Scientific Exploration

A key narrative of The Great Influenza is the story of scientific exploration. In the prologue, John M. Barry writes that the story of the 1918-19 pandemic is “a story of science, of discovery, of how one thinks, and of how one changes the way one thinks.” In the first chapters, Barry describes the shift of perspective that took place in the medical world in the eighteenth century, when medicine shifted from a foundation of abstract reasoning to a foundation of empirical science. This shift can be understood on a philosophical level by examining the questions science asks and how those questions are answered.

Barry writes: “The two most important questions in science are ‘What can I know?’ and ‘How can I know it?’” The pursuit of these questions leads scientists to “the frontier” as they push themselves to the edge of what they know. This type of exploration requires courage, a comfort with uncertainty, and a special type of judgment. These qualities necessary for successful scientific exploration are what set certain scientists in the book apart from others. Only a few of them possessed the “instinct for what mattered and the ability to pursue it vertically and connect it horizontally.”

William Welch lacked the “deeper wonder” to focus on one specific scientific question, but he had the ability to connect the work of one scientist to the work of another. Oswald Avery, however, was captured by wonder. He “tugged at a thread and kept tugging, untangling it, following where it led”; ultimately, his “obsessive” study of pneumococci opened up the world of molecular biology. Paul Lewis possessed genius and potential, yet he lacked Avery’s instinct. In the laboratory, he “could not find the right loose thread to tug at.” He could not utilize his failures to either redirect him or come to a deeper understanding. Unlike Welch, he did not recognize his own inability in the laboratory. He simply kept trying, and ultimately failing. Through these portraits, Barry shows the various paths scientific exploration can take.

The Importance of Leadership 

Leadership is a prominent theme throughout The Great Influenza. The book focuses on individuals with power, illustrating how the use—or misuse—of power can have widespread consequences.

In the scientific community during the influenza pandemic of 1918–1919, key leaders included William Welch and Simon Flexner. Under their guidance—and under the guidance of those they led—American medicine was revolutionized. As a teacher, Welch had the ability to inspire his students and to create a culture of unity at the Hopkins. Both he and Flexner were able to identify the strengths of others and understand how those strengths could complement the larger work of medical science. As the leader of the Rockefeller Institute, Flexner was able to make difficult decisions and direct the work of others. Flexner gave scientists time and space to explore; when Lewis first came to the Institute, Flexner told him that he would “expect nothing from him for a year.” Like Welch at the Hopkins, Flexner’s personality influenced the culture of the Institute as a whole.

In the realm of politics, The Great Influenza examines governments from the municipal to the national level. In many cities, lack of strong leadership left “a vacuum,” and that vacuum was typically filled with collective fear. Existing leadership was often undermined by either corruption or incompetence. In some cases, other organizations—from upper-class families to the Red Cross—tried to fill that vacuum. On a national level, President Woodrow Wilson’s ruthless focus on the war effort set the tone for how the country would respond to the pandemic.

Occupying a nexus between the political and the scientific worlds, US Army Surgeon General William Gorgas demonstrated capable leadership. In spite of many obstacles, including superiors who refused to listen to his recommendations, Gorgas prepared for an epidemic in every way he could. He remained focused on his goal of reducing American deaths due to wartime disease, and his decisions saved many lives.

Other military leaders, however, forged ahead with plans that simply added to the death and suffering. In a particularly poignant example, a father of one young soldier who died of influenza wrote an accusing letter to Secretary of War Newton Baker. Baker “took to heart” these charges, and he “replied in a seven-page, single-spaced letter, a letter of his own agony.” In this situation and others, The Great Influenza illustrates the weight of responsibility that comes with leadership. The book shows how during a pandemic, the difference between strong and incompetent leadership can be measured in human lives.

Nature Versus Science 

At the beginning of The Great Influenza, Barry states that the 1918 pandemic was “the first great collision between nature and modern science.” Throughout the book, nature is often personified as a “raging” force.

By the end of the pandemic, Barry describes the world as “sick at heart.” Part of this widespread disappointment and disillusion was due to “the utter failure of science, the greatest achievement of modern man, in the face of the disease.” Scientists who had initially approached influenza with arrogance had become humbled by it. And Barry makes it clear that when the virus finally did dissipate, it was not due to any human efforts; rather, it was due to the natural processes of immunity and the fact that the virus mutated back to its normal form.

While much of The Great Influenza praises the courageous individuals who studied influenza with grim determination, Barry is clear that nature is ultimately the stronger force and a continual source of uncertainty. In the afterword, when Barry speculates about a future pandemic, he points out how advances in science and public health are still woefully inadequate in the face of another lethal influenza virus.

The Value of Truth 

In The Great Influenza, the value of truth is a theme that appears in different ways. First, the entire realm of scientific exploration and debate is a search for truth. Guided by scientific principles, investigators have a standard for how to discover and verify truth. Throughout the 1918-19 pandemic, the search for the disease pathogen often revolved around the question of “Pfeiffer’s bacillus,” a bacteria that had been declared by German scientist Pfeiffer to be the cause of influenza. Some scientists accepted this as truth, and this false certainty derailed their study. And in the context of a pandemic, the successful discovery of scientific truth can be the key to mitigating disaster.

The value of truth is equally relevant when Barry examines the social consequences of the pandemic. He quotes the words of Hiram Johnson in 1917: “The first casualty when war comes is truth.” In the context of wartime, truth had already been compromised by the time the influenza virus hit. The ongoing lies of newspapers and politicians, who generally sought to suppress information about the pandemic, cost incalculable lives. The lies and omissions spread terror, and it was “the fear, not the disease, [that] threatened to break society apart.” Barry traces how the lack of public information resulted in collective panic. With less access to solid information, citizens filled in the gaps of their knowledge with assumptions and anxieties. 

In the face of a future pandemic, it is crucial that “those in authority must retain the public’s trust.” They must do this by foregoing all manipulation and managing of the truth. They must simply “tell the truth.” In doing so, they will dismantle the terror that comes from the unknown.