Writing down pandemics: the eternal deadly fascination

Don’t call me a fan of COVID-19, but it reminded me of how deeply the subject of pandemics is embedded in our psyches. With that in mind, I combed through my files for examples in literature and opened a discussion of author John M. Barry’s The Great Influenza, dealing with the 1918-1919 epidemic that ranks as one of the worst in history. Barry spoke at the 2013 Literature + Medicine conference at Texas Health Presbyterian Hospital in Dallas. The following post is an excerpt from his lecture, originally published at this site June 11, 2014.

Barry’s book “should be required reading for anyone who wants to go into medicine,” the conference’s organizer, cardiologist John F. Harper said. “I think we take for granted some of the medical advances we have, the magnitude of this great pandemic, and the likelihood that it could happen again.”

Barry wryly admitted that as a teenager he was torn between a career in writing and a career as a clinician, finally deciding on writing after his parents shut down his early attempts at bacteriological experiments.

“What is the connection between literary understanding and medicine?” Barry asked his audience. “It’s the methodology, “specifically, the testing of hypotheses. “Every true writer shares one essential element with scientists—trying to express something that is true and important, that gets back to methodology.”

Barry’s methodology as he begins tasks such as the seven year-long writing of The Great Influenza “starts by questioning yourself. . . I try to remain aware, aware of my biases. This doesn’t turn my biases into strengths, but it can limit their dangers.”

During this exercise in self-awareness, he asks himself four major questions: what happened, that is, what exactly is being investigated; how it happened, or the mechanism; why it happened; and “the key to creativity and the key to imagination, the most important question: so what?”

Benjamin West, 1796

Surprisingly, Barry noted that very few fictional writers have made use of the 1918-1919 pandemic, perhaps because the horror of it remained in popular memory so long.

One of those few was Texas writer Katherine Anne Porter, in her novella, Pale Horse, Pale Rider, lauded by the April 1939 London Times Literary Supplement as a “first choice” novel for the year.

(Porter’s home state of Texas was less impressed. The Texas Institute of Letters passed over Pale Horse later that year, awarding its annual prize to folklorist J. Frank Dobie.)

Pale Horse runs only about fifty pages in Katherine Anne Porter: Collected Stories and Other Writings. Despite its literal description of the protagonist’s delirium during a near-fatal bout with the 1918 influenza (of which Porter herself was a survivor) I found it far more accessible than Porter’s more famous Ship of Fools. 

Porter contracted the virulent influenza strain in early October 1918, while she was a reporter for the Rocky Mountain News in Denver, Colorado. She was so ill that her colleagues had her obituary set in type, preparing for the death which sometimes occurred within two days of the flu’s onset.

The experience “simply divided my life, cut across it like that,” Porter would later write. “So that everything before that was just getting ready, and after that I was in some strange way altered, really. It took me a long time to go out and live in the world again.”

During the course of the disease, her thick black hair fell out. When it grew back, it was completely white. She was twenty-eight years old.

“The road to death is a long march beset with all evils,” Porter’s protagonist Miranda dreams between her periods of delirium. “The heart fails little by little at each new terror, the bones rebel at each step, the mind sets up is own bitter resistance and to what end? The barriers sink one by one, and no covering of the eyes shuts out the landscape of disaster, nor the sight of crimes committed there.”

Porter rendered the symptoms of her disease so precisely that the Centers for Disease Control discussed her book in its April 2013 publication, “Emerging Infectious Diseases: Emerging Viruses.” As John M. Barry would later write, the disease’s victims “came with an extraordinary array of symptoms, symptoms either previously unknown entirely in influenza or experienced with previously unknown intensity. Initially, physicians, good physicians, intelligent physicians searching for a disease that fitted the clues before them—and influenza did not fit the clues--routinely misdiagnosed the disease,” as dengue, malaria, cholera, typhoid.

Barry wrote as a testament to the collision between modern science and epidemic disease. Porter wrote as a testament to the strength of one woman’s spirit, and to the ability of art to transmute horror. It was a lesson the world would soon need again. Five months after the publication of Pale Horse, Pale Rider, Hitler invaded Poland. The next world war had begun.

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Maybe real pandemics are too scary to write about, but we love to scare ourselves with fictional ones. Still to come, more pandemics from the likes of Michael Crichton (The Andromeda Strain), Emily St. John Mandel (Station Eleven), and Justin Cronin (The Passage).