It is hard to say which has had the greater effect on the course of historic events: the actions of specific individuals, or the external forces beyond human control. "Man plans and God laughs," goes the Yiddish proverb. This is as true for tsunamis and hurricanes as it is for deadly outbreaks of infectious disease.
In the decades since mass vaccination put an end to polio in this country in the middle of the 20th century, we have mostly been spared fast-moving, deadly epidemics. It is, however, worth remembering that we still are vulnerable, especially to viruses such as influenza for which effective treatment may not exist or be widely available.
This is what makes "Fever Season,'' Jeanette Keith's history of the 1878 outbreak of yellow fever in Memphis, so fascinating — and potentially instructive — to today's reader. Until the early 1900s when doctors discovered how yellow fever was spread, outbreaks tended to be a regular part of life in the South in hot months. In 1878, a particularly virulent strain of the virus traveled north from New Orleans through the Mississippi Valley to Illinois, killing an estimated 18,000 in just a few months.
That epidemic was widely considered the worst ever. "But,'' Keith writes, "it was Memphis's plight that riveted national attention.'' Within weeks after the fever struck, more than half of the residents fled. At least two-thirds of those in the city contracted the fever, and the loss of life was staggering: One-quarter of the Memphians who remained (more than 5,000 people in total) died during the three months it ravaged the city.
Relying upon diaries, newspaper articles, and letters, Keith, a Bloomsburg University history professor, provides a gripping account of the spread of the epidemic. But the book's greatest strength resides in the portraits of average citizens and their responses, for better and for worse, to the disaster.
The outbreak brought out the best in some, like Annie Cook, a madam who stayed behind after sending all but one of her prostitutes away and converting her brothel into a makeshift hospital. Hundreds of others also remained to care for the sick, like Dr. William Armstrong and Kezia DePelchin, a 50-year-old volunteer nurse from Texas, though they could have found shelter elsewhere. Many caregivers got sick and died in the course of their duties, including Armstrong.
The outbreak also brought out the most callow and craven of behaviors, such as that of the widower who fled Memphis, leaving his children behind to die, or of the man who refused to care for his wife when she was hospitalized, asking: "If I goes, who takes care of my dog?"
In October, at the end of the siege, the Rev. Sylvanis Landrum, who stayed throughout the epidemic to help the sick (and who lost two sons to the fever), offered his congregation this observation: It would have been impossible to "tell in advance who will be the hero, who the coward, in a crisis like the epidemic. People who were expected to behave well had been cowardly, and meanwhile, those from whom nothing good was expected had proved to be heroes.''
"Fever Season'' left this reader pondering what he might do were he ever cast into similar circumstances. As Keith states in the introduction, her purpose in writing this book was to examine the ways in which disease influences the actions of those who live through it, personally and collectively. In this respect, "Fever Season'' is an unqualified success.
Dennis Rosen, a pediatric lung and sleep specialist who practices in Boston, can be reached