Herbert Hoover, not part of the American peace delegation but a large figure in Paris because he had charge of feeding a desolated and barren Europe, said, 'Prior to that time, in all matters with which I had to deal, he was incisive, quick to grasp essentials, unhesitating in conclusions, and most willing to take advice from men he trusted' .[Now] others as well as I found we had to push against an unwilling mind. And at times, when I just had to get decisions, I suffered as much from having to mentally push as he did in coming to conclusions.' Hoover believed Wilson's mind had lost 'resiliency.'
Colonel Starling of the Secret Service noticed that Wilson 'lacked his old quickness of grasp, and tired easily.' He became obsessed with such details as who was using the official automobiles. When Ray Stannard Baker was first allowed to see Wilson again, he trembled at Wilson's sunken eyes, at his weariness, at his pale and haggard look, like that of a man whose flesh has shrunk away from his face, showing his skull.
Chief Usher Irwin Hoover recalled several new and very strange ideas that Wilson suddenly believed, including one that his home was filled with French spies: 'Nothing we could say could disabuse his mind of this thought. About this time he also acquired a peculiar notion he was personally responsible for all the property in the furnished place he was occupying' . Coming from the President, whom we all knew so well, these were very funny things, and we could but surmise that something queer was happening in his mind. One thing was certain: he was never the same after this little spell of sickness.'
Grayson confided to Tumulty, 'This is a matter that worries me.'
'I have never seen the President look so worn and tired,' Ray Baker said. In the afternoon 'he could not remember without an effort what the council had done in the forenoon.'
Then, abruptly, still on his sickbed, only a few days after he had threatened to leave the conference unless Clemenceau yielded to his demands, without warning to or discussion with any other Americans, Wilson suddenly abandoned principles he had previously insisted upon. He yielded to Clemenceau everything of significance Clemenceau wanted, virtually all of which Wilson had earlier opposed.
Now, in bed, he approved a formula Clemenceau had written demanding German reparations and that Germany accept all responsibility for starting the war. The Rhineland would be demilitarized; Germany would not be allowed to have troops within thirty miles of the east bank of the Rhine. The rich coal fields of the Saar region would be mined by France and the region would be administered by the new League of Nations for fifteen years, and then a plebiscite would determine whether the region would belong to France or Germany. The provinces of Alsace and Lorraine, which Germany had seized after the Franco-Prussian War, were moved from Germany back to France. West Prussia and Posen were given to Poland (creating the 'Polish corridor' that separated two parts of Germany. The German air force was eliminated, its army limited to one hundred thousand men, its colonies stripped away) but not freed, simply redistributed to other powers.
Even Lloyd George commented on Wilson's 'nervous and spiritual breakdown in the middle of the Conference.'
Grayson wrote, 'These are terrible days for the President physically and otherwise.'
As Grayson made that notation, Wilson was conceding to Italy much of its demands and agreeing to Japan's insistence that it take over German concessions in China. In return the Japanese offered an oral (not written) promise of good behavior, a promise given not even to Wilson personally or, for that matter, to any chief of state, but to British Foreign Secretary Alfred Balfour.
On May 7 the Germans were presented with the treaty. They complained that it violated the very principles Wilson had declared were inviolate. Wilson left the meeting saying, 'What abominable manners' . This is the most tactless speech I have ever heard.'
Yet they had not reminded Wilson and the world that he had once said that a lasting peace could be achieved only by (and that he had once called for) 'A peace without victory.'
Wilson also told Baker, 'If I were a German, I think I should never sign it.'
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Four months later Wilson suffered a major and debilitating stroke. For months his wife and Grayson would control all access to him and become arguably the de facto most important policy makers in the country.
In 1929 one man wrote a memoir in which he said that two doctors believed Wilson was suffering from arteriosclerosis when he went to Paris. In 1946 a physician voiced the same opinion in print. In 1958 a major biography of Wilson stated that experts on arteriosclerosis questioned Grayson's diagnosis of influenza and believed Wilson had instead suffered a vascular occlusion - a minor stroke. In 1960 a historian writing about the health of presidents said, 'Present-day views are that [Wilson's disorientation] was based on brain damage, probably caused by arteriosclerotic occlusion of blood vessels.' In 1964 another historian called Wilson's attack 'thrombosis.' In a 1970 article in the Journal of American History, titled 'Woodrow Wilson's Neurological Illness,' another historian called it 'a little stroke.'
Only one historian, Alfred Crosby, seems to have paid any attention to Wilson's actual symptoms (including high fever, severe coughing, and total prostration, all symptoms that perfectly fit influenza and have no association whatsoever with stroke) and the on-site diagnosis of Grayson, an excellent physician highly respected by such men as Welch, Gorgas, Flexner, and Vaughan.
Despite Crosby, the myth of Wilson's having suffered a minor stroke persists. Even a prize-winning account of the peace conference published in 2002 observes, 'Wilson by contrast had aged visibly and the tic in his cheek grew more pronounced' .[It] may have been a minor stroke, a forerunner of the massive one he was to have four months later.'
There was no stroke. There was only influenza. Indeed, the virus may have contributed to the stroke. Damage to blood vessels in the brain were often noted in autopsy reports in 1918, as they were in 1997. Grayson himself believed that Wilson's 'attack of influenza in Paris proved to be one of the contributory causes of his final breakdown.'
It is of course impossible to say what Wilson would have done had he not become sick. Perhaps he would have made the concessions anyway, trading every principle away to save his League of Nations. Or perhaps he would have sailed home as he had threatened to do just as he was succumbing to the disease. Then either there would have been no treaty or his walkout would have forced Clemenceau to compromise.
No one can know what would have happened. One can only know what did happen.
Influenza did visit the peace conference. Influenza did strike Wilson. Influenza did weaken him physically, and (precisely at the most crucial point of negotiations) influenza did at the least drain from him stamina and the ability to concentrate. That much is certain. And it is almost certain that influenza affected his mind in other, deeper ways.
Historians with virtual unanimity agree that the harshness toward Germany of the Paris peace treaty helped create the economic hardship, nationalistic reaction, and political chaos that fostered the rise of Adolf Hitler.
It did not require hindsight to see the dangers. They were obvious at the time. John Maynard Keynes quit Paris calling Wilson 'the greatest fraud on earth.' Later he wrote, 'We are at the dead season of our fortunes' . Never in the lifetime of men now living has the universal element in the soul of man burnt so dimly.' Herbert Hoover believed that the treaty would tear down all Europe, and said so.
Soon after Wilson made his concessions a group of young American diplomatic aides and advisers met in disgust to decide whether to resign in protest. They included Samuel Eliot Morison, William Bullitt, Adolf Berle Jr., Christian Herter, John Foster Dulles, Lincoln Steffens, and Walter Lippmann. All were already or would become among the most influential men in the country. Two would become secretary of state. Bullitt, Berle, and Morison did resign. In September, during the fight over ratifying the treaty, Bullitt revealed to the Senate the private comments of Secretary of State Robert Lansing that the League of Nations would be useless, that the great powers had simply ar
ranged the world to suit themselves.
Berle, later an assistant secretary of state, settled for writing Wilson a blistering letter of resignation: 'I am sorry that you did not fight our fight to the finish and that you had so little faith in the millions of men, like myself, in every nation who had faith in you. Our government has consented now to deliver the suffering peoples of the world to new oppressions, subjections and dismemberments - a new century of war.'
Wilson had influenza, only influenza.
CHAPTER THIRTY-THREE
ON SEPTEMBER 29, 1919, Sir William Osler began coughing. One of the original 'Four Doctors' in a famous portrait of the founding faculty of the Johns Hopkins Medical School, a portrait that symbolized the new primacy of science in American medicine, he was and still is regarded as one of the greatest clinicians in history. A man of wide interests, a friend of Walt Whitman, and author of the textbook that ultimately led to the founding of the Rockefeller Institute for Medical Research, Osler was then at Oxford.
Osler had already suffered one great loss with the death of his only child in the war. Now he suffered as well from a respiratory infection he diagnosed as influenza. In Oxford that fall, influenza was prevalent enough that the dons considered postponing the school term. To his sister-in-law, Osler wrote, 'For two days I felt very ill & exhausted by the paroxysms' of coughing. He seemed to recover, but on October 13 his temperature rose to 102.5. He wrote a friend he had 'one of those broncho-pneumonias so common after influenza.' He tried to work on a talk about Whitman and also wrote Welch and John D. Rockefeller Jr. about giving a grant to his alma mater, McGill University. But on November 7, he felt 'a stab and then fireworks' on his right side. Twelve hours later he began coughing again: 'A bout arrived which ripped all pleural attachments to smithereens, & with it the pain.'
After three weeks his physicans took him off morphine, gave him atropine, and said they were encouraged. On December 5 he received a local anesthetic and a needle was inserted into his lungs to drain fourteen ounces of pus. He gave up working on his Whitman talk and felt certain now of the end, joking, 'I've been watching this case for two months and I'm sorry I shall not see the post mortem.'
His wife did not like the joke. His pessimism was crushing her: '[W]hatever he says always does come true (so how can I hope for anything but a fatal ending?' She tried to remain optimistic as the disease dragged on. But one day she found him reciting a Tennyson poem: 'Of happy men that have the power to die, / And grassy barrows of the happier dead. / Release me, and restore me to the ground' .'
He had turned seventy in July. A birthday tribute to him, a Festschrift (a collection of scientific articles in his honor) arrived on December 27, entitled, Contributions to Medical and Biological Research, Dedicated to Sir William Osler. Publication had been delayed because Welch was editing them. Welch never did anything on time.
His most recent biographer believes that had he been at the Johns Hopkins Hospital instead, he would have received better care. Physicians would have used x rays, electrocardiograms, earlier surgical intervention to drain an empyema, a pocket of pus from the lung. They might have saved him.
He died December 29, 1919, his last words being, 'Hold up my head.'
He had always held his head high.
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If finally it seemed past, yet it wasn't past. In September 1919, as Osler was dying, Blue predicted that influenza would return: 'Communities should make plans now for dealing with any recurrences. The most promising way to deal with a possible recurrence is, to sum it up in a single word, 'preparedness.' And now is the time to prepare.'
On September 20, 1919, many of the best scientists in the country met to try to reach a consensus on the cause of the disease or course of therapy. They could not, but the New York Times stated that the conference marked the beginning of a joint federal, state, and city effort to prevent a recurrence. Two days later the Red Cross distributed its own confidential battle plan internally: 'Proposed Staff Organization for Possible Influenza Emergency / Confidential / Note: No publicity is to be given this bulletin until' the first indication of a recurrence of influenza in epidemic form, but until such time there should be no public statement by a Red Cross Chapter or Division office.'
By February 7, 1920, influenza had returned with enough ferocity that the Red Cross declared, 'Owing to the rapid spread of influenza, the safety of the country demands, as a patriotic duty, that all available nurses or anyone with experience in nursing, communicate with the nearest Red Cross chapters or special local epidemic committees, offering their services.'
In eight weeks in early 1920, eleven thousand influenza-related deaths occurred in just New York City and Chicago, and in New York City more cases would be reported on a single day than on any one day in 1918. In Chicago, Health Commissioner John Dill Robertson, who had been so concerned about morale in 1918, organized three thousand of the most professional nurses into regional squads that could range over the entire city. Whenever an influenza case developed, that victim's home was tagged.
The year 1920 would see either (sources differ) the second or third most deaths from influenza and pneumonia in the twentieth century. And it continued to strike cities sporadically. As late as January 1922, for example, Washington State's health director, Dr. Paul Turner, while refusing to admit the return of influenza, declared, 'The severe respiratory infection which is epidemic at this time throughout the state is to be dealt with the same as influenza' . Enforce absolute quarantine.'
Only in the next few years did it finally fade away in both the United States and the world. It did not disappear. It continued to attack, but with far less virulence, partly because the virus mutated further toward its mean, toward the behavior of most influenza viruses, partly because people's immune systems adjusted. But it left a legacy.
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Even before the epidemic ended, New York City Health Commissioner Royal Copeland estimated that twenty-one thousand children in the city had been made orphans by the epidemic. He had no estimate of children who lost only one parent. Berlin, New Hampshire, a tiny town, had twenty-four orphaned children not counting, said a Red Cross worker, 'in one street sixteen motherless children.' Vinton County, Ohio, population thirteen thousand, reported one hundred children orphaned by the virus. Minersville, Pennsylvania, in the coal regions, had a population of six thousand; there the virus had orphaned two hundred children.
In March 1919 a senior Red Cross official advised district officers to help wherever possible on an emergency basis, because 'the influenza epidemic not only caused the deaths of some six hundred thousand people, but it also left a trail of lowered vitality' nervous breakdown, and other sequella [sic] which now threaten thousands of people. It left widows and orphans and dependent old people. It has reduced many of these families to poverty and acute distress. This havoc is wide spread, reaching all parts of the United States and all classes of people.'
Months after 'recovering' from his illness, the poet Robert Frost wondered, 'What bones are they that rub together so unpleasantly in the middle of you in extreme emaciation' ? I don't know whether or not I'm strong enough to write a letter yet.'
Cincinnati Health Commissioner Dr. William H. Peters told the American Public Health Association meeting almost a year after the epidemic that 'phrases like 'I'm not feeling right,' 'I don't have my usual pep,' 'I'm all in since I had the flu' have become commonplace.' Cincinnati's public health agencies had examined 7,058 influenza victims since the epidemic had ended and found that 5,264 needed some medical assistance; 643 of them had heart problems, and an extraordinary number of prominent citizens who had had influenza had died suddenly early in 1919. While it was hardly a scientific sample, Peters believed that few victims had escaped without some pathological changes.
Throughout the world similar phenomena were noted. In the next few years a disease known as 'encephalitis lethargica' spread through much of the West. Although no pathogen was ever identified and the disease itself has since disap
peared (indeed, there is no incontrovertible evidence that the disease, in a clearly definable scientific sense, ever existed) physicians at the time did believe in the disease, and a consensus considered it a result of influenza.
There were other aftershocks impossible to quantify. There was the angry emptiness of a parent or a husband or a wife. Secretary of War Newton Baker (who had been criticized for being a pacifist when Wilson appointed him) particularly took to heart charges that War Department policies had in effect murdered young men. In several cases troops from Devens were transferred to a post whose commander protested receiving them because of the epidemic. The protests were futile, the troops came, and so did influenza. The father of one boy who died at such a camp wrote Baker, 'My belief is that the heads of the War Department are responsible.' Baker replied in a seven-page, single-spaced letter, a letter of his own agony.
The world was still sick, sick to the heart. The war itself' The senseless deaths at home, on top of all else' Wilson's betrayal of ideals at Versailles, a betrayal that penetrated the soul' The utter failure of science, the greatest achievement of modern man, in the face of the disease'
In January 1923 John Dewey wrote in the New Republic, 'It may be doubted if the consciousness of sickness was ever so widespread as it is today' . The interest in cures and salvations is evidence of how sick the world is.' He was speaking of a consciousness that went beyond physical disease, but physical disease was part of it. He was speaking of the world of which F. Scott Fitzgerald declared 'all Gods dead, all wars fought, all faiths in man shaken.'
*
The disease has survived in memory more than in any literature. Nearly all those who were adults during the pandemic have died now. Now the memory lives in the minds of those who only heard stories, who heard how their mother lost her father, how an uncle became an orphan, or heard an aunt say, 'It was the only time I ever saw my father cry.' Memory dies with people.
The Great Influenza Page 43