The Great Influenza (45 page)

With this information any reasonably competent scientist could grow and identify the bacteria. At least now they would know that if Pfeiffer's was not found it was because it was not there.

Avery himself still would not be rushed, would not discuss a conclusion he was not yet ready to support. But based on Avery's work Cole told Russell, 'I feel less and less inclined to ascribe the primary infection to the influenza bacilli - although that possiblity cannot be excluded until the real cause of the infection is demonstrated' . I am very hopeful that the anti-pneumococcus vaccination can be pushed rapidly. While the anti-influenzal vaccination' (by this he meant vaccine against
B. influenzae
) 'seems to me still doubtful we have very good evidence that the anti-pneumococcus vaccination is going to prove to be of a great help.' He added, 'It seems to me the influenza epidemic gives an opportunity for developing this in a way that could not have otherwise been done.'

There was nothing easy about making either the antipneumococcus serum, which in tests had just cured twenty-eight of twenty-nine patients suffering infection with Type I pneumococcus, or the vaccine. It took two months to prepare the vaccine properly, two months of a difficult process: making 300-liter batches of broth (and the pneumococci themselves dissolved too often in ordinary broth, which meant adding chemicals that later had to be removed) concentrating it, precipitating some of it out with alcohol, separating out the additives, standardizing it. Avery and other Rockefeller investigators did make one important advance in production: by adjusting the amount of glucose in the media they increased the yield tenfold. But they could still move only twenty-five liters a day through centrifuges. It mocked the need.

In the meanwhile the killing continued.

Part VIII

THE TOLLING OF THE BELL

CHAPTER TWENTY-SIX

W
HILE SCIENCE
was confronting nature, society began to confront the effects of nature. For this went beyond the ability of any individual or group of individuals to respond to. To have any chance in alleviating the devastation of the epidemic required organization, coordination, implementation. It required leadership and it required that institutions follow that leadership.

Institutions are a strange mix of the mass and the individual. They abstract. They behave according to a set of rules that substitute both for individual judgments and for the emotional responses that occur whenever individuals interact. The act of creating an institution dehumanizes it, creates an arbitrary barrier between individuals.

Yet institutions are human as well. They reflect the cumulative personalities of those within them, especially their leadership. They tend, unfortunately, to mirror less admirable human traits, developing and protecting self-interest and even ambition. Institutions almost never sacrifice. Since they live by rules, they lack spontaneity. They try to order chaos not in the way an artist or scientist does, through a defining vision that creates structure and discipline, but by closing off and isolating themselves from that which does not fit. They become bureaucratic.

The best institutions avoid the worst aspects of bureaucracy in two ways. Some are not really institutions at all. They are simply a loose confederation of individuals, each of whom remains largely a free agent whose achievements are independent of the institution but who also shares and benefits from association with others. In these cases the institution simply provides an infrastructure that supports the individual, allowing him or her to flourish so that the whole often exceeds the sum of the parts. (The Rockefeller Institute was such an institution.) Other institutions avoid the worst elements of bureaucracy by concentrating on a clearly defined purpose. Their rules have little to do with such procedural issues as a chain of command; instead rules focus on how to achieve a particular result, in effect offering guidance based on experience. This kind of institution even at its best can still stultify creativity, but such institutions can execute, can do a routine thing efficiently. They resemble professionals trying to do their jobs and duty; they accomplish their tasks.

In 1918 the institution of the federal government had more force than it had ever had - and in some ways more force than it has had since. But it was aiming all that force, all its vital energy, in another direction.

* 

The United States had entered the war with little preparation in April 1917, and mobilizing the country took time. By the summer of 1918, however, Wilson had injected the government into every facet of national life and had created great bureaucratic engines to focus all the nation's attention and intent on the war.

He had created a Food Administration to control and distribute food, a Fuel Administration to ration coal and gasoline, a War Industries Board to oversee the entire economy. He had taken all but physical control over the railroads and had created a federally sponsored river barge line that brought commerce back to life on the Mississippi River, a commerce that had been killed by competition from those railroads. He had built many dozens of military installations, each of which held at least tens of thousands of soldiers or sailors. He had created industries that made America's shipyards teem with hundreds of thousands of laborers launching hundreds of ships, dug new coal mines to produce coal for the factories that weaned America's military from British and French weapons and munitions - for, unlike in World War II, America was no arsenal of democracy.

He had created a vast propaganda machine, an internal spy network, a bond-selling apparatus extending to the level of residential city blocks. He had even succeeded in stifling speech, in the summer of 1918 arresting and imprisoning (some for prison terms longer than ten years) not just radical labor leaders and editors of German-language newspapers but powerful men, even a congressman.

He had injected the government into American life in ways unlike any other in the nation's history. And the final extension of federal power had come only in the spring of 1918, after the first wave of influenza had begun jumping from camp to camp, when the government expanded the draft from males between the ages of twenty-one and thirty to those between the ages of eighteen and forty-five. Only on May 23, 1918, had Provost Marshal Enoch Crowder, who oversaw the draft, issued his 'work or fight' order, stating that anyone not employed in an essential industry would be drafted (an order that caused major league baseball to shorten its season and sent many ballplayers scurrying for jobs that were 'essential') and promising that 'all men within the enlarged age would be called within a year.'
All
men, the government had said, with orders for an estimated thirteen million to register September 12. Crowder bragged about doing 'in a day what the Prussian autocracy had been spending nearly fifty years to perfect.'

All this enormous and focused momentum would not be turned easily.

* 

It would not be turned even by the prospect of peace. In mid-August, as the lethal wave of the epidemic was gathering itself, Austria had already inquired about peace terms, an inquiry that Wilson rebuffed utterly. And as the epidemic was gathering full momentum, peace was only weeks away. Bulgaria had signed an armistice on September 29. On September 30, Kaiser Wilhelm had granted parliamentary government to the German nation; that same day Ludendorff had warned his government that Germany must extend peace feelers or disaster (immediate disaster) would follow. German diplomats sent out those feelers. Wilson ignored them. The Central Powers, Germany and her allies, were simultaneously breaking off one from one another and disintegrating internally as well. In the first week of October, Austria and Germany separately sent peace feelers to the Allies, and on October 7, Austria delivered a diplomatic note to Wilson formally seeking peace on any terms Wilson chose. Ten days later (days of battle and deaths) the Austrian note remained unanswered.

Earlier Wilson had spoken of a 'peace without victory,' believing only such a peace could last. But now he gave no indication that the war would soon be over. Although a rumor that the war had ended sent thrills through the nation, Wilson quickly renounced it. Nor would he relent. He was not now fighting to the death; he was fighting only to kill.
To fight you must be brutal and ruthless
, he had said.
Force!
he had demanded.
Force to the utmost! Force without stint or limit! The righteous and triumphant Force which shall make Right the law of the world, and cast every selfish dominion down in the dust
.

Reflecting his will, there was no letup in the ferocity and wrath of the Liberty Loan rallies, no letup in the frenzied pressure to produce in coal mines and shipyards, no letup among editorials or for that matter news stories exhorting people to insist upon total and complete German capitulation. Especially within the government itself, there was no letup. Instead Wilson pressed, pressed with all his might (and that meant all the nation's might) for total victory.

If Wilson and his government would not be turned from his end even by the prospect of peace, they would hardly be turned by a virus. And the reluctance, inability, or outright refusal of the American government to shift targets would contribute to the killing. Wilson took no public note of the disease, and the thrust of the government was not diverted. The relief effort for influenza victims would find no assistance in the Food Administration or the Fuel Administration or the Railroad Administration. From neither the White House nor any other senior administration post would there come any leadership, any attempt to set priorities, any attempt to coordinate activities, any attempt to deliver resources.

The military, especially the army, would confront the virus directly. Gorgas had done all that he could have, all that anyone could have, to prepare for an emergency. But the military would give no help to civilians. Instead it would draw further upon civilian resources.

The same day that Welch had stepped out of the autopsy room at Devens and called Gorgas's office, his warning had been relayed to the army chief of staff, urging that all transfers be frozen unless absolutely necessary and that under no circumstances transfers from infected camps be made:
The deaths at Camp Devens will probably exceed 500' . The experience at Camp Devens may be fairly expected to occur at other large cantonments' . New men will almost surely contract the disease
.

Gorgas's superiors ignored the warning. There was no interruption of movement between camps whatsoever; not until weeks later, with the camps paralyzed and, literally, tens of thousands of soldiers dead or dying, did the army make any adjustments.

One man did act, however. On September 26, although many training camps had not yet seen any influenza cases at all, Provost Marshal Enoch Crowder canceled the next draft (he would also cancel the draft after this one). It had been scheduled to send one hundred forty-two thousand men to the cantonments.

It was a bold move, made despite the unquenched appetite of George Pershing, in charge of the American Expeditionary Force, for men. In France, Pershing was pressing forward, earlier that same day launching a major offensive in the Meuse-Argonne region. As the Americans charged out of their trenches, the Germans shredded their ranks. General Max von Gallwitz, the commander facing them, entered into his official record, 'We [have] no more worries.'

Despite this, Crowder had acted immediately and likely saved thousands of lives, but he did not cancel the draft to save lives. He did so because he recognized that the disease was utterly overwhelming and creating total chaos in the cantonments. There could be no training until the disease passed. He believed that sending more draftees into this chaos would only magnify it and delay the restoration of order and the production of soldiers. In
Murder in the Cathedral,
T. S. Eliot could call it 'the greatest treason: to do the right thing for the wrong reason.' The men who lived because of Crowder might disagree with the poet.

But Crowder's decision and the efforts of the Gorgas-led army medical corps would be the only bright spots in the response of the federal government. Other army decisions were not such good ones. Pershing still demanded fresh troops, troops to replace those killed or wounded in battle, troops to replace those killed by or recovering from influenza, troops to replace those who simply needed relief from the line. All the Allied powers were desperate for fresh American boys.

The army had to decide whether to continue to transport soldiers to France during the epidemic. They had information about the costs. The army knew the costs well.

* 

On September 19 the acting army surgeon general, Charles Richard (Gorgas was in Europe) wrote General Peyton March, the commander of the army, urging him that 'organizations known to be infected, or exposed to the disease, be not permitted to embark for overseas service until the disease has run its course within the organization.'

March acknowledged the warning from Gorgas's deputy but did nothing. The chief medical officer at the port of embarkation in Newport News, Virginia, rephrased (more emphatically) the same warning: 'The condition [on a troopship] is almost that of a powder magazine with troops unprotected by previous [influenza] attack. The spark will be applied sooner or later. On the other hand with troops protected by previous attack the powder has been removed.' He too was ignored. Gorgas's office urged quarantining troops heading overseas for one week before departure, or eliminating overcrowding on board. March did nothing.

Meanwhile the
Leviathan
was loading troops. Once the pride of the German passenger fleet, built as the
Vaterland,
she was the largest ship in the world and among the fastest in her class. She had been in New York when America entered the war, and her captain could not bring himself to sabotage or scuttle her. Alone among all German ships confiscated in the United States, she was taken undamaged. In mid-September, on her voyage back from France she had buried several crew and passengers at sea, dead of influenza. Others arrived in New York sick, including Assistant Secretary of the Navy Franklin Roosevelt, who was taken ashore on a stretcher, then by ambulance to his mother's home on East Sixty-fifth Street, where he stayed for weeks too ill to speak with even his closest adviser, Louis Howe, who kept in almost hourly touch with his doctors.