The Doctor Will See You Now

by Cory Franklin

  In our modern society, anti-vaxxers have taught us a tragic lesson: namely that better information, combined with more experience and more knowledge, does not always translate into greater wisdom.

  56

  WHEN THE AVIAN FLU COMES

  * * *

  In the whole the face of things, as I say, was much altered; sorrow and sadness sat upon every face; and though some parts were not yet overwhelmed, yet all looked deeply concerned; and as we saw it apparently coming on, so everyone looked on himself and his family as in the utmost danger.

  —DANIEL DEFOE, A JOURNAL OF THE PLAGUE YEAR

  CONSIDER THIS SCENARIO: A duck migrating through China stops to inspect a chicken that has died of avian flu, and the duck contracts the flu virus. The duck then carries the virus to a farm in Hong Kong and infects pigs, which already harbor a human flu virus, contracted from the farm’s owner. The pigs become the ideal breeding ground for a virulent hybrid virus created by the shuffling of genetic material between human and bird viruses. The lethal hybrid virus is passed to the farmer and quickly appears in Hong Kong.

  A month later the boss greets you and coworkers entering the company’s conference room for a morning meeting. He distributes handouts as he tells stories about his recent Far East vacation. He has a brief coughing spell.

  The convergence of the events in the Far East and that morning meeting means the boss’s innocent cough might convert that conference room into a deadly source of contagion for employees, their families, and their friends.

  The irony of human epidemics is that they usually begin in a subtle, innocuous fashion—something to ponder when you read about the prospects of a future avian flu epidemic. During flu season, most of the emphasis is on what the government will or won’t do to control such an epidemic. But the private sector must expand its role in controlling and managing this threat too. The entire workforce has to develop a heightened consciousness.

  The United Nation’s World Health Organization has predicted that between 2 million and 7.4 million people could die from a global influenza pandemic if one occurred today. The economic costs could potentially run into the hundreds of billions of dollars. Quarantine would be a real possibility, causing serious social disruption. President George W. Bush once even proposed using the US military to contain a flu outbreak. The government is constantly working on vaccine testing and developing and acquiring large stocks of antiviral drugs.

  But Hurricane Katrina taught us the folly of putting all our eggs in the government’s basket—government can only do so much. If a lethal flu strain did happen to strike, even a perfect response by federal, state, and local government would not avert disaster. Reliance on the public sector alone would be insufficient. Early involvement of the private sector will be imperative for economic preservation and, more important, to save lives.

  Even before flu season arrives, the first step by companies should be the pedestrian, but absolutely essential, provision of providing tissues (in some settings, face masks) and hand sanitizers to employees. Hand hygiene should be a priority. It’s important to encourage employees to get a flu vaccine; the strains the flu vaccine is most effective against every year are more likely than the avian flu to cause human disease, so it is a reasonable approach.

  Second, when a flu outbreak occurs, contagion is such a threat that employees should be encouraged not to come to work if they develop flu-like symptoms. This means companies may have to allow more sick days. Whenever possible work should be done at home and conferencing should be online; the flu virus is one virus the Internet won’t transmit. Businesses where an epidemic increases foot traffic, such as pharmacies, emergency medical services, and health care facilities, should have replacement workers on call.

  Conversely, in the event of a severe outbreak, businesses such as entertainment sites and nonessential retail stores should anticipate temporary shutdowns. Finally, private businesses have a critical role in working with public health officials to provide information and reassurance to a worried public in the event of a possible epidemic. And some legal indemnification may be necessary. Businesses, by suppressing their inherent aversion to government requests, could perform a service by providing important surveillance information on employees’ health status to government authorities.

  In the worst-case situation, an avian flu outbreak could create social dislocation and suffering unknown in the United States since the 1918 influenza pandemic. The personal toll on every citizen would be incalculable. To spare us a similar fate, the private sector must be part of any comprehensive national plan on how to deal with avian flu and other contagious strains.

  57

  THE CHICAGO EXPERIENCE WITH A NINETEENTH-CENTURY EPIDEMIC THAT KILLS

  AGAIN TODAY

  * * *

  The human mind always tries to expunge the intolerable from memory, just as it tries to conceal it while current.

  —H. L. MENCKEN

  A CHOLERA EPIDEMIC that began in 2010 has devastated Haiti, killing nearly ten thousand people and hospitalizing tens of thousands. The epidemic is still not completely under control in the country, with several hundred new infections each month. Meanwhile, in 2017 a cholera epidemic emerged in war-torn Yemen; there have been over one hundred thousand cases and over one thousand deaths.

  Cholera, caused by a waterborne bacterium, thrives in areas of unsanitary conditions, overcrowding, and shortages of clean water. It results in diarrhea and rapidly fatal dehydration unless treated promptly with fluids and antibiotics. The Haitian epidemic resulted from the aftermath of tropical storms and a devastating earthquake. But officials have acknowledged it was also the result of inadvertent contamination by UN peacekeepers. It is a reminder that cholera, a pandemic disease in the nineteenth century, can still ravage the twenty-first-century Third World.

  Because improved sanitation and modern medicine have drastically reduced the threat of cholera in the industrialized world, few remember its impact on the United States two centuries ago. Major European and American cities, including Chicago, were plagued by successive cholera epidemics, causing tens of thousands of deaths. Because Chicago developed along Lake Michigan, its early history was profoundly influenced by those outbreaks, and vestiges of that influence remain today.

  Until 1816 cholera was a disease limited to South Asia. The first cholera epidemic remained contained in eastern Asia until 1823. However, in 1826 a second Asian pandemic began, and cholera was carried by Russian troops into Poland in 1831. Within a year, the disease was endemic in Europe and the British Isles, devastating London and Paris. It spread as a by-product of the early Industrial Revolution. Steam-powered rapid transportation, urban population migration, crowded slums, inadequate water supplies, ineffective elimination of sewage, and unprepared city governments all played a part.

  With trepidation Americans read in their newspapers of the European epidemic in the early 1830s. Inevitably, immigrants on crowded ships from Britain brought cholera to Montreal in 1831. Cholera crossed the St. Lawrence River and Great Lakes, cutting a swath through Buffalo, New York; Detroit, Michigan; and the Eastern Seaboard cities.

  Cholera reached Chicago as a consequence of the 1832 Black Hawk War. Driven from Illinois, Chief Black Hawk, tribal leader of the Sauk and Fox, led a party from Iowa back across the Mississippi. The Illinois governor dispatched the Illinois militia and requested several thousand federal troops, who arrived on ships from Buffalo, commanded by Gen. Winfield Scott (future war hero of the Mexican-American War). This move was probably an overreaction since Black Hawk’s “hostile war party” consisted of only one thousand, including six hundred women and children, who were bearing seeds for planting crops.

  The Illinois militia quickly dispatched Black Hawk, ending forever the Native American threat to Cook County and the Chicago region. However, General Scott’s troops, who proved unnecessary, brought cholera from Buffalo to Fort Dearborn, and hundreds died just before Chicago was incorporated in 1833.

 
The continuing threat of cholera was impetus for the creation of the Chicago Board of Health in 1835. Despite this, subsequent cholera epidemics broke out in 1845 (traveling up the Mississippi and brought by workers on the Illinois and Michigan Canal) and at least four other times before 1873, killing thousands of Chicagoans.

  Those cholera epidemics were also responsible for Chicago’s first hospitals, several small, temporary structures built in the 1840s and 1850s designed to isolate cholera and smallpox victims. Inadequate for Chicago’s burgeoning population, they were replaced by Mercy Hospital, the oldest continuously running hospital in Chicago.

  Today orphanages, homes for parentless children, are a little-remembered historical footnote. But they were once prominent institutions housing thousands in nineteenth-century Chicago. The first Chicago orphanages, the Chicago Orphan Asylum and the Catholic Orphan Asylum, began as a result of an 1849 cholera epidemic that left many children without parents. Social concerns caused orphanages to disappear eventually, but the eradication of cholera was one reason they were no longer necessary.

  An 1851 cholera epidemic prompted the creation of Chicago’s first public water board. The board commissioned an engineer with previous experience working on the Erie Canal to design a city water-supply system. The city’s first water pipes were laid with a goal of preventing cholera and other diseases, as well as fighting fires in the wooden structures of the central business district (structures that burned during the infamous Great Chicago Fire of 1871).

  The early burial grounds in Chicago were near Lake Michigan at Fort Dearborn, along the river. In the 1840s a large city cemetery complex extended in what is now Lincoln Park, including land the city purchased from the estate of a wealthy cholera victim. After another cholera epidemic, the proximity of the city cemetery to the water supply became a public health concern. In the 1860s, large numbers of bodies were transported to cemeteries farther from the lake, which remain today, including Graceland, Rosehill, and Oak Woods.

  Improvements in sewage and sanitation finally ended the scourge of cholera in Chicago in the early 1880s. Over the years there were reports of a terrible 1885 epidemic of cholera and typhoid fever that killed ninety thousand. It is almost certainly an urban myth since no contemporaneous accounts exist, which would be incredible considering the improbably high number of deaths (equivalent to 250 Great Chicago Fires). By then cholera had basically been eradicated in Chicago.

  Today cholera’s impact on early Chicago has been largely forgotten. Barring a cataclysmic natural disaster or major societal upheaval, Chicagoans will never again experience a cholera epidemic. But the story of cholera is as integral to the fabric of Chicago as the colorful accounts of crooked politicians, World’s Fairs, and gangsters that regale us in our history books.

  VII

  SCIENTIFIC PHILOSOPHY

  58

  CAN SCIENCE AND RELIGION COEXIST?

  * * *

  Godspeed, John Glenn.

  —SCOTT CARPENTER

  IN 1962 PROJECT Mercury astronaut Scott Carpenter, the backup pilot for Friendship 7, delivered one of the most famous phrases in American history to pilot John Glenn, the first American to orbit the Earth. Ironically, Glenn never heard it because his microphone was tuned to a different frequency. Carpenter’s message followed that of mission control test conductor Tom O’Malley, who also broadcast a personal prayer, “May the Good Lord ride all the way.”

  The significance of this story, beyond its historical importance, was the underappreciated role of religion in the early American space program. Lost in the eulogies for John Glenn when he died in 2016 was how important religious faith was to him and some of his colleagues in the high-tech atmosphere of the space race. For a time Glenn and Buzz Aldrin, the second man to walk on the moon, were elders in the same Houston church. A devout Presbyterian and churchgoer, Glenn prayed routinely during his flights as a test pilot and astronaut.

  He once told the Associated Press that he saw no contradiction between belief in God and evolution: “I don’t see that I’m any less religious by the fact that I can appreciate that science just records that we change with evolution and time. . . . It doesn’t mean it’s less wondrous and it doesn’t mean that there can’t be some power greater than any of us that has been behind and is behind whatever is going on.”

  In today’s fractious secular society, such an opinion is not especially popular, particularly among scientists. The oft-quoted astrophysicist Neil deGrasse Tyson asserts publicly there is little common ground between science and religion. But besides John Glenn, there have always been men of science who have taken a more nuanced view of science and religion.

  Dr. Charles Townes won the 1964 Nobel Prize in Physics for his invention of the laser and also the 2005 Templeton Prize for “exceptional contribution to affirming life’s spiritual dimension, whether through insight, discovery, or practical works.” (Dual winners of the Nobel and Templeton include Mother Teresa and the Dalai Lama.)

  Dr. Townes once spoke of his religious belief in the context of outer space:

  Science is an exploration of what things are like and how they work. Why they are that way is more a religious question. And the two are complementary. I think they are both important. Why did the universe begin? Why is the universe here? Why are we here? And why did the laws of science come out the way they are so we could be here. I think the apparent friction between science and religion is kind of artificial. I see no real friction between the two but some people want to make it that way. We need more integration between the two in the future. We need to be more open-minded and deeper in our thinking.

  The world’s greatest twentieth-century scientist, Albert Einstein, struggled his entire life with the fundamental relationship between religion and science. A secular Jew, Einstein abjured formal religion but disapproved of those who used his views to endorse atheism. He expressed a sentiment similar to Townes: “Science without religion is lame, religion without science is blind.”

  Richard Feynman, a giant of American physics and a celebrated iconoclast, delivered a famous speech in 1956 at the California Institute for Technology titled “The Relation of Science and Religion.” Feynman, also a secular Jew, said, “Although science makes some impact on many religious ideas, it does not affect the moral content. Religion has many aspects; it answers all kinds of questions . . . about what things are, where they come from, what man is, what God is—the properties of God, and so on . . . the metaphysical aspect of religion.”

  Hardly a religious man, Feynman proceeded to raise the centuries-old question of the interplay of religion and science, which still resonates today:

  Religion also tells us another thing—how to behave. Leave out of this the idea of how to behave in certain ceremonies, and what rites to perform; I mean it tells us how to behave in life in general, in a moral way. It gives answers to moral questions; it gives a moral and ethical code. . . . Western civilization, it seems to me, stands by two great heritages. One is the scientific spirit of adventure—the adventure into the unknown, the attitude that all is uncertain; to summarize it—the humility of the intellect. The other great heritage is Christian ethics—the basis of action on love, the brotherhood of all men, the value of the individual—the humility of the spirit. These two heritages are logically, thoroughly consistent. But logic is not all; one needs one’s heart to follow an idea. . . . How can we draw inspiration to support these two pillars of Western civilization so that they may stand together in full vigor, mutually unafraid? Is this not the central problem of our time?

  As much as anyone, John Glenn understood the humility of the intellect. In 1998, at seventy-seven, he became the oldest man to go into space when he traveled on the space shuttle. When he returned, Glenn opined on Feynman’s central problem, “To look out at this kind of creation and not believe in God is, to me, impossible. It just strengthens my faith.”

  Godspeed, John Glenn.

  59

  BACK TO THE FUTURE: NAVIGATI
NG BY THE STARS

  * * *

  As technology goes up, creativity and imagination go down.

  —JIM NICHOLSON

  AS LONGTIME WRITER, reporter, and intelligence expert Jim Nicholson implies, technology should complement—not replace—old-school skills. In that vein, because of fears that the global positioning system (GPS) could be jammed or hacked, the US Navy has announced it will reinstitute classes on celestial navigation—that is, plotting course and direction by the stars. “We went away from celestial navigation because computers are great,” Lt. Cmdr. Ryan Rogers, deputy chairman of the United States Naval Academy’s department of seamanship and navigation, recently told the Capital Gazette. “The problem is there’s no backup [for GPS].”

  The navy will complement the more precise but potentially vulnerable GPS by teaching the navigation method mariners have employed since antiquity. The New York Times has reported that Russian submarines troll ominously close to critical undersea communication cables from the North Sea to waters near US shores, ready to disrupt high-tech communication, so this development represents a teachable moment about overreliance on technology.