Essay: The summer plague

Cork, Ireland, 1956. For six-year-old Patrick Cockburn it should have been a time of carefree innocence. Instead, a polio epidemic was about to change his life forever

M

y parents, Claud and Patricia Cockburn, were curiously unworried when they heard of an abnormal number of polio cases in Cork in the summer of 1956. At the time we had moved from Ireland to Hampstead for a few months so my father could work at Punch magazine, which alcolm uggeridge had briefly revivified. y mother, though, never liked London and was eager to get back to the Georgian house and farm where we normally lived, in the countryside about 30 miles east of Cork city.

I was six and my brother Andrew nine. y parents knew that we were vulnerable because polio, also called "infantile paralysis", primarily affected children. News about the outbreak was sparse, but the risk seemed small. Brook Lodge, to which my parents had moved after World War II, was a mile and a half from Youghal, a small seaside town where nobody had recently got polio. The house had been built partly with defence in mind during the Irish land wars with long stone walls on one side and two fast-flowing streams on the other. Perhaps its isolation - we had no car or telephone - gave my father and mother a deceptive sense of safety. They thought that if Andrew and I did not take the trap or gig into Youghal, and kept away from the beaches, we would be all right.

On the boat from Wales to Cork my father had several conversations with other passengers, who expressed, he later recalled,"the sort of apprehensions you encountered among people travelling to London from the country during the bombing". They knew more about the extent of the epidemic in the city than we did. We reached Cork docks late in the morning and mountains of luggage were packed into a van. We hired a car to go to Youghal, but first we wanted to do some shopping in St Patrick's Street in the centre of Cork. This was normally packed with cars and people - Cork pedestrians were famously aggressive - making it impossible to park. On this day it was agreeably empty. The same was true of the shops. y father remarked that we seemed to have hit on a lucky day. The driver of the car turned around in astonishment. "People are afraid," he said. "They're afraid to come into Cork. Business is going to hell. If the epidemic goes on, in a few weeks half the shops in this street will be bankrupt." We hurriedly bought a few essentials and headed for home.

In Brook Lodge we felt safe enough. There was a walled garden and four fields, about 35 acres in all. I rode around on an elderly white donkey called Jacky. I spent days happily, but ineffectively, trying to dam one of the streams with pebbles and mud. But my father was wrong to think that the house was isolated. The main contact with the outside world was himself. We lived well, but were permanently short of money. In the month after we returned to Ireland, he had to return to London several times to see alcolm uggeridge and Punch, hoping, he wrote later "to shore, and even perhaps establish on sound foundations, our always tottering financial structure". He noticed on the train from Cork to Dublin, then the site of the nearest airport, that Dubliners would move down the other end of the buffet car to avoid anybody with a Cork accent.

At about this time my father suddenly got a severe headache and a pricking feeling in his fingers. He did not realise its significance. For every person who gets polio in its crippling form, hundreds get the virus without serious effect. This immunises them, but while they have the disease they can carry it to others. A few days after my father's last visit I had a headache and a sore throat. The local doctor was called. Within 24 hours he diagnosed polio. I remember little of what happened, except crying as I was put into a cream-coloured ambulance. y mother, searching desperately for something to say that would cheer me up, said: "The driver will sound his horn and all other cars will have to get out of the way." I was not comforted. I sensed the anxiety of the people standing in the driveway by the back door of the ambulance and sobbed louder.

I was extremely frightened. I had never spent any time away from my parents. The ambulance took me to St Finbarr's, the fever hospital, a converted grey stone 19th-century workhouse on the south side of the city. The first death in the epidemic, a girl of five, had died there six weeks earlier. The hospital was old, but the staff friendly and kind. I lay in a bed in a crowded ward for three weeks. Nobody, apart from doctors and nurses, was allowed into the room. Every few days a nurse would point to the door of the ward and I could see my parents waving from the other side of a glass porthole.

A few days later my brother Andrew joined me. He was at a school in Dublin when I was taken to hospital. y father had immediately telephoned the school to tell the headmaster to send him home. He waited for him at Cork station. He recalled: "I really thought that all might still be well up to the very last moment when the diesel train pulled into the station and Andrew got out. I then saw that his body was bowed slightly forward in an awkward way and he was moving his legs sluggishly." By the next morning he was also in St Finbarr's. I greeted his arrival with relief. He was in a different ward than myself, but a nurse gave him piggy-back rides - we were not allowed to walk - up and down the stairs so he could sit on my bed and talk to me.

I have no memory of realising that I could no longer walk, still less that this might be permanent. The poliomyelitis virus, to give the disease its full name, attacks the nerves of the brain and spinal cord leading to paralysis of the muscles. Some shrivel and die. In other cases the nerves are only stunned and can be brought back to life by courses of physical exercise over a two-year period. After three weeks at St Finbarr's I was sent to an orthopaedic hospital at Gurranebraher, on a hill overlooking Cork. It was a horrible place. Its single-storey isolation blocks had been built for TB patients and rapidly converted for use in the polio epidemic. I was lonely because Andrew had recovered and gone home, only his big toe affected by the disease. The nurses maintained a gruff, barrack- room discipline. One night I woke up and heard a nurse telling a small boy who had messed his bed that if he did it again he would have to eat his own excreta. Afterwards I had difficulty sleeping because I was frightened the same thing would happen to me. For food we got a thin, watery mince with hard, boiled potatoes. Claud and Patricia brought me toys, but there was an air of violence in the ward and the toys were usually broken within a few days.

I was there for six months. y physical condition got slightly better. I could move about the ward on crutches with my legs in steel callipers and my back supported by a hard plastic waistcoat like a corset. I was miserably unhappy. Other boys teased me because I was Anglo-Irish and spoke with an English accent. Claud and Patricia came to see me twice a week, but I gradually fell silent and would not speak to anybody. The doctors told my mother they thought the muscles controlling my vocal cords were damaged. y father wrote: "All the time he, who had been so gay, so alert, inquisitive and talkative was sinking into a kind of voiceless apathy." The senior medical staff were a very distant presence in Gurranebraher; the nurses' chief fear being that the head nurse, who made sporadic night- time inspections of the ward, would catch them all playing cards. y parents decided, against the advice of the doctors, to take me home.

Once back in Brook Lodge I began to recover my spirits. ost of the time I could only crawl, but my arms were unaffected so I painted all the skirting boards in my nursery. I went to Whitechapel Hospital in London for a series of operations on my feet the purpose of which was to transfer the muscles, which had survived, to do the work of those that had died. By good fortune this type of operation had been pioneered by the brother of Kitty uggeridge, the wife of alcolm. y legs were covered in plaster casts and itched mercilessly. alcolm gave me a long, slim oroccan dagger to scratch inside the plaster. Over two years I learned to walk again without callipers or the plastic waistcoat and gave up crutches when I was 10. By then polio was being rapidly eradicated. In the US, Dr Jonas Salk had carried out successful trials of a new vaccine in 1954. It was already being used experimentally in small quantities in Britain at the time I contracted the disease. By the early Sixties, polio - under the impact of mass vaccination - had largely disappeared.

Going back to Cork this summer - 43 years after the epidemic - I realised I did not know much about what had happened in the city in 1956. I had the vivid but disjointed memories of a six year old: the ambulance coming to take me away; Claud and Patricia peering through a window in the fever hospital; my misery in Gurranebraher. Over the years I noticed that very little appeared about the epidemic in Irish history books, even though it paralysed the second- largest city in the country for a year. y father wrote a moving chapter about his two sons getting the disease in the third volume of his autobiography View From The West (1961). There is a succinct account of the epidemic in an excellent A thesis by Fiona Wallace on voluntary provision for the disabled. Kathleen O'Callaghan, a senior health officer at St Finbarr's, told me that the reason for the lack of published information was simple enough. She said: "People were that frightened at the time that they tried to forget it. I would see people cross the road rather than walk past the walls of the fever hospital."

Polio was peculiar in that it produced visceral fear only equalled by Aids today. Tony Gould, in his superb history of the disease, A Summer Plague: Polio and Its Survivors, writes: "For the great part of the century it was polio that spread panic and paralysis in unequal proportions through the populations of the Western world." It created fear because it struck at children and it maimed rather than killed. Its symbol was less the coffin than the wheelchair, like that of Franklin Delano Roosevelt who caught polio in 1921, the "iron lung" to enable victims to breath, and callipers and crutches to help them walk. In the US it became known as "The Crippler". In an epidemic in New York in 1916 there were even greater signs of panic than in Cork 40 years later. Towns outside the city tried to protect themselves by sending deputy sheriffs to patrol the roads with shotguns. They turned back all cars with children under the age of 16. Strange stories spread, such as one that blondes were more vulnerable to the virus than brunettes. Cats were suspected of spreading the disease and 72,000 of them were hunted down and killed.

The fear was all the greater because polio did not behave like other diseases. Unlike typhus or cholera, it mainly hit the middle classes rather than the poor. In Cork most of the victims were in the relatively prosperous southern suburbs and not the terrible slums in the north of the city. At the height of the epidemic Dr Gerard cCarthy, the medical officer for Cork county, pointed this out, saying: "The higher the standard of living, the greater the tendency towards the disease. Generally the well- washed and well-laundered children are the more susceptible." aureen O'Sullivan, a Red Cross nurse, noticed that "80 per cent of the victims came from affluent or semi-affluent families."

There was a good reason for this. Polio has a strange history. It is an old disease. An ancient Egyptian stele portraying a young man with a withered leg leaning on a stick shows that it may have existed some 3,500 years ago. It struck at individuals. Sir Walter Scott got it when he was 18 months old and was crippled in one leg (his grandfather tried to cure Scott's lameness by wrapping him in the bloody skin of a recently killed sheep). But at the end of the 19th century polio took on a new and more menacing form. For the first time there were polio epidemics and they happened in the richer countries like the US, Denmark, Sweden, Australia and New Zealand. This was because public health was improving with better water supply and sewage systems. Previously people lived in symbiosis with the polio virus. The majority of small children were self-immunised because they got the disease, often without symptoms, when they were still protected by their mother's antibodies. Only in the last decades of the last century were there enough potential victims without immunity for polio to turn into an epidemic. These victims, as Dr cCarthy noted, were likely to be the children in better-off families living in the most hygienic conditions.

The doctors in charge of combating the epidemic in Cork in 1956 - Dr cCarthy in the county and Dr Jack Saunders in the city - pointed out in muted terms that they could not really stop the spread of the disease. Too many people - like my father - had it in a non-paralysing form and were unwitting carriers. Dr Saunders hinted that his main hope was that the epidemic would burn itself out because "for every case detected there are one or two hundred undetected or undiagnosed cases in the community, principally among children." In other words the polio would stop when it ran out of victims who had not already got it.

This was hardly reassuring for people in Cork. It was difficult to take on board the fact that the greatest danger was lack of immunity rather than meeting somebody who carried the disease. Ironically my parents never realised that the very isolation of Brook Lodge, which they counted on to protect their children, put us in greater danger. There were three farm houses within half a mile of the house and we travelled mainly by horse-drawn transport. We had not mixed enough with other children to acquire immunity. If we met a carrier, and with my father travelling backwards and forwards to London this was almost inevitable, we were likely to get the disease.

Looking through old copies of the daily Cork Examiner in the county library, it is easy to see the quandary facing Dr cCarthy and Dr Saunders. They needed to do the limited amount they could for the victims of polio - and whatever the failings of Gurranebraher, treatment at St Finbarr's was as good as anywhere in the world. At the same time they tried to stem a panic by carrying out vigorous and visible measures to stop the spread of infection which they doubted would have much effect. They had some warning that a polio epidemic was on the way. A keen sportsman from Dungarvan, a town by the sea in the neighbouring county of Waterford, got polio in February, 1956. He was brought to St Finbarr's, the main fever hospital for the south west of Ireland, and placed in an "iron lung" to help him breath (he remained on a life-support machine for 20 years). The next victim came from Tralee in Kerry. It was only on 13 June that the first case of polio was reported in Cork city and by early July the number had risen to six. For the first time reports of an epidemic begin to appear in the local press. They were usually accompanied by subheadlines claiming that there was "No occasion for for undue alarm" and "Outbreak a mild one". These repeated understatements somehow conveyed the very sense of fear which the newspapers were trying so hard to avoid. By the middle of July the number of children entering the fever hospital in Cork had risen to four a day. Kathleen O'Callaghan says, "The worst thing was talking to the parents. Children accept these things better than adults. The parents kept asking me if their children would die or be left crippled. They couldn't understand why we couldn't tell them. They were worried that their children would get brain damage."

Cork is, and was, a gregarious city even by Irish standards. It was not surprising that my parents were astonished to find St Patrick's Street empty when we returned from London. With a population of only 75,000 it was an intimate, close-knit community. In working-class neighbourhoods, keys were commonly left in the door. Children moved easily from house to house. From the second week in July this began to change. Parents were advised to keep their children at home. Open-air public baths were closed. A visit by Buff Bill's Circus was cancelled. Dr Saunders said, "I put the facts before them and they co-operated to the full extent, in spite of the obvious financial loss involved." People swimming in the river Lee, which flowed through Cork and received the full drainage of the city, were threatened with prosecution. War was declared on house flies. Pasteurised milk was viewed with suspicion and tested.

The over-reassuring official statements seem to have had exactly the opposite effect to that intended. By the end of the epidemic in early 1957, rs O'Callaghan recalls that 546 polio patients passed through the fever hospital (although some may have been misdiagnosed). But people in Cork believed there were many more. Pauline Kent, a physiotherapist who treated me at a clinic in City Hall, remembers "rumours that dead bodies were being carried out the back door of St Finbarr's". ost people in Cork were believers in the old nostrum, "Never believe anything until it is officially denied." A month into the epidemic in Cork, many were convinced that not only were the dire facts of the epidemic being suppressed in the city, but that it had spread to Dublin where people were dying like flies in the fever hospitals. They believed, so my father sardonically recorded, that "due to the savage wiles and intrigues of the Dubliners, the newspapers had been, as the Irish saying goes, `brought to see' that it would not be in their interests to report the state of affairs in Dublin. Instead they should concentrate on ruining poor Cork."

By the time I got polio in September, hotels and businesses in the city were all suffering heavy losses. The Irish Tourist Association, representing hoteliers, made a sporting but unsuccessful effort to keep the figures for new polio cases out of the newspapers, demanding that such information be treated as confidential by medical staff. The Cork Examiner and the Evening Echo, the two local papers, at first gave bald, accurate, if self- consciously upbeat, information about the spread of the disease. y father said: "The owners of some of the biggest stores in the city made a demarche. In deputation to the newspapers they threatened to withdraw advertising from such periodicals as might continue to report regularly and in detail on the polio epidemic there." A British Sunday paper described Cork as "a city in panic". The city corporation was enraged. Alderman Casey, the Lord ayor of Cork, said the report was beneath contempt, adding, "Press publicity, which is ill-advised and ill-informed, has done immeasurable damage to the traders of the city." An irate councillor played the patriotic card, saying British papers "were not slow to publish anything which tended to discredit the Irish people". From mid-September, whatever the reason, the local papers largely stopped reporting the epidemic.

By now towns and cities in the rest of Ireland were treating people from Cork as pariahs. Danny urphy, then a 20-year-old lorry driver, says he had difficulty finding a bed for the night in Dublin: "When they saw you were from Cork, they didn't want you. They were all terrified." A company in county Wicklow asked the Department of Health in Dublin if it should accept a shipment of pottery from Cork which was wrapped in straw. There was embittered controversy over the postponement of sports meetings, notably Gaelic football matches in Dublin in which the Cork team was playing. Dubliners were fearful that crowds of Cork supporters would spread the infection. They wanted the games cancelled. Fiona Wallace, in her account of the epidemic, found a letter from one frightened Dubliner to the Department of Health, saying, "Let Cork's own town keep their polio and not infect our clean city. Wake up and do something before the polio of the Corkonians is laid upon us."

The polio virus traditionally flourished during the summer months and disappeared finally with the first frosts. The local medical establishment believed, rightly, that the epidemic would ebb as the pool of potential victims, who had no immunity to the disease, dried up. They had little faith in postponing football matches or closing schools, arguing that there were too many carriers for it to be effective. Dr cCarthy said: "If I had my way, apart from isolating in hospital every case detected, I would take no other elaborate precautions." People in Cork - and this was also true of other epidemics in New York and Copenhagen - could not quite take on board the fact that thousands of them were getting polio, but in 85 per cent of cases they showed no symptoms. Of those that did have the symptoms - a headache, sore throat, mild fever and vomiting - the majority suffered no long-term ill-effects. This sounds reassuring, but understates the strain on relatives. They had to wait for days to find out if their child was paralysed and months to know about the extent of the disability. At this time my father and mother used to sit in a friendly pub with a telephone in Youghal, ringing up St Finbarr's three or four times a day to ask about Andrew and myself. Sometimes a nurse would say, "They seem to be doing well." A few hours later another person answering the phone in the hospital would say, "They seem to be doing as well as can be expected." y parents knew that the different phraseology meant no real change, but they could not stop themselves compulsively mulling over the nurses' words, wondering if our condition really had deteriorated between the first and second phone call.

The last cases of polio admitted to the fever hospital as a result of the epidemic came in early the following year. Official statistics show that overall 499 people got the disease in Ireland in 1956, of whom 220 were from the Cork area. The number admitted to hospital suspected of having polio was slightly larger. The figures seem low, but they conceal the fact that by the end of the year most people in Cork had got the disease, although very often without realising it. By 1957 the first trials of the Salk vaccine were taking place in Ireland and within a few years polio was eradicated.

The fear outlasted the epidemic for quite a few years. aureen O'Sullivan, the Red Cross nurse who had arranged physical training for victims in the late Fifties, remembers that "at the sight of my ambulance in their street people would think that the polio was back. They would run into their houses and a few would get down on their knees to pray. They had lost all hope - they were that frightened."