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by Lisa M. Budreau, Ph.D.
When the United States entered the First World War in 1917, the US Army Medical Department officials believed they had learned vital lessons about disease from the Spanish-American War. Feeling better prepared for war than ever before, and with stronger preventive measures in place, such as a proven vaccination program against smallpox and typhoid fever, its preparation still fell short of the demands that lay ahead. Neither it, nor any other medical organization in the world, could do much to cope with the influenza pandemic of 1918-1919. Modern medicine was powerless against this virulent virus that swept across the globe, killing millions.
With soldiers everywhere packed into close quarters, the Army suffered heavily from the flu and its associated respiratory consequences, especially pneumonia. Deaths from the flu and respiratory disease accounted for 80 percent of the 55,868 deaths from all diseases during the war. Men caught the virus on trains taking them to their embarkation points or in the transports crossing to France. Many died without ever leaving their American camps.
At a time when heroic death on the battlefield was considered an honor, families and some elements of the military were reluctant to acknowledge those who fell victim to pneumonia or the flu. Loved ones at home, such as young Essie Bishop of Tate, Tennessee, were quick to defend men like her husband, Robert, who died of pneumonia in December 1918, before arriving overseas. Essie, widowed six months after marriage, wrote, “He was not in the service long enough to accomplish very much . . . [but] I believe he would have made a brave soldier, anyway. He was my soldier and I want my little boy to feel proud of his ‘Daddy’ even though he saw no active service.” 
Officers’ and Nurses’ mess at Camp Hospital #28, Nevers, France, December 28, 1918. (Signal Corps Photograph, 45874)
To help address the medical needs of the military during wartime, the Army’s Medical Department relied heavily on the Army Nurse Corps, created in 1901. Despite the continued growth of the organization, no regular Army hospital units were ready for departure at the outbreak of war in 1917. However, a number of 500-bed Red Cross Army Base Hospital units were trained and ready for service. Six of these units were ordered to France in May to support the appeal for medical assistance from the British who had been at war since 1914. Vanderbilt University’s hospital followed months later by sending a dozen of its medical doctors, aided by enlisted men and nurses recruited from the Nashville area, to operate Vanderbilt Hospital Unit “S,” based in Nevers in central France.
On November 9, 1917, a send-off gathering took place at a full Ryman Auditorium, followed by a 10-day crossing of the Atlantic in a convoy. Vanderbilt Hospital Unit S departed from Nashville on Nov. 16, 1917, and established their base hospital overseas, where they remained until their return on March 8, 1919.
Dr. Albert W. Harris left his home on the Glen Leven estate in Nashville to volunteer with the medical doctors sent by Vanderbilt Hospital to operate Unit "S", based in Nevers in the Bourgogne region of central France. He and his military tunic are pictured here (Tennessee State Museum collection, 2007.146.52 and 2007.146.45.1)
World War I nurses in the Vanderbilt unit. Vanderbilt sent a dozen medical doctors, aided by enlisted men and nurses recruited from around Nashville, to operate Vanderbilt Hospital Unit “S,” based in central France. (Tennessee State Museum collection, 9.329A)
The American Red Cross (ARC) was a primary avenue of service for women during the opening months of the war and by the armistice in 1918, there would be 21,480 experienced regular and reserve nurses who volunteered to serve a draftee army. The US Surgeon General, William C. Gorgas, and the ARC issued a public plea for 5,000 more graduate and registered nurses by June 1, 1918, with an additional request for 25,000 to 50,000 to join by January 1919.
As the urgent request for nurses in the U.S. went out, an estimated 1,800 trained African American women expected their participation to be welcomed. Eager for duty overseas, they had offered their services as early as December 1917, and were permitted to enroll, but they waited for a call that would not come until the end of the war. The Army Medical Department refused them this opportunity. No black nurses had ever served in the Army Nurse Corps. The cause was said to be a lack of facilities like separate mess and quarters for them. For its part, the Red Cross prided itself in accepting all races, but they could not change the segregated army of the time.
African American nurses during the First World War era. (Fisk Photograph Collection)
The flu epidemic of 1918-1919 drastically changed the situation when it swept the world and medical help was scarce but in desperate need. In the spring of 1918, with the end of the war still uncertain and the flu epidemic at its highest proportions, the Surgeon General now called on a limited number of black nurses, enrolled in the Red Cross, to be available for service at military bases in the United States. The first contingent was never sent overseas and none who served received any benefits or pension from the army because they were sworn into service after the armistice.
Today, the names of 3,400 Tennesseans who died in World War I are engraved on the bronze plaques around the War Memorial courtyard. Many lost their lives to the flu pandemic of 1918. However, one name stands out, that of Elizabeth Wiseman, the only woman memorialized here. She died of the flu in 1918 after volunteering to nurse the sick and wounded overseas.
 Robert Bishop file, Gold Star Questionnaires, RG53, Tennessee State Library and Archives.
 Photo Essay: Vanderbilt Hospital Unit ‘S’ in World War I (https://news.vanderbilt.edu/vanderbiltmagazine/vanderbilt-hospital-unit-s-in-world-war-i/)
Lisa M. Budreau, Ph.D., is the Senior Curator of Military History at Tennessee State Museum and author of the book Answering the Call: The U.S. Army Nurse Corps, 1917-1919 (GPO, Wash. ,DC, 2010).