by Deborah Blum
Yet the influenza continued to spread. Private hospitals, with every bed full, turned people away daily. Public hospitals, like Bellevue, lacked that option, but so many doctors and nurses fell ill that the trustees debated closing the hospital. Rooms overflowed; cots were crammed into the halls; when the hospital ran out of rooms, staffers took doors off their hinges and used them for dividers. In the pediatric ward, children were crammed three to a bed. Deaths averaged ten a day at Bellevue; some days they totaled more than fifty. “It got to the place where I would only see patients twice,” one intern recalled. “Once when they came in—and again when I signed the death certificate.”
Norris’s staff was doing little but processing influenza cases, desperately trying to record influenza deaths, keep correct numbers, save blood samples, and note deaths due to other causes. As Norris wrote to the mayor, the hospital’s regular staff was so busy trying to save a few of the sick that “they were unable to furnish death certificates to the unfortunate relatives or friends.” Everyone, from physicians to chemists, was pressed into the hated job of churning out the certificates. At the same time Norris was trying to protect his beleaguered staff from being sent to war. The Selective Service had gone into effect in mid-September. The war department had set draft age at 18 to 45, which meant that eight of Norris’s eleven doctors were eligible.
“Should any of our men be drawn away in the draft, it will be next to impossible to obtain physicians of training in pathology and pathological work in general who could take their place and we cannot get along with a smaller number of physicians,” Norris wrote urgently to the army, pointing out that the previous year, his office had handled more than twelve thousand cases, and that had been before the epidemic. “We cannot do the important work which the office must perform” with fewer men.
In particular, Norris wanted to keep his thirty-four-year-old toxicologist from being called up. He wrote another letter, pleasant in tone, edged with an underlying threat. Gettler had done several examinations of “poisons and drugs removed from the clothes of soldiers” in the past year. In fact, the toxicologist “comes in touch with the soldiers and sailors who die within city limits and there have been a considerable number of cases which we have had to handle delicately, and I’m happy to say that were are on the most friendly working basis with the various services of the government.”
Norris hoped to keep it that way; no one would enjoy publicizing reports concerning drunken soldiers (such as the one who had recently fallen off a subway platform just as the train arrived) or the several sailors poisoned by wood alcohol. His files contained records of both. The letter turned out to be very convincing or, some might say, an effective kind of blackmail. Either description worked—Norris didn’t care. The point was that he got to keep his very necessary chemist, doing his very necessary job.
IN GETTLER’S laboratory, the wooden floorboards were already discolored by chemical drips and sizzles. The white plaster walls were smudged gray by smoke and fumes, and the stone counters were crowded with glass bottles and flasks and dishes of discolored liver samples.
In this room, where the background music was the sizzle of gas burners, the snakelike hiss of distillation, and the bubbling of flasks over flames, poison defined the world outside. To others, the warm glow of a gas-lit window might signify a family evening at home. But here chemists tested blood and tissue for the carbon monoxide that fed those lamps. They worried about the strychnine used in medicinal tonics, the cyanide used in photographic processing, and the arsenic packed into rat baits. As they all knew, here in the third-floor laboratory, the most ordinary of household supplies could be used to kill; in the first month of 1919, Gettler had determined that a thirteen-year-old girl had poisoned a baby simply by using Lysol to clean its bottle.
So it was that as Prohibition moved toward reality—Wyoming had become the thirty-sixth state to ratify the amendment on January 16, 1919—Gettler and his small staff returned to the idea that wood alcohol was about to increase in popularity. The Eighteenth Amendment, now that it had attained full ratification, was scheduled to go into effect in 1920. Already, though, the medical examiner’s office was charting a rise in alcohol poisoning, as New Yorkers hurried to find alternative supplies.
By the late fall of 1919 more than sixty people in the city had died from drinking wood alcohol and another hundred had been blinded. The same pattern played out across the country: 70 wood alcohol deaths in the Connecticut Valley, 9 in Chicago, 15 in Cleveland, and 3 in Memphis; 12 cases of blindness in Denver; and so on. But the official reports underestimated the totals, Norris warned. Many doctors still didn’t know how to detect a wood alcohol death—the chemical procedures were still incomplete.
His department hoped to change that.
“DURING THE YEARS 1918 and 1919, I have had occasion to examine over 700 human organs for alcohol,” Gettler wrote, in a paper explaining detection of wood alcohol in human tissue. In preparation for the expected deluge of poisoning cases, Gettler—already showing his perfectionist nature—had evaluated fifty-eight different methods for identifying wood alcohol, both in tissue and in the so-called whiskey itself.
He compared the tests’ effectiveness on “eight typical good grain whiskies,” then on alcoholic cider and five confiscated samples of wood alcohol. He tested them on another five cocktails made by mixing wood alcohol with water: each time he increased the amount of water, diluting the alcohol and making it more difficult to detect.
He then evaluated methods of detecting wood alcohol in human organs. His favorite method involved grinding up a chunk of tissue—500 grams, about the size and weight of a roll of nickels—and putting the pinkish ooze into a flask with a drop of mineral oil (to prevent frothing). He then steamed his ooze by putting the flask in a boiling water bath, which turned it into a dark sludge. He mixed the sludge with acid and allowed it to cool. If he then stirred an unstable, reactive oxygen compound into the sludge—say, a fizzy salt like potassium dichromate—and reheated the flask, the ever-active oxygen triggered a further breakdown of the alcohol inside. Formaldehyde would come bubbling out. Most alcohols produced only a trace of formaldehyde, but wood alcohol released an overpowering amount—stinging, poisonous, and unmistakable.
Testing a bottle of spirits involved a similarly elaborate process of distillation and oxidation. But Gettler recognized that for inspectors in the field, who needed to do a quick test in a saloon, lugging around a distillation apparatus was awkward, not to say impossible. The on-the-road alternative was to heat a copper coil to red hot and plunge the glowing metal into the alcohol. The heated metal would cause wood alcohol to interact with oxygen in the air—a different kind of oxidation—and release a nose-stinging whiff of formaldehyde.
An inspector had to be willing to risk numbing his sense of smell to conduct the portable test, and the copper wire results were reliable only if the bottle contained a high percentage of wood alcohol, a good 40 proof (i.e., 20 percent) or more. If the wood alcohol was dilute, perhaps used just to spice up other ingredients, “it is extremely difficult, even impossible, for many people to detect the presence of methyl [wood] alcohol,” Gettler wrote. “I have tried this experiment on many individuals, using the same liquor, and found that some said methyl alcohol was present, others believed it to be absent, and still others were undecided.”
Gettler wasn’t fazed by that challenge. When had the detection of poison ever been easy?
THE BLOODY, poisonous, horrible war was finally over—an armistice was signed in 1918, and the official treaty of surrender was concluded at Versailles in 1919. Parades, celebrations, and parties reigned in New York as the troops came spilling off ships.
But Mayor Hylan was not in a celebratory mood. He wrote to Norris and other department heads that diligent city employees should not become overly festive: “My attention has been called to the fact that when transports with returning troops are passing up the river, great quantities of torn papers are thrown . . . City e
mployees should be sufficiently well informed to know that such acts are in violation of the ordinances, and cause additional work and expense to the City, not only in the cleaning up of this illegal litter, but in the waste of paper. Will you kindly issue instructions forbidding this practice?”
And by the way, department heads should stop asking for money to improve their departments. Norris, he’d found, was a particular pest. As Hylan informed his medical examiner, “It is impossible for an official to do any constructive work if he is to be constantly annoyed in this manner.”
Norris ignored his complaints. In December, Hylan wrote again to Norris, begging him to stop lobbying for a larger staff. If Norris would give up “playing politics, that is endeavoring to fill positions,” the medical examiner would find that he had extra time to work on improving his department from within. But the mayor acknowledged in the same letter that he’d been telling Norris this for two years; he had no real expectation of his advice being taken.
Norris, naturally, continued to demand that larger staff. Meanwhile he and Gettler decided to launch a campaign alerting residents of “the liquor capitol of the country” to the dangers of wood alcohol. “We have found what apparently is an increased number of cases of methyl alcohol, as shown by chemical examination of the viscera,” Norris wrote to the health department. “This would indicate that the alcohol sold all over the city contains methyl alcohol in dangerous amounts.”
In December there had been forty-two wood alcohol deaths in Manhattan and another nine in the surrounding boroughs; more than a hundred new cases of alcohol-related blindness had also been reported. The National Committee for the Prevention of Blindness, which kept its headquarters on Manhattan’s Upper West Side, pointed out that this pattern was repeating across the country. Nearly a thousand people nationwide had recently lost their eyesight due to wood alcohol poisoning. Doctors attributed the blindness to the destructive effect of formic acid on the optic nerves.
As the month wound down, as the official Prohibition date got closer, Norris, Gettler, the city health commissioner, the head of the New York Academy of Medicine, and the Committee for Blindness Prevention held a press conference urging the city to prevent the sale and distribution of wood alcohol and all other forms of methyl alcohol. “One teaspoon of wood alcohol is enough to cause blindness,” Norris warned. And drinking a tumbler of the stuff could kill a man within a few hours.
Gettler, Norris, and their comrades unanimously predicted that Prohibition, rather than making alcohol disappear, would instead create “numerous harmful substitutes for whiskey.” They made the prediction in December 1919, too early to say whether they would be proved right or whether they were just expressing the dark perspective that came from too many hours of working in Bellevue’s pathology building.
THREE
CYANIDES (HCN, KCN, NaCN) 1920–1922
COCKTAIL PARTIES sparkled defiantly through the last chime of the day, to the dreaded first minute of January 20, 1920. With morning would come the official start of Prohibition, so the revelers danced through the night in black-draped rooms featuring open coffins to collect empty bottles. In Times Square, crowds gathered to mourn the stroke of midnight. The dancers and the mourners were shiny in party clothes, somber in mock funeral wear, dressed up with black top hats and smoke-fine veils, just as drunk as they could be. Some stayed into the morning, crowding along Broadway with their whiskey-fed protests. Others slipped away to continue the festivities in private.
It was easy enough to keep the party going. As soon as legal drinking ended, purveyors of illicit alcohol came helpfully forward. As Gettler had predicted, they offered some devastatingly lethal brews. That January poison alcohol deaths rippled across the country: eight in New York City, four dead in a single day in Hartford, two in Toledo, seven in Washington, D.C. Soon the police discovered that murderers had learned to take advantage. In a typical case, barely a month after Prohibition, two men were found dead in Newark, several hours after buying liquor at a Bowery joint. They were thought to be alcohol deaths until a standard chemical analysis of the bodies found they were loaded with potassium cyanide. The killer, whoever he was, was long gone.
Within a year, the once openly rowdy saloons had given way to secretive speakeasies and to bootleggers who would sneak gin to one’s door at a delivery rate of two dollars a bottle. “The speakeasies are a remarkable feature of the new American life,” wrote one fascinated British visitor.
Every time you go for a drink there is adventure. I suppose it adds to one’s pleasure to change into a pirate or a dark character entering a smuggler’s cave. You go to locked and chained doors. Eyes are considering you through peepholes in the wooden walls . . . You sign your name in a book and receive a mysterious-looking card with only a number on it. And you are admitted to a back-parlour bar with a long row of loquacious drinkers. There may be a red signal light which can be operated from the door in case of a revenue officer or police demanding entrance.
When the light flashed over the front door, the patrons fled out the back.
By summer’s end, a bare half-year into the new amendment, New York officials were already worrying about enforcement. In August a Brooklyn magistrate presided over the trial of a burglar who had broken into a supposedly closed saloon and spent a night guzzling its gin supplies. The judge vented his frustration: “Prohibition is a joke. It has deprived the poor workingman of his beer and it has flooded the country with rat poison.” Police department chemists, analyzing the so-called gin in the Brooklyn bar and around the city, reported that much of it was industrial alcohol, redistilled to try to remove the wood alcohol content. The redistilling was not notably successful. The poisonous alcohol remained, and there was more: the chemists had detected traces of kerosene and mercury and disinfectants, including Lysol and carbolic acid, in the beverages. “Drinkers are taking long chances on their health,” warned the police commissioner, “if not their lives.”
BUT FOR THE new speakeasy devotees, the risk was part of the fun. Sometimes it was all the fun. It was amusing and exotic, as the British writer noted, to spend time in the dim light and hot jazz of some hidden corner, to experiment with the strange liquids that appeared at the table. Another groggy patron wrote, about a night of clubbing: the bartender “brought me some Benedictine and the bottle was right. But the liqueur was curious—transparent at the top of the glass, yellowish in the middle and brown at the base . . . Oh, what dreams seemed to result from drinking it . . . That is the bane of speakeasy life. You ring up your friend the next morning to find out whether he is still alive.”
At the underground clubs, inventive bartenders enjoyed new respect for disguising the taste of the day’s alcohol. They created a new generation of cocktails heavy on fruit juices and liqueurs to mix with the bathtub gin, bright and spicy additions to cover the raw sting of the spirits. There was the Bennett Cocktail (gin, lime juice, bitters), the Bee’s Knees (gin, honey, lemon juice), the Gin Fizz (gin, lemon juice, sugar, seltzer water), and the Southside (lemon juice, sugar syrup, mint leaves, gin, seltzer water).
At least, those were the kind of drinks served at the city’s classier joints—say Jack and Charlie’s 21, on 52nd Street. Or Belle Guinan’s El Fay Club on West 45th, where the hostess gleamed like a candelabrum and the house band played “The Prisoner’s Song” when dry agents were spotted in the crowd. Down in the Bowery, as the police could tell you, the drink of choice was a cloudy cocktail called Smoke, made by mixing water and fuel alcohol. Smoke joints were tucked into the back of paint stores, drugstores, and markets, among the dry goods and the stacked cans. The drink was blessedly cheap—fifteen cents a glass—and just about pure methyl alcohol.
In a bad season, Smoke deaths in the Bowery averaged one a day. Government agents trying to hunt down suppliers of the poor man’s cocktail swore that it was served right from cans stenciled with the word POISON—and that people didn’t care. They just gambled that it wouldn’t kill them and drank it anyway.
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AS DEMANDS for chemical analysis intensified, Norris was infuriated that the Hylan administration remained so stingy regarding his department. The mayor restricted funds every year, as if still holding on to his initial grudge.
In 1922, as Norris noted in yet another letter to the mayor, he had only forty-one employees in his office (compared to sixty-two under Riordan). Annual pay for the doctors working under him averaged less than $4,000 a year. Chemists didn’t even get that—by pestering the mayor constantly, he’d finally managed to get Gettler’s salary above $3,000 annually.
His own yearly salary was only $6,000; as Norris pointed out, none of the staff got the kind of incomes enjoyed under the old coroner system. But he was angrier still about the lack of basic support for the department as a whole. All new equipment purchased in 1921 had been paid for by Norris himself or by his staff: every test tube, every scalpel, a new scale to weigh tissue samples, a small brass microscope to study tissue damage. All of it. Gettler was dipping into his less-than-generous salary to buy extra chemical supplies and the weekly allotment of raw liver for his experiments.
The medical examiner’s office could not possibly do its best work, Norris said, when the city officials failed to recognize the “well known fact that guilt or innocence may rest entirely on the chemical and biological analyses” of evidence at a crime scene. And if anyone doubted that premise, it was about to be painfully proven in a beautiful little hotel in Brooklyn.