In the Grip of Death

JOANNE: Major funding for BackStory is provided by an anonymous donor, the National Endowment for the Humanities, the University of Virginia, the Joseph and Robert Cornell Memorial Foundation, and the Arthur Vining Davis foundations.

BRIAN: From the Virginia Foundation for the Humanities, this is BackStory.

NATHAN: Welcome to BackStory, the show that explains the history behind today’s headlines I’m Nathan Cibbikky,

JOANNE: I’m Joanne Freeman.

BRIAN: And I’m Brian Balogh.

100 years ago, Europe was bogged down in the final years of the First World War, which had cost millions of lives. But a more deadly onslaught was to come. As early as the spring of 1918, soldiers started getting sick. Not just here in the United States, but all across the world, they were coming down with something like the flu. And historian Nancy Bristow says that the flu was nothing new.

NANCY BRISTOW: Influenza, the grippe– they used those terms interchangeably– has become a domesticated illness. It’s something they expect to see every year. And indeed they expect some people to die of it every year.

BRIAN: But as the infection spread from soldier to soldier and then soldier to civilian, doctors realized this flu was not what they were used to treating.

NANCY BRISTOW: Right away they can see that the pace of infection is very fast. It’s moving from city to city to city very quickly. The progression through a single patient is very rapid in some cases. Often, it would take a week or two for someone to die, but it could happen in less than 24 hours, literally from being healthy to being dead.

BRIAN: For military doctors nowhere was this more apparent than Fort Devens in Massachusetts. That September the epidemic struck the base, which has 50,000 soldiers. Within weeks, over 10,000 of those men came down with the virus and its horrific symptoms.

One doctor there wrote to a friend about the devastation.

MALE SPEAKER: These men start with what appears to be an attack of la grippe or influenza. We have been averaging about 100 deaths per day, and still keeping it up.

JOHN OXFORD: The first manifestation would be headaches and aches and pains and a desperate desire to go to bed. BRIAN:

BRIAN: Virologist, John Oxford.

JOHN OXFORD: Now, that can be associated with a cough as well and a sky high temperature.

NANCY BRISTOW: They may be suffering from chills and sort of what were described as nervous symptoms. And that was only the beginning.

JOHN OXFORD: Within maybe two days of you having all those symptoms, you’re lying there with your cough. You may find the cough is not getting any better. And it is a distressing cough.

NANCY BRISTOW: Leading eventually to delirium, unconsciousness, hemorrhaging taking place in the lungs, so people are really struggling to get a breath. Their bodies as a result of that absence of oxygen begin to be discolored, turning blue or purple.

JOHN OXFORD: And it’s been called a heliotrope cyanosis. And what it means, heliotrope, is lavender colored.

MALE SPEAKER: Two hours after admission they have the mahogany spots over the cheekbones. And a few hours later you can begin to see the cyanosis extending from their ears and spreading all over the face until it is hard to distinguish the colored men from the white.

JOHN OXFORD: So if a marton, like in my own hospital, the Royal London, came into the ward, we could look down the beds in that ward and any patient lying there that had this blue, this lavender coloration of the face, blue lips, and blue ears, she could more or less say, well, hang on a minute, to the nurse. We can prepare those beds because they’re going to die.

MALE SPEAKER: It is only a matter of a few hours then until death comes. And it is simply a struggle for air until they suffocate. It is horrible.

NANCY BRISTOW: They would find that the lungs had the appearance, as one doctor says, like the lungs of the drowned. People were literally drowning in their own bodily fluids.

MALE SPEAKER: One can stand it to see one, two, or twenty men die, but to see these poor devils dropping like flies sort of gets on your nerves.

BRIAN: And there was something else about this disease which horrified doctors. Typically, flu tended to attack the very young and the elderly. But this flu was killing people in the prime of their lives.

NANCY BRISTOW: So in a regular mortality chart for influenza, you have a U with the high influenza mortality being among the very young at the left end of the chart and the very old at the right end of the chart. In 1918, you have what we call a W chart because you have a spike in the middle, those young adults, the very people who are the leaders of a society, the teachers, the politicians, the parents. And almost half of the deaths in this pandemic take place in individuals between the ages of 20 and 40, which is extraordinarily uncommon.

BRIAN: Yeah I remember my wife telling me when I told her what the topic was for BackStory that her grandmother died. And I asked how old. You know, 30 or 32 years old, right that spike in the middle of the W.

NANCY BRISTOW: Right. That’s exactly right. And when I give talks about this there are always people in the audience with those family stories.

BRIAN: Including her own. Bristow took an interest in the pandemic when she learned that her own great grandparents had died from the illness dubbed the Spanish flu.

NANCY BRISTOW: It’s a misnomer based on the reality that Spain didn’t have wartime censorship because they’re a neutral in the war.

JOHN OXFORD: And when this outbreak started, you didn’t want to let the Germans know– or the Germans didn’t want to let English know that they had a bit of a problem in the background. And so everyone kept quiet about it. In Spain, why should they keep quiet? They had nothing to do with the war really. And the King, Alfonso the second was ill. The prime minister was ill. Everyone seemed to be ill And suddenly the newspapers were full of it in Spain. And the rest of the world I think looked around and said, what’s going on in Spain? And so since that time, much to the annoyance of the Spanish and much to the annoyance of Spanish virologists, I can tell you, we’ve all called the Spanish flu ever since.

BRIAN: No matter what doctors should have called it, one thing was clear.

NANCY BRISTOW: This is just not regular influenza, that they are in the throes of something new and horrifying, and for which they are going to be a bit at sea.