Reprint of "Love in the Time of Influenza: Hemingway and the 1918 Pandemic"

Author’s Note - April 2020
When Alex Vernon and Suzanne del Gizzo asked if they could reprint my 2012 essay, “Love in the Time of Influenza: Hemingway and 1918 Pandemic,” for our Society’s blog, I naturally said yes, and then went back to see what I had written so long ago. I realized that the essay was not written to be read by people themselves in the midst of an historic pandemic of a novel virus. How I wish we could have kept our knowledge of such things scholarly and theoretical instead of up close and personal. I would love to turn the dial on the time machine back to 2012.
But as comparisons are unavoidable now, I wanted to say, by way of reassurance, that while both pandemics are epochal, history-making eruptions of disease, there are important differences between the 1918 influenza pandemic and the 2020 covid-19 pandemic we should all bear in mind. More than a century of advances in science, technology, medicine, and public health stand between us and 1918. If we respect the well-understood dangers of covid-19 and make the calculated, science-driven sacrifices our public health officials ask of us, together we can alter the course of the disease.
In 1918, the world was at war, with mass movements of troops, navies, and refugees spreading disease unchecked.  The League of Nations was only a gleam in Woodrow Wilson’s eye. Today, the World Health Organization of the United Nations monitors a planet mostly at peace via its Global Surveillance of Epidemic-Causing Diseases System, instantly transmitting warnings around the globe, directing preparedness and response, and providing human resources and medical supplies such as covid-19 test kits.  In 1918, Marconi’s wireless radiotelegraph was the latest technology for transoceanic communication. Now, the worldwide web unites the globe, allowing scientists from many nations to collaborate with one another on projects such as building ventilators using 3-D printers or pioneering gene-editing technologies for faster testing. In 1918, there was no vaccination against influenza nor any knowledge of how to create one. Not until 1938 would Dr. Jonas Salk break a path, using the same techniques that would bring us his more famous polio vaccine in 1952. Today the first clinical trials of a vaccine for covid-19 are already underway. In 1918, there were no ventilators to assist patients needing help to breathe. Even the primitive “Iron Lung” that saved so many victims of polio was a decade in the future. There was no U.S. Center for Disease Control (not founded until 1946), never mind state CDCs, giving us daily updates and providing doctors and scientists expert in epidemiology to guide the response of government at every level.  Nor was there television and internet news to instantly communicate vital information to the public. The list of differences could go on and on.
The important similarities between the 1918 influenza pandemic and the 2020 covid-19 pandemic are similarities of the human heart, expressed in the essay in letters between Hemingway in a Milan hospital, his family members back home in Oak Park and Chicago, and his beloved Agnes von Kurowsky, away nursing on the front lines of the disease. As I reread their words while sheltering here at home in Maine, I am struck by how similar their emotions are to ours now, and also by how brave they were—and it heartens me.  I also have renewed conviction that Hemingway’s experience of the 1918 pandemic both changed him profoundly and underlies some of his best fiction about WW I in ways we’ve yet to appreciate.
Take care and stay safe, everyone.   
Susan F. Beegel
Editor's Note: This essay, "Love in the Time of Influenza:  Hemingway and the 1918 Pandemic" by Susan F. Beegel, was originally published in War + Ink:  New Perspectives on Hemingway's Early Life and Writing edited by Steve Paul, Gail Sinclair, and Steven Trout.  It is posted here with the permission of Kent State University Press. 
© 2014 by The Kent State University Press, Kent, Ohio, 44242.  All Rights Reserved.  This piece is provided for individual use only.




Susan F. Beegel

In 1918 a virulent strain of influenza emerged that would spread around the world, fueled by World War I with its patriotic rallies and parades, its streams of refugees, and its mass movements of troops, such as the 1.5 million American soldiers sent to Europe in the last six months of the war (Crosby 31).  Before the 1918 flu burned itself out, it had killed between fifty and one hundred million people worldwide, about two-thirds of them in a twenty-four week period from mid-September to early December.  The pandemic killed far more people than World War I, with its 9.2 million combat deaths, or World War II, with 15.9 million dead in battle.  It claimed more lives than the Black Death of the Middle Ages in one hundred years, and killed more people in twenty-four weeks than AIDS has killed in twenty-four years.   Because the flu affected young people between the ages of twenty and thirty disproportionately, it is estimated to have killed between eight to ten percent of the world’s total population of people in this age group.  In the United States, about twenty-eight percent of the population was infected, and so many people died that that average American life expectancy dropped from fifty-one in 1917 to thirty-nine in 1918 (Kolata7-8, Barry 4-5).

Why was this particular flu so deadly? In The Treatment of Acute Infectious Diseases, a 1916 medical textbook, Dr. Frank  Meara states prophetically: “[W]e do not look upon influenza as a highly dangerous disease [because] we do not attribute the deaths from pneumonia to the influenza infection with sufficient emphasis, so little precaution is taken to protect the individual or the community” (183).  And yet, as Dr. Meara knew, one result of infection, “much dreaded and to be constantly watched for,” was pneumonia. And influenza pneumonia, he warned, “has a high mortality which differs in different epidemics” (180).  That is what made the 1918 influenza so deadly—no other influenza before or since has had such a propensity for pneumonic complication. The pneumonia that came with it was so lethal that it could kill within forty-eight hours after the first ache and cough, filling the lungs with bloody fluid and destroying their delicate tissue (Crosby 8).

In spite of all of this, the 1918 influenza pandemic has until recently been almost entirely overlooked by historians in general, and literary historians in particular (you won’t find “influenza” in the index of Paul Fussell’s The Great War and Modern Memory, for instance). Nor will you find the subject much treated by Hemingway biographers.

Yet, as a cub reporter on the Kansas City Star, Hemingway was living very near the “hot zone” where this flu may have broken out.  Although at the time it was called the “Spanish flu,” epidemiologists tracing the historic roots of the disease now believe that the virulent form actually arose early in March 1918 at Camp Funston in Fort Riley, Kansas, where tens of thousands of recruits were jammed into crowded barracks (Kolata 10, Barry 95-97).   Hemingway had joined the Seventh Missouri Infantry of the National Guard in November 1917, and, on Tuesday nights, his unit drilled at Camp Funston (Letter to his Parents). 

Fortunately for American literature, Hemingway did not sleep in the barracks or dine in the mess halls at Camp Funston, and his spring enlistment in the American Red Cross got him out of the Guard just before flu struck the camp. He would dodge the flu again in the summer.  The virulent form arrived in France with the American Expeditionary Forces in August 1918—several months after Hemingway passed through on his way to Italy as an ambulance driver (Crosby 38).  From France, the second—and deadliest—wave of the disease began to advance across Europe. In October 1918, the nineteen-year-old, Hemingway was recovering from his war wounds at the American Red Cross Hospital in Milan when “la spagnola” broke out in Italy.  Over the next few months, between five and six million Italians would come down with the flu, and between five hundred thousand and six hundred thousand would die (Gandolfi, Tognotti).1

Hemingway was deeply in love with his nurse, Agnes von Kurowsky, and wearing her ring, when, on October 4, 1918, she lost her first patient to the flu.  In her diary, Agnes wrote: “Mr. Colter was so much worse last night & tonight that Cavie came on with me tonight. We were so in hopes we could pull him through. Dr. Jardine came @ 10.45 & said these cases were liable to go very quickly—& the Lieut. died at 11.30 almost in my arms. We worked over him like fiends & did everything we could think of but, it was no use. I cried for the first time over losing a patient, but it seemed so dreadful to die off in a strange land with none of his people near & he was so sweet!” And the following day she added: “I was just about done up this a.m. after that night of sorrow. Cavie stayed with me until 4.  We laid him out and I shaved him, & I never saw anyone look so lovely and smiling. Tonight I tried my best to go out & forget it—so I persuaded Cavie and the Kid to go for a drive. . . .”  (Villard and Nagel 85). 

Hemingway was almost certainly present at Lieutenant Colter’s death, writing about it later in his short story “A Natural History of the Dead,” originally interpolated in the 1932 Death in the Afternoon: “The only natural death I’ve ever seen, outside of loss of blood, which isn’t bad, was death from Spanish influenza. In this you drown in mucus, choking…. (DIA 139).  His point, of course, was that death from natural causes could be as horrifying and humiliating as any death on the field of battle—or more so.

Even more interesting is Hemingway’s untitled short story about this death, located by the late Peter Griffin in the Kennedy archives and published in part in Griffin’s Along with Youth (95-96, see also Hemingway “At one o'clock”). The narrator, a hospital patient in love with his nurse, helps her to hold the dying flu victim up as he “drown[s] noisily in mucus.”

Afterwards, the narrator confesses: 

It was the first man I had seen die of the influenza and it frightened me. The two nurses cleaned him up and I went back to my room and washed my hands and face and gargled and got back into bed. I had offered to help them clean up but they did not want that. When I was alone in the room I found I was very frightened by the way Connor had died and I did not go back to sleep. I was frightened into a panic. After a while the nurse I was in love with opened the door and came into the room and over to the bed.

She expects him to kiss her, but he is afraid to, understandably worried that he will get the flu.

           She was quiet, sitting there on the bed and what I had said was coming between us solidly.

           “You’re too afraid to kiss me.”


           She was quiet again. Then she said, “I’d have sucked it all out with a tube if it would have done any good.”

He describes the nature of his fear.

           “I’m afraid all right. I never saw anybody die like that.”

           “All pneumonia patients do.”

           “But this is worse because it is so sudden. There isn’t any time to wear the body out and yet the violence [isn’t] from outside.”

           “There are plenty of bad ways to die,” she said.

The nurse goes out to gargle again to please her lover.

When she came back I kissed her, but it was better never than late. It was natural that I should be afraid of the flu and I am not ashamed of that nor of many other things I have been afraid of, but being afraid is very different from cowardice and it was cowardice not to kiss her and she knew it as well as I knew it and that knowledge drove like a wedge between us. Anyone who thinks an act of cowardice does not take a long time to wipe out or pay off is a fool.” (Griffin 95-96, Hemingway “At one o’ clock in the morning…”).2

In this very short story the wounded narrator, who ought to be a war hero, is transformed by the influenza into a valor-ruined man in the eyes of his nurse-lover, the medical professional who willingly risks her life to care for patients with deadly infectious diseases, and who has a broader experience of death than his own.

Two days after Lieutenant Colter’s death, at about 11 pm on the night of October 6, a rumor reached Italy that Kaiser Wilhelm had proposed an armistice to President Wilson, and that the war was over (Villard and Nagel, 86).  The rumor of peace was false, but hundreds of thousands of Italians poured into the streets to celebrate, and the flu epidemic exploded. In Milan, the government reacted by using road sprinklers and fire engines to spray streets and public buildings with disinfectant. Public assemblies were banned, and the maximum number of people allowed to use trams, cafés, shops, and public buildings was limited (Gandolfi, Tognotti).

Eleven days after Lieutenant Colter’s death, on October 15, Agnes was dispatched to Florence to nurse at a hospital where the influenza epidemic had felled most of the medical staff.  She wrote to Hemingway from the train, where she was watching a woman passenger ill with flu being tenderly cared for by her husband. Agnes felt the role reversal implicit in her departure: “It’s funny to feel that I’m going away from you when all along I was picturing how it would feel when you went away from me” (Villard and Nagel 97-98).

Hemingway had apparently given her a charm to protect her from the flu—“[D]o you think you should have given me your good luck, dear boy? Suppose you go back to the Front while I’m here, & have it not to guard you” (Villard and Nagel 98).  The charm may have been a St. Anthony medal, like the one Catherine so tenderly gives to Frederic on his departure for the front in A Farewell to Arms (43). On November 1, Agnes wrote to Ernest in great exhaustion about the illness of her fellow nurse Elsie Jessup, her own lack of sleep, and the thirty recuperating soldiers in her care. “Everybody here has a cough, but, I think I had a light attack, which I succeeded in warding off by medicine and St. Anthony” (Villard and Nagel 121).

While Agnes was away, Hemingway was undergoing physical therapy on his wounded legs, and preparing for a brief return to the front—just in time to catch a glimpse of the victorious Italian campaign of Vittorio Veneto (Villard and Nagel 110-111).  The commander of Hemingway’s old Red Cross ambulance unit, Captain Robert W. Bates, wrote home about the epidemic’s course in the Italian Army that October:

I never have had such a feeling about anything before; just let yourself begin to snuffle a bit, and you picture yourself in your grave this time next week.  So it goes; I am telling you nothing that you have not already seen in the papers, and in order not to do so will make no mention of the numbers involved. I feel as if I had been going to funerals for a long time and as if it were a natural part of my life. (qtd. in Bates 56).

Agnes’s letters to Ernest show how worried they both were about the epidemic. “Do you know, that this week when I didn’t get your letters, I imagined you had gotten sick & all sorts of foolish things….” she wrote, and “Now there you go a-worryin’ over me for absolutely niente. I hasten to assure you I am in good health” (Villard and Nagel 112).  There was reason to worry, as the hospital in Florence was overrun with hundreds of ailing soldiers, and Agnes shared other news with Ernest: “Jo Holdener, my classmate in England, says they have 600 cases—25 of whom are nurses--& 5 of those have died already—(of the nurses). Cheerful, isn’t it?”  (Villard and Nagel 109). And she shared her own attitude:  “Trained nurses are usually noted for being reckless about their own health, while trying hard to keep up that of others” (Villard and Nagel 118). Agnes also told him: “Mama wrote me how terrible the epidemic was in America, & she hoped she wouldn’t get it—giving me something else to worry about” (Villard and Nagel 109). 

Hemingway too had something else to worry about.  Back in the United States, the Spanish flu had arrived near Hemingway’s Oak Park home on September 11, 1918, when it struck at the Great Lakes Naval Training Station, the largest facility of its kind in the world, thirty miles north of Chicago (Barry 192). Within days, there were twenty-six hundred cases in the Station’s hospital, equipped for just eighteen hundred patients (Crosby 57). Hemingway’s older sister Marcelline would write to him: “Two of my best friends died at Great Lakes during the recent epidemic. Over 900 died during four weeks there. Sam [her boyfriend] was terribly ill but he is better now” (Sanford 295). On September 19, all liberty was cancelled for men at the Station, but it was too late. The naval recruits had spread the disease into the city, and before the Chicago epidemic was over, there would be more than fourteen thousand dead (Crosby 57, 215).  And now Hemingway began to receive truly worrisome letters from home. On October 2, two days before Lieutenant Colter died in Milan, Marcelline wrote: “Helen Gody died yesterday from the Spanish flu. Mobs of people have it in Oak Park” (Sanford 292).

It’s possible that the Hemingway family unwittingly helped bring the flu to Oak Park. In her memoir, At the Hemingways, Marcelline writes: “With my sisters and mother I entertained a series of homesick boys from Great Lakes. Each weekend the sailors, usually two or three of them, were sent out to our home from the service club in Chicago, where my parents had signed up offering to take the servicemen over Sunday. Dozens of other families like ours in the surrounding suburbs took Army and Navy men too. Always the boys snapped pictures of my sisters and me, and of the ‘swell place’ they had stayed for the weekend” (Sanford 164).

During the epidemic, Marcelline was studying social work at Chicago’s Congregational Training School, working in the city’s slums and at the outpatient clinic of Cook County Hospital. More than two thousand patients with influenza were admitted to Cook County during one four-week period, and thirty-one percent of them died (Crosby 271). Soon Marcelline was volunteering as a nurse’s aide, visiting patients in the city’s tenements. “The flu was striking everywhere. . . . Marion Vose and I acted as volunteer helpers to Miss Wilson, a trained nurse who roomed in our school that winter. We tied on our masks and accompanied Miss Wilson to those homes where the mother, or both parents, were sick with influenza. As untrained helpers, all we could do was change and bathe the babies, clean up the kitchens, and help feed the youngsters when the parents were too ill to do so. Real nurses were sometimes busier than the doctors, and harder to get, so even our help was needed.”  Several of Marcelline’s classmates at the Congregational Training School were “terribly ill” with flu, and one died (Sanford 174-175).

Of course Hemingway’s doctor father was in the front lines. In early October, Clarence wrote to his son: “Today Mother & I celebrate our 22nd wedding anniversary. I am very busy. An epidemic of Spanish influenza.”  On October 13, he wrote again, “I am very busy with influenza patients,” and enclosed a notice about the death of Douglas Roberts, a young man Ernest’s age and a friend of their pastor’s son, at the Great Lakes Training Station.

On October 21, he wrote with that splendid callousness that characterizes Dr. Adams in “Indian Camp”: “Influenza epidemic gives me a feast!”  And on October 27, “I never was so busy professionally. Many doctors gone and this epidemic is an extra with its feast and famine for doctors. So long old Scout, read Field & Stream and dream of Walloon and Hortons.” And, on November 8, “I am very busy indeed with Dr. Potthoff in the service. I am used by the Public right up to my limit.”

Although Dr. Hemingway endeavored to sound chipper when writing to his hospitalized son in Italy, Marcelline remembered, “[M]y father was called so frequently to take care of flu patients that at one time he told me he had had no sleep in 48 hours. . . . All the doctors were rushed and bone-weary in the same way” (Sanford 175).

Hemingway’s mother apparently wrote less frequently, but her letters too were concerned with the flu. On October 21, “The epidemic has been so fierce all over the country (Spanish influenza) which always goes into pneumonia that all churches, clubs, theatres, schools, movies, & social gatherings are closed and prohibited. People dying at the rate of 400 a day from it in Chicago. Cousin [Mary?] Bailey died of it last week in Charles City [?]. That leaves Alice all alone.”

His sister Ursula wrote: “Ernie, you remember Bobbie Hurst don’t you? I’d gone with him quite a bit this year and was going to the football game Saturday with him, and he died!  Influenza turning to double pneumonia—It’s been terrible.  I know this is [sort] of sad to write in a letter, but Bobbie thought such a lot of you, and had just told me the other day to write you and send his congrats—on [being] up—so I wanted to tell you about him. He was such a peach and a good friend.”

Madelaine, nicknamed Sunny, was not reassuring: “Dad just called me in his office and looked at my throat and said I had the ‘flu.’ O bird. My head is beginning to ache so I think I better go to bed. So good night, but tell all the Austrians and Germans you can that I would like to get a good chance at them and see what they would look like when I got through.”

Again, the effect of all this was to shift the attention away from the decorated war hero in Italy recovering from his wounds and back to the home front, where even Hemingway’s seven-year-old  little sister Carol was in harm’s way: “Dear Ernie, When are you coming home? We are in quarantine. We cannot go out of our yards. We do not have school or church. That is fun. [We] do not hafto do enee thing but plae. Will you bring me a ring. . . .  I hope that you will be betr soon. I [am] and I cut out paper dolls. It is fun to. It is raining or I would be plainge.”

Tragic news from home was almost inevitable, and it arrived in a letter to Hemingway from his father: “On November 6th, day before yesterday, we received a telegram from Frank Butler, Bishop, California, that his sister Vada, Uncle Leicester’s wife, had died that day of influenza. We are all sad as we so learned to love and appreciate her when she visited last April. We at once wired a long message of sympathy yesterday morning and received a long telegram from Frank Butler that told us that the same day his sister Vada died there was received a telegram from Washington D.C. that told Aunt Vada that Lieutenant Leicester C. Hall, Air Service, A.E.F. in France was missing in action since 15 September 1918. . . . You can imagine your dear mother’s special anxiety at this time. We must hope and pray the war will end soon and that if Uncle Leicester is a Hun prisoner, he may soon make his exchange. Truly our family is having history carved deep into its flesh . . . .” (Letter to Ernest Hemingway, December 4, 1918).

Aunt Vada was Nevada Butler Hall, the tall, dark-haired, strikingly beautiful daughter of a gold prospector from the West. Marcelline remembered her as a charming person with a gracious manner, a pleasant, low speaking voice, and a love of theater. Hemingway’s Uncle Leicester—his mother’s brother—had married Vada in his forties, not long before departing to serve as a flyer with the aviation services in the war.  Vada had been ill for ten days before lapsing into unconsciousness for 24 hours and dying, in Marcelline’s words, “pathetically alone” (Sanford 173-76).

The war did end soon—on November 11, 1918—Germany’s surrender probably hastened by its three hundred thousand troops down with the blitzkatarrh and the long lines of hearses in Berlin (Crosby 26, 160). The influenza, however, did not end, but went raging on through December and January, even into February, fueled by armistice celebrations and returning troops.  Agnes and Ernest were briefly reunited in Milan, but by November 22, Agnes was back in the front lines of the epidemic. First, she was sent to Padua, where no one met her at the train because the hospital’s chauffeur had dropped of the disease in the streets on the way to pick her up, and where she found soldiers dying for lack of adequate attention.  Then, on to Treviso, where there were so many “awfully sick” patients there were no sheets left to make up the beds, and where fellow nurses were dropping and being sent to other hospitals with better care (Villard and Nagel 129, 134).  Agnes was becoming increasingly impatient with Ernest’s boasting: “I want you to know I’ve passed through some of the hardships of war, & you have no corner on the market—old dear” (Villard and Nagel 132). 

On January 4 1919, Hemingway departed reluctantly for the States after a final pleasure trip to Sicily with his friend Jim Gamble. He expected that Agnes would soon follow and marry him.  Instead, Agnes went on to Torre di Mosta to nurse civilians struck by the epidemic. In February 1919, she wrote to Ernest: “Today was a very sad one, as 2 of our little patients—brother & sister 14 & 16 yrs. both died of Influenza and pneumonia very much like Colter” (Villard and Nagel 160).  Her “Dear John” letter followed within a month.  Older than Hemingway by eight years, Agnes could not get away “from the fact that you are just a boy—a kid” (Villard and Nagel 163).  Doubtless the influenza epidemic helped her to see that.

The tragedy of Hemingway’s Uncle Leicester and Aunt Vada—a tragedy of the influenza epidemic—interfered once again with Ernest’s status as a wounded war hero. In March 1919, he wrote bitterly to Jim Gamble, “And the Dear Uncle, missing believed killed, turns up alive and well in England and beats me home by a week. Damn him. ” Leicester did not learn of his wife’s death until he landed in the United States.  Naturally the family rallied around Leicester, whose long-anticipated moment of joyous reunion had been transformed into a stunning bereavement.  Hemingway never did warm up to the uncle who had stolen his hero’s welcome, and in January 1921 wrote his mother a telling letter about “not being able to love Uncle Leicester except as something abstract like a character in fiction.”

Fortunately for us, Hemingway did love Uncle Leicester as a character in fiction. Historian Alfred Crosby, who astutely notes that the flu was Hemingway’s “hated rival” for the attentions of Agnes von Kurowsky, nevertheless laments that for Hemingway, Spanish influenza rated “just one mention” in “A Natural History of the Dead” (316), and that he did not give us a literary account of the 1918 flu to match Katherine Anne Porter’s short story “Pale Horse, Pale Rider,” or Thomas Wolfe’s veiled account of his brother’s death in Look Homeward, Angel (Crosby 315-316).  But “In Another Country” is Hemingway’s influenza story.3   The wounded major has lost his “very young wife” to the pneumonia that was the flu’s sequel—“She had been sick only a few days. No one expected her to die” (SS 272). The young narrator, who has lost only his ability to play football, and who is learning that war medals may have more to do with being in the wrong place at the wrong time than with courage, comes to understand that the major’s loss is greater than his own. It’s an ironic little story to be sure, but the irony of returning from war to face the death of a loved one at home was literally repeated millions of times in 1918.

Hemingway resonated to his uncle’s loss more than he would admit, having spent the height of the influenza epidemic desperately anxious about his own beloved, who had left him behind in relative safety while she risked her own life wherever the disease burned with greatest ferocity.  His awareness of the tragic twist taken by Leicester and Vada’s story, his understanding that such losses were common,4 his fear that Agnes might die, and his admiration for her courage naturally underlie the romance of A Farewell to Arms, and the war story’s unexpected conclusion with Catherine’s death.  And all of those letters from home that Hemingway received during the epidemic—letters reminding the war hero that parents and siblings, relatives and friends were also in danger—enriched the novel by deepening his understanding that “the world” (not merely the war), “kills the very good and the very gentle and the very brave impartially” (FTA 249, my emphases).

  Yes, A Farewell to Arms is set before the influenza epidemic. The novel begins in the late summer of 1915 and ends in the spring of 1918.  But its famous first chapter ends with a reminder that epidemic disease, as well as the enemy, menaces the marching troops, that they face death from natural causes as well as death on the battlefield. “At the start of the winter came the permanent rain and with the rain came the cholera. But it was checked and in the end only seven thousand died of it in the army” (FTA 4).  Readers have often remarked on the irony of that “only seven thousand,” but none have understood how doubly ironic that line would be to survivors of the 1918 influenza epidemic, which killed tens of millions.

And yes, Catherine dies in childbirth, an ending that may have occurred to Hemingway when his wife Pauline Pfeiffer underwent a Caesarean section in Kansas City while he was at work on the novel in 1928.  Neither novelist Owen Wister nor Hemingway’s editor Maxwell Perkins, who were among the first to read the manuscript of A Farewell to Arms, understood Catherine’s death. Both men were concerned that the novel’s two themes—love and war—did not seem to come back together at the end (Reynolds 76-77). Perkins wrote to Hemingway—“I can’t shake off the feeling that the war, which has deeply conditioned this love story—and does so still passively—should do so actively and decisively. It would if Catherine’s death might probably not have occurred except for it, and I should think it likely that the life she had led as a nurse, and all the exposure, etc. might have been largely responsible. If it were, and if the doctor said so during that awful night, in just a casual sentence, the whole story would turn back on the war and realization of Henry and the reader” (qtd. in Reynolds 77).

Hemingway wisely ignored this advice. It’s part of his genius to have recoded the lessons taught to him by an historic influenza epidemic in the timeless fact of childbirth.  Dramatic as the hardships of war may be, men “have no corner on the market, old dear” (Villard and Nagel 132).  Like the nurse risking her life to save lives, Catherine dies in attempting to bring forth life—again, a universal tragedy that gives A Farewell to Arms relevance far beyond the events of 1918.  Hemingway’s own father, who specialized in obstetrics, had been fond of quoting a Dr. De Lee, who wrote that “‘more women die and are wounded in confinement every year than men die and are wounded on the field of battle’” (C.E. Hemingway 43).5  When death is so integral and inescapable a part of life, and when courage is so essential to all—to women and children as well as soldiers at the front—then war, and the valorization of war, become that much more pointless.  Why kill one another when sooner or later the world will accomplish it for free?  That, perhaps, is the grand theme of Hemingway’s World War I masterpiece—and it is certainly the theme of the 1918 influenza pandemic, if a disease can have a theme.

As Crosby has observed, many American writers were affected by the epidemic.  Gertrude Stein drove ambulances in France, carrying men prostrated by flu to the back of the lines.  The flu kept F. Scott Fitzgerald out of the war. His division was ordered to France in October 1918, but their embarkation was delayed by the devastating impact of the flu on troopships, and the war ended before they could depart. Fitzgerald’s beloved mentor, Father Sigourney Webster Fay, the original of Father Darcy in This Side of Paradise, died of flu in January 1919.  William Faulkner was training with the Royal Air Force in Canada when a quarter of the officers and men at his air base came down with the flu. Willa Cather devoted a few pages to the flu epidemic on board a troopship in her novel One of Ours.  Dr. William Carlos Williams saw as many as 60 patients a day during the epidemic’s height. Thomas Wolfe lost his brother. William Maxwell lost his mother. Mary McCarthy was left an orphan when both of her parents died within days of each other (Crosby 315-317). 

John Dos Passos crossed to Europe with the Norton-Harjes ambulance corps on board a troopship where men were dying daily. He came down with the disease just days after landing in France, and described it as “a combination of pneumonia, TB, diphtheria, diarrhea, dispepsia, sore throat, whooping cough, scarlet fever, and beri beri, whatever that is” (Crosby 315, Ludington 232).  Fortunately he had fully recovered before meeting a young ambulance driver named Ernest Hemingway in Italy (Baker 42).

Katherine Anne Porter lost her fiancé and nearly lost her own life. At the end of her 1939 masterpiece about this, “Pale Horse, Pale Rider,” she writes about leaving the hospital after a last encounter with her lover’s ghost:

Miss Tanner said, “Your taxicab is waiting, my dear,” and there was Mary, ready to go. No more war, no more plague, only the dazed silence that follows the ceasing of the heavy guns; noiseless houses with shades drawn, empty streets, the dead cold light of tomorrow.  Now there would be time for everything. (Porter 208)

The passage is perhaps indebted to the conclusion of A Farewell to Arms, when Frederic too has an unsatisfactory good-bye with his own dead lover:

But after I had got them out and shut the door and turned off the light it wasn’t any good. It was like staying good-by to a statue. After a while I went out and left the hospital and walked back to the hotel in the rain. (FTA 332).

Leaving the hospital. The dead cold light of tomorrow. The walk back to the hotel in the rain. Both of these works are beautiful expressions of the grief and numbness that followed World War I and the 1918 influenza. Perhaps it’s time literary scholarship recognized how thoroughly the pandemic affected Hemingway and his generation.



Photo:  Agnes von Kurowsky and Ernest Hemingway, 1918.

I’d like to express my thanks to my late friend and colleague, Alfred W. Crosby, for his interest and encouragement, as well as for his inspirational scholarship. His book, America’s Forgotten Pandemic, is the ground-breaking history on this subject.

1 I am much indebted I to my generous Italian colleague, Luca Gandolfi, for reading Eugenia Tognotti’s treatise on the 1918 epidemic in Italy for me, and answering my questions about the outbreak there with the aid of her work.

2 There are some minor differences between Griffin’s transcription and the John F. Kennedy Library’s File 260.

3 Hemingway’s 1933 short story, “A Day’s Wait,” about a young boy terrified of dying from influenza because he does not understand the difference between Fahrenheit and Centigrade, has its biographical basis in a 1932 incident involving the author’s nine-year-old son Bumby. Yet to its contemporary readers, survivors of the 1918 epidemic like the boy’s father, the doctor’s reassurances in the story—“This was a light epidemic of flu and there was no danger if you avoided pneumonia,” might not have seemed so very reassuring (SS 346; my emphasis).

4 Hemingway may or may not have known that his commanding officer, Captain Robert Bates wrote home on November 5, 1918 about the death of a girl named Madelaine that Bates had met in Paris: “Her sister wrote me two weeks ago that she had the Spanish flu, and asked me to continue writing to her until she was well enough to answer. Then she wrote to me that she was worse. I sent her a little bow-knot of the American colors as a ‘porte-bonheur’ [good-luck charm] and they wrote to me that they had pinned it to her bed. Then a friend of hers wrote me of her death; she said that they had pinned the little ribbon on her coffin.” (qtd. in S. Bates 56)

5 The observation is still true today, when the International Federation of Gynecology and Obstetrics World Congress reports that more than 2 million women and infants die from complications of childbirth annually (“More than…”).



Baker, Carlos. Ernest Hemingway: A Life Story.  New York: Charles Scribner’s Sons, 1969.

Barry, John M. The Great Influenza: The Epic Story of the Deadliest Plague in History.  New York: Viking Press, 2004.

Bates, Stephen.  “’Unpopularity Is the Least of My Worries’: Captain R.W. Bates and Lieutenant E.M. Hemingway.”  The Hemingway Review 29.1 (Fall 2009): 47-60.

Crosby, Alfred W. America’s Forgotten Pandemic: The Influenza of 1918. 2nd ed. New York: Cambridge University Press, 2003.

Fussell, Paul.  The Great War and Modern Memory.  1975.  New York: Oxford University Press, 1977.

Gandolfi, Luca.  E-mails to the Author. 4 May 2007 and 8 May 2007.

Griffin, Peter.  Along with Youth: Hemingway, The Early Years.  New York: Oxford University Press, 1985.

Hemingway, Carol.  Letter to Ernest Hemingway.  11 November 1918.  Hemingway Collection. John F. Kennedy Library. Boston, MA.

Hemingway, Clarence Edmonds.  Letters to Ernest Hemingway.  [?], 13, 21, and 27 October; 8 and 13 November 1918, and 4 December 1918. Hemingway Collection. John F. Kennedy Library. Boston, MA.

__________.  “Sudden Death That May Come to a Recently Delivered Mother.” 1908. The Hemingway Review 18.2 (Spring 1999): 43-45.

Hemingway, Ernest.  “At one o’ clock in the morning…” File 260.  Hemingway Collection. John F. Kennedy Library. Boston, MA.

__________. “A Day’s Wait.”  The Short Stories of Ernest Hemingway. New York: Charles Scribner’s Sons, 1938.  436-439.

__________. Death in the Afternoon. New York: Charles Scribner’s Sons, 1932.

__________.  A Farewell to Arms. 1929. New York: Charles Scribner’s Sons, 2003.

__________.  “In Another Country.”  The Short Stories of Ernest Hemingway. New York: Charles Scribner’s Sons, 1938. 267-272.

__________.  Letter to Grace Hall Hemingway.  10 January 1921. “At one o’ clock in the morning…” File 260.  Hemingway Collection. John F. Kennedy Library. Boston, MA.

__________.  Letter to James Gamble. 3 March 1919. Knox College Library.  Galesburg, IL.

__________.  Letter to his Parents.  15 November 1917.  Hemingway Collection. John F. Kennedy Library.  Boston, MA.

Hemingway, Grace Hall.  Letter to Ernest Hemingway. 21 October 1918.  Hemingway Collection. John F. Kennedy Library. Boston, MA.

Hemingway, Madelaine [Sunny].  Letter to Ernest Hemingway. 21 October 1918. Hemingway Collection. John F. Kennedy Library. Boston, MA.

Hemingway, Ursula.  Letter to Ernest Hemingway. 18 November 1918. Hemingway Collection. John F. Kennedy Library. Boston, MA.

Kolata, Gina.  Flu: The Story of the Great Influenza Pandemic of 1918 and the Search for the Virus that Caused It.  New York: Farrar, Straus, and Giroux, 1999.

Ludington, Townsend, ed.  The Fourteenth Chronicle: Letters and Diaries of John Dos Passos.  Boston, MA: Gambit, 1973.

Meara, Frank Sherman.  The Treatment of Acute Infectious Diseases.  New York: Macmillan, 1916.

“More than 2m infants, women, die from childbirth annually.”  The Medical News. 8 October 2009. .  14 October 2009.

Porter, Katherine Anne.  “Pale Horse, Pale Rider.”  Pale Horse, Pale Rider: Three Short Novels. 1939. New York: Harcourt Brace, 1990. 141-208.

Reynolds, Michael.  Hemingway’s First War: The Making of A Farewell to Arms.  Princeton, NJ: Princeton University Press, 1976.

Sanford, Marcelline Hemingway.  At the Hemingways: A Family Portrait  [1962], With Fifty Years of Correspondence Between Ernest and Marcelline Hemingway.  Moscow, ID: University of Idaho Press, 1999.

Tognotti, Eugenia.  La spagnola in Italia.  Storia dell’influenza che fece temere la fine del mondo.  Milan: Franco Angeli, 2002.

Villard, Henry S. and James Nagel.  Hemingway in Love and War: The Lost Diary of        Agnes von Kurowsky.  Boston, MA: Northeastern University Press, 198.


Susan F. Beegel, April 13, 2020

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