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Sobering lessons from nearly a century ago

a book review by Eric Jackson

The Great Influenza:

The Epic Story of the Deadliest Plague in History

by John M. Barry

Penguin, New York (2005)

465 pp, $16 in paper

ISBN 0-14-303649-1

This history book, which I picked up at the excellent little bookstore at Smithsonian Tropical Research Institute’s Tupper Center in Ancon, is much more than the tale of the great influenza epidemic that helped to ensure that the First World War ended with a cough, a whimper, an indecisive armistice and a flawed Versailles Conference.

What? You didn’t know that the flu broke Germany’s last attempt at a major offensive on the Western Front? You didn’t know that the flu broke Woodrow Wilson’s resolve in the face of his French counterpart, Georges Clemenceau? This book gets into those details, but is far more ambitious than that.

This is in large part the story of the rise of scientific medicine in the United States, the licensing of physicians and the accreditation of medical schools, and the small group of men (with but a few women) who brought that about.

You’ve heard of what Dr. William Crawford Gorgas did in Panama? Fast forward a few years to when he was the US Army’s top doctor in Washington and a mysterious killer flu was racing through military installations and America’s big cities, and ultimately out to the country, north to the polar regions, south to the tropics and beyond and all the way around the world. This wasn’t just an epidemic, but a pandemic that left a death toll estimated variously between 20 and 100 million people. Dr. Gorgas is a character in this book, albeit not as big of one as Dr. William Henry Welch. The US Army, likewise, is a major player but maybe not as major as Johns Hopkins University.

This is also a tale of political arrogance, abuse of power and the engendering of a climate of pervasive fear and enforced silence, the intentional policies of a president who was re-elected because he kept America out of war and then smashed all dissent to lead the nation into Europe’s maelstrom. It’s the tale of an intimidated and controlled press and a government that nobody believed anymore, and an ‘everybody for themselves’ breakdown of the social order in the face of an epidemic that Woodrow Wilson never admitted to the American people.

It’s also a tale of heroism, of scientists rising above rivalries in a vain attempt to stop the epidemic that nevertheless pushed the envelope of scientific inquiry in several directions, of cops in corrupt machine run cities who risked their lives to clear away the dead, of doctors and nurses who perished in the line of duty.

The book ends with an afterword that’s disquieting, that concludes that it could easily happen again, maybe on an even grander scale. Why’s that? Because while medicine has progressed in certain ways, public health has been backsliding in others. (For one example, we have larger populations of people with compromised immune systems than they had back then.) Because in the SARS and bird flu outbreaks of the 21st century, the governments of such countries as China, Vietnam, Thailand and Indonesia acted much as the Wilson administration did, withholding information and telling lies, behaviors that would be massively fatal had those outbreaks turned out to be a pandemic killer flu like the one that apparently swept out of rural Kansas early in 1918 and killed so many millions of people.

And quite frankly, although there is now a new gag law to prevent the publication of the documentary record, this book has its parallel in the Torrijos administration and the information control games that it played and continues to play in the poisoned medicines scandal. We’ll never get an admission from the Palacio de las Garzas that the government suppressed information in order to avoid an embarrassment in an upcoming referendum and that people died as a result of that behavior, but that’s what happened. The people who run our government at the outset called the campaign for the Torrijos - Alemán Zubieta Plan to expand the Panama Canal “war,” and if the body count from their information control was nothing compared to the one from Woodrow Wilson’s, chalk that up to the smaller stage and the luck of the draw when calamities were being passed out by the power that is.

Read this book because it’s a good read, read it because it’s a required lesson in civics, read it to understand what science is and how it got to be that way. Read it to rally your own sense of dignity, your own courage and your own patriotism when the scoundrels in charge and their acolytes think that they have these things under their complete control.