Tweet
There are some interesting links at the original site.
http://www.baltimoresun.com/news/hea...alth-headlines
The overlooked pandemic
By Linell Smith
Sun Reporter
Originally published October 20, 2006
Through the veil of nearly 90 years, Paul Schenker remembers people lining up outside any rowhouse they saw a doctor enter. Then a teenager in East Baltimore, he watched his neighbors wait anxiously to plead for a remedy, for anything that might cure the influenza.
Now 103 and living in a condominium on Park Heights Avenue, the retired surgeon recalls how helpless he felt when his own mother became ill.
"Everyone was frightened," Schenker recalls. "I was frightened. I knew it was a deadly disease."
It was the fall of 1918. While America fought the final battles of World War I in Europe, the homeland was attacked by a virus that would kill as many as 650,000 Americans - more than were lost to all the battles of the 20th century.
Death came so swiftly, so abundantly, that Baltimore could not furnish enough coffins. Soon it lacked for gravediggers.
Few nowadays are familiar with what transpired during an event that some call the "forgotten pandemic." It was long neglected by historians even though as many as 50 million died worldwide by the next spring. Tributes were paid to war dead or disaster victims and rarely to those lost to the flu.
Instead families have handed down their private memories. To bring them to light, The Sun asked readers to share their accounts. Among the dozens who responded were several, such as Schenker, who had first-hand experiences. Many of their recollections appear online or in this article, a part of Baltimore's history that would otherwise go untold.
Lately scholars and health care planners have been tracing the flu's trail through society. They are learning not only how the pandemic crippled institutions but also how it affected human behavior, revealing the need to anticipate psychological as well as physical trauma. The threat of avian flu makes their findings relevant.
The 1918 flu caused havoc in part because the virus selected the hardiest along with its usual victims among infants and the elderly. Now scientists think they know why: A reconstructed form of the 1918 virus triggered a powerful immune response that can destroy the lung.
There are parallels to the response in present-day avian flu victims, says Laurie Garrett, an author whose expertise includes infectious disease. "The immune system goes haywire," she says. "And the people who seem to have had the harshest response are the ones with the most robust immune systems."
In 1918, the loss of the very workers and parents who made society run smoothly magnified the effects of the flu. Although medicine has made great strides since, the existence of high-tech health care may not be enough to prevent spiraling unrest in a future pandemic.
Drawing from the lessons of the past, flu planners should tackle emotional as well as physical needs, scholars say. The stresses of illness, death and municipal breakdowns in 1918 prompted unpredictable acts of heroism and selfishness, they found. And the reverberations, sometimes unspoken, lasted for decades.
"Behavior was completely erratic," says Nancy K. Bristow, a professor of 20th-century U.S. history at the University of Puget Sound in Tacoma, Wash. She says some people did all they could, while others only protected themselves.
"There'd be a sick widow and children starving on one block because no one would bring them food while there was a major mobilizing effort to help victims occurring on the next block."
A medical anthropologist has tried to anticipate how modern society would react to the sort of mass suffering and social disruptions caused by the flu. Using Baltimore as a model, Monica Schoch-Spana wrote "Lessons from the 1918 Pandemic Influenza" in 2000 for the Johns Hopkins University Center for Civilian Biodefense Strategies.
Her report was intended as an analog for a possible bioterrorism attack. Now it also provides insights for flu preparedness.
Schoch-Spana found that in 1918, Baltimore's emotional needs exceeded "narrowly defined medical ones" and suggests finding ways to help people cope with such traumatic circumstances as witnessing death.
She concluded, for instance, that the city inadvertently heightened public anxiety by closing churches and synagogues.
"It was seen as taking away a central place for comfort and solace," says Schoch-Spana, who is now at the University of Pittsburgh's Center for Biosecurity.
She also found that bigotry limited African-Americans' access to hospital care and that public morale was shaken by lack of clear communication.
"An epidemic is a disaster that unfolds over time. It has an extended crisis period in contrast to something like a hurricane," she says.
The pandemic hit the United States in three waves. The first, in the spring of 1918, was mild. The most lethal came that fall. The last, in the winter of 1919, was less virulent. Yet it brought the death toll in Baltimore to about 5,000, one of the worst records among cities measured by the Census Bureau.
The sickness took root in the military camps. In Maryland, it struck troops at Camp Meade as early as Sept. 17 while they were waiting to leave for Europe, and swept through the Army's medical department at Fort McHenry. It also hit Camp Holabird, which was in the southeast part of the city, and Edgewood Arsenal, which is now a part of Aberdeen Proving Ground.
From the onset, people had no idea what to expect. Baltimore's health commissioner, John D. Blake, initially downplayed the illness in the military camps as "the same old influenza that the physicians have recognized and treated for many years."
That was not uncommon, says John Barry, author of The Great Influenza, a recent best-selling history. "I've sometimes heard public health physicians referred to as 'The Department of Public Reassurance.' The idea that you need to tell the truth is a lesson that can be learned from this pandemic."
Government planners have designed formats to deliver timely, factual reports online and in other media. The idea is to strike a balance between provoking panic and abetting complacency, says a federal official.
"We don't want people not to have any anxiety, because then they don't take the precautions to be safe," says Daniel Dodgen, emergency management coordinator for the federal Substance Abuse and Mental Health Services Administration. "But we don't want them to be so anxious that they are paralyzed to take care of themselves and their loved ones."
In 1918, Baltimoreans sifted through rumors and conflicting reports in newspapers. Some doctors thought the flu was ordinary "grip" - a term used for flu - worsened by war work. Other accounts speculated that German agents had unleashed germ warfare. For a while, even German-owned Bayer aspirin was suspect.
Because of the war, the disease was perceived in nationalistic terms, Schoch-Spana says. "The flu was called a 'Hun' of a disease. Coughs and sneezes were characterized as more dangerous than bullets or poison gas."
The disease was widely known as the Spanish flu. During wartime, neutral Spain published accounts of the outbreak while other European countries censored them.
Some people also began calling it "the blue death" because of the terrifying symptoms. When final complications set in, the victims' skin often darkened as their lungs failed.
In reconstructing that fearful time, The Sun interviewed historians and various record keepers to supplement material gleaned from newspapers, diaries, and archives. In addition, 55 readers were interviewed about surviving the flu or its effect on their relatives.
Painful memories
Paul Schenker's sick mother was fortunate enough to be seen by a doctor who made house calls in their neighborhood. After she fell ill at home on East Pratt Street, he and his two younger sisters could not care for her during the day, he says.
At 15, he was bundling newspapers after school to supplement the income of his father, who had come to the United States from Russia and worked in a sweatshop with other immigrants.
The family lived in one of the areas near the harbor where the virus first spread among civilians. People would line up, in a scene such as Schenker recalled, to get popular remedies of the day that proved to be no cure: camphor, aspirin and quinine.
No one dared predict who would survive the flu.
Molly Dora Schenker recovered to see her son marry and become a surgeon at Sinai Hospital.
A few miles to the southwest, however, the flu derailed the Everhart household. In less than two weeks, 7-year-old Ralph lost his 31-year-old father and 8-year-old sister. His mother placed her four surviving children in a Baltimore orphanage because she was unable to provide for them.
"It was a horrible thing to go through," says April Jefferson, daughter of the late Ralph Everhart. "My father was really traumatized by what happened, and it affected his [personal] relationships for the rest of his life."
People were cautioned not to kiss, shake hands or speak face to face. In South Baltimore, neighbors shouted greetings and news across the street. If they came closer, they would put a hand over their mouths when talking, says Virginia Stein of Linthicum Heights. She learned this from her grandparents, Maud and Robert DeLashmutt, who got sick while they were courting.
"If someone on your street had the flu, it was awful," they told her. "Everyone got a lot more nervous."
In early October of that year, Baltimore officials abruptly canceled a patriotic parade and then closed schools, colleges and other gathering spots. Soon churches and synagogues were off limits as well.
City officials made plans to "flush" the streets of dust they believed contained germs. Trolley tokens were washed daily. Some people wore face masks. Public spitting was cause for arrest.
The flu sickened one-fourth of Baltimore's almost 600,000 residents, Schoch-Spana found, and hospitals were overwhelmed. The city was unnerved by the avalanche of deaths and the collapse of essential services. Illness sidelined police, firefighters, phone operators, postal workers and the doctors and nurses who were already in short supply because of the war.
It cut across social classes, stealing dock workers, hotel bellmen and society ladies.
Guilford matron Margaret Stirling Baldwin died 16 days after she attended a patriotic rally to pose as "The Goddess of Liberty" for James Montgomery Flagg, the Liberty Loan poster artist who proclaimed her the "prettiest woman in Baltimore." Her obituary was accompanied by the same illustration of her and her daughter that had promoted the rally.
More than 3,000 died in the city that October, a month that became the deadliest in U.S. history.
The flu was fast, overtaking or killing within a day or two. Accounts describe people dying in hospital elevators, robust teenagers keeling over.
"My mother remembered collapsing on the front stoop of her home on McElderry Street, near Patterson Park," says 61-year-old Roberta Ross. "She was 17. The next thing she remembered was waking up three days later. When she looked out the window, there were coffins piled on the street corner. So many people were dying so quickly, they couldn't pick them up and get them away quick enough."
Julia Chmielewski Abbey was 10 when her uncle died at home, near her rowhouse on Highland Avenue in Canton. At that time, the bells at the St. Casimir and Holy Rosary Catholic churches tolled continually for the dead, Abbey told her children during her lifetime.
"The death wagons were going up and down the street. If you had a person who had died in your house, you brought them out to the wagon. They put them all in a mass grave," says Joan Abbey Krause. "My mother's uncle was buried in a mass grave."
So was Edward Shanahan, an Irish immigrant who had come to Baltimore in the 1880s. His granddaughter, Pat Shanahan, grew up hearing tales from her parents about the coffins piled on sidewalks.
Sol Levinson and Bros. Funeral Home held six funerals in September, 82 in October and eight in November.
"On one day alone, there were seven services," says Stanley Levinson, who now co-owns the business. "They couldn't get the people buried fast enough."
When coffins ran out, the city spent $25,000 on an emergency supply. The mayor asked mourners to make do with any available caskets, while undertakers requested they bathe and dress their relatives' bodies. Many funerals were held at home to avoid wider infection.
Mount Auburn Cemetery, one of the largest cemeteries for African-Americans, overflowed with the coffins of flu victims. Men to dig the graves "could not be obtained at any price," The Sun reported. When the pile surpassed 150 - many unburied for two weeks or more - a desperate mayor called on the War Department.
A detail of 350 soldiers from Camp Meade buried the dead.
Pharmacist Joseph Sandler dug the grave at United Hebrew Cemetery for his 4-year-old daughter, recalls his son, Gilbert Sandler of Baltimore.
"Baby" Helen Sandler died at the peak of the epidemic that her father tried futilely to combat. The East Baltimore pharmacist continued making house calls throughout the neighborhood, dispensing medicine he knew to be useless.
"Most people didn't have access to doctors, so they went to him," Sandler says of his late father. "He would take a little piece of string and tie camphor to it and put it around the necks of the sick children because it gave hope to their sad and devastated parents."
Anxiety and grief finally poisoned one father, Walter Atson of Fleet Street. When the 27-year-old man began to cough and sneeze, he told his wife, Dora, that his time was up - and that he would not die alone. Pulling out a gun, he shot her twice but only wounded her. He tried, and failed, to take his own life.
Dora Atson told police that after three of their children had died from the flu, her husband had grown ever more fearful he would be next.
Even when health officials believed the danger had passed, the flu could flare up. Historians suspect that Armistice Day celebrations on and about Nov. 11 helped create "wavelets" of flu in some communities.
Baltimorean Harriet Jones spent Armistice Day in Nashville, Tenn., where she grew up, and recalls getting the flu not long afterward. Five years old at the time, she was hospitalized for at least a week and was still recovering at Christmas.
"In that hospital, they kept all the windows open to treat the patients," says Jones, now 93. "They also gave me eggnog with some kind of whiskey in it. I couldn't stand it. ... As a result of that heavy fever, all my long hair began to come out so badly that my mother finally cut it off."
Katherine Bullen, who also survived the flu, has a distinct memory of the coffins at the train station in Frederick. The 6-year-old child stood on the platform as her mother tried to keep her from staring at the "crude wooden boxes containing the bodies of strangers who had died in our city."
However, the 94-year-old woman, now living in York, Pa., would not forget them or other grim images her parents never discussed with their children.
"I guess we were all too scared," she says.
Ann G. Carmichael, a medical historian at Indiana University, says that coffins, corpses and mass graves figure in family stories because they are a "profoundly disturbing point of connection" between generations.
"They show the loss of a fundamental dignity and humanity - and that the [customary] reassurances of religion and civilization were absent at the time," she says.
Trumped by war
For decades, American historians overlooked the scope of the Great Influenza. Alfred W. Crosby documented its predations in America's Forgotten Pandemic, first published in 1976 under another title. He determined that World War I not only advanced the spread of the flu but also helped obscure it.
"Because of the war, we spent most our time ignoring the **** thing," he says. "By the time we realized what was going on, it was over, and we were just swatting at its tail feathers."
Historian Nancy Bristow says she believes the war and the pandemic became conflated in the public mind, with the losses of the flu "subsumed" by those of battle.
"Epidemics are largely forgotten historically, and that would especially happen at a post-war time when American power was burgeoning internationally," she says. "The story of our inability to stop the flu was not a narrative people wanted to hear."
She learned only 10 years ago that her orphaned father had lost his parents to the flu, making her wonder how many others carried a residue of pain they hadn't linked to the pandemic.
Bristow equates the lack of acknowledgement to the silence that greeted veterans returning from Vietnam.
"In this country, we don't tend to think about the lifetime suffering of individuals," she says. "And cultural amnesia can bring more pain to those who are still remembering their loss every single day of their lives."
It's a reminder that the emotional fallout from a pandemic can continue to harm people, sometimes for generations. One lesson, Bristow says, is "to be attentive to the grief of those who survive - and to realize how powerful their losses are."
Family secrets
Saul Lindenbaum, a child psychologist in Baltimore, has observed how silences can haunt families - including his own.
In October 1918, his mother, Sophie Trost Lindenbaum, was 4 and living in New York's Lower East Side. When her father, Herman Trost, fell sick, her mother, Lena, nursed him back to health. Then, like many other exhausted caretakers, Lena Trost contracted the flu. A few days later, she was dead.
Sophie never forgot her father's reaction to her mother's death - a powerful scene that Saul Lindenbaum described in a family history:
"Lena was in the bed, eyes closed, just as Herman had left her. She had died at six o'clock that morning just two days shy of her 27th birthday. ... Sophie watched as he walked to the bed and opened Lena's eyelids as if he could not believe she was gone. ... She was dead, there was no doubt about it. Herman leaned forward and struck the wall with his forehead. Then he did it again and again as the children watched in wonder and fear."
When Herman remarried, he told his daughters to "forget about" Lena, perhaps believing he was doing them a favor, Lindenbaum says.
Instead, he burdened them with a painful secret. Not until 1956 did Sophie tell her then-15-year-old son, Saul, that the grandmother he loved was not his blood relative.
In the 1980s, Lindenbaum discovered another secret: He had an uncle he never knew existed. After Lena died, Herman placed their youngest child - a toddler with some undisclosed abnormality - in an institution. No relative alive today knows what became of him.
Little Joseph Trost disappeared into the pandemic's great wake of forgetting.
"My mother always had a sense of life being very fragile, that everything could be lost in a moment," Lindenbaum says.
"I think the silence probably made it harder. As a therapist, I have to believe that if you can talk about things, it helps you ease your way. ...
"My grandfather used to say he believed in heaven because he felt that this earth was hell. He used to say, 'It can't get worse than this.'"
But he never told his grandson why. And Saul Lindenbaum never thought to ask.
linell.smith@baltsun.com
Sun researcher Paul McCardell contributed to this article
http://www.baltimoresun.com/news/hea...alth-headlines
The overlooked pandemic
By Linell Smith
Sun Reporter
Originally published October 20, 2006
Through the veil of nearly 90 years, Paul Schenker remembers people lining up outside any rowhouse they saw a doctor enter. Then a teenager in East Baltimore, he watched his neighbors wait anxiously to plead for a remedy, for anything that might cure the influenza.
Now 103 and living in a condominium on Park Heights Avenue, the retired surgeon recalls how helpless he felt when his own mother became ill.
"Everyone was frightened," Schenker recalls. "I was frightened. I knew it was a deadly disease."
It was the fall of 1918. While America fought the final battles of World War I in Europe, the homeland was attacked by a virus that would kill as many as 650,000 Americans - more than were lost to all the battles of the 20th century.
Death came so swiftly, so abundantly, that Baltimore could not furnish enough coffins. Soon it lacked for gravediggers.
Few nowadays are familiar with what transpired during an event that some call the "forgotten pandemic." It was long neglected by historians even though as many as 50 million died worldwide by the next spring. Tributes were paid to war dead or disaster victims and rarely to those lost to the flu.
Instead families have handed down their private memories. To bring them to light, The Sun asked readers to share their accounts. Among the dozens who responded were several, such as Schenker, who had first-hand experiences. Many of their recollections appear online or in this article, a part of Baltimore's history that would otherwise go untold.
Lately scholars and health care planners have been tracing the flu's trail through society. They are learning not only how the pandemic crippled institutions but also how it affected human behavior, revealing the need to anticipate psychological as well as physical trauma. The threat of avian flu makes their findings relevant.
The 1918 flu caused havoc in part because the virus selected the hardiest along with its usual victims among infants and the elderly. Now scientists think they know why: A reconstructed form of the 1918 virus triggered a powerful immune response that can destroy the lung.
There are parallels to the response in present-day avian flu victims, says Laurie Garrett, an author whose expertise includes infectious disease. "The immune system goes haywire," she says. "And the people who seem to have had the harshest response are the ones with the most robust immune systems."
In 1918, the loss of the very workers and parents who made society run smoothly magnified the effects of the flu. Although medicine has made great strides since, the existence of high-tech health care may not be enough to prevent spiraling unrest in a future pandemic.
Drawing from the lessons of the past, flu planners should tackle emotional as well as physical needs, scholars say. The stresses of illness, death and municipal breakdowns in 1918 prompted unpredictable acts of heroism and selfishness, they found. And the reverberations, sometimes unspoken, lasted for decades.
"Behavior was completely erratic," says Nancy K. Bristow, a professor of 20th-century U.S. history at the University of Puget Sound in Tacoma, Wash. She says some people did all they could, while others only protected themselves.
"There'd be a sick widow and children starving on one block because no one would bring them food while there was a major mobilizing effort to help victims occurring on the next block."
A medical anthropologist has tried to anticipate how modern society would react to the sort of mass suffering and social disruptions caused by the flu. Using Baltimore as a model, Monica Schoch-Spana wrote "Lessons from the 1918 Pandemic Influenza" in 2000 for the Johns Hopkins University Center for Civilian Biodefense Strategies.
Her report was intended as an analog for a possible bioterrorism attack. Now it also provides insights for flu preparedness.
Schoch-Spana found that in 1918, Baltimore's emotional needs exceeded "narrowly defined medical ones" and suggests finding ways to help people cope with such traumatic circumstances as witnessing death.
She concluded, for instance, that the city inadvertently heightened public anxiety by closing churches and synagogues.
"It was seen as taking away a central place for comfort and solace," says Schoch-Spana, who is now at the University of Pittsburgh's Center for Biosecurity.
She also found that bigotry limited African-Americans' access to hospital care and that public morale was shaken by lack of clear communication.
"An epidemic is a disaster that unfolds over time. It has an extended crisis period in contrast to something like a hurricane," she says.
The pandemic hit the United States in three waves. The first, in the spring of 1918, was mild. The most lethal came that fall. The last, in the winter of 1919, was less virulent. Yet it brought the death toll in Baltimore to about 5,000, one of the worst records among cities measured by the Census Bureau.
The sickness took root in the military camps. In Maryland, it struck troops at Camp Meade as early as Sept. 17 while they were waiting to leave for Europe, and swept through the Army's medical department at Fort McHenry. It also hit Camp Holabird, which was in the southeast part of the city, and Edgewood Arsenal, which is now a part of Aberdeen Proving Ground.
From the onset, people had no idea what to expect. Baltimore's health commissioner, John D. Blake, initially downplayed the illness in the military camps as "the same old influenza that the physicians have recognized and treated for many years."
That was not uncommon, says John Barry, author of The Great Influenza, a recent best-selling history. "I've sometimes heard public health physicians referred to as 'The Department of Public Reassurance.' The idea that you need to tell the truth is a lesson that can be learned from this pandemic."
Government planners have designed formats to deliver timely, factual reports online and in other media. The idea is to strike a balance between provoking panic and abetting complacency, says a federal official.
"We don't want people not to have any anxiety, because then they don't take the precautions to be safe," says Daniel Dodgen, emergency management coordinator for the federal Substance Abuse and Mental Health Services Administration. "But we don't want them to be so anxious that they are paralyzed to take care of themselves and their loved ones."
In 1918, Baltimoreans sifted through rumors and conflicting reports in newspapers. Some doctors thought the flu was ordinary "grip" - a term used for flu - worsened by war work. Other accounts speculated that German agents had unleashed germ warfare. For a while, even German-owned Bayer aspirin was suspect.
Because of the war, the disease was perceived in nationalistic terms, Schoch-Spana says. "The flu was called a 'Hun' of a disease. Coughs and sneezes were characterized as more dangerous than bullets or poison gas."
The disease was widely known as the Spanish flu. During wartime, neutral Spain published accounts of the outbreak while other European countries censored them.
Some people also began calling it "the blue death" because of the terrifying symptoms. When final complications set in, the victims' skin often darkened as their lungs failed.
In reconstructing that fearful time, The Sun interviewed historians and various record keepers to supplement material gleaned from newspapers, diaries, and archives. In addition, 55 readers were interviewed about surviving the flu or its effect on their relatives.
Painful memories
Paul Schenker's sick mother was fortunate enough to be seen by a doctor who made house calls in their neighborhood. After she fell ill at home on East Pratt Street, he and his two younger sisters could not care for her during the day, he says.
At 15, he was bundling newspapers after school to supplement the income of his father, who had come to the United States from Russia and worked in a sweatshop with other immigrants.
The family lived in one of the areas near the harbor where the virus first spread among civilians. People would line up, in a scene such as Schenker recalled, to get popular remedies of the day that proved to be no cure: camphor, aspirin and quinine.
No one dared predict who would survive the flu.
Molly Dora Schenker recovered to see her son marry and become a surgeon at Sinai Hospital.
A few miles to the southwest, however, the flu derailed the Everhart household. In less than two weeks, 7-year-old Ralph lost his 31-year-old father and 8-year-old sister. His mother placed her four surviving children in a Baltimore orphanage because she was unable to provide for them.
"It was a horrible thing to go through," says April Jefferson, daughter of the late Ralph Everhart. "My father was really traumatized by what happened, and it affected his [personal] relationships for the rest of his life."
People were cautioned not to kiss, shake hands or speak face to face. In South Baltimore, neighbors shouted greetings and news across the street. If they came closer, they would put a hand over their mouths when talking, says Virginia Stein of Linthicum Heights. She learned this from her grandparents, Maud and Robert DeLashmutt, who got sick while they were courting.
"If someone on your street had the flu, it was awful," they told her. "Everyone got a lot more nervous."
In early October of that year, Baltimore officials abruptly canceled a patriotic parade and then closed schools, colleges and other gathering spots. Soon churches and synagogues were off limits as well.
City officials made plans to "flush" the streets of dust they believed contained germs. Trolley tokens were washed daily. Some people wore face masks. Public spitting was cause for arrest.
The flu sickened one-fourth of Baltimore's almost 600,000 residents, Schoch-Spana found, and hospitals were overwhelmed. The city was unnerved by the avalanche of deaths and the collapse of essential services. Illness sidelined police, firefighters, phone operators, postal workers and the doctors and nurses who were already in short supply because of the war.
It cut across social classes, stealing dock workers, hotel bellmen and society ladies.
Guilford matron Margaret Stirling Baldwin died 16 days after she attended a patriotic rally to pose as "The Goddess of Liberty" for James Montgomery Flagg, the Liberty Loan poster artist who proclaimed her the "prettiest woman in Baltimore." Her obituary was accompanied by the same illustration of her and her daughter that had promoted the rally.
More than 3,000 died in the city that October, a month that became the deadliest in U.S. history.
The flu was fast, overtaking or killing within a day or two. Accounts describe people dying in hospital elevators, robust teenagers keeling over.
"My mother remembered collapsing on the front stoop of her home on McElderry Street, near Patterson Park," says 61-year-old Roberta Ross. "She was 17. The next thing she remembered was waking up three days later. When she looked out the window, there were coffins piled on the street corner. So many people were dying so quickly, they couldn't pick them up and get them away quick enough."
Julia Chmielewski Abbey was 10 when her uncle died at home, near her rowhouse on Highland Avenue in Canton. At that time, the bells at the St. Casimir and Holy Rosary Catholic churches tolled continually for the dead, Abbey told her children during her lifetime.
"The death wagons were going up and down the street. If you had a person who had died in your house, you brought them out to the wagon. They put them all in a mass grave," says Joan Abbey Krause. "My mother's uncle was buried in a mass grave."
So was Edward Shanahan, an Irish immigrant who had come to Baltimore in the 1880s. His granddaughter, Pat Shanahan, grew up hearing tales from her parents about the coffins piled on sidewalks.
Sol Levinson and Bros. Funeral Home held six funerals in September, 82 in October and eight in November.
"On one day alone, there were seven services," says Stanley Levinson, who now co-owns the business. "They couldn't get the people buried fast enough."
When coffins ran out, the city spent $25,000 on an emergency supply. The mayor asked mourners to make do with any available caskets, while undertakers requested they bathe and dress their relatives' bodies. Many funerals were held at home to avoid wider infection.
Mount Auburn Cemetery, one of the largest cemeteries for African-Americans, overflowed with the coffins of flu victims. Men to dig the graves "could not be obtained at any price," The Sun reported. When the pile surpassed 150 - many unburied for two weeks or more - a desperate mayor called on the War Department.
A detail of 350 soldiers from Camp Meade buried the dead.
Pharmacist Joseph Sandler dug the grave at United Hebrew Cemetery for his 4-year-old daughter, recalls his son, Gilbert Sandler of Baltimore.
"Baby" Helen Sandler died at the peak of the epidemic that her father tried futilely to combat. The East Baltimore pharmacist continued making house calls throughout the neighborhood, dispensing medicine he knew to be useless.
"Most people didn't have access to doctors, so they went to him," Sandler says of his late father. "He would take a little piece of string and tie camphor to it and put it around the necks of the sick children because it gave hope to their sad and devastated parents."
Anxiety and grief finally poisoned one father, Walter Atson of Fleet Street. When the 27-year-old man began to cough and sneeze, he told his wife, Dora, that his time was up - and that he would not die alone. Pulling out a gun, he shot her twice but only wounded her. He tried, and failed, to take his own life.
Dora Atson told police that after three of their children had died from the flu, her husband had grown ever more fearful he would be next.
Even when health officials believed the danger had passed, the flu could flare up. Historians suspect that Armistice Day celebrations on and about Nov. 11 helped create "wavelets" of flu in some communities.
Baltimorean Harriet Jones spent Armistice Day in Nashville, Tenn., where she grew up, and recalls getting the flu not long afterward. Five years old at the time, she was hospitalized for at least a week and was still recovering at Christmas.
"In that hospital, they kept all the windows open to treat the patients," says Jones, now 93. "They also gave me eggnog with some kind of whiskey in it. I couldn't stand it. ... As a result of that heavy fever, all my long hair began to come out so badly that my mother finally cut it off."
Katherine Bullen, who also survived the flu, has a distinct memory of the coffins at the train station in Frederick. The 6-year-old child stood on the platform as her mother tried to keep her from staring at the "crude wooden boxes containing the bodies of strangers who had died in our city."
However, the 94-year-old woman, now living in York, Pa., would not forget them or other grim images her parents never discussed with their children.
"I guess we were all too scared," she says.
Ann G. Carmichael, a medical historian at Indiana University, says that coffins, corpses and mass graves figure in family stories because they are a "profoundly disturbing point of connection" between generations.
"They show the loss of a fundamental dignity and humanity - and that the [customary] reassurances of religion and civilization were absent at the time," she says.
Trumped by war
For decades, American historians overlooked the scope of the Great Influenza. Alfred W. Crosby documented its predations in America's Forgotten Pandemic, first published in 1976 under another title. He determined that World War I not only advanced the spread of the flu but also helped obscure it.
"Because of the war, we spent most our time ignoring the **** thing," he says. "By the time we realized what was going on, it was over, and we were just swatting at its tail feathers."
Historian Nancy Bristow says she believes the war and the pandemic became conflated in the public mind, with the losses of the flu "subsumed" by those of battle.
"Epidemics are largely forgotten historically, and that would especially happen at a post-war time when American power was burgeoning internationally," she says. "The story of our inability to stop the flu was not a narrative people wanted to hear."
She learned only 10 years ago that her orphaned father had lost his parents to the flu, making her wonder how many others carried a residue of pain they hadn't linked to the pandemic.
Bristow equates the lack of acknowledgement to the silence that greeted veterans returning from Vietnam.
"In this country, we don't tend to think about the lifetime suffering of individuals," she says. "And cultural amnesia can bring more pain to those who are still remembering their loss every single day of their lives."
It's a reminder that the emotional fallout from a pandemic can continue to harm people, sometimes for generations. One lesson, Bristow says, is "to be attentive to the grief of those who survive - and to realize how powerful their losses are."
Family secrets
Saul Lindenbaum, a child psychologist in Baltimore, has observed how silences can haunt families - including his own.
In October 1918, his mother, Sophie Trost Lindenbaum, was 4 and living in New York's Lower East Side. When her father, Herman Trost, fell sick, her mother, Lena, nursed him back to health. Then, like many other exhausted caretakers, Lena Trost contracted the flu. A few days later, she was dead.
Sophie never forgot her father's reaction to her mother's death - a powerful scene that Saul Lindenbaum described in a family history:
"Lena was in the bed, eyes closed, just as Herman had left her. She had died at six o'clock that morning just two days shy of her 27th birthday. ... Sophie watched as he walked to the bed and opened Lena's eyelids as if he could not believe she was gone. ... She was dead, there was no doubt about it. Herman leaned forward and struck the wall with his forehead. Then he did it again and again as the children watched in wonder and fear."
When Herman remarried, he told his daughters to "forget about" Lena, perhaps believing he was doing them a favor, Lindenbaum says.
Instead, he burdened them with a painful secret. Not until 1956 did Sophie tell her then-15-year-old son, Saul, that the grandmother he loved was not his blood relative.
In the 1980s, Lindenbaum discovered another secret: He had an uncle he never knew existed. After Lena died, Herman placed their youngest child - a toddler with some undisclosed abnormality - in an institution. No relative alive today knows what became of him.
Little Joseph Trost disappeared into the pandemic's great wake of forgetting.
"My mother always had a sense of life being very fragile, that everything could be lost in a moment," Lindenbaum says.
"I think the silence probably made it harder. As a therapist, I have to believe that if you can talk about things, it helps you ease your way. ...
"My grandfather used to say he believed in heaven because he felt that this earth was hell. He used to say, 'It can't get worse than this.'"
But he never told his grandson why. And Saul Lindenbaum never thought to ask.
linell.smith@baltsun.com
Sun researcher Paul McCardell contributed to this article
Comment