Pale Horse, Pale Rider*

(This column first appeared in the October 27, 1997 Buffalo News.)

    A ghoulish Halloween inquiry: During what half year period in world history were the most people killed?

    The answer to that macabre question may surprise you.  Asked it a few days ago, I would have chosen among three answers: (1) some time in the 14th Century when the Black Death was reducing the population of Europe by two-thirds, (2) a period in 1863 or 1864 during our Civil War or (3) another in 1917 or 1918 during World War I, in both wars when tens of thousands of soldiers were being killed on battlefields.  My three guesses would all have been wrong -- as I suspect would yours as well -- but, oddly, the last one would have been close in time.

    The correct answer is the period from September 1918 through February 1919 when at least 21 million and more likely twice that many people were killed by -- the flu.  (That information is in Alfred Crosby's "Epidemic and Peace, 1918.")

    In Buffalo over 3,000 died; in New York City 33,000; nationwide the figure was over a half million.  Where reasonably accurate statistics are available, between 1/2 and 1 percent of the population was struck down.  In the five major cities in New York State, for example, 1 of 107 died.  But in a few isolated communities, especially those in Alaska and northern Canada, everyone died.

    That was only part of the story.  Most who lived through those months were severely ill.  Hospitals were extremely overcrowded.  Doctors and nurses worked 20 hour days and still could not attend everyone; many care-givers were eventually stricken themselves.  In Ontario, Canada alone over 100 doctors died.  Mortuaries were overwhelmed and hundreds of dead bodies piled up for lack of grave diggers.

    Troop ships, first carrying soldiers to the final days of World War I and then after the November armistice returning with them, were so hard hit by flu that their weakened crews could barely steer them into port.  There their sick further overwhelmed local facilities.

    What a war ending for thousands of soldiers.  They made it through grinding battles like Chateau-Thierry and St. Mihiel only to die of a disease generally thought of as a brief infection with associated headache and sniffles.  And unlike most diseases this particular virus hit young adults hardest.  Usually it is the elderly and the very young who die.  They did but this time even more of those effected were in their 20s and 30s and the associated family disruptions extended the tragedy.  In the following years orphanages were severely overcrowded.

    The disease struck swiftly.  People healthy one day would die the next from lung-filling fluids, literally drowning.  Even if they made it through this sudden pneumonia, their recovery usually took weeks and even months.

    It all happened in this century, yet we know so little about this tragic event.  As Crosby says, our children today learn more about biblical plagues than they do about this disaster that affected so many of our own families.  He believes that the glorious news of peace stole the spotlight from the unhappy news of this devastating illness.  While it is nice to know that good news does sometimes overwhelm bad, it is unfortunate that the lessons of this violent plague have been lost.

    Now we have improved medical responses to influenza and pneumonia.  And recent flu strains have been far less virulent.  At the same time, however, our defenses against viruses like these are weakening.

    I didn't get a flu shot this past winter and fortunately had only a brief, rather mild bout.  I won't gamble this year and I hope that you won't either.


Alfred W. Crosby, Jr., Epidemic and Peace, 1918 (Westport, Connecticut: Greenwood Press, 1976).

Eileen Pettigrew, The Silent Enemy: Canada and Deadly Flu of 1918 (Saskatoon, Saskatchewan: Western Producer Prairie Books, 1983).

* Katherine Anne Porter, Pale Horse, Pale Rider (New York: Harcourt, Brace and Company, 1939.  (The reference, used again here in the title of this column, is to an African-American spiritual that begins, "Pale Horse, Pale Rider done taken my loved one away."  Ms. Porter's novel is one of the few in which the so-called Spanish influenza plays a central role.)