Also by Albert Marrin
Black Gold: The Story of Oil in Our Lives
FDR and the American Crisis
Flesh & Blood So Cheap: The Triangle Fire and Its Legacy
A National Book Award Finalist
Thomas Paine: Crusader for Liberty
Uprooted: The Japanese American Experience During World War II
A Sibert Honor Book
A Volcano Beneath the Snow: John Brown’s War Against Slavery
THIS IS A BORZOI BOOK PUBLISHED BY ALFRED A. KNOPF
Text copyright © 2018 by Albert Marrin
All rights reserved. Published in the United States by Alfred A. Knopf, an imprint of Random House Children’s Books, a division of Penguin Random House LLC, New York.
Knopf, Borzoi Books, and the colophon are registered trademarks of Penguin Random House LLC.
For picture credits, please see this page.
Visit us on the Web! GetUnderlined.com
Educators and librarians, for a variety of teaching tools, visit us at RHTeachersLibrarians.com
Library of Congress Cataloging-in-Publication Data is available upon request.
ISBN 9781101931462 (trade) — ISBN 9781101931479 (lib. bdg.) — ebook ISBN 9781101931486
Random House Children’s Books supports the First Amendment and celebrates the right to read.
v5.1
ep
Contents
Cover
Also by Albert Marrin
Title Page
Copyright
Epigraph
Prologue the Great-Granddaddy of Them All
Chapter I: The Pitiless War
Chapter II: Diseases of War
Chapter III: Puny Man
Chapter IV: A Fear and Panic
Chapter V: To the Bitter End
Chapter VI: A Detective Story
Notes
Further Reading
Picture Credits
About the Author
This may serve to describe the dreadful condition of that day, though it is impossible to say anything that is able to give a true idea of it to those who did not see it, other than this, that it was indeed very, very, very dreadful, and no such tongue can express.
—Daniel Defoe, A Journal of the Plague Year, 1722
If you are in the business of infectious disease epidemics, you can’t ignore the 1918 flu—it’s the great-granddaddy of them all.
—Dr. Donald Burke, Johns Hopkins Bloomberg School of Public Health, 2004
Monday, March 11, 1918. Fort Riley, north-central Kansas. On a vast windswept plain covering more than 20,000 acres, scores of barracks, staff buildings, warehouses, repair shops, stables, and tent cities dotted the grounds. Rumor had it that ghosts roamed the parade ground on nights of the full moon, when coyotes howled. Fort Riley was home to the Seventh Cavalry, the unit that, forty-two years earlier, Colonel George Armstrong Custer had led to fight the Sioux and Cheyenne during the Indian wars.
That late-winter day in 1918 dawned cold and gray. Army recruits shivered, for, one wrote his folks, “barracks and tents were overcrowded and inadequately heated, and it was impossible to supply the men with sufficient warm clothing.” To make matters worse, sand blown by gale-force winds stung bare skin and got into eyes and mouths, crunching between teeth. It had, some said, the faint smell of manure. Though Fort Riley had scores of motor vehicles, the U.S. army still used thousands of horses and mules to haul supplies. The animals left manure all over, which cleanup squads raked into piles, waist-high, for burning every few weeks. Two days earlier, work details had burned several hundred tons of the stuff with fuel oil. The fires gave off a foul yellowish haze, the wind scattering the powdery ashes into the sleeping quarters and mess halls.1
Fort Riley, Kansas. (c. 1918–1919) Credit 1
Recruits had swarmed into Fort Riley because their government sent them there. A savage war had been raging for nearly four years, since July 1914. Then called the Great War or the World War, today we know it as World War I or the First World War. Mainly, it was a struggle for power in Europe and for overseas colonies, raw materials, and markets. Two groups of nations fought. On one side stood the Central Powers, led by Germany and including Austria-Hungary, Bulgaria, and the Ottoman Empire, ruled by the Turks. Opposing them were the Allies, primarily the British Empire, France, Russia, and Italy. Though waged chiefly in Western Europe, the war spilled into nearly every corner of the globe.
Neutral at first, American public opinion gradually tilted in favor of the Allies. With the world’s largest economy, the United States needed to trade its manufactured goods to prosper. But when Britain’s Royal Navy blockaded Germany’s seaports, cutting off overseas supplies of food and raw materials, Germany retaliated, unleashing its submarines to keep vital supplies from reaching the Allies. After German U-boats (“undersea boats,” or submarines) torpedoed American cargo ships, Congress declared war in April 1917.
Even though the United States was the world’s industrial leader, its 378,000-strong army was tiny compared to the millions of men fielded by the European powers. A latecomer to the war, the United States was embarrassingly short of modern weapons, many of which it had to buy or borrow from the Allies. America’s chief advantage was its manpower. Within days of the declaration of war, the nation set about creating an army of more than 4.7 million men, the largest in its history until then. Basic infantry training would take place in thirty-two camps across the country, and in dozens of facilities where specialized skills such as artillery, military engineering, and flying airplanes would be taught. Fort Riley’s training area, called Camp Funston, held 56,000 recruits, making it the largest camp in the country.2
Among the recruits was Private Albert Gitchell, a mess cook. Before daybreak on March 11, 1918, Gitchell awoke feeling achy, his throat raw, as if scoured with hot sandpaper. Too sick to prepare breakfast for his company, he dragged himself to Hospital Building 91. The orderly on duty took the private’s temperature and promptly put him to bed with a “bad cold.” But then a strange thing happened. Moments after Gitchell’s head hit the pillow, Corporal Lee W. Drake appeared with the same complaint. Others quickly followed. By noon, 107 men had been admitted to the hospital with “bad colds.” And that was just the beginning: within two weeks, a total of 1,127 men had been stricken. Upon closer examination, doctors decided they had an influenza outbreak—a local flare-up of an infectious disease—on their hands.
Influenza! Influenza! Just let the word slide off your tongue; it has such a mellow sound. Yet its history is anything but mellow. The name comes from the Italian influenza coeli, meaning “influence of the heavens,” for Italian scientists in the 1600s thought meteors, comets, and the position of the planets shaped events on Earth. A century later, English speakers borrowed the Italian word; flu is simply a shortened form of influenza. The French called it la grippe, from gripper, “to grasp or hook,” because the infection grabs hold of its victims.
Influenza outbreaks were usually an annual winter event in the Northern Hemisphere. Always a nuisance, flu sickened many but was gone after a few days of misery. Before 1918, most people, including physicians, were blasé about flu, accepting it as an expected part of life, to be endured, along with taxes and toothaches. “Influenza,” the New York Times reported in 1901, “has apparently become domesticated with us.”3
The disease’s early symptoms resemble those of the common cold, only more severe: fever, cough, runny nose, muscle aches, fatigue. Harvey Cushing, a brilliant brain surgeon, caught la grippe in December 1906. Cushing described the ordeal in his diary: “Of all the depressing, rotten maladies this takes the cake, and I wonder that anyone had been able to stand being under the same roof
with me for a week. One’s many bad qualities surge to the surface and among them the cardinal symptoms of the disease may be…quarrelsomeness, irritability, loss of memory, despondency…and a hopelessness of spirit. Don’t get it.”4
Nevertheless, influenza was not a “reportable disease,” a disease that, by law, physicians and hospitals must report to the local board of health. Reportable diseases include measles and diphtheria, killers especially of young children. Yet, unlike the common cold, which almost never causes death, seasonal flu can and does kill, though seldom in large numbers in relation to population size. Nowadays, the disease claims, on average, 36,000 Americans each year, out of a population of 320 million. Contrast this with another number: 35,092 Americans died in motor vehicle accidents in 2015. Worldwide, seasonal flu infects up to a billion people, killing up to half a million of these.5
What happened at Fort Riley, however, was more than a seasonal outbreak. As time would tell, it was merely the start of the mildest of three influenza waves that seemed to roll in out of nowhere. In the summer of 1918, the second wave struck as a highly contagious and lethal epidemic, an illness that races through a community, attacking many people at once. Worse yet, within weeks the epidemic exploded into a pandemic, an illness that travels rapidly from one continent to another, spreading worldwide, sickening and killing millions.
Crowded hospital corridors were a common sight at the height of the 1918 epidemic. Credit 2
Flu pandemics are nothing new. Medical historians think the first one struck in 1510, infecting Asia, Africa, Europe, and the New World. Between the years 1700 and 1900, there were at least sixteen pandemics, some of them killing up to one million people. Yet these were tame compared to the 1918 calamity. It was by far the worst thing that has ever happened to humankind; not even the Black Death of the Middle Ages comes close in the number of lives it took. A 1994 report by the World Health Organization pulled no punches. The 1918 pandemic, it said, “killed more people in less time than any other disease before or since.” It was the “most deadly disease event in the history of humanity.” Other scientists called it “the greatest medical holocaust in history.”6
The numbers are mind-boggling. No other disease, no war, no natural disaster, no famine comes close to the great pandemic. In the space of eighteen months in 1918–1919, about 500 million people, one-third of the human race at the time, came down with influenza. The exact total of lives lost will never be known. An early estimate, made in 1920, claimed 21.5 million died worldwide. Since then, researchers have been continually raising the number as they find new information. Today, the best estimate of flu deaths in 1918–1919 is between 50 million and 100 million worldwide, and probably closer to the latter figure.7
Russia’s Communist tyrant Joseph Stalin liked to say: “One death is a tragedy; the death of millions is a statistic.” By that, Stalin—a wholesale murderer in his own right—meant that we are able to personalize another individual’s suffering, feeling it as he or she does, but an enormous calamity, striking tens of millions, has a numbing effect. It is too awful for the mind to grasp and thus strikes us as merely a cold statistic, a number that blends individuals into a mass. Yet behind each individual is the tragedy of loved ones lost, a broken family, hardship, and sadness.
So it was with the 1918 pandemic. I know. My grandfather left Russia in 1913 to open a dry-goods shop in Cape Town, South Africa, planning to send for the family once the business got going. It was not to be. World War I came, and the flu took him; he lies in an unmarked grave.
My father, then sixteen, was drafted into the Red Army during the Russian Civil War. While he was fighting in Siberia, the flu struck him, too. Pa used to tell how, burning with fever, he went by horse-drawn sled to a hospital set up in a barn smelling of manure. The place was full, and he had to wait on a stretcher until a bed “opened”—that is, until a patient died. One soon did. Pa saw orderlies take the body away—then they put him to bed without changing the dirty sheets. The medical staff fed him beet soup and gave him glasses of vodka, a strong liquor. That was it. In 1918, even the best doctors knew nothing about what caused influenza, why it was so deadly, and how it spread. Tragically, medical science could not shorten the pandemic by so much as a day, or cure a single case. Pa’s survival made him believe in God.
Today, we have a better, but not a full, understanding of what happened a century ago. Scientists agree that World War I and influenza joined together to make a bad situation worse. In a sense, the pandemic was nature’s war on humanity, amid a war waged by humanity against itself. The wretched conditions in the training camps and on the fighting fronts created an ideal environment for the disease. These conditions allowed the influenza virus to mutate—change—into the “devil virus.” Influenza, too, shaped the final stages of the war by influencing military operations, troop strength, and morale.8
On average, 2,250 soldiers a day were killed on the front in Western Europe. In total, over 9 million men lost their lives fighting on all fronts, and about 21 million civilians died as a direct result of the war. These are huge numbers. But if we assume 100 million influenza deaths, the disease killed at least three times as many people as the conflict itself. Compare this to AIDS, the scourge of the late twentieth century. In just four months at the height of the pandemic—August through November 1918—influenza took more lives than AIDS did in thirty-nine years—that is, 78 million between 1975 and 2014.9
In the United States, influenza death rates were so high that the average life span fell by twelve years, from fifty-one in 1917 to thirty-nine in 1918. If you were a “doughboy”—slang for an American soldier—you had a better chance of dying in bed from flu or flu-related complications than from enemy action. After the war, the War Department listed 50,280 U.S. combat deaths; around 227,000 doughboys were hospitalized for battle wounds, and 340,000 for flu, of whom 51,164 died.10
A milder third wave began in late 1918, but the pandemic did not fade away for good until 1920. It is not very well known today. Though every nation has memorials to its World War I dead, no nation (that I know of) has any to its flu victims or the valiant men and women who gave their lives caring for them.
Scientists who study influenza today agree on the need for vigilance against future pandemics. Yet we cannot accomplish this without seeing the 1918 pandemic in a broader context. For it was part of a larger story, one going back many thousands of years, to before the dawn of civilization. The story is complicated. Like a mass of intertwined plant roots, the roots of the 1918 outbreak lie deep in the natural world, the history of science, and the sweeping arc of human history.
I cannot say it is a happy story or a pretty one; I admit that researching the pandemic gave me the blues at times. Often terrible, it illustrates how quickly an advanced civilization can begin to unravel in the face of a baffling affliction. An old proverb says: “Knowledge is power.” It is, and that is why I have written this book. We need to look backward so we can look forward. We must understand what happened a century ago so we can better face facts and better defend ourselves when the next pandemic strikes, as scientists believe it surely will.
Infectious disease is one of the great tragedies of living things—the struggle for existence between different forms of life…. Incessantly the pitiless war goes on, without quarter or armistice.
—Hans Zinsser, Rats, Lice and History, 1935
VISITORS FROM THE DEEP PAST
For untold generations, before the invention of written history, people lived in small family groups numbering, at most, a few dozen members. Our distant ancestors were merely creatures among other creatures, struggling to survive in an untamed wilderness. Called “hunter-gatherers” by modern social scientists, they were nomads, wanderers, people without a fixed place to live or call home. Each group had little contact with other groups, going from place to place, hunting animals and gathering roots, nuts, berries, and fruits to eat.
Unable to preserve or store food, nomads had to move cont
inually, and on foot, to find their next meal. Without the wheel, a later invention, they also lacked draft animals; in fact, they kept no animals, except dogs, used for hunting and, in a pinch, for a meal. They carried their few possessions strapped to their backs or lashed between two wooden poles, which the women dragged along the ground. The men walked ahead, armed with clubs, stone-tipped spears, and bows and arrows, eyes peeled for danger or for game to pursue. Camps usually were just overnight stops to eat and sleep. But if the hunting in an area was good, the group might stay for a few days longer to butcher a kill, fill their bellies, and rest up for the trek ahead.
A Neolithic cave painting discovered in Spain. Credit 3
Hunting accidents, falls from trees, feuds within a group or with other groups took a steady toll. Still, the nomadic lifestyle had one advantage: it limited the impact of infectious diseases carried by animals.
All types of living beings have diseases that afflict them alone. Sometimes, however, a disease attacking one life-form “crosses over” and infects another life-form. Ancient nomads did not live amid heaps of rubbish, their own waste, and polluted water. After a few days or weeks at a campsite, they moved on, leaving behind any disease-causing microbes that might be around. If a disease crossed over to, say, a hunter, he might die. The disease might even infect the entire group, killing everyone. But that would be the end of the disease; it stopped when there was no one left to infect. It could flourish only by becoming a “crowd disease,” infecting a population large enough to allow victims to pass it to the healthy.1
About 11,000 years ago, humankind reached a critical turning point. Across the world, big game animals—mastodons, giant sloths, and saber-toothed tigers—became extinct, probably because of overkilling by the hunters themselves. Naturally, as food became scarcer, nomads sought other ways of feeding themselves. Many began to experiment, growing wild plants like wheat, barley, and rice for food. They also learned to domesticate wild animals—that is, to tame and raise them. Cattle, horses, oxen, sheep, goats, pigs, ducks, geese, and chickens: all became important food sources, and some, like horses and oxen, became working animals.
Very, Very, Very Dreadful Page 1