The Barbary Plague

responsibility. Since the army didn’t issue any fresh vegetables at all, he explained, the food couldn’t have come from his operation.¹⁷

Refugees hoarded food in their tents, attracting hungry vermin. So the army ordered that all cooking be confined to communal kitchens. But refugees set up the kitchens too close to the latrines, and many camps lacked screens to keep out the clouds of flies. The homeless on Telegraph Hill shunned the latrines and found relief in the shrubs, contaminating soil and groundwater. Garbage scavengers and latrine excavators were unreliable in their pickups and frequently dropped or scattered their collections. From the fractured sewer mains, rats scurried out to banquet on garbage heaps. They found sanctuary in the ruins, grew fat on the leftover rations, and bred furiously.

Soon camps were diagnosing refugees with cases of typhoid as well as scarlet fever, measles, mumps, diphtheria, and smallpox. Mass vaccination of the refugees began in the camps. Army doctors set up a smallpox hospital in Golden Gate Park, and tent clinics sprouted all over town.

Bedding, gauze, tents, food, and sanitary equipment rolled in by the ton. Along with all the standard disaster rations, the city’s sanitary chief received this refreshing telegram from army headquarters in Washington: “Henry E. Netter, Philadelphia, has offered donation carload of eighty barrels rye whiskey for hospital purposes. Do you want it[?]” The medicinal spirits were shipped express.¹⁸

After checking the condition of the refugee camps, Blue had an unexpected encounter with his old nemesis. An Italian teenager in Oakland named Louis Scazzafava fell sick with a fever and aching, swollen glands. His sickness occurred just a few days after he’d gone hiking in the hills behind the Berkeley campus. Blue looked into the case. It was bubonic plague. However, it was a mild case, and with relief, Blue reported that the boy would live.

Blue’s duties in the East were calling him back. He had the public health service’s Norfolk station to look after. He also had the health and hygiene of the Jamestown Exposition under his command. President Roosevelt and the First Family were scheduled to preside over its grand opening, set for spring of 1907. It had to be perfect.

Still, he was reluctant to go. San Francisco’s health seemed far from secure. The army and Red Cross were holding disaster at bay, although their pit latrines and diarrhea made life in the refugee camps an ordeal. Above all, he was troubled by his encounter with Louis Scazzafava, the teenage plague survivor. Plague wasn’t his reason for coming west, but that was the memory that lingered.

“There seems nothing more for me to do here,” Blue wrote to the surgeon general, “yet I am loth [sic] to leave in view of the possibility of plague among campers and pic-nic crowds in the Berkeley hills.”¹⁹

Pushing aside his premonitions, Blue boarded a train back to his post in the East.

“Comfort the People”

IN 1907, SAN FRANCISCO ROSE phoenixlike from the rubble. The city was in such a rush to reinvent itself that it used firebricks, blistered survivors of the inferno, in construction. In Chinatown, these relics of the Great Fire stood out like dark scars on the fresh new facades.

Amid the upbeat clamor of construction, no one expected the trouble brewing aboard the tugboat Wizard. A seaman named Oscar Tomei had fallen ill. Stuporous with fever, Tomei was brought ashore and loaded into a buggy bound for the U.S. Marine Hospital. When he got there, Tomei lapsed into a coma. Burning and mute, he couldn’t give doctors any clue to how he’d caught the infection swimming in his blood.

Bacillus pestis, the plague bacteria. On May 29, Tomei died.

Disbelief, then fear, gripped the doctors. Wasn’t plague wiped out three years ago? They scrambled to interview Tomei’s shipmates about his illness, but the Wizard and its crew were gone. The tug had steamed out the Golden Gate and headed north up the Mendocino coast. Word came that the Wizard sank in high seas, taking Tomei’s history to the bottom of the ocean.

Plague was back in San Francisco, its origins unknown. Now a new team presided over the crisis: Governor George Pardee was ousted after his supporters in the Southern Pacific Railroad Co. cooled toward his independent style. The railroad switched its support to a rural congressman, James N. Gillett, who was elected governor with the help of that old San Francisco kingmaker Boss Abe Ruef.¹

Ruef’s own political star was sputtering out, too. Muckraking newspapermen and graft-weary politicians teamed up to evict the corrupt administration from City Hall. They asked President Roosevelt’s help in enlisting a famous Secret Service agent, William Burns, and a special prosecutor, Francis Heney, to probe the payoffs. Ruef maintained his innocence until he was indicted on sixty-five counts of bribery. Then he pleaded guilty and testified against his old protege Mayor Schmitz—ensuring felony convictions for both.²

With Ruef and Schmitz headed for jail, the city appointed as mayor a respected attorney and physician, Edward R. Taylor, who they hoped could heal City Hall from the inside out.

For ten weeks after Oscar Tomei’s death, plague went silent. Then on August 12, the peace was shattered by a telephone call to the city board of health. Physician Guido Caglieri called from his office at Broadway and Kearny to report a desperately sick young Italian couple in his care.

Francesco Conti and his wife, Ida, were laid up with high fevers and crushing headaches in their house at 20 Midway in the Latin Quarter. The doctor administered fever remedies, which in that day ran the gamut from aspirin to arsenic, from lemonade to opium. Their fevers fell and then rose again to 104 degrees. Only then did the doctor discover the mirror-image lumps that protruded from Francesco’s right groin and Ida’s left thigh. He called an ambulance. The Conti house was quarantined, their child placed with charity child services.

Francesco, clinging to life, was carried to the City and County Hospital isolation ward. He would live. For his wife, it was too late. The infection overflowed from her bursting lymph glands, poisoning her bloodstream in an overwhelming sepsis. Under the germ’s assault, her blood pressure fell, and in this state of shock, her organs failed. By the time the ambulance arrived, Ida was dead.

At that moment, across town, the doctors at the Marine Hospital were hovering over another dying sailor. This time it was a crew member from the steamer Samoa. Just twenty-one years old, Alexander Ruvak wheezed like an ancient marine. His agonal gasps left a ruby froth on his lips. When his struggle ended in death, the doctors were ready to list simple pneumonia on his death certificate. Then they noticed the lumps on his neck—suspicious symptoms that called for an autopsy. From both his lungs and his glands, the doctors extracted fluid swimming with plague bacteria.

The next day was August 13. At the clapboard City and County Hospital, doctors hovered over two newly admitted patients. Guadalupe Mendoza and Jose Hyman, Spanish laborers in their twenties, had been housemates, sharing a Pacific Street shack on the waterfront, where rats congregated. When the fever struck them down, the men were brought to the hospital, where no amount of care could save them.

As their bodies were prepared for autopsy, a sixty-three-year-old Irish-born orderly named Jeremiah O’Leary was on duty on the ward. His hand had an open wound.

By the time the doctors finished their autopsy and figured out what had killed Mendoza and Hyman, the orderly O’Leary had a rising temperature.

A tremor of terror passed through the isolation wards as word spread that the orderly had contracted plague from a patient. A nervous young intern named Arthur Reinstein panicked and refused to tend to O’Leary.

Pale and agitated, Reinstein submitted a letter of resignation, citing “obvious reasons.” The city health board fired him for moral cowardice and neglect of duty. The orderly O’Leary died after a swift two-day siege. Reinstein later begged to return to work, got reinstated, and then resigned again—this time for good.³

Rats infiltrated the wards of the City and County Hospital, but their presence wasn’t noticed until a patient, who came to the hospital to get well, got sicker instead. A forty-year-old Irish-born laborer named John Casey was admitted for a routine illness. While in his hospital bed, he contracted bubonic plague from the unseen vermin. Next, a nurse and intern at the hospital contracted plague.

The hospital was now hopelessly contaminated. Quarantined on August 27, it closed its doors to all but