Red Cross volunteers assisting during the epidemic. (1918) Credit 65
Constant emotional stress got the best of even the strong-willed. One night Dorothy Deming and another nurse, also named Dorothy, lost their battle to save a flu patient. Come morning, they broke the heart-wrenching news to the patient’s family. Crying inwardly, Deming tried to hide her feelings. She rushed to a linen closet, “always our place of refuge, and there ahead of me, was Dorothy sobbing her heart out. We really let go. I wonder about this sometimes when I hear people say nurses are hard-boiled.”63
When things got really bad, nurses worked extra shifts. Though groggy from lack of sleep, they forced themselves to stay focused, braced by mugs of steaming black coffee. Like doctors, they got the flu, and some died of it. At one point, Minneapolis’s City Hospital reported nearly half its nursing staff had been down with influenza during a three-week period. At New York’s Mount Sinai Hospital, eighty-five nurses fell ill, of whom eighteen developed pneumonia. Yet when the student nurses were ordered to remain home until the danger passed, “the class voted unanimously to stay and serve.”64
Despite all the hardships, many nurses said they would not have traded their experiences for anything. “For me, nursing came alive during that test,” Dorothy Deming wrote in 1957. “Now, patients came first. Reassure them, ease them, help them, watch them…and comfort them….This was nursing as I had dreamed of it; it was nursing at its most demanding….We grew to full professional stature in those dark days.”65
Red Cross nurses during a demonstration at a Red Cross Emergency Ambulance Station. (1918) Credit 66
Deming and her sisters were not alone. The nurse shortage challenged other women eager to show their ability and patriotism. The American Red Cross helped mobilize them in the fight against influenza. A flyer pleaded:
A STERN TASK FOR STERN WOMEN
There is nothing in the epidemic of SPANISH INFLUENZA to inspire panic.
There is everything to inspire coolness and courage and sacrifice on the part of American women.
A stern task confronts our women—not only trained women, but untrained women….
HUMANITY CALLS UPON THEM
LIVES DEPEND ON THEIR ANSWER….
WILL YOU ENROLL FOR SERVICE NOW?66
Two high-society women socializing in flu masks. (1918) Credit 67
They enrolled. New York society women—the mothers, wives, and daughters of America’s richest men—heard the call. Lillian Wald, founder of the Henry Street Settlement, which provided the first visiting nurse service in the United States, saw them in action. “Dignified and discerning women,” Wald noted, “stood on the steps of Altman’s and Tiffany’s Fifth Avenue shops and accosted passers-by.” Volunteers, the fur-clad and bejeweled ladies declared, needed only “willingness and courage” to serve.67
Franklin D. Roosevelt’s wife, Eleanor, overcame her fears to work in a Red Cross canteen, where she served hot meals to troops bound for France. The wife of William Randolph Hearst, America’s most influential newspaper owner, answered the call to help. She and her society friends sped across New York City in their limousines as members of “flying squads.” Other women worked in hospitals, bringing patients food, carrying stretchers, and cleaning. They also rubbed shoulders with lower-class volunteers from the tenements. A Wald aide recalled that one tireless worker “who could always be counted on” had been a prostitute.68
The St. Louis Red Cross Motor Corps on duty, with stretchers at the ready. (1918) Credit 68
Helping others did wonders for volunteers’ self-esteem. Why, if women showed such dedication and courage in this crisis, they could do anything—even vote in elections! Opponents argued that “the ladies” should not have the right to vote because they were too unstable, too emotional, too “fragile” to make important decisions without male guidance. Women’s activities during the pandemic helped change minds. Thus, it was no accident that, in August 1920, most states approved the Nineteenth Amendment to the U.S. Constitution, which granted women the right to vote.
But in the fall of 1918, nobody could predict the future. Big questions preyed on people’s minds. Would the Allied or the German home front crack first? Could the Americans, newcomers to the war, turn the tide of battle for the Allies? Whatever happened, one thing was sure: the devil virus would have its say.
We can’t stop this war on account of Spanish or any other kind of influenza.
—Colonel S. M. Kennedy, chief surgeon of the Port of New York, August 18, 1918
THE BIG PUSH
On a rainy afternoon late in August 1918, Allied commanders, elegant in their spotless uniforms and glistening black boots, stood before a wall map at French headquarters outside Paris. While the enemy still held huge chunks of France and Belgium, all signs pointed in the right direction: Germany was getting weaker. General Ludendorff’s spring offensive had failed, due in part to the first wave of the flu pandemic, which had since died out. Meanwhile, the Allies were gaining numerical superiority; more than 1.2 million American troops had arrived in France or were on the way. Now that the balance of forces had tipped in their favor, the commanders planned a massive attack on key points along the entire 550-mile Western Front. Its aim: to crush Germany’s armies, leaving Germany no choice but to sue for peace on Allied terms.
General John J. Pershing. (1917) Credit 69
The American commander, General John J. “Black Jack” Pershing (1860–1948), struck first, followed by the British, French, and Belgians in turn. On September 12, units from his First Army broke through the German lines at Saint-Mihiel, a strategic town on the Meuse River in northern France. On September 26, Pershing launched the Meuse-Argonne offensive, which would continue until November 11, the last day of the war. The offensive took its name from a twenty-one-mile stretch of the Western Front running eastward from the Meuse River near the fortress of Verdun to the western edge of the Argonne Forest. This was the largest American military operation since the Civil War. With the 1.5 million troops under his command, coupled with their modern weapons, Black Jack could easily have wiped out the combined Union and Confederate armies.1
At precisely 1:00 a.m., Pershing’s artillery roared in unison, the weapons creating a false dawn with their gun flashes. The waiting AEF troops held their hands over their ears against the shattering noise. Men filing past the guns felt the hot breath on their faces. It was, said medical officer William Holmes Dyer, “the most terrific bombardment of the war….The old woods in which we were trembled as if by earth quake…and our ears were deafened.” By early November, the U.S. army had fired off more artillery ammunition than the Union army had used in the entire four years of the Civil War.2
U.S. soldiers of the Twenty-Third Infantry, Second Division, firing a machine gun at a German position in the Argonne Forest, in France. (1918) Credit 70
The German army resisted with every ounce of skill gained during four years of grueling combat. Dr. George Washington Crile, an American surgeon, noted the results in his diary on October 17: “Everything is overflowing with patients. Our divisions are being shot up; the wards are full of machine-gun wounds….Rain, rain; mud, blood; blood, death! All day, all night, we hear the incessant tramp of troops—troops going in, wounded coming back. Even in our dreams we hear it.”3
German bombers attacked some hospitals near the front line nearly every night. Shirley Millard and other off-duty nurses slept in tents a few hundred yards from their hospital. After one ferocious air raid, Millard told her diary about “the blood red sky at sunrise.” A tree next to the hospital “blossomed horribly with fragments of human bodies, arms and legs, bits of bedding, furniture, and hospital equipment.” These “decorations” were like those for a devil’s Christmas tree.4
Ambulances brought hundreds of poison-gas cases to Millard’s hospital each day. The poor fellows, mostly boys away from home for the first time, “cannot breathe lying down or sitting up,” Millard wrote. “They just struggle for breath.
But nothing can be done. Their lungs were gone….One boy, today, screaming to die. The entire top layer of his skin burned from his face and body.” She gave him an injection of morphine, a drug made from opium, to dull his pain until the end came. She could not decide which was more ghastly: death by poison gas or by influenza. Often the two went hand in hand. Owing to their damaged lungs, gas victims were at greater risk of dying of the bacterial pneumonia that often went along with the flu.5
Nurses in gas masks tending to soldiers on the front line. (1917) Credit 71
Unfortunately, the pandemic’s second wave, its most lethal phase, coincided with the Meuse-Argonne offensive. Boston, New York, and Philadelphia were already struggling with its effects on civilians. Now the flu had “engulfed the First Army,” its chief surgeon, Alexander N. Stark, told his superiors. General Pershing agreed; flu had laid him low for a few days. The disease, he reported on October 5, had “assumed serious proportions.” By that date, army hospitals had nearly 70,000 flu patients, “of whom many developed a grave form of pneumonia”; 32 percent would die. In other words, these trained fighters lay helpless in bed instead of engaging the enemy.6
Reports poured into Pershing’s headquarters from front-line units telling of men who “could hardly drag themselves around,” so sick had the flu made them. Yet the virus did more than eat into a soldier’s body; it ate into his spirit. As letters from home brought news of the pandemic, soldiers worried about their loved ones.7
A postcard photo taken in France of Harry S. Truman in his World War I uniform. (1918) Credit 72
Captain Harry S. Truman, later the thirty-third president of the United States, served in an artillery unit during the Meuse-Argonne offensive. Truman’s reaction reflected that of his comrades. Upon learning that the flu had struck his hometown of Independence, Missouri, the captain became frantic. His fiancée, Bess Wallace, and her brother Frank and two close friends had come down with the disease. Now the front, with all its dangers, seemed safer than the United States. Truman wrote: “Every day someone in my outfit will hear that his mother, sister, or sweetheart is dead. It is heartbreaking almost to think…that the ones we’d like to protect more than all the world would have been more exposed to death than we.”8
Flu cases clogged the AEF’s medical services. There were so many that medical personnel—stretcher bearers, ambulance drivers, field-hospital aides—had orders to separate flu cases from the wounded. But more often than not, this wasn’t feasible—dodging enemy artillery shells and machine-gun bullets left no time to make a medical diagnosis. So they put all sorts of cases together, helter-skelter, exposing the wounded to infection. A flu-infected soldier, however, was more of a liability than a wounded soldier, because nobody else could “catch” a bullet wound. Thus, influenza killed wounded men who might otherwise have lived if they had been separated from their infected comrades and treated in time.9
Meanwhile, hospital staffs fought to save their patients, often a losing battle. Like their sisters back home, AEF nurses worked under intense pressure. “Patients have been pouring in with grippe,” one wrote. “Work is desperate. A twelve-hour day with twenty minutes for lunch….I think twenty-two patients have died now.” For another nurse, influenza seemed “to be some frightful plague…and the proportion of deaths [is] higher—much higher—than we’d had for wounds at any time.”10
Sheet-music cover art for the ballad “The Rose of No Man’s Land.” (1918) Credit 73
In every army, nurses were the ones most beloved. They, more than any other medical professionals, carried the daily burden of caring for the sick and wounded. German soldiers worshiped die Schwestern, the sisters. To Allied soldiers, nurses were the “Roses of No Man’s Land,” beautiful flowers blooming amid the horrors. A sentimental song of the same title expressed their feelings:
There’s a Rose that grows in No Man’s Land,
And it’s wonderful to see.
Tho’ it’s sprayed with tears,
It will live for years
In my garden of memory.
It’s the one red rose
The soldier knows,
It’s the work of the Master’s Hand;
In the War’s great curse, stands the Red Cross Nurse,
She’s the Rose of No Man’s Land.11
German nurses faced overwhelming odds at the front and at home. Their country suffered a lot worse than the Allies. Since German industry absorbed a large proportion of the workforce, including farmers, the nation depended on food imported from abroad. This was a serious weakness, one that Britain, the world’s leading naval power, was quick to exploit. By 1918, the Royal Navy’s blockade had cut Germany off from all foreign sources of food, raw materials, medicines, and fertilizers. Put simply, the blockade aimed to create mass starvation. Winston Churchill, the civilian head of the Royal Navy, admitted its purpose was “to starve the whole population—men, women, and children, old and young, wounded and sound—into submission.”12
Allied troops ate well; hungry Germans often raided their trenches to grab any food they found lying around. Equally important, since the Americans came, there were enough Allied soldiers to allow units to rest for a few days in the rear before returning to the trenches. Food shortages and exhaustion ravaged General Ludendorff’s front-line troops, making them more vulnerable to influenza. “A tired man,” Ludendorff correctly noted, “succumbs to contagion more easily than a vigorous man.”13
German troops, too, worried about their families back in the “Fatherland.” Conditions on the German home front worsened by the day. Owing to the blockade, shops had little or nothing to sell. Products made of rubber, cotton, and leather vanished from shelves. Soap grew scarce, so people and clothing stank. Once-prosperous citizens looked like tramps, dressed in dirty, threadbare clothes and shoes coming apart at the seams. Coal and electricity shortages made it impossible to heat homes. People froze to death in their beds. Hospitals ran out of medicines and gauze bandages; white paper substituted for bandages.
Yet food shortages took the greatest toll on civilian health and morale. German women “worn away to skin and bone, with seamed and careworn faces,” roamed city streets searching for food, a medical officer reported. The government could only supply “war bread,” a vile blend of turnips, potato skins, and sawdust. Hungry people ate stray cats, and rats, too. In Berlin, housewives butchered weakened and dead horses in the streets. “They fought each other for the best pieces, their faces and clothing covered with blood,” a newspaper reported. “Other emaciated figures rushed over and scooped up the warm blood with cups and napkins. Only when the horse was reduced to a skeleton did the scavengers disperse, anxiously clutching bits of flesh to their hollow breasts.” Things got so bad that law-abiding citizens took matters into their own hands. In Berlin, crowds looted shops, prompting the government to call in combat troops to restore order.14
A looted shop after a food riot in Berlin. (1918) Credit 74
Germany’s youngest suffered worst. Starving mothers could not produce enough milk to breast-feed their infants. A few weeks after the war ended, Henry W. Nevinson, a well-known English journalist, saw the result in Cologne, a leading industrial city. He wrote: “Although I have seen many horrible things in the world, I have seen nothing so pitiful as these rows of babies feverish from want of food, exhausted by privation to the point that their little limbs were like slender wands, their expressions hopeless, and their faces full of pain.”15
Influenza scythed through Germany’s hungry, weakened, stressed-out civilians. “Influenza Everywhere,” said the headline of a Berlin newspaper, to nobody’s surprise. In that city, it carried away over 1,700 people in a single day, October 15. In Hamburg, Germany’s second-largest city, flu sent a daily average of 400 people to the cemetery. “We are returning every day to the barbarism of the Middle Ages in every way,” a resident sighed. “I am astonished that there are no religious fanatics nowadays to run through the streets, dressed in sackcloth and ashes,
and calling on the people to repent their sins.” The anonymous writer was remembering the flagellants who’d tramped the roads during the Black Death of the fourteenth century. Government experts calculated that 763,000 Germans died as a result of the “hunger blockade.”16
Despite the hardships, the German army fought with the courage of desperation. But the handwriting was on the wall. If fighting continued at the same pace, its position would collapse along the entire Western Front.
RUSH RUSH RUSH RUSH
General Pershing drew the same conclusion. At this critical moment in the war, he realized, numbers counted more than ever. If the Allies could keep up the pressure, keep hammering away, Germany would have to give up, saving countless lives. Still, there was a problem. Influenza had taken down so many American troops that an army division could not keep attacking for more than a few days without replacements. These could come from only one source—training camps in the United States. So, on October 8, Pershing cabled the War Department in Washington: “RUSH RUSH RUSH RUSH.”17
Pershing’s cable arrived just as the pandemic’s second wave was rolling full speed across America. Army reports told of soaring death rates at training camps like Camp Devens. From a medical standpoint, it made no sense to push more recruits into these incubators of disease. The army’s acting surgeon general, Charles Richard, urged its chief of staff, General Peyton March, to cancel all draft calls. “Epidemic influenza has become a very serious menace,” he told March, “and threatens…to exact a heavy toll on human life, before the disease has run its course throughout the country.” At the surgeon general’s urging, on October 7 the army canceled the monthly draft call for 142,000 men. But General March, a stern old soldier, refused to go any further. Recruits already in training, or aboard ships at sea, would proceed to France whatever the cost, he insisted.18
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