Books discussed in this issue

The Great Influenza
by John M. Barry
Penguin Books, 546 pp., $16.00 (paper)

Polio: An American Story
by David M. Oshinsky
Oxford University Press, 342 pp., $16.95 (paper)

Plague and Fire
by James C. Mohr
Oxford University Press, 235 pp., $19.95 (paper)

The Ghost Map
by Steven Johnson
Riverhead Books, 299 pp., $26.95 (hardcover)

The Demon Under the Microscope
by Thomas Hager
Harmony Books, 340 pp., $24.95 (hardcover)

So, how are you feeling? Do you have a rash, chills, body aches, or a painful bump? Well, even if you feel fine now, you could be dead by morning. That is what plagues and pandemics do. They strike randomly and kill swiftly. Like all natural disasters, epidemics reveal our total vulnerability. They make us afraid. As a result, books about diseases often read like medical thrillers, with determined heroes-in-white pitted against the deadly viral villains. But the best works in this large corpus of nonfiction thrillers have something more to relate about human vices, prejudice, or hubris.

There have always been popular books about human epidemics, one of the first being Daniel Defoe’s Journal of the Plague-Year (1722), a fictionalized history of London’s last great bout with the bubonic plague in 1665. Nearly 400 years later, Defoe’s tale is still a classic, with more than a dozen editions in print. The modern model for the diseased branch of narrative nonfiction is Randy Shilts’ chronicle And the Band Played On: Politics, People, and the AIDS Epidemic (1987). His book tracks the discovery and spread of HIV, with emphasis on government indifference to an illness then perceived as a “gay disease.” Subsequent bestsellers have included The Hot Zone by Richard Preston (1994), which preyed upon public fears of Ebola and Marburg viruses, “headline” diseases with a mortality rate hovering near 100 percent.

The current rash of disease-based thrillers includes John M. Barry’s book, The Great Influenza (2004), a mesmerizing account of the flu pandemic in 1918-19, set against the backdrop of World War I. The villain in this book is a virus that was born somewhere in the American Midwest, subsequently spreading across the globe. It was, as Barry keeps repeating, “still influenza, only influenza.” Of course, this particular strain of flu finished off more people in 24 weeks than AIDS killed in 24 years. It slaughtered more people in a year than the Black Death carried off in a century. It was one bad bug.

Barry begins the book with several chapters about medical “warriors” in white lab coats, with a proven record of success against contagious disease. Then Barry introduces us to the virus, a vicious and invisible mass murderer that preys on healthy young adults. The book relies on detailed medical documentation but never lapses into coma-inducing jargon. There are clear explanations of the lab research, virus mutation, and vaccine production.

As the good guys struggle against the bad bug, they also contend with sabotage by politicians and city officials concerned about public panic; the people appointed to protect society give aid to the killer. The battle rages at a fevered pitch, and the doctors do not win. The pandemic ends only when the virus runs out of victims to infect.

Thirty years after the influenza epidemic, polio was the new bug to beat. David M. Oshinsky’s book, Polio: An American Story (2005), shows what can happen when an entire nation mobilizes to fight a disease. Winner of the 2006 Pulitzer for history writing, Oshinsky’s book takes us behind the scenes of the public anti-polio campaigns to reveal the forces that manipulated America’s response. We see powerful men, including polio-victim Franklin Roosevelt, using the power of the press to generate tremendous financial support to combat a childhood illness that afflicted comparatively few people. We see how the media became an instrument of the March of Dimes – an entity that controlled more medical research funding than the U.S. government.

Oshinsky also examines the lives of two flawed heroes in the battle against polio: Jonas Salk and Albert Sabin. These giants of medicine fought each other for funding and for recognition as the inventor of an effective polio vaccine.

A masterful book, Polio leaves one with the sick feeling that millions of people donated time and money to fight an illness largely because of politics and media hype. Beware the power of the press and the presidency.

Politics also play a major role in Plague and Fire (2005), an Oregon Book Award winner, by James C. Mohr, a University of Oregon history professor. In this story, a corrupt government pushes for Hawaiian statehood while trying to control (and cover up) an outbreak of bubonic plague in Honolulu’s Chinatown district. A trio of doctors receives absolute authority to fight the disease, but their only effective weapon is fire. Against a backdrop of existing racial tension, a fire gets out of control and destroys Chinatown. Thousands of Asians are suddenly homeless and confined to quarantine camps.

As a historian, Mohr tends to focus on the tensions and transitions of the time. He examines power and racism at a time when Hawaii’s political and cultural structures were experiencing tremendous change. Mohr also returns several times to the meaning of medical “authority” in an era when practitioners did not even agree on the basic causes of illness. When he explores a point of tension, such as the conflict between “traditional” and “bacteriological” practitioners, he lets the historical material make his point. For example, as the plague grinds into its fourth month, “Critics accused the Board’s physicians of still not knowing how the epidemic was continuing to spread … They were right. But the critics had no answers either.” Mohr allows the confusion and stress of the experience to stand, instead of trying to explain it away. It is unlikely that so much power will ever again be concentrated in the hands of so few. But the story has relevance because it questions the concepts of public power and medical “authority” during times of collective medical crisis.

In The Ghost Map (2006), the protagonists are not typical medical heroes; they are radicals proposing nontraditional treatments for cholera and smallpox. In this and the other books, the lion’s share of attention goes to the twin evils of ignorance and prejudice. Johnson’s Ghost Map is about a cholera epidemic that scourged a London neighborhood in 1854. While Johnson follows the progression of individual families from contagion through death, he provides a parallel narrative about the pioneering doctor who uses on-site interviews and the new science of statistics to track down the viral source: a public pump.

This story takes place 35 years before the advent of bacteriology, and Johnson does an adequate job of explaining prevailing medical theories of the time. However, he fails to successfully link his narrative about a brief cholera outbreak with his promised “argument for seeing that terrible week as one of the defining moments in the invention of modern life.” The last third of this book attempts to construct parallels between the amateur data-gatherers of past and those of the present. Johnson claims that, “The influence of the Broad Street [London] maps extends beyond the realm of disease. The Web is teeming with new forms of amateur cartography … today’s mapmakers record a different kind of data: good public schools, Chinese takeout places…” The book has both a Conclusion and an Epilogue – but no discernable ending. It merely trails off into vague rants about the dangers of mega-cities, the significance of the Internet, and the intellectual importance of virtually anyone with Web access.

The Demon Under the Microscope (2006) by science writer Thomas Hager features the ambitious subtitle: from battlefield hospitals to Nazi labs, one doctor’s heroic search for the world’s first miracle drug. Positioned as the stand-alone story of researcher Gerhard Domagk, Hager’s book manages to cover the history of early 20th century pharmacology with considerable breadth, introducing most of the era’s major medical heroes. Hager gives meaningful context to this condensed period of medical history by couching the era in terms relevant to modern readers: “In 1931, humans could fly across oceans and communicate instantaneously around the world. They studied quantum physics and practiced psychoanalysis … But in at least one important way, they had advanced little more than prehistoric humans: They were almost helpless in the face of bacterial infection.” After establishing the political and commercial environment, Hager leads readers into the competitive high-stakes world of private-firm researchers and drug suppliers. Along the way, Hager tackles a variety of side stories, ranging from the way that modern researchers pursue potential drugs, to the recent rise of drug-resistant bugs. Without sermonizing, the book helps readers to understand the relative impotence of drugs during their grandparents’ generation – and the possibility that society could be without effective drugs once again.

All of these books are about biological warfare against diseases that bear the unmistakable imprint of terrorism: random attacks, sudden death, and deep fear. We look into these pages for reassurance that we will always beat the evildoers. Instead, we discover that humans are a species with grave flaws – most notably pride and prejudice – that can be just as deadly as the microbes.

ALLYSON WRIGHT, a graduate student in the University of Oregon’s literary nonfiction program, last wrote for Etude about dead bodies.  Is she trying to tell us something?