The Plague of San Francisco | The Golden City | 4

0:00American scandal uses dramatizations that are based on true events. Some elements, including dialogue, might be invented, but everything is based on historical research.

0:25It's February of 1903 at San Francisco City Hall. Inside a packed hearing room, 34-year-old federal doctor Rupert Blue stands before a fractious meeting of local landlords. Dr. Blue is in charge of the Marine Hospital Service in San Francisco. He and his predecessors in the job have faced years of hostility from newspapers and politicians. But Blue has finally secured the backing of city and state authorities for a sanitation campaign to eliminate bubonic plague from the city once and for all. He's proposed a huge demolition scheme in Chinatown to sweep the cramped and unhygienic streets that provide ideal conditions for the disease to spread.

1:04But landlords in Chinatown are seeking a legal injunction to stop the plan. So if Blue is to move forward, he must win them over.

1:16He tries to raise his voice above the chatter. Gentlemen, if I may please, just a moment of your time. Thank you. Now, I understand these measures might sound radical. They sound crackpot is what they sound. Blue peers through the crowd. A pink-faced landlord at the back of the hall is jabbing a finger at him. You're asking us to tear down property we spent years building. And for what? Sir, if you don't mind waiting until the end, please, I'll answer all your questions then. No, no, no, I don't have any questions. I have some statements. I own a row of properties between Stockton Street and Waverly Place, and I will not see them destroyed.

1:52They are mine. Sir, I appreciate your concern, but rest assured our plans do not include the demolition of entire buildings, just the balconies and stoops. And how will tearing down balconies get rid of the plague? That is a fair question, sir, and the answer is actually pretty simple. These balconies block sunlight and restrict airflow, leaving the streets below them damp, poorly ventilated, and vulnerable to rot and decay. So you're asking us to believe that a little sunlight is going to miraculously end the plague? No, sir, of course not. Sunlight alone will not achieve much. But combined with our other sanitary measures, it could make a real difference.

2:30Uh-huh. But who's going to pay for the price of all this disruption? It's going to be us, right? The landlords and the business owners who are just trying to earn an honest living here. Well, you're right. There will be some disruption. But we will try to keep that to an absolute minimum. And I promise we're going to work with the utmost efficiency. Well, I have a hell of an efficient fix for you. Why don't you get rid of the Chinese? They're the ones spreading this disease. Actually, sir, it is I say we have them moved to Angel Island, or better yet, back to China. Blue suppresses a sigh. To him, it's clear that the real blame lies with the landlords and their cramped, squalid buildings.

3:05Still, Blue knows he must tread carefully because he can't afford to alienate these men. Gentlemen, gentlemen, look, look, I give you my word. If you support our efforts, my staff and I will work tirelessly to make this city healthy again. But you have to trust us. Because if we don't act now, this disease will not stay in Chinatown. It will spread. It will spread to your families. It will spread to your homes. And I think you'd agree it's well worth losing a balcony or two to prevent that. Eventually, the landlords reluctantly agree to back Dr. Rupert Blue's campaign. Their threat of legal injunctions has dropped.

3:41And soon after, sanitation teams begin removing stoops, dismantling balconies, and clearing away piles of rotting timber in Chinatown. They go from house to house, fumigating rooms, scrubbing down surfaces, and sprinkling floors with chlorinated lime. And slowly, the district's familiar stench of decay is replaced by the acrid smell of antiseptic. Dr. Blue begins to feel encouraged, but only slightly. He's still terrified that another outbreak of the plague will erupt elsewhere in the city and overwhelm the already strained Marine Hospital service. If that happens, Blue fears that he'll have no chance of containing the plague to San Francisco.

4:18It will spread beyond the city's limits, and Blue will become just the latest in a long line of federal doctors who failed to stop it.

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5:43The spring of 1903 marked a turning point in San Francisco's battle against bubonic plague. After almost three years of denial and obstruction, California's politicians, reporters, and businessmen finally came together to fight the disease spreading on the West Coast. This new era of cooperation gave Dr. Rupert Blue something he'd never had before in San Francisco, some time to think. So while sanitation teams did their work in Chinatown, Blue and his staff began looking into the question of exactly how bubonic plague was spread. Although it had been known for centuries that rats were carriers of the disease, little was understood about how it spread from animals to humans.

6:22Dr. Blue was about to get a lead on the mystery, but more people would have to die first. This is Episode 4, The Golden City.

6:34It's July 1903 in San Francisco's Chinatown. 35-year-old Italian laborer Pietro Spadafora weaves his way through the crowds on his way home from work. Spadafora doesn't live in Chinatown, but he's gotten into the habit of passing through to pick up cheap produce. And as he walks through the maze of alleyways today, Spadafora notices a change in the neighborhood. Many of the buildings have been partially torn down. Their balconies, stoops, and awnings have been stripped away, leaving the streets feeling wider and more open. Then Spadafora spots something on a street corner that makes him pause.

7:09It's a pile of discarded lumber, just sitting out, abandoned in the open. Spadafore smiles because to him it's free firewood. He checks to make sure the coast is clear before helping himself to several planks. Hoisting them onto his shoulder, he hurries off down an alleyway. Then he heads north before crossing Broadway into the Latin Quarter, home to the majority of San Francisco's Italian, Mexican, and Spanish residents. His ragged leather shoes splash through puddles, tramping over discarded newspapers bearing headlines about Dr. Rupert Blue and his campaign to rid Chinatown of rats. But Spadafore doesn't read the newspapers, and he doesn't concern himself with politics or public health.

7:49Like countless other poor immigrant laborers here, his every waking moment is devoted to scraping together a living to support his family. So when Spadafore arrives at his tenement building, he carries the free firewood up the creaking staircase to the apartment he shares with his wife, mother, and two small children. There, Spadafore breaks the planks into smaller pieces and then places a few inside their stove. Soon, the dingy apartment is filled with warm, flickering light and the smell of hot food. But when Spadafora lies down to sleep that night, he notices an itchy red bump on his arm. He scratches at it a few times and then drifts off happily to sleep.

8:26A few days later, Spadafora comes down with a fever. Unable to report for work, he remains bedbound for several days as his condition steadily worsens. Eventually, his desperate family takes him to the Southern Pacific Hospital on Mission Street, but it's too late. On July 19, 1903, Pietro Spadafora succumbs to his sudden illness, and by then his elderly mother is exhibiting the same symptoms, and soon she too is dead. These fatalities are quickly reported to the Marine Hospital Service. Autopsies uncover tissue samples teeming with plague bacteria. At his headquarters in Chinatown, Dr. Rupert Blue reads the case reports with a growing sense of dread.

9:07The Latin Quarter is another densely populated district, and if plague gains a foothold there, then a second outbreak in San Francisco is almost inevitable. So Blue and his team trace Spadafora's movements. They soon find out about his habit of walking through Chinatown. That alone is unlikely to have exposed him to plague, but when health officers search the dead man's property, they find the stolen firewood. This lumber must have been the source of the disease. Something about it killed Spadafora and his mother. Blue soon discovers what it is. The wood is crawling with fleas. At this point in time, few scientists have made any connection between fleas and the spread of bubonic plague.

9:49The prevailing theory is that although rats can introduce the disease to a new place, it spreads primarily from person to person. But there are other theories. Four years ago, a French medical researcher began noticing insect bites on the bodies of plague victims in South Asia. He proposed that fleas, commonly found on rats, could transmit the disease to humans through their bites. But the international medical community dismissed the idea. They clung to the belief that plague primarily affected Asians due to their poverty and perceived poor hygiene. In the U.S., this racist theory was advanced by those at the very top of the medical profession, including Surgeon General Walter Wyman himself.

10:30But after the deaths of Pietro Spatafora and his mother, Dr. Rupert Blue begins to think that the flea hypothesis is correct. Spatafora has no identifiable close contact with rats or anyone infected by the plague, but he has been exposed to fleas. Blue immediately orders all lumber removed from buildings in Chinatown to be disinfected before it's dumped. Then he concentrates the ongoing sanitation campaign on purging the city of rodents. He advocates the use of traps and poison, but also introduces a bounty of 10 cents for every rat, dead or alive, brought to his Chinatown laboratory. There, Blue's team of doctors carefully examine the rodents, searching for evidence of plague before incinerating the remains.

11:16The work is grim and painstaking, but as the pile of dead rats grows over the weeks that follow, the number of plague cases falls. Dr. Blue begins to feel cautiously optimistic. He may not only have ended the plague in California, but also finally confirmed how the terrible disease spreads. But by early the following year, that optimism looks suddenly premature. Months after the death of Pietro Spadafora, there's a new surge of cases in San Francisco's Latin Quarter. And as Dr. Blue pours over the data, a dreadful new possibility dawns on him. By focusing on rat control in Chinatown, he may have simply just driven the rodents out of one district and into another.

12:00It's February 1904 in a ramshackle row house in the Latin Quarter. Inside a gloomy parlor, Giuseppe and Luisa Rossi are holding a funeral for their 18-year-old daughter, Irina. Candles flicker beside the open casket, throwing shadows on a crucifix on the wall and a framed image of the Madonna. Dressed in black, Giuseppe gazes down at his daughter's body and tugs at the beads of her rosary. Last week, Irena fell ill with a high fever. Giuseppe and Luisa could only wait and watch, bewildered and horrified, as their daughter got sicker and sicker. She died earlier this morning. A knock at the door interrupts their silent vigil.

12:41Assuming it's the priest, Giuseppe goes to open the door. But it's not a clergyman waiting there. Instead, two federal health inspectors stand on the doorstep. They've received word that an Italian girl in the Latin Quarter has been bedbound with a high fever, and they've come to investigate it as a possible case of plague. Giuseppe tells them that they're too late. Irene passed away this morning. But the officials aren't here to save her. They want to determine what killed her. Giuseppe recoils, refusing, asking the inspectors to leave and let them mourn their daughter in peace. But the officials stand their ground.

13:16They have a duty to investigate every suspicious death, and that means conducting an autopsy. After much debate, Giuseppe relents, but on two conditions. First, the autopsy must be done right away so Arena can be buried tomorrow. Second, he demands to be present to ensure his daughter's body is treated with respect. After a short conference, the officials agree. So that night, Giuseppe sits in the Marine Hospital Service Laboratory in Chinatown, watching surgeons make careful incisions in Arena's body. Tears brim in his eyes as the doctors removed tissue samples from his daughter's lungs and spleen, and lab results soon confirm Irena died of pneumonic plague, the most aggressive form of the disease that attacks the lungs.

14:00So it comes as little surprise to the doctors when just days after her death, both Giuseppe and Luisa also succumbed to the disease. For Dr. Rupert Blue, the death of the Rossi family is an alarming sign that plague is spreading once again. So immediately, he orders the sanitation efforts that proved so successful in Chinatown be extended to the Latin Quarter. The streets are then cleaned, old and unhygienic structures are demolished, and concrete is laid in place of wooden floors, preventing rats from nesting underneath. These measures work. The rat population shrinks and the number of plague cases decline.

14:36A full-blown outbreak in the Latin Quarter has been averted. And by May of 1904, the citywide death rate has fallen by 15 % on the previous year. Soon, there are weeks and then months with no new plague cases at all. Dr. Blue is hesitant to declare an end to the epidemic, but his boss in Washington has no such reservations. Confident that San Francisco is now safe and the reputation of the Marine Hospital Service has been restored, Surgeon General Walter Wyman sends a telegram to Dr. Blue. His work in California is done. He's being reassigned again, this time to Norfolk, Virginia. But unlike his unhappy predecessor, Dr.

15:17Joseph Kenyon, Blue leaves San Francisco a hero. His departure in early 1905 is marked with an official proclamation thanking him for his skillful cooperation in all pertaining to the welfare of San Francisco's sanitary health and commercial prosperity. After five years and at least 113 deaths, the plague seems to be over. The citizens of San Francisco begin to look to the future with hope. Their city has emerged from the crisis as a more modern metropolis, poised to embrace the promise of the 20th century.

15:51Just over a year later, a few minutes after 5 a.m. on April 18th, 1906, San Francisco Mayor Eugene Schmitz is fast asleep in bed, when suddenly he's woken by a violent tremor shaking the house. Julia? Julia, wake up! What? What's going on? I think it must be an earthquake. Look at the ceiling. Above them, the chandelier swings back and forth wildly as the entire mansion trembles around them. Mrs. Schmitz bolts up in bed, terrified. Eugene, what do we do? I don't know. I don't know. But suddenly, just as quickly as it began, the shaking stops and the house falls silent. In the distance, dogs begin to bark.

16:31Cautiously, Schmitz gets out of bed and pads over to the window. His wife draws up the covers around her. Is it over? Yes, my dear, I think it might. Schmitz is thrown to the ground as an even more powerful tremor rips up through the earth. He scrambles over to the bed as a spiderweb of cracks splits the ceiling and chunks of plaster fall to the floor. He looks up at his wife, terrified in bed. We need to get out of the house. Come, quickly, quickly. Schmitz grabs his wife's hand and they race downstairs in their nightclothes as their house continues to shudder around them. They bolt for the front door and run out into the street, away from the building that is now swaying violently on its foundations.

17:12The mayor's wife is pale. She staggers and clutches onto her husband. Oh, Eugene. Oh, courage, my dear. Courage. We're safe out here. We're safe. Let's just hold on. By the time the ground stops moving, more than 30 ,000 buildings in San Francisco have been reduced to rubble. Deep cracks have opened up in the cobblestone streets, swallowing entire houses, streetcars, and stagecoaches, and leaving more than 3 ,000 people dead. But the danger doesn't end with the earthquake. Over a quarter of a million residents will be left homeless by this disaster. And with all these people forced to live in filthy camps and shanty towns, disease will begin to spread among the ruins of San Francisco.

17:55And the stage will be set for yet another battle with bubonic plague.

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19:26at all. Right. They were in it. And if you don't listen to them, then I will cut off your tongue, then cut off your head, and then put the tongue in the head hole. Aw, you tried. Listen now exclusively on Audible and Donald the Audible app today, or off with your head! I'm kidding.

20:02Shortly after noon on April 18, 1906, San Francisco Mayor Eugene Schmitz holds an emergency meeting in the rubble of City Hall. It's just a few hours since a devastating earthquake hit the city, and Mayor Schmitz is concerned about law and order. He authorizes the police to shoot and kill any looters, but his city is facing far bigger problems than a few opportunistic thieves. In the wake of the earthquake, ruptured gas lines have sparked huge fires, which are incinerating the few buildings left standing. By the end of the week, over 200 ,000 people are living in refugee camps in public parks.

20:37And soon these camps evolve into sprawling shanty towns. Crude wooden shelters line the dirt tracks that serve as streets. Swarms of flies buzz around open-air kitchens and poorly dug latrines. And as the weeks pass, the ground is churned into a swamp of mud, trash, and human waste. Following the departure of Dr. Rupert Blue, sanitation measures in the city are left in the hands of the military. Army medics try their best to organize waste disposal and impose some order in the camps, but soon there are hordes of rats marauding the shanty towns. Cases of pneumonia and dysentery are detected, and the fear is that more serious diseases won't be far behind.

21:19And in late spring 1907, more than a year after the earthquake, a young sailor is admitted to the U.S. Marine Hospital with a high fever and swollen lumps on his groin. Soon he slips into a coma and dies. An autopsy confirms doctors' worst fears. The bubonic plague has returned to San Francisco. More cases quickly follow, culminating in six deaths in the span of less than a week. And after all the city has been through over recent years, the citizens of San Francisco are terrified. Luckily for them, there's been a change in leadership in the city. The plague skeptic Eugene Schmitz has been ousted in a corruption scandal.

21:58His political fixer Abe Roof is gone too. And while Schmitz continues to protest his innocence, a new man has taken charge at City Hall. Unlike his predecessor, Mayor Edward Taylor has made public health a priority. So when the signs of another potential plague epidemic emerge, he wastes no time. Taylor immediately contacts Washington to request federal support, and Surgeon General Walter Wyman knows exactly who to send. Over the past four years, Dr. Rupert Blue has risen from obscurity to become one of the most celebrated doctors in the entire Federal Health Service. Now the 39-year-old returns to the city where he made his name.

22:37When he arrives, he finds San Francisco on the brink of crisis yet again. There are still tens of thousands of people living in refugee camps, and the city is scarred by burned-out buildings, broken sewers, and piles of rubble. The conditions are ripe for another epidemic, but Blue is determined that this time will be different.

22:59So in September of 1907, Rupert Blue attends a meeting of the San Francisco Board of Health. The room falls silent as the board's president rises to speak. Dr. Blue, I know I speak on behalf of everyone on this board when I say a hearty welcome back to San Francisco. Blue nods politely. Thank you. That's very kind of you all. This city has done much for me. I only wish I were back under better circumstances. As do we all, doctor. As do we all. Before we begin, let me say this plainly. The board stands firmly behind a robust response to this outbreak. We offer you our complete support. There's a rumble of approval from around the table.