Leadership and Crisis Theme Analysis

The Great War had brought Paul Lewis into the navy in 1918 as a lieutenant commander, but he never seemed quite at ease when in his uniform. It never fit quite right, or to sit quite right, and he was often flustered and failed to respond properly when sailors saluted him.

Nothing about the boyhood or youth of William Henry Welch suggested his future.

In the spring of 1918 death was no stranger to the world. Indeed, by then the bodies of more than five million soldiers had been fed into what was called the “sausage factory” by generals whose stupidity was matched only by their brutality.

Wilson had demanded that “the spirit of ruthless brutality. . . enter into the very fibre of national life.” To carry out that charge, Creel had wanted to create “one white-hot mass,” a mass driven by “deathless determination.” He was doing so. This was truly total war, and that totality truly included the medical profession.

As the virus moved, two parallel struggles emerged.

One encompassed all the nation. Within each city, within each factory, within each family, into each store, onto each farm, along the length of the track of the railroads, along the rivers and roads, deep into the bowels of mines and high along the ridges of the mountains, the virus would find its way. In the next weeks, the virus would test society as a whole and each element within it. Society would have to gather itself to meet this test, or collapse.

The other struggle lay within one tight community of scientists. They—men like Welch, Flexner, Cole, Avery, Lewis, Rosenau—had been drafted against their will into a race.

The Liberty Loan campaign would raise millions of dollars in Philadelphia alone. The city had a quota to meet. Central to meeting that quota was a parade scheduled for September 28.

Two days after Philadelphia’s Liberty Loan parade, Wilmer Krusen had issued that somber statement, that the epidemic in the civilian population “was assuming the type found in naval stations and cantonments.”

Lewis knew full well that little of what he was doing was good science. It was all, or nearly all, based on informed guesswork. He only worked harder.

As he worked, the society about him teetered on the edge of collapse.

While science was confronting nature, society began to confront the effects of nature. For this went beyond the ability of any individual or group of individuals to respond to. To have any chance in alleviating the devastation of the epidemic required organization, coordination, implementation. It required leadership and it required institutions follow that leadership.

By World War I, the revolution in American medicine led by William Welch had triumphed. That revolution had radically transformed American medicine, forcing its teaching, research, art, and practice through the filter of science.

So the final lesson of 1918, a simple one yet most difficult to execute, is that those who occupy positions of authority must retain the public’s trust. The way to do that is to distort nothing, to put the best face on nothing, to try to manipulate no one.