The American Plague: The Untold Story of Yellow Fever, the Epidemic that Shaped Our History - Molly Caldwell Crosby (2006)

Part III. Cuba, 1900

Chapter 17. Guinea Pig No. 1

On September 13, Jesse Lazear sat in the yellow fever ward of the Las Animas hospital in Havana pressing a glass test tube against the abdomen of a bedridden soldier. The patient’s skin was the color of smeared iodine, and his body burned from the fever lit within. Dark, wooden shutters were open, and sunlight streamed across the Spanish tile floor of the hospital room as Lazear held the tube steady and waited for one of his “birds” to take a blood meal from the sick patient. Aedes aegypti are particularly sensitive to movement and will flutter away at the slightest twitch. As a vector, it makes the mosquito all the more deadly as during this dance of lighting, then lifting off, she’ll bite several times in a short time span trying to get a full meal. With each bite, more of the virus is passed into the host’s bloodstream.

Somewhere in the room, Lazear heard the wing beats of a mosquito, as many as 500 beats per second. It was a tinny whine in the stagnant hospital air. He saw the insect flickering like candlelight on the edge of his vision, and then he watched it light onto his arm, its legs crooked, and he felt a pinch. Lazear, who stalked, captured and kept mosquitoes with meticulous obsession, probably first thought to imprison the winged prey in one of his test tubes. But, he was still waiting for the other mosquito, confined beneath glass, to feed on the infected patient. If he moved now, the other one would surely refuse to finish.

Regardless of the many things that consumed his thoughts at that moment, the mosquito had its fill of blood and flitted away before Lazear could capture it for his collection. He had not even gotten a good look at this particular insect. It was probably one of the many malaria mosquitoes that hovered around the hospital for fresh supply.

At least that was the story he told his colleagues.

In his logbook, however, Lazear wrote an unusual entry on September 13. In all cases before that, page after page of records, Lazear had used the soldier’s name and simply the date he was bitten, with no other attention to the mosquito. A one-line entry with a name and date. On that day, however, in his elegant hand, Lazear did not write the soldier’s name, but instead wrote: “Guinea Pig No. 1.” He went on to write that this guinea pig had been bitten by a mosquito that developed from an egg laid by a mosquito that fed on a number of yellow fever cases: Suarez, Hernandez, De Long, Fernandez. It was a precise, detailed history that proved beyond doubt that the mosquito was loaded with the virus when it bit the healthy soldier. The guinea pig’s name was never used.

For the next few days, Lazear’s life continued much as it had over the last few months in Cuba. He fed and cared for the mosquitoes in the lab. He carefully documented in his logbook Carroll’s illness, as well as Dean’s, recording blood counts every day. He went sea bathing and ate in the officer’s mess hall; he read books by the light of a candle before bed.

Then, he began to lose his appetite. He skipped a few meals in the mess hall. He didn’t mention it to anyone, nor did he ask to see one of the yellow fever doctors; instead, he worked hard in the lab trying to ignore the oncoming headache.

On September 18, he complained of feeling “out of sorts” and stayed in his officer’s quarters. His head pounded, and Lazear decided to write a letter. Maybe occupying his thoughts with more cheerful things would take his mind off the pain. He wrote to his mother: “Dear little Houston must be very cute. How I wish I could see him . . . Mabel is probably with you now or at any rate will be by the time this reaches you. I wish I could be there too . . . Please don’t stop writing often because Mabel has come.” He made no mention of feeling ill, nor did he ever mention to his mother or Mabel that James Carroll had fallen ill with yellow fever. That night, Lazear started to feel chilled as the fever came on. He never went to sleep; he worked at his desk through the night, trying to get all the information about his mosquitoes organized. By morning, he showed all the signs of a severe attack of yellow fever. The camp doctors made the diagnosis, and Lazear agreed to go to the yellow fever ward. He asked Albert Truby to look after his belongings during his illness.

Lazear was carried by litter out of the two-room, white pine-board house in which he had lived since he and Mabel first arrived in Cuba. His clear blue eyes were alert as the soldiers held him, and he seemed to fully understand what was happening. The house was fumigated with sulfur dioxide, and Truby removed any valuables, including all books and photographs, as well as a small notebook he found in the blouse of Lazear’s army uniform.

Lazear was moved into the yellow fever ward at Camp Columbia, occupying the second to the last dwelling. There, Lena Warner nursed Jesse Lazear, recording his vitals. The surgeon general required a log of fever cases for army record. The book, maintained by the chief surgeon of the camp, detailed a patient’s name, regiment, nativity, age and medical history. There were physiological diagrams for a surgeon to draw exactly where a bullet might have entered and exited the body, and there was a full-page fever chart. Warner tracked Lazear’s temperature as it rose to 103 degrees, and his pulse hovered around eighty.

Carroll had gained enough strength to walk, though he remained very frail. He and Agramonte made their way through Camp Columbia, past the hospital buildings, across the tracks, down the row of one-room buildings that kept the yellow fever victims isolated as neatly as their jars caged the deadly vectors. Carroll was profoundly shaken by the sight of his colleague: “I shall never forget the expression of alarm in his eyes.” Lazear’s diaphragm was beginning to spasm, and he knew better than most that it meant the black vomit would soon begin. Agramonte would later write about the relief he felt when he finally saw his friend’s eyes grow blank, and Lazear’s mind lost hold of his wife, son and an infant daughter he had never met. Both doctors pressed Lazear for more information, but all he would say was that he had not experimented on himself. Instead, he told them a mosquito in the hospital landed on his arm, and he could not brush it away.

Reed received a cable with the news that Lazear had contracted yellow fever. He wrote to Carroll immediately: “Your letter of Sept. 20th has just been received, telling me of Lazear’s attack—I am now anxiously awaiting Maj. Kean’s next cable . . . I cannot but believe that Lazear will pull through. I hope & pray that he does come out alright.”

On September 25, Reed sent a letter to Kean: “I have been so ashamed of myself for being here in a safe country, while my associates have been coming down with Yellow Jack.” He also wrote: “I somehow feel that Lazear will pull through, as he is such a good, brave fellow.”

That same day, Lena Warner braced Lazear’s arms with all of her weight, shouting for help. Still, he bolted from the bed, darting around the small, frame-wood room as wildly as a trapped insect beating against glass. Two soldiers ran into the ward, pinning Lazear to the bed, tying restraints onto his wrists and ankles.

The Cuban sun beat down against the one-room shack, and Warner sponged his body with iced whiskey and water. She recorded his temperature, which had held at 104 degrees for days, on the chart beside his bed. His eyes were wild.

It was twilight; she could hear the music from the main hall and the drone of soldier’s voices in the distance. Inside the clapboard ward, the dim light and smell of death took Warner out of the camp in Cuba to another time, twenty years before, when she lay on the floor of a plantation house outside of Memphis surrounded by the corpses of her family. Her skin burned at the memory. Flies had swarmed around the bodies, and as always, there was the sound of mosquitoes, the hum of their wings flinching in the hot air.

Lena Warner heard Lazear’s restless stirring in the bed, felt the intimacy of watching someone sleep. But the quiet did not last. Lazear’s body began to lurch, and black vomit roiled from his mouth, through the bar hanging above his hospital cot. He writhed in the bed, and his skin grew deep yellow. His 104 temperature slowly fell, leveling out at 99 degrees, and Jesse Lazear died at 8:45 p.m. at the age of thirty-four.

His arm and leg restraints were removed, and Albert Truby signed the death certificate for the quartermaster: “I have the honor to inform you that Jesse W. Lazear, Acting Assistant Surgeon, U.S.A., died at this hospital at 8:45 pm, Septr 25, 1900.” For the diagnosis, he wrote “yellow fever.” For the immediate cause of death, Truby left the space blank; a diagnosis of yellow fever was explanation enough.

Plans were made for a quiet burial so as not to affect the overall morale of the camp; but Truby insisted that Lazear receive full military honors. The entire military personnel of the camp, along with many other friends and officers, walked to the cemetery, while ambulances carried the nurses. Everyone wore white uniforms as they surrounded the gravesite like a colonnade and listened to the post band play taps. Though close to fifty mourners attended the service, only one member of the Yellow Fever Board was there: James Carroll. Reed was still in the U.S., and Agramonte had left a few days before on orders from General Wood to gather supplies in New York.

The same day as the funeral, September 26, Mabel Lazear sat in the home of her mother-in-law on Atlantic Avenue in Beverly, Massachusetts. She felt exhausted after recovering from childbirth and looking after a newborn; she had only been out of the hospital for a couple of weeks. The bell rang that morning, and she was handed a cable message. Her first thought must have been that it was from her husband—she had not heard from him in two weeks, and he had plans to return to the U.S. sometime in October. Then, she read the short cable: Dr. Lazear died at 8 this evening. It was signed by Kean, who thought that Mabel received word days ago that her husband was ill with yellow fever. She had not.

Jesse Lazear’s logbook, tall, thin, edged in dark red leather, had its last entry on September 13 with the listing of Guinea Pig No. 1. Lazear’s distinctive handwriting, with flourishing letters and elegant shape, ended that September, and new entries in different handwriting, most likely that of Walter Reed’s, did not begin again until December.

Reed retrieved Lazear’s logbook and studied it for clues. After careful examination, Reed concluded that Lazear had most likely infected himself and thus died of a medical suicide. Insurance would not be paid out to his family if this proved to be the case, and in all likelihood, that is why Lazear neither listed his name in the ledger nor admitted to self-infecting. Or, perhaps, Lazear did not want his family to know the truth. Mabel wrote to James Carroll asking for the details of her husband’s death, pleading that in spite of his passion for medicine, she could not believe her husband would ever deliberately infect himself. After all, he had a wife and two children.

Shortly after the experiments in Cuba ended, Lazear’s logbook disappeared from Walter Reed’s office and was not seen for fifty years. The second, smaller notebook that Truby found in the pocket of Lazear’s uniform was never seen again. The real cause of Jesse Lazear’s death was a secret carried to the grave by every member of the Yellow Fever Board.