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Chapter 3
Themes
Key
LitCharts assigns a color and icon to each theme in The Great Influenza, which you can use to track the themes throughout the work.
Leadership and Crisis
Truth, Free Press, and Propaganda
Science vs. Nature
Education, Research, and Institutions
Summary
Analysis
The Johns Hopkins School of Medicine finally opened in 1893, seeking to revolutionize American medicine. One notable feature was that the institution itself paid faculty salaries, not student fees. It made its impact quickly, and of the first four Americans to receive a Nobel Prize in Physiology or Medicine, three went to Hopkins and one had studied in Europe.
Welch was behind many of Hopkins’ early achievements. He became a national figure, serving on prestigious scientific board positions. In particular, he did two noteworthy things: first, he helped reform medical education, not just at Hopkins but at schools that followed Hopkins’ example. Second, he directed tens of millions of dollars into lab research.
This passage reiterates the two things that most scientists need: money and institutional support. Welch was an expert in providing these resources for his colleagues and protégés, and this was what won him such widespread admiration.
Themes
Unlike Europe, in the U.S. medical research didn’t have government monetary support or wealthy patrons. The greater monetary support in Europe had led to a golden age of medical discoveries, including vaccines against major diseases like anthrax and typhoid. In addition to vaccines, European scientists also looked for ways to help people who were already sick. This led to the discovery of cure for the deadly childhood disease diphtheria, arguably the first major cure ever discovered. When the diphtheria antitoxin was distributed, fatality rates fell almost two thirds.
The book highlights the importance of men like Welch by showing how they were filling a leadership vacuum created by the U.S. government’s reluctance to support medical education as proactively as European governments did. While the book presents Welch’s work in a positive light, the book advocates for governments to get more involved as well, showing here how European government involvement had a beneficial impact on diphtheria.
Themes
Frederick Gates was a Baptist minister and an assistant to John D. Rockefeller who theoretically only managed his philanthropic endeavors but who also sometimes helped Rockefeller make a profit. Gates found a medical textbook written by William Osler. Reading the book convinced Gates that there was a lot of unrealized potential in the medical field.
Gates and Rockefeller are not scientists by any means—in Barry’s portrayal, they almost seem to found the Rockefeller Institute on a whim, since they apparently get the idea for a multimillion-dollar institution from reading a single textbook. Ultimately, however, this whim is enough, since they wisely leave running the institute to more capable scientists.
Themes
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Rockefeller launched the Rockefeller Institute for Medical research. Welch turned down an offer to head, suggesting that Simon Flexner run it instead. Still, Welch remained very involved with the institute’s launch.
Here, Welch demonstrates both the wisdom of knowing his own limits and generosity towards his colleagues—important traits that helped make him such a successful leader.
Themes
Flexner was a former juvenile delinquent who eventually got his medical degree. Insecure about his background, Flexner read a lot to make up for gaps in his knowledge.
Most of the people profiled in this book came from privileged backgrounds, so Flexner’s history as a juvenile delinquent makes him stand out. It suggests that in rare cases, strong institutions help foster social mobility.
Themes
One of Flexner’s early successes was an experiment where he helped cut down the death rate for patients with bacterial meningitis. This brought a lot of publicity, both to him and to the Rockefeller Institute where he worked. Flexner was a capable leader with a talent for tackling big problems, and some of the undergraduates that worked with him would go on to win Nobel Prizes.
As medical science matured, success was increasingly measured by objective standards, like how much a given treatment cut down the death rate for a disease. Flexner’s meningitis experiments prove that despite his rough background (or perhaps in some ways because of it), he possessed the clear thinking needed to solve difficult medical problems.
Themes
Even before the Rockefeller Institute’s success, America’s medical science was finally beginning to get a better reputation abroad. Though there were still disagreements among prominent scientists, the groundwork was in place for U.S. medicine to become a global leader.
Barry takes stock of where American medical education was by the late 19th century. Though Johns Hopkins and the Rockefeller Institute are a focal point of the book, Barry acknowledges that the revolution in U.S. medicine was taking place on a larger scale and can’t be fully attributed to any one person or institution.
Themes
