; the carrier mosquitoes would infect ever more victims with the deadly parasite, thereby creating more diseased blood for still more mosquitoes to feed upon. Un checked, the disease would flare into a monstrous geometrical progression of death, taking hundreds, possibly thousands, of lives.

  Were conditions on the Isthmus to remain as they were, and were upwards of twenty to thirty thousand men to be brought to Panama, as planned, then, Gorgas calculated, the annual death toll from yellow fever alone could run to three or four thousand.

  The build-up of men and equipment was beginning. Every arriving steamer had its contingent of prospective carpenters, mechanics, file clerks, assistant engineers, all eager to be “in at the start at Panama.” General Davis, who had been named the first Governor of the Canal Zone, and Chief Engineer Wallace had arrived and had taken up residence in Panama City. Gorgas, still working with the same small staff, tried to explain the situation, the need for immediate decisions, for men and supplies, and he got nowhere.

  In August Admiral Walker and several of the commission came for an inspection tour and Gorgas again made his case as explicit as he knew how. The admiral and his party departed, weeks passed, nothing happened. Gorgas’ cabled requests were answered evasively, if at all. Presently he was reminded by return cable that cables were costly and henceforth to use the mails.

  III

  The problem in essence was that Admiral Walker, Governor Davis, and several others on the Isthmian Canal Commission, as well as a very large part of the populace and its political leadership, did not seriously entertain the notion that mosquitoes could be the cause of yellow fever or malaria. To spend time and money chasing after mosquitoes in Panama would be to squander time and money in a most irresponsible fashion.

  That the minds of men in such positions could be so closed in the face of all that had been learned and demonstrated in Cuba, not to mention the insistent warnings from Roosevelt and Welch, may seem inconceivable. In the conventional understanding of history, human advancement is marked by specific momentous steps: on December 17, 1903, at Kitty Hawk, the Wright brothers fly in a heavier-than-air machine and at once a new age dawns; in a hospital ward outside Havana Dr. Jesse Lazear dies a martyr’s death and the baffling horror of yellow jack is at last resolved. But seldom does it happen that way. Ideas too have their period of extrinsic incubation, and particularly if they run contrary to what has always seemed common sense. In the case of the Wright brothers, it was five years after Kitty Hawk before the world accepted the idea that their machine could fly.

  During the long hearings of the Morgan Committee in 1902, prior to the vote on the Spooner Bill, despite all the concern expressed over disease in Panama, the recounting of the French tragedy, the mosquito theory had not even been discussed. George Morison mentioned it once in passing, but without evoking the slightest interest among the others, who had been content to dwell on miasmatic fumes emanating from the rank isthmian landscape. No reference was made to the breakthroughs achieved by either Ross or Reed, nor was anything ever said of Gorgas’ demonstrated success at Havana. Yet all the efforts of the Yellow Fever Commission, all of Gorgas’ work, had been initiated by the Army, all the resulting reports had been published at government expense.

  In the autumn of 1904, with the situation on the Isthmus unimproved, Gorgas returned to Washington to plead his case. It had been nearly four years since the epochal report of the Yellow Fever Commission. Ross had won the Nobel Prize in 1902 for his discoveries. A scientific congress held in Paris in 1903 had thoroughly reviewed Reed’s work and declared that the mosquito transmission of yellow fever was a “scientifically determined fact.” But to Walker, Davis, and their fellow commissioners, Gorgas was wasting their time. Walker’s word for the theory of mosquito infection was “balderdash.” Gorgas spent hours waiting in Walker’s anteroom, hours more with Walker going over
the evidence in support of the theory. The correct procedure, Walker insisted, was to get rid of the garbage and the dead cats, paint the houses, pave the streets. In his zeal he even offered to give Gorgas a detailed set of rules to guide him in the work. Walker remained a bastion of integrity. The years he had devoted to the canal question, his study of the French disaster in particular, had convinced him that material wastefulness and graft were the gravest threats to American success at Panama. To Gorgas he remarked, “. . . whether we build the canal or not we will leave things so fixed that those fellows up on the Hill can’t find anything in the shape of graft after us.”

  With Davis, who had returned briefly to Washington, Gorgas had no better success. “What’s that got to do with digging the canal?” was his rejoinder to Gorgas’ plan. Davis professed great friendship for Gorgas, then in tones that Gorgas later described as kindly and patient, Davis tried to “set him right.” “On the mosquito you are simply wild,” Davis said. “All who agree with you are wild. Get the idea out of your head.”

  Before Gorgas had left for Washington, several of his staff had urged him to resign rather than face such continuing ignorance and obstructionism. But having gotten nowhere with the commission–indeed, having been shown how very little actual authority he possessed–he sailed again for Colón within a few weeks. Old Walker’s attitude, however galling, was of a kind he had experienced before in the military. He had kept his temper. He made no attempt to undermine or dislodge anyone on the commission, nor did he resort to political or social by-paths to the war Department or to the White House. The doctor was neither fighter nor schemer. But then neither would he give up. “That persistence which had always been his chief asset . . . forced him to the task,” according to his wife. He was not merely returning, moreover; he was returning to stay, for this time he took her with him.

  Of all those who had been named to positions of importance that year, only Gorgas would stay on. Not only was he the one perfectly qualified man for his particular role and the one really solid appointment made in 1904, he was also to be the only major official of importance to stay with the work on the Isthmus from start to finish.

  It is in Marie Gorgas’ published reminiscences that we find some of the earliest first impressions of Panama as recorded by one of the American canal force. Colón was “unspeakably dirty,” swarming with naked children, ugly, dilapidated, and terribly depressing. Yet the two-hour ride on the Panama Railroad more than compensated. In places the jungle swept the sides of their car and the jungle itself she found astonishingly beautiful. From the depot at Panama City they rode to Ancon in an open victoria through “a sea of mud reaching at times almost to the hub . . .” Their quarters were to be on the second floor of the hospital, in Ward Eleven, once the officers’ ward for the French.

  . . . Dr. Carter was on hand to greet us . . . A flight of stairs led to the gallery of the second floor. Although it was only a little after five o’clock, the short twilight gave a somber though refreshingly cool aspect. My spirits rose. On the right, facing the stairs, was the large living room, comfortably furnished . . . With wicker chairs and small tables–a room of many windows. Following the gallery to the right was a bedroom running across the back porch . . . Two small rooms across the back porch were fitted up as bath and servants’ rooms. There was no running water, and, as I found out afterward, water was exceedingly scarce, being delivered daily in small quantities.

  During the years of French occupation, she was told, more men had died of yellow fever in this building–in these very rooms–than in any other building on the Isthmus.

  After dinner with the staff–served “Spanish style” in six or seven courses, in a screened, candlelit room on the ground floor–she, her husband, Dr. Carter, and several others returned to the upper gallery.

  There is an alluring something about a night in the tropics. Dr. Gorgas experienced a melancholy pleasure listening to the sighing of the royal palms . . . in imagination visioning through the haze of his cigar the ghosts that haunted the old building. . ..

  It was a beautiful and starry evening. Beyond stretched the great Pacific, the dotted islands in the distance dimly seen . . . every place teeming with the history of departed glory and vast enterprise.

  The night, with its “creeping noises on the roof and On the floor,” had considerably less charm. In the morning she had her first full view of the city and bay spread below.

  We were on a high point, with only the road separating our ward from the sheer descent to the valley below, a descent so steep that a retaining wall had been built as a protection. The road was bordered by a row of stately royal palms, planted by the French . . . Beyond a stretch of green valley the hills and mountains were seen emerging from the heavy mist . . . The sun was rising from the Pacific, a strange phenomenon, and the rays gave a jeweled appearance to the dew-soaked plants and the leaves of the trees. . ..

  The city of Panama lay tantalizingly near . . . From our high point . . . the pastel shades of the Spanish tiled roofs were easily discernible; also the animation and movement of the streets. . . . She remained “content,” however, to confine her excursions to walks about Ancon Hill in company with the French nuns in their blue gowns and vast white headdresses, or with Laura Carter, wife of Dr. Carter, who arrived in midsummer.

  Miss Hibbard, the head nurse, Jessie Murdock, and the other American nurses (Margaret Magurk, Mary Markham, Eleanor Smith, Anna Turner) were quartered in still another ward. “Old rusted French beds, with mildewed mattresses and pillows lined the walls,” Bessie Murdock remembered. “Each [bed] had a candle, but it was soon found that it was not wise to keep these burning, as they attracted moths and all sorts of flying insects. Yet, in spite of these many difficulties, we were not disheartened, but thoroughly enjoyed the novel experience.”

  Accommodations in the ward for the unmarried male members of the staff were no less “deluxe,” as one of them, W. C. Haskins, would recall for his fellow townsmen in Oelwein, Iowa:

  One straight-backed chair was made to do for the entire bunch. . . . We had but one lamp. . . . There were no mirrors, and the fortunate possessor of an individual looking glass was to be envied. Some combed their hair and shaved with the aid of the swinging glass windows backed up against the wall. There were but two washstands for all of us. . . . We lived in constant dread of the alacrán, or scorpion, who seems to have a penchant for buildings long unused, and for going to sleep in your clothes or shoe. . ..

  Gorgas, who spoke a little Spanish, had already done more to win the trust and friendship of the Panamanians than any other American on the Isthmus. The name Gorgas was Spanish. According to family tradition, he was descended from a Spaniard who settled in Holland in the sixteenth century, when Spain ruled the Low Countries. And from his experience in Cuba he was appreciative of Latin pride and humor. In Manuel Amador, a fellow physician, he had an especially important ally. His tact, his sensitivity to the feelings of others, were unfailing. An American engineer would remember him as “a grand, quiet, lovable man.” Dr. Victor Heiser, a young American physician who was passing through en route to the Philippines, saw Gorgas stopped in the street by a beggar. “He bowed to the man, shook his hand, even inquired for his name, then gave him a single penny–the only coin he had I suppose–but it was all done so perfectly naturally, with such dignity that the man walked away very pleased.”

  From Gorgas’ private secretary it would also be learned years later that the kindly doctor, seemingly as imperturbable as ever, could also become so incensed over red tape and bureaucrats in Washington that he would sweep the papers from his desk, lock them in a drawer, and storm out of the office, not to be seen again for a day or more.

  He rose early, cared little about his clothes, his customary ensemble a rumpled three-piece civilian suit, stiff detachable collar, black tie with stickpin. His main pleasures were food–virtually anything set before him–horseback riding, a glass of beer, conversation, and books, his reading being done a
ccording to a lifelong routine. He always kept three books at hand–one scientific, one of classical literature or history, one light fiction–which he took up in turn, giving each exactly twenty minutes according to a pocket watch placed on the table beside his chair. In this fashion, he said, he was able to remember what he read.

  “He loved especially the adventure stories of H. Rider Haggard,” his daughter would recall; “King Solomon’s Mines! I think those books had a great deal to do with his enthusiasm for the adventure of Panama, for being there in the jungle then.”

  It was in the autumn of 1904, during the time Gorgas was on home leave, that Ronald Ross made his brief, almost universally ignored, visit to Panama as the result of an invitation issued by Gorgas. Ross crossed the Atlantic to attend the world’s fair in St. Louis, where, among other things, he noted surprising numbers of both Stegomyia and Anopheles mosquitoes nicely thriving. Then, following a pleasant few days with William Osier at Baltimore, he sailed for Colón on the steamer Advance. Gorgas came down to the New York pier to see him off. For an hour before the ship sailed, they sat chatting on the fantail, the two men who had done more than any others alive to rid the world of tropical plague and whose lonely, unending battle with official indifference or official enmity had long since made them brothers of the same blood.

  After a week on the Isthmus, Ross described Gorgas’ projected campaign as sound in every particular. Panama, Ross declared, could be made an example for the entire world.

  NATIONAL ARCHIVES

  John F. Wallace

  John Stevens

  PANAMA CANAL COMPANY

  Fumigation brigade, Panama City

  Stegomyia fasciata, an adult female (much enlarged)

  NATIONAL ARCHIVES