War and Pestilence: a Doctor’s Story
In this time of medical crisis, I believe most of us have a renewed respect for our medical personnel. From the highly skilled healers to the hospital night custodians, they are laboring under stressful, frightening circumstances. They are leaving their families to care for others while running the risk of endangering their own health and that of their own families. Today’s post is dedicated to our doctors, nurses, and all medical and hospital staff across the country and around the world. It speaks of an earlier time when decisions about warning the public of the dangers were handled very differently resulting in uncontrolled spread of the Spanish Flu and tremendous loss of life.
In September 1918, it seemed as though the world was poised on the brink of regaining its sanity and that the conclusion to the War to End All Wars might actually be in sight. Germany was experiencing significant defeats and her allies were crumbling all around her. With America pouring waves of fresh troops into the conflict, Germany was now outmatched. The outcome of the war seemed inevitable. What no one anticipated was the emergence of a deadly new enemy that was about to explode onto an unsuspecting public.
In Georgia, it started in the military training camps at Augusta and Savannah and raged across the state until even the most isolated communities were afflicted. It descended without warning on the Salacoa Valley in northwest Cherokee County the second week of October. Although it is possible today to commute for work from Salacoa to Atlanta, until the late 1950’s the county government considered the valley so rural and so sparsely populated that the winding mountain roads were left unpaved and one had to ford the creek in order to enter the valley proper because there was no bridge. It was in this isolated community that my grandfather had his medical practice and where he and my grandmother raised eleven children to adulthood.
In the excerpt below, literary license was taken regarding the telephone system that operated within the valley in the early twentieth century. I do not know exactly when it was established or when it was abandoned, but my father’s older sisters spoke of the local system and the lady who operated it when they were children. Early telephones were battery operated, which made service possible even in isolated areas that did not have electric service. I suspect the Depression ended the system as it did so many things. After the local telephone system was abandoned, the valley did not have phone service until Southern Bell agreed to run party lines in the mid-1950’s. Electric power arrived in the late 1940’s when an Electric Membership Corporation was formed.
The following is a fictionalized version of family stories that came out of 1918, a period when an invisible enemy wreaked havoc on an unsuspecting world.
Excerpted from The Calling, an unpublished work of historical fiction:
James put aside his newspaper and watched Mary Alice move about the kitchen putting the finishing touches on supper. With Randy and Hiram in France, the strain showed in the new gray at her temples and a few more lines around her eyes. Even so, she was just as beautiful as the day he first saw her sitting beside her mother on a church pew. With this new worry was plastered all over the two-day-old Atlanta Constitution, they would both no doubt have more gray before it was over.
As Mary Alice placed the last bowl on the table, the telephone’s bell jangled. With a sigh, she stepped to the wall and lifted the earpiece. After a couple of seconds, her eyes grew wide and she signaled for James to take the call.
“Dr. Buchanan, you gotta come now. My children’s all done took real sick and they’s burning hot and coughing like they gonna bring up a lung.”
As James gathered his medical bag and some extra medicines, two more calls came in from other families, all describing the same symptoms. James did not return home until noon the next day and stayed only long enough to gather additional supplies and grab a quick meal. While he was gulping down a little dinner, another call for help came and he was off again without giving Mary Alice any indication of when he would return.
By afternoon, the county school superintendent sent word to close Salacoa School until further notice. Too many children were already infected and the young were being hardest hit by what was now being called an epidemic.
James dismounted from Searchlight and stepped onto the porch just before bedtime, limber tips of pine branches tucked under his arm.
Mary Alice followed him into the house, picking up needles as they fell. “Why are you bringing in that mess? That stuff won’t burn. It’s too green.”
James dropped down on the first chair he came to and massaged the bridge of his nose. “That’s the point. Get me the fireplace shovel and some matches. And call the children. I’m going to set these pine tips smoldering and I want y’all to breath in the smoke. Pinesap is a natural sanitizer and breathing infected air spreads this flu. We don’t have much in the way of medicine to fight this once you’re sick, so the best plan is to stay well.”
After the children had gone to bed, Mary Alice took James’s supper from the warming area of the range, but he waved the plate away. “Can you just make me some mush? My stomach’s acting up and I think mush and a little milk’ll sit on it better.”
James ate without enthusiasm. When a person is exhausted, even the act of eating is a chore and it seemed that everything he ate these days caused him discomfort. He had been meaning to see his friend, Dr. Fogarty, about the problem, but he couldn’t take the time right now.
As he choked down the mush, he quizzed Mary Alice. “Are you keeping everything scrubbed like I told you to?”
Her eyes narrowed as she frowned. “Yes, I keep my kitchen clean. I always have.”
James ignored the notes of irritation in her voice. “I can’t be too clear about how important it is to not just wipe up. You’ve got to sanitize, as well. Scrub everything- every dish, pot, the table, everything- after every use with soap and hot water. Make sure the children scrub their hands and arms often. They are not to put unclean hands near their mouths or noses. Period. I’ll let you know where I am as best I can. I’m going to Mr. Wilson’s now. I’ll be there most of the night. I’ll try to come by home in the morning.”
The spark of irritation in Mary Alice’s eyes flamed. “I am doing all of that. Can’t you see…”
James didn’t give her time to finish. He planted a kiss on the side of her head and strode through the door toward the barn. There was no time to worry about hurt feelings or for arguments.
As he rode the uncomplaining Searchlight through the night, Mr. Wilson’s gaunt face floated before his mind’s eye. The old man was now well advanced in years and had little hope of surviving the hold the disease had taken. The best James could offer was comfort and his presence at the end. Without family, Mr. Wilson was very alone in the world. He had always been so appreciative of the invitations to Sunday dinner and the small attentions others paid him. The old man would not be left to die alone no matter the personal toll. The effects of too little sleep and constant worry plagued him, leaving him with a complaining stomach and ebbing energy. Perhaps he could rest beside Mr. Wilson’s bed.
Visions of withered bodies and haunted faces confronted James as they had during his medical school days. They implored him once more to help them, but instead of trying to move the object barring their way as they had in the past, they were simply watching as he alone pushed with all of his might. It moved a little, but the faces were still not satisfied. They pointed to the unseen barrier with stick-like arms and looked at him with eyes filled with grief. He renewed his efforts, but the object only moved an inch or two. Failure stared at him from the other side. Its face wore an expression of condemnation, accusing him with its baleful stare of not doing his best. It silently mouthed the words, “You promised. You promised.”
James awoke with a start to an unnatural quiet. He picked up Mr. Wilson’s wrist and found it still warm to the touch, but not as warm as living flesh. James began gathering his supplies. Grief would have to wait its turn. Other patients needed him. The body could not be left where it was and the county would have to be notified. He would make the call from home and maybe sleep in his own bed for a couple of hours before starting his rounds.
Hearing a vehicle pull into the yard, James went out onto the porch. He found Charles Sinclair standing at the bottom of the steps with his truck idling.
“You gotta come now. Sarah’s took real sick.”
It had been a long time since James had seen fear darkening his friend’s eyes. “If you’ll notify the preacher we need a burial party organized, I’ll go to your house now. Please stop and let Mary Alice know where I am. Send a rider into Waleska to call the county, as well.” James did not wait for an answer. His foot was in the stirrup before he finished speaking.
James found Sarah burning with fever and having difficulty drawing breath. He had no sooner finished making her more comfortable and gotten her fever down when Mary Alice called to say that a family across the valley needed him. James consulted his pocket watch. Charles should be back soon. He scribbled a quick note with instructions for Sarah’s care and left. By the time he arrived at the distant farm, the family of parents and five children were very ill with high fevers. There was no one to come in and help care for them so James stayed with them until a call came from another family. He then divided his time among the three farms. As the rampaging epidemic roared into its third week, James had been home only a few times to get clean clothes.
He stumbled wearily through his own back door for the first time in four days and greeted Mary Alice with, “I’m only here for a few minutes. Could you make me some cornmeal mush while I change clothes?”
The expression on Mary Alice’s face told him how bad he must look. As he turned to go to their bedroom, she placed a hand on his arm. “You need more than mush. Please stay long enough to eat a meal. It won’t take that much longer to eat real food for a change.”
James was too exhausted to argue. “I’ll stay for a little while, but mush is all that will set well. My stomach is up to its old tricks. And please bring hot water so I can shave.”
In the bedroom, he stared at his reflection in the mirror above the washstand. Mary Alice was right. He couldn’t go on like this much longer. Darkened flesh encircled his eyes and his skin sagged over the peaks and valleys of his skull. An ironic grimace lifted one corner of his mouth. In truth, he pretty much looked like a death mask.
Mary Alice came to the door and leaned against the jamb. When he met her gaze in the mirror, tears shone in her eyes. “Please stay home for a little while and get some rest. It won’t do anybody any good if you kill yourself. You just can’t keep going like this. Surely there’s another doctor who can come in and help.”
He really didn’t have the time or the energy for this. He wiped his razor and threw it at the washstand. It landed with a clatter, gouging the wooden surface. “I can’t stop now and you know it.” His words bounced off the room’s fourteen foot ceiling. He bowed his head and leaned on the washstand. Mary Alice did not deserve to be the target of his frustration. Lowering his volume, he continued, “I simply cannot quit.”
The sight of tears streaming down Mary Alice’s cheeks stabbed him. She suffered, too. Being a doctor’s wife was not easy. There were far too many times when his patients’ needs took precedence over those of his family, too many times he had left her to cope with their eleven children and the waiting patients that lined their porch when he was out on calls. At mealtimes, she cooked without complaint for whoever was waiting. She nursed their children when they were ill because he was away tending to other people’s children.
Going to her, James put his arms around her and drew her to his chest as she wiped her cheeks. “I’m sorry, my love. Please understand. If there were anyone else to care for the community, I would do as you ask, but there isn’t. This is what I was called to do and I can’t fail now.”
“I know that. I really do.” Mary Alice’s voice shook. “But I don’t think God or anyone else expects you to kill yourself. Please, please try to get some rest.”
James smiled and kissed the top of her head. “I didn’t want to create false hope, so I didn’t say anything, but I’ve heard from the state Health Department. They are going to try to send a couple of nurses to help, but the whole state is hit just as hard as we are.” He released her, strode from the room, and was gone before she could speak again.
The nurses eventually arrived from Atlanta, giving James the help he needed. October leaves had flamed into November’s chill, bringing frost nearly every morning and the reopening of the school. The flu epidemic roared to an end as suddenly as it had begun. One day it was raging, the next it simply vanished and the valley breathed a collective sigh of relief. The pandemic’s toll was accounted by most to be the worst in a lifetime, but amidst all of the grief, hope returned. The Germans capitulated as predicted, the guns ceased, and the Armistice was signed. It was a terrible irony that too many American boys had died in their stateside military camps, some without ever seeing a day of war, others having survived the trenches only to face an unseen enemy at home.
Note: The real James lived for another 9 years, dying at the age of 57 of stomach cancer. He continued to practice medicine until just a few months before his death. My grandmother, the real Mary Alice, lived to be 92 and held the life-long belief that my grandfather’s dedication to his patients and the stress of his rural practice were in part responsible for his early demise.
Linda Bennett Pennell is an author of historical fiction set in the American South or about Southerners traveling far from home. While she writes about the land of her birth, anything with a history, whether shabby or regal, ancient or closer to our own day, has fascinated her since early childhood. This love of the past and the desire to create stories of it probably owes much to her Southern roots.
Southern families are filled with storytellers who keep family and community histories alive. It is in their blood and part of their birthright. Linda’s family had many such yarn spinners who entertained the family on cold winter evenings around her grandmother’s fireplace and during long summer afternoons on her wraparound porch. And most important of all, most of those stories were true.