Review of Laura Spinney, Pale Rider: The Spanish Flu of 1918 and How it Changed the World, Vintage: London, 2018, ISBN 978-1-78470-240-3

Reviewed by: Tara Sheemar

Pale Rider was published as the centenary of the so-called Spanish flu approached, particularly as a multi-disciplinary effort combining various related studies in fields like science, history, psychology, sociology, economy, political science, environmental studies, demographics, and epidemiology. It can prove to be extremely useful to revisit it now as we witness the Corona pandemic, and the exponential rise of literature connected to diseases. The title is inspired by Katherine Anne Porter who wrote Pale Horse, Pale Rider after catching the flu (and whose hair fell out and grew back all white). One is struck immediately by the ease with which the author, Laura Spinney, moves across space and time to build a powerful narrative inspired from a technique of story narration used by women in southern Africa, which involves ‘weaving circles around a central idea’. The science journalist and fiction writer places before the reader a plethora of facts connected with the world in which the 1918 influenza erupted. The notes to the chapters reveal the vast and varied sources the author has tapped into.

Part 1 traces the relationship of humans and viruses from pre-historic times onwards, acknowledging that the domestication event, and establishment of denser human settlements were crucial factors in the spread of ‘crowd diseases’ like measles, smallpox, tuberculosis and influenza. Parts 2 to 6 detail the story of the virus, and how it came to encompass the entire world, thus making the scope of the research too wide to magnify a particular context. It brings together research done in various regions and disciplines to create a ‘collective memory—a living photograph of the Spanish flu’, as we are told in the afterword. This begins with examining the attempts to study the anatomy of the influenza virus, and its early mistaken identity as a bacillus. The author points out that the ‘germ theory’, combined ideas of hygiene and sanitation leading to campaigns to purify water, promote cleanliness, and vaccination program. This was a definite shift from the 19th century belief that diseases and natural disasters were acts of God.

The trajectory of the flu is traced through the first officially recorded case of a mess cook on March 4, 1918, at Camp Funston in Kansas. Spinney recounts how it traversed various parts of the world in 3 waves ending with the ‘Late Epidemic’ as mirrored in Japan in 1920. What makes the account more engrossing is the little details about certain personalities who were impacted in different ways by the flu. This makes very heavy subjects, such as disease and death, amusing at places, like the argument between poet W.B Yeats and his former romantic partner Maud Gonne, which is cited from one of the biographies of the poet. In most instances, however, the account is full of pathos. The reader is rooted to descriptions like that of Pedro Nava’s personal experience as a young man visiting his uncle in Rio, Brazil, and the death of a beautiful girl he admired, – who ‘belonged to the past now, as distant as the Punic Wars, as the ancient Egyptian Dynasties’. The author highlights the more fundamental impact of the flu in terms of ‘the lost generation’. the patients who succumbed to it and were lost to history. The account of the tragic decimation of the Yupik, one of the indigenous communities of Bristol Bay, Alaska, is equally absorbing. Importantly, this is connected to causes like lifestyle, geographical location, and lack of timely relief.

The naming of the 1918 influenza, as Spanish Flu, is pointed out as a historical wrong, since it did not originate in Spain, but somehow remained in use since it was the one adopted by the Allied powers, the victors of the War. The case of the Chinese province of Shansi illustrates how difficult it was to identify a respiratory disease in poor isolated villages where malnourished people suffered simultaneously from other diseases and were opposed to ‘foreign’ medicine. The densely populated cities of the 20th century are pointed out as an additional factor in disease outcome. The comparative analyses of the urban response of New York as a case of success, and the Persian pilgrimage city of Mashed as a case of failure, is described through the background of differences in history, politics, culture, and access to health facilities. The flu led to adoption of various ‘social distancing’ measures, experiments with various ‘cures’ termed as ‘polypharmacy, ’the use of ‘alternative’ medicine, faith, and rituals like the ‘black wedding’ of Jewish communities. She highlights how people showed ‘collective resilience,’ identifying as members of a group, instead of opting for selfish isolation.

Alternative theories about the origin of the flu, Shansi in China and Ètaples near the Western Front, are discussed. Here, as elsewhere, she weaves the disease narrative in connection with political, economic, geographical, climatic, lifestyle, and other considerations. The connection between war and disease is emphasised, possibly in its origins, and in its spread, and it is stated as the main cause in causing the virulence of the flu. For example, the Chinese Labour Corps and/or mustard gas are given the ignominious blame for spreading it. Spinney meticulously lists out the contributions of various scientists towards the identification of the virus, and the genomic sequencing. Noticeable are the early experiments of researchers who were risking their lives, a risk which seemed normal due to war. Significantly, ‘Spanish flu’ is genetically connected with later flu pandemics, the ‘Asian flu’ of 1957 and the ‘Hong Kong flu’ of 1968, and also the ‘swine flu’ of 2009, which led to it being dubbed as ‘the mother of all pandemics’. Subsequent attempts to trace the origin of the flu through genetic studies seemed to strengthen the conclusion that it emerged in North America; that it was transferred from birds, with horses as a possible intermediary. We are warned about the barnyard and told how a poor farmer boy recruit from Haskell County, Kansas, could have carried it from the farm animals. The give and take between man and environment, we are warned, has considerably altered in the Anthropocene era, resulting in humans pumping genes into nature.

The randomness of the morbidity impact of the flu is connected with how ‘culture shaped biology’, with malnourishment, lack of proper living conditions, and gender (India being the sole country where more women died) being major factors. One of the examples is that of the adivasi Dangs in Gujarat, who lost 16.5 percent of their populations due to socio-economic factors. Ultimately, it was revealed that regardless of their culture, diet, social status, or income, one in 10,000 people are particularly vulnerable to flu since it is inherited from their parents.

The impact of the flu is pertinently presented as being very wide in scope while acknowledging that “things happened the way they did because of a host of complex, interacting processes, and to try to pull one free of the mix risks misleading”. Among the after effects is included: the global baby boom and ‘purging’ of the less fit; chronic impact on health including ‘melancholia’, mental illness, crippling lethargy, and encephalitis; shrinking of agricultural output in India due to labour morbidity; orphaning of large numbers of children who were then pushed to destitution and subsequent legalisation of adoption; painful readjustment, demoralisation, and lawlessness; prophets and spiritualism; universal healthcare and private funded philanthropy; accelerating the end of war and impacting the peace process. The flu highlighted inequality illuminated injustice of colonialism and capitalism and led to workers strikes and anti-imperialist protests. In India, she connects it with the spread of the national movement under Gandhi due to the relief measures at the grass roots level. In literature and arts, she connects it with pessimism, a move away from romanticism, and a centring of disease. Though all these are very complicated topics, and a variety of historical forces would have contributed to all these events, at least one can acknowledge that disease, in this case the ‘Spanish flu’, was a significant historical player that had been side-lined for a long time.

The reader is informed that research agencies had predicted the occurrence of pandemics in near future in the year 2016. Governments were advised to earmark $4 billion a year for pandemic preparedness including creating a public health workforce, disease surveillance, laboratory facilities, and community engagement. Nonetheless, SARS-Cov-2 took the world by surprise. Extremely useful is the suggestion about how people could voluntarily accept containment measures if they were more informed about the nature and risks of disease.

The 1918 influenza killed 50-100 million people, or between 2.5 and 5 percent of the global population. It had a W shaped curve with adults aged between 20 and 40 being particularly vulnerable, as well as the very young and very old. The impact, presented by most research and reports in numbers, is brought out by Spinney, via the various personal accounts that she taps into, building a human centred narrative. Highlighting the personal depth of the tragedy along with the magnitude of the impact is the hallmark of the book. Thus, we are told that people who survived but lost close ones may have imagined other futures, of ‘alternate histories’.

Now that we are in the middle of the Covid-19 pandemic, which is reshaping itself and the world in ways which will be subsequently explored for a long time to come by various disciplines, Spinney’s analyses and conclusions appear extremely applicable, including the premonitory warning that ‘another flu pandemic is inevitable, but whether it kills 10 million or 100 million will be determined by the world into which it emerges

About the reviewer:

Tara Sheemar is Associate Professor in the Department of History, Janki Devi Memorial College, University of Delhi. Her book titled Plunging the Ocean: Courts, Castes and Courtesans in the Kathāsaritsāgara was published in 2017 by Primus Books and was based on her doctoral research. She has published and presented various papers related to her research interests including gender, sexuality, religious praxis, courtly culture and aesthetics.

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