by Black Death at the Golden Gate- The Race to Save America from the Bubonic Plague (retail) (epub)
The speed at which the disease traveled made it seem like the very air was infected. On September 7, one of the forty-five thousand soldiers stationed at Camp Devens, an Army training base on the outskirts of Boston, reported to the base’s hospital. Staff observed that the man seemed delirious and diagnosed him with meningitis, and he joined the approximately ninety other patients then under care at a hospital designed to hold up to 1,200. The next day, a dozen more soldiers appeared with the same symptoms. More and more sick men began appearing, prompting doctors to change their diagnosis to influenza. At the peak of the outbreak, 1,543 soldiers at the base fell ill in a single day. With so many doctors and workers sick that there was no one left to provide care, the hospital stopped accepting new patients, leaving soldiers to die in their barracks.
“These men start with what appears to be an ordinary attack of LaGrippe or Influenza, and when brought to the Hosp. they very rapidly develop the most vicious type of Pneumonia that has ever been seen. Two hours after admission they have the Mahogany spots over the cheek bones, and a few hours later you can begin to see the Cyanosis [a term for a patient turning blue from lack of oxygen],” wrote Roy Grist, a physician at the hospital. “It is only a matter of a few hours then until death comes . . . It is horrible. . . . We have been averaging about 100 deaths per day . . . For several days there were no coffins and the bodies piled up something fierce.”
By October, the Public Health Service was tracking thousands of deaths a week from the flu. Up to 40 percent of service members in the Army and Navy developed symptoms, crippling the nation’s ability to protect itself. Shipyards up and down the East Coast had to close for days at a time because there weren’t enough healthy workers. In San Antonio, 53 percent of the city’s population came down with the disease; in Philadelphia, twelve thousand people died within a six-week span. Families began to fear their relatives; neighbors saw in every cough the germs that would lead to their own deaths. Philadelphia’s head of emergency aid begged, “We simply must have more volunteer helpers . . . these people are almost all at the point of death.” In Kentucky a Red Cross official reported that there were “hundreds of cases . . . [of infected] people starving to death not from lack of food but because the well were panic stricken and would not go near the sick.” Victor Vaughn, the head of the Army’s communicable disease division, wrote in his diary that “If the epidemic continues its mathematical rate of acceleration, civilization could easily disappear . . . from the face of the earth within a matter of a few more weeks.”
Blue was slow to respond to the epidemic, wasting weeks as his officers tried to get samples of the bacterium from different areas of the country to see if it was the same strain that had caused widespread deaths in 1893. Unlike the plague, which could be tracked by the movement patterns of rats, the flu spread as if at random, frustrating any attempt to contain it. As the death toll rose, Blue continued to downplay the significance of the outbreak. In May of 1918, Congress had passed the Sedition Act, levying prison terms of up to twenty years for spreading information that interfered with the country’s war effort. Officers at all levels of government focused on maintaining the country’s morale while suppressing information that undercut Americans’ sense of safety. “There is no cause for alarm if precautions are observed,” Blue told reporters, though he knew otherwise. His few public instructions to combat the disease included reminders of the importance of washing hands with soap and water and avoiding crowded places, especially if one was already feeling ill. The advice made little impact, and over the last three months of 1918 more than four million Americans were infected with the disease, causing 400,000 fatalities and dropping the average American life span by twelve years. Among pregnant women, fatality rates ranged from 23 percent to 71 percent.
The third wave of the flu began in January of 1919. Among its victims was President Wilson, who collapsed while attending the Versailles Peace Conference. His fever climbed to 103 degrees and he suffered intense coughing fits, leaving him in such a weak and confused state that it was widely commented upon by other attendees. A young aide accompanying the president to Paris died after coming down with similar symptoms. Wilson struggled throughout the proceedings, and his diminished capacities were later seen as one of the reasons why the Treasury of Versailles, which ended the First World War, was so deeply flawed. The harsh penalties it imposed on Germany helped fuel Hitler’s rise to power.
Then, as quickly as the flu appeared, it vanished, its lethal power subdued as those who had been exposed to earlier waves developed immunity. The disease killed an estimated 675,000 Americans, ten times as many as died in the war. Between fifty and one hundred million people died worldwide, with the most deaths concentrated in areas far from medical care. In the Fiji Islands, 14 percent of the population died within sixteen days; in some areas of Alaska, entire villages developed the disease and perished within the span of a week.
Though it was impossible to ignore the failure of the Public Health Service to stop the disease, Blue assumed that the end of the pandemic would allow him to return to his primary mission of improving the nation’s sanitary conditions. His four-year term was scheduled to expire in 1920, and he wrote an eleven-page memorandum in March of 1919 outlining the goals he intended to accomplish over the next four years. Among other plans, he proposed to expand the so-called “pure milk” laws to require pasteurization nationwide, establish clinics for sick children and implement a form of national health insurance.
He had little inkling that politics would intervene. On the morning of October 2, President Wilson suffered a stroke that left him paralyzed on his left side and blind in his right eye. Wilson’s wife, Edith, conspired with his personal physician, Dr. Cary T. Grayson, to hide the president’s condition from the country for the remainder of his term. With Edith Wilson effectively serving as the nation’s chief executive, the Wilson administration leaned heavily on trusted allies in Washington. Treasury Secretary Carter Glass soon began lobbying to replace Blue with Hugh Cummings, a twenty-five-year veteran of the Public Health Service who hailed from Glass’s home state of Virginia and who carried none of the baggage from the poor treatment of returning veterans or the country’s ill-equipped response to the flu. Edith Wilson offered no objections and signed off on the plan.
Blue thus became the first Surgeon General in the country’s history who was involuntary removed from office. Not knowing what else to do with his life at the age of fifty-two, he accepted a demotion and continued to serve in a lower role, all the while growing increasingly bitter. Eager to keep his deposed rival away from power, Glass sent Blue on a series of assignments in Europe which kept him outside the U.S. for several years. Blue’s work in bringing modern sanitation methods to France earned him the Legion of Honor in 1923, fulfilling a dream that he had nursed as a child on the cotton fields of South Carolina. “You will recall that as a boy I admired the First Napoleon perhaps more than any other figure in history, and that I never tired of reading his life and of his deeds as a soldier and as a statesman,” he wrote in a letter to his sister Kate after receiving the award. “I never thought then that I would ever receive, much less deserve, the decoration which he bestowed upon his officers and men . . . I wear the ribbon in the lapels of all my coats.”
Though it helped restore his self-worth, the award was not enough to soothe the resentment that had built up toward not only his replacement but other men in the Service whom he considered disloyal. Blue began drinking heavily and was known to start listing all the slights and sins he had suffered, calling his rivals “snakes” and “damned skunks.” One night, he turned his wrath on Rucker, who had served next to him in San Francisco and New Orleans faithfully, calling him a “God-dam apostate.” The insult stung Rucker and they did not speak again for years.
At an age when many men were considering retirement, Blue felt alone. He had long ago accepted that he would remain single for his entire life, without a family of his own to turn to. Yet the Service had al
ways provided him something that he had ached for as a boy: a purpose. Now that too was gone, and there seemed to be nothing left to redeem him.
CHAPTER 18
A HERO ONCE MORE
On October 2, 1924, a physician named Giles Porter pulled up outside a small home at 700 Clara Street, a few blocks away from the Los Angeles River. The sun hung high overhead in the empty blue sky, giving no indication that autumn was approaching. The city’s obliviousness to the changing of the seasons was a large part of what had drawn more than a million new residents to Los Angeles over the last two decades, creating what was at the time the nation’s fifth-largest metropolis with a sprawl of broad streets lined with young palm trees.
Clara Street belonged to an older, poorer Los Angeles. Less than half a mile away stood the Los Angeles Plaza, the site where the city had been officially founded in 1781 as little more than a trading post amid the empty valleys of Southern California. The neighborhood remained rooted in its Spanish past even as the city changed around it. Well-to-do white immigrants fleeing the harsh winters of the East Coast settled first in English-speaking districts to the west of nearby Union Station, the region’s chief link with the rest of the country, and expanded outward from there, filling in some of the nation’s first suburbs.
What remained in the neighborhood surrounding Clara Street were the remnants of a forgotten era that had not yet been wiped away. Olvera, one of the oldest streets in the city, was less than a ten-minute walk away, and along its muddy alleyway stood the Avila Adobe, built by one of the first Mexican mayors of Los Angeles when it was a village home to fewer than five hundred people. The building, which had served as headquarters for Commodore Robert Stockton and General Stephen W. Kearny when they captured the city during the Mexican American War, was now run down and dilapidated, buffeted on all sides by machine shops and grime. Tracks leading into Union Station were close enough that passing trains rattled dishes and forced a temporary pause in conversation, the future once again imposing itself upon the past.
As he got out of the car, Porter could see downtown Los Angeles rising behind him, where workers were clearing a lot on Spring Street in advance of the construction of a new thirty-two-story City Hall that when completed, would be topped by a soaring white tower jutting into the sky like a monument to progress. He walked up to the door and knocked, not sure of what he would find. Inside, Jesús Lajun lay suffering from what appeared to be the flu. A laborer for the Los Angeles streetcar system, Lajun had missed the last few days of work with a high fever, and swollen lymph nodes along his thighs and groin made it difficult for him to move. His fifteen-year-old daughter, Francisca, lay nearby, overcome by what appeared to be the same virus. Porter saw nothing remarkable about their condition and told them to rest, leaving the home not long after he had entered it.
Francisca’s symptoms worsened the next day. A thirty-nine-year-old neighbor named Luciana Samarano, then six months pregnant, offered to stay at the house to care for her until she recovered. The girl’s fever seemed immune to any remedy, prompting Jesús Lajun to call for an ambulance on October 4. Francisca died on the way to the hospital, due to what doctors on call listed as double pneumonia. Jesús, still ill, remained at home, where his fever continued to climb. He died one week after his daughter from what doctors said was pneumonia.
Over the following days, others on Clara Street came down with what seemed to be a particularly lethal form of the disease. A physician by the name of George Stevens called Los Angeles General Hospital to report that he had cared for several patients in the neighborhood who all complained of chest pains, backache, fever and a deep, hacking cough. The quick onset of symptoms was like no form of pneumonia that he had seen before, he warned hospital staff, leaving him puzzled as to whether it might be a different, more deadly illness.
Ten days after she cared for the dying girl in the Lajun household, Luciana Samarano fell ill. She sequestered herself in a back room at 742 Clara Street, a small single-story house that she shared with her family and a few boarders, and hoped that the illness would pass. On October 19, she suffered a miscarriage and died a few hours later, having never broken her fever. Doctors who arrived to issue a death certificate saw nothing unusual and allowed the body to remain in the home, where the Samarano family held a funeral service before burial.
Soon other members of her family became sick, as if they were the next ones standing in a line of dominoes. Her husband, Guadalupe Samarano, developed a fever in the days following Luciana’s funeral and quickly deteriorated. His weakened condition prompted his family to call a priest, Father Medrano Brualla from Our Lady Queen of Angels Church, to administer last rites before an ambulance arrived and took him to General Hospital. He died the same afternoon and his body was released to his family, who once again held a funeral service at home.
In the following days, nearly everyone who had attended the funeral fell ill. Father Brualla, who spoke at both funerals, was rushed to General Hospital where he died before doctors could stabilize him. The four Samarano brothers, ranging in age from ten-year-old Roberto to eighteen-month-old Raúl, arrived at the same hospital after developing the same high fever and deep, painful cough that had killed their parents.
Fearing an outbreak of meningitis, doctors took tissue samples not only from the Samarano boys but from dozens of other patients who began appearing at the hospital with the same symptoms, all of them arriving from within the blocks of Clara Street. Dr. George Maner, the hospital pathologist, joked with a colleague that this was what an outbreak of plague must look like. He then peered through a microscope at a biopsy taken from Roberto Samarano’s body and discovered that it was teeming with pneumonic plague, the most virulent form of the disease. He stood up, white-faced, and asked a doctor nearby to take a look, though there was no need. The distinctive rod-shaped bacilli were obvious, a part of the rudimentary training in bacteriology that every doctor now received. Suddenly the wave of deaths made sense and pointed to an inescapable conclusion: after more than a decade in remission, plague had returned to kill again.
Over the next several hours, the assistant superintendent of the hospital sent telegrams to federal and state officials and medical supply dealers throughout the state, asking if any doses of plague serum were available. The request piqued the interest of Benjamin Brown, a Public Health Service surgeon stationed in Los Angeles, who arrived unannounced at General Hospital and quickly confirmed his suspicions. He wired Surgeon General Cummings in code that afternoon, noting “Eighteen cases ekkil [pneumonic plague]. Three suspects. Ten begs [deaths]. Ethos [situation bad]. Recommend federal aid.”
Police began stringing rope around the eight blocks surrounding Macy Street, the nearest main thoroughfare to Clara Street, shortly after one on the morning of November 2. Approximately 2,500 residents, the vast majority of them Mexican American, were sealed into quarantine. Seven-day rations were given to each household while health officers accompanied by a Spanish-speaking interpreter began a house-to-house inspection in search of additional carriers of the disease. Anyone who lived in the same building as a known plague victim was taken to General Hospital as a precaution, cloistering 114 potential cases in a handful of rooms.
Those who remained in the district were told to wear thick clothing at all times and urged to clean their homes as thoroughly as they could. Policemen patrolled the edges of the district, preventing anyone from entering or leaving. Shortly after sunrise, Nora Sterry, the white principal of an elementary school in the neighborhood, was turned away. “They can’t keep me out,” she vowed to reporters who had gathered at the quarantine lines. “All my children are in there. And, if you see the flag waving from the mast in the Macy Street schoolyard tomorrow morning, you will know I am there.” Indeed, the flag rose the next morning. Sterry, with the help of two missionaries, turned the school’s cafeteria into a relief station, cooking food for families whose rations were already running low.
Fear of the disease spread throughout the c
ity, fueled in part by the refusal of the press to confirm or deny its presence. The Los Angeles Times, the dominant newspaper in the city—which considered boosting Southern California as a land of sunshine and happiness its most important function—waited until the sixth day of the quarantine to identify the disease as plague, which it insisted was only “the technical term for the malignant pneumonia appearing in a small area of the Mexican quarter.” Others in the city acted more quickly. The newly opened Biltmore Hotel, then the largest hotel west of Chicago, fired all of the 150 Latino workers on its staff regardless of whether they lived near the infected district. Walter Dickie, the secretary of the state Board of Health, urged the city and the Chamber of Commerce to “insist that all of that area where Mexicans live is put in sanitary condition and undoubtedly there is a great deal of that area that ought to be condemned and destroyed.” Four other predominantly Latino neighborhoods were soon placed under quarantine, though no new victims had been found.
By the middle of November forty people were dead from plague, all of them in some way connected to Luciana Samarano. The trail of victims included her mother, sister, uncle, husband, three of her sons, her stepmother, a stepbrother, four friends, five cousins, six boarders, a nurse who treated her, the nurse’s sister, the priest who administered last rites to her husband, the ambulance driver who drove her husband to the hospital and a neighbor. They died within a span of two weeks, their burials proceeding like a grim parade. All had died after developing the pneumonic form of the disease, which can be spread merely by a cough. Hoping to forestall a wider epidemic, health officials burned down the Samarano home and every other residence that had harbored the victims. Then they waited, hoping that no new cases would emerge.