Dr. Isaac Starr, circa 1950. (Courtesy of the National Institutes of Health: Images from the History of Medicine.) by George McNeely As we are all learning “real time” about how to struggle …
by George McNeely
As we are all learning “real time” about how to struggle through an epidemic, it is informative to look back to how people in Chestnut Hill experienced the 1918 influenza epidemic.
Dr. Isaac Starr grew up in Chestnut Hill and graduated from Chestnut Hill Academy. He lived through that epidemic and wrote about it in 1976 for “Annals of Internal Medicine.”
In August 1918, he was about to enter his third year as a medical student at the University of Pennsylvania. Almost every member of his class had enlisted in either the Army or Navy medical corps, except for a few Quaker conscientious objectors. He had not been called up and was hiking in the White Mountains with his father, the investment advisor and philanthropist Isaac Starr, when he first learned about the flu epidemic in a late August newspaper article.
He returned home to Chestnut Hill and in mid-September started his classes. The regular schedule was interrupted with a lecture about the influenza virus, based largely on research from the previous flu epidemic in 1888. Shortly thereafter all classes were canceled and the third and fourth year students were conscripted to help with the response to the growing epidemic.
On September 28, the Philadelphia city fathers ignored the advice of leading health officials and held the Fourth Liberty Loan Campaign parade along Broad Street. Attended by an estimated 200,000 people, it is believed that Philadelphia’s record number of influenza deaths could be traced to that parade.
The City was woefully unprepared for what was to come. Most trained doctors and nurses were away with the war effort. Knowledge about influenza was antiquated, based largely on the previous epidemic some 25 years earlier. Urban poverty, crowding, malnutrition and lack of access to health care each played their part. As in our own time, false information traveled fast, including rumors that the epidemic had been started intentionally by the Germans.
Starr recounts that a partially demolished former hospital building in center city was transformed into an emergency hospital within three frantic days and he was assigned to act as the “head nurse” for the 25 beds on the top floor. Patients soon started to arrive. Still living back in Chestnut Hill, Starr drove into Center City each day and observed first-hand the unfolding epidemic.
He wrote: “Thus my patients who often entered the ward with what appeared to be a minor illness became in a few days delirious and incontinent, gasping for breath and deeply cyanotic. After a day or two of intense struggle, they died.” (“Cyanotic” describes a bluish discoloration of the skin caused by an inadequate flow of oxygen.) Some of his descriptions are so graphic they are better suited for medical journals. He estimated that 25% of the patients on his floor died each day.
He describes medical supervision that was infrequent and incompetent, although well intentioned, mostly by elderly doctors who were not away in the War and were not trained for this situation.
But there were lights even in the darkness. He describes assistance from a variety of volunteers, including a number of nuns from the Sisters of Charity who risked their lives.
The published records of the Sisters of Saint Joseph during the epidemic discuss their work in the parish of Our Mother of Consolation (OMC) in Chestnut Hill. The voices of the sisters present an unfamiliar Chestnut Hill.
"Conditions in some places were indescribable. Often there were no beds for the poor afflicted victims, no bed clothing, no linens, nothing but filth and rags,” reads the account. “Calling at another house, where the Sisters had been told there was distress, they were met at the door by an old lady, too old to attend to household duties. She refused to let the Sisters come in. Knowing, however, that sad conditions existed there as two of the family had been taken to the hospital and the man and wife still in the house were very ill, the Sisters returned to this house the next day…. The old lady met them later, and told them that she had the ‘wash ready for them.’ The Sisters did the washing, and, as a consequence, returned to the Convent to go to bed themselves for a four weeks' struggle with influenza.”
In another part of our town, on October 15, Mrs. Edward Stotesbury (Eva) sent a telegram to the Secretary of the Navy, Josephus Daniels (now in the National Archives). The Stotesburys had recently moved into their immense Whitemarsh Hall in Wyndmoor, designed by Horace Trumbauer. In that telegram, she offered the use of an unidentified country club in suburban Philadelphia as a convalescent home. She noted that her husband was president of the board and described the building as having "wide porches, large amusement rooms, and a baseball field." Her son by her first husband, James Cromwell, had survived a severe case of influenza, which prompted her generous offer. The club was closed for the season, but she said she would have it reopened and staffed by the Red Cross Navy Auxiliary.
Our Town has not been able to confirm which club she was offering. But more likely it was the Germantown Cricket Club, of which the Stotesbury’s were members, than the nearer Philadelphia Cricket Club. Apparently nothing came of that offer.
Dr. Starr’s closing comments reflect a situation oddly familiar to us now.
“While this was going on in my ward, the life of the city had almost stopped. Public assembly was forbidden, so there were no plays, movies, concerts, or church services. Schools were closed. Some stores and businesses stayed open, some did not. ... I often counted the cars we passed while motoring the 12 miles between Chestnut Hill and the emergency hospital in center city; on one of our midnight trips we passed no cars at all.”
The years immediately following that epidemic were shadowed also by the trauma, death and dislocation of the war years. But Chestnut Hill continued. The epidemic led to positive outcomes, including an expanded national emphasis on public health and preventative medicine. OMC continued to do good works. Eva Stotesbury lived for another 20 years in regal style at Whitemarsh Hall. Her son recovered from the flu and went on to marry the heiress Doris Duke. And Starr himself went on to a long and distinguished medical career at the University of Pennsylvania.