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Surviving the Blue Killer, 1918


ISSUE:  Spring 1998

It was not only mistaken but thoughtless, Mother would say ever afterward, for The Baby’s death to be remembered as the town’s first of the 1918 influenza pandemic. That sadness occurred on February 6, which was early for even the opening and mildest of the plague’s three waves; the second was the one that counted most and did not strike till late summer, she would remind you. And anyway, Mother would insist, flu had nothing to do with the death: she knew when each of her other four sons arrived, kicking and hollering, that he was ready for whatever the world might offer, and she knew just as well that The Baby’s life was never in her hands, but the Lord’s.

And it made no difference whatsoever, Mother would add, that when The Baby went into seizures young Dr. Melvin Thompson was up in the tobacco end of the county, giving medicine for a sweep of fever through a neighborhood of “free-issue” farmers, never slaves but land-owners, known for no traceable reason as Texans: one of the South’s many collections of indefinable people of color. It was of no consequence, she would go on, that old Dr. Aubery McEachern had to be summoned and arrived too late, breathing paragoric through his yellow whiskers and mumbling instructions to the sturdy horse pulling his buggy, he having returned his copperhead Ford car to its blocks when winter set in.

The truth is, Mother wanted no connection in anybody’s memory with her experience and the Texans’ flu-like sickness.

It was raining the day The Baby died and raining harder the next, when the funeral was conducted in our parlor by Mr. Hawley, the new Presbyterian minister, and Uncle Joe Barclay, who presided over the Church in the Old Fields, four miles out of Depotville near the Haw River, which was the mother church of every other Presbyterian communion in that part of Alamance County, North Carolina. Uncle Joe’s proper name was Jonah and he was in-law kin, married to Papa’s youngest aunt on his mother’s side.

Only our family and the two preachers attended the funeral. The Baby lay in a white coffin with a bouquet of sweetpeas in a tiny hand. Then Mr. Hawley and Uncle Joe, sitting on the front seat of the Barclay surrey with the coffin lying across their knees, and Papa sitting behind them, drove through the red mud to the cemetery. Mother didn’t go because she was beginning to cough—just the grippe, she would say, clearly no immunization from what awaited her down the pike. She kept her wide-eyed little boys with her, safe from the cold rain. I was five-and-a-half years old and Older Brother would be seven next month; the other two were younger and I didn’t pay much attention to them that far back.

Whether or not the 80-years-ago worldwide influenza scourge’s arrival in Depotville, a one-square-mile town of fewer than a thousand souls, should be traced to that February and to our house, the visitation toward the year’s close was less selective and more distinguishable than our early bane. My memory has kept nothing of the gap: in my reflections winter slips into fall, from a death to the fear of more. At the single period’s worst, our family was among many to be placed under the state’s unofficial quarantine.

Mother, Older Brother, and I were put to bed by Dr. Thompson at about the same time. Papa somehow managed to care for us and the unaffected younger children until help came.

Uncle Joe’s household was as disabled as ours. Aunt Edna, Little Edna, and Frank, who was about Older Brother’s age, came down with the flu. Two older girls were away from home, either in college or teaching school, and an older boy was a soldier in France helping to fight the War to End All Wars.

Besides caring for his stricken three and miming the house and stable, Uncle Joe drove in his light carriage all over the Hawfields community helping ailing members of his congregation as best he could. Church services were suspended for three weeks under a State Board of Health regulation banning public assemblies, including schools. The pastor’s days were long, difficult, and hazardous.

Early on, Uncle Joe needed medicine but dared not leave his patients for several hours at that stage. We having no automobile. Papa rode a horse from the livery stable to deliver it. Coming back he saw two Army airplanes flying low and in tandem so as to follow the railroad tracks, which ran through the center of Depotville—and were responsible for the town’s creation off Hawfields just prior to the Civil War.

Papa’s description of the sight roused me from lethargy that illness increasingly deepened. I had never seen an airplane. I wished I had been behind Papa on the horse, upon the blanket extending from under the saddle, holding onto him. I wished it so much that I dreamed about airplanes.

Uncle Joe didn’t catch even a sniffle during that terrible season. He said it was because he chewed tobacco. But he became so worn out that one Saturday night, shaving a week’s growth of beard, he unintentionally cut off the mustache that had been part of his lean and creased face since he graduated from Danville Theological Seminary back in his home state of Kentucky.

II

The rails that the airplanes followed also steered influenza inland from Wilmington, on the coast, where it appeared in mid-September, brought, no doubt, by ship from a contaminated port such as Philadelphia. Train passengers carried the flu bugs from there.

Lately it has been determined that this was swine influenza, originating on United States pig farms, and not Spanish flu, as it mistakenly has been known everywhere through the decades. But the Spanish label is sticking and unlikely to unglue, except in scientific papers. Uniquely contageous and dangerous to young adults, it found ideal agents for spread in U. S. soldiers serving in World War I. Although the pandemic struck in three waves—spring of 1918, fall of the same year, and winter of 1918-19—it was the same disease in each season and on every continent. The third wave, wrote David L. Cockrell in The North Carolina Historical Review (July 1996), “was like the first, with many reported cases but fewer deaths than in the previous fall”—which was as true for Boston and Bombay as for Depotville.

The North Carolina Board of Health counted 13,644 influenza deaths among the state’s 2,559,123 residents. The nation’s toll was about 675,000, the global toll at least 20 million and possibly twice that. An estimated 28 percent of the American people were infected. Deaths exceeded 2. 5 percent as compared to 0. 1 percent in other influenza epidemics. Influenza and its overweight offspring, pneumonia, in 1918 were greater by 20 percent than their expectable death rate among 15- to 34-year-olds, usually the most secure of all ages. The impact depressed the average life expectancy in the United States by more than 10 years. North Carolina’s medical facilities typically “were overwhelmed by the masses of sick and dying.”

If the pestilence was of Biblical proportions, Miss Sudie Cheek was our angel of mercy.

Miss Sudie was a trained nurse—trained was the term, not registered—who upon retiring from a metropolitan hospital had come home to Cheeks Crossing, barely beyond the town limits, and was helping flu-crippled families. Dr. Thompson told Papa she might be available to us. Then he said no, hold on now, he believed she was committed to Mr. Bucket Monroe, who owned the Hi-Dollar tobacco warehouse. Mrs. Monroe’s sickness had gone into pneumonia and a grown daughter was sneezing and coughing ominously.

Nevertheless, the very next day Miss Sudie arrived at our door, a stout and pleasant woman who, we learned soon enough, had being-in-charge down pat. She brought a suitcase.

Our parents’ bedroom was our sick ward. Right away Miss Sudie lightened the room and helped Mother with a sponge bath. I lay on a trundle bed rolled from under Mother’s four-poster, and Older Brother on a cot brought from the attic. Miss Sudie told us to turn over and close our eyes. In a household five-sixths masculine, I had become curious about feminine specifics and managed a peep, but Mother had positioned herself like Rembrandt’s nude bathing in a brook, and I was confused. Yet as a pre-school child without art or nature for comparison, I realized that my 33-year-old mother was gracefully formed. (Ten years later, when an early Miss America’s picture and dimensions appeared in the newspaper, she jokingly, but not without vanity, used a tape measure to confirm that she still wasn’t too far off the ideal.)

With Miss Sudie’s takeover, Papa felt bound to go into town, half a mile away, to look after the cotton-batting factory for as much of its 13-hour work day as he could. He had developed a way to process kapock through cotton machines to make it suitable for life jackets. It was government work, part of the World War I effort, and a government inspector was on site—which made Papa all the more anxious to be there too. He had installed the machinery in a building of his design and stayed on as manufacturing manager at the company’s urging. Although he was college-trained in mechanics, you wouldn’t have known it from the way he tolerated noise and lint and how he scribbled reminders on his office wall instead of a calendar, such as these (along of course with dates): “Presbytery meeting . . . Bank payment due . . . Turned cow . . . Bobby starts new medicine,”

Our family would not acquire an automobile until 1923. Papa walked to and from work. Telephones had come to Depotville by 1918 but the system was primitive. Our number was five-oh, Dr. Thompson’s was two-five. The doctor’s calls were received at their residence by his wife (Mrs. Doctor Thompson, naturally, as in Mrs. Banker Harris, Mrs. Lawyer Harrison, Mrs. Preacher McIver, Mrs. Grocerystore Goodwin, Mrs. Brickyard Horner, and Mrs. Bootlegger Pemberton).

The town had just one drugstore. Mr. Toody Green, the 250-pound pharmacist, was so busy that he had his wife help him. She messed up some prescriptions, causing considerable criticism. I heard Papa tell Miss Sudie that the state licensing authority might step in, but nothing happened that I know of.

For a while the drugstore was the only downtown business operating at full scale, although the groceries continued to deliver food and kerosene oil. Tobacco people were unhappy with the state’s suspension of markets. “As the situation worsened,” Professor Cockrell wrote, “the state government moved to enact stronger regulations. . . . The board of health imposed a ban on almost all social intercourse that made it illegal for anyone to hold an event that would draw a crowd. This restriction, if properly adhered to, would have closed all industries and businesses.” It was beyond enforcement.

III

One evening upon returning home from work Papa stretched out on the sick-room rug and quickly fell asleep. Finding him there, Miss Sudie took his temperature and pronounced that he would have to go to bed and stay there. That’s the only time I can remember seeing Papa cry. But he accepted Miss Sudie’s order and fell upon the children’s-room bed he’d taken over from Older Brother and me.

Mother was stirring about by then. Older Brother had recovered enough to go outdoors with Miss Sudie. Papa’s fever burned out quickly and within a few days he was up, although he stayed home longer than that. I was causing some worry. Before leaving us to help another family. Miss Sudie had Dr. Thompson check me out.

Mother read to me a lot during that period, mostly from our accumulation of children’s books. I knew lots of the stories practically by heart. But the one about Pinocchio was new to me.

It upset me terribly. For weeks I had bad dreams about the poor little wooden boy whose nose grew every time he told a story-and-not-the-truth to the shoemaker and his wife. Such punishment, it seemed to me, was cruel. Never since then have I read, listened to. or viewed on screen the Pinocchio story. When my grandson received a Pinocchio puppet one Christinas, I could look upon it only in sorrow.

At length I began to feel better. One evening after the doctor had called again, Papa said my throat was well enough for me to have grape-nuts for breakfast. He seemed elated. I must have been subsisting on cocoa and thin soup. Fruit juices could not have been available.

Although I had never heard of grape-nuts, I was more than ready to take a whack at them. Seldom had I been happier than when feasting upon scuppernongs from Mr. and Mrs. Shakespeare Harris’s arbor a mile through the woods from our house—an odd place for a banker to live, but fortunate for me. And I was yet to have my fill of walnuts from a giant tree in a sagebrush field beyond a winding branch, towed home in a billy-goat wagon and cracked on a Hint rock in our back yard as big and round as a bushel basket.

When a bowl of grape-nuts was brought to my bed the next morning, I tried not to show my disappointment to Papa. Eating Mr. Post’s cereal is something else I have managed to avoid in the 80 years that have passed since then.

No one spoke of death from influenza during our isolation. But five people we knew succumbed.

The first was a lame man of middle years who lived alone in a small house where he repaired clocks. Other houses on the street were substantial, and neighbors saw little of the clock-fixer. Upon learning that he was ill, Dr. Joe Hurdle, the town dentist and nearby resident, went immediately to him, and was able to clear his throat and feed him broth but not to save his life. Dr. Hurdle figured that the poor fellow died in less than three days after becoming sick.

Also dying quickly were a Confederate veteran who had a little dray business and his wife, in their 70’s and frail. Their one-room log house was, of all places for an old man who in his youthhood thought he could whip five abolitionists, a former slave cabin behind a once-grand but now crumbling house older than the town and occupied by a tobacco speculator—a pinhook—and his family of seven or eight. The mistress of the establishment had been a much-courted beauty when rooming in college with Papa’s baby sister. That household, like ours, was badly treated by the flu, but survived.

Then on December 23 Mother’s father—Grandpa Brown Peterson—died of pneumonia at his home down near South Carolina in a village where he had brought his family from a riverside farm so the 10 children would have a school. Eight of the 10 were daughters, and he was up to his hindparts in grandchildren he couldn’t tell apart, one from another. It being Sunday as well as Christmastime when he died, it would have been unthinkable for Papa to accept help from neighbors or kin, or to look for it elsewhere; so Mother, again vigorous and independent, took a south-bound train alone. Next day Papa asked the four of us children if we would mind if Santa Claus didn’t come till the day after Christmas. All voted no. Hence at Christmas dawn, when we were called into the living room where the tree and stockings were, there stood Mother, still in her traveling clothes and her suitcase near, and we rushed to her before looking at our Santa Claus things.

One more of our acquaintances or kin died of influenza during 1918. He was an Army Reserve officer married to one of Papa’s cousins, preparing to ship out for a World War I command in Europe.

Among U. S. soldiers that fall, influenza was as fearsome as bullets. Indeed, more North Carolinians among them died from the disease than from combat. At Camp Greene, near Charlotte, wrote Miriam Grace Mitchell and Edward Spaulding in Echo of The Bugle (1979). “. . . The onset was sudden and overwhelming, often claiming its victim within 24 hours. [Charlotte] undertakers were swamped- . . . Coffins [were] “stacked to the ceiling” at railroad stations, awaiting trains to take them home.”

Mill villages likewise suffered extremely. Like soldiers in Army camps, residents lived and worked without much separation. Selena W. Saunders, who voluntarily accompanied a trained nurse among the sick in Cramerton, in the North Carolina textile belt, wrote these recollections in a brief essay, The Big Flu (1976):

This new disease was different. It struck suddenly, spent itself quickly in a burning three-day fever, often leaving its victim dead. The people lost faith in the remedies they had relied on all their lives, and they became frantic. Some of them locked themselves in their house, and refused to open the door for anyone. . . . Merchants nailed bars across their doors, and served the customers one-at-a-time at the doorway. We found whole families stricken, with none able to help the others. In one family the mother died without knowing that her son, who lay in the adjoining room, had died a few hours earlier.

For two weeks, volunteer workers made and delivered hot chicken soup and other meals for the sick and needy. . . . Soon the people came from their houses to bask in the bright October sun.

Organized volunteers and neighbors must have boiled barrels of soup for the sick. The Alamance Gleaner in Graham, our county-seat weekly newspaper, said home demonstration agents distributed “dainty soups.”

IV

Family and community ancedotes of the 1918 plague abound among persons of middle years and older. Following are examples I gathered by pure chance upon introducing my interest:

• A university library curator said that as a child he was forever hearing from his parents about somebody investigating an untended house out toward the swamps and finding all five members of a family dead in their beds.

• A town librarian explained her unusual knowledge of my topic by noting that her parents were in France, her father a World War I soldier, her mother a Red Cross worker, when the flu pandemic reached there. A colleague overhearing us said flu killed her husband’s grandmother in West Virginia at age 29.

• Responding to my question about influenza’s legacies, a physician was reminded that an often-repeated story at home in his boyhood was of nine deaths from influenza-pneumonia in a farm family of 11.

• The operator of a bookstore told me her mother was her father’s second wife; the first when a bride accompanied her husband on a business trip to New York, where she fell ill of flu in the hotel and soon died.

• A neighbor retired from the State Department reminisced that an aunt, serving as a volunteer in a German prisoner-of-war camp in Eastern North Carolina, amid influenza deaths of several inmates managed to rescue a stricken young man who, in gratitude, gave her his Iron Cross; in time the medal was passed on to my neighbor, and in further time he gave it to a German diplomat he knew well, who was surprisingly touched, his grandmother having died in Germany during that bleak period.

• A tragedy that over the decades has faded from sensation to family narrative was told to me by an old schoolmate who just last year, at age 85, closed his law office in the town where we live. It seems to merit the attention of the World Health Organization.

That is because my friend R. F. Hoke Pollock’s father, William Durward Pollock, died of influenza complications in Kinston, the a North Carolina tobacco center, on Aug. 15, 1918: exactly one week before “the first case in the [pandemic’s] second wave was recorded. . .in Brest, a major port of incoming troops,” as Malcolm Gladwell wrote in The New Yorker (Sept. 29, 1997). Within days, Gladwell continued, the disease appeared simultaneously in Boston and Freetown, Sierra Leone.

A 56-year-old attorney, legislator, and political leader renowned as an orator, Mr. Pollock took the cars of “the Mullet Line,” officially the Atlantic and North Carolina Railroad, to Morehead City, a small fishing port, to address a Liberty Loan rally. Upon returning home, he came down with a violent fever. He was treated by his brother and brother-in-law, both prominent physicians, plus a consultant.

They concluded that their patient had caught a mysterious tropical disease sailing up from the Indies. To lower his temperature they placed a 100-pound block of ice at each side and turned an electric fan upon him. Straightway he developed pneumonia, went into a coma, and never awakened. As the Cramerton mother breathed her last without learning her son was dead, Mr. Pollock perished unaware that three days earlier he had become the father of a little girl.

Hoke Pollock related this to me as we chanced to stand together at a doorway waiting for a shower to lift and I casually asked what he recalled of our childhood’s influenza terror. After informing me he said, “This is the first time in a long while I’ve had occasion to tell my father’s story. He was the first to die in Kinston from that flu and probably the first in the state.” Could he also have been the first anywhere to suffer the second wave’s sting?

• Although a pediatrician had no 1918 flu account, he suggested to me after hearing of my close call, “Dosed you on sulfur and molasses, didn’t they?”

V

Whatever Dr. Thompson and Miss Sudie coaxed down my poor throat and greased onto my skinny chest, neither they nor the Pollock doctors with their ice and fan were likely to have shocked the conventional. The preeminent Johns Hopkins pathologist William Henry Welch said in a speech that the pandemic “cast a great shadow on the medical profession.”

In his fine account of the North Carolina health emergency, Professor Cockrell wrote, “Doctors, armed with medical skills and techniques that would be considered primitive when compared with today’s standards, found themselves powerless to halt the spread of the disease or to save many of those already ill. Called the “blue death,” the virus inducted severe pneumonia in its victims with amazing speed as it filled their lungs with bloody fluid and turned their skin a bluish color. Numerous victims died in a matter of days, some within forty-eight hours. . . . Philadelphia, probably the worst hit of the large cities, reported more than forty-five hundred fatalities in one week” of the infestation’s second wave.

Every patent medicine producer in the land changed labels to claim its snake oil would prevent or cure influenza. A cigarette manufacturer advertised that smoking its brand would do the trick. Cockrell continued that “in the fall of 1918 three newspapers in Providence, R. I. advertised a total of thirty-two “new” medicines for the treatment of influenza.”

Alfred W. Crosby, foremost scholar of the 1918 catastrophe and author of America’s Forgotten Pandemic: The Influenza of 1918 (1976/1989), wrote that “the experts were reduced to recommending mass adoption of ineffective masks, and even to inoculating thousands with worthless vaccines.” Wearing masks was required by law in San Francisco and many other West Coast cities. “If we want to avoid a reprise of the 1918 ordeal we should examine it,” Crosby advised, “because we still do not know why it was as bad as it was.”

Our unknowingness persists. Yet the disease is being universally monitored, studied, and resisted. A report of ongoing progress at the Armed Forces Institute of Pathology in Washington appeared in the journal Science (March 21, 1997), prepared by the pathologist Jeffrey Taubenberger, molecular biologist Ann Reid, and three of their Institute colleagues.

A 21-year-old Army private stationed at Fort Jackson in South Carolina in 1918 was among scores of influenza’s uniformed victims whose bodies underwent autopsy. Army doctors preserved some of the tissues in formaldehyde and paraffin, the Fort Jackson soldier’s among them. From his body five genes were isolated by the Taunberger team and analyzed by advanced methods. The virus thus detected was a mutation evolving in pigs: hence swine flu.

As a step toward understanding the origins and virulence of the 1918 pandemic, that discovery could lead to predicting future outbreaks and preparing against them. Tissue samples are being sought for similar analysis throughout the world, from Australia to the Arctic.

Influenza viruses may pass into pigs from birds, usually wild waterfowl, and from pigs into human beings. Although 1918’s first recorded case was not at Fort Jackson but at Camp Funston in Kansas, Dr. Taubenberger has suggested that the strain be known as Influenza A/South Carolina.

With support from Taubenberger studies, author Gladwell in The New Yorker speculated that in or near Kansas “flu-contaminated duck feces dropped into a barnyard, whereupon a pig became infected while nosing in the dirt and passed the virus onto a farmer,” and inevitably into the Army camp.

That hypothesis may be a bit fanciful. Geography and logistics aside, it well could be that the chain of events began not in a Kansas barnyard but an Iowa pig ranch. Iowa in that period produced twice as many pigs as any other state, and Iowa flu epizootics during and after 1918 are a topic of Crosby’s book.

Science noted that virologist Robert Webster of St. Jude’s Children’s Hospital in Memphis, hearing of the Taubenberger report, commented, “What this means is that we had better watch what is happening to the pig population of the world.” Key word there is world.

In North Carolina, which is pressing Iowa for pig-production primacy, nearly all of the crop never touches the ground—never roots with its powerful snout designed for rooting. Feeding is managed mechanically in a cement-and-metal pig factory, which is becoming prototypical for the rest of the nation. If odors and overflowing waste lagoons are disturbing, swine influenza is becoming rare down Hog Road.

In other countries pig-farming is less assembly-line, especially in China. There both ducks and pigs are plentiful and often in close proximity. And as Dr. Webster has pointed out, it seems that ever-changing swine flu viruses create new flu strains in people.

(Direct transfer of avian influenza to people was not determined until the strain appearing in 1997 in Hong Kong was traced to chickens.)

VI

History books tell next to nothing of the blue killer. The disease was easing when the Allied victory ended World War I and attention turned from it. Yet the pandemic and war were, in a sense, one and the same: as men in uniform, mostly U. S. , and merchant seamen of all flags spread to far places, so did influenza. The virus reached from America to Europe and on to even the Alaskan wilderness and Pacific jungles.

Statistics in America’s Forgotten Pandemic indicate how fitting it is that a U. S. armed forces agency is ferreting out the plague’s secrets. Of the 675,000 Americans estimated to have died of influenza, 43,000 were mobilized for war. At the second wave’s cruelest, September through November, the death count at Army bases in this country was 21,193. In France during September, 37,000 Americans and 25,000 French combat troops were sick-listed by flu. Soldiers in the trenches were less affected than those behind the lines.

Similarly, U. S. Navy men at sea, from picketboatmen to crews of crowded transports, fared better than their shoreside mates—for indefinite reasons. During the pandemic’s peak three months, 3,137 died at U. S. naval bases and schools, 880 in a single September week. Forty percent of the Navy suffered from influenza in 1918.

Seldom have our civilian and military populations been more closely bound than when influenza raged on land and sea. Learning of the disease’s origins and exceptional violence could be as beneficial to national security as Star War shields.

VII

Until marrying I went back to Depotville for vacations. I could fish and read at will there, and anyway couldn’t afford much better in those Depression times. So there I was at age 25 or 26, glad to escape for 10 days the burdens of being night editor of the Durham Morning Herald: straw boss, that is, for an inattentive managing editor and resented by the three old desk bulls who, along with the police reporter, were my staff.

Having worked the 6 p. m. -to-2 a. m. shift for several years, I had trouble going to sleep at my parents’ bedtime. Only they remained at the homeplace. During my visits I would read past midnight.

On this first night back home, sitting barefoot under the living room lamp, not yet relaxed, I became aware of the Family Bible lying on the big oak library table that Papa had fashioned long ago. I picked it up to see if I could find again where Paul advised the Corinthians that “evil communications corrupt good manners,” which I had been sentenced to write a hundred times by my sixth-grade teacher upon her discovery that I was inventing some of the Bible verses I recited at my turn during morning devotionals.

The old book opened near its middle at what seemed to be a page marker. It was not a marker, though, but a sweetpea, dried and pressed flat, with the stem intact as well as the faded blue flower. I knew immediately it was from the undertaker’s bouquet that The Baby took to his sad little grave. Memories of those dreadful months of 1918 flooded my mind. I put on my shoes and walked out to the cemetery—out to the spot where the town reckoned, rightly or not (and making no difference, for it soon would forget), as being where it made a small down payment on history’s costliest pandemic. Our road lately had been paved to where it crossed the railroad tracks.

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