The Great Influenza (49 page)

The Philadelphia office of the state Council of National Defense was run by Judge J. Willis Martin. His wife, Elizabeth, had organized the country's first garden club and was largely responsible for making Rittenhouse Square a green spot in the city. She also headed the council's Women's Division as well as Emergency Aid, the most important private social agency in the city.

Nearly all the social agencies were run by women, strong women of intelligence and energy and born to a certain rank, but excluded from all pursuits beside charity. The mayor had created a committee of society women to respond to emergencies; it included Pepper's wife along with Mrs. John Wanamaker; Mrs. Edward Stotesbury, whose husband was the city's leading banker and head of Drexel & Co.; and Mrs. Edward Biddle, president of the Civic Club and whose husband was descended from Nicholas Biddle, creator of the first Bank of the United States, which to his nemesis Andrew Jackson embodied the sinister monied power of the nation. These women despised the Vare machine and had cooperated only to show unity during the war. But with city officials doing nothing whatsoever about the epidemic, the women resigned, effectively dissolving the committee. As Elizabeth Martin wrote the mayor, 'Your committee has no real purpose' . I therefore hereby sever my connection with it.'

Now, in place of the city government, Pepper, the Martins, and their colleagues summoned the heads of a dozen private organizations on October 7 to the headquarters of Emergency Aid at 1428 Walnut Street. There the women took charge, with Pepper adding his weight to theirs. To sell war bonds, they had already organized nearly the entire city, all the way down to the level of each block, making each residential block the responsibility of 'a logical leader no matter what her nationality' i.e., an Irishwoman in an Irish neighborhood, an African American woman in an African American neighborhood, and so on.

They intended to use that same organization now to distribute everything from medical care to food. They intended to inject organization and leadership into chaos and panic. In conjunction with the Red Cross (which here, unlike nearly everywhere else in the country, allowed its own efforts to be incorporated into this larger Emergency Aid) they also appealed for nurses, declaring, 'The death toll for one day in Philadelphia alone was greater than the death toll from France for the whole American Army for one day.'

The state Council of National Defense had already compiled a list of every physician in Pennsylvania, including those not practicing. Martin's ad hoc committee beseeched each one on the list for help. The committee had money, and access to more money, to pay for the help. It set up a twenty-four-hour telephone bank at Strawbridge & Clothier, which donated use of its phone lines; newspapers and placards urged people to call 'Filbert 100' twenty-four hours a day for information and referrals. It transformed kitchens in public schools (which were closed) into soup kitchens that prepared meals for tens of thousands of people too ill to prepare their own. It divided the city into seven districts and, to conserve physicians' time, dispatched them according to geography, meaning that doctors did not see their own patients.

And it became a place that volunteers could come to. Nearly five hundred people offered to use their own cars either as ambulances or to chauffeur doctors - they were supplied with green flags that gave them right-of-way over all other vehicles. The organizers of the Liberty Loan drive diverted another four hundred cars to help. Thousands of individuals called the headquarters and offered to do what was needed.

* 

Krusen had not attended the October 7 meeting of the private groups and had been slow to act before. Now he changed. Perhaps the deaths finally changed him. Perhaps the fact that someone else was taking charge forced him to move. But he seemed suddenly not to care about the Vares, or selling war bonds, or bureaucracy, or his own power. He just wanted to stop the disease.

He ceded to the group control over all nurses, hundreds of them, who worked for the city. He seized (in violation of the city charter) the city's $100,000 emergency fund and another $25,000 from a war emergency fund and used the money to supply emergency hospitals and hire physicians, paying them double what the Public Health Service was offering. He sent those physicians to every police station in South Philadelphia, the hardest-hit section. He wired the army and navy asking that no Philadelphia physicians be drafted until the epidemic abated, and that those who had already been drafted but had not yet reported to duty be allowed to remain in Philadelphia, because 'the death rate for the past week [was] the largest in records of city.'

The U.S. Public Health Service still had no presence in Philadelphia and had done nothing for it. Now Rupert Blue did the only thing he would do for the city in its distress: he wired the surgeon general of the navy to 'heartily endorse' Krusen's request. The deaths spoke far more loudly than Blue. The military did allow Philadelphia to keep its doctors.

Krusen also cleaned the streets. The streets of South Philadelphia literally stank of rot and excrement. Victorians had considered it axiomatic that filthy streets per se were linked to disease. The most modern public health experts (Charles Chapin in Providence, Biggs in New York, and others) flatly rejected that idea. But Dr. Howard Anders, who earlier had been ignored by the press when he warned that the Liberty Loan parade would spread influenza, was given page one by the
Ledger
on October 10 to state, 'Dirty streets, filth allowed to collect and stand until, germ-laden and disease-breeding, it is carried broadcast with the first gust of wind - there you have one of the greatest causes of the terrible epidemic.' Other Philadelphia doctors agreed: 'The condition of the streets spreads the epidemic.'

So Krusen sent trucks and men down them with their water sprays and sweepers almost daily, doing the job Vare had been paid for many times but had never done. Krusen, Emergency Aid, and the Catholic Church teamed up to do one more thing, the most important thing. They began to clear the bodies.

* 

The corpses had backed up at undertakers', filling every area of these establishments and pressing up into living quarters; in hospital morgues overflowing into corridors; in the city morgue overflowing into the street. And they had backed up in homes. They lay on porches, in closets, in corners of the floor, on beds. Children would sneak away from adults to stare at them, to touch them; a wife would lie next to a dead husband, unwilling to move him or leave him. The corpses, reminders of death and bringers of terror or grief, lay under ice at Indian-summer temperatures. Their presence was constant, a horror demoralizing the city; a horror that could not be escaped. Finally the city tried to catch up to them.

Krusen sent police to clear homes of bodies that had remained there for more than a day, piling them in patrol wagons, but they could not keep up with the dying and fell further behind. The police wore their ghostly surgical masks, and people fled them, but the masks had no effect on the viruses and by mid-October thirty-three policemen had died, with many more to follow. Krusen opened a 'supplementary morgue' at a cold-storage plant at Twentieth and Cambridge Streets; he would open five more supplementary morgues. He begged military embalmers from the army. Pepper and Martin convinced the Brill Company, which made streetcars, to build thousands of simple boxes for coffins, and they gathered students from embalming schools and morticians from as far as 150 miles away. More coffins came by rail, guarded by men with guns.

And graves were dug. First the families of the dead picked up shovels and dug into the earth, faces streaked with sweat and tears and grit. For gravediggers would not work. The city's official annual report notes that 'undertakers found it impossible to hire persons willing to handle the bodies, owing to the decomposed nature of the same.' When Anna Lavin's aunt died, 'They took her to the cemetery. My father took me and the boy, who also had the flu, and he was wrapped (my father carried him) wrapped in a blanket to the cemetery to say the prayer for the dead' . The families had to dig their own graves. That was the terrible thing.'

Pepper and Martin offered ten dollars a day to anyone who would touch a corpse, but that proved inadequate, and still the bodies piled up. Seminary students volunteered as gravediggers, but they still could not keep pace. The city and archdiocese turned to construction equipment, using steam shovels to dig trenches for mass graves. Michael Donohue, an undertaker, said, 'They brought a steam shovel in to Holy Cross Cemetery and actually excavated' . They would begin bringing caskets in and doing the committal prayers right in the trench and they'd line them up right in, one right after another, this was their answer to helping the families get through things.'

The bodies that were choking homes and lying in stacks in mortuaries were ready to go, finally, into the ground.

To collect them, Archbishop Denis Dougherty, installed in office only a few weeks earlier (later he became the first cardinal from the archdiocese) sent priests down the streets to remove bodies from homes. They joined the police and a few hardy others who were doing the same.

Sometimes they collected the bodies in trucks. 'So many people died they were instructed to ask for wooden boxes and put the corpse on the front porches,' recalled Harriet Ferrell. 'An open truck came through the neighborhood and picked up the bodies. There was no place to put them, there was not room.'

And sometimes they collected the bodies in wagons. Selma Epp's brother Daniel died: '[P]eople were being placed on these horse-drawn wagons and my aunt saw the wagons pass by and he was placed on the wagon; everyone was too weak to protest. There were no coffins in the wagon but the people who had died were wrapped in a sort of sackcloth and placed in the wagon. One was on top of the other, there were so many bodies. They were drawn by horses and the wagons took the bodies away.'

No one could look at the trucks and carts carrying bodies (bodies wrapped in cloth stacked loosely on other bodies wrapped in cloth, arms and legs protruding, bodies heading for cemeteries to be buried in trenches) or hear the keening of the mourners and the call for the dead, and not think of another plague - the plague of the Middle Ages.

* 

Under the initial burst of energy the city seemed at first to rally, to respond with vigor and courage now that leadership and organization seemed in place.

But the epidemic did not abate. The street cleaning accomplished nothing, at least regarding influenza, and the coroner (Vare's man) blamed the increasing death toll on the ban by the state public health commissioner on liquor sales, claiming alcohol was the best treatment for influenza.

In virtually every home, someone was ill. People were already avoiding each other, turning their heads away if they had to talk, isolating themselves. The telephone company increased the isolation: with eighteen hundred telephone company employees out, the phone company allowed only emergency calls; operators listened to calls randomly and cut off phone service of those who made routine calls. And the isolation increased the fear. Clifford Adams recalled, 'They stopped people from communicating, from going to churches, closed the schools,' closed all the saloons' . Everything was quiet.'

Very likely half a million (possibly more) Philadelphians fell sick. It is impossible to be more precise: despite the new legal requirement to report cases, physicians were far too busy to do so, and by no means did physicians see all victims. Nor did nurses.

People needed help and, notwithstanding the efforts of Emergency Aid, the Council of National Defense, and the Red Cross, help was impossible to get.

The
Inquirer
blared in headlines; 'Scientific Nursing Halting Epidemic.'

But there were no nurses.

The log of a single organization that sent out nurses noted without comment, 'The number of calls received, 2,955, and calls not filled, 2,758.'
Calls received, 2,955; calls not filled, 2,758
. And the report pointed out that even those numbers (93 percent of the calls unfilled, 7 percent filled) was an understatement, since the 'calls received' does not represent the number of nurses required, for many of the calls were for several nurses to go to one place; two of the calls being for 50 nurses each.'

Those nurses were needed, needed desperately. One study of fifty-five flu victims who were not hospitalized found that not one was ever seen by a nurse or a doctor. Ten of the fifty-five patients died.

* 

It now seemed as if there had never been life before the epidemic. The disease informed every action of every person in the city.

The archbishop released nuns for service in hospitals, including Jewish hospitals, and allowed them to violate rules of their orders, to spend overnight away from the convent, to break vows of silence. They did not make a dent in the need.

By then many of those who had earlier rushed forward to volunteer had withdrawn. The work was too gruesome, or too arduous, or they themselves fell ill. Or they too were frightened. Every day newspapers carried new and increasingly desperate pleas for volunteers.

On the single
day
of October 10, the epidemic alone killed 759 people in Philadelphia. Prior to the outbreak, deaths from all causes (all illnesses, all accidents, all suicides, and all murders) averaged 485 a
week.

Fear began to break down the community of the city. Trust broke down. Signs began to surface of not just edginess but anger, not just finger-pointing or protecting one's own interests but active selfishness in the face of general calamity. The hundreds of thousands sick in the city became a great weight dragging upon it. And the city began to implode in chaos and fear.

Pleas for volunteers became increasingly plaintive, and increasingly strident. Under the headline 'Emergency Aid Calls for Amateur Nurses,' newspapers printed Mrs. Martin's request: 'In this desperate crisis the Emergency Aid calls on all' who are free from the care of the sick at home and who are in good physical condition themselves' to report at 1428 Walnut Street as early as possible Sunday morning. The office will be open all day and recruits will be enrolled and immediately sent out on emergency work.'