The Great Influenza

William Welch was known in his lifetime as the “Dean of American Medicine.” As a founder of the Johns Hopkins Hospital and the first dean of the Johns Hopkins School of Medicine, Welch was a seminal figure in American sciences. Virtually every important American scientist of the 20th century either worked with Welch, studied under him, or learned from one of his acolytes. Simon Flexner of the Rockefeller Institute used Hopkins as a model for recreating all medical schools in the United States to become more rigorous. Thus, Welch’s impact is still felt today.

He had no family and no close friends. His entire life was dedicated to medical research and education. Though he did not do much lab research himself, his skills as a motivator and recruiter of scientific minds was second to none. He absorbed information from all fields of science to figure out how best to allocate resources toward research projects. He sat out the fight against the influenza pandemic after contracting the illness, choosing instead to recover alone in Atlantic City. However, nearly every figure profiled in The Great Influenza worked directly with Welch or because of Welch’s recommendation. He was a founder of the National Research Council, which worked with the army to prepare army camps for war and ensure they were set up to prevent a pandemic from spreading. He also orchestrated the first study of influenza after touring Camp Devens.

His role in the text and the pandemic is pivotal, as there would be practically no medical research possible if not for Welch. Thus, Barry starts the book with the birth of Hopkins and Welch’s outsized role in medical history. Even as he disappears from the fight against the pandemic, his words of advice and analysis still appear throughout the text as a way of confirming other researchers’ suspicions and corroborating Barry’s own assessments.

Paul Lewis was an American pathologist who worked at the Rockefeller Institute, the University of Pennsylvania, and Princeton University. The Rockefeller Institute was second only to Hopkins in medical history significance, and Lewis was one of its brightest young scientists and a protege of the institute’s first director, Simon Flexner. Working with Flexner on polio, Lewis became one of the world’s premier virologists. He was living in Philadelphia and conducting lab research at the University of Pennsylvania when the influenza pandemic arrived in 1918.

During the pandemic, he, like many other researchers, became obsessed with finding a vaccine for influenza, but his research skills were not as pronounced as those of other great scientists. He also did not know when to stick with one method and when to move on to a new approach or another area of research. This problem was exacerbated during the pandemic when chaos ruled a lot of labs. During the pandemic, Lewis focused intently on finding Pfeiffer’s bacillus rather than looking for a new approach. In the 1920s he became frustrated and despondent over an inability to make progress in the lab or recognize what he had discovered. For example, he and his assistant did isolate influenza in swine, and the assistant would, after Lewis’s death, use that discovery to prove the origins of the influenza pandemic and, by extension, the fact that influenza was definitely caused by a virus, not Pfeiffer’s bacillus. Lewis did not live to see that, choosing instead to recklessly study yellow fever in Brazil, where he died of the disease in 1929, having infected himself in the lab, possibly intentionally.

Lewis serves an important role in The Great Influenza. Barry dedicates the book to his spirit and opens the Prologue with Lewis studying diseased sailors in Philadelphia. Lewis’s death also ends the book. To Barry, Lewis is a cautionary tale, a romantic spirit who could not recognize his actual talents and instead obsessed over the tasks he wished he could perform. Barry argues that Lewis could’ve been the next Welch, but Lewis himself wanted to be in the lab, not directing others there. Still, Lewis’s role in virology is an important one. The tragedy is that he did not live to see it, just as so many did not live to see their destinies due to the pandemic itself. To Barry, Lewis is the last victim of the 1918 influenza, as it derailed his research methodology and his life.