[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!"
