Barry, John M. The Great Influenza: The Epic Story of the Deadliest Plague in History. New
York: Viking, 2004.
The major thesis of this social history of the influenza epidemic of 1918 is that this disease was
not the result of the virus' mutation, or the emergence of a new pathogen, but the "unintended
consequence" of Thomas Woodrow Wilson's "righteousness" in his "war to end wars." He was a
true believer in his cause and he was willing to order total mobilization and, against the advice of
his medical consultants, to mix millions of men in overcrowded cantonments in what were to
become the breeding grounds of the greatest killer plague in history. Wilson provided the
laboratory in which the virus could emerge and then, the conditions - crowded camps,
overcrowded troopships - within which contagion was likely. It is estimated that as many as 100
million people died worldwide in several weeks in the fall of 1918. And Wilson's self-
righteousness did it to us! (The parallels to our own day are the self-righteousness of the Bush
White House are striking.)
To Wilson, influenza was just another cost of the war, another cost of "doing the right thing." It
was one which he was willing to pay or, better, one which he demanded of the country and the
country - indeed the whole world - paid dearly. Perhaps, then, it is appropriate that Wilson fell
victim to influenza and this illness seemed to have affected his mind; it was only 4 months later
that he had his stroke.
The novelty and insightfulness of this thesis commands attention in itself, but this book is so
much more than it's organizing thesis. In 461 pages of text and another 60 in annotations, the
author examines the social context this plague: most particularly, the medical profession of the
day. Our reaction/response to the epidemic was a matter of the medical institution and its
organization which involved several important medical researchers and organizers plus the
Rockefeller fortune. And this is the context of the history: Paul A. Lewis, Oswald T. Avery,
Simon Flexner, and, most important, William Henry Welch, described here as "the single most
powerful individual in the history of American medicine." If one is to understand the reaction of
the nation to the disaster, one must understand these men. All too briefly, WWI brought the
plague and our response to it was the work of Rockefeller money and Johns Hopkins University.
This is a very different story than the search for variant viruses or the tragedies which befell
Philadelphia with the onset of influenza. I do not mean to suggest that Barry has ignored the
calamities which befell individuals, he has not and the book is full of tragedy. But that is not the
thrust of this book. The real tragedy described here is the failure on everyone's part to
acknowledge it and to take steps to do something about it.
As terrifying as the disease was, the press made it more so. They terrified
by making little of it, for what officials and the press said bore no
relationship to what people saw and touched and smelled and endured.
People could not trust what they read. Uncertainly follows distrust, fear
follows uncertainties, and, under conditions such as these, terror follows
fear. (p. 335)
Government, the medical profession, the press, all lied. The people were assured "the epidemic is
on the wane," and "there is no cause for alarm if precautions are observed," and "the so-called
Spanish influenza is nothing more or less than old fashioned grippe." (p. 335) And thousands,
and hundreds of thousands of Americans died. Yet, the political rule was simple: "Nothing was
to be done to interfere with the morale of the community." (p. 337) There was a war on, a war we
had to win.
And it was in this frame of mind that the military shipped troops to Europe knowing full well that
these troopships would be floating coffins for the mix of men crowded aboard. We shipped these
men - not as gun fodder, but as evidence of our commitment to the victory and so they died.
What is most cruel: the armistice came on 11 November 1918 while we were shipping troops in
the middle of the epidemic. (Germany has already made overtures, the war was ending, and we
shipped the best and brightest anyway. But we BELIEVED in the rightness of our cause. And so
we killed our young men.)
We blame a virus for the deaths of millions around the world. Actually, the virus originated in
Haskell County, Kansas, early in 1918, in Camp Funston, the second largest encampment in the
country. That virus was, in that sense, of American origin. Further, it was the war effort that
provided the hotbed for the spread of the virus - the cantonments, the hasty mass movement of a
mix of mankind - that made the spread of the virus easy. And it did spread:
in India alone, some 20 million died.
I've glanced at some of the other reviews of this book. Several seem to have been written by
erstwhile students of mine who, seeking to get off easy, read the first and final pages and try to
fake the rest. It is a sophomoric effort but one resorted to by lazy people. One might read those
reviews and think there is nothing new to this book, no novel theory about the Great Epidemic of
1918. Here is as new insight into the 1918 epidemic: Once again, we has found the enemy and
"They is us." It would be a shame to see this classified as just another effort to explain the
epidemiology of influenza in modern, i.e., "genetic" terms. This is too important to be neglected
like that. This is not a genetic approach to the influenza virus, it is a social evaluation of our
political and medical institutions.