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A hundred years ago, in February 1919, the world had made it through two waves of the worst influenza outbreak in history and was suffering the final sporadic throes of the so-called Spanish flu. This is a gruesome and sudden death: Sickness could come back in the morning and be somebody seriously incapacitated by night, then dead by the next morning. Because of the biological particulars of this virus, half of the victims who died between 20 and 40 years old. This flu, unlike most strains, which has been victimized by the young and old, killed working people, soldiers, politicians, mothers and fathers of small children-the people most occupied with the labor of society. In all, 675,000 Americans died in the world in 1918 and 1919-far more than the 53,402 who died in combat in World War I.
And yet, for years, Americans did not talk about it much in public. Historians of the flu, starting with Alfred Crosby America's Forgotten Pandemic was the first comprehensive account of the outbreak in the United States, have long wondered the curious fact that this terrible experience is so small mark on the cultural record. Looking at major American newspapers and political discourse in the afterlife, Crosby found that the whole thing seemed to have vanished without a trace. "The flu never inspired awe, not in 1918 and not since," Crosby wrote. Crosby notes that the major writers of that generation, who were busy memorializing the experience of the Great War and probing the depths of the "modern" soul, did not talk much about the flu either. Katherine Anne Porter, William Maxwell, Thomas Wolfe-to write about the epidemic in the ensuing decades. It was not until the end of the 20th century that American historians and documentarians turned their attention to the pandemic.
What was it about the flu that provoked this silent response? Is there something about mainstream American culture, with its optimism and pride, that simply refuses to reckon with the idea of mass death from an unstoppable illness? A close read of a recent history suggests that 20th century silence about the flu epidemic of 1918-19 shows how uneasy many Americans have been with failure, death, and loss, and how strongly the most memorializes acts of caregiving. In fact, they have had enough to do so, they have not been able to do anything to help them. Given America's somewhat pathological focus on results-oriented medicine, and aversion to the acceptance of death, it's little wonder that these women's efforts went unhailed.
Some of the subresponse to the Spanish flu might have been the product of historical circumstance, rather than an artifact of Americans' particular culture. In 1918, the nation's attention was directed to the outcome of the war in Europe. It's also worth remembering that 100 years ago, people were much more accustomed to losing family members to infectious disease. For Americans of the early 20th century whose grandparents might have died of diseases like smallpox or yellow fever. Despite its severity, it did not sound scary. Influenza, flu, influenza, grip-whatever you called it but it is a homey, familiar kind of sickness, a week or so feeling shaky, and then back to normal , "Crosby wrote.
Is there something about mainstream American culture, with its optimism and pride, that simply refuses to reckon with the idea of mass death from an unstoppable illness?
But this "homey, familiar" affliction was singularly murderous. Perhaps it was the contrast between its familiarity and the reality of its terror that made it difficult to process. Literary scholar Jane Elizabeth Fisher posits that the American failure to respond to the truth could be a matter of overload: "The silence surrounding the 1918 influenza pandemic can also be described as a tribute to its awe-inspiring destructive power, the terrifying number of people killed and the inability of human language
It is also a story with few visible protagonists. Doctors, the manly conquerors in other American storiesth In 1918, Alfred Crosby wrote: "All the Physicians of 1918, Alfred Crosby wrote anything," Alfred Crosby wrote. Doctors-then almost universally male-remembered the flu as a time of self-doubt and anguish. "Give us another war with Germany, Mexico and all the other heathenish countries in favor of another blast of this distressing flu," a physician from Tennessee wrote. This doctor feels like a "great, merciless juggernaut has rolled over the land and left us weping and wailing in its path." Historian Nancy Bristow, in her book American Pandemic, quotes one physician who describes the heartbreaking experience: The patient would be dead before you. He could diagnose you and give you some medicine and the next day you'd be dead. … The main thing of visiting each day was to find out who was dead and then bury them. "
This ordeal was not just emotionally upsetting; it was a real blow to doctors' collective professional ego. During the epidemic, mainstream medicine found itself beset by doubters. It was so impossible to treat that folk remedies filled the gap: People tried powdered lobelia, sagebrush tea, rabbits' feet, and a laundry list of other home cures. Homeopathic and osteopathic doctors trumpeted their success with the flu. These doctors raise their mainstream colleagues' weaknesses to criticize them: '' Dominant therapy has been weighed in the balance and founding, '' one homeopath wrote. Bristow quotes for flu-period advertisement for a medicine that questions the single largest advancement of late-19th-century medical science, germ theory: "Those doctors who believe GERMS the cause of disease and have to give drugs to KILL the GERMS are butting their heads against a stone wall and having a new theory of disease." Mainstream physicians had with these to counter these attacks. Historian John M. Barry quotes Victor Vaughan, a former president of the American Medical Association, who said: "Never again allow me to say that medical science is on the verge of conquering disease."
The most common treatment for bed rest, pain relief, insulation, and plenty of warmth. Beyond that, a "prescription" was anyone's guess, and the remedies that doctors prescribed for a list. All kinds of useless "vaccines" were developed. Patients may be prescribed to the bowels, turpentine enemas for the same purpose, bloodletting, quinine (because it worked for malaria, so … try it?), Camphor injections, typhoid vaccines (to stimulate the immune system), alcohol " in heroic doses, "narcotics, linseed poultices, gold (a treatment documented in Willa Cather's novel One of BearAn egg in a cup of orange juice, given every two hours. In such a varied list, you can see how to make a difference.
While male doctors flailed, women took charge of the day-to-day care for flu sufferers. Perhaps this is another reason why the epidemic is so bad. In the United States, home-based care for sickness was de rigueur in the 19th century, and "it was still customary in the second decade of the twentieth century for serious illnesses to be treated at home," historian Emily Abel writes. Care for the flu was an hour-by-hour labor of love-or duty. The nurse would keep the patient hydrated and nourished. Along the way, of course, the nurse risked being infected herself.
Some people have had a relationship with them, or the women in their families were sick too. These patients are looking for professional nurses in their homes, visiting under the auspices of the government, or working in hospitals to fill the gap. For these professionals, the epidemic was the ultimate test. Professional nurses, who were already in high demand, of the war, actually seem to have the epidemic-of its dangers-a time of great professional fulfillment. Nancy Bristow found, through reading their memoirs and writings, that such nurses remembered the epidemic period with something you could call fondness. She quotes Mabel Chilson, a student nurse who recalled how it felt to start in 1918: "The nurses soon became the happiest family and when off duty we had jolly good times. The greatest comfort we have had the knowledge that each girl was doing her best and making good as a nurse. "
Bristow found similar responses in diaries and letters written by nurses across the country. Their cheerfulness is jarring. "The happy memories of the epidemic are many. … The list of treasured experiences is long, "wrote one. "Terrible as was the epidemic influenza, with its frightful toll, there was some tremendous exhilaration to be felt by such a terrible test," wrote another. Nurses at the time insisted that their job, that they should be respected, should be respected. One nurse wrote: "It was a most horrible and yet most beautiful experience. … In 1918, Bristow points out, "The medical profession has been compromised by the medical profession." "The nurses, on the other hand, needed to be managed care-not to fix the disease. They could not do this, but be proud of having done it.
Some nurses commented that this is a socially significant, not just personally virtuous-a gesture of inclusion, proving that the United States had the heart to comfort all the sufferers. Writing in the Survey, a progressive magazine, in November 1918, Frances Hayward recounted the story of her indigent nursing experience and immigrant men in New York during the pandemic. "Hayward wrote," I can not help feeling that in the old building on the river, something more than a fight against influenza had taken place. "Another disease was being fought, a disease of which the nurses were suffering as patients-the disease, the plague of class feeling. Amidst the inconveniences and discomforts of the hospital Lodging House, the kind of democracy to which we are all working showed a sign of health. "
Some nurses explained this noble service as socially significant, not just personally virtuous-a gesture of inclusion, proving that the United States had the heart to comfort all Sufferers.
And it's these reactions-somehow cheerful in the face of great tragedy-that feel most characteristically American. In Katherine Anne Porter's Novella Pale Horse, Pale RiderMiranda and her lover Adam, before they get flu, chat while they're walking down the street during Adam's leave from the military: "Did you ever see so many funerals, ever?" Miranda asks. "Never did. Well, let's be strong minded, "Adam says, shifting the conversation to their plans for that night. Miranda makes it through the flu, but she's forever changed; when she's returned to the living, she finds out that Adam has died. Porter, who criticizes American optimism, who thinks it is a singular tendency to look forward to a backward-a tendency that also blunted the memory of the flu, with its shame and confusion and sadness.
Perhaps mainstream culture in the United States and other Western countries is still too much optimistic to reckon with this kind of threat. We have made progress in preparation for another such epidemic, but not nearly enough. In a paper published in 2015, summarizing findings from interviews about the 2009/2010 H1N1 pandemic with people in Australia and Scotland, Mark DM Davis and a team of researchers wondered what might be pandemic. Was it something the researchers termed "health threat fatigue"? Goal complacency and resistance were not the major responses they found; rather, "health individualism" determined people's responses to the prospect of pandemic flu. Respondents did not think a pandemic was preventable; they just believed that they could boost their own immunity as a defense. People who have been so influential that they could "push through" any influenza.
There's something about the idea of a pandemic that would kill you and your loved ones-orally, and your diet-is difficult to imagine. This is why most of our pandemic-oriented fantasy in culture and public life (Contagion "" "" "" "'' '' '' '' '' '' '' '' '' '' '' '' '' '' '' '' '' '' '' '' '' '' '' '' '' '' '' '' '' '' '' We like a war so much more than a flu. But it might be the flu that gets us.
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