Jonas Salk: A Life by Charlotte DeCroes Jacobs, M.D., Oxford University Press, 2015
By Sheila Orysiek
SAN DIEGO — For those of us who were children in the 1950’s, embedded in our memories of summertime fun, we also remember the horror of the dark shadow of poliomyelitis – polio – which hung over our days. The terror of a headache, a sore throat, or a sniffle, brought to mind visions of young children forever encased in metal tubes called “iron lungs.” A lifetime of twisted limbs, paralysis – that is if one was lucky enough to survive the infection. Though adults also contracted polio it was called infantile paralysis because it mostly struck children.
Little was known about this worldwide scourge: how it was spread, what manner of contagion (bacterial or viral) was involved, and the conditions under which it thrived. Research seemed to show that dirty living conditions did not contribute to its virulence – in fact just the opposite. Children living in an unsanitary environment were less likely to be victims – which was quite the opposite of most other contagions.
Polio appeared in the summer – each year the number increasing over the last – and then as the days cooled down, it would disappear. However, the cooler months brought another scourge: influenza. This struck people of all ages, in every socio-economic strata, all over the world; people died by the millions.
Jonas Salk, the eldest of three sons, was born in 1914 in New York City to Jewish parents who had immigrated from Poland. Though not deeply religious, he very much believed in the Judaic precept of “tikkun olam” – the obligation to help to repair the world. He wanted to make a difference and he believed that is what he was meant to do.
Salk attended a public high school for intellectually gifted boys who were otherwise barred from prestigious high schools because of religion or ethnicity. Because the Ivy League universities had strict quotas to keep Jewish students to a minimum, City College of New York was founded to give them the upper education they craved. Competition was intense and though the facilities were minimal – CCNY produced eight Nobel winners and more Ph.D’s than any other school except UC Berkeley.
After graduation, Salk accepted an appointment at the University of Pittsburgh and then with Dr. Thomas Francis moved to the University of Michigan to begin working on a vaccine to combat influenza. Techniques were developed to successfully inject “killed” influenza virus to promote the production of antibodies in as yet uninfected people. Salk then moved on to the arduous task of duplicating this method with the polio virus.
Author Charlotte Jacobs, M.D., takes what could easily be a complicated technical history and makes it accessible to a broad readership. The huge task of bringing the polio vaccine to human trials involved the vaccination of almost a million children in the second grade as well as enlisting an additional million in the first and third grades as the control groups. The staggering logistics included: 14,000 schools, school principals, teachers, parents, city officials, public health officers, 40,000 nurses, almost all of them volunteers. Everyone involved had to be recruited and trained.
Dosages and the timing of a series of three injections had to be computed, formulated and distributed – in a time before computers. Just getting second graders to successfully take home and return parental (filled out and signed) consent forms was a challenge. Every child was evaluated and tested before, during and after the trials.
Pharmaceutical companies were licensed and trained, protocols written, materials distributed (including lollipops for the kids), statistics compiled – it was more like gearing up for a war effort; which, in fact, it was. In addition, the intent was to complete this within a year while the children were still in school and before the onset of the next deadly summer. There was no government money involved – it was all financed by the small contributions of “ordinary” people to the March of Dimes. This is an engrossing story within a story.
Salk’s life was forever changed in 1955 when it was announced that the vaccine was safe and effective; he became known throughout the world. He was subsequently accused of seeking the limelight but he was just as often urged to use it to raise funds for further research. He had to learn to live with that dual persona.
The epic battle between Jonas Salk who advocated the use of killed virus and Albert Sabin, who advocated the use of weakened but live virus raged on for decades. Sabin’s vaccine produced a small number of annual polio victims due to the possible reinvigoration of the weakened but still alive virus. However, it was easier (and cheaper) to administer; one dose delivered on a cube of sugar.
Salk’s vaccine produced no new victims but had to be injected. Sabin won the battle and his vaccine was eventually declared to be the official standard in the United States. Europe, however, preferred the Salk vaccine. Undeterred, Salk continued the war, slowly but surely convincing the scientific community in the United States that use of a killed virus was much safer.
Salk never patented the vaccine and he never penetrated the elite clique of scientists in the United States who considered him a mere “kitchen chemist.” He was never honored with a Nobel Prize and was never nominated to the prestigious (American) National Academy of Sciences. He was, however, revered in Europe and honored there with election to the French Academy of Sciences.
He went on to found and build the Salk Institute in La Jolla, California, bringing together many of the great minds of the day. As AIDS became a threat, Salk began to study its complications and came up with some of the first treatments. He was eventually ousted from the Institute he created.
Jonas Salk was a complicated man living in a complicated environment and both his professional and private life reflected that. Jacobs weaves all of this into an engrossing book which I truly enjoyed and highly recommend. It would make a stirring movie.
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Orysiek is a freelance writer who specializes in arts and literature. Comments may be made to sheila.orysiek@sdjewishworld.com