“Flu” is not a very scary word. It’s something most people have gotten – and gotten over – many times. “Influenza” is a very scary word. It means pandemics and quarantines and deaths. In reality the two words describe the same virus. We just expand it by three syllables when we’re taking it seriously. Five years ago John M. Barry wrote a book that takes it very seriously, “The Great Influenza”. The bombastically grim subtitle is “The Epic Story of the Deadliest Plague in History”.
(I meant to read the book when it came out but I never got around to it. I was reminded of it when Barry penned an op-ed piece in The New York Times back in April at the height of the media obsession with what we’re calling “swine flu”. It’s now officially reached “pandemic” status which basically means that not only is it transmissible from one person to another, but it’s also reached all the way around the globe. Fortunately, this variant of the H1N1 influenza virus has so far proved relatively mild, which means that, as of earlier this week, it had killed only 163 people despite infecting almost 36,000. In the op-ed Barry pointed out that the 1918 virus, which was also of the H1N1 variety, had a similarly mild first trip around the globe in the spring of 1918 before coming back in the fall and killing in unprecedented numbers. Happily, Novartis announced last week that it had developed a vaccine.)
“The Great Influenza” is a marvelous book which tells the tale of the horrible 1918 pandemic, and tells it well. It is thoroughly researched and manages the always tricky feat of explaining scientific concepts to non-scientists without causing boredom or confusion. For example, it explains what the H and the N stand for. The H is hemagglutinin and little spikes of it allow the virus to attach itself to, and then penetrate, the cells in your respiratory tract. Once inside the virus begins replicating itself until the cell dies and between 100,000 and 1 million new viruses come bursting out. The N is neuraminidase, a different kind of little spike, that prevents newly formed virus from sticking to the cell from whence it came so they can instead go infect other cells. Creepy, huh?
Beyond the microscopic nitty gritty is the story of how medicine came to be a science based discipline and of how in 1918 it wasn’t quite ready to cope with influenza. It is a tale both chilling and thrilling, even when you know how it ends. Hospitals overwhelmed, men dropping like flies in overcrowded army camps, and scientists maddeningly behind the curve of the disease.
Something Barry only touches on in the book, but which is clearly repeating itself today, is the simple human denial of disease. World War I, to which the pandemic is inextricably linked, killed far fewer people and yet it looms much larger in out memories. Trench warfare, poison gas and the guns of August still ring a bell with us. Whereas there are almost no works of fiction concerned with influenza. There are no cenotaphs or cemeteries, no famous poems and no Mel Gibson movies.
It isn’t hard to understand this willful amnesia. Death by disease in these numbers lacks the drama necessary for tragedy. It doesn’t feel like a contest and so there is no suspense. Indeed, it wasn’t a contest, it was a culling. There’s no glory in the virus because there wasn’t any victory. Influenza came and went of its own accord. And this forgetting isn’t limited to fiction. Anyone who’s taken high school level American history has studied World War I at least a little, but if the pandemic is mentioned at all it’s in passing, or as a deathly side effect and nevermind the relative body counts.
But of course influenza didn’t just come and go leaving no mark on the world. Barry makes a convincing case that in fact it had a profound outcome on the peace treaty that led to the next war. In 1919 when President Woodrow Wilson was in Paris negotiating with the French and the British he was struck ill. Weakened, he lost his spirit for fighting with his European counterparts and gave in to their demands for a harsh peace. Post-war Germany was crippled and humiliated by that deal and it set the stage for the later rise of the Nazis. Wilson’s illness is usually explained as a minor stroke, he would later suffer a massive one, but Barry finds a far more credible and likely culprit in influenza. The symptoms match and there was, to say the least, a lot of it going around. Hell of a bug.
