Arriving at the tail
end of WWI, the so-called "Spanish" Flu (or the H1N1
virus) traveled with returning
soldiers to every inhabited continent. Doctors and nurses
worked tirelessly to care for their patients, sometimes forgetting to sleep or
eat. Thousands of medical workers
expired on the front lines of the fight against the
disease.
The fatal strain
of influenza may have originated in the United States, France, or the
United Kingdom. The countries were in the midst of fighting WWI, so
their governments downplayed the outbreak in
the name of keeping up morale. Because Spain was neutral in the
war, Spanish newspapers were free to report about the pandemic. Thus, the
disease became known as the “Spanish” Flu. Before it was over, at least 50 million people
had lost their lives. It was the worst pandemic of the 20th century.
Despite
the shortage of official reporting, photographs from that time
period and chilling quotes from health workers can help
us understand what life was like during the 1918 pandemic.
"It Seemed As If It Would
Not Be Possible To Get Coffins For The Dead"
In June of 1918,
influenza began wreaking havoc on the city of Manchester. The city’s Medical
Officer of Health, Dr. James Niven,
said that:
The distress was
prolonged, so that it was realized that a real calamity had befallen the city.
Mothers and fathers were often stricken together. The children, themselves ill,
could not receive attention, and for a time it seemed as if it would not be
possible to get coffins for the dead, or gravediggers to dig the graves.
Manchester wasn’t the
only place with a coffin crisis. In some places, whole towns ran out of
wood to make coffins. In one case, a city's health official decided to steal a load of coffins from
a passing train. Dr. Niven described the effect of the shortage on
his city:
Great difficulty
occurred in getting the dead buried at the height of the epidemic, partly
because of the lack of grave diggers, partly because of the difficulty in
getting coffins. Bodies were left as long as a fortnight unburied, partly at
home, partly at the public mortuaries, and partly at the premises of
undertakers.
"We Don't Care A Rap What
The Owners Of The Building Think About [The Quarantine]"
During the height of
the outbreak in the United States, public health measures varied drastically
from city to city. Spokane’s public health officer, Dr. John Anderson,
imposed some of the strictest regulations in the country,
including closing public places, requiring everyone to wear masks, and
arresting people who initiated social gatherings.
Dr. Anderson plowed
forward with plans to turn a local hotel into a hospital, even when the
hotel owners refused to cooperate:
We don’t care a rap
what the owners of the building think about it or about us… We don’t propose to
haggle with them over it. This is a very serious emergency and if the owners of
the Lion Hotel think they can put a dollar in one side of the scale and a human
life in the other and get away with it they are very, very badly
mistaken.
Anderson believed in
protecting his city at all costs. As the body count rose, he continued to
take drastic measures, regardless of public opinion. He told a local newspaper:
It is just as
necessary to concentrate responsibility and authority in one man here as on the
battlefield. Perhaps more so, for the soldier fights a visible foe while the
health authorities and the physician are combating an invisible enemy… It is
prompt action which saves the day, and we know it as never before after this
epidemic.
"We Would Put Winding
Sheets On Them Even If They Weren't Dead"
After graduating
nursing school, Josie Mabel Brown moved to Great Lakes Naval Hospital. As
she settled into her first nursing job, influenza cases began to overwhelm the
staff and resources of her hospital. The pain of her first placement stayed
with her the rest of her life. Since there were twice as many sick men as
beds, she had to wrap soldiers for burial before they
passed:
As the boys were
brought in we would put winding sheets on them even if they weren't dead. You
would always leave the left big toe exposed and tag it with the boy's name
ran[k], and next of kin.
"The Dead Bodies Are
Stacked... Like Cord Wood"
The first wave of flu
hit armies in Europe right at the end of WWI. More soldiers succumbed to the disease than in
combat. Medical personnel, like Victor C. Vaughan,
despaired at the scale of the crisis:
I see hundreds of
young, stalwart men in the uniform of their country coming into the wards of
the hospital in groups of ten or more... They are placed on the cots until
every bed is full and yet others crowd in. The faces soon wear a bluish cast; a
distressing cough brings up the blood-stained sputum. In the morning the dead
bodies are stacked about the morgue like cord wood.
"I Wonder Whether We Can
... Control The Hysterical Desire ... To Get Into Nursing"
When the first
outbreak of influenza hit the United States in 1918, thousands of professional
nurses were abroad serving with the army. This led to a massive shortage
of healthcare workers in the US. To respond to the crisis, cities began
recruiting nurse volunteers through short-term training programs. Clara Noyes, the
head of the American Red Cross Nursing Service, noted:
There are moments when
I wonder whether we can stem the tide and control the hysterical desire on the
part of thousands, literally thousands, to get into nursing.
Registered nurses,
like Noyes, had spent decades demanding respect and fair pay for nursing
professionals. Noyes despaired that the rise of volunteer nurses might
damage their hard work: “[T]he most vital thing in the life of our
profession is the protection of the use of the word nurse.”
"The Nurse Developed A Lung
Infection, Dying Soon After The Woman She Had Been Nursing"
During the peak of
the pandemic, hospitals did not have enough space to adequately
distance beds or enough equipment to keep medical personnel safe. As a
result, thousands of nurses perished while in service.
Basil Hood, the
medical superintendent of St. Marylebone Infirmary, mourned his diminishing
staff:
Each day the
difficulties became more pronounced as the patients increased and the nurses
decreased, going down like ninepins themselves... Sad to relate some of these
gallant girls lost their lives in this never-to-be-forgotten scourge and as I
write I can see some of them now literally fighting to save their friends then
going down and dying themselves.
Dr.
Hood described how one nurse was so dedicated to her patient that she
refused to rest. He said, “She was consumed with a burning desire to save her …
inevitably, the nurse developed a lung infection, dying soon after the woman
she had been nursing.”
“Porters Went To Fetch [A
Patient] With A Wheelbarrow Because There Was No Other Transport
Available."
During the pandemic,
hospitals lacked sufficient supplies to care for their patients. Medical
workers had to make due with whatever was available. For example, one nurse in
Christchurch, New Zealand, described her harrowing experience moving a
patient in a wheelbarrow:
The wife was taken
back to her hotel, but nobody knew where it was. The husband was admitted to my
ward. He was very delirious, singing hymns one minute, cursing the next. He got
out when no one was looking and, in his nightshirt… The porters went to fetch
him with a wheelbarrow because there was no other transport available. He died
later that same day.
The nurse goes on to
explain that this couple was on their honeymoon. The H1N1 virus was
particularly fatal for young people between the ages of 20-40.
Medical workers watched patients expire right as their lives were supposed
to begin.
“We Thought She Had Black
Stockings On, Until We Discovered It Was Dirt!”
In the midst of all
the tragedy, healthcare workers had to maintain both grit and fortitude to
treat all their patients with dignity. A volunteer nurse named Dorothy Hoben remembered
that:
One night the
ambulance men brought in a fat old woman who must have weighed at least sixteen
stone and was incredibly dirty. We thought she had black stockings on, until we
discovered it was dirt! … She was so very, very ill. At least the poor old soul
died clean.
“He Just Couldn’t Accept That
He Hadn’t Died, And Became So Deranged... He Was Removed To A Mental Hospital.”
In some cases, the
mental stress of the pandemic led to mental breakdowns. Jean Forrester, a
member of an ambulance brigade, reported of one patient:
[He] was delirious
and kept asking if it was four o’clock, as he was going to die then. Four
o’clock came and went, but he did not die. He just couldn’t accept that he
hadn’t died, and became so deranged in his ravings that he was removed to a
mental hospital.
This case was not an
isolated anomaly. New York City’s Health Department Chief reported that in some
influenza patients “intense and protracted prostration led to hysteria, melancholia, and insanity with suicidal
intent."
A Live Woman Was Found In Bed
With Her Dead Husband “Driven Out Of Her Mind.”
While in some
patients the virus brought on delirium and self-destructive behavior,
others faced mental breakdowns due to the stress of the pandemic itself. The
pandemic spurred despair and anxiety, even in healthy people who never
caught the virus. For example, while on a house call, Maurice O’Callaghan of
the St. John Ambulance Brigade, found a woman in bed with her deceased
husband:
We found a man who
had been dead three days. His body was in the bed, and his wife was lying in
the same bed, not dead but driven out of her mind with a dead husband and could
not get up.
A WWI Veteran Said Working As A
Flu Nurse Was Worse Than Losing His Arm In Battle
One night,
as Ivy Landreth was volunteering as a nurse in New Zealand, a sick man
ended his life by cutting his throat. Her brother had to take care of the
body. She recalled her brother,
a WWI veteran, saying that working in the hospital was worse than going to
battle:
He had never
experienced anything so bad all the time he was at the war, in spite of the
fact that he had lost his left arm at Passchendaele.
Some call the
generation that came of age during WWI and the Spanish Flu "the Lost
Generation," because so many young people lost their lives. Many
soldiers and nurses who survived the war, passed soon after from
influenza.
The St. Louis Health
Commissioner Refused To Ease Social Distancing Measures, Telling The Mayor “You
CAN’T Do It” And “I WON’T.”
During the 1918
influenza pandemic, the health commissioner of St. Louis, Dr. Max C. Starkloff, closed
all non-essential businesses (including schools, churches, parks, saloons, and
dance halls) and banned gatherings. He knew that St. Louis citizens
were not happy about the drastic measures: “I looked into my waiting room
(the next day) and it was black with people protesting the order...”
Even the Mayor
objected, telling the commissioner that he had “overdone it.” When the
Mayor asked Starkloff to lift the rules, Starkloff stood firm. “Mr. Mayor,
you CAN’T do it,” Starkloff said, “and I WON’T.”
Dr. Starkloff’s
leadership paid off. A 2006 study concluded that St.
Louis lowered the impact of the virus more successfully than any
other large city in the US.
Patients Were “As Blue As
Huckleberries”
At first, it was
difficult for doctors to differentiate between H1N1 and the conventional
flu. Patients developed flu-like symptoms,
including fever, nausea, and aches. However, in more severe cases patients
developed dark spots on their skin and severe pneumonia.
Dr. Albert Lamb from
a New York City hospital described watching his patients suffocate as their
lungs filled with fluid:
On admission, nearly
all of the cases were as blue as huckleberries… Most of them died… We had to
stand by helpless except for what temporary relief we could give.
“We Worked Day And Night,
Hardly Taking Time To Eat”
Throughout the
pandemic, nurses, doctors, and public health officials worked tirelessly to
save lives. One nurse from Michigan, Annie Conlon, described
her experience working on the front lines:
We had a terrible
time in this country (Luce County, Michigan), losing 100 persons, or one person
out of 50… I worked with Dr. Perry, our health officer, going to the logging
camps in the hospital, in the homes, wherever the need was greatest at the
time. We worked day and night, hardly taking time to eat.
Annie’s story reminds
us of the heroism of healthcare workers, past and present
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