The Barbary Plague

rats.

Blue never lost his appetite for fieldwork—even after his tenure as surgeon general was over. He happily got back into harness to travel west and confront his old nemesis, the rat, when a plague outbreak claimed thirty victims in Los Angeles in 1924. He urged that the country maintain a standing force of public health officers ready to take the field to fight outbreaks at a moment’s notice, as he had done throughout his career.

He often received letters from a public curious about the modern toll of an ancient scourge. One of them was from Alda Will, a woman in Coronado, California, who wrote the surgeon general seeking advice for a friend who had survived bubonic plague. She asked what lingering aftereffects her friend might suffer.

Dear Madam, Blue cautioned, the scourge of bubonic plague leaves “severe traces” on the human heart, and it may never be the same.¹⁴

Acknowledgments

AS A MEDICAL REPORTER covering epidemics from plague to AIDS, I had read and reread Daniel Defoe’s A Journal of the Plague Year, for insight into the human dynamics of epidemic, and how fear drives people to folly. In 1994, just as I began a new assignment writing The Wall Street Journal’s health column, the plague resurfaced half a world away in India. The 1994 outbreak unreeled before Western eyes like a febrile nightmare: photos of masked Indian doctors tending the sick and the dead. The outbreak conjured up images of ailing jet travelers landing in New York or Los Angeles. My editors requested a column on the Indian outbreak. I wrote about how the U.S. Centers for Disease Control and Prevention surveillance teams were monitoring airports to prevent the epidemic from being imported. The CDC experts were alert to the threat of travel-borne disease, but mystified by the panic. Plague, they said, is already endemic in the wildlife of the western United States. What seemed like an exotic foreign scourge was, in fact, already at home on these shores. How plague came to America was a story I wanted to tell.

But reconstructing the history of a smoldering ten-year plague required help from many hands. Early in my research I benefited from reading the scholarly analysis of medical historian Guenter Risse of the University of California at San Francisco. Dr. Risse’s 1992 article in the Bulletin of the History of Medicine, “‘A Long Pull, a Strong Pull, and All Together,’” opened my eyes to the political dynamics at work in quelling the outbreak, as well as to the wealth of primary source material documenting the episode. Moses Grossman, retired chief of pediatrics at San Francisco General Hospital, who has treated plague in children, offered early encouragement in the research. Scholars of the city’s past, Gladys Hansen and Charles Fracchia of the San Francisco Museum and Historical Society, graciously shared their expertise. Susan Haas of the Society of California Pioneers guided me through her group’s photo archives.

Special thanks are due to John Parascandola, U.S. Public Health Service historian, who was a generous guide to his field, sharing documents, insights, and interpretation. Like Chaucer’s scholar, “gladly wolde he lerne, and gladly teche.”

I spent a week happily plundering the documents at the National Archives and Records Administration in College Park, Maryland, with the assistance of ace archivist Marjorie Ciarlante, who met me with a hand truck the size of a Volkswagen bug, piled with boxes from NARA’s Records Group 90, Central File (1897–1923). Inside lay the history of the U.S. Public Health Service plague fighters in century-old letters, autopsy reports, and telegrams that were crisp and tobacco-hued with age. Thanks are also due the staff of NARA’s facility in San Bruno, California, where documents on the Angel Island Quarantine Station and 1906 earthquake are housed. I am grateful to Stephen Greenberg, Elizabeth Tunis, and all the staffers at the National Library of Medicine in Bethesda, Maryland, for help in researching the papers of Joseph J. Kinyoun, and for photographs and other documents.

At the University of California at Berkeley, I benefited from the rich holdings of the Bancroft Library and the East Asian Library. Special thanks go to librarian Wei-Chi Poon, who patiently checked out reel after reel of the century-old Chinatown newspaper on microfilm. My appreciation goes to Professor Charles McClain of Berkeley’s Boalt Hall School of Law for his analysis of the clash between public health and civil rights. The San Francisco Public Library’s San Francisco History Center was a haven for documentary and photographic research. Thanks go to Tom Carey and Pat Akre and their colleagues.

Unlocking the secrets of turn-of-the-century Chinatown culture would have been impossible without the help of my translator, Sister Prisca Hui, Roman Catholic nun and experienced translator. She interpreted scores of articles from the Chinatown daily newspaper, Chung Sai Yat Po, guiding me with humor and zest through the linguistic subtleties of the immigrant community on “Gold Mountain.” I am indebted to many scholars of San Francisco’s Chinatown for helpful discussions, including Him Mark Lai, the Reverend Harry Chuck, James Chin of the Chinese Consolidated Benevolent Society, Professor Judy Yung of the University of California at Santa Cruz, and the staff of the Chinese American Historical Society in San Francisco.

Plague scientists from the U.S. Centers for Disease Control and Prevention in Fort Collins, Colorado—Drs. Kenneth Gage, David Dennis, and May Chu—shared all they know about plague, from rats to fleas to human victims. The plague laboratory chief of the Pasteur Institute in Paris, Elisabeth Carniel, shared stories of venturing into plague zones from Vietnam to Madagascar—while pregnant and un-vaccinated.

I am indebted to the people of Marion, South Carolina, for graciously tolerating a Yankee reporter who came to town in hot pursuit of the ghost of their native son Rupert Blue. The hospitality of Tom Griggs, cultural guidance of Tommy Lett, and the social history provided by Mmes. Elizabeth McIntyre, Suzanne Gasque, and Lucia Atkinson, along with Judge T. Carroll Atkinson III, imparted understanding and flavor to my project. Special thanks to Robert McCollum, owner of Bluefields plantation, for letting me tour the house where Rupert Blue grew up.

My friend Mary Christine Kartman deserves thanks for helping with the quest for information on Lillian Latour, Rupert Blue’s vivacious, jet-eyed autumnal romance, and for braving the handwritten notes of the historian Bess Furman, and locating a plague journal on microfilm.

It is a challenge to do research on a hermetic hero who “never complains, never explains” and rarely divulges his personal life in his professional milieu. For such was the persona of Rupert Blue. After much searching, I located descendants of the Blue family—Eleanor Stuart Blue of Washington, D.C., and J. Michael Hughes of Jacksonville, Florida. Ms. Blue, the great-niece of Rupert Blue, cordially shared memories and memorabilia of her great-uncle, including the gold watch given him by the city of San Francisco. Mr. Hughes, Blue’s great-nephew, was patient with my persistent inquiries, and finally located in his attic a cache of personal letters of Rupert Blue’s covering almost a half century of his extraordinary career. Boundless gratitude to both for entrusting me with family treasures.

I owe similar thanks to Colby Buxton Rucker of Arnold, Maryland, for entrusting me with diaries and other writings—both unpublished and published—of his grandfather William Colby Rucker’s, who was, for almost forty years, Rupert Blue’s sidekick in battles against bubonic plague and yellow fever. Dr. Rucker was Dr. Blue’s Boswell, and was as transparent and emotive as his boss was opaque and stoic. His account of the plague campaign opened a window on Blue’s character.

None of my research and writing would have been possible without the support of many editors and colleagues at The Wall Street Journal, including managing editor Paul Steiger and deputy managing editor Daniel Hertzberg. Thanks to bureau chiefs Gabriella Stern, Michael Waldholz, and Elyse Tanouye, and to deputy bureau chiefs Ron Winslow and Bob McGough. In San Francisco, thanks are due many colleagues, including Steve Yoder, Carrie Dolan, Ann Grimes, and Sharon Massey.

My agent, Henry Dunow, is a champion for his swift and intuitive grasp of my project from early days, and for prodding me to mine those mountains of inert documents until I found the human pulse of my story.

Nobody could be more fortunate than to have Random House editor in chief Ann Godoff as mentor and guide, grooming my book from the mortifying mechanics of a first draft to the finished manuscript. Her zest for everything from the scientific arcana to the dynamics of narrative drive opened my eyes to the storyteller’s art. I’m grateful for the energy of Sunshine Lucas, and the early enthusiasm of editors David Ebershoff and Courtney Hodell of the Modern Library.

Every researcher stands on the shoulders of giants, and I found a dozen willing to put aside their professional duties to read my manuscript: U.S. Public Health Service historian John Parascandola, plague scientists Drs. David Dennis, Ken Gage, and May Chu, Dr. Moses Grossman, Chinatown historian Him Mark Lai, San Francisco historians Gladys Hansen and Charles Fracchia, medical historian Guenter B. Risse, law professor Charles McClain of U.C.