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At the height of WWI, history’s most lethal influenza virus erupted in an army camp in Kansas, moved east with American troops, then exploded, killing as many as 100 million people worldwide. It killed more people in twenty-four months than AIDS killed in twenty-four years, more in a year than the Black Death killed in a century. But this was not the Middle Ages, and 1918 At the height of WWI, history’s most lethal influenza virus erupted in an army camp in Kansas, moved east with American troops, then exploded, killing as many as 100 million people worldwide. It killed more people in twenty-four months than AIDS killed in twenty-four years, more in a year than the Black Death killed in a century. But this was not the Middle Ages, and 1918 marked the first collision of science and epidemic disease. Magisterial in its breadth of perspective and depth of research and now revised to reflect the growing danger of the avian flu, The Great Influenza is ultimately a tale of triumph amid tragedy, which provides us with a precise and sobering model as we confront the epidemics looming on our own horizon. John M. Barry has written a new afterword for this edition that brings us up to speed on the terrible threat of the avian flu and suggest ways in which we might head off another flu pandemic.


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At the height of WWI, history’s most lethal influenza virus erupted in an army camp in Kansas, moved east with American troops, then exploded, killing as many as 100 million people worldwide. It killed more people in twenty-four months than AIDS killed in twenty-four years, more in a year than the Black Death killed in a century. But this was not the Middle Ages, and 1918 At the height of WWI, history’s most lethal influenza virus erupted in an army camp in Kansas, moved east with American troops, then exploded, killing as many as 100 million people worldwide. It killed more people in twenty-four months than AIDS killed in twenty-four years, more in a year than the Black Death killed in a century. But this was not the Middle Ages, and 1918 marked the first collision of science and epidemic disease. Magisterial in its breadth of perspective and depth of research and now revised to reflect the growing danger of the avian flu, The Great Influenza is ultimately a tale of triumph amid tragedy, which provides us with a precise and sobering model as we confront the epidemics looming on our own horizon. John M. Barry has written a new afterword for this edition that brings us up to speed on the terrible threat of the avian flu and suggest ways in which we might head off another flu pandemic.

30 review for The Great Influenza: The Story of the Deadliest Pandemic in History

  1. 4 out of 5

    Stephen

    I am really surprised at the number of positive reviews this book got, both professional and consumer. I am currently a little more than halfway through and feel the need to write something in case I don't finish it and lose the desire. Before critiquing Barry and his writing style, or lack thereof, his editor, Wendy Wolf deserves special mention. This is the first book I have ever read in which I have made special note of the editor and will refuse to read anything she works on in the future. I I am really surprised at the number of positive reviews this book got, both professional and consumer. I am currently a little more than halfway through and feel the need to write something in case I don't finish it and lose the desire. Before critiquing Barry and his writing style, or lack thereof, his editor, Wendy Wolf deserves special mention. This is the first book I have ever read in which I have made special note of the editor and will refuse to read anything she works on in the future. I was sorely tempted to tally the number of repetitions of key phrases, pieces of information and entire narrative sequences. Perhaps editing this book was too daunting a task to do it well and still preserve the intent and message, but if so, I would have quit. Wendy gets 1 star. Before she edited it though, he wrote it. As I understand it, the 1918 Influenza outbreak, with its undercurrents of concurrent revolutions in medical science, oppressive (and at times seemingly unconstitutional) governmental policy, sheer human agony, and internationality, is replete with its own inherent drama. No additional tear-jerkers are necessary - the reporting of how 50 million people died worldwide would be plenty. Barry decides that manufactured melodrama is the most effective vehicle to convey this, however. How can one assume how people felt during a worldwide pandemic? After assuming it, how can one essentially write fiction in a non-fiction book as it is described? In addition to his atrocious writing style, Barry seems to thread 3 or 4 books into one, and doesn't even separate them with definitive breaks in his book. In a text which is nominally about an historical event, we read biographical sketches of several men who weren't even involved in fighting the disease. I recommend this to no one. Read the wikipedia article on '1918 Influenza'. It's probably far less annoying. UPDATE: After getting through 300 out of 460 pages of this poorly organized, melodramatic, poor excuse for historiography, I realized I was not only wasting my time reading it, but I was also wasting my time complaining about it to my friends and family. Thats a TRIPLE waste of time. Barry is not worth this investment. I caution every one of you. Unless you want to boost your self esteem and have a John Irving moment of "Wow, I could seriously do way better than this... and this guy got published!" DO NOT READ THIS BOOK. I hope you read this, Barry, and send me an apology. I've never written a review this bitter. Mostly because I've never been this bitter about a book.

  2. 5 out of 5

    Matt

    This book is what happens when I combine the iPad, Amazon’s one-click shopping, and my functional alcoholism. I had just sat down in my favorite chair for my weekly wine-drunk. No sooner had I dropped some ice cubes into a pint-glass full of Yellow Tail wine (because I’m that classy), than Steven Soderbergh’s Contagion began playing on HBO. I never intended to watch the movie. Based on the trailers, I had decided that it was too much like the movie Outbreak, except with fewer monkeys and 100% le This book is what happens when I combine the iPad, Amazon’s one-click shopping, and my functional alcoholism. I had just sat down in my favorite chair for my weekly wine-drunk. No sooner had I dropped some ice cubes into a pint-glass full of Yellow Tail wine (because I’m that classy), than Steven Soderbergh’s Contagion began playing on HBO. I never intended to watch the movie. Based on the trailers, I had decided that it was too much like the movie Outbreak, except with fewer monkeys and 100% less helicopter chases involving Dustin Hoffman and Cuba Gooding, Jr. Still, people who drink Yellow Tail out of pint glasses can’t be choosers, so I let the film unspool. Like all of Soderbergh’s works, Contagion was slick, engaging, and sharply edited. As the all-star cast began dying from a mysterious and highly contagious disease, and as I started to get a buzz from that pint of cheap wine, it occurred to me that I was suddenly, desperately interested in infectious diseases. So I bought John M. Barry’s The Great Influenza, about the so-called Spanish flu of 1918 that killed as many as 100 million people. Unlike influenza, my interest in the topic quickly wore off. It was only several months later that I finally got around to it. Totally worth the drunken purchase! Barry’s epic is a work of incredible scope and depth. It combines accessible science/medical writing, perceptive character sketches, and telling human anecdotes to corral a story – a global pandemic – that doesn’t necessarily lend itself to the written word. (Film is the more obvious medium for pandemic stories. All you need is a computerized map of the world in a neutral color. Then, have that map start to turn red while someone intones, “24 hours…48 hours…72 hours…”). In Barry’s words, the 1918 influenza pandemic “was the first great collision between nature and modern science.” To that end, he begins the book with a brisk, wide-ranging, and fascinating history of medicine, gradually narrowing his focus to the state of American medicine at the turn of the century. It was, in a word, deplorable. There was no consistency in education, no overarching standards, no pursuit of progress. While American doctors were still pondering the leech, Europeans were making the advances: In Europe, governments, universities, and wealthy donors helped support medical research. In the United States, no government, institution, or philanthropist even began to approach a similar level of support. As the Hopkins medical school was opening, American theological schools enjoyed endowments of $18 million, while medical school endowments totaled $500,000… The future of American medicine got a bit brighter with William Welch and the founding of the Johns Hopkins Medical School. Welch is one of the titanic figures in American science, a stethoscope-wearing J. Robert Oppenheimer – not necessarily a great scientist or discoverer, but a manager nonpareil. It was Welch who would lead the U.S. response to the influenza outbreak. The Great Influenza attempts to tell a huge story. An outbreak is hard to contain in a book (and also, obviously, in real life). It is not a singular event, but a worldwide phenomenon; it does not happen in a single place, to a single person, but to everyplace, and millions of persons. Accordingly, the narrative diffuses once Barry begins the story of the flu itself (ground zero of the pandemic is hotly debated; Barry pinpoints Haskell County, Kansas, as the originating spot). Of necessity, the story begins to hop around a lot, to locations all over the globe. There are a lot of staggering numbers (x numbers infected, y numbers dead) interspersed with illustrative stories that provide a micro view of a global disaster. For instance, Barry relates the story of an Army camp commander (World War I was the mechanism by which this disease spread so far and wide) who committed suicide after failing to take proper steps to protect and quarantine his troops. One of Barry’s real gifts is to explain medicine and biology to a drunk such as myself. I am a concrete thinker, a literalist. My ability to imagine things I can’t see – such as biological processes – is surpassed only by my ability to do one-armed pushups while shaving. Using metaphor and analogy, Barry does a wonderful job of providing both the hard science and a simple explanation to interpret it. For instance, Barry explains how the immune response to influenza ultimately made healthy young adults the flu’s greatest victim: Macrophages and “natural killer” cells – two kinds of white blood cells that seek and destroy all foreign invaders… – patrol the entirety of the respiratory tract and lungs. Cells in the respiratory tracts secrete enzymes that attack bacteria and some viruses (including influenza) or block them from attaching to tissue beneath the mucus, and these secretions also bring more white cells and antibacterial enzymes into a counterattack; if a virus is the invader, white blood cells also secrete interferon, which can block viral infection. All these defenses work so well that the lungs themselves, although directly exposed to the outside air, are normally sterile. But when the lungs do become infected, other defenses, lethal and violent defenses, come into play. For the immune system is at its core a killing machine. It targets infecting organisms, attacks with a complex arsenal of weapons – some of them savage weapons – and neutralizes or kills the invader. The balance, however, between kill and overkill, response and overresponse, is a delicate one. The immune system can behave like a SWAT team that kills the hostage along with the hostage taker, or the army that destroys a village to save it. The 1918 influenza pandemic killed between 21 million (according to a 1927 AMA study) and 100 million people (according to Nobel laureate and influenza researcher Macfarlane Burnet). That meant that about 5% of the population of the world died. It is a terrifying proposition. Using today’s population numbers, the fatalities would be between 70 and 300 million people. With all the different flu scares we’ve had, Barry was eventually obligated (perhaps by his publishers, at gunpoint) to update his book to remind us how we’re all going to die. Like all “new afterwords,” the one included at the end of The Great Influenza feels halfhearted and unnecessary. If you’ve paid attention at all to the hundreds of preceding pages, it is not difficult to extrapolate what might happen during a present-day outbreak of an infectious disease or out-of-control virus. Ultimately, I don’t think I was half as terrified as I was supposed to be. For one, I rate my chances of dying in a deadly pandemic as relatively low, compared with – say – wine poisoning. Moreover, despite being more interconnected than ever – accelerating the spread of flu, or Ebola, or whatever – we are also better-equipped to battle nature than ever before. That’s because we no longer believe in miasma theory or worry about our bodies humors. Finally, I watch a lot of Doomsday Preppers and I’ve come to realize that all I need to survive is a pump that turns pee into water, a few boxes of energy bars, and a gun for every hour of the day.

  3. 4 out of 5

    Dave

    This book had promise, and is good in spots - but the overall product suffers greatly from lack of direction and editorial control. If I could rate the best third of the book, I would give it five stars. The other two thirds of the book suffers substantially from a lack of focus, inclusion of unnecessary information, and overly dramatic narrative. And, to add insult to injury, the footnotes are handled in such a fashion that they become nearly useless. In the afterword, it becomes quite obvious t This book had promise, and is good in spots - but the overall product suffers greatly from lack of direction and editorial control. If I could rate the best third of the book, I would give it five stars. The other two thirds of the book suffers substantially from a lack of focus, inclusion of unnecessary information, and overly dramatic narrative. And, to add insult to injury, the footnotes are handled in such a fashion that they become nearly useless. In the afterword, it becomes quite obvious that the author made a bad assumption at the start of his endeavor. After spending seven years researching the book, he concluded that he could not tell the story of the epidemic without covering the history medical science leading up until that time. He also wanted to write the book from the perspective of the scientists and politicians who reacted to the influenza outbreak; he seemed more interested in covering their actions than the virus itself. These assumptions are incorrect. The most interesting and relevant portion of the book is the history of the virus itself. If Barry had simply explained how the virus worked, how it may have come into being, and then followed each wave of the epidemic in chronological order, this book would have been much more enjoyable and much shorter. Instead, he covers material which is not relevant - and by focusing on this material he breaks up his coverage of the virus, thereby rendering the best part of the book less enjoyable. The first third of the book is dedicated to the history of modern medical science. Some of the material is of interest, but this history is not necessary for any discussion of the influenza virus. It has absolutely no impact on the remainder of the book. The reader could simply skip the first 30% of the book and would not notice it. I actually found this information to be interesting, that that does not warrant their inclusion in a 450 page book with a supposed focus on the 1918 epidemic. The second portion of the book is the most direct discussion of the virus in the book, and it is quite good. Barry provides a brief explanation of how the virus works and why it is so successful. He then discusses the impact of the disease, rivaling any horror story while doing so. The amount of chaos and suffering caused by the outbreak is quite sobering. During this time, Barry also discusses the prevailing political climate. As this outbreak occurred during WWI. President Wilson's desire to turn the entire country into a weapon required news of the virus to be controlled rather tightly. This was exacerbated by a good deal of corruption at lower levels of government. The result was a climate in which misinformation and inaction killed tens of thousands of Americans. This material is entirely relevant, and I actually might have liked for him to focus more on it. The last portion of the book covers the scientific community's attempts to control the virus. This is really a misguided effort, as there is no significant discovery to work towards. While the scientists Barry introduces the reader to are all very accomplished, none of them are able to make any headway with their influenza work. The book becomes a spastic collection of various experiments carried out by a handful of scientists. The text is hard to follow as it is all over the map, and after you finish it you realized that the last third of the book is about as relevant as the first third, only less interesting. It is almost comical; one of the scientists he covers during the entire book is Paul Lewis. Towards the end of the book, after discussing Paul Lewis' troubled family life ad nauseam, and filling the reader in on all sorts of work Lewis did with tuberculosis (which had no impact on any influenza research), Barry goes on to tell us how Lewis died while working with the yellow fever in Brazil. So essentially, any mention of Paul Lewis in the book was completely superfluous.

  4. 4 out of 5

    Mike

    This book took me a long time to read, for several reasons. First, it really is two books in one. The first book is a history of the men and women and institutions involved in the change to scientific medicine in this country around the turn of the century. The second is the story of the influenza plague of 1918-1922 itself, the horrors of it, the death rate, the physical symptoms, the psychological effects, and the rather interesting fact that it seems to have been largely forgotten as the hist This book took me a long time to read, for several reasons. First, it really is two books in one. The first book is a history of the men and women and institutions involved in the change to scientific medicine in this country around the turn of the century. The second is the story of the influenza plague of 1918-1922 itself, the horrors of it, the death rate, the physical symptoms, the psychological effects, and the rather interesting fact that it seems to have been largely forgotten as the history of the 20th century wore on. Barry bookends the second book with the first book, and you get the impression of an author who has researched the bejeesus out of his subject and time period, and is just brimming over with information that he needs to get down on paper. But the book on scientific medicine really needs to be edited out of the book about the flu plague, because the interaction of the two stories is bizarrely very small - when the plague comes, the scientists and researchers he has spent so much time describing have very little, almost no, impact on the progression of the disease itself. When the flu passes, the researchers continue to work on it, frantically, but nearly everyone is wrong about the cause of the disease for years and year. Other scientific discoveries are made in studies of other diseases, and finally a study of infected pigs sheds light onto the causative agent. The organization of the telling of the influenza epidemic also needs editing, as Barry tells the story roughly chronologically but then diverts around geographically, sometimes telling the same kinds of stories again and again. So by the end of the book, you've read several horrifying stories of deaths by neglect, several accounts of the desperate medicinal efforts made, several accounts of rapid movement of the virus through populations. All of this loose organization makes the book a bit of a slog. The second reason the book took me so long to read is just how painful the descriptions of the virus, the horrible effects it had on the bodies of its victims, the families of its victims, the communities of its victims, the mindsets of its victims and those who lived with the epidemic, were . . . it was horrifying in its scope and scale. The author certainly succeeds in one of his objectives, and that is to let everyone know that FLU CAN KILL, and even though everyone treats it with nonchalance, it is only through luck that we haven't encountered a very virulent and lethal strain lately. Reading this book would be an important thing to do for people who routinely skip their flu shot every year, and will spur the reader to think about what they would do with sick family members if the healthcare system was completely overwhelmed. The most interesting part of the book was a chapter on the psychological damage the virus wrought on some people, and trying to link Woodrow Wilson's actions during the Paris peace conference of 1919 with changes brought on by a bought of the flu in April of that year. I think he proves his case that Wilson was changed mentally by the illness. What is less clear is whether the outcome of the Peace Conference would have been different because of it - the Germans were delusional about the end of WWI in any case, so it is a bit hard to lay Hitler and WWII at the feet of the flu. I still would recommend this to nearly everyone. It is important to realize what we might have to deal with during any given flu season, and this book should be enough to scare anyone straight with regard to that. The author does a great job of describing the science of the pathology and doesn't make any big mistakes with the molecular biology that I caught.

  5. 4 out of 5

    A.L. Sowards

    I thought this would be a history of the misnamed Spanish flu of 1918 (it originated in the US, but since Spain was one of the few countries not at war and not censoring information, it took that country’s name). This book included information about the epidemic, but also extensive details about the founding of Johns Hopkins and the Rockefeller Institute and the men (and at least one woman) involved in those organizations. I had been hoping for the story of the epidemic all over the world, but t I thought this would be a history of the misnamed Spanish flu of 1918 (it originated in the US, but since Spain was one of the few countries not at war and not censoring information, it took that country’s name). This book included information about the epidemic, but also extensive details about the founding of Johns Hopkins and the Rockefeller Institute and the men (and at least one woman) involved in those organizations. I had been hoping for the story of the epidemic all over the world, but this account was focused on the US with only minimal attention for other regions. I thought the parts about the epidemic were interesting, but I found the writing style repetitive and long-winded. Rounding up to 3 stars.

  6. 5 out of 5

    Sherry Sharpnack

    As an immunizing pharmacist who lived through the craziness of the early onset (October) of the swine flu pandemic of 2009, I have long been interested in the great influenza pandemic of 1918-19. What were the circumstances? Why did so many young people die, when usually it’s infants and the elderly? I was hoping this book would answer those questions, and in part, it did. However, I really did not need a history of medicine in general (back to Galen?!), laboratory medicine in particular, and med As an immunizing pharmacist who lived through the craziness of the early onset (October) of the swine flu pandemic of 2009, I have long been interested in the great influenza pandemic of 1918-19. What were the circumstances? Why did so many young people die, when usually it’s infants and the elderly? I was hoping this book would answer those questions, and in part, it did. However, I really did not need a history of medicine in general (back to Galen?!), laboratory medicine in particular, and medical colleges in America. This took up almost the first third of the book and IMHO was really unnecessary. Synopses of the main physicians trying to isolate the organism that caused the pandemic would have been sufficient. For this reason, the book only gets 4 stars. When we do get to the history of the pandemic, the statistics just get mind-boggling: as many as 8 to 10 percent of all young adults alive at the time succumbed to the flu. Approximately two-thirds of the deaths occurred in a 24-week period. People who awoke healthy were often dead within two to four days, some within 12 HOURS. The flu “killed more people in a year than the Black Death of the Middle Ages killed in a century; it killed more people in twenty-four weeks than AIDS...killed in twenty-four years.” Priests drove down the street in Philadelphia calling out for people to bring out their dead, just like the Middle Ages. Many cities came to absolute standstills. Even after reading this book, I can’t wrap my head around how awful the Great Influenza was, and can only worry about our preparedness for the next time the virus mutates into an unrecognizable form.

  7. 5 out of 5

    Joel

    Like a poorly crafted pop song, this book is full of occasional flashes of intelligence and brilliance, but is brought down to the level of the two star by it's repetitive nature and bogged down by details. Okay, the metaphor doesn't really work with the "bogged down by details" part, but other than that, it's apt. In attempts to create a rhythm, and strike a melodic note with his writing, Barry uses phrases he thinks are poignant to the point of annoyance. It's honestly like that Debbie Gibson s Like a poorly crafted pop song, this book is full of occasional flashes of intelligence and brilliance, but is brought down to the level of the two star by it's repetitive nature and bogged down by details. Okay, the metaphor doesn't really work with the "bogged down by details" part, but other than that, it's apt. In attempts to create a rhythm, and strike a melodic note with his writing, Barry uses phrases he thinks are poignant to the point of annoyance. It's honestly like that Debbie Gibson song "Shake Your Love." Well, John M. Barry, you're not shaking my love anymore. He does Shake My Love during the best parts of the book: the graphic details of the disease itself. But when it comes to relaying the nature of it's affects on various cities and people, it certainly unshakes my love. Unshakes my love with a passion. The subject matter tends to be so new and fascinating that it keeps you reading, and the 2nd third of the book is worth the time spent on the rest. All told, let's just say I hope there isn't another devestating influenza like the one of 1918-1919 so we don't have to sit through another John M. Barry retelling of it. Oh, and also 'cause the 50+ million deaths sounds pretty shitty.

  8. 5 out of 5

    Mike

    I read many of the reviews of The Great Influenza: The Epic Story of the Deadliest Plague in History. Many reviews are on target, the book just doesn't meet expectations for what should be a powerful tale. Unless you already have the book, I wouldn't rush to get it. How can I characterize it? Pompous, pretentious, repetitive, bloated,...? It seems he is trying to write like Simon Winchester, bringing in various threads to make a colorful tapestry. Except it is threadbare, strained, frayed. Just I read many of the reviews of The Great Influenza: The Epic Story of the Deadliest Plague in History. Many reviews are on target, the book just doesn't meet expectations for what should be a powerful tale. Unless you already have the book, I wouldn't rush to get it. How can I characterize it? Pompous, pretentious, repetitive, bloated,...? It seems he is trying to write like Simon Winchester, bringing in various threads to make a colorful tapestry. Except it is threadbare, strained, frayed. Just didn't work for me. A real shame because the story deserves a powerful telling. There was one part that was outstanding. His description of Woodrow Wilson's administration and the Progressive hell that enveloped the US leading up to and during WWI was absolutely chilling and precise. The Espionage Act, the American Protective League, the associated American Vigilance Patrol, the Four-minute men, the Committee on Public Information… I don’t know if Barry intended to paint such a chilling picture of the rise of propaganda, censorship and government force but he does an excellent job. Just 2 Stars for me. Darn it, was hoping it would be amazing.

  9. 5 out of 5

    Sara W

    Getting a little boring, so I'm taking a break from it. I think I expected a social history (how everyday people dealt with the flu, how it affected communities, etc.), and instead it's a very detailed history of medicine at the time (and well, well before the time of the flu!). I think I made it through a good 1/4 to 1/3 of the book (or more) before the Spanish flu began to get mentioned. The focus is on the medicine and doctors (individuals and as a profession - you get the whole history of U. Getting a little boring, so I'm taking a break from it. I think I expected a social history (how everyday people dealt with the flu, how it affected communities, etc.), and instead it's a very detailed history of medicine at the time (and well, well before the time of the flu!). I think I made it through a good 1/4 to 1/3 of the book (or more) before the Spanish flu began to get mentioned. The focus is on the medicine and doctors (individuals and as a profession - you get the whole history of U.S. medical schools) at the time. While interesting in its own right, it's not what I expected. The title is a little misleading considering how much of this book does not cover the Great Influenza. In addition, the book seems to jump around weirdly, so it's a little hard to keep track of things. I agree with the other reviews which mention the poor editing. I'm planning on finishing the book at some point (at least skimming it) because portions of it are interesting and what I was looking for.

  10. 4 out of 5

    Kimba Tichenor

    The title is a bit of a misnomer. Although the Great Influenza of 1919 was a pandemic, the author focuses exclusively on its history in the United States. As several other reviewers have noted, this book could have benefited from a good edit. A significant share of the book focuses on the history of medicine in the United States prior to the Great Influenza, providing biographical information on medical researchers both who would play a role in trying to find an effective treatment for the disea The title is a bit of a misnomer. Although the Great Influenza of 1919 was a pandemic, the author focuses exclusively on its history in the United States. As several other reviewers have noted, this book could have benefited from a good edit. A significant share of the book focuses on the history of medicine in the United States prior to the Great Influenza, providing biographical information on medical researchers both who would play a role in trying to find an effective treatment for the disease as well as many who did not. Perhaps a good editor could have also reined in the author's tendency to focus on graphic descriptions of the presenting symptoms of the disease. Page after page describe the color of various bodily secretions, etc. While it is understandable that the author wanted the reader to appreciate the severity of this strain of flu, too much of this type of detail reduces the narrative to a sensationalist account aimed at making the reader feel squeamish. At least for this reader, it would have been more interesting if the author had focused more on the social, cultural, and political ramifications of this pandemic in the US and elsewhere and less on pus and other secretions.

  11. 5 out of 5

    Mike (the Paladin)

    I hesitate to go 3 starts on this book, but for what it is it's a good book. The thing is (and I've seen other reviewers here say the same thing) it's not what I would call "primarily" about the 1918/1919 Influenza pandemic. That's what I was "primarily" interested in. My grandparents and great grandparents lived through this time. My grand-aunt lived into her 90s and close to 100. She was one of those people (and most of us have known them) who seemed to have a "cast iron constitution". She was I hesitate to go 3 starts on this book, but for what it is it's a good book. The thing is (and I've seen other reviewers here say the same thing) it's not what I would call "primarily" about the 1918/1919 Influenza pandemic. That's what I was "primarily" interested in. My grandparents and great grandparents lived through this time. My grand-aunt lived into her 90s and close to 100. She was one of those people (and most of us have known them) who seemed to have a "cast iron constitution". She was seldom sick and when she was she generally didn't slow down much for it. She wouldn't speak about a lot of her past and that included the flu epidemic (that generation seemed to be big on stoicism). When we asked she spoke about it a little. She was a young woman/older girl and was the one who ended up taking care of her whole family. She spoke of the bodies and how they couldn't all be buried and were stacked about. I got this book because I wanted to know more about the epidemic. This book however is more about the state of medical science in the 18th, 19th and early 20th century. It covers the changes and the discoveries these changes drove science to. About halfway through the book we get to some direct text on the pandemic itself but the author is more interested in the state of medicine in general. The story of the book carries on well past the epidemic but not primarily about the effects of the pandemic itself but the effect on medical science and the doctors who were involved in research. So it was fairly interesting and it tells the story that it tells very well. I would like however to find a book more concerned about the pandemic itself. We do get some information of that type here, don't let me mislead you. I'd say maybe 25% of the book is concerned with the flu, how it spread and the idiotic bureaucratic mistakes that added to it's spread. The facts of life for the people who lived with it, the situations like small cities that simply set out armed guards and cut themselves off from the outside. It's here but not the primary focus. I guess I'll keep looking. Three stars but good for what it is.

  12. 4 out of 5

    Clif

    John Barry is in love with science and we are the beneficiaries in this comprehensive account of the influenza epidemic that came at the end of WWI. Some of his prose is quite lyrical when he praises the scientific method and the virtue of rational thinking combined with imagination in some of the researchers he covers. But there are villains as well as heroes here as we enter an earlier time where government did almost nothing while private initiatives and funding allied with individual effort t John Barry is in love with science and we are the beneficiaries in this comprehensive account of the influenza epidemic that came at the end of WWI. Some of his prose is quite lyrical when he praises the scientific method and the virtue of rational thinking combined with imagination in some of the researchers he covers. But there are villains as well as heroes here as we enter an earlier time where government did almost nothing while private initiatives and funding allied with individual effort to fight disease. You'll get a view of the Wilson administration and the issues of post-war politics. You'll discover the primitive state of American medicine at the turn of the 20th century. You'll learn why the Germans and the French were far ahead in medical research in the beginning of the book and how one American was instrumental in pulling together the human and financial resources to advance the training of a group of American doctors to equal that of the Europeans. Any history should teach the reader a thing or two and this book excels in that. Medical terms are introduced and carefully explained as are the basic concepts of genetics. How does a virus attack a healthy cell and why does a virus mutate so rapidly that any drug is hard-pressed to remain effective even over a period of months? You'll find out. I happened across an article in a current newspaper dealing with the attempt to find a vaccine that would be effective against all viruses and to my surprise I found I understood all of the terms because I had read this book. Written with an intensity and urgency that will keep your attention, The Great Influenza deserves a read.

  13. 5 out of 5

    Florence

    This is a very frightening book. We usually consider the flu to be a non life threatening disease. Not true in 1918. The disease killed millions in a worldwide pandemic. The actual number of fatalities can never be known because medical systems were so overwhelmed that many people were dying at home without ever seeing a medical professional. The grisly details of how ordinary people suffered are in this comprehensive book. Also covered are scientific descriptions of bacteria and viruses that a This is a very frightening book. We usually consider the flu to be a non life threatening disease. Not true in 1918. The disease killed millions in a worldwide pandemic. The actual number of fatalities can never be known because medical systems were so overwhelmed that many people were dying at home without ever seeing a medical professional. The grisly details of how ordinary people suffered are in this comprehensive book. Also covered are scientific descriptions of bacteria and viruses that a reader without a scientific background can comprehend. The pandemic seemed to be a perfect storm. President Woodrow Wilson was myopically focused on victory overseas as the Great War raged on. He made a fateful decision to send ailing troops to Europe, disregarding the advice of military health experts, exponentially expanding the disease to Europe. It took over 20 years to identify the virus that causes influenza. Initially it is transferred from an animal and has the diabolic ability to rapidly mutate to a form that can be spread among humans. Can a pandemic of this scope occur again? Almost certainly.

  14. 5 out of 5

    Mike

    Overall this was a very good book. Expansive, thorough, and at times utterly fascinating. I'm sure people around me are completely sick of me talking about the flu at this point but this is that kind of book that will do that to you. It falls short of getting five stars for a couple of reasons, some of which are about the book but most of which are about me as a reader: 1. It's almost too expansive: In Barry's quest to explore every possible nook and cranny of the 1918 Influenza pandemic he leave Overall this was a very good book. Expansive, thorough, and at times utterly fascinating. I'm sure people around me are completely sick of me talking about the flu at this point but this is that kind of book that will do that to you. It falls short of getting five stars for a couple of reasons, some of which are about the book but most of which are about me as a reader: 1. It's almost too expansive: In Barry's quest to explore every possible nook and cranny of the 1918 Influenza pandemic he leaves no scientific idea or historical actor unearthed and thoroughly discussed. This lends to a skater shot feel to the book as you lurch from one person to another in chronological order with whole chapters about the science of viruses and bacteria popping up here and there to interrupt the forward momentum of the story. I feel like I got a about a dozen very short, somewhat shallow, biographies in this one book and a bit more science that I really wanted. 2. Lack of a supporting personal story or strong main character: When I contrast this book with Steven Johnson's "Ghost Map", which is all about John Snow and how he dealt with a cholera outbreak in London in the 19th Century, I find that it didn't hold my attention all the time because I didn't really connect with any of the people in the book or feel like there was a broad narrative that was pulling me along. Sure, he does a good job of showing how the pandemic began, how it peaks, and how it ebbs but the pandemic is far too amorphous for me to really relate to. And while he clearly shows how many of the people in the book react at these different phases I didn't really feel like I got to know any of them with the kind of detail that Johnson pulled out of John Snow. 3. Hey, you got your science book in my history book! No, you got your history book in my science book! Wow, they're two great genres that kind of make for a confusing mess when you put them all together: Okay, this gripe is all about me as a reader. I'm WAY more interested in history and politics than science. Unless the science is about robots, zombies, or space ships at a certain point I kind of just zone out. Barry, at times, gets super deep on the science of influenza explaining in great detail how it infects the body and causes no end of problems. While it is a great feat of writing to talk about that sort of thing without losing the reader (to his credit it was never confusing) it doesn't make for a compelling read for me. When Barry talks about history in this book it's completely riveting, I literally couldn't put it down, but then there would be a speed bump science chapter and I'd have to slog through it to get back to the ideas that were the most interesting to me. It made for a frustrating read at times. Over all I would highly recommend this book. It really was quite good, my gripes aside. And, frankly, the historical implications of the book make it worth the read alone (namely that at a crucial junction in the negotiation of the Treaty of Versailles at the end of World War I Pres. Wilson came down with the flu and it, for a bunch of reasons, left him possibly permanently mentally impaired - he believed from that point on that French spies had infiltrated the White House for example - is shocking. Given that that treaty is often held directly responsible for the rise of Nazi Germany, and World War II, and that the principle features of that treaty may have caused the rise of the Nazi's were almost all pushed by the French and opposed by Pres. Wison, until his bought with the flu that is, one is left believing if not for the flu the world could have been very different). If you like science and enjoy history I think this would be a very satisfying reading experience. As an aside, I gave this book to my Grandmother for Christmas in 2009 when she was 91 years old. She and I developed a pattern late in her life of me giving her books that I'd read that I liked for birthdays and Christmas. She was an avid reader and game to read anything, although like me her preferences were more inclined to history, biography, and travel. This was one of the rare books I gave her without reading first. When I asked her, on Christmas 2011, to lend me one of her favorite books she gave me this one. She was born in April of 1918, near the beginning of this book, and I think for her the book explained a lot of things people would mention in her childhood that never made much sense (relatives who died during the flu, particular idioms people would use, or beliefs they had about sickness). She died in March of 2012 just a month shy of 94. In reading this book I am profoundly impressed by her intelligence. This book is not an easy read in spots (there were sections I read twice) and for someone who didn't even finish high school to read this book and not only understand it but enjoy it is a testament to the amazing person she was. This book still has the post-it note she always put on the inside front cover of books she got as gifts with the date, occasion, and person(s) who gave it to her. While she may be gone it makes me happy that she and I could at least share this one last experience together.

  15. 4 out of 5

    Lena

    Beyond five stars. How many books are entertaining, important, engaging and edifying? I can only think of one, this one. I thought this was going to read like a thriller by Michael Crichton or Dan Brown following a plucky single doctor who fights hard for his patients, makes a breakthrough, and saves the day. That's not this book because that's definitely not what happened. The book starts off with a history of medicine. I had a vague idea about this beginning with Hypocrites and then jumping t Beyond five stars. How many books are entertaining, important, engaging and edifying? I can only think of one, this one. I thought this was going to read like a thriller by Michael Crichton or Dan Brown following a plucky single doctor who fights hard for his patients, makes a breakthrough, and saves the day. That's not this book because that's definitely not what happened. The book starts off with a history of medicine. I had a vague idea about this beginning with Hypocrites and then jumping to those bleeders in Period dramas that announce, "He's not long for this world." with much in between. But there wasn't much in between and that's the problem. While the other sciences moved in leaps and bounds medicine did not. There were lightbulbs and trains and the doctor was still coming to bleed you. Barry gives two reasons for this stagnation. The first is the anathema of autopsy. For the longest time it was simply unthinkable to cut into and examine a human being, it was too close to butchers work. Then there was a religious stigma attached but even in the twentieth century the liberal gods spoke out against it. Hell, even today hardened cops don't like attending autopsies. The second reason is a little trickier to understand - medicine is not logical like the other sciences. Barry gives an excellent example. A doctor in the early 1900s noticed that the face flushed during fever so he reasoned that fever could be a capillary issue. To test his theory he bled his fever patients. They went pale, their temperature dropped, and they were ravenous for food and drink. A cure! He published his finding, which was easily replicated, and was much lauded by the medical community. It was perfectly logical. It was wrong. Due to this reputation for butchery, witchery, and general ineffectiveness, being a doctor was not a respected profession. Medical schools were shockingly bad pass/fail systems where teacher salaries were based on butts in seats. Things changed quickly when they changed and you'll have to read the book to find out. This was the first book I read in 2016 and here I sit on the last evening of the year trying to finish this review. It was not mere procrastination; I was daunted by how much I enjoyed, learned, and was affected by this book. I became a vegetarian for four months and switched out all my beauty products to the more expensive cruelty free lines. And that was not even the point of the book. This entire review and I haven't even mentioned the word flu. Sigh. Just read it. *special thanks to my 2015 Secret Santa Krystal!

  16. 4 out of 5

    Paul

    It was a book, only a book. I have to keep telling myself this because even though author John M. Barry apparently felt like he was writing the tome to end all tomes about this chapter in world history – including the hideous phrase, "It was influenza, just influenza" over and over and over again – in the end, what he created was a terrific 200-page story of the world's deadliest pandemic wrapped in 250 pages of overwritten irrelevance. Barry spent seven years working on this book, and it shows. B It was a book, only a book. I have to keep telling myself this because even though author John M. Barry apparently felt like he was writing the tome to end all tomes about this chapter in world history – including the hideous phrase, "It was influenza, just influenza" over and over and over again – in the end, what he created was a terrific 200-page story of the world's deadliest pandemic wrapped in 250 pages of overwritten irrelevance. Barry spent seven years working on this book, and it shows. By which I mean it's meticulously researched, thoroughly detailed – and very poorly edited. It's clear he was too invested in his work and failed utterly at even the most basic test of what was relevant to his thesis. Thus we have short books about the history of Johns Hopkins University and modern medicine, about the failed response of the scientific community to the flu pandemic, and about the flu pandemic itself and the political and military decisions that exacerbated it. This latter is a five-star book – tightly written, cogent, fascinating and novel-like in its intensity while still lucidly explaining the mechanism of influenza infection and the immune system's response – but the rest should have been excised. In addition to the massive editing failure this book represents, Barry seems to understand on some level that his work is all head, no heart. It's about scientists and science, and cares very little for the actual people who got sick and died during the pandemic. The result, however, is to overwrite his descriptions of the flu's effects on cities like Philadelphia. He finds a rhetorical trick and hammers it home well past the point of overuse. He constantly uses "for" instead of "because," which trips up the reader. By the end of the book, I was skimming pretty heavily. Despite flashes of brilliance, The Great Influenza is a book, only a book, and not one worth the time required to invest in it.

  17. 4 out of 5

    Mike

    This turned out to be a great follow-up to Connie Willis’ Doomsday Book. (view spoiler)[ Since that book deals with epidemic disease, also. In the present there is a virulent influenza outbreak and in the past there is the plague sweeping through England. This book deals with the deadliest outbreak of virulent influenza so far which, at the time, was often thought to be a form of plague (because of extreme cyanosis). Neat, tie-in huh? (hide spoiler)] However, I originally added it to my TBR list it This turned out to be a great follow-up to Connie Willis’ Doomsday Book. (view spoiler)[ Since that book deals with epidemic disease, also. In the present there is a virulent influenza outbreak and in the past there is the plague sweeping through England. This book deals with the deadliest outbreak of virulent influenza so far which, at the time, was often thought to be a form of plague (because of extreme cyanosis). Neat, tie-in huh? (hide spoiler)] However, I originally added it to my TBR list it on it own merits and so it shall be judged. Although I have always been a fan of hard science, when I was younger, I was especially fond of microbiology, biology, genetics and how humankind discovered and then combated diseases. The names of Edward Jenner, Joseph Lister, Louis Pasteur, Robert Koch, Walter Reed, Paul Ehrlich, Alexander Fleming, and many others were in the many textbooks, fictionalized accounts, and biographies that I read back then. Today I continue to read about these topics and others in physiology and medicine. This book strikes a good balance between being a “geeks” book and one that is written solely for the popular audience. (The virology book I read a few months ago was much more the science tract.) It favors the casual reader more than the scientist, but I did not feel cheated by this emphasis. In places it delved into the mechanisms that make influenza such a dangerous and difficult virus. So, it you’ve ever been curious about what the HxNy designations for “flu” strains mean, this book tells you in clear and exact sentences. But the author did write only about the actual “Spanish flu” pandemic of 1918-1920 and the men who tried to fight it. Because of his own research, he expanded this book to cover the revolution in Medicine that had been created by these same individuals as American doctors became the equal of those in Europe. These men and the institutions that they created became the backbone for the best research and science in the world. As such, there is biographical information on many pioneers that few today know of (but should). Of course the book also covers the actual influenza pandemic; charting its origins and progress across the US and the world. But it does not stop there. It puts it into context of the age and America’s entry into The Great War. The conditions that that mobilization created were the perfect way for the disease to spread in local groups and wherever travelers went. (Unlike many diseases, the influenza victim is contagious before they feel any symptoms - making detection and effective quarantine very, very difficult.) There are snapshots of specific outbreaks that detail how individual Army (or Navy) groups dealt with the disease as well as various cities and communities. These accounts reflect both the existing infrastructure and the political realities of the day. In many cases, only by ignoring “official” mechanisms was anything doe to aid those places. The book is laid out pretty well mostly in historical order. As the author develops his topics he occasionally repeats material. For myself, I noticed these and thought they were unnecessary, but to a less careful reader they may have been useful to refresh the point as new consequences were developed. It wasn’t frequent or lengthy enough to subtract any points from my review. Clearly the author and editor took care to balance these passages against their value. I did learn a couple of things from reading this book. I’m hiding them as spoilers just in case you follow my exhortation to read this for yourself, (view spoiler)[ One, that Fort Devens in Massachusetts (now closed and re-developed) was one of the earlier outbreaks (although not the earliest). (I remember staying there once for some Boy Scout event.) Two, that Johns Hopkins Hospital and University was really the first good Medical School (and laboratory) in the U.S. (Harvard did not become so for many more years.) Three, that Alexander Fleming never saw the value of penicillin as an antibiotic for use in humans (at least he never tried to develop it to be such). Instead, he used it to control the growth of other bacteria in cultures when he was trying to grow colonies of a specific bacillus (which is where he first found it.) Supposedly he did not think that it could be made in large enough quantities and pure enough for use in people. Later he shared the Nobel Prize along with two others for its discovery. Four, Oswald Avery was the scientist (with two co-workers) who actually demonstrated that DNA molecules were the carrier of “traits”/genes (i.e. genetic information). His research was part of an investigation into the causative agent of influenza. He was side-tracked by the fact that pneumococci were able to convert from a type that the immune system easily fought off to one that would quickly infect with serious consequences. For over 11 years he worked this problem, publishing in 1944 when he was 67 years old. His theory was confirmed by others and then “proven” by Watson & Crick. When he died two years later he still had not received the Nobel Prize for this work (or his many earlier contributions), although he is one of the fathers of molecular biology and immunology. (hide spoiler)] As you can see, it made an impression on me. The Great Influenza is a book deserving of four stars (4.0) and at least four and one-half (4.5). It just barely misses the full five (5.0). If you have any interest in this topic I heartily recommend it. Actually it carries warnings about current diseases that make it good for everyone.

  18. 4 out of 5

    Thomas Paul

    It killed more people in 6 months than the Black Death killed in a century. People who were young and strong were the most likely to die. In the US, 650,000 people died. The average life expectancy in the US went down by 10 years. Worldwide, perhaps 100 million people died. And yet, it was only the flu. Even today, 90 years after the epidemic, it kills 36,000 Americans in a typical year and we are hardly more prepared to face another epidemic. John M. Barry has written a fascinating account of th It killed more people in 6 months than the Black Death killed in a century. People who were young and strong were the most likely to die. In the US, 650,000 people died. The average life expectancy in the US went down by 10 years. Worldwide, perhaps 100 million people died. And yet, it was only the flu. Even today, 90 years after the epidemic, it kills 36,000 Americans in a typical year and we are hardly more prepared to face another epidemic. John M. Barry has written a fascinating account of the influenza epidemic of 1918. But the book is a lot more than just a review of the flu. Barry starts out by examining the state of the American health system at the time of the epidemic and how it reached that state. He explores the revolutionary changes to medicine that occurred in the late 19th and early 20th century and the people who led those changes. He shows us why, even today, a cure for influenza is beyond our reach, explaining in layman’s terms how the influenza virus changes to become deadly and changes again to lose that deadliness. He explains how an endemic virus can lead to an epidemic of unimagined proportions. Barry also shows how the demands of World War I on troop movements, the propaganda campaigns to keep morale high, and the failure of leaders to listen to the doctors and researchers led to a killing field of historic size. His account tends to concentrate on Philadelphia because the city was hit extremely hard and much of the research going on was near that city but he does cover other areas around the world hit hard by the virus, although his coverage of the flu outside of the US is sketchy at best. He gives us writings from diaries and newspaper articles to show what was actually happening and how the media tried to downplay the epidemic. He gives us detailed accounts of the research (and the researchers) that was done to fight the epidemic, explains why this research was mostly unsuccessful, and does it all in a way that is easy to understand even if you don’t have a medical degree. Barry likes to use foreshadowing, hints of what is to come, to keep the reader’s interest and it does work, even if it is a bit melodramatic. Even the chapter titles, “The Tinderbox”, “It Begins”, The Race”, provide some melodrama to the story. The book mostly moves at a good pace and I found myself having trouble putting it down. Barry has written a book that everyone should read, whether you are familiar with the epidemic or not. It is a fascinating, terrifying, detailed, and extremely important book.

  19. 4 out of 5

    Kay

    "One always tends to overpraise a long book because one has got through it." – E.M. Forster It took me the better part of the summer to listen to this audiobook in my car (I don't drive that much) -- and I confess that it soon became more of a chore than a pleasure. I do wish there had been a competently edited abridged version, for if ever a book cried out for editing, it was this one. Some of the book's strengths, however, include the exhaustive account of how the pandemic started and spread, n "One always tends to overpraise a long book because one has got through it." – E.M. Forster It took me the better part of the summer to listen to this audiobook in my car (I don't drive that much) -- and I confess that it soon became more of a chore than a pleasure. I do wish there had been a competently edited abridged version, for if ever a book cried out for editing, it was this one. Some of the book's strengths, however, include the exhaustive account of how the pandemic started and spread, not to mention the effect it had on society. There was a huge amount of material on how the authorities (mostly didn't) deal with the crisis, one of the key themes of the book being that in order to deal with such a threat that the civil authorities need to be completely honest about it. Point taken, but it was repeated over and over and over.... as were the somewhat melodramatic accounts of how the bodies stacked up, what having the disease was like, what the death toll was, and so on and so forth. Another strength was the intimate portraits of key researchers who rushed to find the cause of -- and a vaccine for -- the particularly virulent strain of influenza. There was a problem, though, in that the book's entire first section was a somewhat tedious historical account of the Johns Hopkins Institute. I'm still not sure why that was necessary (and suspect it wasn't). Granted, it was good to know what the state of medicine was at the turn of the century, but such an overview certainly could have been done more concisely. I also had real issues with the way several medical researchers, and in particular Paul Lewis, were cast into "roles" -- with Lewis the tragic figure that the author claimed was "the last victim" of the pandemic. Humph! However, I did find it fascinating to read about the details and design of medical research, and in particular how viruses mutated and became more or less deadly. In fact, I wished for a bit more of that information and less of the endless parade of statistics that Barry seemed so inordinately fond of. I came to believe that he had never met a statistic he didn't like (or subsequently use). Again, I was puzzled about why the editors hadn't intervened and winnowed out the repetitious material. Scott Brick, the reader for this book, was one of the biggest irritants, however, and no doubt significantly contributed to my feeling that the book was NEVER going to end. While his voice wasn't an unpleasant one, he seemed to have a very narrow "range" of intonation and emphasis. In fact, it sounded like he was overemphasizing just about everything, and he had a particular way of lingering over and stressing the word "any" that made me want to shriek after the first few hours. I had a hard time separating my irritation with his reading from my general impatience with the book, which is probably the reason I gave this three stars rather than two -- I'm not entirely sure whose fault it was that I didn't find this as interesting as I'd expected. (Plus, as Forster noted, one DOES tend to overpraise a long book that one finally manages to finish.) If I'd been reading this book rather than listening to it, undoubtedly I would have been able to skim pretty efficiently, slowing down for the parts that interested me the most and just skipping over the repetitive bits. But as a "captive" listener, it was pretty tough going.

  20. 4 out of 5

    Patti

    Fascinating book. Many, many times in the book, I stopped and said to myself, "that's interesting, I never knew that". The early history of the practice medicine in this country and lack of training of the doctors was jaw dropping. During WWI, academic instruction in general suffered due to total commitment to the war effort. "In view of the comparatively short time during which most of the student-soldiers will remain in college and the exacting military duties awaiting them, academic instructi Fascinating book. Many, many times in the book, I stopped and said to myself, "that's interesting, I never knew that". The early history of the practice medicine in this country and lack of training of the doctors was jaw dropping. During WWI, academic instruction in general suffered due to total commitment to the war effort. "In view of the comparatively short time during which most of the student-soldiers will remain in college and the exacting military duties awaiting them, academic instruction must necessarily be modified along the lines of direct military value." I appreciated the great detail used in explaining the scientific rigor in trying to understand the disease that was plaguing the country and world. All the dead ends and false leads with persistent desperate scientists trying to find the answers in the midst of horror. "These things become easy to discern in hindsight. But how does one know when to persist, when to continue to try to make an experiment work, when to make adjustments - and when finally to abandon a line of thought as mistaken or incapable of solution with present techniques? How does one know when to do either?" With headlines starting to appear again about the danger from the Swine Flu which we might face in the fall, this book should be widely read and attention paid.

  21. 5 out of 5

    Jeff

    Some people think I'm obsessed with disasters, but really I'm just fascinated by change. It's why I love history, among other things. 50 to 100 million people dying over the course of a year is a pretty big change, and the fact that it was all caused by a tiny little microscopic tidbit is utterly compelling. Mr. Barry does a more than thorough job of telling the story. You get a history of medicine, a science lesson in the biology of viruses, a review of the socio-political factors that led the Some people think I'm obsessed with disasters, but really I'm just fascinated by change. It's why I love history, among other things. 50 to 100 million people dying over the course of a year is a pretty big change, and the fact that it was all caused by a tiny little microscopic tidbit is utterly compelling. Mr. Barry does a more than thorough job of telling the story. You get a history of medicine, a science lesson in the biology of viruses, a review of the socio-political factors that led the US to enter WWI, and then you get a close-up, detailed look at the influenza pandemic of 1918-1919 and the search for a cure. Then you get a look at the effect the pandemic had on the course of medicine and virology. A very readable and exciting book, with interesting, important characters you've likely never heard of. Occasionally Mr. Barry indulges in literary flourishes that can distract from the story rather than add to it, but that's a minor flaw in an otherwise excellent book.

  22. 4 out of 5

    Stacy

    Very educational and interesting. Compelling

  23. 5 out of 5

    Nikki

    Whew. The Great Influenza is a heck of a read: there’s a lot of information, and it takes quite a while to get to the actual point of the epidemic, because first it covers certain aspects of medical history. As with so many books like this, in places it becomes a sort of biography of the greats who were involved — it’s going to be interesting to see pop-science deal with the increasingly team-based approach to science, without central characters to pin the narrative on. In many ways, this is mor Whew. The Great Influenza is a heck of a read: there’s a lot of information, and it takes quite a while to get to the actual point of the epidemic, because first it covers certain aspects of medical history. As with so many books like this, in places it becomes a sort of biography of the greats who were involved — it’s going to be interesting to see pop-science deal with the increasingly team-based approach to science, without central characters to pin the narrative on. In many ways, this is more history than science, though it does go into the discovery of the actual cause of influenza, the (lack of) treatments available then and now, the effects it has on the human body, etc. Still, it’s also very much about public health policy and medical practice: it is not just “oooh cool a deadly pathogen”. Which, if you’re scoffing and thinking that flu isn’t a deadly pathogen, do think again. Even seasonal flu can kill those who are weakened in some way, or unlucky, and the 1918 flu killed from 50 to 100 million people in the years the pandemic ran through (about 1918-1920, to the best of my understanding). It’s difficult to predict how flu will mutate, because it does so all the time, and there are various different strains active in the population at different times. It’s also present in other host species, meaning we can cross-infect our livestock and pick up infections from them. Flu is a problem, and it was a huge problem back in 1918 without so much commercial flight and recreational travel. The way it swept the globe then is nothing to what it could do now if we’re complacent. If you’re blasé about the potential of a flu pandemic like H1N1, I recommend this to change your mind. There’s a lot of gory detail here about how the 1918 flu killed, alongside the more sterile descriptions of lab experiments and the dry series of events, and the nitty-gritty of how the influenza virus invades a host cell. It’s not exactly a thrilling read unless you find the topic truly fascinating (I do), but there is a lot here of interest. (Get your flu shots.) Reviewed for The Bibliophibian.

  24. 5 out of 5

    Lizzy

    This review was written by Liz Roland and posted by Lizzy Mottern. This substantial book that exhaustively researched ( 60 pages of notes and bibliography) reads like a massive thriller, compelling the reader forward to find a vaccine/cure for this deadly, ever-mutating virus that killed more people in late 1918 and early 1919 than the plagues of the Middle Ages killed in a century. In the U.S., nearly seven times as many people died of this virus as died in World War I. John Barry, an award-winni This review was written by Liz Roland and posted by Lizzy Mottern. This substantial book that exhaustively researched ( 60 pages of notes and bibliography) reads like a massive thriller, compelling the reader forward to find a vaccine/cure for this deadly, ever-mutating virus that killed more people in late 1918 and early 1919 than the plagues of the Middle Ages killed in a century. In the U.S., nearly seven times as many people died of this virus as died in World War I. John Barry, an award-winning historian who has received prizes for both his Rising Tide: the great Mississippi flood of 1927 and how it changed America, and The Great Influenza, weaves multiple strands of narrative together as he details how the epidemic spread and how doctors and researchers joined together to fight this global health crisis at the end of WWI. Barry argues persuasively that society's ability to contain another pandemic is a political as well as medical question. The similarities between the great influenza of 1918 and our current swine flu are chilling. This review was written by Liz Roland and posted by Lizzy Mottern.

  25. 4 out of 5

    Carole

    I found the book a page turner...almost a medical mystery in the way it was laid out. As a physician, I was familiar with many of the names of physicians from the early 20th century, but the author draws such clear pictures of them--their character, experience, and flaws--that I found it a fascinating history of medicine as it developed late in the 19th century and into the early 10th century. There was also fascinating political history in the way it impacted the communication and decision-makin I found the book a page turner...almost a medical mystery in the way it was laid out. As a physician, I was familiar with many of the names of physicians from the early 20th century, but the author draws such clear pictures of them--their character, experience, and flaws--that I found it a fascinating history of medicine as it developed late in the 19th century and into the early 10th century. There was also fascinating political history in the way it impacted the communication and decision-making regarding the epidemic. As someone concerned with pandemic planning today from the standpoint of ethics, there were many lessons to be learned. My husband...not a doctor...is enjoying it as we speak.

  26. 5 out of 5

    Ken

    Begins brilliantly with a concise and breezy history of infectious disease study. Continues as a very readable tale of the influenza epidemic, but eventually gets a bit bogged down in many minute details that I would just have well skipped (it’s a long book). However, overall a very important and significant account of how modern mankind dealt with a serious infectious agent, with grave implications for today’s world.

  27. 4 out of 5

    Hadrian

    Bit slow, and could use a good editor. A merely adequate history of one of the greatest epidemics in history.

  28. 4 out of 5

    Rachel

    This book. I don’t know. There’s so much to love, but there’s also so much to hate, and, even worse, there’s so much to induce snickering at utterly inappropriate times. At least we know what the author was going for: in the acknowledgements, John M. Barry says that he started out to tell the tale of the 1918 global influenza pandemic – numerically, the deadliest outbreak of human infectious disease – with a focus on those studying and trying to control it. But then he realized the story of that This book. I don’t know. There’s so much to love, but there’s also so much to hate, and, even worse, there’s so much to induce snickering at utterly inappropriate times. At least we know what the author was going for: in the acknowledgements, John M. Barry says that he started out to tell the tale of the 1918 global influenza pandemic – numerically, the deadliest outbreak of human infectious disease – with a focus on those studying and trying to control it. But then he realized the story of that pandemic was entwined with a philosophic transformation in science, so he widened his focus considerably. Fine. Great, even. Here, however, is what the author gives us: the Winchester Mystery House of books.* It is chock-full of topics at every scale, some, but by no means all, of which are: • The history of Western medical science and its transformation from being driven by un-probed, unifying theories (think, treatments based on bodily humors), to figuring out what’s going on using evidence and experimentation. • The early history of Johns Hopkins • The histories of many particular medical researchers, only a subset of whom participated in influenza research • Role of propaganda in WWI, with specific reference to influenza reporting • Where this swarm of influenza viruses came from, how they spread, why they were so deadly • Accounts of the 1918 pandemic, focused on a handful of cities in the eastern US His topics are all intriguing, and about 95% of what he includes is legitimately related to his project. I also respect the enormous difficulty of obtaining source material, what with WWI media censorship and the understandable lack of meticulous records from the outbreak’s height. But The Great Influenza just reads like Barry was larking about in research tangents and lost all sense of proportion about which, and how much of each, should end up in his book. When he finally gets to it, the actual description of the influenza outbreak comes off as oddly piecemeal. And why all the Paul Lewis? Why? Why?? Now, don’t get me wrong. I don’t think Barry should have scaled his efforts back to fit his original plan. This intellectual switch from knowing everything because belief/logic to using the scientific method arrived gradually in various fields, and was an especially long time coming for medicine. By 1918, there were finally a couple of generations of trained medical researchers, so the Great Influenza is a perfect early case study for what the new scientists and scientific process could achieve. And actually, I wish more authors integrated a quick primer on what science is and isn’t in pop-science books, like Barry's: “Ultimately a scientist has nothing to believe in but the process of inquiry.” (view spoiler)[No. I don’t believe in evolution, thanks. (hide spoiler)] However, Barry never manages to create a whole greater than the sum of its parts. What we have here is a bunch of unruly parts with no whole. And, to borrow what may be the author’s most favoritist end-of-paragraph construction, it gets worse. It gets worse. For someone with an unusually Enlightened grasp of the philosophy of science, Barry sure makes some rookie mistakes. One of the biggies is how he frequently describes “science” (and other non-animate concepts) as doing stuff. Pretty soon, I started picturing “Science” as this furry, frowny, Alot-like creature lumbering around with a lab coat and a Petri dish. Plus, his prose is almost unreadably melodramatic, with a higher density of “greatest-,” “most powerful-,” “doomed-,” and “the fabric of society was ripping apart-” style superlatives than one of my 9th-grade essays. Yes, the greatest and most epic plague in the whole entire history of mankind ever of all time (or whatever this book’s freaking subtitle is) was awful. But readers don’t need constant verbal blunt-force trauma to get that. The ~50,000,000 dead kind of speak for themselves. As a quick demo of both the drama and personification failings, it didn’t take more than a quick page fan to locate this juicy little chapter opening: ”Nature chose to rage in 1918, and it chose the form of the influenza virus in which to do it. This means that nature first crept upon the world in familiar, almost comic, form. It came in masquerade. Then it pulled down its mask and showed its fleshless bone. “ Seriously? Snicker centrale. The only valuable contribution of those words is to give me a handy visual for Nature as it hangs with Science and Alot. Nature didn’t choose shit, as you yourself, Mr. Barry, attempted to explain pages ago with your discussion of influenza evolution. Now hyper-drama in a scientific discussion can be misleading (view spoiler)[Like his: ”An infection is an act of violence; it is an invasion, a rape, and the body reacts violently.” Umm, not exactly. (hide spoiler)] , but constantly anthropomorphizing abstractions is not just a semantic mistake. It actually undermines scientific discussion. On the pettier side: for all his multitudinous research, some of his facts are wrong, and important topics are oversimplified or plumb missing. Like, on page 39 of my edition, Barry gets the publication date of The Origin of Species wrong by a decade. Where is One of Ours in his discussion of contemporary literary accounts of the influenza outbreak? Where’s the virulence theory in his discussion of why the 1918 viral swarm was so dangerous? To cap it all off, there’s an icky flavor to his treatment of gender and ethnicity. I cringed at “Negroes” and “natives” and his anachronistic use of “man” for all humans. The way he discussed female scientists was rather different in tone than his discussion of males. And Barry cites S. Weir Mitchell as an early physician who did “outstanding research,” which may be true, but is bound to raise the hackles of anyone who’s ever read The Yellow Wallpaper. Dr. Mitchell was hardly a paragon of evidence-based medicine. I was always trying to slip more science into my old narrative nonfiction book group, and I so wanted us to read this book. But, as it turns out, I can’t recommend The Great Influenza, and I’m glad we never chose it. I’m glad we never chose it. This book pairs well with One of Ours, because there WERE more contemporary fictional accounts of this pandemic, and with The Emperor of All Maladies, because it IS possible to weave historical, scientific, and anecdotal information into a compelling, coherent narrative of disease, and, what the hell, with A Journal of the Plague Year, because although composed of similar messy parts, Defoe made them a whole. In 1722. (And with The Ghost Map: The Story of London's Most Terrifying Epidemic--and How It Changed Science, Cities, and the Modern World, if you prefer your disease books to be parts without a whole.) _____________________________ * (I can’t resist belaboring this metaphor, so it’s totally fine to skip this part. My feelings won’t be hurt a bit.) See, the Winchester Mystery House is this crazy place that shares many attributes with a functional, albeit grandiose, house. However, it’s filled mysterious rooms nobody used, staircases that lead nowhere, blank walls where you expect a door, and doors where you expect a blank wall, among other peculiarities. Sarah Winchester clearly had a passion for the process of creating the house, but the product’s convoluted architecture is best attributed to her reliance on spirit guidance. The Great Influenza is like that, but a book.

  29. 4 out of 5

    Melinda

    I highly recommend this book! It reads like a "who-done-it", except that you know who did it (the influenza virus) and you are watching the medical scientists struggle to find solutions while the wild-fire of the 1918 influenza pandemic raged all around them. Will they find a solution in time? (see the bottom paragraph for an answer to this question) Before documenting the path of the 1918 influenza, the author lays the groundwork for the transformed medical atmosphere from the late 1800's into t I highly recommend this book! It reads like a "who-done-it", except that you know who did it (the influenza virus) and you are watching the medical scientists struggle to find solutions while the wild-fire of the 1918 influenza pandemic raged all around them. Will they find a solution in time? (see the bottom paragraph for an answer to this question) Before documenting the path of the 1918 influenza, the author lays the groundwork for the transformed medical atmosphere from the late 1800's into the early 1900's in America. This path thus shows the beginnings of the the Rockefeller Institute for Medical Research, the Phipps Institute, and Johns Hopkins University. Names of medical pioneers and influenza warriors such as Paul Lewis (who proved that polio was caused by a virus in 1907 and developed a vaccine that was 100% effective in protecting monkeys), William Henry Welch (the single most powerful individual in the history of American medicine, who directed the rise of Johns Hopkins University, and who with John D. Rockefeller Jr. created the Rockefeller Institute for Medical Research, arguablly the best scientific research institute in the world), Simon Flexner (first head of the Rockefeller Institute for Medical Research, the man who brought the mortality rate for common bacterial meningitis down to 18% in 1919 WITHOUT antibiotics!), Rufus Cole (who made the Rockefeller Institute Hospital a model for the way clinical research is conducted), Army Surgeon General William Gorgas (whose work in abating the transmission of yellow fever and malaria by controlling the mosquitos saved hundreds of thousands of lives, and allowed construction on the Panama Canal), Oswald Avery (whose work on influenza would lead him to one of the most important scientific discoveries in the 20th century, that DNA is the material of which genes and chromosomes are made), Anna Wessel Williams (the leading female bacteriologist in the world who worked hand in hand with William Park trying to develop a serum or vaccine for influenza), William Park (teamed with Anna Wessel Williams, developed the diptheria antitoxin still in use today), and Richard Shope (who as the first to prove that a virus caused influenza) fill the pages of this book. After setting the stage with its influenza warriors and medical laboratories, the author then begins the saga of the influenza virus itself. Influenza struck in the first wave in the winter and spring of 1918, a mild "three day fever" form that most recovered from. The second wave hit in the fall of 1918. This wave was the most virulent and deadly. The third wave hit somewhere in the winter / spring of 1919, and was once again a less virulent form. In just 2 years the virus mutated into a super killer, then back into a more mild disease. In raw numbers, the lowest estimate of the worldwide death toll at the time was 20 million. Knowing what we know now, epidemiologists today estimate that influenza caused at least 50 million and possibly 100 million deaths worldwide. All that in a time when the population of the world was 1/3rd of what it is today. The terrifying aspect of the super killer influenza was that it did not strike the traditional victims... the old and the very young, but instead hit hardest in the age group of 20's and 30's. If the upper estimate of 100 million deaths is accurate, then 8 to 10 percent of all young adults then living were killed by the virus. And these deaths happened with blinding speed. The influenza pandemic stretched out over 2 years. But 2/3rds of the deaths occurred in a period of 24 weeks. That is about 66 million deaths in 24 weeks. Averaged out that would be 2.5 million deaths per week. Yet more than half of those 66 million deaths happened from mid-September to early December of 1918. That is really 33 million deaths in 10 to 12 weeks! That's 3.3 MILLION deaths PER WEEK in the late fall and early winter of 1918! And remember that the world population at the time was less than 1/3rd of what it is today (which is 6.8 billion people). The numbers are just staggering, and I had to keep reading them and figuring out the numbers and it still is a staggering thought. So many died in so short a time! Epidemiological evidence from the work of Dr. Loring Miner seems to show that the new influenza virus originated in Haskell County, Kansas early in the winter of 1918. Dr. Miner documented early cases of the new influenza that showed disturbing mortality rates in a very short period of time. The virus then went to a huge army base in the eastern part of the state as troops were gathered in preparation for their deployment to Europe for WWI. From that army base, soliders were sent to France, soldiers were transferred to other bases in the United States....and the disease began sweeping through North America, Europe, South America, Asia, Africa, and the entire world. Some situations requiring fast decision making in chaotic circumstances were carried out well. Other situations were not handled as well. The ins and outs of these crossing paths of decisions, deaths mounting rapidly, politics, mililtary directives, and newly formed medical laboratories make up the rest of the book. The story is staggering, but gripping. In answer to the question at the beginning of this review, the answer is "no, the medical scientists did not find a solution during the time of the 1918 thru 1920 influenza pandemic". They learned alot, yes. They also learned that the only way to be protected from the disease was through isolation from it. Medical practices helping and treating the ill were improved, but a vaccine was never been found. The only reason the killing influenza stopped killing was because it mutated away from the more virulent form into a milder form. So the question immediately to ask is "what happens if the virus mutates back to the virulent form?". And that is the question we are left with at the end of the book. In the concluding chapter, the author raises these issues and concludes tentatively that in pandemic times, an authorized power (government, World Health Organization, army, someone) must have the authority to act and to act quickly, and their decisions must trump individual freedoms. Mandatory vaccinations, mandatory quaranatine, mandatory travel restrictions are the things that must be done to protect the larger population. The "needs of the many outweigh the needs of the one", if I may quote a Star Trek movie. In times of such overwhelming medical need, quick decisions must be made and sometimes they must be harsh.

  30. 5 out of 5

    Colleen Browne

    This book starts out with a summary of medicine from Hippocrates to the First World War. That seems like it would be a long slog but because there was so little advancement during that time, it is done fairly quickly. As a reader with very limited knowledge of the history of medicine, I found this very interesting. What I didn't know at the beginning of the book was that the better part of the book was spent with the author going off on tangents only peripherally related to the pandemic. There i This book starts out with a summary of medicine from Hippocrates to the First World War. That seems like it would be a long slog but because there was so little advancement during that time, it is done fairly quickly. As a reader with very limited knowledge of the history of medicine, I found this very interesting. What I didn't know at the beginning of the book was that the better part of the book was spent with the author going off on tangents only peripherally related to the pandemic. There is a great deal of information in this book, too much information. This book could have done with a good editor. The length of the book was about the same length as most of the books I read, and in many cases, much shorter but it didn't feel that way. It felt much longer. Barry's use of metaphor was helpful in explaining his subject and his style of writing wasn't awful as many reviewers have charged but he didn't seem to know when to stop on those threads that he followed out to what felt like oblivion at times. This is the first book I have read devoted to the subject (and may be the last). I could not recommend this book; at least not to anyone just interested in the pandemic. I can only suppose that there are better books on the topic.

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