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August 22 - September 5, 2020
Born in Montreal, he grew up in New York City the son of a Baptist minister who preached at a church in the city. He had a good many talents. At Colgate University he tied for first prize in an oratory contest with classmate Harry Emerson Fosdick, who became among the most prominent preachers of the early twentieth century
John Rockefeller Sr. built Riverside Church for Harry).
Like Welch, he never married, nor was he known to have had an emotional or intimate relationship with anyone of either sex.
Karl Landsteiner,
With the possible exception of his love for music, Avery
The German offensive made great initial gains. From near the front lines Harvey Cushing, Halsted’s protégé, recorded the German advance in his diary: “They have broken clean through. . . .” “The general situation is far from reassuring. . . . 11 P.M. The flow of men from the retreating Front keeps up.” “Haig’s most disquieting Order to the Army . . . ends as follows: ‘With our backs to the wall, and believing in the justice of our cause, each one of us must fight to the end. The safety of our homes and the freedom of mankind depend alike upon the conduct of every one of us at this moment.’”
to
Between June 1 and August 1, 200,825 British soldiers in France, out of two million, were hit hard enough that they could not report for duty even in the midst of desperate combat. Then the disease was gone.
that it had slowed the German offensive. Rumors now unsettled the city that these deaths too came from Spanish influenza. Those in control of the war’s propaganda machine wanted nothing printed that could hurt morale. Two physicians stated flatly to newspapers that the men had not died of influenza.
The ability to smell was affected, sometimes for weeks. Rarer complications included acute—even fatal—renal failure. Reye’s syndrome attacked the liver. An army summary later stated simply, “The symptoms were of exceeding variety as to severity and kind.”
The most pregnant word in science is “interesting.” It suggests something new, puzzling, and potentially significant. Welch had asked Burt Wolbach, the brilliant chief pathologist at the great Boston hospital known as “the Brigham,” to investigate the Devens cases.
The virus inflamed or affected the pericardium—the sac of tissue and fluid that protects the heart—and the heart muscle itself, noted others.
“The only comparable findings are those of pneumonic plague and those seen in acute death from toxic gas.”
The immune system begins its defense far in advance of the lungs, with enzymes in saliva that destroy some pathogens (including HIV, which makes its home in most bodily fluids, but not in saliva, where enzymes kill it). Then it raises physical obstacles, such as nasal hairs that filter out large particles and sharp turns in the throat that force inhaled air to collide with the sides of breathing passageways.
Once an infection gains a foothold, the immune system responds initially with inflammation. The immune system can inflame at the site of an infection, causing the redness, heat, and swelling there, or it can inflame the entire body through fever, or both.
The actual process of inflammation involves the release by certain white blood cells of proteins called
“cytok...
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Cytokines can cause more serious and permanent damage as well. “Tumor necrosis factor,” to give one example, is a cytokine that gets its name from its ability to kill cancer cells—tumors exposed to TNF in the laboratory simply melt away;
In the 1970s physicians began to recognize a pathological process in the lungs that could have many causes but, once the process began, looked the same and received the same treatment. They called it ARDS, which stands for acute respiratory distress syndrome. Almost anything that puts extreme stress on the lung can cause ARDS: near drowning, smoke inhalation, inhaling toxic fumes (or poison gas) . . . or influenzal viral pneumonia. Doctors today looking at pathology reports of lungs in 1918 would immediately designate the condition as ARDS.
ARDS as “a burn inside the lungs.” It is a virtual scorching of lung tissue. When viral pneumonia causes the condition, the immune system toxins designed to destroy invaders are what, in effect, flame in the lung, scorching the tissue.
(In 2003 a new coronavirus that causes SARS, “severe acute respiratory syndrome,” appeared in China and quickly spread around the world. Coronaviruses cause an estimated 15 to 30 percent of all colds and, like the influenza virus, infect epithelial cells. When the coronavirus that causes SARS does kill, it often kills through ARDS, although since the virus replicates much more slowly than influenza, death from ARDS can come several weeks after the first symptoms.)
It is impossible to know what percentage of the dead were killed by a viral pneumonia and how many died from bacterial pneumonias which can also progress to ARDS.
All real scientists exist on the frontier. Even the least ambitious among them deal with the unknown, if only one step beyond the known.
Not all scientific investigators can deal comfortably with uncertainty, and those who can may not be creative enough to understand and design the experiments that will illuminate a subject—to know both where and how to look.
Sternberg did not pursue his discovery of the pneumococcus, and he did not pursue his discovery that white blood cells devoured bacteria. He did not because doing so would have deflected him from his unsuccessful pursuit of yellow fever.
damage to himself and his “organization,” relying on patriotism
The death toll ultimately reached thirty-three thousand for New York City alone, and that understated the number considerably, since statisticians later arbitrarily stopped counting people as victims of the epidemic even though people were still dying of the disease at epidemic rates—still dying months later at rates higher than anywhere else in the country.
For the plan to keep men quarantined in isolated groups had a flaw. They had to eat. They went to mess one group at a time, but they breathed the same air, their hands went from mouths to the same tables and doors that other soldiers had touched only minutes before.
The best advice was this: stay in bed. And then the doctors moved on to the next cot or the next village.
What could help, more than doctors, were nurses. Nursing could ease the strains on a patient, keep a patient hydrated, resting, calm, provide the best nutrition, cool the intense fevers. Nursing could give a victim of the disease the best possible chance to survive. Nursing could save lives.
the training of large numbers either of nursing aides or of what came to be called practical nurses prevented the creation of what might have been a large reserve force. The plan had been to produce thousands of such aides; instead the Army School of Nursing had been established. So far it had produced only 221 student nurses and not a single graduate nurse.
PHILADELPHIA STAGGERED under the influenza attack, isolated and alone. In Philadelphia no sign surfaced of any national Red Cross and Public Health Service effort to help. No doctors recruited by the Public Health Service were sent there. No nurses recruited by the Red Cross were sent there. Those institutions gave no help here.
ceded to the group control over all nurses, hundreds of them, who worked for the city. He seized—in violation of the city charter—the city’s $100,000 emergency fund and another $25,000 from a war emergency fund and used the money to supply emergency hospitals and hire physicians, paying them double what the Public Health Service was offering. He sent those physicians to every police station in South Philadelphia, the hardest-hit section. He wired the army and navy asking that no Philadelphia physicians be drafted until the epidemic abated, and that those who had already been drafted but had
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whether or not she has any experience in nursing to come to
“They weren’t going to risk it, they just refused because they were so panic-stricken, they really were, they feared their relatives would die because so many did die—they just dropped dead.” No one could buy things. Commodities dealers, coal dealers, grocers closed “because the people who dealt in them were either sick or afraid and they had reason to be afraid.”
Even war industries, despite the massive propaganda campaigns telling workers victory depended upon their production, saw massive absences. Anna Lavin said, “We didn’t work. Couldn’t go to work. Nobody came into work.” Even those who weren’t sick “stayed in. They were all afraid.”
New Zealand: “I was detailed to an emergency hospital
women volunteers.” They had sixty beds. “Our death rate was
was much altered; sorrow and sadness sat upon every face; and though some parts were not yet overwhelmed, yet all looked deeply concerned; and as we saw it apparently coming on, so every one looked on himself and
Nebraska, expressed puzzlement that “[t]he county newspapers
• In 2001 a terrorist attack with anthrax killed five people and transfixed America. In 2002 an outbreak of West Nile virus killed 284 people nationally in six months and sparked headlines for weeks, along
Camus wrote, “What’s true of all the evils in the world is true of plague as well. It helps men to rise above themselves.”
In Cumberland, Maryland, a gritty railroad and industrial city in the heart of a coal-mining region—where one actually could throw a stone across the Potomac River into West Virginia—to prevent the spread of the disease, schools and churches had already been closed, all public gathering places had been closed, and stores had been ordered to close early.
owners and customers refused to stand face-to-face and left orders on sidewalks, there was still too much interaction
Australia had escaped. It had escaped because of a stringent quarantine of incoming ships.
43 percent
of the
days and
few days after he had threatened to leave the conference
THE GREATEST QUESTIONS remained the simplest ones: What caused influenza? What was the pathogen? Was Pfeiffer right when he identified a cause and named it Bacillus influenzae? And if he was not right, then what did cause it? What was the killer?
