Rating: 
Summary: Great drama: deserves a better writer.
Review: I was very much looking forward to this book, and now about 100 pages into it, I'm not sure I'll even finish it. The influenza outbreak of 1918 is inherently a fascinating story, but it is unfortunate that this great and important drama was taken up by such a mediocre writer. Simply put, the author lacks the necessary skill to complement this story - and the publishing house failed to pair him with a competent editor. The extensive opening dissertation on the development of modern medicine, for instance, could have been related in a cohesive and understandable fashion; instead Barry hops around tracing so many confusing threads that the reader is left baffled as to the real trajectory. Much more annoying is his breathless style of writing and his habit of inserting his own melodramatic asides at every turn that it resembles a sophomore trying to impress you of the import of each development. I was tempted to shout "I get it! I don't need you to add swelling music to underscore every point." Upshot: the great influenza plague of 1918 makes a great story. I wish a more skilled writer had been the one to tell it.
Rating: 
Summary: Extremely frightening historical essay...
Review: I went looking for a book on this particular epidemic, because my great-grandmother died of influenza in Aug 1918. She was a grand-mal epileptic who was in an institution in Indiana, and her death certificate stated she died of influenza causing complications of her epilepsy. People who were placed in institutions of any kind up until the 1960's were at extreme risk of contracting infectious disease easily, and in those days when these places were poorhouses or institutions for the feeble-minded the care was merely warehousing. What did the local, state, or federal health care system care about the deaths of people like my great-grandmother...when they were at war, and these people merely used up health care that was better spent on those without chronic diseases or disabilities especially during a time of war?
I was perplexed during the first couple of chapters of this book, because Barry went so far back to start the background he needed to lay for the readers concerning the 1918 influenza epidemic. The medical and public health information was interesting, even if, as other reviewers stated the author tended toward the slightly 'hoky' presentation of information. I got the feeling the author was writing for a possible screenplay...and I found out after finishing this book, that this actually book was used as the basis for a PBS special on this American Experience a few years ago, so maybe that's how the book started as well as explains the melodrama.
However...after this preliminary background was delivered, and I started on the book proper, I ended up forgettin about the delivery pretty-much as the book got deeper into both the epidemic and the public health history of this pandemic. The last time I read a book that made my heart plunge into my stomach was when I read Edgar Allen Poe at night when I was a teen. Most horror books don't have the capacity to raise my hackles like this book did, and there are only about 3 other books on public health and disease that made me sit up straight and pay attention (See Preston's book 'The Hot Zone' and Laurie Garrett's books).
I couldn't believe how much we as a nation, as a world, have forgotten about this pandemic. I've taken classes in epidemiology and I went to med school for neuroscience research...this pandemic was mentioned in passing. I think this is the wrong way to go about it. This book should be required reading for medical and public health students. One, so the symptoms of this disease can be imprinted on the brains of every doctor, so that the possibility of a return of this infectious agent (H1N1) will be considered any time some doctor sees a person with this amazing group of symptoms. Second, that we can change the attitudes and the way we currently deal with infectious disease, because to miss this again even for a few weeks could possibly be the death sentence for the human race (I know, a bit melodramatic).
It's amazing how much information Barry got on this epidemic given the time period, and the lack of emphasis usually on public health problems. So much tied into setting up the world for having this pandemic. It involved politics in both the governments and in medicine (always); it involved mistakes made on an individual and collective basis by both physicians, researchers, politicians, newspapers, the military who so obviously thought of these young men as merely cannon fodder (most of them...one general over a camp in Indiana paid his own price for making a bad decision that caused the rapid overwhelming of this camp with the flu, leading to one of the worst cases of military cantonments killing more of these young men than the war actually did).
It also involved great medicine, great men and women who worked overtime to try and find a way to control or stop this 'locomotive' disease that cleared a path throughout the world of nearly 1/3 of its inhabitants. Just as there are stories of horror in this book, there are also stories of courageous men and women, young men in the medical schools of that time period who were forced into early care in hospitals because there just were not enough physicians who could handle this number of sick and dying; women volunteers in the Red Cross and throughout communities who functioned in almost a complete vacuum; men who were willing to override the establishment and expose themselves to death in playing with the known bacterial and viral possible agents as well as so many corpses and so much death that it must have been depressing and panicking to see all this...but they continued.
The last few chapters were indeed sobering, because Barry demonstrated so much of the bad science that I still saw in med schools and the attitudes that allowed this pandemic to continue. We have come a long way health-wise, but we also have newer problems to worry about especially with easy transportation that makes our world so much more compact, and provides a scary situation for infectious disease.
I felt so bad for the young scientist who eventually died of infectious disease because he was floundering and could not concentrate on a single focus. I experienced that myself in graduate school. It's hard to focus when there are so many intriguing problems in public health and in virology. That's why there is now a system of oversight (or used to be) that helps both grad students and Ph.D. researchers to stay focused on a single topic, a single problem. It doesn't always work, but I think if this many were to be here today his peer group would be able to help him more in staying on track, even those there were men back then who definitely tried to help him.
Frightening to think that this could possibly and will probably occur again. Makes me more frightened for my children and my grandchildren, and there isn't a whole lot we can do in this situation except pay attention.
Couple of notes to specific readers. Geneaologists should read this book, because when cities were burying bodies at the height of the pandemic, many people were lost. So those looking for names during this time period had better be aware that this might be the explanation for not being able to find a burial site or death certificate for many people, as the people who did these things were just overwhelmed. Those who study epidemiology should be aware that there are always groups who are ignored during a crisis like this...those with disabilities are abandoned basically by society, yet when they are neglected this population will provide fodder for an infectious agent. This is happening now with HIV in the Deaf community. Do people honestly think that if a Deaf person gets AIDS, so what, they aren't going to give it to hearing people? Get a grip on reality here...and realize ignoring any group for any reason will provide fodder for a pandemic. Ethicists had better deal with the problem soon of rationing health care, because Barry brought up the very real issue concerning this topic and the probability that politicians and society will determine who receive medical care during another pandemic, and Barry illustrated that there will be a loss of individual rights to life and to care in another pandemic. Do we really want a bunch of politicians and lawyers determining our fate?
The newspaper yesterday stated that there have been 5 deaths from an avian flu in Cambodia and Vietnam, and there have been warnings that this could lead to another pandemic as the virus becomes accommodated to us as host. No one seems to be overly-concerned....
Karen Sadler,
Science Education,
University of Pittsburgh
Rating:
Summary: a brilliant and provocative book
Review: I wish I could give this book 10 stars but Amazon doesn't allow for that. This is a great book. The story it tells is gripping enough, but the writing is magnificent, and it's all seen in a broad context and extraordinarily well-researched. If you have even the slightest interest in American history, science in general, medicine, or how your own body works, then this book is for you. There are also a lot of lessons in this book that apply to our situation today not only re: influenza, but re: all emerging diseases. This more than just the story of the 1918 influenza pandemic. It is also a story of war, and of science, and of individual scientists, one of whom later discovered-- as a direct result of influenza research-- that DNA carries the genetic code, another of whom became so despondent over his own scientific failures that he committed suicide by giving himself yellow fever while researching the disease, hoping that his death would be followed by a sort of Viking funeral in which that restored his reputation. As if that's not enough, the author deserves enormous credit for explaining what viruses are, how they attack, and how the immune system responds. He deserves even more for coming up with an original-- and very well supported by the evidence-- hypothesis as to where the pandemic began. And he sets all this against the background of World War I and shows how the war, at least in the U.S., played a key role in the response of health authorities. But perhaps the most amazing thing about this book is some of its almost throw-away, sidebar paragraphs-- paragraphs that really make you think. Aside from demolishing Thomas Kuhn's thesis about the way science advances, aside from explaining why "therapies" like bleeding patients lasted for 2300 years, it demonstrates the importance of method and shows why logic is of only limited use in biology. Did I say this was a great book? It is.
Rating: 
Summary: Interesting but yes, flawed!
Review: I've read some of the other reviews and agree with most of them. The history itself is dramatic enough and does not require a capping statement every few paragraphs dramatically restating the obvious conclusion Mr. Barry has drawn. Mr. Barry does not take a non-partisan view of this period in history and makes assertions about President Wilson that are not part of the popular view of his administration and heritage. While reading this somewhat biased history of the Great Influenza epidemic, I found an incredible error on page 303 where Mr. Barry refers to "George Pershhing, in charge of the American Expeditionary Force". I believe, he is referring to General John J. "Blackjack" Pershing, one of America's most famous military men. Finding this obvious flaw makes me distrustful of the rest of the history Mr. Barry quotes. I have read other books about this same topic and have learned some new details from this book but like other reviewers, I think that there are many details regarding the rest of the world, and the rest of the story, that are left out.
Rating:
Summary: Bad Medicine, Bad Timing, And A Virus That Wouldn't Quit
Review: In February 1918, most likely in Haskell County, Kansas, a local airborne virus mutated into the deadliest and most contagious influenza strain ever recorded in the annals of medical history. To put this catastrophe into perspective, more residents of the continental United States died of the 1918 influenza outbreak than were killed in the stunning tsunami of late 2004-four times as many, to be more precise. Worldwide, guestimates run between 50 million and 100 million fatalities from a disease born and bred in the American heartland. How did it happen? Could it have been prevented? And more importantly, can it happen again?
These are the questions tackled by John Barry in his study of a natural calamity that historians on the whole have tended to sidestep. In his 650-page study of Herbert Hoover's 1918 tenure as America's food czar, George Nash devotes exactly two paragraphs to the influenza, identifying it as a foreign [Spanish] plague brought to America's East Coast. Curiously, the 1918 influenza outbreak has been, till now, a primarily oral tradition. When my doctor's receptionist noticed the book under my arm, she quickly blurted out: "My grandmother lost all her hair during the plague." My mother told me that her father had nearly died.
Barry begins with a lengthy analysis of medical research and practice after the Civil War. In general, the average American doctor was poorly educated. Some did not have high school diplomas. One Ivy League medical school rejected a proposal for written comprehensive exams on the grounds that many of its students could not read or write. Research was scattered at best. Barry describes the opening of Johns Hopkins University in 1876, an institute founded precisely to address the glaring absence of cutting edge medical research. But its heroes would labor in obscurity for many years.
Thus, valuable information about immunology and virology was not available in 1918 as an innocuous strain of influenza passed from birds to humans in Kansas, mutating in the process to something far more terrifying. Barry's description of virology is remarkably clear and precise for the layman. [One is struck at how biological viruses and computer viruses are similar.] A virus by its nature is in constant flux, mutating as its environment dictates. It is an invader, reprogramming normal cells to do its bidding. In this case, the new task was a disarming of the immune system in the respiratory tract. A denuded respiratory tract thus left a patient vulnerable to pneumonia, the primary killer in this biological holocaust.
The plague actually struck twice [with aftershocks for about three years]. The first wave, the Kansas outbreak next to an army base, was highly virulent and often fatal. But the second wave, six months later, a mutated form, attacked a population weakened by the first round. Scientists were divided on strategy: isolate the influenza virus itself, or develop a vaccine for pneumonia. They had some success with the latter, and virtually none with the former. What they did agree upon was the highly contagious nature of the disease and the importance of an informed populace.
But here the virus found a veritable political petri dish. Having taken years to decide, Woodrow Wilson led America into World War I with unmitigated ruthlessness. To call attention to a disease that was beginning to ravage stateside army cantons and large cities was seen as a dangerous, subversive distraction from the national war effort. Thus national censorship prohibited newspapers from calling attention to appalling death rates or even to health advisories about public gatherings. Despite pleas from scientists, war bond rallies went on as scheduled. Barry argues that the news embargo increased panic and made a bad situation worse.
The disease itself did not look like influenza to most contemporaries, and even today's readers will justifiably wonder if this plague was of a kind with the "flu" normally encountered in the winter months. This disease killed swiftly, in some cases in less than a day from onset. The victim became discolored and bled from multiple orifices. Only the wracking cough was the true clinical constant with other forms of influenza.
Most city governments were paralyzed by incompetence or, more likely, by the illness itself. Gradually local movements ignored Wilson's executive sanctions. In Philadelphia, particularly hard hit, the Biddle and Drexel families essentially assumed emergency services in conjunction with the Catholic Church and other bodies. Catholic Charities, for example, assumed responsibility for corpse removal, and priests with horse drawn carriages made daily rounds to remove bodies from tenements and other residences. Philadelphia victims were buried in mass graves.
Barry describes both the scientific and the emotional components of this tragedy well. Perhaps too much attention was paid to turn-of-the-century cutting edge researchers. Although invaluable to American medicine, scientists had nothing for this virus, nor did the production machinery exist at the time for a mass national vaccination even if they had been successful. One might also argue about the author's preoccupation with Woodrow Wilson's shortcomings, and his belief that the influenza affected Wilson's deliberations at Versailles drifts dangerously close to grassy knoll territory.
Has the medical community come to an understanding of the 1918 influenza virus such that history will not repeat itself? Yes and No. Late research has determined that the 1918 virus was encapsulated in a protective coating, like an M&M piece of candy. Why this happened, and how to penetrate this defense, still elude scientists. On the brighter side, better community health, the practice of isolating infected animals and humans [as occurred with the SARS outbreak, for example], improved medical procedures for pneumonia, and a highly developed pharmaceutical industry are all factors which would at least tend toward a mitigation of severity. That said, a mutation similar to the 1918 event would still dwarf the wildest imagination of any biochemical terrorist.
Rating:
Summary: The Great Influenza: The American Experience
Review: In The Great Influenza, John Barry has produced a massive and exhaustively researched description of one of the greatest disasters of human history. At least, from the American point of view. While there are a few glancing references to what was going on in the rest of the world, there is no serious discussion of any attempts to deal with the pandemic in other countries, even in other industrialized countries. On the other hand, Barry has chosen a very specific point of view: the transition of American medicine and medical training from folk wisdom to science. It's a compelling point on which to balance a long and exhaustive (there's that word again) study of how America and, specifically, American medicine confronted an epidemic in which people were dying faster than the technology of the time could handle, an epidemic in which society itself was nearly overwhelmed by death. As other reviewers have noted, the book's weakness is a tendency towards melodrama, as in the far-too-often repeated tag line "This was influenza. Only influenza." After a while, you think to yourself, "Yes, we get it. Give it a rest." On the other hand, the book has one of those quirky displays of real brilliance in the last two chapters in which Barry deals with how science is done well (in the case of Oswald Avery) or done poorly (in the case of Paul A. Lewis). These two chapters are so strong that they could stand on their own, and what they have to say about the process of scientific thought itself is fascinating. Avery's story is that of a man who was just relentessly focused, who kept digging deeper and deeper into a single issue until he discovered the source of heredity itself. Lewis's story, on the other hand, is that of a man who simply lost his way. Distracted by the need to administer an institute, the need constantly to raise money, to deal with the politics of science, the need to socialize and just plain hustle to support the work of others, Lewis lost the focus that Avery had and ending up flailing in a sea of theories and methodologies. In fact, if you don't read any other part of this book, read these two chapters. There is no question about The Great Influenza being a monumental work. It's so good that you just have to overlook the bits of melodrama that pop up from time to time. The research is, well I obviously can't use "exhaustive" again, so let's say nearly encyclodedic. In fact, there's so much research, and so much documentation that Barry has used an odd method of footnoting. Instead of using footnote numbers that refer to the notes section at the end of the book, you have to turn to the notes section and find the specific page and text being referenced. Unfortunately, as a result you don't know while you're reading which bits have footnotes and which don't. I'd prefer actual footnote numbers. Ah, well. I'm sure it seemed like a good idea at the time. In any case, Barry has produced a massive and important work of epidemiological history which is, at the same time, as readable as a thriller. In writing this review, I kept wavering between giving it four stars or five stars and finally decided on five based on the scope, the thoroughness, and what Aristotle would call the "point of attack," that is, the point at which the story really begins, which is, in this case, the birth of truly scientific medical education in America. All in all, it's a truly fascinating and immensely readable piece of history.
Rating:
Summary: Legacy to Future Generations
Review: John Barry has done it again. His ability to embrace huge, sophisticated bodies of knowledge and political complexity and then bring his research to the reader with skill and impact is an awesome talent. He has brought us a complete understanding of what those before us suffered and endured during the horrible pandemic of a few generations ago, the great Influenza of 1918. He has shown us the worst and the best of Americans experiencing and coping with the horrors of World War I and, simultaneously, the horrors of a catastrophic epidemic within our country. There is much he has told us that will inspire, just as there is much that discourages and dismays. It is imperative that Americans learn from the events described in Barry's extensive coverage for all therein is relevant to where we are now. After reading this book, the reader should have a much greater appreciation for the phrase, "living on borrowed time."
This is a book to keep and pass on to your children and grandchildren. We need to perpetuate this time in the history of our nation. How much we learn from this account, from all the the mistakes and from all the examples of heroism that Barry has brought us, may determine the fate of ourselves and generations after us.
Rating:
Summary: The Great Influenza: The Epic Story of the Deadliest Plague
Review: Late in this history of the 1918 influenza pandemic, Barry observes that the event has survived in memory more than in any literature. Apparently, people would rather not record horrors that make them feel insignificant. Fortunately, there are deep-digging historians. Barry presents the pandemic as the first great challenge to the modern American medical establishment, whose response, although it was overwhelmed, demonstrated what medical science applied to public health practice might do, and as a test of national, state, and municipal political responsiveness to domestic crisis. Medicine, though far too lightly equipped, rose to the occasion, but politicians, from President Wilson on down, refused to acknowledge any crisis except the war in Europe and thwarted medicine's best preventive efforts. To portray the forces that met the crisis, Barry first tells the story of scientific medicine in America, begun by the shaping ofohns Hopkins Hospital and University under William Welch into the model for all other U.S. physicians' training and medical research institutions. The researchers who directly engaged the great flu were Welch proteges, and though they failed at the time, the continued research of one culminated in discovering the significance of DNA. Meanwhile, the death and panic, national and worldwide--the flu most probably started inansas, and troop movements that the army continued against its surgeon general's advice spread it cross-country and to Europe--were appalling. For readers, however, they are the somber underscoring of an enthralling symphony of a book, whose every page compels attention.
Rating: 
Summary: A glimpse into the past reveals elements of the future
Review: My father survived the great influenza. He was three when he caught it and nearly lost his life. Instead, he lost the hearing in his left ear. It was just another moment in his past for him. He didn't attach any significance to it except for noting that his mother and father were scared to death that he wouldn't survive. He did. There were others who were less fortunate. John Barry's well researched book acts as more than a glimpse into the past; it's a cautionary tale about the present as well. Barry notes that the great influenza was the first pandemic in modern history that seemed unstoppable; it killed more people in 24 hours than the black plaque killed during a century. It left lingering effects in the more of a parkinson's life disorder where brain cells of the substania nigra were destroyed due to the effects of the virus and fever. World War 1 wasn't won by armies but by the effect of the flu. The virus spread like wildfire throughout barracks and through regiments. It was the merchant of death and humanity was at its mercy. The heroes in this war against nature were scientists. Oswald T. Avery, Anna Wessel Williams, William Park all were among the heroes who marched against this nasty virus. The results of their(and their compatriots)hard work is a world where humanity has a fighting chance against these nasty diseases. The most telling story is quoted from the book THE PLAGUE OF THE SPANISH LADY. In it, the author recounts the tale of Charles Lewis in South Africa. He boarded a streetcar to take him home. In the course of the three mile journey the conductor died. Then the driver and 5 others died. All within a three mile stretch. That's how lethal this virus proved to be. Barry also recounts the discovery of ARDS (Acute Respiratory Distress Syndrome) which leaves the lungs looking like forest after a massive fire. The airways are as bare and desolate looking as the moon. Barry's book is both frightening and hopeful. We face the same challenge now as pathogens continue their massive assault around his. The problem has always existed we've only just begun to understand the threat. We take for granted that we live in a fragile, uncertain world. We've got the wits to recognize our enemy. When these threats occur we just need the time to respond.
Rating:
Summary: A moving portrait of a natural disaster
Review: No American was left untouched by the Great Flu Epidemic, and Barry effectively illustrates the daunting scope of this great disaster. Through his exhaustive and detailed research, he shows the breadth of the influenza in the USA. Consider this: In one week, half again more people died in Philadelphia of influenze that died at the WTC on Sept. 11. Imagine the impact such a tragedy -- hundreds of thousands dying in a very short period of a seemingly unstoppable illness -- would have in today's American society. Comparisons to the Black Plague are exceedingly appropriate. This is an excellent and touching historical exploration, which also suggests humankind remains extremely vulnerable to epidemics.
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