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

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

 

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

 

In September 1918, the second pandemic influenza wave was making its

way through the America. Military bases were especially hard hit by

the pandemic in the US. Below is a reprint of a letter from a

recently recruited military doctor assigned to a US Army base in

Massachusetts, Camp Devens. This was a training base for new recruits

and was one of the worst affected by the flu. The letter is important

for its clear description of the rapid course of the illness, how this

pandemic flu differed so greatly from the usual seasonal variety, and

how the medical resources of the camp had become exhausted by the

sheer number of cases and the high case fatality rate.

 

 

 

Camp Devens, Mass.

Surgical Ward No 16

29 September 1918

(Base Hospital)

 

 

 

My dear Burt-

It is more than likely that you would be interested in the news of

this place, for there is a possibility that you will be assigned here

for duty, so having a minute between rounds I will try to tell you a

little 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 in

Detroit, so when I came here I was somewhat behind in the niceties of

the Army way of intricate Diagnosis. Also to make it good, I have had

for the last week an exacerbation of my old " Ear Rot " as Artie Ogle

calls it, and could not use a Stethoscope at all, but had to get by on

my ability to " spot " ' em thru my general knowledge of Pneumonias. I

did well enough, and finally found an old Phonendoscope that I pieced

together, and from then on was all right. You know the Army

regulations require very close locations etc.

 

 

 

Camp Devens is near Boston, and has about 50,000 men, or did have

before this epidemic broke loose. It also has the Base Hospital for

the Div. of the N. East. This epidemic started about four weeks ago,

and has developed so rapidly that the camp is demoralized and all

ordinary work is held up till it has passed. All assemblages of

soldiers taboo.

 

These men start with what appears to be an ordinary attack of LaGrippe

or Influenza, and when brought to the Hosp. they very rapidly develop

the most viscous type of Pneumonia that has ever been seen. Two hours

after admission they have the Mahogany spots over the cheek bones, and

a few hours later you can begin to see the Cyanosis extending from

their ears and spreading all over the face, until it is hard to

distinguish the colored men from the white. It is only a matter of a

few hours then until death comes, and it is simply a struggle for air

until they suffocate. It is horrible. One can stand it to see one, two

or twenty men die, but to see these poor devils dropping like flies

sort of gets on your nerves. We have been averaging about 100 deaths

per day, and still keeping it up. There is no doubt in my mind that

there is a new mixed infection here, but what I dont know. My total

time is taken up hunting Rales, rales dry or moist, sibilant or

crepitant or any other of the hundred things that one may find in the

chest, they all mean but one thing here -Pneumonia-and that means in

about all cases death.

 

 

 

The normal number of resident Drs. here is about 25 and that has been

increased to over 250, all of whom (of course excepting me) have

temporary orders- " Return to your proper Station on completion of

work " . Mine says " Permanent Duty " , but I have been in the Army just

long enough to learn that it doesn't always mean what it says. So I

dont know what will happen to me at the end of this.

 

 

We have lost an outrageous number of Nurses and Drs., and the little

town of Ayer is a sight. It takes Special trains to carry away the

dead. For several days there were no coffins and the bodies piled up

something fierce, we used to go down to the morgue (which is just back

of my ward) and look at the boys laid out in long rows. It beats any

sight they ever had in France after a battle. An extra long barracks

has been vacated for the use of the Morgue, and it would make any man

sit up and take notice to walk down the long lines of dead soldiers

all dressed and laid out in double rows. We have no relief here, you

get 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 here

all the time, and they are TIRED.

 

 

 

If this letter seems somewhat disconnected overlook it, for I have

been called away from it a dozen times the last time just now by the

Officer of the Day, who came in to tell me that they have not as yet

found 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 for

a 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 o

Pneumonia that when I go to eat I want to find some fellow who will

not " Talk Shop " but there ain't none nohow. We eat it, live it, sleep

it, and dream it, to say nothing of breathing it 16 hours a day. I

would be very grateful indeed if you would drop me a line or two once

in a while, and I will promise you that if you ever get into a fix

like this, I will do the same for you.

 

 

 

Each man here gets a ward with about 150 beds, (Mine has 168) and has

an Asst. Chief to boss him, and you can imagine what the paper work

alone is - fierce,-- and the Govt. demands all paper work be kept up

in 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 are

busy. I write this in piecemeal fashion. It may be a long time before

I can get another letter to you, but will try.

 

 

 

This letter will give you an idea of the monthly report, which has to

be in Monday. I have mine most ready now. My Boss was in just now and

gave 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.