People Australia

* Walter B’s real name has been redacted. As a condition of access to patients’ records, the New South Wales Department of Health has required that I do not give the real names of any patient who died less than 110 years before the date of publication. 

Walter B (a pseudonym) survived the ‘Spanish Influenza’ pandemic in Australia in 1919, but he spent two weeks in Callan Park Hospital for the Insane, suffering from the after-effects of his illness. He was of Jewish birth, born in 1886 in Rosseln, a town in the Kovno Governorate, then part of the Russian Empire. It is now part of Lithuania. He migrated to Australia sometime in 1914, probably to escape the persecutions, famines, repressive legislation and violent pogroms of the Czarist period. The Pale of Settlement, the area where Jews in the Empire were permitted to live, and which included Kovno, has been described as the ‘largest ghetto in the world’. As a result of the perceived lack of personal and economic security, more than two million Jews emigrated from Russia between 1880 and 1920, mostly to the United States and Britain. Walter soon settled down in Paddington, a suburb of Sydney, marrying a Sydney woman in 1917 and fathering two children. He worked as a ‘ritual slaughterman’, probably employed by a Kosher butcher.

According to his admission notes, Walter, then aged 33, was ‘sociable and conscientious’ and taught his children Hebrew. He had been in good health until about four weeks before admission but had developed a temperature and was sent to bed. He was treated for pneumonic influenza by Dr Rice. He did not improve after a week’s bed rest and was sent to the nearby St Vincent’s Hospital in Darlinghurst. St Vincent’s had been established by five Catholic nuns in 1838, catering for the poor on a non-sectarian basis. Walter apparently recovered physically from the influenza but became delirious and was transferred to the Reception House for the Insane in Darlinghurst. At this House, the mental status of patients thought to exhibit symptoms of insanity was assessed. If the symptoms were temporary, the person could be discharged without the stigma of being certified insane. But when Walter’s wife visited him at the House, she saw that he would not take his food, was ‘hypochrondiacal and depressed’. He believed that he would not get better and complained of pain in the head.

On admission to Callan Park, Walter was diagnosed with ‘psychosis of exhaustion — post influenzal’. He exhibited some loss of memory and was ‘pale, thin and anaemic’. In the period before the pandemic, other patients had experienced psychiatric symptoms after contracting influenza. Fanny Chandler, aged 64, had been diagnosed with ‘senile insanity’ in 1892. The ‘supposed cause’ of her condition was influenza. She was very weak and feeble and had to be kept in bed. Fanny died from ‘chronic brain disease’ about five weeks after admission. The supposed cause of 34-year-old Georgina W’s complaint of ‘melancholia delusional’ in 1906 was ‘repeated influenza’. Apart from longstanding poor oral health, Georgina had recovered physically — her heart and lungs were ‘healthy’. But she was to stay another three years in Callan Park before she was judged fit for discharge.

Associations between influenza and subsequent psychotic disorders have been reported since the eighteenth century and have been observed in successive pandemics since the ‘Russian influenza’ of 1889-1893. The pathology of the effects of the virus on the central nervous system is still not well understood. Common complications are manic psychosis and encephalitis. Moreover, some researchers have argued that symptoms of ‘nervous exhaustion’, suicidal ideation, depression, anxiety and insomnia that were widely observed during the pandemics arose from fear of infection, or pessimism about recovery once infected. The suicide rate in England and Wales increased by 25 per cent from 1889 to 1893. Indeed, Walter exhibited symptoms of exhaustion, depression and hypochondria at the Reception House and at Callan Park. He believed that he would not recover. Moreover, pre-natal exposure to influenza is associated with an increased risk of bipolar disorder in adulthood. It is likely that many survivors of the 1918-1919 pandemic, and some of their children, developed various mental disorders as an after-effect of the infection.

Walter was initially in a depressed and confused state. He was slow to answer and understand questions, but doctors recognised that some of these difficulties were due to his as yet imperfect grasp of English. Walter did not cough but continued to complain of headaches. After a week in the ‘recent and acute’ ward for men (Ward Four), his physical health improved and he ‘gave no trouble’. Walter had recovered from his depression and confusion and showed a little impatience at his continuing detention. But doctors thought that he did not realise the serious nature of his illness. After a few more days at the Hospital, Walter was discharged.

It appears that Walter fully recovered from his mental illness. In 1921 he applied to the Commonwealth Home and Territories Department to be naturalised, stating that he had been residing in Australia for seven years. In this application he declared that he was of Jewish nationality. He does not seem to have troubled the authorities further. Walter’s wife died in 1951 and he passed away the next year, aged about 66. They are buried together in the Rookwood Cemetery, and are survived by three children and three grandchildren. The New South Wales Inspector-General of Mental Hospitals reported that 180 patients died from influenza in the pandemic year of 1919. The Inspector-General’s report for that year does not list ‘influenza’ as a specific cause of admission, but it is very likely that Walter was not the only patient whose physical illness led to mental illness.