Wyman agreed, and chose his experts with care: From the University of Pennsylvania, he tapped Simon Flexner, a bespectacled thirty-seven-year-old medical educator who would later gain fame at the Rockefeller Institute in New York. From the University of Michigan, he chose Frederick Novy, thirty-six, a goateed professor of medicine. From the University of Chicago, he recruited Lewellys Barker, thirty-three, a lanky young anatomy professor who had been a protégé of the legendary William Osler at Johns Hopkins University. All three knew plague when they saw it. Novy had studied plague in Berlin. Flexner had researched it in the Philippines with Barker. Barker had then followed pestilence to Bombay, India, a city he found “preternaturally quiet and dismal” under the smoky pall of funeral pyres. There, he later wrote, he “realized what the horrors of the Black Death of Europe in earlier centuries must have been.”27
In late January 1901, the three plague experts left their laboratories and classrooms behind and boarded trains for the West Coast. They traveled fast and light, carrying no lab equipment with them, checked into the Occidental Hotel, and looked for a laboratory where they could work. It seemed simple enough, but nothing in San Francisco was simple.
Kinyoun’s laboratory on Angel Island was well equipped but tainted by controversy. A University of California scientist offered lab space but was forced to withdraw his offer for fear Governor Gage would cut his university’s funding.28
Finally, the city of San Francisco found makeshift lab space in room 161 of City Hall. Every day, the special commission made the rounds of Chinatown, visiting the sick and the dead. Accompanying them was Wong Chung, the secretary of the Chinese Six Companies, acting as their translator and guide.
Wong Chung was a moon-faced gentleman who wore the traditional queue. A respected figure on the Chinatown commercial scene, Wong was also fluent in English, and could unlock his neighborhood’s secrets as only a native speaker of Chinese could. It is hard to know what persuaded him to help the visiting doctors. Perhaps the Chinese Six Companies wanted him to inform them of what the Caucasian physicians were up to. Perhaps Wong himself suspected that the plague scare might turn out to be real. Whatever the interior thoughts of this quiet man, his work assisting the two-week investigation set the stage for a relationship between Chinese and whites that would turn the tide of the epidemic.
Every day, they improvised autopsies in dimly lit apartments, surrounded by the grieving families and friends of the dead. Then they returned to room 161 of City Hall, armed with their autopsy samples. After placing the samples on glass slides and peering into the microscope, they wrote up each case for their report.
Plague or no plague, whatever the panel found was destined for a confidential report to the surgeon general in Washington, D.C. During two weeks in February 1901, they examined thirteen people dying of all causes.
“Of the thirteen deaths which came to our attention, occurring from Feb. 5 to Feb. 16th inclusive, six were undoubtedly due to infection with plague,” the panel concluded. “A seventh may have been a case of plague which went unrecognized.”29
Among them were two actors, a theater cook, and a cigar maker who tried to soothe his buboes with a plaster of salve and honey. There was a little girl initially misdiagnosed with typhoid, and a middle-aged laborer. All had succumbed under the eyes of the nation’s preeminent infectious disease specialists. Such was the power of plague and the powerlessness of doctors to stop it.
The mystery of the seventh case involved Chung Moon Woo Shee, a homemaker who died of a suspicious fever. But just as the trio of experts made the first incision in their autopsy, her watching family cried out inconsolably. Their wails of grief froze the doctors’ scalpel in their hands. Out of respect, they laid down their tools. There would be no autopsy that day. Her case remained unsolved.
Just as the commission wrapped up its report, the youngest commissioner, Lewellys Barker, developed a sudden fever. He was overtaken by aches, and odd lumps began to erupt. After two weeks in plague houses and makeshift morgues, it looked ominous. They’d all taken precautions, injecting themselves with liberal doses of Yersin’s plague antiserum, but it wasn’t perfect protection.
Even though Yersin’s antiserum was far safer than the Haffkine vaccine, it also could cause problems. The two products worked differently in the body. The preventive Haffkine vaccine, made from killed plague bacteria, was injected before exposure to immunize a person—that is, to spark the production of human antibodies that could fight off plague. The Yersin antiserum, on the other hand, was a solution of ready-made antibodies given to boost immunity even after a person was already exposed to plague. But since this antiserum was drawn from the blood of horses exposed to the plague, it contained proteins foreign to the human body. So some recipients of the antiserum mounted an intense immune reaction against these horse proteins. The reaction—fever, joint pain, and hives—was known as “serum sickness.”
Serum sickness could be very dangerous indeed, but it wasn’t plague. And to his colleagues’ intense relief, Barker’s illness turned out to be just that—a case of serum sickness mimicking early symptoms of plague. It was a false alarm, but a reminder that no one was immune.30
Their grim task completed, and their lips sealed about their findings, the expert panel trio prepared to leave for home. But a trickle of leaks about the plague report in the Sacramento Bee alerted Governor Gage to impending trouble. He demanded an audience at the Palace Hotel.
Billing his visit as a courtesy call, Gage brought a delegation and prepared to lobby the scientists to head off any threat to his state. The plague commissioners, in no mood to be bullied, gave it to him straight: The state had the plague, and they intended to report it to the surgeon general. The governor retreated to Sacramento to plot his next move.31
On February 28, he summoned newspaper and railroad executives. They chartered a special train to the capital and huddled with the governor until four A.M. Then, their plan of action decided, they went home to pack for Washington, D.C.32
Sidelined, Kinyoun watched helplessly. He tried to forewarn Surgeon General Wyman about the governor’s delegation and its rumored mission to suppress the panel’s findings.33 Now in charge, Joseph White dined with the mayor and medics to muster support for his plague-control operations. But privately, he despaired. “The people and the place here,” he wrote the surgeon general, “are a law unto themselves….”34
“The situation here is worse than you think,” he added. “I cannot foretell the outcome, but I fear disaster. A year ago it might have been checked but now I am extremely doubtful of any success…. I fear the service has met… a Waterloo.”35
Seal of Silence
ON A TRAIN BOUND FOR Washington, D.C., the governor’s men vowed to defend the Golden State in a deal that was pure brass. Having failed to deny the plague at home, they hoped to strike a bargain with federal officials to cover up the proof of its existence. The delegates—men from the Chronicle, the Examiner, the Union Iron Works, and the Southern Pacific Railroad—agreed with Governor Henry Gage that only secrecy could save California from the ruin of a nationwide trade embargo.
Senators George C. Perkins and Thomas R. Bard of California acted as midwives to the plan. They had wired all the parties—from Governor Gage and the newspapers to the surgeon general’s bosses at the Treasury Department—to make sure everyone was on board.1,2