The federal doctors did not pull out, however. The federal public health mission was, in fact, broadening its scope. Under Walter Wyman, the name of the U.S. Marine Hospital Service was changed to the U.S. Public Health and Marine Hospital Service. Just as the plague campaign had broadened from shipboard inspection to investigation of an urban outbreak, so the service was evolving now from a corps of doctors treating sick seamen to a public health service fighting epidemics all over the country.
It was fortunate that the federal doctors stayed on the scene. For in the summer of 1902, the plague came roaring back. After months of quiet infestation, the rats emerged from hiding, coated with ravenous fleas. Suddenly, Mark White and his team had more than they could handle.
On July 12, Chin Guie, an employee of the Chinese consulate, staggered into the Oriental Dispensary. The dispensary gave comfort but delayed calling the federal doctors until Chin was in his final agony. Mark White arrived to find the man near death. In five minutes, Chin was gone. White learned that one of the state board’s doctors, Dr. Fitch, had treated him for syphilis—despite a big bubo on his thigh.
In the weeks that followed, more victims surfaced: a young restaurant worker, an aged cigar maker, a housewife, a cook, another newspaper man, and a blind woman who had never left her apartment. She was case number 71.
The little morgue and lab was strained. Carbolic acid—part of the morgue and lab’s daily disinfection bath—stained its floor the hue of tobacco juice around a spittoon. The building had no rugs and only a single heating grate to dispel the penetrating fog that flowed off the bay. The daily workload increased: collecting the dead, conducting autopsies, taking blood and tissue samples, growing cultures of bacteria, and injecting test animals to confirm a diagnosis. With each new death, the process began again. The small lab staff fell behind. White asked for an extra $25 a month for help in making cultures. Surgeon General Wyman vetoed the plan as too costly.
While the shell game of people moved around San Francisco Bay continued, White learned that someone had paid $100—about two months’ wages—to smuggle a sick teenage boy out of San Francisco to Oakland’s Chinatown. There, three days later, the boy died and a cook fell mortally ill with plague.19 By September 1902, the toll reached eighty cases.
The Chinese government installed a new consul general in San Francisco. The new consul tried again to ban autopsies in Chinatown as a racist practice. The public health doctors refused, ruling that the victim of any suspicious death—irrespective of race—had to undergo a postmortem examination to rule out the possibility of plague. Amid this changing of the guard, the Chinatown gangsters known as “highbinders” grew bolder. Highbinders, named for their habit of coiling their queues high up under their hats, had long waged turf battles for control of lucrative Chinatown rackets.
But now the highbinders took aim at a new target: the interpreter Wong Chung. Where the state health board had seen Wong Chung’s work as troublesome, some Chinese now saw it as treason. The knives were out.
“The Chinese are threatening Wong Chung because he is assisting the Marine Hospital Service in the work of eradicating plague,” Mark White wired the surgeon general. “… Wong has been advised by friends to guard against highbinders. The situation [is] serious.”20
One night, Wong attended a special meeting of his old colleagues at the Chinese Six Companies. As the elders talked business, several highbinders emerged from the crowd. They lunged for Wong Chung. Wong, although deceptively soft and middle-aged, was nimble. He dodged and evaded their grasp, his queue flying. The Chinese Six Companies president threw himself between Wong and his pursuers. In the scuffle, the assailants fled, disappearing into the night streets of Chinatown.21
After the botched assault, U.S. secretary of state John Hay moved in to shield Wong from violence. Hay formally asked the Chinese minister in Washington to help stop the harassment of “Federal Chinese employees in their official duties.”22 Under the cloak of state department protection, Wong Chung continued his medical rounds unmolested.
“Send Blue ASAP”
THE AUTUMN OF 1902 saw California’s plague stalemate become a national scandal that the state could no longer conceal or deny.
In San Francisco, another white patient caught doctors off guard. Arthur Caswell, thirty-three years old, was a hard-drinking salesman at the Adolph Schwartz apparel store on 3rd Street. Caswell spent his days peddling suits, his nights hoisting glasses at a saloon. On Friday, October 24, he worked all day fitting suits on soldiers who had just shipped home from Spanish-American War duty in Manila. That night, he crawled home exhausted. On Saturday, a wave of nausea hit him harder than any hangover ever had. By Sunday morning, Caswell awoke to find a hard red lump and a gnawing pain in his groin.
He rushed to Clara Barton Hospital on Geary Boulevard. Doctors found the tender bulge in his pelvis and diagnosed Caswell with a strangulated hernia, a dangerous condition that occurs when a loop of intestine pokes through the muscle wall and becomes choked off from its blood supply. After scrubbing for emergency surgery, the surgeon made an incision in Caswell’s right groin. He was shocked to find no hernia at all. Instead, he saw a skein of infected lymph glands.
The surgeon bundled Caswell into an ambulance and transferred him to the City and County Hospital. Mark White met the patient there. He examined the infected glands, which were starting to hemorrhage. There was little doubt about the cause. White injected him with Yersin’s plague antiserum, and Caswell hung on.
While Caswell was fighting for his life, the leaders of the State and Provincial Health Boards of North America were fighting to get the facts about San Francisco’s plague. As they gathered for their annual conference in New Haven, Connecticut, members had read dispatches from San Francisco in the New York newspapers. News of the unchecked epidemic, which ran counter to official state denials, infuriated the conferees. They moved plague to the top of their agenda and immediately passed a resolution condemning California. The plague was “a matter of grave national concern,” they declared, branding the state’s inaction an “irretrievable disgrace.”1
The San Francisco Board of Supervisors monitored the meeting with trepidation. The board sent frantic appeals to Governor Gage’s ranch in Downey, where the lame duck governor had gone in the waning days of his administration. They implored Gage to come to the city and acknowledge the outbreak. Gage refused.
Arthur Caswell failed to respond to the injections of antiserum. He died on Halloween, the city’s eighty-ninth case of bubonic plague.
Mark White had no idea how Caswell contracted plague. He lived and worked far from Chinatown and denied visiting there in more than a year. On the plague death list, doctors wrote a footnote labeling Caswell “a rounder,” as if his drinking sprees explained his fate.2
While Mark White struggled against rising plague and obdurate politics, Surgeon General Wyman quietly hedged his bets. He dispatched another doctor, Arthur Glennan, out West. Glennan’s job was to investigate sporadic plague cases in outlying areas of California and to make one last bid for cooperation from the outgoing governor.
Glennan took the train into Southern California. In the fragrant heat of his orange and walnut groves, Gage heartily welcomed Glennan. But when he learned the nature of Glennan’s mission, Gage exploded.
“That God-damned plague again!” he said.3