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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.
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Michael D. Morgan
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As an initial, rough draft, this manuscript shows amazing potential as an important look at a terrifying and prescient topic. As a finished work, it is the most poorly edited book I've ever read.
In the acknowledgments, Barry writes the most important thing that the reader needs to know about getting through this book: "This book was initially supposed to be a straightforward story of the deadliest epidemic in human history, told from the perspectives of both scientists who tried to fight it and political leaders who tried to respond to it....Instead....it didn't seem possible to write about the scientists without exploring the nature of American medicine...." He was wrong. Rather than the exploration of American medicine being essential, enlightening, or even remotely relevant, the result is two completely unrelated books in one. One book is a terrifying and page-turning "straightfoward story of the deadliest epidemic in human history." The other book is a mind-numbingly boring list of names of doctors and scientists, descriptions of university politics, and confusing explanations of experiments that have nothing to do with the influenza pandemic. In fact, on page 259 of the book, Barry says that the people who the first 89 pages are about had nothing to do with research or medical breakthroughs regarding the influenza epidemic in any way!
My favorite example of what Barry considered essential to include in this book about the 1918 pandemic is the story of a scientist named Lewis. Barry tracks Lewis's career almost to the minute. He describes the tuberculosis research that he did, talks about his job offers, how much he was offered, what contracts he declined, his marital problems, what his childrens names were, the gardening that he did in his spare time, job offers he turned down, what people said about him at lunch, more about job offers, how his tuberculosis reasearch never really went anywhere or produced any useful results and he lost the general respect and confidence of the scientists around him. Then, when the reader is waithing for how all of this incredibly boring detail somehow becomes relevant to the 1918 pandemic or influenza research, Barry describes how Lewis went to a Brazilian jungle to do yellow fever research, gave himself yellow fever and died. What does this have to do with the topic of the book? NOTHING!! What insight or perspective is to be gained from Lewis's tale? NONE!!
Including some perspective about the state of American medicine during the pandemic is crucial to the story of the pandemic, but that isn't what Barry does. He simply lists names of scientists and where they worked in a manner that is as informative and interesting as the parts of the Bible that list who begat who. His philosophy of this book is like some entertainment rag that feels it is crucial to a story about the Iraq War to list every celebrity who attended a party in Hollywood and what each of them wore. These portions of the book -- which comprise roughly half of it -- are unreadable and irrelevant.
And even the portions of the book that are incredibly fascinating and well-researched reveal a complete lack of editorial guidance. At times, Barry keeps repeating "this was after all only influenza" as some sort of misguided literary device. Repeating this over and over might seem like a good way to build gravitas to a freshman English student in a C- paper, but any competent editor would have recognized it as just irritating and pathetic and removed at least the last 1,000 instances of its use. (The number 1,000 may be a mild exaggeration.) The book also contains frequent grammatical mistakes and clumsy sentences that make me wonder if there even was an editor.
What's worse is that the book skims over incredibly interesting aspects of the pandemic. For example, the virus was called "Spanish Flu" despite that fact that Spain suffered from the flu much less than England, France, Germany or America; and despite that it probably originated in America. It became "Spanish Flu" because Spanish newspapers reported honestly about its effects while wartime censorship in England, France, Germany, and America caused the press to lie about its severity. Barry deserves credit for researching and writing a little bit about how local political corruption and grossly unconstitutional actions of the federal government aided the spread of the flu, and about how "staying the course" in WWI was partially responsible for making the pandemic so deadly. Unfortunately, he just flits over these extremely prescient and timely topics, skims the surface of icebergs, then dives back into telling the reader about what some fat guy named Welch had for dinner and that Lewis turned down an $8,000 a year job in Iowa.
Barry says that it took him seven years to write this book. My guess is that he did an extordinary amount of research in that period of time. Then, he realized that a lot of his research didn't really fit into the book and that writing it properly required doing a great deal more research into public records, government documents, and judicial opinions. This probably sounded daunting. So instead of writing the book that should have been written, he wrote half of it and filled another couple hundred pages with gibberish. And with a naked disrespect for the consumer, Penguin Books had the nerve to publish it in its current form.
I recommend buying this book used and reading the relevant portions of it. Some of the medical history is very interesting and a tiny little bit of it is relevant to the influenza pandemic. However, VERY little of the medical and scientific portions of the book are either interesting or relevant. The good news is that because these chapters have virtually nothing to do with the subject of the book, the reader can feel free to skim through them or skip some entirely without fear of missing information. I read every word of this book because I kept hoping that all of the gibberish eventually had a point. It doesn't, and I've written this review to try to save you from the same fate. In fact, if you value your time and have a low tolerance for boredom, just start reading at chapter six. From there, understand that Welch, Avery, Flexner, Lewis, etc. never emerge as having ANYTHING to do with the influenza pandemic.