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Of “St. James Infirmary” and COVID-19

Listening to a jazz classic on the viral frontlines

Cab Calloway in 1933
Cab Calloway in 1933 (photo: Carl Van Vechten Collection/Library of Congress)

Times are seldom what one wishes them to be when the word “frontline” is commonly used. It suggests that a pernicious edge has encroached upon society, slicing away the status quo and its knack for scumbling certain harsh realities. In the age of COVID-19, that edge is most prevalent in hospitals. We all see the stories: the mid-career doctors who commit suicide allegedly on account of the death and dying they’ve seen. We don’t often know, of course, the real reasons why people take their own lives, and they’re never so basic as the news makes it out. But we also know that some of us are experiencing things that most of us are not, bearing witness to a kind of terror that we are left only to imagine.

The various dispatches from those frontlines have lately put me in mind of jazz’s most evocative medical dispatch, one of the most terrifying songs in the medium, but one which, remarkably, was a hit several times over for an assortment of artists.

We’re not exactly sure of the origins of “St. James Infirmary,” in which a broken man—or a man about to be broken by grief—goes to a hospital to see his “baby,” by which he means his significant other. She may or may not be dead, given that she’s “stretched out,” a term you really only want to encounter if you’re an athlete and all limbered up for the big game. She’s likely in a coma, and the time has come for a final farewell, something that often occurs these days over FaceTime. We’ll call this the early jazz version.

The song is likely based on an 18th-century British rural folk blues called “The Unfortunate Rake,” about a gamboling youth who tucks into the ladies with regularity, in the style of Fielding’s Tom Jones, acquiring a not-very-merry collection of venereal diseases, which effectively do him in.


The title is a misdirection. Rakes were considered hail fellows well met for whom, for whatever reason, things usually worked out more or less well. You could say they had a tendency to skate. You’d be living your life with strict mental and physical discipline and then have tragedies befall you; meanwhile, that rake down the street would still be having a grand old time on what the Pogues’ Shane MacGowan later sang of as the sunny side of the street. So this was sobering, and it was comeuppance—the universe had clapped back at a rake having gone too far.

The ballad made it to Appalachia during the time of the first World War, with the name of a local hospital being dropped into the lyrics. In all of its versions, it has always had a form of stop-you-dead opening line, which hasn’t varied much. In the hills of Georgia, that opening line was, “As I went down by St. James hospital one morning.” The “as” is deadly. Those who have known death understand that it’s not a “when,” not a fixed point; it becomes so, to a degree, only after, when it lodges in the past as something that happened to someone close to us which also became something that happened to us. There is, let us say, a lot of “during” to death. It takes time. Those seconds are not regular temporal seconds; they are emotional seconds, whose length can be for years. You remember everything about the day a loved one died, unless you have repressed those memories, because the seconds were stretched.

The very first word of the song establishes that activeness. We enter the fear with the singer who is also going to be our witness and reporter. In this instance, the body on the cooling board is that of the singer’s son. The passing over has already occurred by the time of arrival. The body is “as cold as the clay.” Such an arresting choice of word—the associative link is with wetness, congealment, a foreshadowing of human form being interred in earth, the various elements. We bury someone, we inevitably think of the rain that will come down, exposure. We cry, or feel as if we are about to.


Like a pandemic, the ballad will travel. Having come west from England to the American South, it will now range to the Yankee North, where some form of it is encountered by the songwriter Irving Mills. A Ukraine-born Jew living in Manhattan, he worked in music publishing, with a gift for knowing when a song might do the 1920s version of going viral. Here was an occasion where the subject matter corresponded to that idea of sprawl and spread. From what I can gather, there was a reel quality to the Appalachian version, which makes sense, given how predominant that strain of music was in the folk tunes of the time, as you know if you’ve ever dipped into Harry Smith’s Anthology of American Folk Music, the definitive musical survey of that time and place. Mills urbanizes the song while knocking out the venereal-disease element, imbuing it with the feeling of the Everyperson, the lascivious and chaste alike. Death’s bony finger was not particular.

In 1928, Louis Armstrong recorded a version of Mills’ adaptation. It’s a blues, with a clever—and gutting—musical pun: rather than using the standard 12-bar format, the sections are truncated into eight-bar portions. Length is cut, like the life is cut in the song’s story.

Armstrong being Armstrong, he infuses the song with something of the New Orleans funeral march, as if channeling Sam Morgan and his rolling, roiling, fugato piano airs. At the same time, this feels as modern as music has ever been, such that it’s easy to think of Albert Ayler, that paragon of jazz’s New Thing, hearing this in the 1960s and honing his latest grand idea of the avant-garde. Arthur “Zutty” Singleton’s bass drum pulses like a heartbeat for the first two bars of the song, then is silenced, either on its own or underneath the volume of Armstrong’s trumpet and his ensemble mates taking up the descending minor-key riff. In other words, life goes on.


Piano genius Earl Hines delivers an early solo as bridge, as if he’s an attendant, a nurse, a grief counselor, escorting us where we need to go. Arrival comes in the form of Armstrong’s vocal. He descries a white table upon which the body is laid. It’s a telling detail—in death, we have a tendency to think of the person who has left us in roseate ways even in non-roseate areas. They become, in a sense, virginal, an idea riffed upon here with that white slab. The detritus cleared.

Armstrong uses little vibrato or ornamentation. He’s proceeding in straight-line fashion, dishing out what was once called the “straight dope,” the antithesis of our fake news. The singer is bearing up for the telling of his tale, but one has the feeling that the second it is over, he will crash upon the floor. Our man Zutty plays some of the most complicated hi-hat patterns that you’ll hear anywhere in early jazz. They swirl like clusters of thoughts that one just cannot escape, not immediately evident but behind the ensemble, a sort of percussive subconscious. None of this is leaving the brain anytime soon.

Version upon version of the song will be cut going forward. Many have a go—Bobby “Blue” Bland, Eric Burdon, Duke Ellington, Dock Boggs, back-in-the-day garage rockers the Standells, more-recent garage rockers the White Stripes—but no version may be worthier of revisitation than Cab Calloway’s waxing from 1930.


Calloway is the last artist you’d associate with this song. He was seen as jazz’s wild man, on the cusp of being a novelty act, which is unfair. Calloway was no more a novelty artist than, say, Little Richard, who might be his rock & roll analogue. He scatted, he sang nonsense verse and made doggerel sound like vital Modernist poetry that you just didn’t understand fully yet, but would later, when you were ready. With Calloway, there was always an element of arriving at his music rather than just hearing it. A sensation of event was woven throughout, a hoodoo tessellation of both earth and spirit, the earthly and the ethereal.

Slashing chords start the song, a filleting of the very air in front of us. We’re used to an intro, a working up to the first verse, but as we’re realizing right now in these scary COVID times, life—and death—can come at you fast and hard, when it breaks out of the status quo.

Calloway’s orchestra swings the hell out of the riff, much more so than Ellington’s unit. The groove is deep, and when Calloway’s vocal begins, you’re not ready for the high notes and the falsetto he deploys. He’s singing via ululation, a crossing of lucidity—the enunciation is impeccable—and the phantasmagoric. We might not be amiss in thinking he’s singing as if he were the song’s original rake, come back to tell us a thing or two about the other side. 


This is going to be a hit—so much so that in 1933, Calloway performs a version of the song for a Betty Boop cartoon, in which a character named Koko the Clown (presumably no relation to the Koko of Duke Ellington or Charlie Parker) busts a move to Calloway’s death groove. I don’t know what to make of that. I’d like to say it feels incongruous, but it doesn’t. There’s a certain sense in the emotional mashup, a life sense, in that extreme polarities always exist in overlapping moments, with no one moment—even our darkest—happening in isolation.

The infirmary of the song has always struck me as having a haunted-house aspect, but that’s the fear of the unknown, perhaps more than anything. I take comfort that such as it was in 18th-century England, in Appalachia, in Jazz Age Manhattan, in early animation, we can delineate, here in 2020, some hope on account of the song’s vigor even in its blues.

There’s an immediacy to the song I find palliative. It suggests, “Say what you have to say in the times when you should say it,” which isn’t a death thing, but a life thing. On the frontline, both exist in concert, but that’s really how it is on some level for each of us every day, in COVID days and non-COVID days. Consider “St. James Infirmary” an extreme reminder, which can be useful when things return to normal, and the status quo absorbs the frontline.


Colin Fleming

Colin Fleming writes fiction and nonfiction on myriad topics—art, film, music, sports, literature, current events—for a wide range of publications, and talks regularly on radio and podcasts. His most recent books are an entry in the 33 1/3 series on Sam Cooke’s Live at the Harlem Square Club, 1963, a volume about the 1951 film Scrooge as the ultimate work of cinematic terror, and the story collection, If You [ ]: Fabula, Fantasy, F**kery, Hope. Find him on the web at (where he maintains the unique online journal, the Many Moments More blog) and on Twitter @colinfleminglit. He lives in Boston and has contributed to JazzTimes since 2006.