The American Plague

by Molly Caldwell Crosby

  When the commission visited another camp to inspect sanitary conditions, the colonel gave them a tour of the grounds, which were foul. Reed turned to the colonel and said, “Shakespeare and Vaughan are on this commission because they know something of camp sanitation. I am here because I can damn a colonel.” Then, he lectured the officer on the responsibility an officer has to enforce good sanitation and health among his troops.

  The worst camp they visited was Chickamauga Park on the border of Tennessee and Georgia; it was the largest camp in the country, and its name literally means “River of Death.” When the commission first arrived, the better part of 60,000 troops had just moved out, and piles of human excrement littered the ground at every step, soaking into the soil and water supply.

  The common element in all of the camps was poor sanitation. The commission studied the conditions at all of the camps, plotting the arrival and departure of new troops, the supply of water, the food prepared in the mess hall and the orderlies who would empty bedpans, then eat lunch without washing their hands. The board sprinkled lime on the latrines and then watched as the same flies landed on food in the mess hall, their fine-haired legs tinged with the disinfectant. Finally, the commission put all of the pieces together.

  Typhoid, the commission showed, was not only infectious, but also contagious. It seeped into the water supply through poor sanitation and spread among the troops through poor hygiene. Departing regiments left scores of infected tents and bedding behind when they moved out, and a new regiment soon occupied them. And flies carried the bacteria all through the camp, depositing it in new places. The Typhoid Commission found the order of feces, filth, fingers and flies as the agents spreading the disease. With basic sanitation practices, the camps could improve their odds against typhoid dramatically.

  With new sanitation measures in place, the surgeon general had great hopes for eliminating not only typhoid but other diseases as well—especially yellow fever. The Spanish-American War had ended, but troops remained, occupying Cuba and dying of disease. Though typhoid and dysentery had proven to be most disastrous, yellow fever was the most feared. The haunting stigma surrounding the American plague remained. Soldiers who had never even seen it feared it above all others; stories of the 1878 epidemic still circulated. “Medical men for centuries had been working in the dark, not knowing what to fight. That fact alone made yellow fever the most fearful of all diseases,” wrote one army doctor.

  Sternberg’s hopes perished with the onset of another yellow fever epidemic in Havana in 1900.

  Cleaning up the camps had done nothing to slow the spread of yellow fever. Two hundred years of scourges and two decades of Surgeon General Sternberg’s personal study had yielded no definitive answers about the disease. So Sternberg handpicked a frontier physician who had shown remarkable promise in the lab and swift success with typhoid. Sternberg had a special assignment in mind for Reed, and he would soon report to a camp just outside of Havana called Camp Columbia.

  Victor Vaughan and Edward Shakespeare would be left on their own to finish the typhoid report. Vaughan would hardly fade behind the fame of Walter Reed. His career had only begun— Victor Vaughan became one of the heroes in the fight against the 1918 influenza pandemic, and one historian would call him “second only to Welch in his influence on American medical education.” Still, Vaughan would also learn a valuable lesson, one that many other doctors failed to realize. “Never again allow me to say that medical science is on the verge of conquering disease,” he later said.

  CHAPTER 12

  A Meeting of Minds

  Everything about Camp Columbia was vivid. The colors were bold: bright blue sky, yellow heat, the flat swath of green, the clapboard buildings standing row after row like game pieces carved from bone. Though several miles from shore, the white light of the camp was suffused with salt and sea wind. The scent of overripened pineapples in nearby fields sugared the air, but beneath the sweetness, the chemicals were pungent. The smell of disinfectants, iodine and alcohol crossed the breeze. The landscape appeared vast, unbroken, except for the shadeless royal palms with their gray trunks standing like granite columns among the buildings. At the northeastern point of the camp, the Gulf of Mexico stretched in staggered shades of blue. The weather existed in extremes as well with only two seasons: wet or dry.

  Camp Columbia’s focus was the care and treatment of sick soldiers. Three hospital buildings stood on stilts of varying heights that leveled the walking porches connecting them, and walkways of white limestone led to the main entrance. One housed a convalescent ward. Another held a small restroom and bathing rooms connected by a large iron pipe to funnel in heated water. There was also a surgical ward with eighteen beds, an operating room and dressing rooms. And one ward, lined with thirty beds and fine mesh netting, held the typhoid and undiagnosed fever patients. Several hundred feet away, across the La Playa road and a footbridge, even past the railroad tracks on the outer edge of the Columbia Barracks, were eight small huts. They were the yellow fever wards.

  The camp had been built on a high plain about six miles west of Havana near the town of Quemados, Marianao, and it housed 1,900 American soldiers—part of the 15,000 men and women left behind to occupy Cuba following the war. The men woke early to the bugle calls, working in the hospital wards until noon. After lunch and an hour of “bunk fatigue,” the doctors, nurses and enlisted men were back at work.

  The enlisted men came from all parts of the United States. They were young, many only twenty or twenty-one years old, and made to look even younger by their clean-shaven faces. With the advent of disposable razor blades, the heavy beards of the last century were gone, and facial hair now signaled status. A moustache was an indication of rank in the army. The bigger the moustache, like Teddy Roosevelt’s walrus whiskers, the higher the rank. Most of the officers went for something in between, opting for a pencil moustache or handlebar style. And accordingly, the enlisted men went clean shaven.

  For entertainment, the men traveled into Havana, where they saw ball games and bought pastries and snacks like Bermuda onions and Norwegian sardines. Sometimes, they bought brandy.

  The Cubans, who were accustomed to the local cocktails, found the drunken, staggering Americans very amusing. There was also the occasional afternoon swim off La Playa one mile away from Camp Columbia. In the evenings, classical music from the camp’s band filled the night sky.

  Dr. Albert Truby first arrived at Camp Columbia in 1898, sailing into the Havana harbor, where Spanish soldiers stood along the Cabaña Fortress, and Cuban locals sat along the seawall to see the American ships arrive. It was December, and Truby and his men wore their winter wool uniforms, now damp with sea air and sweat. Under his watch, Truby had 1,000 soldiers—all nonimmunes.

  Truby looked like a doctor. He wore small, wire-rimmed spectacles on a round, almost cherubic face. His hairline was receding, and in general, he appeared gentle. Truby had just earned his commission from the medical examination board at the Army Medical Museum in Washington, D.C. As Truby and the applicants stood before the board, he noticed a tall, slender officer. The officer was especially interested in the applicants’ knowledge of malaria. Prepared slides were placed beneath the microscope, and the applicants were asked to identify common bacteria and malarial parasites. The officer was quiet and courteous. He seemed like a teacher, one who knew his subject very well, and he gave Truby a feeling of confidence. When asked about malaria, Truby remarked on the recent work proving that mosquitoes can transmit the fever. The officer seemed momentarily pleased then continued the questioning. Only two of the applicants were accepted that day, and Albert Truby was one of them. He would be recommended to the surgeon general for an appointment in Cuba. Truby thanked the medical examination board and the slender officer who had been so interested in malaria. It was the first time Albert Truby met Walter Reed. The second time they met was in Cuba.

  Although he had never seen a case of yellow fever prior to his appointment, it was Truby’s j
ob to field all fever cases. The patients, taken to the mesh-wire receiving ward, had their blood screened for malarial parasites and their urine tested for albumen. There were local doctors, self-described yellow fever experts, but they rarely showed the talent to back up the claim. There were two doctors, however, that Truby and other contract surgeons relied upon for a yellow fever diagnosis. One was Carlos Finlay, and the other was Juan Guitéras; both had been members of the original Yellow Fever Commission in 1879.

  The surgeon general sent Walter Reed to Cuba in March of 1900. Reed left the typhoid report, stalled due to a lack of funds, in the capable hands of Victor Vaughan and Edward Shakespeare. Prone to bad bouts of seasickness, Reed, on the advice of a friend, took a dose of bromide before they set sail for Havana. He retired to his stateroom and went to sleep. When he awoke, he was impressed with the medication. He didn’t feel sick at all, until he went up to the deck and realized that the ship had not yet set sail. For the next two days, he spent most of the voyage sick in his cabin.

  Reed was sent to the Columbia Barracks to investigate a new disinfectant made from seawater called electrozone. Tank wagons rolled through Havana showering city streets with the expensive, salt-laced sanitizer. The disinfectant didn’t impress Reed, but Camp Columbia and its physicians did.

  Reed stayed in a new bungalow flanked by a wide veranda on each side. The building served as quarters for bachelor medical officers. Its clapboard frame shored up a large tile rooftop that draped over the edges of the wide porches where rain would soon fall in fixed streams. Shutters on every wall allowed for a breeze-way, and in some of the nicer buildings the windows were made of glass. In many, however, there were only the wooden shutters to close against the rain. It was on this veranda that Reed and the other doctors stationed at Camp Columbia sat in their army whites and listened as the band’s music drifted in the approaching dusk. The insects were not yet prolific, but soon, as the wet season approached, the hum of mosquitoes would hang on the melody of the nighttime music.

  Albert Truby stood on the porch with Reed, as did two other contract surgeons. Reed’s good friend Jefferson Randolph Kean, chief surgeon of western Cuba, was also there, as was Dr. Aristides Agramonte, an American doctor of Cuban descent. Agramonte had worked with Reed in Washington before being sent to Havana.

  Another doctor sat on the veranda that night. Though he looked younger than the other men, he was an assistant surgeon for the army and the resident bacteriologist who headed the camp’s lab. Just a few months before, Albert Truby had put in a request to Major Kean for a full-time bacteriologist to head the lab at Camp Columbia, and the army appointed Jesse Lazear.

  Dr. Jesse Lazear was from the East, born and raised near Baltimore at Windsor, the estate of his grandfather. He had a close-cropped beard and black hair offset by blue eyes. He rarely spoke and asked questions even less. Lazear was well liked by everyone, even described as lovable by a number of the men. Agramonte, who had been a fellow classmate at Columbia, would later write of Lazear, “A thorough university man, he was the type of old southern gentleman, kind, affectionate, dignified, with a high sense of honor, a staunch friend and a faithful soldier.” The word most often used in reference to him was gentleman, and in that age of moral high-mindedness, manners and codes of conduct, it was the greatest compliment one could bestow. Jesse Lazear was the type of man who wrote to his mother every day and loved Cuba because he didn’t have to play golf.

  At only thirty-four years of age, he was highly accomplished, and often, more qualified than medical officers who outranked him. Lazear attended Washington and Jefferson College, graduated from medical school at the College of Physicians and Surgeons at Columbia University in New York, as well as Johns Hopkins University. Soon after graduating, he left for Europe to study with the greatest minds in science at the Pasteur Institute. His studies continued in Scotland, Germany and France, where he wanted to improve his language skills. As most groundbreaking scientific studies came out of Europe, they were usually in German or French, so Lazear wanted to read and understand them in their original language. When he sailed back to the States, he returned to Baltimore, where at the age of thirty, he became the first doctor in charge of a clinical lab at Johns Hopkins.

  While Lazear was a physician who would be talented in any number of fields, lab work was particularly suited to his ability. He was gifted with perception, a sort of insight for the way things work, and he was meticulous. His thick glass slides, smeared with blood, were kept in perfect order in a wooden box alongside a leather logbook for notations. Next to the slides sat his microscope, which resembled a spyglass. It was his attention to detail, his obsession with accuracy, which would prove to be the haunting mystery left in Cuba long after the doctors departed the island.

  As Lazear sat on the veranda that warm March night, he and the other men watched Reed with a sort of reverence. Not only Reed’s rank but his reputation impressed colleagues. He was twenty years Lazear’s senior, and a close friend of Welch and the surgeon general. Lazear also felt a sort of kinship in their work; they had worked in the camp lab often. Walter Reed even visited Jesse Lazear and his wife at their home in Cuba. “Mabel,” Lazear proclaimed, “I have another convert. Major Reed also believes the mosquito theory.”

  Lazear was enthusiastic about his work with yellow fever and the theory of Cuban physician Carlos Finlay, the scientist who had put forth a theory that the fever was spread by mosquitoes. Once the connection between malaria and mosquitoes was made, Finlay’s theory seemed all the more plausible to Lazear. Finlay was thrilled when Lazear approached him about his theory. Finlay was now in his sixties with long burnside whiskers. It had been twenty years since he first proposed his theory; the mad scientist would finally be given the chance to be taken seriously.

  As the sky grew plum colored, and the music had long since silenced, Reed sat with the other doctors on the veranda and talked about medicine. But most of all, they discussed yellow fever. Reed’s interest was tireless.

  When Reed finished his investigation of electrozone, he sailed back to the States to give his opinion of the disinfectant to Surgeon General Sternberg. Though Sternberg had sent Reed to Camp Columbia on orders to examine the disinfectant, it’s more likely that he wanted to pique Reed’s interest in yellow fever. It is not known whether Reed approached the surgeon general about a yellow fever study, or if Sternberg proposed the idea to Reed, but in the end, it was a moot point. In less than two months time, Reed would be on his way back to Camp Columbia.

  After Reed left Cuba, Lazear’s work continued as it had before. He spent his days in the hospital or lab and his nights at home with his wife, Mabel, and their one-year-old son, Houston.

  Jesse Lazear met Mabel in Europe, where they were both traveling with their mothers. Mabel was described as a young lady with expressive eyes and an intriguing introspective appearance. Like Lazear, she had a love of the outdoors, and at her family ranch in California, Lazear and Mabel had enjoyed trout fishing, hunting and climbing together. They married on September 8, 1896, in San Francisco when Lazear was thirty and Mabel was twenty-two years old. They settled in Baltimore, and Houston was born three years later. All three moved to Cuba the following year when Lazear joined the army as a contract surgeon. Considering the Victorian age, it is not unusual that there is no mention in any correspondence about the fact that Mabel was four months pregnant with their second child when they arrived in Havana.

  Lazear thrived during those first few months in Cuba. He wrote to his mother, “We were surprised to find Havana a most beautiful city, entirely unlike anything we had ever seen before. The color effects are charming—wonderful greens and pinks. There are numerous fine gardens with magnificent palms and flowers.”

  Lazear kept a ribbon-bound photo album of their stay in Cuba. The recent invention of the Kodak box camera allowed for the first time average people to take snapshots of their lives candidly, rather than posed formally in front of a photographer. In his album, Laze
ar pasted pictures of Cuban landscape, Havana street scenes and his family: Houston toddling through a grass field; Mabel, with the sea air blowing strands of her hair from its bun, holding Houston and a toy guitar on the beach. The last photo in the album is a loose-leaf one of Jesse Lazear. He sits on a wooden fence with mountains in the background. The snapshot is a striking difference from the posed, stiff photos of recent times. His posture is relaxed as he perches on the top board of the fence, his two feet balancing him. His arms rest on his legs, his hands folded one over the other in the middle. He is dressed casually with a cap tilted on his head while he smokes his pipe. There is a hint of a smile on his face. He looks content, happy even.

  Lazear’s living quarters were not quite what they were in Baltimore. He quickly wrote to his mother to unpack the boxes of golf clubs, books of Shakespeare, linen napkins and dishes. They need not be shipped. Much in the style of the other buildings at Camp Columbia, Lazear’s family quarters consisted of a two-room house made of wide, pine boards. A wooden bridge connected the two wings. In one house, Lazear and his wife lived; in the other, Houston and his nanny, Gertrude, slept. There was a roof and rafters, but no ceiling. There were shutters, but no glass windowpanes. A sloping roofline covered the walk-around porch.