A Doctor's Letter during the Height of the 1918 Pandemic

June 6, 2006

http://fluwikie.com/annex/WoodsonMonograph.htm#_Toc116746517

[27] Published in the British Medical Journal, December 22, 1979

In September 1918, the second pandemic influenza wave was making itsway through the America. Military bases were especially hard hit bythe pandemic in the US. Below is a reprint of a letter from arecently recruited military doctor assigned to a US Army base inMassachusetts, Camp Devens. This was a training base for new recruitsand was one of the worst affected by the flu. The letter is importantfor its clear description of the rapid course of the illness, how thispandemic flu differed so greatly from the usual seasonal variety, andhow the medical resources of the camp had become exhausted by thesheer number of cases and the high case fatality rate.

Camp Devens, Mass.Surgical Ward No 1629 September 1918(Base Hospital)

My dear Burt-It is more than likely that you would be interested in the news ofthis place, for there is a possibility that you will be assigned herefor duty, so having a minute between rounds I will try to tell you alittle about the situation here as I have seen it in the last week.

As you know I have not seen much Pneumonia in the last few years inDetroit, so when I came here I was somewhat behind in the niceties ofthe Army way of intricate Diagnosis. Also to make it good, I have hadfor the last week an exacerbation of my old "Ear Rot" as Artie Oglecalls it, and could not use a Stethoscope at all, but had to get by onmy ability to "spot" ' em thru my general knowledge of Pneumonias. Idid well enough, and finally found an old Phonendoscope that I piecedtogether, and from then on was all right. You know the Armyregulations require very close locations etc.

Camp Devens is near Boston, and has about 50,000 men, or did havebefore this epidemic broke loose. It also has the Base Hospital forthe Div. of the N. East. This epidemic started about four weeks ago,and has developed so rapidly that the camp is demoralized and allordinary work is held up till it has passed. All assemblages ofsoldiers taboo.

These men start with what appears to be an ordinary attack of LaGrippeor Influenza, and when brought to the Hosp. they very rapidly developthe most viscous type of Pneumonia that has ever been seen. Two hoursafter admission they have the Mahogany spots over the cheek bones, anda few hours later you can begin to see the Cyanosis extending fromtheir ears and spreading all over the face, until it is hard todistinguish the colored men from the white. It is only a matter of afew hours then until death comes, and it is simply a struggle for airuntil they suffocate. It is horrible. One can stand it to see one, twoor twenty men die, but to see these poor devils dropping like fliessort of gets on your nerves. We have been averaging about 100 deathsper day, and still keeping it up. There is no doubt in my mind thatthere is a new mixed infection here, but what I dont know. My totaltime is taken up hunting Rales, rales dry or moist, sibilant orcrepitant or any other of the hundred things that one may find in thechest, they all mean but one thing here -Pneumonia-and that means inabout all cases death.

The normal number of resident Drs. here is about 25 and that has beenincreased to over 250, all of whom (of course excepting me) havetemporary orders-"Return to your proper Station on completion ofwork". Mine says "Permanent Duty", but I have been in the Army justlong enough to learn that it doesn't always mean what it says. So Idont know what will happen to me at the end of this.

We have lost an outrageous number of Nurses and Drs., and the littletown of Ayer is a sight. It takes Special trains to carry away thedead. For several days there were no coffins and the bodies piled upsomething fierce, we used to go down to the morgue (which is just backof my ward) and look at the boys laid out in long rows. It beats anysight they ever had in France after a battle. An extra long barrackshas been vacated for the use of the Morgue, and it would make any mansit up and take notice to walk down the long lines of dead soldiersall dressed and laid out in double rows. We have no relief here, youget up in the morning at 5:30 and work steady till about 9.30 P.M.,sleep, then go at it again. Some of the men of course have been hereall the time, and they are TIRED.

If this letter seems somewhat disconnected overlook it, for I havebeen called away from it a dozen times the last time just now by theOfficer of the Day, who came in to tell me that they have not as yetfound at any of the autopsies any case beyond the red hepatitis stage. It kills them before they get that far.

I don't wish you any hard luck Old Man but I do wish you were here fora while at least. It's more comfortable when one has a friend about.The men here are all good fellows, but I get so damned sick oPneumonia that when I go to eat I want to find some fellow who willnot "Talk Shop" but there ain't none nohow. We eat it, live it, sleepit, and dream it, to say nothing of breathing it 16 hours a day. Iwould be very grateful indeed if you would drop me a line or two oncein a while, and I will promise you that if you ever get into a fixlike this, I will do the same for you.

Each man here gets a ward with about 150 beds, (Mine has 168) and hasan Asst. Chief to boss him, and you can imagine what the paper workalone is - fierce,-- and the Govt. demands all paper work be kept upin good shape. I have only four day nurses and five night nurses(female) a ward-master, and four orderlies. So you can see that we arebusy. I write this in piecemeal fashion. It may be a long time beforeI can get another letter to you, but will try.

This letter will give you an idea of the monthly report, which has tobe in Monday. I have mine most ready now. My Boss was in just now andgave me a lot more work to do so I will have to close this.

Good Bye old Pal,"God be with you till we meet again"Keep the Bowels open.(Sgd) Roy.