Think in the Morning continues our look into the literary memories of the 1918 Pandemic.  Our first read was Pale Horse, Pale Rider. Katherine Anne Porter gave us an unforgettable memory of the impact of the Spanish flu and the Great War on a young couple whose paths crossed for a short time in Denver, Colorado.  They Came Like Swallows was William Maxwell’s tragic story of a family disrupted by the death of a wife and mother.  Willa Cather wrote One Of Ours about her first cousin.  After enlisting to escape a failed marriage and an unfulfilling life, her cousin left on a troop transport ship to France.  He valiantly saved one of his friends while dozens more died after a virulent outbreak of influenza only to be killed himself shortly after in the battle of Cantigny.  Thomas Wolfe in Look Homeward Angel described the haunting death of his older brother from the influenza that ultimately killed hundreds of thousands of Americans and millions worldwide—more than all the wars of the twentieth century combined. We now turn to the brilliant mind and “keen social observer” John O’Hara whose story The Doctor’s Son provides us with a detailed view of the multiple impacts of the 1918 influenza on a small town in Pennsylvania.  It is hoped that all of these accounts (and more to come) will prove helpful in assessing where we are today in the COVID crisis, what we might expect moving forward, and how we could or should react to it.

O’Hara (James, the narrator of the story) chooses his hometown of Pottsville, Pennsylvania (which he renames Gibbsville) as the site of his story.  In a mere 32 pages O’Hara introduces more characters and scenes than you might expect in a seasoned novel.  The year is 1918, the Spanish flu is raging and Dr. (“Mike”) Malloy, James’s father, is so exhausted that he resorts to keeping a revolver in a fruitless attempt to get some sleep.

He had to have the revolver, because here and there among the people who would come to his office, there would be a wild man or woman, threatening him, shouting that they would not leave until he left with them, and that if their baby died they would come back and kill him … not even a doctor who had kept going on coffee and quinine would use a revolver on an Italian who had just come from a bedroom where the last of five children was being strangled by influenza.  So my father, with a great deal of profanity, would make it plain to the Italian that he was not being intimidated, but would go, and go without sleep.

A medical student, Dr. Myers, arrives to temporarily take the place of Dr. Malloy so that the doctor can rest and recuperate for a few days.  James drives Dr. Myers around the medium sized town to meet the locals and learn the lay of the land.  The elite of the town, who live in the choice areas, are Anglo Saxon Protestants while there are ethnic “patches” (pockets) of Irish Catholics, Italians, and “Hunkies” (Eastern European immigrants).

Over the course of the story, James, who is a mature thirteen year old, learns about the weaknesses of men and women, and finds his own first (unrequited) love.

… it was in the tiny mining villages—“patches”—that the epidemic was felt immediately.

The first stop for Dr. Myers is the family of David Evans, the district superintendent of the largest mining company.  Mrs. Evans, Adele, was “half Polish” … “in her middle thirties and still pretty” (after having two girls) “with rosy cheeks and pale blue eyes and nothing ‘foreign’-looking about her except her high cheekbones and the lines of her eyebrows, which looked as though they had been drawn with crayon.”  After a few calls, James and Dr. Myers return to have lunch with the Evanses.  Mr. Evans was off on business matter.  James is sweet on Edith Evans, Adele’s seventeen year old daughter.

Dinner was a typical meal of that part of the country: sauerkraut and pork and some stuff called nep, which was nothing but dough, and mashed potatoes and lima beans, coffee, tea, and two kinds of pie, and you were expected to take both kinds.

After lunch we get an eyebrow-raising tour of Gibbsville as Dr. Myers and James make a series of calls. After attending to a crowd of patrons at Kelley’s (a mostly Irish Catholic saloon), they follow a “Hunkie” lady to help with her family and we get our first taste of the impact of the influenza on the community.  When Dr. Myers sees the situation, he sends James to get his doctor’s case from the car. James hears the Doctor yelling.

“Come away, God damn it!  Come away from her, you God-damn fool!”  He turned to me for help and said:  “Oh, Jesus, James, this is awful.  The little girl just died.  Keep away from her.  She has diphtheria!” 

“I couldn’t open the back of the car,” I said.

“Oh, it wasn’t your fault.  Even a tracheotomy wouldn’t have saved her, the poor little thing.  But we’ve got to do something for these others. The baby has plenty of spots, and I haven’t even looked at the other two.”  The other two had been awakened by their mother’s screams and were sitting up and crying, not very loud.  The woman had the dead girl in her arms.  She did not need the English language to know that the child was dead.  She was rocking her back and forth and kissing her and looking up at us with fat streams of tears running from her eyes.  She would stop crying for a second, but would start again, crying with her mouth open and the tears, unheeded, sliding in over her upper lip.

… I walked across the hall to the other bedroom and pulled up the curtains.  The man was lying in his underwear; gaunt, bearded, and dead.

I knew he was dead, but I said:  “Hyuh, John, hyuh.”  The sound of my voice made me feel silly, then sacrilegious, and then I had to vomit.

Later we witness how the ethical, religious and cultural divides in the community bear on the various attempts to control the pandemic.

… The women of wealth who could drive their own cars drove them, fetching and carrying blankets and cots, towels and cotton, but their husbands made some of the women stop because of the dangers of influenza and Army medical officers.

… The rector of the Second Presbyterian Church appeared before the Board of Health and demanded that the nuns be taken out of the hospitals on the ground that they were baptizing men and women who were about to die, without ascertaining whether they were Catholics or Protestants. 

… The Standard had a story on the front page which accused unnamed undertakers of profiteering on “rough boxes,” charging as much as for pine boxes as they had for mahogany caskets before the epidemic.

… Doctor Myers at first wore a mask over his nose and mouth when making calls, and so did I, but the gauze stuck to my lips and I stopped wearing it and so did the doctor.

… Collieryville [a neighboring town] seemed strange with the streets so deserted as on some new kind of holiday.  The mines did not work on holy days of obligation, and the miners would get dressed and stand around in front of the poolrooms and saloons, but now they were not standing around, and there was none of the activity of a working day, when coal wagons and trucks rumble through the town, and ten-horse coal teams, guided by the shouted “gee” and “haw” of the driver, would pull loads of timber through the streets on the way to the mines.  Collieryville, a town of about four thousand persons, was quiet as though the people were afraid to come out in the cold November gray.

James and Dr. Myers visit Wisniewski’s, a Polish saloon where a bizarre scene unfolds, both humorous and unnerving.

… (Wisniewski’s) was a saloon in a newer patch than Kelly’s.  It was entirely surrounded by mine shafts and breakers and railroads and mule yards, a flat area broken only by culm banks until half a mile away there was a steep, partly wooded hill which was not safe to walk on because it was all undermined and cave-ins occurred so frequently that they did not bother to build fences around them.

… Wisniewski himself was sick in bed, and everybody understood that the doctor would see him first, before prescribing for the mob in the barroom. 

… Doctor Myers and I went to Wisniewski’s room, which was on the first floor.  Wisniewski was an affable man, between forty and fifty, with a Teutonic haircut that never needed brushing.  His body under the covers made big lumps.  He was shaking hands with another Polack whose name was Stiney.  He said to us:  “Oh, hyuh, Cheem, hyuh, Cheem.  Hyuh, Doc.”

“Hyuh, Steve,” I said.  “Yoksheemosh?”

“Oh, fine dandy.  How’s yaself? How’s Poppa?  You tell Poppa what he needs is lay off this here booze.”  He roared at this joke.  “Ya, you tell him I said so, lay off this booze.”  He looked around at the others in the room, and they all laughed, because my father used to pretend that he was going to have Steve’s saloon closed by the County.  “You wanna drink, Cheem?” he asked, and reached under the bed and pulled out a bottle. I reached for it, and he pulled the bottle away.  “Na na na na na.  Poppa close up my place wit’ the County, I give you a drink.  Ya know, miners drink here, but no minors under eighteen, hey?” He passed the bottle around, and all the other men in the room took swigs.

Doctor Myers was horrified.  “You oughtn’t to do that.  You’ll give the others the flu.”

“Too late now, Doc,” he said.  “T’ree bottle now already.”

“You’ll lose all  your customers, Steve,” I said.

“How ya figure dat out?”  said Steve.  “Dis flu make me die, dis bottle make dem die.  Fwit!  Me and my customers all together in hell, so I open up a place in hell.  Fwit!”

The Doctor’s Son is a gem of a story, “as good as anything O’Hara ever wrote” according to The New Yorker where John O’Hara “contributed nearly two hundred and thirty short stories, including the “Pal Joey” sketches, to The New Yorker, from 1928 to 1967.”

According to Gina Kolata in How Pandemics End:

No more respect was accorded to dead people than would nowadays be accorded to dead goats.” Some hid in their homes. Others refused to accept the threat. Their way of coping, Boccaccio wrote, was to “drink heavily, enjoy life to the full, go round singing and merrymaking, and gratify all of one’s cravings when the opportunity emerged, and shrug the whole thing off as one enormous joke.”

Based on O’Hara’s account of the 1918 influenza in Pennsylvania, things hadn’t changed much over nearly 600 years.  And, anyone reading Twitter or Facebook today might reasonably conclude the same.  To quote Gina Kolata at some length:

According to historians, pandemics typically have two types of endings: the medical, which occurs when the incidence and death rates plummet, and the social, when the epidemic of fear about the disease wanes.

“When people ask, ‘When will this end?,’ they are asking about the social ending,” said Dr. Jeremy Greene, a historian of medicine at Johns Hopkins.

In other words, an end can occur not because a disease has been vanquished but because people grow tired of panic mode and learn to live with a disease. Allan Brandt, a Harvard historian, said something similar was happening with Covid-19: “As we have seen in the debate about opening the economy, many questions about the so-called end are determined not by medical and public health data but by sociopolitical processes.”

Endings “are very, very messy,” said Dora Vargha, a historian at the University of Exeter. “Looking back, we have a weak narrative. For whom does the epidemic end, and who gets to say?”

While we have come a long way in the scientific realm, the best response remains the commonsense behavioral modifications of social distancing, sheltering in place, and hand washing.  Whether we will have the patience to continue these practices until vaccines or treatments become available remains to be seen.