[Anna] Hi! I'm Anna Dhody
Curator of the Mütter Museum and Director of the Mütter Research Institute.
And I have with me today my dear friend, Caitlin Doughty.
[Caitlin] The other "Do-dee." The other "Do-dee" you need to know-dee.
[Anna] It's really obvious that our names are totally different.
I am D-H-O-D-Y, and it's pronounced "do-dee."
[Caitlin] I am D-O-U-G-H, which actually spells the word "dough."
T-Y, which spells "ty."
And yet my name is "do-her-tee," "dow-tee," any number of things.
[Anna] But you pronounce it "do-dee." [Caitlin] I pronounce it "do-dee."
[Anna] And I pronounce it "do-dee." So no confusion there, glad we wrapped that up.
[Singing together] The Dhody/Doughty Sisters!
[Caitlin] Talking death!
[Music]
[Anna] Now, we're here to talk about death. Shocking. But very specific death in Philadelphia.
Philadelphia was one of the hardest-hit cities in the world with the 1918-1919 influenza pandemic.
Did you know that? [Caitlin] Second only to Pittsburgh, I believe.
[Anna] I knew I couldn't get you on that. [Caitlin] They just told me that off-camera.
[Anna] Pennsylvania, not in a good way, so we're very infamous for that.
But, what happened here is we can actually trace the origin of the
explosion of influenza deaths and we know who to blame.
It was the result of this bond parade that they insisted on holding.
We can't say for certain that it was the bond parade that was the catalyst for this massive issue in Philadelphia
but what we can say is that 200,000 people showed up to this parade
and 3 days later, all the hospitals were full, so, I mean you tell me.
[Caitlin] Doesn't sound like a coincidence to me. [Anna] I don't know what you need
but I think that's pretty telling. [Caitlin] That's why I don't go in large groups at all.
[Anna] You know we had the Eagles' parade here during flu season, can I just tell you?
And I think that was like two million or a million people.
I suggested that Purell sponsor it, but they didn't tweet me back.
So what I have here, this is actually from our library collection.
This is a scrapbook of all these newspaper clippings that were collected at the time that it was happening.
This is a unique, very delicate object that we have that really chronicles in real-time the epidemic.
And what's really interesting is that there was a significant problem with bodies.
And this is kinda bringing into my question with you. There was just no place to put them all.
That could be a serious health concern, a public health issue, right?
And also just, what was it like to have bodies piling up?
Is this something that you've ever had to deal with? Ever learned about?
[Caitlin] No, I mean there's lots of times that this has happened throughout history
and more recent history, it's been much more after a natural disaster, after an earthquake.
The Titanic, they brought the bodies back to Halifax and put them on a curling rink
because that was the only cool place that could hold all the bodies.
But obviously, we need to also be thinking about it in terms of epidemics of any kind
especially if it's easily spreadable, especially the most dangerous situation would be something
like ebola, where the bodies themselves were actually dangerous.
[Anna] So in this case, I don't think the dead bodies themselves would be a method of transmission
but so many people were dying at home. And one of the things we noticed here is that it was
very hard hit in immigrant communities, where they might be living under
closer quarters, there were a lot more people packed into one apartment, so there's nowhere for them to go.
[Caitlin] Well, it sounds like if it was transmitted by expectorating, coughing, shooting out the live virus
if you were in incredibly close quarters and someone is actively dying and coughing
yes that person could die, but that doesn't mean that the people around them while that person was dying
would not be infected by that point as well, correct?
[Anna] Yeah, and that's I think one of the reasons why more evidence towards blaming that bond parade is
because you had 200,000 people from all the different neighborhoods in Philadelphia coming from far and wide.
Somebody probably had it, whether they were showing symptoms or not.
They're coughing, they're spreading it around, and then what are those people doing after the parade?
Going home, spreading it.
[Caitlin] Well you also have a situation where, yes, the dead body itself, because it's no longer coughing
it's no longer the active the virus, viruses don't live very long in the body after death
you might think that the dead body was dangerous.
In the beginning of the 20th century, yes, you had germ theory
yes, we had begun to understand how disease was actually transmitted
not through miasma floating through the air.
[Anna] That's a great word, though. [Caitlin] Yeah, it is a great word.
It's my krautrock band, but it's not actually true.
But, there's a difference between how bacterial diseases are spread
how viral diseases are spread, and they didn't really have that distinction
so it's possible they could've also believed that these dead bodies were dangerous.
For example, I noticed here: the lower picture shows an embalmer at the morgue preparing a body
so there "will not be a menace to public health."
[Anna] To me that clearly indicates that they thought the body was somehow
a vector of disease, of transmission. And again, why would they not think that?
[Caitlin] Yeah, why would they not think that? Everyone's dying.
[Anna] And it's not a pretty death. You had bodies turning blue.
[Caitlin] And they obviously just didn't have the facilities to take care of them.
And so you had some people taking care of the bodies at home, but if you weren't quite sure
if it was still safe to have the body at home, you probably just felt like you had to either bury it yourself
or you had to turn it over to a funeral director, who might be overcharging you.
Or leaving them in one of these piles that had started to develop of the bodies.
[Anna] Yeah, well you can see we have this very interesting picture right here
that shows just coffins stacked up.
[Caitlin] Well you notice from these photos, too, that they're obviously hand-digging these graves.
And it's hundreds of men hand-digging these graves, so they didn't even have the ability we have now
like say there's a huge earthquake somewhere, we can immediately bring in the backhoes.
And obviously a mass grave is not your first choice for disposal, but it is more technically possible
and it can be engaged in a much quicker way.
Whereas this, they probably couldn't even dig the burial spots to put the burial bodies in.
And of course you also didn't have cremation, which would be your second line of defense.
[Anna] Right, in fact, we actually found out that there were students from a seminary
that were volunteering to dig graves during this crisis because they could do it.
Everybody was kind of pressed into service. You did what you could.
We have to remember, this was during World War I.
So you have a significant depletion of the young male population anyway that's off to war.
So you're talking about an under-resourced industry anyway. So people were piling up.
[Caitlin] I often say that I think that World War I in combination with the flu epidemic
doesn't get enough credit as for what really changed death care in the United States.
Because you have the Civil War, which most people talk about as this is when embalming rose
and this is where you had to transport the bodies from the South back up to the North.
And then into the 20th century, you had these embalmers really trying to make embalming a thing.
I especially love what it says here, the caption is:
"Embalming victims at the city morgue"
which you don't usually see it put like that.
But the embalmers are trying to do this and make it a real career and funeral directors are doing the same.
But I think just the pure sheer amount of death that happened in World War I and with the influenza
really tired out the population to the idea of treating each death themselves
and caring for each body themselves and having that kind of relationship with it.
You really see a lot of people saying "You know what, at this point, I am ready to turn
the person over to a funeral director because there's just so much death everywhere we look."
They get weary. Sort of like social media now.
You know, there's so much going on that's so dark that you just get weary and you run out of steam.
[Anna] I like how you have social media and death kind of on the same--
[Caitlin] I mean, is that untrue? [Anna] No, it's very good, I think it's very appropriate.
Now here's a weighted question and I hate to make fear-mongering a thing
but this isn't like a "if this happens again," it's a "when this happens again."
So in your professional opinion, are we as a nation ready for another situation like this?
When there's a huge amount of fatalities due to an infection, a contagion.
[Caitlin] Also not to be fear-mongering, but in Los Angeles, for instance, where I work
the coroner's office, the morgue, is already filled to the brim.
People might think that, "Okay, if there's a mass fatality, there's a big huge refrigeration unit at the coroner's
and the official government capacity that can hold 300 people."
No. Those are already filled with indigent dead, people who haven't been autopsied yet.
We work with a crematory that's on the larger side, and there's room for perhaps 100 bodies.
Perhaps, you know, you could really make it work, especially if
you really stacked people up, which you wouldn't normally do, which wouldn't be legal or ethical normally
but in a situation of mass death, might be your only choice.
I don't believe that we have a really smart system in place for deputizing
large storage freezers for food or for other things, and saying, "We're coming in and we're using this!"
[Anna] On an average day in Philadelphia at this time period, you were looking at between about
50 to 70 people a day would be dying.
So then you had October 12th, to put it in perspective, 861 people died that day alone.
And there would be another couple hundred the next day and another couple hundred the next day.
So if you were in a situation: 861 people drop dead in one day in LA, what's gonna happen?
[Caitlin] Well, I think we could do 861 people, but I sort of do wonder about things like social media, about
do we know why it's happening? Is it clear why it's happening? Do we have a plan in place?
We just recently got an email from the coroner's office looking for volunteer funeral homes for ebola.
And I told my friend who works in healthcare in Washington, DC, I was like:
"Hey, what do you think about this?" And she said: "Oh they should not have sent that."
But at the same time, how do you prepare funeral homes?
We don't want to get people into a frenzy over something that hasn't happened yet.
But, then again, you also have to be prepared for the worst case scenario.
[Anna] We do have national mechanisms in place for mass fatalities, it's called "DMORT"
which I believe is "Disaster Mortuary Operations and Response Team."
And I think there's about 10 regionally, and then
they will mobilize to the site of a plane crash or a very localized incident.
And you might have multiple DMORTs going to one plane crash.
So imagine if every city has hundreds of fatalities, even if you did mobilize all those units
they would still rapidly become overwhelmed because I think those are meant for
very specific one-off disasters.
[Caitlin] And I think what most people don't know about something like 9/11 is
yes, they set up all these big tents and they had all the autopsy technicians or medical examiners come in
but there wasn't much left.
You're not talking about whole perfect bodies where whole perfect autopsies were performed on them.
They were just sort of doing what they can with cataloguing what was left.
[Anna] And we're still doing it. [Caitlin] And they're still doing it
the work continues to this day.
So there's a difference between major mass fatalities versus someone comes in and is quite whole.
They're quite together and they've just died of this terrible disease
but there's also 1000 other people just like them. That's a lot of flesh, that's a lot of body.
That's a lot of people who want a decent burial or cremation for them as well.
[Anna] And also, October, it might not have been freezing cold, no refrigeration really
so they're rapidly decomposing most likely.
[Caitlin] And if you have a cremation machine. A big standard industrial cremation machine.
Each cremation takes anywhere from an hour to two hours, but then it has to cool down
before you can remove the body from that.
So unless we were to get to a point where we're putting multiple bodies in at a time
which I think it would have to get pretty bad before that decision was made.
You know, we're still only talking about maybe 12 cremations a day per machine.
So you have 3 machines, that's only 36 bodies.
So cremation would've been almost non-existent in 1918. To put it into perspective
into the 1980s in the United States, the cremation rate was only 3%.
But it's now over 50%, so we've had a huge jump in the cremation rate.
[Anna] Do you think that's more economic? Is it more socially-accepted?
Is it more people of the religion who accept that? What do you think is the main driver?
[Caitlin] All three of those things. The idea of cremation being simpler, easier.
But I will say that it's not quite as effective as just burying people in trenches for something like this.
They do train you in disaster situations if you're going to be a mortuary technician
if you're going to be in that situation to very carefully label each body.
The name, possibly their social security number if you have it, pictures of them
identifying marks on them. And if you're really specific about that, and you put that laminated with them
the hope is that once this pandemic, epidemic, whatever it is, is over
you'll be able to exhume that communal grave, and
give the individual people the burial that their family might have wanted.
[Anna] Mindful about what you said about the limitations of cremation
do you think that might actually be what would happen even in 2019/2020?
Because we just don't have the infrastructure for all those cremations, if we did have an event like this
they'd probably do something like that: just get people in the ground with those identifiers?
[Caitlin] We have much more access to refrigeration now, and the body will last under refrigeration
for a very long time without too much material change in the body.
So it's quite possible that, again, if you could deputize these large freezers
you could put hundreds of bodies in one and as long as they were well-labeled
well-identified, you wouldn't have to take immediate action on that, you could
wait months before you took action on it, and that body would essentially be fine.
[Anna] Would that be like taking an eminent domain over a TGI Fridays?
[Caitlin] Exactly, I mean sometimes I just want to do that even without an epidemic.
[Anna] I am gonna just eminent domain your freezer. [Caitlin] Just bust into a 7-Eleven.
[Anna] The carne asada's coming out and the people are going in. I can see that happening.
Who's gonna wanna go out in the middle of all this and get nachos?
[Caitlin] I know that refrigeration was less available at that time, but was there any move
to refrigerate bodies in Philadelphia while this was going on?
[Anna] As a matter of fact, there was a brewery, it was called Commonwealth Brewery
apparently not the same one that exists today.
And they voluntarily cleared out their cold storage to put bodies in, so that was very nice of them.
[Caitlin] That was nice of them. What a nice corporate gesture.
[Anna] Yes! You know it's interesting because they had all these cures, and I think alcohol
but not beer, but whiskey was touted as a possible cure, as was red pepper sandwiches.
[Caitlin] Just like bread, red pepper, bread? [Anna] Yeah and I think it was even bell pepper
not like even spicy pepper, but just a red bell pepper sandwich.
But, to be clear, you still need a flu shot. You can have the red bell pepper sandwich, but also the flu shot.
[Caitlin] That's not what gave me not-the-flu last year.
[Anna] Red bell peppers have more vitamin c than oranges.
[Caitlin] Huh. Also a scurvy cure. [Anna] Yes! The more you know. Doo doo doo doo!
Well, Caitlin, thank you so much, this was so much fun! [Caitlin] Thank you for having me!
[Anna] Any time we can get together and talk death, it's just one of my favorite things.
[Caitlin] Careful what you wish for. I live at the Mütter now.
[Anna] Yes! You have permanent residency whenever you want.
You can visit Caitlin's web series, "Ask A Mortician."
And please come and visit our newest exhibition, which will be opening on October 17th.
It's one of our most ambitious to date. It's called "Spit Spreads Death!"