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How many cases make an epidemic? Survivors of the great polio plagues of the 1940s and ’50s will never believe that in the U.S. the average toll in those years was “only” 1 victim out of every 5,000 people. Was that really all it took to scare the nation out of its wits, sending families scurrying in all directions -to the mountains, to the desert, to Europe -in vain hope of sanctuary. Perhaps polio’s other name, infantile paralysis, had something to do with it. Images of babies in wheelchairs and tots on crutches tend to skew one’s perception. And just in case anyone wasn’t scared enough, the National Foundation for Infantile Paralysis hammered the nightmare home with photos that seemed to show up everywhere of sad-looking children in leg braces. “Please give to the March of Dimes.” Oh yes, indeed, five times at the same movie -or so it sometimes felt.
It was inevitable that whoever was first to allay such fears would become a national hero. “The Man Who Saved the Children” should be good for a statue in every town in the world. And since the odds of a microbiologist’s becoming even a little bit famous are a lot worse than 5,000 to 1, it was perhaps inevitable that this hero’s achievements would immediately be disputed. In a scientific field so heavily manned, findings routinely crisscross and even minor discoveries can leave a trail of claims and counterclaims, not to mention envy and acrimony, that are truly incurable.
Thus a monument to the conquest of polio faithful to the facts would consist of not one man in a white lab coat but two of them glaring at each other. Both Drs. Jonas Salk and Albert Sabin could and did make convincing cases for themselves and pretty good ones against each other too. But since the public usually prefers one hero to two, and since Salk did get there first, he got the monument.
Between occasional shouts of “Eureka!” even the heroes of science tend to have quiet careers. But Salk’s career stands out in at least two respects: the sheer speed with which he outraced all the other tortoises in the field and the honors he did not receive for doing so. How could the Man Who Saved the Children be denied a Nobel Prize? Or summarily be turned down for membership in the National Academy of Sciences? What was it about Salk that so annoyed his fellow scientists?
That he was fast, there was no doubt. And hungry too. After taking brilliant advantage of the amazing public education available to New Yorkers in the first half of this century, this son of Orthodox Polish-Jewish immigrants whizzed through his medical training to fetch up at the University of Michigan an enviable fellowship to study virology under the distinguished Dr. Thomas Francis -who, incidentally, would remain in Salk’s corner for life, politics or no politics.
Salk’s major patron at Michigan, however, proved to be no one man but the whole U.S. Army, which needed a flu vaccine at once to help win World War II and was happy to complete Salk’s education in speed under pressure. After that, it was a snap for him to set up his own peacetime lab at the University of Pittsburgh and equip it to the gills for the Great Crusade -the one that every immunologist in the world then had his eye on -against the Great White Whale itself, poliomyelitis.
Fortunately, Salk had somehow found time to do basic research on the virus and write a few theoretical papers, and it was these that caught the eye of Basil O’Connor, the zealous head of the Infantile Paralysis Foundation, who decided to play a hunch and shove some dimes in Salk’s direction with instructions to get going.
With that, the seeds of resentment, deep and abiding, were sown. By then, dozens of worthy researchers had been toiling far longer than Salk in the fields of polio and would have given their microscopes for such funding and freedom. Who was this hired gun who appeared from nowhere with a bankroll the size of a special prosecutor’s, plus free use of all the backbreaking work that had gone before?
In fact, the key piece of research, available to all, was completed a few years earlier by the one undisputed hero of this story, Harvard’s John Enders. It was his team that figured out how to grow polio in test tubes -suddenly giving vaccine hunters everywhere enough virus to work with.
Now the goal was truly in sight, and who got there first was largely a matter of speed -Salk’s forte -and luck. “Salk was strictly a kitchen chemist,” Sabin used to gripe. “He never had an original idea in his life.” But imaginative people perennially underrate efficient ones, and at the time, the kitchen chemist -who prepared his vaccine by marinating the virus in formalin -was just what the doctor ordered.
Salk and Sabin came from the two competing schools of vaccine research. Sabin, like Louis Pasteur, believed the way to produce immunity was to create a mild infection with a “live” but crippled virus, and he concocted his competing vaccine accordingly. Salk, from his flu-fighting days, knew the immune system could be triggered without infection, using deactivated, or “killed,” viruses. And, as it turned out, his quick-and-dirty killed viruses were better suited to a crash program than Sabin’s carefully attenuated live ones. By 1954, Salk and Francis were ready to launch the largest medical experiment yet carried out in the U.S., vaccinating more than 1 million kids ages six to nine, some with the vaccine, some with a placebo. The children weren’t told which they were getting.
The vaccine worked. But the world of science has a protocol for releasing such findings: first publish them in a medical journal, and then spread the credit as widely as possible. Salk took part in a press conference and went on radio but gave credit to nobody, including himself -of course, he was going to get the credit anyway. And that was the mistake that would haunt him.
Radio was right; vanity was wrong. This was not some breakthrough in carbuncle research but hot news that couldn’t wait one more minute. Within the brotherhood of researchers, however, Salk had sinned unforgivably by not saluting either Enders or, more seriously, his colleagues at the Pittsburgh lab. Everything he did after that was taken as showboating -when he opened the Salk Institute, a superlab in La Jolla, Calif., for the world’s scientists to retreat to and bask in, and even when not long before his death in 1995, he started a search for an AIDS vaccine, to a flourish of trumpets and welcome new funding.
Just as some politicians are at their best when running for office, so Salk came into his own as a spokesman for vaccination. Although it is generally accepted in the field that the real man on the monument should be Enders (who in 1954 shared the only Nobel Prize given for polio research), it seems unlikely that either he or the pugnacious Sabin would have performed half so patiently as Salk the ceremonial chores expected of monuments or would have sat so politely through so many interviews and spread the gospel of disease prevention quite so far and wide and indefatigably.
And one last thing. Like the millions of American veterans who have never ceased thanking Harry Truman for dropping the Bomb and ending World War II, the folks who got their polio shot between the first Salk vaccine and the Sabin model have never had any quarrel with Salk’s high place in history. (The two vaccines are now given in alternating booster shots.) There are times when even genius has to give way to the old Yankee virtues of know-how and can do. And if in this instance these happened to be embodied in the son of a couple of Polish-Jewish immigrants… well, a lot of that kind of thing happens in America.
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