THE POLIO MAN

The Story of Dr. Jonas Salk

John Rowland 

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Grade Level is 9.5 using the Flesch-Kincaid readability test in Microsoft Word.

First edition published by Roy Publishers, Inc., New York, 1960.

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THE POLIO MAN

The Story of Dr. Jonas Salk

JOHN ROWLAND

To

Dr. Katharina Dalton

 this story of a great doctor in a very 

different field from hers

FOREWORD

The author is deeply indebted to the United States Information Service at the American Embassy in London, for ready assistance with background information, and for the loan of a number of books, including one quite indispensable source-book, Polio and Its Problems, by Roland H. Berg. This, while it contains nothing of the detailed work which led in 1955 to the Salk vaccine (it was published, indeed, in 1948) has a vast mass of information on early research on polio in the United States and elsewhere, and has been much drawn upon for the historical facts in the present volume.

Thanks must also be offered to the authorities of the Mount Sinai Hospital, New York, for gladly providing information about that Institution. The authorities of the New York University College of Medicine also provided much valuable information about the history and development of the College.

CHAPTER ONE

NEW YORK STUDENT

New York! To so many young people, all over the United States of America—indeed, all over the world—it is the most fabulous of cities, and yet a city whose districts and whose streets are familiar, since they have been seen a thousand times in films.

The Bronx and the Bowery, Manhattan and Long Island, Wall Street and Broadway—these names have to many people become almost the basis of a modem fairy-tale. It is a tale of happiness to some and heart-break to others, for no place can be more lonely than a great city, and many of the young people who come to New York seeking fame or fortune find that they have few friends there.

It was not so, however, with young Jonas Edward Salk, when on a momentous day he walked for the first time up the steps of City College, New York. A diffident young man, he was not at all sure that he would be able to pass all the difficult examinations that lay ahead; but at least he knew that he would not be lonely. He was born in Upper Manhattan, New York, on October 28, 1914; and except for holidays in the mountains he had lived all his life in and around the city. Its streets, its sidewalks, its subways, were as familiar to him as the fields and hedgerows would be to a farmer’s son.

He had some nervousness, however, as he started work at College—though, indeed, he need not have been nervous about his ability. He had gone through the normal educational career of a young American in the days following the First World War, attending grade school and showing brightness and intelligence on which his early teachers reported with pleasure. He had his moments of mischief, too, but that did not worry anyone, least of all his parents, because they felt that he should be given his head; and in any case his father, a shrewd and knowledgeable man, was certain that only the boy with a healthy amount of mischief in him would be likely to make his way in the world. Mr. Daniel Salk thought that the boy who was too obedient was the boy who was likely all his life to do what he was told, and was certainly not the boy who would think things out for himself.

Even in schooldays Jonas Salk wanted to think things out for himself. Sometimes he asked awkward questions which his teachers found it difficult to answer—but this faculty of asking awkward questions was to stand him in good stead later on, when he came to pursue the difficult paths of scientific and medical research. The man who tries to study the way in which disease develops is really asking awkward questions of nature, as is every research scientist.

Jonas Salk’s awkward questions in his schooldays led him to a special school. This was known as the Townsend Harris High School; it had been established, as a kind of experiment, to see if it would be possible to pick the brightest children over a wide area and give them special teachers and special teaching. It was described as a “secondary school for exceptional students.” Just what proportion of those exceptional students justified the honor that was paid them at an early age it is impossible to say—but there can be no doubt that Jonas Salk was one of them. A teacher of his early days has called him a boy “who read everything that he could lay his hands on. He had hobbies, he played the games of the day, he threw himself with equal enthusiasm into everything which he attempted. When he went to college, he continued many of these interests, though he was now getting more and more interested in medical questions of one sort and another—and when he was granted his degree in 1934, it was that of a Bachelor of Surgery.

The lectures were absorbing; even more so were dissections of muscles and nerves, the studies of the way in which the human body worked. He was especially interested in the substances called proteins, which make up the basis of body-building foods; and fairly early on in his career as a medical student he had already read a good deal of the curious little things called viruses—smaller than the germs which cause so many diseases, and yet themselves able to cause disease in human beings, in animals, and in plants.

Jonas was not, however, a pure research worker and nothing else. He knew that even though there might be a temptation for a doctor to think of his patients as machines, a doctor who did that would probably not be very successful. He needed to know the technique of his job—indeed, during some of the long holidays that came his way while he was a medical student, he worked as a laboratory technician for the professors and lecturers, gaining extra skill in making microscope slides and in carrying out all sorts of medical and chemical tests, watching the leading doctors of New York setting about their complicated tasks. Another summer he went to a boys’ camp outside New York, where he was engaged as what was known as a “counselor”—helping the boys to iron out some of their problems, settling their arguments, and all the while learning more about human nature. During the years Dr. Salk was at college, he was gaining in experience and in knowledge, until at the time of his graduation he was one of the outstanding students of his year.

Especially was he fascinated by the viruses. He thought much of a lecture he had heard, in which the lecturer had said that most of the diseases which were caused by infections of these mysterious things were really diseases of the proteins of the human body. This might be said of influenza, a virus disease which seemed to have completely defied the doctors; it might also be said of poliomyelitis, sometimes called infantile paralysis, but more often shortened to “polio,” which had stricken many thousands of people, from Franklin D. Roosevelt downwards.

Viruses were much more difficult to track down than ordinary germs, if only because they were so small. The polio viruses, for instance, were so tiny that twenty-five million of them would go on the head of a pin. Ordinary germs could be seen by a good microscope—he had seen many of them in the course of his medical studies, and he had learned to identify them by their size and shape. But viruses could not be seen under a microscope; it was only by the symptoms of the diseases that they caused that they could be recognized. This was the main reason why such diseases worried and puzzled most of the doctors.

Dr. Salk read all that he could find about viruses and the diseases that they caused. Especially the problem of infantile paralysis fascinated him, even in those early days. He learned that it was not a new disease, though most people thought of it as being something that was only known in modern times. Ancient Egyptian paintings showed people who had obviously been crippled by it; a five thousand-year-old skeleton had been dug up in Egypt, and an examination of the bones showed that this ancient Egyptian had suffered from polio. In Germany and in Sweden it had been reported as a mysterious disease as long ago as 1784.

The patient showed signs of fever. The early stages were not unlike those of a heavy cold, or an attack of influenza, but then the victim complained of pains in the legs or back, and this was followed by a degree of paralysis, when the limbs could not be moved, or could be moved much less than the normal amount. It was soon found that the disease did not attack only young children; adults could catch it as well. But for a long time the name “infantile paralysis” was commonly used for it. It was a killing disease; many of the victims died. But it was not easy to say why some died and some recovered; nor was it easy to say why the degree of paralysis varied widely from one patient to another. There were, indeed, many mysteries about polio, and it was to be a long time before these were solved.

The first modern outbreak of the disease in the United States was in 1894, when a small number of people in the Otter Creek valley, at the foot of the beautiful hills of Vermont, were attacked by it. Most of the victims were children. About a hundred children, all told, suffered from the disease; they had a high fever, and, when the fever subsided it was found that their limbs were in many cases partly paralyzed. Dr. C. S. Caverley of Otter Creek did his best with the problem. He showed that there was not always paralysis; sometimes the children made a complete recovery. He wrote a long report on this outbreak, and in the yellowing pages of an ancient copy of a medical journal Dr. Salk read that report. Why, he asked himself, had the disease suddenly burst out in this small town? Dr. Caverley showed that most of the cases that had occurred had come from the area close to the Otter Creek—a small river that wound its way down the valley. He did not attempt to explain why this should be so; he simply recorded it as a fact that future doctors would have to take into consideration.

The outbreaks of polio were not only in America, however; from time to time they had taken place elsewhere. When something of this kind happens, doctors usually study the disease by injecting some of the blood from one of the victims into animals; it is then possible to get the germs or viruses developing and to try out all kinds of substances of one kind and another which may destroy them. But the scientists of many nations tried for a long time before they could get an extract of the polio virus; and when they had managed to secure it, they were to begin with not able to find any animal in whose blood the virus would thrive. It was actually an Austrian, Dr. Karl Landsteiner, who first succeeded in transplanting the polio virus from a human victim to an animal. The animals found suitable were monkeys. Dr. Landsteiner showed that if he took some material from the spine of a human being suffering from polio and injected it into the veins of monkeys, these animals soon showed the typical symptoms of the disease. Later an American, Dr. Simon Flexner, who was to become head of the famous Rockefeller Institute of Medical Research, found that it was possible to pass on the disease by this procedure of taking extracts from the spinal cord (the bundle of nerves inside the spine) of a diseased monkey and injecting it into a healthy animal.

Some people feel that this is a rather cruel thing; but it is not easy to see how such a disease can be studied without using animals. The only other way is to use human beings, and no one would want to run the risk of giving a human being such a disease as polio.

Jonas Salk, as he read of these pioneers of research, probably never guessed that one day his own name would rank with the greatest of them; but he had an increasing sense of discovery as he sat in the college library and pored over the pages of old copies of medical journals, seeing what had been said and done by previous generations of doctors on this very puzzling problem and many others.

He found that while the disease of polio had occupied the attention of many medical men in many countries, it was only in 1916 that it really “hit the headlines” in the United States. Previous epidemics had been for the most part in small and distant communities; but in 1916 it came into the busiest parts of the country. On June 27, 1916, it was reported that over a hundred people in Brooklyn were suffering from it, and it soon struck down more victims in Philadelphia. During July and August it got worse; there were, all told, about 27,000 victims, of which nearly 6,000 died. In New York City there were some 9,000 people suffering from the disease, of which 2,000 died, while most of the survivors were paralyzed to some extent. Large numbers of people, terrified at the way in which the illness was spreading, tried to leave the city, and there were huge queues waiting at the booking offices of all the main railway stations. The city authorities, afraid that this might spread the disease to other parts of the country, announced that only people who could provide a medical certificate that they were free of polio would be allowed to leave.

As Jonas read all this, he pondered the problem anew. He read newspaper cuttings that had been filed in the college library. Some of them had the most fantastic theories about the cause of polio. One paper announced that it was spread by cats—and went on to say that 215 cats had been “arrested” in the worst-stricken area of Brooklyn. Another paper remarked: “Cats and dogs spread disease; but what about doctors’ beards?”

In spite of all this, there was no satisfactory explanation of the cause of the 1916 outbreak. In the end, it faded away as suddenly as it had begun. The cause of its start was not understood, and the cause of its end was just as mysterious to the medical men of the time.

Some Swedish doctors had been working on the theory that polio was spread in the air, and that the virus might therefore be present in the mouths or the noses of the patients. Dr. Flexner, the first American to study the disease thoroughly, showed that there were people whom he called “carriers”, who, while they might not be obviously suffering from polio themselves, would be capable of giving it to others. Dr. Flexner thought that these carriers might have had a slight attack of the disease which they knew nothing about, and would then be immune to future attacks. They might then have the virus in their bodies without realizing it.

This report of Dr. Flexner’s excited Jonas Salk very much. If people would have some sort of immunity to a disease after a mild attack, might this, he wondered, provide a clue to a solution of the whole polio problem? As he was still a student, he was not, of course, in possession of knowledge deep enough to answer this question. But as he walked the busy streets of the city, he pondered it nonetheless; and as he went about his business as a laboratory technician in the vacation, the thought frequently in his mind was this matter of viruses, and their ability to infect human beings.

Another point which was much discussed in the early literature of the subject was whether there was one kind of virus which caused a particular disease—or were there several? Dr. Max Theiler of the International Health Division of the Rockefeller Foundation was the person who gave the first hint here. Dr. Theiler used white mice in some of the experimental work which he was carrying out. Dr. Theiler’s laboratory assistant, who had, among his many other tasks, to look after the mice, was called George. And one day George found one of the mice which did not scamper about, as did most of the others in the cages. It sat down on the floor of the cage, and seemed to be unwilling to move, which was something very unusual with such a lively little creature as a mouse.

Looking at it thoughtfully, George prodded it with his finger. It just hopped clumsily from one side of the cage to the other. George told his chief what had happened, and Dr. Theiler examined the mouse. It was suffering from a good deal of paralysis in its legs; that was why it had been so slow-moving.

Dr. Theiler realized that this was important. He killed the mouse painlessly; then he took some of its spinal cord, made it into an emulsion, and injected some of this into other mice. Within a week of the injection these mice showed symptoms of paralysis. There was therefore a kind of mouse polio. Soon Dr. Theiler was able to show that with mice, too, there were carriers—apparently healthy mice which could transmit the disease to others. The virus which he had found he called the G. Strain of Theiler Virus —the “G.” being added in honor of George, the laboratory assistant, but for whose work the discovery might never have been made.

As soon as he had heard of this, Jonas had something else to think about—the idea that polio might not be one disease, due to one strain of virus. It might be a term that was applied to several diseases, all of which had very similar symptoms.

So when he graduated at City College, Dr Salk had many ideas in his mind. Some of his friends and colleagues were at once going into practice, starting as doctors in towns and cities, small and large, throughout the United States. For a time, he wondered what he would do with his life. Then he came to decide that the work of a general practitioner, however interesting and however valuable, was not really what he wanted. He talked his problems over with his father.

“I don’t really want to be an ordinary doctor,” he said.

“Then what do you want to do?” Daniel Salk asked.

“I want to find out something of the causes of disease,” explained his son.

“But how can you do that?”

“If I’m lucky I can get a research fellowship.”

His father looked puzzled. “What is a research fellowship?” he asked. “How do you get paid? What do you live on?” Mr. Salk did not want to force his son to take on work in which he was not interested. On the other hand, he knew that pure idealism, without any thought of money, was not very practical. He was not wealthy; it would be necessary for Jonas to support himself, now that he was qualified with his B.S. degree.

Jonas was able to reassure him, however. Any post in research would be paid; though it would not be well paid in comparison with a post with some industrial firm. He would not be earning anything like as much money as most of his fellow-students practicing medicine in some town or city. But he would be doing the work in which he was really interested—and he would be doing something which might help to advance medical research.

He read in one of the medical journals that there was a vacancy for a research fellow to study chemistry (in particular the chemistry of proteins) and experimental surgery. This vacancy was at the New York University School of Medicine. It was therefore very attractive to Jonas. For one thing, he had already taken considerable interest in the chemistry of the substances called proteins—the real basis, it would seem, of living creatures. And the post was in New York, the city which had always been his home.

One of his fellow-students, going to take charge of a prosperous medical practice, said to him: “Jonas, why on earth do you want to spend your time studying the chemistry of the proteins? No money in that, you know. Why do you do it?”

Jonas smiled a quiet smile, and answered: “Why did Mozart compose music?”

For him, the thing was as simple as that. There was a task in life which he wanted to carry out—and he was prepared to allow nothing to stand in his way. He felt impelled towards research—and if he was to understand anything about the mysterious viruses which had so far defeated most of the medical men who had tried to study them, he would have to know something about the protein substance on which these viruses flourished. A research fellowship in chemistry and surgery seemed to be ideal; and when he was interviewed by the Board in whose hands the awarding of the Fellowship lay, he felt very nervous. On the outcome of the interview his whole future might well depend—for if he failed to get it, he might be driven back to some task which did not at all interest him. He might, in fact, be driven to take a dull routine job by the mere pressure of the need to earn a living.

But he need not have been nervous. Professors have a reputation for being unpractical and absent-minded, but when they have the responsibility of choosing a man to undertake a task of research they have a way of picking the right man for the job. And in 1934 they picked Jonas Salk.

CHAPTER TWO

RESEARCH FELLOW

There is a difference between the ordinary student, studying for his first degree, and the research man, being paid—though not paid highly—for doing work in some region of science that has never before been thoroughly explored. It did not take Dr. Salk long, after his appointment as Research Fellow at the New York University School of Medicine, to find out that he had moved into a completely different part of the medical world. No longer did he hear men talk of practice in one part of the country or another, comparing conditions and prospects in Florida with those in California, or asking if Chicago was a more expensive place to live in than Cleveland. All that sort of thing seemed of very minor importance among the research staff. Now the main concern of the men with whom he lived day by day was the way in which new methods of diagnosing and treating diseases were being worked out in many countries of Europe and America.

Sometimes they would talk of new ways of preventing diphtheria—notably the immunization treatment which was becoming more and more generally accepted. Sometimes he would hear some leading surgeon discussing a new and daring technique for performing a difficult and dangerous operation. Sometimes they would delve even deeper—and this is when Dr. Salk would prick up his ears—and consider the basic chemistry of the proteins out of which the human body is built.

These conversations he thought the most fascinating that he had ever heard. For a good while he did not dare to join in; as the most junior of all those present, he felt that he could not intervene in a conversation; he could just sit back and listen to everything that the others had to say.

There was at last, however, an occasion when he asked a question. This was when one of the leading medical men was talking about viruses.

“I feel, you know,” this man said, “that we shall never succeed in solving these problems until, somehow, we can spend a lot more time and money on the job.”

“What sort of problems?” said Jonas Salk.

“Understanding how to prevent—or how to cure—a typical virus disease,” explained the first speaker. “Influenza, now—is it one disease, or many? We don’t really know. And if we don’t know the answer to as simple a question as that, how can we hope to find a cure? Or infantile paralysis—polio, as they call it. How can we possibly find a cure for it unless we are dead certain of its cause, of how it is spread and of the best way of preventing that spread? We don’t know—and why don’t we know? Because, with the best will in the world, there isn’t enough money devoted to these things.”

“What about the President’s work?” asked one critical listener. Here, again, Dr. Salk listened carefully.

“You go and read how the President caught the disease himself,” said the first man. “If you do that, you will see that there are still a whole heap of unanswered questions about it all. We’ve got to find the answers to those questions.”

The conversation moved on. But Dr. Salk’s imagination had been touched. When he next got an opportunity of visiting the medical library of the University, he made a point of looking out what could be found of the illness of of the President of the United States.

This illness had occurred to Franklin D. Roosevelt in 1921, when he was at a summer holiday home in Canada at Campobello, New Brunswick. Mr. Roosevelt had a small boat there, which he was sailing on a rough and stormy day. He stayed at the wheel of his boat—the Sabalo—for several hours, fighting the storm in its very teeth. The next day there was a new boat—the Viro—to try out. Again it was stormy, though not as bad as the day before. Mr. Roosevelt got very wet during these little voyages, though he was a skilled handler of a boat, and he did not let the storms upset him. On the way back from his sail in the Viro one of his friends spotted a fire starting in a nearby wood, where some careless person had dropped a cigarette-end. The men landed, took huge switches of brushwood, and fought the fire. It was a long and difficult task. The flames almost defeated them more than once; but they gradually succeeded in stamping and beating them out.

Roosevelt’s sons were with him. When the fire was finally under control, they all felt very hot. A swim was suggested, and they found the cool water very refreshing, after all their efforts at fighting the forest fire.

After the swim they came ashore, to find that there was a huge batch of letters awaiting Mr. Roosevelt. At this time he was a prominent lawyer, and when he had left for this holiday there had been a number of outstanding cases, about which he had asked his partner to write to him as soon as decisions were reached. These cases were detailed in the letters which were now arriving. Franklin Roosevelt saw at a glance that some were interesting and important; so he sat down to read them. He was dressed in a wet swimming suit; he just wrapped a towel around him, not bothering to rub himself dry.

It took him half-an-hour or more to read the letters and to digest their contents. He did not give the matter of his damp bathing costume any thought; when he had finished reading his letters he went indoors, had a rub-down with a rough towel, and then got dressed.

The next morning he had a heavy cold, with a touch of fever. He paid no attention to this until he felt a curious sensation in his legs.

An American doctor—Dr. Keen of Philadelphia—was on holiday in the neighborhood. Mr. Roosevelt knew him slightly, and sent one of his sons around to see if the doctor would call, examine him, and advise him as to this curious illness. When Dr. Keen duly arrived, he was soon very worried. He made his patient move his legs, and was more than a little alarmed to find that this movement was very strictly limited, and that such movement as could be brought about caused a good deal of severe pain. The doctor had no doubt now that this was a case of polio. The odd thing was that while there were a small number of cases—a hundred or so—in New York, there were none at all within miles of Campobello, where the Roosevelt family had now been on holiday for several weeks. If it did indeed turn out to be polio, it would be a totally isolated case, and it would not be easy to decide where it had come from.

However, there was no doubt that it was acute polio, and in a severely paralytic form. Mr. Roosevelt was at once taken back to hospital in New York where he could have better treatment than was possible in a fairly isolated country district.

Mr. Roosevelt was in good general health—his heart and lungs and blood circulation were good. But he was helpless ill his paralyzed state, and learned to walk only months later. Even then, he had to use crutches. Indeed, for the rest of his life he was never able to walk without some sort of artificial assistance.

It was clear enough to Salk what that doctor had meant, when he had said that there were certain problems here—problems which the medical men had not even started to solve. To begin with, it was usually said that infantile paralysis (as it was still usually called) was an infectious disease, which could become an epidemic, if not carefully watched and controlled. But here was one isolated case of the disease at its worst—one case, with not another reported case within many miles. Why?

Secondly, there was the association of the case with such changes in temperature as might be expected to cause a common cold, or even an attack of influenza (another virus disease). Was Mr. Roosevelt’s paralysis due to his sitting about in a wet swimming costume, for half-an-hour or so, while he read his letters?

Finally, there was the association with water. Mr. Roosevelt had been very wet, as a result of sailing in stormy weather; then he had fought the forest fire, getting very hot; finally, after a swim, he had sat about, reading his letters, and had not changed into dry clothes. Had these things anything to do with the fact that the polio virus had attacked him? Jonas recalled that in the report on that first polio epidemic in the Otter Creek valley, the local doctor who had studied the case had stated that a large number of the cases had occurred close to the river. Was there any association of polio with rivers and stretches of water? It was not easy to say; but Jonas thought that there was at any rate something a little suspicious about this. Yet it should be recalled that nothing had been said on these lines with regard to any other epidemic which had been studied—nor had he seen any suggestion of the sort in the accounts which he had read in the medical literature of Austria, Sweden, and other countries.

At any rate, one good thing had come from the fact that polio had attacked a man so much in the public eye. Mr. Roosevelt himself took up strongly the need for extensive work by medical men everywhere on the problem, and in 1934, at about the time that Jonas Salk started his research work at New York University, the President (as Franklin D. Roosevelt had then become) set up a Commission for Infantile Paralysis Research. In a short time no less than seven hundred million dollars were at the disposal of the Commission.

Soon it began to look as if one of the problems was solved—the problem of finance. Thanks to the President, there was now plenty of money available for research; but there still remained the problem of the way in which the research was to be carried out.

While he was working at quite different matters in the New York University Medical School, Jonas Salk quietly studied reports of what others were doing in the way of research on polio and other virus diseases. President Roosevelt had visited Warm Springs, Georgia, where some polio patients, helpless cripples as a result of the disease, had in part regained their muscular strength by frequent swimming in warm water. Roosevelt himself put much money into this, and the papers came out with headlines about people who were swimming back to health. However, it did not seem to be successful in a sufficient number of cases to cause it to be regarded as a treatment worth studying at great length or using generally.

Then one day in 1936, when his work on the chemistry of proteins was progressing satisfactorily, Jonas Salk read with great excitement an account of some work that had been done by a bacteriologist in Stanford University, California, right away on the other side of the American Continent. This man—Dr. Edwin Schultz—had worked along lines already considered by others. It had been shown that infection by the polio virus sometimes came through the nose or the throat, and Dr. Schultz wondered if it would be possible to spray the nose passages of animals (and, for that matter, human beings) with a substance that would prevent the polio virus from developing.

It was known that the virus eventually attacked the nerves of the spinal cord; it was, in fact, the destruction of some of these nerves by the virus that caused the paralysis. So if the virus could be stopped at the point at which it entered the body it would not reach the spinal cord at all.

Accordingly, Dr. Schultz had experimented with a number of chemicals of one sort and another, spraying the nostrils of monkeys with them, and then trying if it was possible to claim any sort of protection against the polio virus. The common substance called alum was at first found to be most successful—and at one stage it was thought that nearly three-quarters of the animals so treated with alum were free from infection.

Alum was then tried out on human beings. People were provided with sprays, and were taught to spray the alum solution into their own noses. It did them no harm; they usually found that it brought on fits of sneezing, but otherwise it did not even cause any discomfort.

The President’s Fund was now thrown into the balance; Dr. Schultz was granted enough money to finance the continuation of this line of study. Scores of different chemicals were tried out. In the end Dr. Schultz found that the most successful of all was a compound of the metal zinc. This was zinc sulphate. Dr. Schultz thought that the virus probably penetrated through the nerves of the nose, got into the nervous system, and so in the end reached the spinal cord. The nose is lined with protein, and Dr. Schultz’s theory was that the zinc sulphate formed a protective covering over these proteins, so preventing the polio virus from reaching the nerves at all.

Some monkeys which had not been given this nose-protecting spray were killed, and their bodies studied, in an effort to find out how the virus moved through their nerves. If the nerves of the nose were cut, it was then claimed that, while it destroyed the sense of smell, even injection of virus into the blood of monkeys did not give them the disease.

The experiments seemed very useful, and seemed to point to a fairly easy way out. But Dr. Salk by this time had come to see that there was rarely an easy way out of a medical problem. He was not therefore altogether surprised when the first full-scale test of the nose protection method—it took place in Canada, where there was a considerable epidemic of polio around the great city of Toronto—produced results which suggested that, even though infection through the nose might produce some of the cases, that there must be other forms of infection as well. In fact, it was only in a comparatively few cases that the nose was the source of infection; so Dr. Schultz’s work, while it had at one time seemed to be a possible solution of the whole question, was now shown to touch only one small part of it.

Meanwhile, many people had been thinking of possible injections to deal with polio. Many diseases—notably smallpox, once the scourge of the world—appeared to have been largely stamped out by means of a vaccine. It seemed that many diseases might be prevented by stimulating the human body to manufacture what is known as an “antibody”—a substance that attacks and destroys the germ or the virus which is the cause of the disease. The substance which produces this antibody is usually either a mild form of the disease itself, or a related disease, which can produce an antibody effective to fight more than its own kind of germ or virus.

Dr. Salk, of course, knew the theory of this; he had learned it quite early on in his career as a student at City College. Now he found that it had been taken up by a number of people—notably Dr. Kolmer of Temple University, Philadelphia. Dr. Kolmer had found mention in the medical papers of as long ago as 1910 of possible antibodies which developed in the blood of polio victims. Now he wondered if it would be possible to stimulate the manufacture of these antibodies by some injection.

The task of a doctor, studying the cause and cure of a disease, is very different from the task of a chemist, studying the way in which some substance behaves in a test-tube. The chemist, if his experiment goes wrong in some way, can simply throw the contents of his test-tube down the sink and start again; the doctor, if he is working on the wrong lines, may find that he has killed a patient. The problem which loomed large in the minds of all those who were studying polio, its prevention and its cure, was how to cause the antibodies to be manufactured in the blood of patients without causing the patients to fall victims to the disease. With some other diseases, it had been found possible to stimulate the antibody manufacture without actually using the germs of the disease itself; and for a time a number of doctors tried this with polio—though without any success. To inject live virus into the veins of a healthy person was taking a terrible risk—and no medical man, however keen on perfecting his way of studying polio, dared to do it.

To begin with, then, when this problem of stimulating the production of the antibodies was approached, it was decided again to use monkeys for the experiments. Once more material was taken from the spinal cord of monkeys suffering from polio; this, it was known, could give the disease to healthy animals; but could it be so treated that it would produce antibodies without causing any kind of paralysis? This was the problem.

Dr. Kolmer of Philadelphia described the work that he was doing along these lines in a series of articles in a medical paper, which Dr. Salk read with great interest.

He found that the virus could be weakened, though not killed, by mixing the virus-containing extract with chloroform, or with a substance called sodium ricinoleate—the active principle of castor oil. The virus extract, when mixed with either of these things, could be injected into healthy monkeys without producing the familiar symptoms of paralysis; the weakened virus, too, seemed to produce the antibodies in the monkeys’ blood. A monkey which had been injected with the weakened virus, mixed with chloroform or the castor oil extract, could later on be given a dose of full-strength virus without falling a victim of the disease. Dr. Kolmer, indeed, felt so sure of the value of this form of treatment that he actually injected his own children with some of the weakened virus.

This was in 1935, when Jonas Salk had been working in his research job for about a year. His work was not directly concerned with any of these experiments, but he read what was published about viruses with increasing interest. He made up his mind, in fact, that if a post with such a research group should fall vacant, he would try with all his might to secure it.

Nearer home, in New York, two doctors were working along quite different lines, and Dr. Salk more than once met them and discussed what they were thinking. Dr. Maurice Brodie and Dr. W. H. Park of the New York City Health Department felt that the use of a live virus, even though it might be much weakened, was a dangerous thing. Nobody, they felt, knew enough about the way in which viruses worked to be quite sure of what was going on. They therefore proposed to kill the virus before injecting it. They said that the dead virus would provide, at any rate, some measure of protection from infection. Dr. Brodie asked for volunteers to try out the dead virus injections, from among the members of the staff of the Health Department. Six people volunteered; they were injected, and no bad results followed. But Dr. Brodie admitted that the test was really too small for there to be any certainty about the result.

Meanwhile, the Philadelphia treatment of weakened virus-injection had been tried out on a fairly large scale, when some thousands of patients were given a dose. Some cases of paralysis followed, though it was thought that these patients might have caught the disease before the injection was given.

Dr. Salk pondered these things. Then he read of a great national meeting of the American Public Health Association, held at St. Louis. He would have loved to attend that meeting, but a comparatively unknown research man at New York University could not expect to be invited to such a gathering of the experts. Moreover, it would cost a good deal in time and money, and he could not expect to be given either leave or financial assistance to attend a meeting with which, in his official capacity as a research fellow, he would not be supposed to have had any direct interest.

He saw with growing excitement that at this meeting at least one leading expert—Dr. Thomas Rivers of the Rockefeller Institute—said that not enough was yet known about viruses, how they grew and multiplied, to enable doctors to be certain of what they were doing. Some viruses, such as one which caused a disease of tobacco plants called tobacco mosaic, were exact chemical substances. They could be analyzed; they could be prepared as crystals. Others seemed to be very complicated proteins, and would not grow outside some animal or plant. He thought that it was a mistake to say that anyone could be completely protected against disease by any kind of exact concentration of some antibody in the blood of a patient. He pointed out that the polio virus attacked only the nerve-cells of patients. Any antibody which might circulate in the veins or arteries of human beings did not, in actual fact, reach the nerve-cells at all.

Dr. Rivers also pointed out something which had already been thought about by many people (including Dr. Salk), and that was that a disease like polio attacked only a tiny minority of the people of the world. The vast majority of people did not get it at all, which looked as if large numbers were naturally immune to the disease. The reason for the immunity was not known. In fact, doctors were more ignorant than they were, as a rule, ready to admit. The end of the conference was a call to both Dr. Kolmer and Dr. Brodie to cease using their vaccines on human beings until more was known about the nature of viruses. Their work was thought to be valuable; but there was still too much danger if the vaccines were widely used on human patients.

Dr. Salk was especially interested in Dr. Rivers’s revelation that some of the viruses seemed to be highly complicated proteins; was he not already working on proteins?

As he went about his day-to-day work he often talked these problems over with Dr. Thomas Francis, who was his immediate chief.

“I think,” Dr. Francis said to him one day, “that we made a mistake in concentrating so much on polio. Polio is a killing disease, and if a doctor makes an error, he may kill a patient. Why not start by working on some virus disease which does not kill?”

“What sort of disease do you mean?” asked Dr. Salk.

“Influenza, say. Influenza is a disease which causes thousands of people to be ill every winter; it loses millions of working days to commerce and industry. If someone could produce a vaccine that would prevent influenza, a vaccine which could be given easily and cheaply to the whole working population every winter—it would be a godsend. And it would be a very paying proposition, too,” added Dr. Francis with a grin. “Any one of the big chemical firms would take up manufacture of such a vaccine on a large scale.”

Jonas Salk thought about this. For a good deal of this time—from 1934 to 1939—he had been doing the interesting research work on proteins and their chemistry which gave him a deep understanding of how medical and chemical researchers did their job. It had no direct connection with the discovery which was eventually to make him famous; but it did give him a real understanding of scientific research, which was to be of great importance in the future. He also did some more directly medical work in New York.

In 1939, however, something very important happened in his personal life. He had met Donna Lindsay, a social service worker, in his occasional visits to various service centers in New York. Since those student days when he had helped at boys’ camps, Jonas had retained his interest in the efforts being made by various voluntary organizations to help the poor and the needy; and on several occasions he had noticed this dark, lively woman, doing worthwhile work in difficult conditions. While a student, he had been too busy, and too much concentrated on the task of fitting himself for his life-work, to think very much about girls. He had gone to student dances and similar functions; but no one there had impressed herself enough upon his imagination to rouse more than a momentary interest in his mind.

It was different, however, with Donna Lindsay; when he was away from her, he found himself thinking more and more about her. And on June 9, 1939, Jonas Salk and Donna Lindsay were married.

Dr. Salk was by now taking his place in one of the greatest of all the medical schools in America. The New York University College of Medicine, with its tall impressive buildings on Twenty-Eighth Street and First Avenue, was a well-known part of the metropolitan landscape of New York. It had as a valuable connection the Bellevue Hospital, where patients of all kinds were treated, and there were parts of the College and the Hospital where specialists of many types could get training and valuable experience. Bellevue Hospital was the largest of the twenty-six Municipal Hospitals of New York City, and had accommodation for over two thousand patients. It was a proud day for Dr. Salk when he saw, in the Official Bulletin of the College, his own name appearing (though in quite a modest position) as one of the “Fellows” who had done research work there. This was in the booklet published with its announcements for the 1938-39 Session, which was dated March 26, 1938. Now all his ambitions were justified; he was in a position to do worthwhile work, and to hope that he might be able to extend the bounds of medical and surgical knowledge.

CHAPTER THREE

YEARS OF CHANGE

In 1939, then, two very important things happened to Jonas Salk. He was married, and the University of New York awarded him the degree of Doctor of Medicine, in recognition of the valuable research work that he had carried out in its Medical School. The time had come, he thought, for him to leave the rather subdued atmosphere of a research laboratory, with its test-tubes and its samples of germs and viruses, and to take a more active part in the work of the medical world.

Later he often felt that, while his work at the New York University School of Medicine had been interesting—indeed fascinating; and while it had given him an insight into the way in which Nature worked, there was a kind of aloofness about the whole affair, which might have been dangerous had he gone on with it for much longer. During part of his period in the School of Medicine he had worked on bacteriology, studying the germs which cause many diseases. So when he left in 1939 he had a wide knowledge of the proteins which build up life and the germs which destroy it. He had, too, his special interest in the viruses which are so much smaller than germs, and which are therefore that much more difficult for the doctor to deal with.

The Mount Sinai Hospital in New York had advertised in the medical journals for a doctor to specialize in dealing with certain infectious diseases; and it was here that Dr. Salk went in 1939, when his M.D. degree had provided him with the qualifications for filling the highest possible positions in the medical world.

It was a fine place—a hospital with nearly a thousand beds, with a fine research department, chemical laboratories, and other departments studying all kinds of ways of dealing with disease.

Started in a fairly small way, as “The Jews’ Hospital in New York,” in 1852, it had soon been decided that it would treat all patients, not only those of the Jewish religion and race. Its name had been changed to “The Mount Sinai Hospital” in 1866, to make it clear that it served the community without any distinction of race or religion.

It had occupied various buildings on various streets in New York over the years. When Dr. Salk went there to work it had a commanding position, along Fifth Avenue and overlooking Central Park. It was a delightful place in which to work, and he was sure that he would be happy there, that he would find worthwhile tasks to do.

He found that the hospital was well equipped in every way. It was, too, interested in all kinds of good works, not always done by hospitals. In 1933, for instance, when New York was faced by the problem of thousands of unemployed people, because of a great world slump in trade, the hospital had started what it called a “Social Service Workroom,” where unemployed people might be given some aim in life. In 1938 a blood bank was started, so that there would always be blood available for transfusions if a patient needed these urgently. It published a journal, which went to universities and medical schools all over the world. If he made any useful discoveries, Dr. Salk knew, they could be published in this journal, so that his new knowledge would soon be shared with medical experts throughout the United States, and in other countries as well.

He had enjoyed his work at the New York University School of Medicine; it had been good work and valuable work; but he was sure that in the Mount Sinai Hospital, surrounded by the hundreds of doctors and nurses who were on its staff, he would be much more closely in touch with the people who were suffering from various diseases, and so would be in a way inspired to do more directly useful work than he had been able to do up to now.

It took him some time to get to know his way around the tall buildings; it took him some time, too, to get to know all the men with whom he would be working. There were doctors who spent most of their time in the wards; there were research assistants, busily occupied in the laboratories; there were nurses and surgeons, with whom he might not have much direct contact, but to whom he liked to talk sometimes, when he relaxed over a cup of coffee, after a heavy morning’s work.

The life was in many ways new to him; yet the work that Dr. Salk did at the Mount Sinai Hospital had much to do with what he made of his life, after he had moved on to other places. It was in New York that he got his first real taste of what it meant to be a medical research man, not just in a laboratory, studying germs and viruses as a chemist studies his chemicals, but studying them where people were actually suffering from the effects of these germs and viruses in their blood. It gave a sense of urgency to all that was being done, since there was always the knowledge that a research task done in a few days, instead of a few weeks or months, might save lives.

Years afterwards an associate of Jonas Salk’s said: “You look at him when he sees a paralytic case, and you can see him thinking: ‘ This can be prevented!’”

That feeling was often to come to Jonas Salk—and the first sense of it undoubtedly came to him in those days of 1939-40 when he was working at the Mount Sinai Hospital.

The war in Europe had broken out; but as yet the United States had not become directly involved in it. Dr. Salk read of the war in Europe; he read of it sometimes with impatience. The task of humanity, as he saw it, was to save life, not to destroy it; and it made him angry to see so much of the world concentrated on destruction.

However, in his day-to-day work at Mount Sinai Hospital he was helping to save life. He walked through the wards, chatting to patients, hi the hospital laboratories, he examined specimens of blood under the microscope, trying to identify the germs which were there, and deciding what was the best treatment to be given to the patients who were now under his care.

Indeed, all through the war Dr. Salk continued to do valuable work in the hospitals of America. It was, someone said long after, a good thing for the health of the world that the authorities had not sent him abroad as an army doctor, as they might so easily have done, for his special genius, as was soon to become obvious, lay not in the routine of dealing with individual patients, but in seeing beyond the problems of the individual to the deeper problems of the cause and the cure of disease.

Yet the individual patients sometimes worried him. Even when he came home to the flat which he now shared with his wife, he still had in his mind some problem that he had been dealing with that day in the hospital. One conversation on such an occasion became quite a family joke, to be written down, years afterwards, by a reporter in search of a “human interest” story about the Salk household.

His wife was telling him something about the day-to-day affairs of the household. She looked at him suddenly, and stopped speaking in mid-sentence.

“Why, Jonas,” she exclaimed, “I don’t believe that you are listening to me at all.” She had noticed a faraway look in his eyes, which told her that he was mentally concentrated on some problem of work at the hospital.

He grinned his cheerful grin. “My dear,” he said, “I’m giving you my undevoted attention.”

In spite of the heavy pressure which was now being piled upon him—in spite, too, of the fact that, while doing much day-to-day routine work in the hospital, he was also continuing some research work in the laboratories—Dr. Salk played an exciting, if sometimes erratic, game of tennis whenever time could be found; he also took up golf, for he knew that one of the dangers of a man doing a difficult job that absorbed all his attention was that he might not be able to keep physically fit. And he always felt that a man who was not physically fit would not be mentally fit either. He himself, therefore, conscientiously kept himself in a state of fitness, dragging himself away from the laboratory at times, when he would have preferred to have continued to work there.

He still read of the work which was going on, all over the world, in the effort to solve the difficult problems of the virus diseases. There was, all the time, more money being made available in the United States for the study of polio and its prevention. With the aid of this fund polio study units were set up in many American universities and schools of medicine. At Yale University a strong team of research men, under Dr. J. R. Paul, studied the problem of whether polio was due to one virus or to a number. Their reports, too, were read as they came out by Jonas Salk, and put into a kind of pigeon-hole in his mind.

Another place where valuable work was being done was at the Michigan Department of Health, where Dr. David Kramer was extending what was already known about the person who was a carrier of the disease. In an orphanage Dr. Kramer studied children, healthy and diseased. He was able to show that there were healthy children who carried the polio virus; he even found that a nurse on the staff of the orphanage was a polio carrier, though as far as she knew she had never shown any of the ordinary symptoms of the disease. This was one of the mysterious things about polio which doctors felt they would have to clear up before any final preventative could be worked out.

Detroit, the largest city in the state of Michigan, was becoming a valuable center of virus research. Dr. Kramer’s work on polio carriers there was providing doctors everywhere with valuable information; and in 1942 Dr. Salk was offered a post by the University of Michigan. A virus research unit had been set up there—not dealing only with polio, but with virus diseases generally, and one of the first men to be appointed to the staff of this unit was Dr. Thomas Francis, under whom Dr. Salk had worked in his days at New York University.

Dr. Francis was building up the staff of his research department; he therefore at once thought of young Dr. Salk—now twenty-eight years of age—as a possible recruit to help with the work that was going on. He wrote to him in New York, and asked if he would care to come and help with the work that was being done in Detroit. The virus research unit there was working on what had long been a favorite project of Dr. Francis—the production of vaccines which would protect people from the annual visitation of influenza. It was thought that if a satisfactory vaccine could be found, it might be produced on a commercial scale, and might then be used to save much illness every winter.

This was, indeed, the scheme about which Dr. Francis and Dr. Salk had talked some years before. But now, in 1942, it seemed to be within reach. Dr. Francis therefore asked Dr. Salk if he would be prepared to leave his post in New York and come to Detroit to work there.

It was not an easy decision to take. Jonas Salk had spent practically the whole of his working life in New York; he was at home there; his life had been bound up with its familiar streets. Moreover his wife, too, was a New Yorker, feeling at home in the great city as she might never feel elsewhere. It was with some trepidation that he asked her what she thought he should do in response to Dr. Francis’s suggestion.

“You want to do this job, Jonas?” she asked.

He hesitated. “It’s just the sort of chance I’ve been waiting for, my dear,” he admitted. “But it means leaving New York and moving miles away. It means leaving our friends at Mount Sinai and making a home in a strange city. It means ...”

“It’s doesn’t matter what it means,” she interrupted him. “If this is the job you want to do, we’ll go.”

That settled it; and the next few weeks were hectic. They had to wind up all sorts of arrangements that they had made in the past few years. Dr. Salk had to make sure that such work as he was doing at the Mount Sinai Hospital could either be brought to a satisfactory end, or so rounded off that it could be continued by someone else, appointed in due course to take his place. A research worker cannot just walk out of his job, as an ordinary office worker can, and know that whoever may follow him can just pick things up and carry on. He has to leave things in a state so tidy that his successor can see exactly how to pick up the threads. It is no use leaving loose ends. So Dr. Salk found his work getting increasingly difficult during those last weeks in New York.

At home in his apartment, too, Mrs. Salk was working hard. Moving in a country the size of the United States is apt to be a difficult and expensive business. If a large amount of furniture has to be moved over long distances, it is sometimes advisable not to bother to take it but better to sell most of it, and buy fresh furniture in the new home when it is found. Yet their New York apartment had been their first home together, and Mrs. Salk could not find it in her heart to get rid of all the items which she and her husband had so enjoyed buying, when they had been furnishing their home before their marriage. Everyone has some sentimental attachment to some of the items of a home—and the problem that the Salks had to face was to decide what to keep and what to sell. There were endless discussions in the evenings, when Jonas came home from his daily work at the hospital; but by the time the day of the move had arrived, all these arguments went by the board, forgotten in the excitement of taking up a new life in a distant city. Apart from this, Dr. Salk was more excited than he had been for years, in that he was sure that the task which he was now going to undertake was something that would give him more scope and more interest than anything which had hitherto occupied him.

On arrival in Detroit, he was met by Dr. Francis. In a matter of a few days he had settled in the laboratory which had been placed at his disposal, and was starting on the study of the virus, or viruses, which caused influenza. The work was in many ways different from anything that he had previous attempted, though some of it was based on the material which he had been reading for years past.

While Dr. Salk was doing this work, he continued to read about what other people were doing. It was in 1940, while he was still in New York, that there had burst upon the American medical world the revolutionary ideas of Sister Kenny, the Australian nurse who had secured some spectacular successes in the after-treatment of patients who had suffered from polio. Years before, Sister Kenny, in her native Australia, had been told by a doctor that there was nothing that could be done to relieve the pain of a suffering child. She had wrapped hot wool bandages—torn blankets, dipped in boiling water and rapidly wrung out—around the half-paralyzed leg of a polio patient, and had found that in a few minutes the child’s bitter crying stopped. It seemed that the pain had been relieved. When she came to the United States, Miss Kenny was enthusiastically received. The American public was so conscious of polio, and its shocking after-effects, that anyone who claimed to be able to do something to relieve it was listened to with considerable respect. She demonstrated her treatment at the Children’s Hospital at St. Paul, and the Minneapolis City Hospital in Minnesota. She was given an opportunity to train others in her methods, and over a thousand doctors and nurses received instructions from her.

Dr. Salk read all this with interest; he thought that it was a fascinating business, and that the treatment might well be good in relieving the after-effects of paralytic polio. But this, after all, was not what he was after. He wanted to prevent the disease being caught, which was something very different from relieving its effects on a patient who had already caught it. Sister Kenny’s idea that the limbs, even though paralyzed, should be kept moving was something quite revolutionary in its way; most doctors said that the limbs should be kept quite still. It seemed that limbs which were kept still got stiffer and stiffer, until they could not be moved at all; whereas if they were moved in the way which Sister Kenny wanted, there was a good chance that they would before long be usable again.

Yet Miss Kenny was not content with the practical value of her treatment; she thought that the success which her treatment brought was enough on which to base a new theory of the way in which the polio virus did its deadly work.

She said that polio was not just a disease of the nerves, which were attacked by a virus. She considered that the virus attacked the muscles, and added that this was why her treatment, by keeping the muscles moving, made far greater headway with paralyzed patients.

While Dr. Salk admired Sister Kenny’s courage, he was sure that her theory of the disease was totally wrong. It had, he thought, been shown quite clearly that polio was a disease of the nerves, and that the virus was something that paralyzed human beings by attacking their spinal cords. Therefore, he thought it was sure that the muscles could not be the first part of the body which the virus attacked. Miss Kenny might be an admirable nurse; her massage and other treatments might be—indeed, were—first-rate. As a way of dealing with patients who had been paralyzed, her technique was good; but her theory was wrong, he thought, and she had little, really, to contribute to the argument about preventing the disease from getting a hold on men and women.

So he went back to his own routine, which might have seemed dull, but was nonetheless, he thought, valuable, in that it was paving the way for a better understanding of what viruses were and how they attacked the human body.

The first problem which was being tackled by Dr. Salk and Dr. Francis was, as has already been said, the problem of influenza. The aim of their work was to find a vaccine that would prevent that disease from spreading, as it seemed to do in most countries, during the colder months of the year. He felt sure that if they succeeded in tackling this problem, the medical world would at once be better equipped to tackle other virus diseases, including polio, which was the nastiest problem of them all.

It was a long and tiresome task. The old theory of a vaccine that should produce antibodies in the blood of patients was that on which their work was based. But they soon found that, while this theory might be good enough, and while they could use extracts from the blood-stream of patients who had suffered an attack of influenza, and might try the effect of injecting these into healthy patients, protection did not always follow.

It began to look as if the influenza virus might be something a little more complicated than it had at first been thought. Perhaps, Dr. Salk told himself, there were a number of different kinds of influenza; perhaps one kind would need one kind of antibody, and another a different one.

If this were so, the issue at once grew complicated. If a patient had to undergo half-a-dozen injections before he could be sure of being clear of influenza for a few months, he might be very reluctant to have such a treatment. He might even prefer to take the chance of catching the disease, thinking that this was less of a nuisance than a series of injections which might mean several attendances at a hospital or a clinic.

There was only one way of overcoming this difficulty, the doctors told themselves, and that was to try to combine the various vaccines, so that a single injection by a mixture would solve the problem. Then one injection might provide protection against a number of different kinds of influenza.

While all this work was going on, the world had changed. The war had come home to the United States, and there had to be faced the new problem of protecting American soldiers, sailors and airmen in many parts of the world from diseases which might be the old and familiar complaints, or might be something quite different. For Americans were now scattered over the world, from the tropical areas in the Pacific where they were fighting Japan, to the frozen north, where convoys of ships were carrying supplies to Russia, hard-pressed under the Nazi invasion. In 1944, Dr. Salk’s work on influenza vaccines was recognized by the authorities of his country, and he was appointed to serve as a consultant on influenza on the body that was known rather clumsily as the U.S. Army Epidemiological Board. This was a board of doctors who had the task of protecting American soldiers against the worst effects of the many epidemics that might be expected to strike in wartime.

Dr. Salk continued to work in Detroit; but more and more often he was asked to attend meetings in various parts of the country, when leading doctors of many states discussed the best way of preserving the health and the physical fitness of the men who were fighting abroad. The work of his colleague and friend Dr. Thomas Francis was also recognized, and the two men were less and less in their laboratories, and more and more attending consultations on many of the new problems that the war was bringing in its train.

It may well have been that the war slowed up the work on the nature of the viruses which caused influenza, though more than one vaccine was produced—some of them with considerable efficacy with particular kinds of influenza. A doctor who is frequently flying hundreds of miles to attend consultations and conferences has not the quiet and the calm necessary to work on his research. He has, as Dr. Salk said, no time to think.

Mrs. Salk knew the worries and the anxieties that were his at this time—and knew them better than anyone else. Always a very undemonstrative man, Dr. Salk during the war years tended more and more to retire within his shell, not allowing anyone outside a very small circle of close friends to realize how he regretted having to neglect what he felt to be his proper work—work which he knew to be valuable and important—in order to give others the benefit of his advice.

But the war had to be won—and Dr. Salk gave all his energy to whatever task the government of his country felt that he was capable of doing. He knew that the war could not last for ever; he was still a young man; and, he told himself, when the enemy was defeated, then he would be able to turn back to the task of solving the problem of the virus diseases—the problem to which he had in a sense dedicated his life.

He knew that he was fortunate in being able to continue to work as a doctor, while many of his non-medical friends, called up for service with the armed forces, were obliged to leave their chosen jobs and get on with the best cheerfulness that they could muster with the unfamiliar task of being a soldier.

Wars are in more than one respect wasteful things. So many important jobs have to be postponed during wartime. Dr. Salk found, as he used to say afterwards, that he was putting many of his ideas into cold storage during those years up to 1945. His work for the government, however, he knew to be worthwhile and essential. Only doctors could look after the health of the troops adequately—and in time of war there are never in any country enough doctors to go round. So, even though he regretted having to spend so much time away from his laboratory bench, Dr. Salk was aware that the government knew better than he where his talents could be used in those difficult and dangerous days. The decisions were sometimes a trifle hard to take; but, once they had been taken, he was content to abide by them.

CHAPTER FOUR

FROM WAR TO PEACE

When the long struggle came to an end, Dr. Salk was not the only person to heave a sigh of relief, to think that now the world would be more normal, and that all the ordinary peacetime tasks could be taken up again, all the more attractive because for a time they had been neglected or ignored.

He had been appointed, in addition to his work for the United States Epidemiological Board, as a special consultant in epidemic diseases to the Secretary for War and the Secretary for the Army. These posts, too, involved him in a lot of traveling and a lot of thought; but he did not begrudge the time spent in them, since he knew that here he was doing work that a doctor should do—pointing out the way to prevent suffering and to save lives. At the end of the war, it might have been expected that he should be relieved of these responsibilities; but the government asked him to continue, and he agreed. Indeed, he attended many consultations of one sort and another up to 1947, when the pressure of other work forced him to resign these official posts once and for all.

At home, life continued smoothly and happily. He now had a family. Three boys were born to them in all—Peter, Darrell, and Jonathan—and Dr. Salk found the development of his boys fascinating to watch. He wondered sometimes if any or all of them would follow in his footsteps and become medical men. But, like most sensible fathers, he knew that he would accept whatever they decided, and let them take up whatever work they wanted to do. He realized from his own experience that the most important thing in life was to get a job which one enjoyed. He had chosen research—and he would be content if his boys in the end found jobs which would suit them as well.

His main task was still in the field of virus research; with Dr. Francis he still worked on the elusive general vaccine that might protect humanity against influenza; but he still studied, night after night, the work that was being done in many places into the far worse disease of polio. It had been thought, with the discovery of what were called the sulpha drugs, that a pill which would prevent polio might be introduced. The National Foundation for Infantile Paralysis had asked Dr. Kramer to study the possibility of this, and Kramer, after more than five years’ work, doubted its possibility.

Other medical research workers were studying the use of various chemicals which might be injected, and which might prevent the onset of polio, or make it less severe if, after all, it attacked a patient. Every disease which is due to the invasion of a germ or a virus has an “incubation period”, which is the length of time known to elapse from the moment of infection to the moment when the disease shows itself. It was thought that if some chemical substance could be found which would lengthen the incubation period for polio, this might mean that the hold of the disease on the patient was being weakened.

In 1946 two teams of American doctors were working on these lines, and Dr. Salk studied their work with interest. It was a new method of attack, very different from that on which Salk was working; but he was never so full of his own ideas that he was not prepared to see what others might do in a completely different way.

These two teams of medical researchers worked in New York and in the University of Minnesota at Minneapolis, nearly a thousand miles apart. The New York group contained old friends and colleagues of Dr. Salk, as it was formed from the research staff of the New York University College of Medicine. This team included Dr. Brodie, Dr. Earle and Dr. Ward, and as he read of their work Dr. Salk thought of the men he had known. In Minneapolis the leader of the team was Dr. Raymond Bieter.

Both groups worked with mice, which were now becoming more and more usual in polio research.

The main aim of both teams of research workers was to find substances (for the most part dissolved in oil) which would slow up the onset of the disease. The injection of solutions, in oil, of some rather surprising substances (for example, potassium permanganate, familiar to all students of chemistry, and even iodine) seemed to have some effect; such substances certainly reduced the concentration of the virus in the body of a mouse. And these doctors therefore began to wonder if it would be possible, in something like the same way, to reduce the concentration of the virus in the human body, thus making it less likely that the disease would spread—and, even if a person caught it, less likely that it would kill him or paralyze him badly, if at all.

Salk heard of this line of work with interest; but he was far from convinced that it was in this direction that the solution of the polio problem lay. Yet Bieter, at the University of Minnesota, used a substance called benzidine on mice, and found that, while it did not entirely protect from the disease, it seemed to save about two-thirds of the victims from the worst kind of paralysis.

The trouble was, of course, that the virus had not been isolated, or prepared in anything like a pure form. Biologists, indeed, have long argued as to whether a virus is a truly living thing, like a germ, or whether it is just a chemical compound, which happens to cause a particular disease. It has already been said in this book that some viruses, especially those which cause certain diseases of plants, have been made, and have been shown to be chemical compounds, which can be analyzed, identified, and prepared in a pure state.

The polio virus, Jonas Salk knew, had not as yet been made pure in this way. There was, therefore, much doubt as to whether there was one virus or many. It had been shown that it could in some cases be taken into the human body by way of the nose or throat—there was some truth in that work done in the past by those who thought that inhaling infected air might cause the disease to spread—but this was only a very small part of the problem. More often infection came through dirt—especially the dirt which contained some of the waste products from the human body. So a great campaign, telling everyone to wash their hands thoroughly after a visit to the toilet, was considered to be an essential part of any effort to defeat the virus of the disease. This of course, still remains true.

In those years just after the end of the war, then, Dr. Salk, while much of his mind was engaged in the great problem of polio, was working, with his colleague Dr. Francis, on the not very different problem of influenza. The University of Michigan gave him every possible facility for this work; and whatever task he was engaged on he found it interesting and rewarding. But he knew in his heart that he would, in the end, have to leave the influenza virus and concentrate on the far more deadly virus of polio.

He therefore welcomed the opportunity which came in 1947, when he was invited to move once more, and to go to the University of Pittsburgh, where there had been set up a special medical research unit to carry out a three-year investigation of virus diseases, their cause and their cure.

Once more there was the problem of a major move of the home. Once more there was the packing of precious pieces of furniture, and the sale of those which were not so precious. Once more Mrs. Salk had to be prepared to leave surroundings now become familiar, and to settle down in a strange and distant city. She did not grumble or complain; she knew in her heart that the work which her husband was doing was very important work and that it had to take precedence over any personal preferences of her own.

The University of Pittsburgh, whither they were now going, and where they were to remain for many years, was a very impressive place. It was, in fact, far more impressive, as far as its actual buildings were concerned, than any other place in which Dr. Salk had ever worked.

At its center was a vast building, known as the Cathedral of Learning—a 42-story skyscraper which towered above the city. Its classrooms, lecture theaters, and laboratories were on the most modern lines. It was surrounded by grounds (what the American colleges call a “campus”) of more than sixty-four acres. There were some 1,600 students, studying all sorts of subjects—science, arts, medicine, law. And as Dr. Salk made his way there, he thought that he was fortunate indeed to be part of such a vast and powerful team, tackling so many of the difficult questions which still puzzled even the best brains in the world.

The special investigation of virus diseases, which Dr. Salk was now to join, was an effort in which four Universities were to combine in operating—the Universities of Pittsburgh, Utah, Kansas, and South Carolina. It was one of the biggest research tasks that American medicine had ever embarked upon, and it was hoped that it would lead to a far greater understanding of many problems, including that of polio, and that of influenza, with which Salk had been in the main concerned in recent years. The fact that he was selected to be one of the team was an indication that the medical world of the United States now recognized his great ability as a research worker, as well as his wide knowledge of viruses and their lethal work.

In Pittsburgh, which is the central steel-producing town of America, he found himself at first feeling a little unfamiliar, since never before had he lived in a great industrial city. With a population of nearly a million people, it was an impressive town; but there was a different atmosphere, a different outlook from New York or even Detroit, where the industrial area had been cleaner and more apart from the city proper.

Yet the problems of disease, the problems of life and death, are much the same everywhere; and, soon after his arrival, Dr. Salk found himself called in as a consultant on the staff of various hospitals. There was, for example, a Hospital for Contagious Diseases in the city; the patients of this hospital were, naturally, those to whom the results of the study of viruses would be most likely to be of value. Also, if the doctors engaged in this work wanted to study the way in which the various diseases struck down their victims, they had to keep in touch with the hospitals.

The study of viruses was a mighty task, as was obvious from the fact that four great Universities had been called in to take part in it. Jonas was pleased that he was to have with him his old friend Thomas Francis; he was pleased, too that his own group was to concentrate in the main on polio—and especially on the study of the polio virus from the point of view of its possible breaking down into various types—what was technically called the “typing” of the polio virus. In other words, it was necessary, before any possible injection to prevent the disease could be worked out, to discover if it was really one disease or several. If it were found that polio was really one disease, which sometimes struck severely, causing considerable paralysis and sometimes less severely, with very little paralysis, it was necessary to find if there were several strains of it, strains of different strengths, which might need different antibodies, and which might therefore demand different injections.

There was also to be taken into account a very different possibility—the possibility that polio might really be several different diseases, caused by different viruses, but with symptoms so much alike that the diseases had been confused by doctors. In this case the more severe disease might be the one which caused extensive paralysis, but the milder ailment might be the cause of slight paralysis. The complications were very great, and no one really expected that the task of research would be easy, or would produce quick results.

Also, if more than one kind of injection were needed to tackle the problem, it would be advisable to find out if it was within the bounds of possibility to combine two or three different substances in one dose, so that a single injection might succeed in giving protection against all the different strains (or even different diseases) that might be proved to exist.

It will be seen that the task was a difficult one, and sometimes, in his early days in Pittsburgh, Dr. Salk felt almost despairing. On occasion he went along to the hospital (usually to get specimens of blood from patients, or to carry out similar tests on those suffering from the disease). He found the patients almost always cheerful, even when their suffering was great; and, as he talked to the victims of polio, he found his own determination to get to the bottom of the problem becoming stronger and stronger. He knew that, as a rule, the number of victims was small—the proportion of the population of the United States or any other country which might be struck down was not great—but those who had been attacked by the virus needed all the help that could possibly be given to them. Moreover, any research scientist who could cut down the number of possible future sufferers, needed only to see a few of those who had already been attacked, to feel that this was one of the greatest possible tasks that medical science could tackle.

Day by day, then, Dr. Salk set about the work. He tried out some of the chemical remedies which had previously been suggested. He found that, while they might sometimes reduce the strength of the virus, that they never gave anything like complete protection—they did not stop the virus altogether. While they might be useful in preventing paralysis of the worst kind, he soon became firmly convinced that this was not the solution. The solution was to find some substance that would stimulate the body to make its own defenses—in other words, the old theory of the antibodies in the blood seemed to be the best theory to work on. And undoubtedly the work on which he was engaged—the work of trying to divide the polio virus into various types— was that which seemed most likely to produce practical results in a fairly short time.

One of the real problems which he and his colleagues in this work had to face at the beginning was the fact that the virus did not, apparently, grow in the ordinary tissues of the human body. Most diseases either attacked a special part of the body, such as the lungs in tuberculosis—or they spread through the blood, which circulated around the body, as it was pumped by the heart. In both cases the germ or the virus was not difficult to identify, and it was not very difficult to attack it. If it were in a special part of the body, injections could be made at that place; if it were an infection of the blood-stream, some substance that would stimulate the production of the antibodies could be injected into the blood.

Also, if it was necessary to grow the germ or the virus in the laboratory, this had to be done in some solution, usually called a “medium”, in which the germ or the virus would readily multiply. To begin with, when the polio virus was studied, it was found extremely difficult to grow it, since in the body it normally grew and multiplied only in the nerve-tissues, not in the muscles or the bloodstream. This, indeed, was one of the greatest problems faced by the research team set up in 1947—that they found it very difficult to grow the virus in the laboratory.

Polio was a disease which was being widely studied not merely in America, but throughout the civilized world. And it was from another American University—the great and famous University of Harvard—that there came the first hint of how one of Dr. Salk’s greatest problems—the problem of growing the virus in the laboratory—might be solved.

Dr. J. F. Enders of Harvard showed in 1949 that it was possible to cultivate the polio virus, almost in the way in which a gardener cultivates a plant, and not merely in tissues like the nerve tissue of an animal. He had tried all sorts of extracts from various parts of the bodies of animals—mainly monkeys—and for a long time he had found that it was only in the nerves, which were very difficult to get in a pure state, that the virus flourished. If parts of the muscles were used, then the virus gradually died away, and was lost. This, in fact, disproved Sister Kenny’s theory.

But at long last, he found something which gave more satisfactory results, and this was something much easier to work with than the nerve-cells. It was the tissue of the kidneys of monkeys. He found that it was possible to get the virus in the kidneys, and that it then grew and multiplied satisfactorily. Doing this over and over again, and then treating the concentrated form of the virus, Dr. Enders found that he could make a very strong virus, which could later be killed by the familiar chemical called formaldehyde. It was a piece of research which staggered the team at Pittsburgh. Later on, Dr. Enders was to show that this virus, cultivated in the kidney-tissue, could be whipped into a creamy emulsion with certain oils, and that it then became even more potent than it had been previously.

But long before Dr. Enders reached this conclusion, the team at Pittsburgh and elsewhere had taken up his first discovery, which had put a new tool at their disposal.

Now, when Dr. Salk went home at night, his wife could see a new gleam in his eye. She knew, from long experience, when his work was prospering. She would talk to him about all that was going on in the laboratory, and, even before he spoke, she would know that everything was going well.

For, now that it had become so much easier to cause the virus to grow and multiply in the laboratory, the research men found their work producing more satisfactory results.

They went regularly to the hospitals of the city, where polio victims were lying helpless in their beds, and they took samples of blood. They also drew extracts from the spinal cord of the patients, for they knew that it was especially in the spinal cord that the virus was concentrated. And these spinal extracts they used in order to study the virus. They grew virus in tubes, in the kidney-substance now proved to be suitable; and then they studied the way in which these various extracts developed in the presence of various chemicals. Their main task was to see if there were types of polio which could be distinguished from each other. For only when this was clear would the treatment be worked out.

It was a long task, and a tiresome task. Often Dr. Salk came home late; often he came home exhausted. But Mrs. Salk grew more and more certain, by his increasing cheerfulness, even when tired, that the research was producing results.

The monkey-kidney tissue was in fact proving better and better as Dr. Salk and his colleagues grew more accustomed to using it. It became more and more easy to grow the virus, to study its virulence and its strength, to decide to which type it belonged. There were, of course, many difficulties still to be faced; the task was never an easy one—but Dr. Salk and his colleagues had not expected it to be easy. If any task of research had been easy, it would not have had to await the twentieth century before being tackled. It would have been discovered long before.

But the fact that it appeared that three strains of polio virus were now being clearly established was one of the greatest steps forward that had been taken for a very long time. On the day that he became sure that these three types were known, Dr. Salk came home very delighted. He was early, and he had booked seats for himself and his wife at a theatre.

“What’s this for, Jonas?” she asked delightedly. “It’s not a birthday or an anniversary or anything, is it?”

“Never you mind, dear,” he said with a quiet smile. “This is rather a special day, all the same. You’ll know all about it in due course.”

With that she had to be content. She knew that her husband was never very eager to talk about the results of his research before they were quite certain; on the other hand, her past experience suggested to her that he was not usually as delighted as this, in such a happy mood, unless some very special results of his work were within striking distance of being proved.

It would, she was sure, probably be some time before these results—whatever they were—would be published in the medical journals. But all the same she was aware that he was almost certainly now reaching a valuable stage in his work against the polio virus.

The doctor, after the little celebration, went back to the laboratory the next day without any further comment. It was to be some days longer before he confided to his wife what the discovery was. By this time the various tests had been repeated several times, so that there was no doubt that it had not been just an accident the first time.

The real aim which had been put before him when he had been asked to help in this great research team, drawn from several of the American Universities, was now almost complete; but he was not content just to rest on his laurels, though he and his assistants had proved something which had eluded the medical men for some years. It had been some time since there had been a suspicion that polio was a disease that might have a number of types, of different virulence; the work of Dr. Salk and his colleagues had now established the three strains that were known to exist. But the problem that they now faced—and faced quite cheerfully—was how this was to be applied in preventing or curing the disease itself.

It had, in fact, to be remembered that what they had proved to exist was not three separate diseases, but three different strains of the one disease. The virus they had shown to exist in three different forms—and one or more of these forms might be present in any particular case. They had not succeeded in proving a direct connection with water, or with swimming; though it might be that the fact that the virus seemed to flourish in the waste matter from human bodies had some relationship with this, since, in a modem state, some of the sewage and other waste from great cities might leak into lakes and rivers.

So, in addition to the production of a vaccine, there was necessary a great campaign stressing the value of cleanliness among the population as a whole.

CHAPTER FIVE

A GOAL IN SIGHT

So far, though his name had been becoming increasingly well known in medical circles, Dr. Salk was almost unknown to the general public, whether in the United States or abroad. A man engaged in scientific research, though it may be research of the greatest possible importance to humanity, does not as a rule become very well known, unless his discoveries are sensational, and the work that Dr. Salk was doing was not, to begin with, such as to be given a splash in the newspapers. Polio was a disease that “hit the headlines” often enough; but so many supposed preventatives and cures had been featured by the press and had proved in the end to be not as widely applicable as at first thought, that even the most sensational newspapers soon came to see that it would not do to announce a new cure for polio every month or so, only to admit later that it was a very partial cure at best.

Newspapers, therefore, were getting a little chary of saying much about work on polio. Also, the work that goes on in a university laboratory is not, as a rule, the sort of work which can be easily explained to non-scientific readers.

So Dr. Salk’s work on the matter of the types of polio virus which might be thought to exist, while it was followed with increasing interest by his fellow medical men, did not at first have much impact on the general public, or upon the non-medical press.

Even the discovery—the first really concrete discovery by the Pittsburgh team—that there were three strains of polio in existence in the United States did not create much of a stir outside the laboratories and the hospitals of the country. Dr. Salk, tor all the fame that this discovery brought to him among his fellow doctors, was not yet to be anything approaching a national figure. The National Foundation for Infantile Paralysis had made a grant to him and to his various colleagues, which enabled them to get on with the job of research, and up to 1952 this grant was used to carry on the work of pure study of types of polio virus. It was not, as far as any outsider could have told, very practical work; it was just the study of the theory of a disease.

But Dr. Salk knew that only if the theoretical basis was accurate would the practical applications of that theory follow. And as soon as the three strains of virus were really identified, it became possible to discover a vaccine that could be injected with some success.

There was some hope, indeed, in the autumn of 1952, that a vaccine was being perfected. Dr. Salk knew the value of the Harvard work outlined in the previous chapter of this book. He was one of the first researchers to see the value and importance of the monkey-kidney extract in which the virus could be kept alive, as well as the fact that, when desired, the virus could be killed by means of formaldehyde.

It was by this method of treatment that the three strains of polio were identified and separated; thus there were worked out vaccines which could be used to inject human patients in such a way that the necessary antibodies would be developed, the human beings thus creating in their own bodies the substances that would find the disease when it appeared.

Some earlier researchers had tried to inject with a weakened form of polio virus, knowing that this would stimulate the growth of the necessary antibodies. This was true; but, of course, if live virus were injected into a man’s body there was another possibility, and that was that the antibody would not grow in time, and then the injection would succeed only in giving him the disease. What was wanted was something that would stimulate the appearance of the antibody without producing the disease; and this, Dr. Salk thought, might well be the dead virus or a mixture of dead viruses. If the three strains of polio, he told himself, could be somehow brought together and caused to grow in the mouse-kidney or monkey-kidney extract; if, when the virus mixture had reached full strength, it could then be killed by means of formaldehyde, the resultant extract of dead virus would be a vaccine that would stimulate the patient’s blood to create the antibodies which would fight the disease, should it strike.

The idea, of course, was not that this should be used only to treat polio when it had already occurred, but that a large number of people should be injected—especially the younger people who, it seemed, were most prone to the disease. If those most likely to be attacked could be treated in this way, it would mean—or it could mean—that before many years were over polio might be as rare as smallpox. Just, Jonas Salk thought, as Jenner’s work on smallpox had proved vaccination to be effective as a preventative in a large proportion of cases, so an effective vaccine against polio might be made. It was towards this that the Pittsburgh workers were now aiming.

One of the most difficult problems that the team had to face at the start was to decide the exact strength of the formaldehyde solution to be used in killing the virus. If too little was used, then there might be some live virus left, and an injection with this would cause the very disease it was desired to prevent; if too much was used, the protective power of the vaccine would be considerably reduced. Dr. Salk worked on this aspect of the question for many weeks. The monkey-kidney tissue was taken, a strong strain of virus was grown in it; then the virus was killed by a measured quantity of formaldehyde of known strength. After a period of time, the resultant extract was injected into a monkey. If he showed signs of contracting the disease, it meant that the formaldehyde was not strong enough, and some live virus still remained.

The whole process then had to begin again, using slightly stronger formaldehyde.

It was a long and tiresome affair in many ways; Dr. Salk on occasion felt utterly weary of the repetition, time after time, of the routine—growing the virus, adding formaldehyde to kill it, injecting into a healthy monkey, and then waiting to see if the monkey would catch the disease. He knew that no piece of research could be exciting all the time—the popular idea that a scientific research worker sets his mind on a discovery, and then suddenly hits on it by a kind of genius was never true in any field of science. In medical research especially, where human lives depended on the results that might be obtained, slow repetition of every experiment, every test, until there could be no doubt at all about the result, was needed.

His laboratory grew more and more unfamiliar as the the months went by. He had found that monkey-kidney tissue could best be kept in a suitable state to grow the virus if it were kept steadily moving; one of his laboratory assistants—a man with a genius for mechanical inventions— therefore produced an apparatus which would keep a series of bottles constantly rocking, and in these rocking bottles the various samples of tissue were kept.

Polio as a disease was now less mysterious. The fact that it had been shown that the virus existed in three forms made it much easier to understand the way in which it spread. Probably the vast majority of the population who escaped, even in the midst of a polio epidemic, had had a very mild strain at some time—a strain so mild that the attack of the disease had passed unnoticed. But even this mild form had been enough to stimulate the patient to produce the necessary antibodies in his system. And now that the three strains had been proved to exist, the progress of the disease was much easier to follow.

It was, indeed, the proof that polio existed in these different strains of varying strength which had been the original aim of the research. The first real triumph of Dr. Salk and his friends was this proof.

The separation of various kinds of polio virus was, of course, interesting and important; but it remained something only theoretical; and while Dr. Salk, like every scientific thinker, was interested in the theory of his job, he had, in his studies of polio, become more and more aware that theory was not enough by itself. To obtain practical results meant that lives might be saved, and that some hundreds of people every year might be cured of helpless paralysis.

He thought, by the month of April in 1953, that he had produced a vaccine which was reasonably effective against all three common strains of polio then known to exist in the United States. This had been produced in the usual way from the monkey-kidney extract; it had been tested, time after time, on monkeys. The animals, after injection with the vaccine, had then been given a dose of live vaccine strong enough to produce the disease—and the disease had not developed.

But what next? That was the question that Dr. Salk asked himself; in the evenings he would tell his wife what had been going on in the laboratory, and would explain to her what the prospects were. Mrs. Salk was, naturally, fascinated at what was happening; she thought that what her husband was doing was of the greatest possible importance for the health of the world, and she knew that the whole future of this possible way of preventing polio would depend on what happened during the next few months. The vaccine apparently was quite effective in preventing the attack of polio on monkeys; the problem now was how to be sure that it was equally effective against polio when it attacked human beings.

One of the very special problems that arose in this connection was the fact that polio never attacks more than a very small proportion of people. American experts, in fact, calculated that only about twenty people out of every 100,000 would suffer from the disease in any one year, which meant that it was very difficult to decide who had been really protected. Some of the people who might be found not to suffer from it might well be people who would have escaped anyway, quite apart from the injection of any vaccine.

Dr. Francis, Dr. Salk’s old teacher and colleague, who had done a good deal of work on many of these problems, was now at the University of Michigan, where he was Chairman of the Department of Epidemiology, which was studying various diseases that might be found so infectious that they might lead to real epidemics. Jonas had written to him very frequently to tell him what was being done at Pittsburgh, and Dr. Francis had kept in very dose touch, knowing exactly what was hoped for in the way of a really good and satisfactory vaccine.

Dr. Salk had also kept the authorities of the National Foundation for Infantile Paralysis informed as to what was being done. That great charitable body helped the work with substantial grants—for such a piece of research on such a large scale is an expensive business. Various hospitals and government bodies also helped—not merely with money, but with advice and with specimens.

Dr. Salk accepted such help willingly enough; but all the same he had come to see that any really satisfactory piece of research work cannot depend on outside help. It depends on the men who are working in the laboratory.

Yet Mrs. Salk knew, from his increasing cheerfulness during those months in the spring and early summer of 1953, that he was getting near a solution of the problem.

“Happy?” she asked him one evening.

“Fairly happy,” he answered. Such an admission, coming from him, meant a lot, for he very rarely admitted that he had got anywhere near his aim until he was pretty certain that the target had been hit.

“Is the vaccine going to be tried out?” she asked her husband.

“I think so.”

“On a big scale?”

“It’ll have to be on a big scale or not at all,” he said. “You see, Donna, unless we can try it out on a lot of possible patients, we shall never know if they are really getting full protection or not.”

“And you think that it will be tried out on a lot of patients?”

“I think so.”

“How many?”

He grinned. “There is talk of several hundred thousand patients being given a shot.”

“Gracious! That means a whole lot of vaccine,” she said in some surprise.

“Sure does,” Jonas agreed.

“How much of your injection does it take for each dose?” Donna asked.

“About one cubic centimeter for each shot of vaccine,” her husband explained. “We think that they may have to have two shots each—and it may even be necessary for there to be a third one.”

“But even if it’s only one c.c. each,” his wife said, “that will mean that you will have to have the stuff made in more or less commercial quantities. I mean, you and your friends at the laboratory can’t make enough of the stuff to treat hundreds of thousands of people.”

He roared with laughter. “Did you think that we should be surrounded by rocking bottles?” he asked. “Did you think that we should be working all day and all night, making the stuff?”

“Well, I rather wondered how it was going to be made, if you were going to have a trial on that scale,” she admitted with a smile.

Dr. Salk explained what was being worked out. Five of the biggest chemical manufacturing firms in the United States had been approached by the government, which had now come to see that the work which was being done by Dr. Salk was very valuable work indeed. These firms had agreed that, if their staff could be taught the way to make the vaccine, they would make substantial quantities—quantities big enough to enable it to be tried out in a really big way.

The scheme took a long time to plan. First of all, Dr. Salk or one of his principal assistants had to visit the factories of the firms who were to make large quantities of the monkey-tissue vaccine that was to be used. The members of the staffs of these firms were all expert in their own way, but this was not to say that they necessarily knew all about the manufacture of a completely new substance. For a period, Mrs. Salk and the boys saw less of him than they had done for years. He was traveling by train or airplane to the various places in which what was now becoming known as the “Salk vaccine” was to be made. It was not easy to explain exactly how it was to be done; the correct strains of virus had to be added at the right moment; temperature had to be carefully controlled; all sorts of factors had to be watched with the utmost care. For this was no slap-happy experiment which, if it failed, could be ignored, and the contents of a wasted test-tube poured down the laboratory sink. This was to be a great test of a vaccine which might save human lives; if anything went wrong with its early stages those lives might be wasted.

While all these preliminary tests were going on, Dr. Salk was in a sense holding his breath. He was sure in his mind that what he was doing was right; he was certain that the vaccine which he was now teaching many men to make was the vaccine which would give a very large measure of protection against polio.

But no research scientist can be quite sure that something which works in the laboratory will be as effective when it is tried out on a large scale outside the laboratory walls. There are all kinds of things that are difficult to allow for. If some new factor came into the picture, he was very much aware that there might be trouble ahead.

There were only too many people who thought that he had, perhaps, already claimed too much for his vaccine— though this had, even thus early, been more a matter of what the papers said about it than what he might say about it himself.

He was not yet forty years old—very young, indeed, for a medical researcher to make his name. There were some people who rather distrusted a young man; they would rather, they said, have the health of the nation in the hands of more experienced men than in the hands of this doctor, whose main work had been done, not in the wards of the great hospitals of the nation, but in the experimental laboratories. That, too, was more than a little unfair; it altogether ignored the early work that Dr. Salk had done; it ignored his period at the Mount Sinai Hospital; it even ignored the fact that in Pittsburgh he had spent considerable periods of time in various hospitals, especially in the Isolation Hospital where patients suffering from polio, as well as other infectious diseases, were being treated.

Dr. Salk’s face was, in fact, familiar to many patients in Pittsburgh. It was soon to become familiar to thousands throughout the country, and throughout the world.

He did not really approve of all this; he had the caution of the true scientist, and he was not keen to claim too much too soon. Also he continued, through the period when he was becoming more and more widely known, to cling to the idea that the work was what mattered, the man doing the research of less importance.

Yet the fact remains that he had now succeeded in proving that polio was one disease, though due to three different strains of virus of varying virulence; he had also produced the vaccine which he hoped would succeed in protecting suffering humanity from all the strains of the disease. The work was important, he knew, in that it seemed to have produced something which would stimulate the bodies of human beings to fight the invading virus. It was this that the forthcoming trials might be expected to prove.

CHAPTER SIX

FIRST TRIAL

Now there came what was perhaps the most exciting part of Dr. Salk’s life. If his wife and children had seen little of him in recent months, when he was traveling around the country, visiting various chemical manufacturers, they now saw less of him than ever. This was not because he was so much away from Pittsburgh, but because he was working such long hours in the laboratory that he was at home only to eat and sleep.

He did not distrust the various firms who were making the vaccine; their workers were, he knew, highly skilled people. But since so much depended on the outcome of the mass trial that was to be carried out, he felt that every sample of vaccine would have to be personally tested, either by himself or by one of his trusted assistants.

The number of children who were to be vaccinated were to be as many as 400,000—which meant a really huge program of manufacture and vaccination. This large number was necessary, as has already been shown, since few of the population would get polio in any case, and only a very big trial would bring worthwhile results.

Dr. Francis, who had considerable mathematical ability, was given the task of assessing the test. It was, in fact, a purely mathematical task. The point was that if, of 400,000 children injected, only some 10 got the disease, and that in a mild form, without any real paralysis, that would mean that there was a considerable measure of protection, since if 400,000 children were chosen at random from the population it would be likely that about 80 would get the disease in a year.

The ordinary people tend to mistrust working with figures in this way; many people, in fact, say that you can more or less prove anything you like by juggling with figures; but scientists know that it is possible to use such figures sensibly, and to show that a particular sort of medical treatment, like injection with the Salk vaccine, is really valuable.

If only 100 or 200 cases had been used as a basis for the trial, it would not be at all certain that the results were accurate, because with a small number there might be things which happened as a matter of pure accident. But with such a large number as 400,000 it was hoped that these accidents might cancel each other out.

In other words, if there happened to be a small epidemic of a particularly nasty sort of polio in one district, this would be canceled out by another district where there was no epidemic at all. Taken as a whole, therefore, it seemed likely that the figures could not lie, and that Dr. Francis’s careful assessment of the results would prove whether or not the vaccine really did give some kind of protection.

It was exciting for Dr. Salk; it was also an anxious time. He felt fairly certain in his own mind that the vaccine really did protect against the onset of the disease; but it had been tried out only on monkeys, and then in quite small numbers. To try it out on a large number of school-children was the decisive thing—and he knew that it would probably be months before the final results were available.

Day by day, however, he hid his anxiety and his excitement; day by day he went to the laboratory, carried on with the ordinary routine testing of the samples of vaccine that came in from the chemical firms who were making the large quantities to be used.

He found that the tests were satisfactory in practically every case; the manufacturers and their staffs had learned well just how the vaccine was to be made. His visits to their works had been justified. If at the time he had found much of this a tiresome business of traveling long distances, he now knew that it was something very much worth while.

Then the vaccinations began. To begin with, Dr. Salk had instructed a number of medical men in the actual technique of the vaccination. It was not really necessary to tell the doctors much, for the vaccine could be used in much the same way as any injection. But, in order that there should be no doubt and no mistake, it was thought advisable that those who should administer the Salk vaccine should be told, by Dr. Salk, or by someone who had worked with him in the early stages, just how it was to be applied.

The dose was very small—only one cubic centimeter—and the giving of the injection caused no pain. It was quite a simple process; now and then Dr. Salk would go to one of the hospitals or clinics where the trial of his vaccine was being held. He would see the cheerful children lining up to have what they now had come to call a “shot” of the vaccine; if he found a child who was a little scared or worried, he would have a chat with him or her, would produce a bar of chocolate from his pocket and the trouble would be over.

Such an affair as this naturally was given much prominence in the papers, and on radio and television. Millions of people throughout the country were aware that this was one of the most important experiments that had ever been carried out in the whole history of medicine.

Dr. Salk’s friendly face became familiar to newspaper readers. One day, when he was attending a medical conference discussing epidemic diseases, he felt utterly weary, and took an hour off to have a swim in the lake. As he walked down the beach he overheard two small boys arguing.

“That’s Dr. Salk,” said one boy, pointing at the doctor as he walked past on his way down to the water.

“Dr. Salk?”

“Yes.”

“How do you know?”

“I saw him on television the other night,” said the first boy.

“That’s not Dr. Salk,” retorted the second.

It is.

The second boy snorted sarcastically. “What would Dr. Salk be doing in a bathing suit?” he asked. Then he went on: “Anyhow, he’s much too young to be Dr. Salk.”

Jonas Salk smiled to himself and walked down to the edge of the water.

On another occasion, he was out in his car, taking his son Peter on one of those excursions which had become rarer as the trials went on. The car radio was switched on, and a news bulletin interrupted the quiet music. One of the items concerned the progress of the polio trials, and Jonas Salk’s name, naturally enough, was mentioned in the course of the news item.

Peter looked up at his father. “Golly, dad,” he said, “I’m glad I’m plain me, instead of famous like you . . . and bothered.”

That made Dr. Salk think for a while. He was, indeed, sometimes bothered at the slow progress of the trials of his vaccine; but he thought that he had managed to conceal his anxiety from the members of his own family.

Yet it was, after all, natural for him to feel some worry at what was happening; for the whole future of the kind of medical research work which he had now been doing for some years really depended on the outcome of these tests. If they failed, he felt that he would never again spend long hard hours in the laboratory; for he had staked his whole reputation on the way in which the tests would go.

He knew, moreover, that if this test did prove successful, that he would probably have to face a whole host of trying times. He had already more than once consented to speak on the radio and to face the television cameras in order to play his part in reassuring those who might feel anxious about allowing their children to take part in this great experiment. He wanted to make clear to everyone that what was being proposed was not to give children a “shot” of a weakened form of virus, but to give them some virus which had already been killed. It could not hurt them, and the medical authorities of the country felt fairly certain that it would do them good, it would help to protect them against the onset of the disease.

That was what he was always keen to stress, whether he was talking to a journalist, or talking direct to the public.

Mrs. Salk sometimes felt anxious about him at this time. He was only forty years of age—very young for a man to make a major discovery in medicine—and she felt, often, that he looked older. His face was sometimes white and drawn; on occasions, when they had gone to bed, she would be conscious that he was not sleeping as soundly as usual. The development of the polio trials was worrying him—and yet there was nothing that he could do to hurry things on.

Every scientific research worker knows the strain of waiting for results—especially when the results are not forthcoming speedily. Dr. Francis had warned him one day that these results would not come quickly.

“How long will it take?” Dr. Salk asked him.

“How long before the vaccinations will be finished?” Dr. Francis asked in return.

“Two or three weeks—maybe a month,” Salk answered.

“Well, we shan’t get anything certain until February or March next year.”

Dr. Salk groaned. “As long as that?”

“We have got to allow a certain amount of time to pass. We can’t be sure on this sort of work with figures, until we’ve given the virus time. I reckon we shall be pretty lucky if we get any results that really mean anything until then.”

“Can’t you give me any sort of preliminary figures a bit earlier?” pleaded Salk.

“Well—yes,” admitted his friend.

“When?”

“I should think, actually, that we shall be pretty sure by the end of October or the beginning of November,” Dr. Francis said. “After all, you know as well as I do that polio for the most part strikes in the hot weather. Most of the cases that occur in our 400,000 will have shown themselves by then. But we’ve got to give them a good deal longer before we can make anything public. You never know— there might be a winter epidemic that would throw all our figures out. It’s not likely—in fact, it’s fantastically unlikely; but we can’t take any sort of chance.”

With that Dr. Salk had to be content. Never, in all his life, had days gone so slowly as those days of the summer of 1954. The actual vaccination went according to program. It was not long before he had the news that 430,000 children had all received their shot of vaccine. Now all that they had to do was to sit back and wait for the results to come in. But the waiting, as Dr. Salk thought, was the most difficult part of the whole affair.

The reports went to Dr. Francis. If any of their selected 430,000 caught polio, the details of the attack—if mild or severe—were at once sent in. Dr. Salk, naturally, got copies of these reports, and sometimes it was with a very trembling hand that he opened a letter from a hospital.

Perhaps, he told himself, the little girl to whom he had given a bar of chocolate had caught the disease; perhaps that rather tearful small boy who had taken such a lot of comforting was now lying, helpless, on a hospital bed. It was all very worrying; he had, of course, known that there would be some cases of the disease, even among those who had been vaccinated, and it was only Dr. Francis, with his graphs and his mathematical tables, who could be sure of what the figures really meant.

By this time Dr. Salk had been put in charge of the Virus Laboratory of the University of Pittsburgh; under him there were a number of able younger men, whose work he had to direct and supervise. But the day-to-day routine of the laboratory got more and more difficult to continue as the results of the huge trial of the vaccine trickled in.

Now and then an enterprising reporter from some newspaper would call at the laboratory, and ask if he could see Dr. Salk. If he managed to penetrate into the director’s sanctum, his request always was: “How are the tests going?”

And Salk’s answer always was: “No comment. I can’t tell you anything yet. We have got to wait until the full figures are available.”

Even the high authorities of the National Foundation for Infantile Paralysis, which had paid for the large quantities of vaccine used in the trial, could not be given much information in the early stages. It was not thought good to build up their expectations too high, in case early success was followed by later failure. On the other hand, if there were a number of cases in the early weeks, this was quite possibly a false picture, since some of the children given shots of vaccine might have already been sickening from the disease, and the vaccination might have been too late to prevent the virus from getting a hold on them.

Then, one day in October, Dr. Francis called. He had come especially to see Dr. Salk and to tell him the results of the preliminary findings.

“Well?” Jonas asked eagerly. “Well? What news?”

“Good news.”

“You mean the vaccine works?”

“As far as I can tell, it works. The number of cases among the 430,000 is considerably less than one would have expected, if one had taken a group quite by chance from all the school-children of this country. It’s not a hundred per cent, certain; there have been some cases, as you know; but I should say that it gives protection to three-quarters of the children. Maybe more. You can say, indeed, that there is seventy-five to ninety per cent, protection.”

Dr. Salk fairly beamed. This was good news indeed. “Can we make this public, do you think?”

Dr. Francis shook his head decisively. “No,” he replied. “You see, we can’t be dead sure until next March or April, as I told you. We don’t often get many cases in the winter months—but we haven’t got any guarantee that cases won’t occur between now and the spring. I think that we might perhaps tell the people at the Foundation—they should, after all, know that the preliminary figures seem to be favorable; but they should be sworn to secrecy. If we announce that this is a success, and then a lot of cases come along in the next few months, we should look precious fools, shouldn’t we?”

Dr. Salk saw the point. But in his own mind he was now quite sure. As Dr. Francis had said, the chance of any real epidemic in the winter months was very small. If most of the injected children had escaped in the hot months of the Pittsburgh summer, it was unlikely that they would catch the disease between October or November and March or April.

In any case, he knew the danger of too early publicity. When he had first reported to a scientific conference on his early work on the vaccine, a journalist had got some information, and rather exaggerated the progress that had been made up to that time. The paper had, in fact, come out with big headlines: “New Polio Vaccine—Big Hopes Seen”—and Dr. Salk had gone on the radio and on television to warn the public that too much hope should not be placed on it at this early stage.

He did not want any repetition of this now. He agreed that nothing should be said in public for some months.

But Mrs. Salk knew. When he came home that evening, his cheerful face told her.

“All right?” she asked.

“All right,” he agreed. And nothing more was said. She knew that his anxieties were over, and that the value of his vaccine was established. She had, indeed, great difficulty in restraining herself from saying anything about the matter to friends and neighbors; but she realized that it would be foolish to spread any news until it was made public.

Some of her husband’s colleagues had been occasionally critical of him before, when he had spoken on the radio or before the television cameras, in his effort to undo the work of that over-enthusiastic pressman. One scientist had even said to him, in rather sarcastic tones: “Well, Jonas, the only time I see you now is on television.”

She knew how he had hated that sort of remark; and she was resolved to give no one an opportunity of saying that kind of thing this time. So she kept quiet, told no one that the tests were almost certainly successful, and was content that he was now sleeping well and that the worst of his anxieties were over for the time.

But Dr. Francis had suggested that they should tell the Foundation Members that the tests seemed to prove some degree of protection. After all, the Foundation had provided the large sum of money that was necessary to launch the trial, and it was only fair that they should be given what information was available.

They were told, but sworn to secrecy. That was understandable. Dr. Francis explained that, while he was sure in his own mind about the result, he did not want any premature disclosure of the information. The members readily agreed.

But Jonas rejoiced when he heard that the Foundation, in November, 1954, had ordered twenty-five million cubic centimeters of the vaccine from six different chemical companies. If they had this amount of confidence in his work, he himself could have no doubt.

It was not easy, in those exciting days, to keep all these things quiet. Mrs. Salk, of course, now knew that success was within sight and so did the members of the National Foundation, from Basil O’Connor downwards. But the general public, in spite of their intense curiosity as to the way in which the tests had gone, were not to be allowed even to guess what was happening.

One or two papers—by a process of intelligent guesswork —hinted that the medical authorities were more than happy at the progress of the great trial of the Salk vaccine; but when, following this, a reporter called at the Virus Laboratory to ask Jonas Salk what results had as yet been obtained, he was met with a blank stare and the quiet “No comment."

The success of the vaccine was not something that could be quietly disclosed to a newspaper reporter, to be then blazoned forth in big headlines to the world. It was something that would have to be officially announced at a great meeting or conference. No doubt a press conference would have to follow, when the reporters would be allowed to ask as many questions as they liked. But to disclose it prematurely would be very wrong—of that he was quite sure.

His nervousness about the result had gone, however. He knew that Dr. Francis was still working on the figures; and as copies of hospital reports lay on his own desk day by day, Jonas found that his own certainty grew, if that were possible, more and more certain.

They had agreed that any large number of cases in the winter months were very unlikely; and he saw, as the reports from the hospitals came in, that the number of new cases, which had declined during October and November, faded away almost to none at all during December and January. The winter was not a time when polio was very much in evidence. It seemed that the virus did not flourish in the colder weather—and this year was proving just the same as previous years in this matter. Dr. Salk smiled to himself when he picked up the official reports that accumulated on his desk day by day. He was a happy man in 1954.

CHAPTER SEVEN

FAME!

From the day in November 1954, when Dr. Salk heard of the Foundation’s decision to order twenty-five million shots of his vaccine, he had no doubt. Any new cases of Infantile Paralysis (as the disease was still called in some quarters) were notified; they had to be added. The occasional case which had been wrongly reported had to be subtracted. But, by and large, the figures, as Francis had announced them in October 1954, remained accurate in April 1955.

It was on April 12th, 1955, that the results were made public, at a conference called at Ann Arbor, Michigan. Dr. Francis, who had by this time made himself the complete master of the long and complicated series of figures which had accumulated over the months, announced that there was, in his opinion, no doubt at all about the results.

The announcement made by Dr. Francis was about as dramatic as it well could be. It stated that the Salk vaccine had been proved to be effective as a safeguard against infection with polio. Vaccinated children had sometimes caught the disease; but the number of cases, as compared with those who had not been vaccinated, were considerably less—indeed, Dr. Francis was able to say with complete confidence that the vaccine gave from sixty to ninety per cent, protection. That really amounted to saying that of a hundred children who would have caught polio without the vaccine, only forty at most (and possibly only as few as ten) would catch it after vaccination. It was a triumphant proof of the value of the work which Jonas Salk had been doing over the years.

As soon as the announcement had been made to the gathering of scientists and medical experts, there was held a press conference, at which newspaper men could question Dr. Francis and Dr. Salk on the work that had been done. Also present was Mr. Basil O’Connor, President of the National Foundation for Infantile Paralysis, whose gift of money had made the long task of research possible.

The press conference was a trying business for Dr. Salk, who still felt much more at home in the privacy of his laboratory than he did facing a battery of newsreel cameras and a crowd of reporters from newspapers. Yet he knew that this was justified. Only by making the discovery well known would it be possible to get as many children as possible treated with his vaccine; only by seeking publicity would a big campaign for vaccination against polio be made practicable.

Dr. Francis, in describing the scene afterwards, said that it was like a minor earthquake; but one of the pressmen present said that he would not have used the word “minor” in this connection. It was a sensation, and almost in a matter of hours the name of Jonas Salk became famous throughout the land.

A Hollywood film company asked his permission to make a film based on his life and his work as a doctor. This request Dr. Salk turned down, almost without a second thought. Soon the letters began pouring in—thousands of them—from polio victims, congratulating him on what he had done to prevent the disease striking down the younger generation as it had the generation now middle-aged. Universities offered him honorary degrees.

Some of these honors he was proud to accept; that which gave him most pleasure was when his old college, City College, New York, expressed its desire to make him a Doctor of Laws.

One evening in June 1955, this degree was conferred on him. The whole thing was done in a typically quiet and informal way. Dr. Salk walked slowly into the office of the University President. The old student was dressed in a dark suit, white shirt and dark tie—nothing showy about his appearance. He found assembled there many of the most eminent men of the college, some of the older ones men whom he remembered as tutors and lecturers from his student days.

As a special touch of kindness, which he appreciated, his father and mother had been invited to attend. And the first thing that he did, after shaking hands with the President and other leading members of the University staff, was to walk over and kiss his parents. Then he allowed himself to be dressed in the cap and gown of the new degree.

One friend who was present on that occasion has told how embarrassed the new graduate looked, in his cap and gown, as he was asked to pose for the newspaper photographers who wanted to take pictures of him. He even winked at a friend, as if to say that a lot of the fuss that was being made of him was unnecessary.

His father, proud of the way in which his son had made himself famous, said to his neighbor, sitting beside him and applauding: “We have to be content with only a glimpse of Jonas these days.”

One of the officials of the college, who remembered him as a student, said: “Well, Jonas, ten years ago you wouldn’t have believed you could handle fame so well.”

Jonas Salk smiled gravely and answered: “Ten years ago I wouldn’t have believed that anything like this could happen.”

He had, once more, newspaper reporters to face; but he was now getting accustomed to the problem of answering the questions of the pressmen.

One newspaper-man said: “I hear you’re trying to find a vaccine that will prevent colds. Is that so?”

Jones said: “All I’m trying to do is to keep my balance.” It was as they were leaving the President’s office, on their way to a private dinner which the College was giving in his honor, that Dr. Salk made a statement, recorded by a journalist, which is perhaps the best definition of his feelings, as a scientific researcher, that he has ever expressed.

One of the ladies who was attending the dinner asked him if he didn’t feel rather like a writer who has published a very successful first book—afraid that he had now reached the top, and that he would never be able to do anything as good again.

Dr. Salk thought this over for a moment before he replied. Then he said solemnly: “I don’t want to go from one crest to another. Science isn’t like novel-writing. To a scientist fame is neither an end or even a means to an end. Do you remember,” he asked her, “what Emerson once said? ‘ The reward of a thing well done is to have done it.’”

The lady was obviously puzzled by this answer. She thought it impossible that any man could be quite so unmoved by having suddenly become famous. She said: “Don’t tell me your head hasn’t been turned by all this.” Dr. Salk answered: “You know, you remind me of the farmer who saw a giraffe for the first time, and said:

‘There ain’t no such animal.’”

There were present at this gathering some representatives from the French Embassy in New York. They, too, had a part to play in the evening’s proceedings. As the party broke up, fairly late, Dr. Salk said to one of his many friends who had been present during the evening: “Say, do you know why those Frenchmen were here? They made me a Chevalier of the Legion of honor. That was very nice of them, wasn’t it?”

He soon learned that his previous idea of the perils and the difficulties of fame was entirely justified. He wanted, not to celebrate publicly the value of his vaccine against polio, but to be allowed to go on with his study of the viruses; to use the knowledge and experience which he had gained in order to apply it, perhaps, to other diseases, or perhaps to understand even more about polio, and to improve his vaccine, so that instead of ninety per cent, protection it would give a hundred per cent.

He found himself subjected to so many requests, snowed under with so many letters, that it took the utmost determination to devote himself to the direction of the laboratory. But he was not prepared to sit back and rest on his laurels. He read the medical journals, paying special attention to what was being done in the way of virus research. He read what vaccines had been tried out in other countries, heard that the British Government, which had seen vaccines developed by the medical men of the British Isles, was soon to embark on a big campaign to persuade young people to have protection against polio.

The British campaign, he realized, was not as flamboyant as the American one; but the aim was the same. He did not know in full detail just how the British vaccine had been prepared; but he was ready enough to give British medical men the credit for having produced a vaccine that might be as effective in its way as his own.

He never thought of himself as an inventor, a patentee of something out of which money could be made. True, he had for a time worked on a vaccine against the common cold, with the idea that, if it could be made, it might perhaps be marketed by one of the great chemical companies. But if this were possible with a vaccine against colds it certainly could not be applied to a vaccine to deal with a killing disease like polio.

A reporter asked him, at this time, who owned the patent of the Salk Anti-Polio Vaccine. For a moment Dr. Salk looked at him in astonishment. Then he said: “The patent is owned by the people!” And, as an after-thought, he added: “Could you patent the sun?” The cost of the trials did not worry him; though it was reported that the National Foundation had spent, all told, some seven-and-a-half million dollars on the experiment.

Not long after the original trials, a member of the U.S. Senate introduced a bill to grant Dr. Salk an annual salary, from the government, of ten thousand dollars a year, so that he would be free from any sort of anxiety about his future, and so that he would be able to spend his time on whatever line of study seemed to him most likely to lead to results.

This, again, was immensely gratifying; there can be few research scientists who have received such a public gift. But Dr. Salk said that if it were granted, he would not spend it on himself; he would devote it all to covering the expenses of whatever research task he might undertake in the future.

He accepted such things not as a tribute to himself, but as a tribute to the value of medical research; and when he was invited to be the guest of honor at a great banquet, or to perform the opening ceremony at a new wing of a hospital, or to carry out any of those honorary tasks that great men are often asked to do, he always refused. His job was the job of studying disease; and he was not prepared to use his fame to get into a high social position—which never interested him very much, anyway.

But there was one invitation which he could not refuse. It came from the White House, the official residence of the President of the United States, and it requested Dr. Salk to come and see the President. Mrs. Salk and the boys were also included in the invitation.

They went, of course. President Eisenhower took them around the beautiful gardens of the White House, showed them sights which few Americans have had the opportunity of seeing, and then he congratulated Dr. Salk on the fine work which he had done. Dr. Salk himself described his feelings, not long afterwards.

“There we stood,” he said, “my wife, my three boys and myself, in the rose garden of the White House while the President congratulated me. I thought to myself, ‘What am I doing here?’ I’d been told beforehand to confine my reply to just a straight ‘Thank you,’ but I couldn’t do it. I felt I had to acknowledge my associates and all those others who had made the vaccine possible. So I said what I felt.”

No doubt President Eisenhower thought all the more of Dr. Salk, because the doctor was not prepared to take all the credit for himself, but wanted to share it with those who had helped him.

As for Dr. Salk himself, he was more pleased in that his wife and his boys could share the occasion with him. They did not seem to be greatly impressed at the time; they were polite with the President, naturally enough, and they found Mr. Eisenhower very pleasant to them. But when the boys were playing about that evening, their father heard one remark from Peter, then aged eleven, which showed him that they had really been far more impressed than they had dared to admit at the time.

Peter suddenly stopped in his game, and said, seriously: “My goodness—I met the President today!”

Certainly as far as Dr. Salk was concerned, it had been a really meteoric rise to fame. In 1952 he had been a comparatively unknown research man in a university laboratory. Three years later his was a famous name and he had received the congratulations of the President. In the whole history of scientific and medical research, there can be few men who have risen so suddenly from quietness and obscurity to the peak of popular fame.

Many a lesser man would have been so impressed by the fuss that was made about him that it would have gone to his head. Not so with Jonas Salk. Always he continued to stress, as in his interview with President Eisenhower, that he was one of a team; that he could not have produced the vaccine without the help of a host of assistants, in his own laboratory, in the research departments of other universities and colleges, and in the laboratories of the various chemical firms who had been associated with the manufacture of the vaccine on a large scale.

He was given every opportunity of asserting his own importance in the medical world; but none of these opportunities were taken. “It’s beautiful,” he once said, “to see how it has worked out. This is fine.” But he would never take all the credit to himself, as many a lesser man would have tried to do. He was always aware that scientific research in the twentieth century was a team business, tackled by a group of men working together—not a matter only of one supreme genius with a special insight into the way in which nature works. Yet Dr. Salk’s own energy and his enthusiasm went far to carry his colleagues with him, in those difficult days when the success of the vaccine seemed to be in the balance.

Even when he had been a comparatively junior research man, at New York University and at the Mount Sinai Hospital, his enthusiasm was obvious to everyone who knew him—and as he began to climb the ladder of fame, taking more and more of the lead as his knowledge grew greater, this energy was more and more to be seen; now, even the President acknowledged the value of the work that Dr. Salk had done.

CHAPTER EIGHT

THE WORK GROWS

In the United States, as in other countries, any vaccine to be injected into human beings is very carefully inspected. Before it can be sold commercially, it has to be licensed by the Government’s Secretary for Health.

Five firms had been engaged in making the vaccine for the test; and on the same day that the Official report was released, Mr. Hobbey, the Secretary for Health, granted licenses to these five firms with an additional one, to make the vaccine in large quantities for delivery to the hospitals and doctors of the country.

It was a sensible move, therefore, that the National Foundation had made in ordering the firms to go ahead some five months before. The National Foundation had been quite sure, from the preliminary reports, that the vaccine would be successful, but they had taken a chance in placing such a huge order—for as much as twenty-five million shots of the vaccine. If by any chance the report had been adverse, or even if it had stated that the results were a little doubtful, the huge quantities of vaccine would have been wasted, and the Foundation would have had to find the very large sum of money to pay for it.

As it was, however, about 650,000 cubic centimeters of the vaccine had already been made, at the time that the license for public sale was issued by the Government. No licenses, of course, had been needed for the vaccine used in the 1954 trials, since it was a purely experimental affair, and it had not been sold for general use in the hospitals or in the surgeries of the doctors.

Dr. Salk and his staff had separately tested each batch of the experimental vaccine. But this was now becoming too big a job for any university department to handle.

If shots of vaccine were to be sold by the million, to be used by doctors and hospitals, it was too much to expect a small group of research men in a laboratory to test it all— they would be spending all their available time carrying out routine tests which could be done just as well by comparatively unskilled people. Moreover, these men would be neglecting tasks which only they could do.

Dr. Salk made it quite clear to the authorities that the methods of testing the vaccine were not difficult, when once they had been mastered, and that it would be quite easy for a group of scientists in the laboratories of each of the firms making the stuff to do their own testing. The great point was that the virus should be allowed to reach a certain strength—that it should not be killed too soon—and that it should then be killed by the addition of a sufficient amount of formaldehyde. It was most important, he stressed, that the virus should be completely killed before the vaccine was used—otherwise there was a danger that, instead of protecting against polio, the disease might be given in an active form.

The firms which had been given licenses to make the vaccine were widely scattered through the country. Two of them had factories in Pennsylvania, one in California, two in Indianapolis, and one in Michigan. Quite apart from the time spent in testing, the fact that they were so scattered over the country made it advisable that each of the firms concerned should train their own testing staff.

The tests were, of course, regularly reported to the Health Department of the Government, but it was thought that the testing staff, most of whom had been drilled by the original research team headed by Dr. Salk, would be perfectly satisfactory and entirely adequate for the tasks that were given to them.

There was one incident, however, which worried Dr. Salk considerably, almost as soon as the vaccine began to be used publicly. This was that a number of children who had been vaccinated by one batch of vaccine showed signs of developing the disease.

The night that news of the first of these cases came in to him, he came home very worried.

“What’s the matter, dear?” his wife asked.

“One or two cases of polio among vaccinated children,” he murmured. “Can’t think how it happened.”

“Surely they might have had the disease before they had a shot of vaccine,” Mrs. Salk suggested.

“It could be,” he agreed. “But I wonder, I wonder...” His voice trailed off into nothing as he thought over what had happened.

His anxiety was abundantly justified the next day, when reports of further cases of polio came from the same area where the first cases had been reported the day before. Dr. Salk had no doubt of the value of his vaccine, but it seemed that in this area something had gone wrong—and he had little doubt in his own mind as to what it was.

Someone had blundered in the laboratory of one maker of this vaccine! He was sure that that was the explanation, and he at once put in a long-distance telephone call to the hospital from which there had come the reports of polio, apparently following injection with the vaccine. They supplied him with details of the manufacturer, and of the date on which that particular batch of vaccine had been received. It was like detective work trying to track down the particular batch of vaccine that was causing the trouble. He suggested to the hospital that they should stop using vaccine for a few days while the matter was being investigated, and that they should at once fly him a sample of the particular batch that seemed to be causing the trouble.

When this arrived a few hours later, Dr. Salk set to work on it. He injected a large quantity into one of the monkeys still kept for experimental purposes; then he waited. It was, as always, a tedious job waiting; but he knew that, even if that sample of vaccine contained the active virus, it would be a few days before the disease showed itself.

But show itself it did. Dr. Salk was much distressed. Someone had made a bad mistake. The vaccine was not as bad as a pure virus extract, such as was used at the beginning of the experimental work; but there was some active virus left, and it seemed that this had given the disease to a few of those children who were injected with it—probably those who were specially liable to catch the disease.

There was only one thing to do. This could not be hushed up, even if he had wished to do it. It must be faced. In any case, the papers had already reported the occurrence of cases of polio among vaccinated children; and some pressmen had hinted that there was doubt as to whether the campaign for vaccination with the Salk vaccine had not been pushed too hard and too fast; that it might be an unsafe treatment, that it might even give the disease to children who would otherwise escape it. Some of the things said in the newspapers were very unfair; but Dr. Salk understood the public anxiety about the disease, and he knew that this would somehow have to be allayed.

A public statement was therefore issued. This stated what had happened; it pointed out that, owing to an error on the part of a comparatively inexperienced laboratory assistant who had been testing on behalf of one of the six makers, a small amount of vaccine had been released which still contained some live virus. There was only one batch which had thus been released; its use had now been stopped; there was no danger in the remainder.

Dr. Salk also made a full report of what he had discovered about the faulty batch of vaccine. This he took to the Secretary for Health. He strongly advised that in future, instead of trusting the manufacturers to test their own vaccine before selling it, every lot of vaccine should be tested by the Public Health Service before it was released for use. This was accordingly done. It was perhaps unfair to the manufacturers—they had for the most part done their testing perfectly well—but it was better to be unfair to them than to allow the public to lose confidence in the vaccine. So from the end of April 1955, none of the Salk vaccine was allowed to be used without being tested by the Public Health Service—and the government made the tests very much stricter than they had been when the makers had been testing their own products. From that time on, indeed, there was no trouble at all with the Salk vaccine.

Mrs. Salk no longer saw her husband come home with that look of worry in his eyes. She rejoiced that at long last his preventative seemed to be well established in public confidence; she was sure that in doing this he had done something that would be remembered in medical history for a very long time to come.

Dr. Salk was now trying to improve his vaccine. The original one was to be given in two or three doses, with a further, so-called “booster” dose some months later, in order to provide certain protection; and he knew that this would probably mean that many children would not get the protection that should be given to them. Their parents might, perhaps, move away after the first dose had been given, and might not bother to get in touch with a hospital or a doctor at their new home; or some people might just be unintelligent about the whole thing, might think that one dose would do, and would dismiss the talk about the need for a second, and the advisability of a third dose as just doctors’ talk.

Dr. Salk, while he no longer had any direct responsibility for the vast program of anti-polio vaccination that was now going on in the United States, naturally took a very great interest in it all, and studied reports that came in almost every day about what was being done in various parts of the country.

To begin with, the real problem was to get enough vaccine to meet the demand. The government had to decide just what was to be done in the way of limiting the use of the vaccine to those who were most in need of the protection that it could give. The original name of the disease of polio—Infantile Paralysis—suggested that it was mainly a disease that attacked very young children. This was to some extent true, in that more children than adults caught it, and that it usually caused much worse paralysis in young children than in grown-ups. But, as has already been said, it was by no means unknown among grown-up people; and there were cases of grown-ups who were severely paralyzed after an attack.

If it were therefore known that a sample of vaccine could be bought at any chemist’s shop; if any doctor or any hospital could be paid a suitable fee, and would then carry out the injection process on anyone paying that fee, there would be a danger that the vaccine would go to the rich—even to the elderly rich, who were not really likely to catch the disease in any case. And poor children, crowded into the tenements of Chicago or New York, might not be able to get protection against polio, either because their parents did not bother to find out if the vaccine was any good, or because there was just not enough money to pay for the treatment.

Almost all the vaccine went, first of all, to the National Foundation for Infantile Paralysis, the body which had largely financed the work of research in Pittsburgh, and elsewhere, which had led to the original discovery of the vaccine. That was as it should be, Dr. Salk was sure. Such a body would not be influenced by the money which anyone was prepared to pay for protection; poor people would be able to be vaccinated as easily as rich ones.

The National Foundation, as soon as the vaccine had been released for general use, embarked on a great publicity campaign for vaccination of school-children. The vaccine was, they said, to be used as it became available, and first of all for the youngest children in the schools—children from five to nine years of age. After the demands of the Foundation had been met, the government said, the commercial selling of vaccine could start. But it was clear that for some time there would not be enough vaccine to meet the demand for it.

One problem, which might have caused trouble, was that the National Foundation was a charitable body; the government of the United States had no legal right to give such a body priority in buying any medical product, yet everyone saw that the Foundation possessed the best means of making sure that the vaccine went where it was most needed; and if it could be given the right of buying all the vaccine it wanted, before any commercial concern came into the picture at all, Dr. Salk’s original idea of giving protection against polio to all the children of the nation would be best carried out.

It might have been thought necessary to introduce a special law, putting the distribution of the vaccine in the hands of the National Foundation; but when the Secretary for Health thought this over, in conjunction with many legal and medical experts, he came to the conclusion that no new law was really needed. All the makers who had been granted licenses to make the vaccine had solemnly promised that they would allow the vaccine to go only to those recommended by the government. At the end of April 1955, the Secretary for Health had appointed a committee called the National Advisory Committee on Poliomyelitis Vaccine (on which Jonas Salk served); and it was decided that this committee should be given the task of working with the National Foundation and the firms manufacturing the vaccine, so that it might be sure that the vaccine produced should go where it would be most valuable.

Dr. Salk rejoiced that the whole thing was being so well organized. He no longer had any direct interest in it; but all his life he knew this would be his special study. As he read articles in the papers about the progress of polio vaccination, he felt a very proud man that so much was coming from the hard work which he had done over the years in Pittsburgh.

By the end of July 1955—only three months or so after Dr. Francis’s favorable report—more than eleven million shots of the vaccine had been made. On that day, the Department of Health issued a statement, showing that the voluntary issuing of vaccine had gone quite smoothly, without any hitch or any hold-up. Every new batch of vaccine that came along, they said, would in future be allocated to that part of the United States which had the largest proportion, among its population, of children between five and nine years of age. The separated States of the United States could make their own arrangements as to how the vaccine delivered to them could be used—how much through hospitals and clinics, and how much through doctors in private practice who could then use it on their own patients. By this means the Secretary for Health thought it would be sure that the vaccine was spread over the United States in a fair way, so that no district and no group of people got an unfair share of something which was still in very short supply.

Dr. Salk had always realized that there were certain difficulties in the way of a big campaign of this sort. For one thing, it was an expensive business, and even the National Foundation had not got unlimited money at its disposal. The actual giving of the injections cost money—it meant that doctors had to give up their time to it, and in some cases that special rooms or buildings had to be rented for the program to be carried out.

There can be few men in the history of medicine who are in a direct sense responsible for a special law being passed by the Parliament of their country. Yet there can be no doubt that Dr. Salk was the real parent of the law which called itself The Poliomyelitis Vaccination Assistance Act, which Congress passed in 1955. This made it possible for the federal government of the United States to make grants in money to the individual states which wanted to start a scheme for polio vaccination of people under twenty years old. It put in the hands of the Surgeon-General of the United States (who was, in a sense, the head of all the medical services of the country) the right to make money grants to States which proposed to start a polio vaccination scheme. The amount of money would depend on the income of the state, and would also depend on the number of unvaccinated people in the age-group who lived in that state. Grants could also be made to states towards the cost of planning a vaccination campaign. It was agreed that if the individual states used money granted in this way to buy vaccine for their citizens, it could be used only for the age-groups thought to be those most needing vaccination—that is to say, young people. The vaccine could not be given to anyone outside those groups; and the Surgeon-General could lay down which groups were to get it first.

The United States has always been a country which very much values the freedom of ordinary men and women and Dr. Salk, in common with a lot of other people, was surprised that there was no criticism of the government’s taking such a firm line on this matter of anti-polio vaccine. At any rate, the Poliomyelitis Vaccination Assistance Act became law in the United States on August 12, 1955—only four months after the Salk vaccine was approved. It was originally intended to be in operation for less than a year—expiring on February 15, 1956, though later Congress extended it to June 30, 1957. It was hoped that by this time there would be enough vaccine available to make these controls on its use no longer necessary.

The size of the movement which Dr. Salk’s discovery had started off can be seen by the fact that the Act allotted over fifty million dollars—it was estimated that this would provide enough vaccine for over a third of the younger people in the United States.

In any case, the Public Health Service did not buy any of the vaccine at once. In the early stages most of it was being sent to hospitals and doctors by the National Foundation. But in September 1955, the first purchases of vaccine by the government took place.

Dr. Salk was justified, now, in his confidence in the vaccine. The government was buying it, recommending it, and sending it where it was most needed.

This was really all that he desired. The National Foundation had put its trust in the great research group which had worked on the polio problem. That trust had been in no way displaced—indeed the nation-wide use of the vaccine was now proving, as nothing else could have proved, that the research work done by Dr. Salk and others had been soundly based. If a hundred per cent, protection was not yet available, it was in sight—and to bring within measurable distance was something of an achievement. It was, indeed, an achievement which few medical men, all through the long ages since medicine became a science, could claim to have rivaled.

And so an experiment—admittedly a vast experiment, but an experiment nonetheless—had become reality. From the vaccination of a small number of animals in a research laboratory to the vaccination of nearly half-a-million school children in that great experiment may have seemed a tremendous step in the dark—but it was not really in the dark. And when Dr. Francis’s work on the results of the experimental vaccinations had been made known, the extension of the injections, so that all young children in the country could benefit by Dr. Salk’s discovery, was a very simple and obvious step to follow. The fears that the United States had known, from those far-off days when the terrified population of some of the cities had struggled to get on already crowded trains, so that they could escape the mysterious infection that was paralyzing so many of their fellow-citizens—those fears had now gone. It was to be hoped that they had gone for ever.

Occasionally, now, Dr. Salk would glance at one of these old articles in the medical journals of the past—articles explaining the spread of polio in some now forgotten epidemic. The articles were written by doctors who seemed, sometimes, to be at the end of their tether, faced as they so often were by the spread of a disease which they did not know how to bring under control.

It might be that Dr. Salk underestimated, on occasion, the personal contribution to the vaccine which he himself had made; it might be that he stressed too strongly the teamwork which had gone towards the preparation of the vaccine; but, as he read those reports of the past epidemics of polio, which had so alarmed both the public and the medical authorities, there could be no doubt at all in his mind that the years from 1952 to 1956 had brought a new hope to the minds of many millions of people.

People in all lands had read of this disease of polio, of the helpless paralysis that it had inflicted on a proportion of its victims—and those people had been afraid, not so often for themselves as for their children. That the new vaccine would ease that fear from the minds of many was one of Dr. Salk’s greatest achievements, for its widespread use would mean that fewer and fewer children would suffer paralysis as the years went by—and that fewer and fewer parents would have in the back of their minds the fear that their children might be attacked by the disease.

CHAPTER NINE

VACCINATING THE MILLIONS

Every scientific researcher knows that there comes a point when the work that he has done suddenly seems to bring exciting rewards. At one time, it seems, he is struggling to convince an unwilling world of the value of what he has done—and then, in a very short time, when the importance of his work has been proved, the world accepts it with delight, and applies it more and more widely. Other countries, including Great Britain, began to inquire about the Salk vaccine which was so famous in America.

A number of British medical research workers had been carrying out studies of polio not very different from the work Dr. Salk had been doing in the United States. Sometimes they had results, and sometimes there was disappointment and failure, just as had been the case with the Americans. There were false trails which had been followed to the bitter end, only to prove wrong. Then, when a particular vaccine had been found useless, the men concerned had to go back to the beginning and start again.

Moreover, the British Government, acting on the advice of the many brilliant doctors of the Medical Research Council, realized that this was a matter which every doctor wanted, but that it was also a matter where very great precautions had to be taken. This meant that the most stringent tests had to be insisted on (even when a satisfactory vaccine was found), in order that there should be no danger of the injections producing the very disease that it was intended to prevent.

There were British doctors, as there had been American ones, who had thought that a weakened form of live vaccine might be the best way of preventing the spread of polio; but in Britain, as in the United States, this was soon discovered to be unsafe and dangerous. In the end a vaccine much like that of Dr. Salk’s was produced, and a campaign of inoculation with this vaccine was started. Owing in the main to the strict tests and precautions on which the British Government had rightly insisted, this vaccine was immediately available only in small quantities (the technique of producing it in bulk had not advanced as far or as fast in Great Britain as in America), and its use was restricted to the very young children who were the most tragic victims of polio.

There was a campaign, organized and supported by the Government, for the treatment of young children with the strictly limited amounts of vaccine that were available; and doctors all over the country pressed the use of this vaccine on all parents of children within the age-groups which were entitled to a share.

Dr. Salk was pleased when he read of these things. He knew that his own vaccine was effective; but he did not necessarily think that he was the only medical man in the world capable of producing a strain which would be effective against the disease.

In Great Britain, however, there was soon some pressure on the Ministry of Health to provide more injections than were at first available. It was suggested in the newspapers that it should quickly be possible to have at least enough to provide everyone up to the age of twenty-one with the safeguard that injection could bring. Medical men and the more thoughtful members of the public had come to see that, even though older people sometimes caught the disease, the vast majority of the cases came from those under twenty-one years of age. The government knew that this demand was sensible; yet they were not inclined to relax the tests which were applied to every batch of vaccine made, or to take the slightest risk with the serum that was being used.

In the end, however, it was decided that the British authorities would get in touch with the medical authorities of the United States, and see if Salk vaccine was available for export to Britain, so that the limited amounts available in Great Britain could be rapidly increased.

Some of the more sensational British papers had, however, made much of the accident in the preparation of Salk vaccine which had occurred in its early days, when one batch containing live virus had escaped detection. The fact that the American authorities had now stepped up their tests, so that there was virtually no danger of this accident being repeated, was not known to the British public as a whole. There was, therefore, some prejudice against the polio “jabs” from America; and many people were very reluctant to allow their children to have Salk vaccine; they said that they would rather wait until enough British vaccine was available.

It was therefore stated that those who wished their children to have this protection against the disease would have the opportunity of saying, in their applications, whether they were prepared to take whatever vaccine was available; or whether they wanted to wait until they were quite sure that British-produced vaccine, with all the tests that the British Ministry of Health still insisted on, that would be used.

This was, in actual fact, a rather unjustified slur on the American process of testing; but it was a prejudice which remained in the minds of many British people.

Large quantities of Salk vaccine were, in fact, used in Britain; in the end the British authorities produced more and more of their own; and gradually the age of those entitled to polio protection was raised. At the beginning of i960 the age-limit had been raised to forty, which meant that practically the whole of the population which was in any way likely to contract the disease had been given the opportunity of protection against it.

By this time Dr. Salk’s fame had spread more and more. By now he did not mind appearing on a radio or television program, if he thought that such an appearance would help to encourage people to get vaccinated against polio. He felt that if everyone knew something about the medical discoveries of the age, they would be more likely to take advantage of them, and more likely to benefit in health from all that he and other medical research workers had been doing. On the other hand, he was sure that medicine was not something that could be used just to make money.

He was, indeed, always a man not overwhelmingly interested in money. He wanted enough to keep himself and his family in reasonable comfort. He wanted enough to see his boys educated. That, in fact, was his main personal ambition.

Above all, he wanted to get back to the daily routine of work in his laboratory. “It’s not a question of modesty,” he once said to a newspaper reporter. “I want to clean up this vaccine job and then get on with other things.”

Some American newspaper men found this desire to get on with his job, not bothering about what the public thought of him, very strange and very difficult to understand. The United States, in modern times, had become the home of publicity. The American public had become used to reading all about any of the figures which loom large in the news.

A film star, or a best-selling novelist, is often featured in the American press with full details of what he eats, what he wears, and what kind of game of golf or tennis he plays. His wife will be photographed in the kitchen, his children playing in the garden—and these pictures will then appear in papers that are read by many millions of people.

Dr. Salk never wanted any of this. His private life, he would say, was his own affair; and he was very reluctant to talk about the work he was doing. Reporters would ask him is he had some important new discovery to give to the medical world; he would grin, and say: “No comment.”

Once a journalist asked him why he would not talk about tilings that he was engaged upon, why he would give no hint of the research that he was going to do.

He explained: “The scientist isn’t a politician, and he isn’t a propagandist. He observes and classifies facts, and then he reaches conclusions on the basis of the data at his disposal. He must avoid being influenced by the pressures on him, or even by the bias of his hypotheses.”

The New York Times article, in which that statement by Dr. Salk was quoted, went on to say: “If Salk the scientist sounds austere, Salk the man is a person of great warmth and tremendous enthusiasm.”

Still, in spite of his enthusiasms, he never gave way to the American publicity drive. “Why do they want to know what I have for breakfast?” he once asked in a rather irritable way, when a number of newspaper men had been talking to him quietly, after a scientific conference.

Yet he could have no doubt about the value of his discovery. When the vaccination program had been in operation for a year—from April 1955 to April 1956—it was found that the paralytic form of polio had been reduced very much. Indeed, the American Public Health Service reported that by 1957, when more and more of the vaccine had been distributed, the number of cases of polio, which had been 14,647 in 1956, had fallen to 5,894. The record number of cases, in 1955, when the vaccination program was only just beginning, had been 28,985.

Basil O’Connor, President of the National Foundation, had become a close friend of Dr. Salk through the years; and when he found that he was turning down all sorts of invitations to dinners and conferences, O’Connor wondered if Dr. Salk was not rather overdoing this business of being the aloof scientist. “It’s a problem,” Mr. O Connor once said, “educating a fellow like that, who has lived in the dark of his laboratory for twenty years.”

Dr. Salk said, thinking of these many invitations to social affairs of one sort and another: “Most of this belongs to the category of mink coats and Cadillac cars—it’s unnecessary.”

From that few people could make him move. Although the number now vaccinated could be counted in millions, he thought that it was still unnecessary to make any fuss about the man who had started all this off.

His vaccine was now not merely a national thing; it was fast becoming internationally known. As early as August 1955, the American Government had announced that it would allow the vaccine to be exported to such countries as needed it badly, if those countries would work out their own schemes, under the control of their own governments; and by 1958, when most of the States of the U.S.A. had sufficient vaccine, the government announced that supplies of the vaccine could now be exported through the ordinary commercial channels, so that any country which wanted supplies could buy them in the open market.

By the beginning of 1959 more than ninety countries had been supplied with vaccine. In Great Britain the Ministry of Health, which had started its campaign for vaccination with a slightly different vaccine produced in Great Britain, had imported two million doses of Salk vaccine to add to the limited supplies produced in Britain.

Before this, one of the largest shipments ever sent abroad went to Budapest, to be given to Hungarian children. This load—over three tons of it—was flown across the Atlantic in specially chartered airplanes. This was in February 1958; in October of that same year three million doses were flown to Poland, where a bad epidemic of polio was striking down many Polish children.

Yet the man whose work had started all tills remained unaffected by his fame, and reluctant, as has been said, to play any great part in public social life.

There was, however, a desire to mark his achievements in some way. The United States is not like Great Britain, where no doubt a knighthood or a peerage would have been conferred on such a man. But on January 26, 1956, Dr. Marion Folsom, who was then American Secretary for Health, carried out a ceremony which most Americans thought justified. This was the presentation to Dr. Salk of a gold medal from the nation, as a mark of its great appreciation of what he had done.

It was an impressive ceremony. President Eisenhower wrote to Dr. Salk on this occasion: “Through dedicated and selfless effort, in the best traditions of medical research, you have brought new hope to mankind in the continuing battle against a dread disease. … I am confident that the entire nation joins me in lasting gratitude and appreciation.”

When the number of people who have received doses of the vaccine be remembered, this statement of the President’s appears only just. By the end of 1955—only seven or eight months after the vaccine had been approved—about eleven million children had received doses. Soon the age-limit was extended up to fifteen years of age, and by the end of 1956 most of these—over fifty million people in all—had been vaccinated. Then the age was stepped up further—to the age of twenty, and it was calculated that this would make sixty-five million people available for a dose or more.

The size of the program would have appalled many people; the task was not easy; but gradually it was carried out. From that unassuming beginning in the Pittsburgh laboratories, only a few short years before, the idea of Jonas Salk had spread. Now it covered almost the entire wide network of the American people, and many people abroad.

Now the World Health Organization set up a special study-group to see what was going on in countries all over the world. As Dr. Salk sat down at his desk, day by day, he would find reports from many countries, put together by the Organization, stating the value of his vaccine. Canada used it and praised it; Denmark, South Africa, Germany, France, Sweden—and in every case they reported that the number of cases of polio had decreased steadily as more and more of the children had their shots of Salk vaccine. In some countries it was a small experimental group that was vaccinated; but this, Dr. Salk felt, was as it should be. The scientist never takes results for granted, until he has tested them for himself; and in countries where the Salk vaccine was only something read about, it was natural that they wanted to try it out for themselves before embarking on any big campaign of vaccination in their own countries. Yet, as is clear from the way in which such countries as Hungary and Poland took the vaccine, medical men in many lands have little doubt about its value.

As early as October 1955 Dr. Salk announced that he was hoping to increase the strength of the vaccine, so as to make it even more effective. Laboratory tests were going on, he said, with various new preparations that seemed to be even more effective than his original vaccine had been. “It is not a new vaccine,” he said emphatically. “Our prime purpose is to make the vaccine a hundred per cent, effective. To reach that goal it will be necessary to conduct a series of experiments similar to the studies on dosage.”

He read with interest the work that was going on elsewhere along somewhat different lines from his own. He had always thought that the only satisfactory vaccine was one that was made from dead virus, killed by the use of formaldehyde. There were, however, many doctors who thought that the virus could be so weakened that it would not give the disease, but that it could be injected, and that it would stimulate the blood to produce the antibodies more quickly and in greater quantity than would be possible with any dead virus extract. Dr. Hilary Koprowski of the Lederle Laboratories was working on these lines; so was Dr. Albert Sabin of the University of Cincinnati. Both these men had been interested in the fact that the vast majority of people did not seem to be liable to get polio, which meant that they had acquired a natural immunity from the disease. That is to say, they had in their blood enough of the antibodies to make sure that the disease would not be able to get a hold.

It was suggested (as has been said earlier in this book) that this might be due to the fact that those people not liable to polio had suffered a very mild attack of the disease and had not known it. But the very mild attack had been enough to cause the antibodies to be made in their blood. The doctors who were thinking on these lines tried if they could find a strain of polio which might mean no more than a headache or a cold, but which would nonetheless mean that the paralytic form of polio could not afterwards attack.

Their work Dr. Salk found interesting; but he was not by any means convinced that it was workable and practical. He still felt that there was some danger if live virus—even live virus of a fairly mild form—were given. He recalled the error that had been made in the early work with his own vaccine, when live virus had been found in one batch; and he was convinced that only the dead virus was safe. In studying such a disease as polio, safety was the first need; and that he had a safe method which gave a very great measure of protection was, he thought, something which was worth a lot.

By 1958 and 1959 the need for safety precautions had been forgotten by many people; but Dr. Salk had not forgotten. He remembered the sort of day which he had sometimes spent in 1955. He would often leave Pittsburgh then to catch the midnight train to Washington. Then there would be a series of conferences and committees at the Institute of Health, starting at half-past nine in the morning and going on for hours. Perhaps a conference with some of the vaccine manufacturers, a meeting with Basil O’Connor or other officials of the National Foundation (which might mean flying from Washington to New York), and then back to Washington again to give evidence before some Congress Committee. Then a hurried journey back to Pittsburgh, after a breathless two or three days away, to try to pick up the threads of the investigation that was going on in his own laboratory.

That had been his life in those exciting days of 1955; and Dr. Salk’s greatest struggle in 1958 and 1959 was to keep himself, somehow, from falling into that endless routine of conferences and meetings.

He refused to be the propagandist; his job, he insisted over and over again, was the role of research scientist, trying to solve some of the problems of nature and trying to see how to attack some disease at its very source.

Indeed, by 1958, while he and his assistants were working to improve the polio vaccine, he was thinking about other problems. Polio, after all, though a disease which might bring terrifying results, was a disease which attacked only a tiny minority of the people. To solve the puzzle of polio was a great triumph but there were other diseases which Dr. Salk longed to do something about, and they were, for the most part, diseases which attacked far more people.

He often thought about rheumatism, for instance—that disease the cause of which is so little understood, but which causes so much pain and suffering. In rheumatism there are tiny crystals of a substance called uric acid which are in the muscles, or even in the joints of the human body. These crystals cause pain, which gradually increases as the patient gets older. It was known not to be a killing disease; no one dies of rheumatism. For that reason many doctors simply did not bother unduly about it, thinking that rheumatism was just one of the ailments from which human being had always suffered, and always would suffer.

Dr. Salk was not convinced of this. He wondered if it might be in some way possible to discover a vaccine that would deal with the pains of rheumatism, perhaps stop the uric acid from making its appearance. He did not know; but it was a problem about which he often thought.

And then there was the greatest killing disease of all-cancer. This was a disease in which one part of the body seems to run riot, a mass of cells forming at some place in the body where they should not be. What was the cause of this? Would it be possible to develop a vaccine which would protect the human race against cancer, as the Salk vaccine was protecting it against polio? This, again, was one of the things about which Dr. Salk would dream.

He would come home at night and tell his wife of the ideas that had come to him. Many of them, he knew, he would probably never see through to the end—but only a few years before everyone would have said that it was impossible to work out a protective vaccine against polio. With all these new things that doctors now could use, who could say where it would end?

It was early in 1958 that a preliminary statement was issued from the University of Pittsburgh regarding the work that was going on in this task of studying cancer. Dr. Salk had long suspected that there was some very complicated relationship between the normal cells of the human body—cells that do all the tasks of living, from sight to digestion—and the cells that cause the growth of a cancer. He worked out a new way of studying the growth of cells—for cells can grow, even when they are removed from the body of which they are a part. And this new method, it was stated, enabled workers in a laboratory to do some of the routine tasks about a hundred times faster than they had ever done them before.

It was not a new discovery; but it was a new method of working, what scientists would call a new technique; and it enabled Dr. Salk to hold out at any rate some hope that the nature of the disease of cancer might, before many years were over, be better understood. If it were better understood, there was then more chance that it might be prevented or cured.

Again he was on his old track, of seeing if it was possible to make the human organism create antibodies which would fight the cancer cells.

Dr Salk was very careful to point out that this was only a very early report, and that he was nowhere near a solution of the problem of cancer. But those who read the report they cheered. If the man who had produced a vaccine that was so often effective in protecting people against polio was now concerned with cancer, might he not, in a few years, produce a vaccine that would give at any rate partial protection against cancer too?

It is not easy, as is being done in this book, to describe the life-work of a scientific researcher while that work is still going on. The discoveries that may come out of Dr. Salk’s laboratory are impossible to forecast, but it is sure that the work that is done there will always be directed to one end—to solving the mysteries of disease, and to protecting humanity against the worst illnesses that may strike.

The future of preventive medicine is, indeed, something that concerns everyone in the mid-twentieth century. Doctors have found how to cure many diseases; but now that they have turned to prevention instead of cure (as Dr. Salk was soon to stress on his first visit to Great Britain) a new era of health may be opening.

Others had shown how tuberculosis, one of the great scourges of humanity, could be stamped out. There were still many diseases which were worrying mankind, and it was (as will be seen in the next chapter) to these that Dr. Salk and his colleagues were inclined to turn, in the years 1958 and 1959. The Salk vaccine against polio was now firmly established; would there soon be corresponding Salk vaccines against other equally deadly diseases? As to that, it is impossible at the moment to say; but it is sure that the special genius of Jonas Salk is such that he will never be content in any way to rest on his laurels.

CHAPTER TEN

GREAT MAN ACCEPTED

By 1959 Dr. Salk’s position was such that he was accepted as a great man. Officially his position was “Professor of Experimental Medicine and Director of the Research Laboratory, School of Medicine, University of Pittsburgh”, and that was a post of considerable responsibility. It was also a position which led many people to look up to him with great respect and admiration. He might still be young; he might still look young; but all the same, the fact remained that this young man now occupied one of the highest positions in the world of American medicine.

He had often been asked to go abroad, to tell the doctors of other lands of what he had done in the world of virus research, to encourage workers in other countries—and even possibly to give them a hint of where this work might lead in the future. For a long time Dr. Salk resisted this pressure; he felt that it was an attempt to build him up in the eyes of the world, whereas he thought of himself as still a very fortunate student of the nature of disease.

In early 1959, however, he started on an overseas tour. He had been prevailed upon to put his knowledge at the disposal of workers doing work not unlike his own. He visited Great Britain first, where his arrival attracted much attention. The trip had been timed to coincide with the Health Congress of the Royal Society of Health, being held from April 27 to May 1 at the beautiful Yorkshire town of Harrogate.

Perhaps he thought, as he traveled from London to Yorkshire, of the fact that it was only just over four years since the results of that first exciting series of tests had been announced. The years from 1955 to 1959 had been stirring years for Dr. Salk, years which had gone far to justify the hard work that he had put in, at first almost without anyone outside a small circle knowing anything about it.

Lord Cohen, a leading British medical man, was President of the Royal Society of Health. The first action of the Congress, after Dr. Salk’s arrival, was to present to him on behalf of the Society a Scroll of Honorary Fellowship. Then he spoke.

The lecture which Dr. Salk had been asked to give was largely a technical one, as was to be expected from the audience to whom it was addressed. Its title was: “Vaccination Against Poliomyelitis: An Ounce of Prevention.” He gave, first of all, an outline of the work that had been done in Pittsburgh, and then made clear what his title suggested—that an ounce of prevention was worth more than a pound of cure. It was this which had been the flaw in Sister Kenny’s work; she almost certainly helped those who had suffered from the disease; but it was even more important, after all, to make sure that the disease should not strike. If one could do that, there would be little doubt that massage, heat, and all the other things which had been used to reduce the paralysis that resulted from an attack of polio would be less and less needed, as time went on.

This lecture was delivered to a packed audience. On the next day Dr. Salk went to the nearby University of Leeds, where the Vice-Chancellor, Sir Charles Morris, awarded to him the degree of Doctor of Science. It was a much more formal occasion than in New York, when he had been given a degree. There was no press conference this time; Dr. Salk was accepted as a great man who did the University an honor by taking its degree.

It was an impressive gathering, with all the senior staff of the University present in their many-colored hoods and gowns. Dr. Salk was very touched at the warmth of his welcome, and at the loud applause which greeted his acceptance of the degree which was being conferred upon him.

He was not, however, to have an easy time during his eight days in the British Isles. It was on Saturday, May 2, that Leeds University had made him a Doctor of Science; on Tuesday, May 5, he was in London to give another lecture—even more technical than that at Harrogate—at the National Institute for Medical Research. This time his subject was: “Is the Control of Poliomyelitis by a Killed Virus Vaccine an Unreasonable Expectation?” It was a subject after his own heart. The use of a killed virus—not a weakened live one—had been the main principle of all the work that he had been doing for years; and now, before an audience consisting almost entirely of medical research men, he was given the chance of explaining his reasons and describing the work that had gone on.

It was, in a sense, the highlight of his rapid tour of Great Britain; and there was discussion after the lecture—discussion in which many of the leading doctors of England took part, discussion when those who had developed a British vaccine were able to say what they had done. Medical Officers of Health of cities where polio epidemics had been brought under control added their piece to the talk. And when the evening was over, Jonas Salk thought that it was one of the most satisfying evenings of his life. The fact that here he was not just idolized as a great man, but talked to by men who were trying in their way to do work very like that on which he had spent so many laborious years—that was what made the evening so memorable for him.

His time in England, however, came to an end all too soon. He was not prepared to be away from his laboratory too long, even though his friends had persuaded him that it was his duty to put his knowledge at the disposal of medical experts in many countries.

When he left England he went to other countries—Holland, where again he spoke about the work that he had been doing in Pittsburgh; then to the Scandinavian countries of Sweden and Denmark. Then there was a long airplane journey south to Italy, where, once more, he was greeted as one of the leading medical authorities of the century.

He found all this interesting—and yet sometimes rather embarrassing. Some of those who sang his praises at these lectures were men old enough to be his father—men who had been practicing medicine before he was born; and he found it not at all easy to accept praise from such men, whose experience, he told himself, was so much wider and deeper than his own. Yet their words were clearly sincere. He had inspired their respect by the work that he had done and when they met this cheerful American, they grew to like him as a person, quite apart from the distinction which his work had brought his way.

After his European tour, he went for a short visit to Israel, the new State which had been set up to house the Jews who wanted to make their own nation. There, too, he was greeted warmly and affectionately. His lectures were listened to with great interest and close attention, for polio was not a disease which attacked only one part of the world. As has already been seen, the Salk vaccine was in use all over the world, and in many countries his solution of the polio problem was attracting attention and study.

So when Dr. Salk returned to his home, he was more than ever aware that what he had done was a priceless gift to the human race. His modesty was not affected; he knew well enough that what he had done was valuable; but he did not think that the work on which he had spent so much time was of any use in building up his own reputation. Indeed, his own reputation was of very little interest to him. What mattered was the growth of what is called preventive medicine.

In such a mood Dr. Salk went back to his office, back to his laboratory bench. He now had at his disposal wonderful resources of equipment and apparatus. He had many skilled and devoted helpers, only too delighted to have the opportunity of working with a man whose name had become a household word to millions of people in many countries.

And there he must be left. This book is only what commercial writers would call “an interim report” on what Dr. Salk had done up to the middle of 1959.  Born in 1914, Dr. Salk, at the age of forty-five, has many years of active life ahead of him, years which he will use, it is quite certain, to good effect. Just where his researches will lead in the future no one can say. He has considered, as has already been made clear, many of the greatest medical problems—cancer, rheumatism, and other diseases. Whether he will have with these anything approaching the success which he has achieved with polio it is, of course, quite impossible to say.

His polio vaccine has been proved; of that there can be no doubt. It does not give a hundred per cent, protection— indeed, he is working to improve its efficiency. As time goes by, he will no doubt achieve that improvement. It is necessary at present to have several shots of the vaccine;

that may be made unnecessary as the technique improves. It may in the course of time become possible for one injection to provide the complete protection at which all medical research men have been aiming. That, too, is something about which we cannot be certain as yet—it will have to wait; and waiting is not always easy in a field where lives depend on the solution of a difficult problem.

But, whether Dr. Salk and his gifted staff ever achieve that end of a hundred per cent, protection or not—whether they are able to extend the work on polio to the other diseases, like rheumatism or cancer—these things do not have any effect, really, on the value of the work which has already been done. If Dr. Salk did nothing more, his place in the history of American medicine, and the medicine of the world, would be certain.

The task of the ordinary doctor is to fight disease when it shows itself. That is a very important task, and a task which all of us know to be very important. When a person falls ill, and the doctor is called in, only the anxious members of the sick person’s household can know how important the doctor is, and how much his work is valued.

But even more important and even more valuable than the doctor who deals with illness when it shows itself is the medical research worker who tries to stop the illness from coming at all. Prevention rather than cure is to be increasingly the aim of medicine in the years that he ahead. For if an illness can be prevented, not merely is there to be taken into consideration the fact that much pain and anxiety will be prevented—pain to the patient and anxiety to his family—but also much loss of work, which, in the end, means loss of the good things of this world to all.

Dr. Salk has worked, as has been described, not merely to find a polio vaccine (though that is one of the main matters with which his name will always be associated), but also to find a vaccine which will prevent influenza and the ordinary, common cold.

The virus of influenza, the virus of the common cold—they may well be more difficult to deal with, more complex, than the virus of polio. For that reason there has not, as yet, been such spectacular success with them. They are not as urgent, they are not as difficult from the point of view of treatment, as polio; but they are important, nonetheless, in that they cause the working people of the world to lose millions of working days every year.

So there is plenty of scope for Jonas Salk and his colleagues in the days ahead. The work will be valuable, and it will be varied. From the common cold and influenza, to rheumatism and cancer—disease still plagues humanity, and there are not wanting men to decide how those diseases can best be treated. “The Polio Man,” Jonas Salk has been called in this book; it may be that if the book were written, not in 1959, but in 1979, he would be called “The Rheumatism Man” or “The Cancer Man”,

But whatever be his final title to fame, there can be no doubt that Dr. Jonas Salk will merit President Eisenhower’s compliment and his good wishes. “I am confident, wrote the President, “that the entire nation joins me in lasting gratitude and appreciation . . . and in best wishes for many years of continued service.”

Those are sentiments which every reader of this book will wish to echo.

 Study Guide

1. In Chapter 1, how did the authorities try to stop the spread of polio during the 1916 outbreaks in Brooklyn, New York, and Philadelphia, Pennsylvania? What do you think of their strategy today? Is it legal today? Is it moral in your opinion?

2. In Chapter 2, Salk learned that Dr. Kolmer’s approach had promise. Why was Kolmer’s work much safer than injecting a live virus into a human? Do any of today’s Covid vaccines use Kolmer’s approach?

3. In Chapter 3 you will see Dr. Salk and his colleagues at the University of Michigan work on a vaccine for influenza. How could a single vaccine protect against multiple strains or types of influenza that might be circulating during a winter?

4. Why in Chapter 4, did Salk and the other researchers at the University of Pittsburgh work so hard to find out if polio was one strain or multiple strains? In other words, was polio caused by one virus, or by multiple viruses causing similar symptoms?

5. In Chapter 4, you will see that Salk believed that the old theory of antibodies would be the solution to polio. How do antibodies created by infections work? How do antibodies in vaccines work?

6. In Chapter 4, why was the contribution of Dr. J. F. Enders of Harvard University so important? You can easily do research on microbes such as yeast cells in your high school biology lab. Why is research on viruses more difficult?

7. This is a question beyond the immediate scope of this book. It would require additional research. Compare the financial support for the polio vaccine with support of the Covid vaccines. What factors may have accelerated the development of today’s Covid vaccines?

8. Chapter 7 discusses the efficacy or potency of the vaccine used in the first large-scale polio vaccine trail. What level of protection did it give the children in the trial? Compare the efficacy of that vaccine with the three Covid vaccines used in the United States in 2021.

9. In Chapter 8 what caused the faulty batch of vaccine which caused polio in some children? What was Salk’s response to the incident?

10. Another question requiring research beyond the scope of this book: the Salk killed virus vaccine is no longer used in the United States. Why was it replaced? What was the process that led to the replacement of the Salk killed virus vaccine? Which organization or organizations is monitoring the efficacy of vaccines in the United States?

For Students and Teachers

You will see on our web site that many of our ebooks are free. All the ebooks below are available on Amazon. For the ebooks still in copyright which are not free, we offer very inexpensive district-wide, school-wide, and classroom-wide licenses. Please call us with questions about  licenses for concurrent use by all your students in a building or school district at 202-464-9126.

(Samples of all the ebooks below are available on Amazon.)

Young Adult Books
(with Flesch-Kincaid Grade Level)

Flight to Freedom-The Story of the Underground Railroad

by Henrietta Buckmaster (4.7)

Revolt on the Amistad 

by Emma Gelders Sterne (5.1)

Patrick Henry: Firebrand of the Revolution

by Nardi Campion (5.6)

Benito Juarez-Builder of a Nation

by Emma Gelders Sterne (6.3)

Juarez-Hero of Mexico

by Nina Brown Baker (6.0)

Malcolm X: Another Side of the Movement

by Mark Davies (6.1)

Mary McLeod Bethune

by Emma Gelders Sterne. (7.6)

The Life of W.E.B. Du Bois: His Was the Voice

by Emma Gelders Sterne (6.5)

Michael Faraday

by Harry Sootin (6.4)

He Wouldn't be King: The Story of Simon Bolivar

by Nina Brown Baker (6.3)

Edward Jenner and Smallpox Vaccination

by Irmengarde Eberle (7.3)

Lenin with a Study Guide

by Nina Baker Brown (9.0)

Thomas Edison

by Roselyn and Ray Eldon Hiebert (9.1)

Revolts, Resistance and Emancipation

by Dorothy Sterling (9.1)

Bayard Rustin: Behind the Scenes of the Civil Rights Movement

by James Haskin (11.0)

Power to the People: The Rise and Fall of the Black Panther Party

by Jim Haskins (11.3)

Military/Political Memoirs

The ebook to the left is one of our bestsellers with over 1,000 positive reviews on Amazon. It was one of the sources for the HBO series on "War in the Pacific."

Helmet for My Pillow: From Parris Island to the Pacific with Maps

By Robert Leckie (7.4)

Serenade to the Big Bird

by Bert Stiles (6.2)

Agent in Italy with a Study Guide

by S.K. (6.4)

Leatherhead in Korea: On the Front Lines with a U.S. Marine Combat Artist

by Norval E. Packwood (mostly illustrations) (3.0)

War in Korea: the Report of a Woman Combat Correspondent

by Marguerite Higgins (Pulitzer Prize Winner for International Reporting) (8.4)

The New Legions

by Donald Duncan (6.7)

U.S. Marines in Vietnam: Small Unit Action in 1966

by Captain Francis J. "Bing" West (6.2)

Runaway Russia

by Florence McLeod Harper (6.4)

Last Flight from Singapore

by Arthur Gerald Donahue, D.F.C. (8.7)

Escape from Corregidor

by Edgar Whitcomb (7.7)

An Army of Amateurs

By Philippe De Vomécourt (7.1)

Journalism, Biographies, African American and American History

Mrs. R: The Life of Eleanor Roosevelt

by Alfred Steinberg (8.3)

Mississippi Notebook: Freedom Summer June-August 1964

by Nicholas Von Hoffman (8.7)

Before the Mayflower: A History of the Negro in America 1619-1962 (Our bestseller since it was published in 2021.)

by Lerone Bennett, Jr. (9.2)

Freedom Ride: Civil Rights and Non-Violent Resistance with a Forward by James Baldwin

by James Peck (9.4)

Abraham Lincoln

by James Daugherty (8.8)

Revolution in Mexico-Death is Incidental

by Heath Bowman and Sterling Dickinson (8.8).

Benjamin Franklin: The First Civilized American

by Philips Russell (9.5)

Thurgood Marshall: From His Early Years to Brown

by Hunter R. Clark and Michael D. Davis (10.1)

Thurgood Marshall: His Triumph in Brown, His Years on the Supreme Court

by Hunter R. Clark and Michael D. Davis (10.2)

Diego Rivera, My Art, My Life, an Autobiography

by Diego Rivera with Gladys March (10.7)

The Lonely Warrior: The Life and Times of Robert S. Abbott, Founder of the Chicago Defender

by Roi Ottley (11.0)

Harlem: People, Power, and Politics 1900-1950

by Roi Ottley, previously published as New World A-Coming for which Ottley won the Anisfield-Wolf Book Award (9.5)

A Stranger in My House: Jews and Arabs in the West Bank

by Walter Reich (14.5)

The Legend of John Brown

by Richard O. Boyer (15.9)

Fiction

So Big

by Edna Ferber (5.9)

Pulitizer Prize Winner for Fiction 1924

The Underdogs

by Mariano Azuela (4.9)

One of Ours

by Willa Cather (6.0)

Pulitzer Prize Winner for Fiction 1923