The Spanish Flu was a deadly pandemic that swept though the world in the early part of the twentieth century. Today we talk with Nancy Bristow about her latest book, ‘American Pandemic’ on the outbreak and its impact.
What prompted you to write ‘American Pandemic?’
I had recently finished my first book on a federal reform agency during the First World War, and I was looking for a project that would allow me to continue to explore issues that remained of interest to me, in particular the relationship of the citizen and the state during wartime. In a conversation with my dad I realized for the first time that my own great-grandparents had been victims of the flu pandemic. I had long been interested in the pandemic, and with this familial link, I had the motivation I needed to sustain me. The project became an effort to understand the world in which my great-grandparents lived and died, and to understand the impact these events must have had on my own grandfather, John Bristow. I had known him well when I was a child, but had never talked to him about his parents or their passing. Because we have no written record of their lives or their deaths, I set out to recreate that world through a broad social and cultural history of pandemic in the United States. During my research I discovered that they had not died in 1918, but perhaps in a later wave of the pandemic of 1920.
When a patient contracted a deadly case of the Spanish Flu, what would happen to them?
This was a terrible disease, one that was both rapid in its onset and frightening in its symptoms. Patients could sicken and die in a day, though a week or ten days was more common. Symptoms included a very high fever, headache, terrible aching in the joints and muscles, chills, congestion, and a cough. Often, as the illness persisted, it moved on to include congestion in the lungs, a blood or sputum-filled cough, nosebleeds, delirium or unconsciousness, and eventually a blue or purple discoloration of the extremities and even the face as patients literally drowned in their own bodily fluids. While this illness killed many of the pandemic’s victims, many others died of pneumonia in a world without antiobiotics.
Do you think society’s response to the Outbreak reveals something about us?
The pandemic experience suggests that even in catastrophe, social identity shapes American lives. During the pandemic, Americans acted on established cultural norms, frequently reinforcing rather than challenging traditional social expectations. Men acted in conformity with masculine norms, women according to the standards of womanhood. Similarly, assumptions about class and racial difference were fundamental in shaping how people experienced the crisis, as poverty and racism meant that more marginalized Americans suffered indignity and discrimination alongside their illnesses.
Also informative is the response in the aftermath. Americans quickly forgot the pandemic as part of our public culture. There are no memorials to the victims, and very little cultural output recalling those moments of crisis. There are several explanations for this, including the distraction of the war and the peace, and the power of social norms to prevent any impact on the culture. I would add, as well, Americans’ tendency toward optimism and our tendency to look to the future rather than the past. The result is that those who continued to live with the pain of loss were left to suffer alone and in silence.
While conducting your research, were there any stories or anecdotes of the Outbreak that stood out in your mind?
To be honest, I have had more stories affect me than I could possibly recount here. The pandemic is a story of humans under the most severe circumstances. It is a tale filled with trauma and tragedy, heroism and cowardice, integrity and injustice. The suffering is beyond imagining as patients suffered terrible illnesses, as people lost loved ones, as families could no longer fulfill the most basic functions of mourning, as communities sometimes rallied in heroic actions and in others acted out longstanding prejudices. One story that has stayed with me is that of a child, Edith Potter, who died at the Chemawa Indian School in Salem, Oregon. Her mother was notified by telegram, first of her illness, then of her worsening condition, and finally of her death. Because of the pandemic, Edith was buried immediately, though her mother desperately wanted her child’s body to be returned to her for burial. A year later, the mother was still seeking to reclaim the body. The tragedy of the loss had been multiplied by separation, by the realities of the pandemic, and ultimately by the disregard for this mother’s needs made easier by cultural hierarchy.
In the 90’s you wrote a book dealing with the First World War called ‘Making Men Moral.’ Did any of the research for that book help in the development of ‘American Pandemic?’
My earlier work made the world of the pandemic one that I felt ready to explore. I was already very familiar with the nation during the war, and had a good grounding in the social and cultural history of the period. I also had some familiarity with the way the experience of disease is framed by the social and cultural context. All of this prepared me to engage with the complex world of the epidemic.
Today, do you think that we are more or less prepared for something on the scale of the 1918 Outbreak?
We are much better prepared than we were in 1918. We know much more about influenza, and flu vaccines are available to help in preventive work. We have antibiotics to help with many of the sequelae that follow influenza. And we have a much more comprehensive national and world public health system in place. Even so, influenza viruses continue to challenge us through genetic shift, and the smaller world we live in means that viruses can travel between continents in hours. Influenza remains a meaningful threat, and so when the World Health Organization or the Center for Disease Control announces problems and proposes cautionary measures, I would encourage people to pay attention.
Anything else you would like to add?
I think there is much to be learned by studying the past. While I don’t imagine we can avoid repeating it, there are surely lessons worthy of our attention. In this case, the needs of the most marginalized during this earlier crisis suggest how seriously the differences and disparities in our culture play out during catastrophes. Hurricane Katrina feels very similar to me, as again we were entirely unprepared to handle the needs of fellow citizens in the midst of chaos, and as a result those with the least suffered the most. Surely a nation with the wealth and opportunity of ours should be working to protect our most vulnerable neighbors from such tragedies.