August 19 2019

Why Spit Spreads Death?

Robert D. Hicks, PhD is the Director of the Mütter Museum and its Historical Medical Library; the William Maul Measey Chair for the History of Medicine; and project director of Spit Spreads Death: The Influenza Pandemic of 1918 in Philadelphia. In the following post he discusses the museum staff’s journey to explore the influenza pandemic of 1918-19 and what sparked their interest in creating Spit Spreads Death.

Exhibitions observe the iceberg theory: that is, when one sees an iceberg, one realizes that four-fifths of the ice is below the water line, unobserved. Thus it is with exhibitions, and Spit Spreads Death is no different: what one sees is a wisp of what one does not see, the research, meetings, design schemes, text revisions, the objects or images ultimately discarded. Why did we decide to undertake this project in the first place? What do we want visitors to experience?

Spit replaces a long-term exhibition, Broken Bodies, Suffering Spirits: Injury, Death, and Healing in Civil War Philadelphia. We did not want to follow a war exhibition with another war, World War I. When thinking of what health event might be of great significance in Philadelphia, pandemics came to mind. In 1793, Philadelphia, then the capital of the young United States, experienced a yellow fever epidemic that killed almost 10% of the city’s population and rendered the United States Congress and local government inoperative. This event, however, was overshadowed by the influenza pandemic of 1918 in which Philadelphia experienced the highest mortality rate of any major American city. This pandemic came into town swiftly, disabled local government and area hospitals, killed 12,000 in the first six weeks, and then slowly vanished. As in 1793 with yellow fever, no one knew (yet) what caused the disease (a virus, as it happens) or how it was communicated. An epidemic is a widespread, active, and uncontrollable disease that stems from a local event; however, a pandemic differs in scale. It is vast, worldwide. Why, though, does the 1918 influenza pandemic not occupy a prominent fixture in the history of the 20th century? Philadelphia has statues and monuments to the Civil War, but none—not a single memorial plaque—to the memory of those who died of the flu.

"Diseases do not arrive in uniform with weapons and flags: they just happen."

In deciding to pursue Spit, we wanted to commemorate the 1918 tragedy by creating art (see the blog by Nancy Hill) as a form of memorialization by recreating the Liberty Loan fundraising parade of September, 1918; coupled with an historical presentation in the form of the exhibition; and consciousness of health threats through a public health fair. The pandemic hit during the closing months of World War I. No part of the country was spared because of the imperative to support the war effort. Throughout the pandemic, President Woodrow Wilson never made a public statement about the flu, and no federal agency provided emergency relief. Further, two federal statutes effectively shut down any criticism whatsoever of the government’s handling of the war, and public talk about the flu could be construed as anti-patriotic. Unlike battles in war, the flu left no structures, battlefields, weapons, only graves and sickrooms. Diseases do not arrive in uniform with weapons and flags: they just happen. Although the Philadelphia press reported on mortality and highlighted the prominent people who were flu stricken, people whose families were afflicted suffered alone, especially as parents and children began to recover from illness while other family members died. Survivors mourned alone and no opportunity arose for a common community discourse about what had just occurred.

Not only are we planning Spit as a form of memorialization, but also mounting an exhibition of this magnitude can lead museum staff down new paths. Exhibition teams do not arrive at the planning table with intimate knowledge of their subject. Rather, mounting an exhibition means learning. As we began to visit relevant local collections to scout possible display artifacts, we acquired personal stories of family trauma, images, and statistical documents, including death certificates. In reviewing reported statistics as compiled by governmental authorities, we began to suspect that the official death tally for Philadelphia, up to 20,000 over six months, may be an undercount. Flu data were not consistently gathered in most places and the official worldwide death count could be as high as 100 million, possibly 50 million, or maybe less. We may be able to contribute new research to understand this event. This likelihood has propelled our interest.

"...what is my responsibility to my family, my community, and myself during a disease outbreak when no one understands the disease itself?"

We also decided to pursue the flu project because, in 1918, the precise source and nature of the flu was yet unknown, its method of transmission vaguely understood. Clinical research to answer these questions began in earnest during the pandemic, but the virus was not identified until the mid-1930’s and the first effective vaccine did not appear until 1945. We anticipated that visitors coming to the Mütter Museum during the lifetime of the exhibition would immediately make a connection to recent news reports of killer disease outbreaks somewhere in the world. We want visitors to experience the wartime ambiance of Philadelphia and learn how Philadelphians responded to the flu. From this, we want to stimulate visitors to reflect on several questions: what is my responsibility to my family, my community, and myself during a disease outbreak when no one understands the disease itself? Can I, or would I exercise leadership at such a time? How should we remember such scenes of devastation?

Participate in the September 28, 2019 parade at which Blast Theory, the artists’ collective working with the Mütter Museum, will create an experience that meditates on these very questions. Then come to the Museum after October 17 to see the exhibition, which will include a short film about the parade: you may see yourself in it.

The Mütter Museum helps the public appreciate the mysteries and beauty of the human body while understanding the history of diagnosis and treatment of disease.

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