August 16, 2024 • 40 mins
Young doctor Jesse Lazear has deadly Yellow Fever. He thrashes around and convulses in his sick bed, and his vomit is black. He is just 34 when he dies.
Curiously, mosquito expert Lazear was researching the disease when he became ill. Some historians think his infection wasn't an accident, and that he was secretly experimenting on himself...
Today, human challenge trials - where volunteers are intentionally given a disease under the watchful eye of medical support - are rare. The authorities are wary of the risks involved. But such trials can also mean that vaccines are developed faster and thousands of lives are saved. Is it time to start thinking differently about experimenting on humans?
For a full list of sources, see the show notes at timharford.com.
See omnystudio.com/listener for privacy information.
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:15):
Pushkin Hello listeners, Happy Friday. Before we crack on with
this episode, I wanted to let you know that Pushkin
Plus subscribers can now hear an astonishing two part story
of disaster. A story of enormous egos and enormous mustaches,
of fraud and financial ruin, of hubris and despair. It's
(00:39):
a story of new technologies and of death on a
massive scale, and ultimately a story of understated genius. What's
this story all about? A war? A revolution? No, something
even bigger a canal. After you've finished listening to this
(00:59):
cautionary tale, you might like to check it out for Now,
on with our episode and a quest to understand how
the gruesome disease of yellow fever spreads. John Moran enters
Building number two. It's a simple timber hut with just
(01:23):
one room measuring fourteen feet by twenty. Dividing the room
in two is a fine, strong wire mesh with holes
of a fiftieth and an inch. Moran is wearing a
night shirt, nothing else. He lies down on the bed
around him buzz mosquitoes fifteen mosquitoes to be precise. Soon
(01:49):
one lands on his hand. He doesn't try to squish
it or flick it off. The mosquito slides its proboscis
through John Moran's skin and sucks his blood. On the
other side of the wire net from Moran and the
mosquitoes sits. Major Walter reed, he could tell you the
(02:12):
life story of every one of those mosquitoes. They've been
sucking the blood of people who are sick with yellow fever.
We're in Cuba, in an improvised U. S Army camp,
just outside Havana. It's the twenty first of December nineteen hundred.
Four days later, on Christmas morning, John Moran wakes up
(02:36):
with chills and a headache. He tries to eat his
Christmas lunch, but he has no appetite. By the afternoon,
his temperatures climbed to one hundred and three. Is it
yellow fever? Moran was twenty four years old. He'd come
to Cuba with the US Army, but left to get
(02:56):
a civilian job as a clerk. It pays better, and
Moran is trying to save money to take a degree
in medicine. A few weeks earlier, when Major Reid had
let it be known that he was looking for volunteers
for his mosquito experiments. Moran's old army friends had made
sure he knew about it. Reed will pay you, They
(03:18):
told him several months worth of salary. John Moran knew
very well how deadly yellow fever can be. It had
just killed the clerk who.
Speaker 2 (03:29):
Worked next to him.
Speaker 1 (03:31):
He thought about it, then went to introduce himself to
Major Reed. I want to volunteer, said Moran. And I
don't want money. I want to do it for science,
for humanity. Major Reed looked at John Moran.
Speaker 3 (03:49):
I take my head off to you.
Speaker 1 (03:50):
He said. John Moran was bravely taking a risk for
noble motives. Are we too scared to let people take
risks like that? Today? I'm Tim Harford and you're listening
to cautionary tales. What's it like to have yellow fever?
(04:33):
Here's one victim describing the onset of their symptoms. It
seemed as if every bone in my body had been crushed.
My spine felt twisted, and my head swollen, and my
eyes felt as if they would pop out of my head.
Even the ends of my fingers felt as though they
would snap off. If that's as bad as it gets,
(04:56):
you're one of the lucky ones. In a week or two,
you'll be okay again, But about fifteen percent of people
aren't lucky. Their illness develops a second, much more serious phase.
Your skin turns yellow from jaundice. You're delirious from fever.
You start to bleed, perhaps from your eyes or your gums,
(05:20):
or perhaps inside your stomach. So when you vomit, your
vomit black organs start to fail. There's no treatment. If
this second phase takes hold, your chance of surviving is
little more than fifty to fifty. No wonder. Yellow fever
(05:41):
once caused such terror in America's port cities. Outbreaks didn't
always spread far, but when they did, they were devastating.
In seventeen ninety three, yellow fever decimated Philadelphia, killing five
thousand people, one tenth of the population. In eighteen fifty three,
(06:02):
it did the same in Your Orleans. Where it came
from was clear enough ships from the Caribbean in the summer.
But once it had arrived, how did it spread? Was
it person to person contact? In Philadelphia, people stopped shaking hands,
(06:24):
Many shrank with affright at even the offer of a hand,
observed one writer. At the time, acquaintances and friends avoided
each other in the streets and only signified their regard
by a cold nod. Or did yellow fever spread through
something in the air. In New Orleans, the authorities burned
(06:47):
barrels of tar and whiskey to try to clear the toxins.
Or did it spread through contaminated objects. During the Civil War,
a Confederate doctor plotted an early attempt at bioterrorism. He
gathered clothes from people who died of yellow fever and
tried to ship them to cities in the North. He
(07:10):
even sent a suitcase full to Abraham Lincoln. The assassination
attempt failed. The doctor was later elected governor of Kentucky.
By nineteen hundred, the question of how yellow fever spread
had become urgent for the US Army. The US had
(07:31):
occupied Cuba, a hot bed of yellow fever. They had
to figure out what to do to keep the troops
as safe as possible. They set up a commission, at
its head, Major Walter Reid. It just investigated how typhoid
spreads on army bases. He had concluded rightly that preventing
(07:51):
typhoid was all about sanitation. Build the trenes wash hands.
But the army had been improving sanitation in Cuba, and
rates of yellow fever were staying stubbornly high. What worked
for typhoid didn't work for yellow fever, So what were
they missing? There were theories and puzzles, like the curious
(08:15):
case of the court martialed soldier. He was kept in
a cell on a military race, closely guarded, so they
knew for sure that he hadn't had contact with anyone
else who'd been ill. Yet still he caught it and died.
It was as if the disease had somehow flown in
(08:36):
through the bars of the cell window. Strange. Major Reid
chose colleagues to assist him. His old friend James Carroll,
a brilliant young doctor Jesse Lazier. They'd go to Cuba
and try to work it out. There was one theory
(08:56):
that could explain the case of the court martialed soldier.
For twenty years, a Cuban doctor had been tirelessly championing
his idea that a certain species of mosquito spread yellow fever.
It was plausible enough on the face of it. Another
species of mosquito had just been discovered to transmit malaria,
(09:17):
why not yellow fever too. The problem was that the
Cuban doctor had been trying for twenty years to prove
his theory, with no success. He bred mosquitoes and let
them feed on yellow fever patients. Then he persuaded nearly
one hundred people to be bitten by those mosquitoes. If
(09:38):
that seems like an insane thing to agree to, remember
that it can't have seemed that much of a risk.
Yellow fever was common, so were mosquitoes, and hardly anyone
bought the idea that the two were linked, And with
every new volunteer, the doctor's theory seemed less and less
likely to be true. Only a few of those bitten
(10:02):
got ill, and most of them had symptoms that were
hard to diagnose with confidence. They might have had a
mildcare of yellow fever, or it might have been something else.
It was hard to say. Just one volunteer unmistakably got
yellow fever soon after the mosquito bite, and who could
(10:23):
be sure that wasn't a coincidence. He might have got
it somewhere else. So the evidence wasn't promising, But Major
Reed and his colleagues wanted to test the theory for themselves.
They visited the Cuban doctor who gave them some mosquito
eggs hid bread. The eggs were.
Speaker 4 (10:41):
A jet black color, one end rounded and blunt, while
the other is slightly pointed, the whole closely resembling a
cancheedah cigar.
Speaker 1 (10:52):
Put them in water, said the Cuban doctor, and in
ten to twelve days you'll have mosquitoes. Reed put his
young colleague Jesse Lazier in charge. That made sense. Laziir
had worked on malaria. He knew mosquitoes hatched the eggs,
and kept each mosquito in its own test tube plugged
(11:14):
with cotton. He'd take them to a hospital with a
yellow fever ward, sit by the bedside of a patient,
remove the cotton plug, and put the open end of
the test tube to the patient's skin. He'd flick the
test tube to get the mosquito moving. Once the mosquito
had drunk its fill of the patient's blood, he'd plug
(11:36):
the test tube again. Could these mosquitoes now infect someone
with yellow fever? There was only one way to find out.
Lazir put a test tube on his arm and let
the mosquito feed on him. An army doctor said he'd
take a bite two. How risky was it really? The
(11:56):
Cuban doctor had done this to nearly one hundred people,
and almost all had been fine. The odds seemed firmly
in their favor. Days passed, and Lazir and the army
doctor remained in perfect health. Other soldiers volunteered too, nobody
got ill. Lazier was fast giving up on the theory.
(12:19):
He told his colleague on the Commission, James Carroll, and
now one of his carefully nurtured mosquitoes seemed about to die.
It had sucked the blood of one yellow fever patient,
but had since been refusing to feed again. It was
listless without another blood meal, it wouldn't last for long.
(12:40):
Carol had never believed in the mosquito theory. Put your
mosquito on me, he said, I'll see if I can
feed it to keep it going for you. There were
two things Jesse Lazier and James Carroll didn't know. They
didn't know that for a mosquito to pass on yellow fever,
(13:02):
it needs to have fed on someone in the first
three days of their infection. Lazier had often fed his
mosquitoes on patients who had been sick for longer than that.
Then it takes at least twelve days for the mosquito
to incubate the virus so it can pass it on
when it bites someone else. Laziir generally hadn't been waiting
(13:25):
that long before he put his mosquitoes onto healthy volunteers.
Lazier passed James Carroll the test tube with the ailing mosquito.
As it happened, precisely, twelve days had passed since this
mosquito had fed on a yellow fever patient. According to
Lazier's notes, a patient who had been on day two
(13:50):
of his illness, Carol, rolled up his sleeve. Lazier put
the test tube to Carol's arm. The mosquito didn't move.
Lazier tapped the test tube to rouse it. Still nothing.
Lazier shrugged and began to take the test tube away.
(14:10):
Give it here, said Carol. He held the test tube
to his arm and waited patiently until at last, the
sluggish mosquito fluttered onto his arm and slipped its proboscis
through his skin. Cautionary, tails will be back in a moment.
(14:53):
Three days after Jesse Lazier's ailing mosquito had fared on
James Carroll's blood, the mosquito was doing well. So was
James Carroll. He was enjoying a swim in the warm
sea off a Cuban beach when I felt as sudden
chill and a crushing headache. By the next day, Carol
(15:14):
had been taken to hospital. He was running a fever
of one hundred and five and trying to say something
about a mosquito. The nurse couldn't follow it. He must
be delirious. Jesse Lazier must have felt mortified. He had
failed time and again to produce a case of yellow fever.
(15:36):
Had he finally succeeded when he wasn't even trying? Laziir
sought out James Carroll's notebook. He wanted to see what
Carol had been doing for the last few days. If
Carol hadn't left the camp, which was fever free, that
would point convincingly to the mosquito as the cause of
(15:56):
the infection. But Carol's notebook said he had been visiting
hospital wards and autopsy rooms where yellow fever victims were dissected.
Skeptics would say that he could have got it anywhere. Still,
at least Lazier now had a lead a mosquito in
a test tube that might have given yellow fever to
(16:17):
James Carroll. Could that mosquito give it to someone else?
Lazier needed another volunteer, and he soon found one in
the army camp. The young soldier expressed curiosity about his work.
Speaker 3 (16:32):
You're still fallen with mosquitoes.
Speaker 1 (16:34):
Doctor, yes, said Lazier. Then will you take a bite? Sure,
replied the soldier.
Speaker 3 (16:43):
I ain't scared of them.
Speaker 1 (16:45):
The soldier said he hadn't been off the camp in
two months. That was perfect. Lazier brought the test tube
with the mosquito that had bitten James Carroll and put
it to the soldier's arm. Five days later, the soldier
began to feel unwell. It's hard to predict how badly
(17:08):
you'll get yellow fever. We now know there are different strains,
some deadlier than others, but the younger you are, the
better your chances. Children would often get it mildly and
then be immune for life. The soldier was young and
lucky his case was mild. James Carroll was older, and
(17:30):
he was having a rougher time, still in his hospital bed,
writhing in pain and burning up. Nurses giving him ice
cold enemies to try to bring his fever down. Jesse
Lazier was desperately worried about James Carroll, but he was
excited too. I rather think I am on the track
(17:53):
of the real germ, he wrote back home. But nothing
must be said as yet, not even a hint. And
then the story gets murky. The Yellow Fever COMMISSI remember,
was headed by Major Walter Reid. Where was Major Reid?
(18:14):
While all this drama was unfolding in Cuba? Reid was
back in America. He had to finish his big report
on typhoid and present it to his bosses in Washington,
d c. He got a telegram describing his old friend
James Carroll's bite and illness.
Speaker 2 (18:32):
He wrote back, I cannot begin to describe my mental
distress over this most unfortunate turn of affairs. The next
piece of news was more positive. Carol at last had
begun to pull through. His fever was down. There'd been
none of the dreaded black vomit. He was weak, but
(18:55):
he'd live. Read fired off a letter.
Speaker 5 (18:59):
My dear Carol Hip Hurrah, God be praised. I can
never recall such a sense of relief in all my life.
I shall simply go out and get boiling drunk. God
bless you, my boy.
Speaker 1 (19:14):
And then another telegram Jesse Lazier had got yellow fever.
The message was blunt, severe case. What had happened? According
to Jesse Lazier, this is what had happened. He was
(19:36):
in a hospital at the bedside of a yellow fever patient,
holding a test tube to the patient's skin. The mosquito
in the tube had just started to feed. Then, said Lazier,
another mosquito that happened to be in the room landed
on his hand. He didn't want to move because he
had disturbed the insect in the test tube and have
(19:58):
to start all over again. And he thought the mosquito
on his hand was from a different species, one that
wasn't suspected of spreading the disease, so he let the
mosquito bite him. Historians think that isn't plausible. Lazia, remember,
(20:19):
was a mosquito expert. He'd studied malaria. He had been
spending day after day intently observing his mosquitoes in test tubes.
He affectionately called them his birds. In their book Yellow Jack,
the authors John Pierce and James Writer say it simply
(20:40):
does not make sense that Lazier did not recognize what
species of mosquito had landed on his own hand. What
historians think happened is this Jesse Lazier experimented on himself again.
Today he claimed he had been bitten by accident. September thirteenth,
(21:03):
nineteen hundred. Lazia's notebook contains a cryptic entry. Up till
then he had recorded the names of all his volunteers,
along with the history of the mosquitoes that fed on them.
This entry simply said, guinea pig number one in the
mosquito it had fed on a patient in the second
(21:27):
day of his illness, fourteen days earlier. If Lazier had
formed a theory about the timelines required to transmit yellow fever,
this was exactly the mosquito he'd have chosen to put
that theory to the test. It's possible, of course, that
(21:47):
Lazier had suddenly decided to feed one of his mosquitoes
on an actual guinea pig, but as nobody on the
commission had ever discussed doing experiments on guinea pigs, it
seems unlikely. We can only presume that guinea pig number
one was Jesse Lazier. Why it on himself and why
(22:11):
hide it? We'll never know. Five days after guinea pig
number one was bitten, Jesse Lazier began to feel unwell.
He sat down to write a letter to his mother,
who was taking care of his wife back in America.
His wife had just given birth to their second child.
(22:33):
He didn't mention his illness.
Speaker 4 (22:36):
Dear little Houston must be very cute.
Speaker 1 (22:38):
He wrote. Houston was their toddler. The next day, Lazier
was carried to the hospital. James Carroll had recovered enough
just about to shuffle over to Lazier's bedside. I shall
never forget the expression of alarm in his eyes, he said.
(23:01):
Lazier's illness moved quickly to the deadly second stage. He
thrashed around so much nurses had to call for soldiers
to strap his wrists and ankles to the bed. He
began to convulse and vomit. The vomit was black. Jesse
Lazier was thirty four years old when yellow fever killed him.
(23:32):
As Major Walter Reed prepared to return to Cuba, he
had a problem. It wasn't just that one of his
team was dead and another would need a long time
off to recover. Their self. Sacrifice had gone to waste.
They'd been brave in getting bitten, but they hadn't been scientific,
as Reid explained in a frustrated letter to the convalescing
(23:55):
James Carroll.
Speaker 3 (23:57):
If you, my dear doctor, had, prior to your bait,
remained at the camp for ten days, then we would
have a clear case. But you didn't. You went just
where you might have contracted the disease from another sauce.
Speaker 1 (24:11):
And what about Jesse Lazier. According to his own account,
he had been bitten while at a yellow fever hospital.
For goodness sake, that knocks his case out, wrote Reed.
Speaker 3 (24:25):
I mean, as a thoroughly scientific experiment.
Speaker 1 (24:29):
There was the young soldier Lazier had infected with the
same mosquito as Carol. His case was highly suggestive, but
not conclusive, not yet to remove any doubt. Walter Reed
was going to have to do more thoroughly scientific experiments,
and for that he'd need more volunteers. Cautionary tales will return.
(25:07):
Walter Reed needed a sight to construct a new camp.
It had to be in a part of Cuba that
wasn't known for yellow fever. He needed well drained land
with no stagnant water for mosquitoes to breed. He couldn't
risk stray mosquitoes buzzing in to mess up his experiments.
He found a two acre site and brought in brand
(25:29):
new tents and equipment so nobody could say they might
have been contaminated. He had the workers quarantined to make
sure they weren't harboring the disease. He then had them
tested for fever three times a day. The workers put
up the tents and two simple wooden buildings in honor
(25:51):
of their fallen colleague. They called it Camp Laziar. Building
number one had nothing to do with mosquitoes. Reid wanted
to disprove once and for all the idea that contaminated
clothing could spread yellow fever. It was a simple wooden
shed fourteen feet by twenty with shuttered windows. By now
(26:14):
it was November, the weather was cooling down. Reed wanted
a fair test in tropical conditions, so he had a
stove installed in the room to keep the temperature above
ninety degrees fahrenheit. Reed got three volunteers to go into
the dark and sweltering hut with a tightly sealed trunk.
(26:36):
It had sent from the yellow fever ward at a
nearby hospital. The trunk contained bed sheets and blankets, all
soiled with a liberal quantity of black vomit urine and
fecal matter. The three men cracked open the trunk and
straightway ran back outside, gasping and wretching, and got their breath,
(27:03):
stealed their nerves, and went back in. They took the
fetid sheets and blankets out of the trunk and gave
them all a good shake. If there were contagious particles
that ought to spread them around. Then they put the
sheets on the beds in the hut and slept on
them for twenty nights.
Speaker 4 (27:25):
We all felt like we were coming down with yellow
fever every day.
Speaker 1 (27:29):
Said one, but they didn't. It was conclusive proof that
this long held theory was wrong. The Kentucky Doctor's suitcase
could never have killed Abraham Lincoln Walter Reed had been
confident that the volunteers in Building number one were never
in danger of death, just discomfort. The mosquito experiments for
(27:55):
a different matter, Reid had studied Jesse Lazier's notebook. He'd
talked to the young soldier Lazier had infected, and he
had drawn the correct conclusion. He needed an incubation period
of at least twelve days. The new knowledge meant Reed's
(28:15):
experiments at Camp Lazier wouldn't be like Jesse Lazier's earlier,
more casual attempts, when the volunteers could take comfort in
odds of one in one hundred. Red knew that his
volunteers were very likely to get yellow fever. He wanted
them to know that. So Reid had a form typed
(28:36):
up spelling out the risks, and every time someone asked
a volunteer he got them to sign it. Informed consent
is standard practice. Now Reid was its pioneer. But why
would anyone sign We heard already the young idealist John
(28:59):
Moran explain his reasons for science and humanity, and Moran
didn't want the money, even though he was saving hard
to go to medical school, and in today's terms, Reed
was offering many thousands of dollars. Others did want the money,
and they had another pragmatic reason too. If you moved
(29:21):
to Cuba from a place without yellow fever, so you
weren't immune from childhood, you felt sure that you'd get
it sooner or later, So why not take your chances now,
knowing you'd have the most attentive medical care. The US
Army could offer. In March twenty twenty, the enormity of
(29:44):
the COVID pandemic was starting to dawn on the world.
Most of us were trying to make sense of the present,
but three academics were looking to the future. We're going
to need vaccines, they said, as quickly as possible. Those
vaccines were already being developed and would need to be tested,
(30:05):
but the traditional clinical trial might take a long time.
A big group of volunteers would receive either the new
vaccines or a placebo and would then go about their
daily lives. Some of them eventually would get COVID, allowing
scientists to figure out whether most of these cases were
(30:26):
in the placebo group, in which case the vaccine would
have worked. But since most people around the world were
trying very hard not to spread the virus, just waiting
for enough of those infections to happen by accident could
take months. Wouldn't it be quicker to deliberately expose your
(30:47):
volunteers to COVID. That's called a human challenge trial, and
they've often been used to develop other vaccines. Josh Morrison
ran a health nonprofit in New York. He thought ourd
volunteer to get COVID if it might speed up a
vaccine that could get life back to normal, would other
people too? He set up a website called One Day Sooner,
(31:12):
and words spread. Within weeks, tens of thousands of people
signed up to say they'd do it if someone asked them.
Some expressed motives much like John Moran's, They'd do it
for science, for humanity. Others were pragmatic. Like other yellow
fever volunteers. They said they thought they'd get COVID anyway,
(31:34):
and they liked the idea of getting it when doctors
and nurses would be watching them closely. But many decision
makers were wary about the idea of challenge trials for COVID.
They're usually used for diseases. We have a good idea
of how to treat at the time, we couldn't treat COVID.
(31:55):
So what said Josh Morrison? This is a global emergency.
We can't take the risk, said others. What if someone dies?
The debate rumbled on through the summer of twenty twenty.
Trials didn't happen for the first set of vaccines. They
were tested in the usual way. One Day Sooner became
(32:17):
an advocacy group for Challenge Trial volunteers. Later, they funded
researchers to ask how many lives might have been saved
if the first vaccines had come, say, thirty days earlier.
Sixty three thousand, the researchers estimated in the US and
(32:38):
UK alone. It's hard to be sure if Challenge trials
really would have given US vaccines thirty days earlier. But
this isn't really about COVID. It's about looking ahead to
the next pandemic and what we might learn one possible lesson.
Let's be more proactive about lining up challenge trials. Let's
(33:03):
be more hard headed about the trade offs when we
ask what if we have a trial and someone dies?
Let's also ask what if we don't have a trial
and sixty three thousand people die. We can't eliminate risk,
but we can take calculated risks in a way that
(33:24):
advances our knowledge. If we have another global emergency and
selfless volunteers again raise their hands, let's not allow their
bravery to go to waste. Jesse Lazier and James Carroll
wasted their bravery because they gave themselves yellow fever in
(33:46):
a way that scientifically proved nothing Whialter Reed was determined
not to waste the courage of his new volunteers, such
as John Moran. He needed to conduct experiments that nobody
would be able to nitpick. In Building number two, Red
wanted to put to rest the idea that led New
(34:07):
Orleans authorities to burn barrels of whiskey and tar, the
theory that yellow fever spreads through toxins in the air.
A fine, strong wire mesh ran down the middle of
the room. On one side fifteen mosquitoes and John Moran
on the other side. Not only read, but two more volunteers,
(34:32):
acting as controls. They slept in their half of the hut,
breathing the same air as John Moran. On Christmas Day,
John Moran got yellow fever. The other two never did.
Moran was young and lucky, His case was mild, and
he recovered. By early February nineteen oh one, Walter Reed
(34:59):
was ready to report the results of his thoroughly scientific experiments.
In a speech to a medical congress in Havana. He
explained how it proved that yellow fever didn't spread through
dirty objects, it didn't spread through the air, It spread
through mosquitoes.
Speaker 2 (35:18):
The hall was Pecked, wrote Reed to his wife, the
applause long and hardy.
Speaker 1 (35:26):
The authorities in Havana set up mosquito brigades to try
to rid the city of the mosquitoes that spread yellow fever.
They went from house to house. Most had no piped water. Instead,
people collected rainwater in open barrels. Mosquitoes laid their eggs
on the surface of that water. The mosquito brigades poured
(35:50):
oil on top. Just a thin film was enough to
suffocate the larvae. As the mosquitoes disappeared, so did the disease.
Over the previous ten years, Havana had averaged four hundred
and sixty two yellow fever deaths a year. In the
rest of nineteen o one, there were five. James Carroll
(36:18):
never fully recovered from his fight with yellow fever. His
heart failed. A few years later. Walter Reed died early too,
though not from yellow fever a ruptured appendix. His name
lives on in the Walter Reed National Military Medical Center
in Bethesda, Maryland. But I was curious what happened to
(36:42):
John Moran, the poster boy for selflessness with the dream
of being a doctor. I found an obituary from nineteen fifty.
Moran had lived to seventy four. He had settled in
Cuba and built a distinguished career as an oil man.
(37:03):
What happened to saving for medical school? Soon after his
bout of yellow fever? The obituary said, Moran took the
money he'd saved so far and invested it in a
get rich quick oil scheme. The scheme failed, Moran had
to give up on his ambition to study. He got
(37:23):
a job in the oil industry instead, and worked his
way up. I can't help wondering if he'd have felt
that need to gamble his savings, if only he'd taken
the payment from Walter Reed, he'd surely earned it. John
Moran risked his life for an experiment, then risked his
(37:46):
savings for his dream career. One risk paid off, one didn't.
That's the nature of risks. When Jesse Lazier and James
Carroll took the risk of being bitten by a mosquito,
we learned far too little because a proper scientific experiment
wasn't in place, And when the volunteers have one day sooner,
(38:10):
we're willing to take a similar risk. In the face
of COVID, we learned far too little yet again because
a proper scientific experiment just seemed too bold for policymakers
to approve. But there'll always be people who'll take risks
as a gift to help others. Shouldn't we be prepared
(38:31):
to accept that gift. The American Plague by Molly Caldwell
Crosby is a compelling history of yellow fever, as is
Yellowjack by John Pierce and James Writer. For a full
(38:54):
list of our sources, see the show notes at Timharford
dot com. If you enjoyed this tale, I recommend you
hop on over to pushkin Plus and check out my
brand new pair of episodes on the Panama Canal. Yellow Fever.
Greek's havoc on this mega project just one of many
obstacles faced by the French and the Americans on their
(39:16):
mission to dig a waterway across Central America. Cautionary Tales
is written by me Tim Harford with Andrew Wright. It's
produced by Alice Fines with support from Marilyn Rust. The
sound design and original music is the work of Pascal Wise.
Sarah Nix edited the scripts. It features the voice talents
(39:40):
of Ben Crowe, Melanie Guttridge, Stella Harford, Jammy Saunders and
rufus Wright. The show also wouldn't have been possible without
the work of Jacob Weisberg, Ryan Dilly, Greta Cohne, Eric's handler,
Carrie Brody, and Christina Sullivan. Cautionary Tales is a production
of Pushkin Industries. It's recorded at Wardoor Studios in London
(40:02):
by Tom Berry. If you like the show, please remember
to share, rate and review, tell your friends and if
you want to hear the show ad free, sign up
for Pushkin Plus on the show page in Apple Podcasts
or at pushkin dot Fm, slash plus
Pushkin Hello listeners, Happy Friday. Before we crack on with
this episode, I wanted to let you know that Pushkin
Plus subscribers can now hear an astonishing two part story
of disaster. A story of enormous egos and enormous mustaches,
of fraud and financial ruin, of hubris and despair. It's
(00:39):
a story of new technologies and of death on a
massive scale, and ultimately a story of understated genius. What's
this story all about? A war? A revolution? No, something
even bigger a canal. After you've finished listening to this
(00:59):
cautionary tale, you might like to check it out for Now,
on with our episode and a quest to understand how
the gruesome disease of yellow fever spreads. John Moran enters
Building number two. It's a simple timber hut with just
(01:23):
one room measuring fourteen feet by twenty. Dividing the room
in two is a fine, strong wire mesh with holes
of a fiftieth and an inch. Moran is wearing a
night shirt, nothing else. He lies down on the bed
around him buzz mosquitoes fifteen mosquitoes to be precise. Soon
(01:49):
one lands on his hand. He doesn't try to squish
it or flick it off. The mosquito slides its proboscis
through John Moran's skin and sucks his blood. On the
other side of the wire net from Moran and the
mosquitoes sits. Major Walter reed, he could tell you the
(02:12):
life story of every one of those mosquitoes. They've been
sucking the blood of people who are sick with yellow fever.
We're in Cuba, in an improvised U. S Army camp,
just outside Havana. It's the twenty first of December nineteen hundred.
Four days later, on Christmas morning, John Moran wakes up
(02:36):
with chills and a headache. He tries to eat his
Christmas lunch, but he has no appetite. By the afternoon,
his temperatures climbed to one hundred and three. Is it
yellow fever? Moran was twenty four years old. He'd come
to Cuba with the US Army, but left to get
(02:56):
a civilian job as a clerk. It pays better, and
Moran is trying to save money to take a degree
in medicine. A few weeks earlier, when Major Reid had
let it be known that he was looking for volunteers
for his mosquito experiments. Moran's old army friends had made
sure he knew about it. Reed will pay you, They
(03:18):
told him several months worth of salary. John Moran knew
very well how deadly yellow fever can be. It had
just killed the clerk who.
Speaker 2 (03:29):
Worked next to him.
Speaker 1 (03:31):
He thought about it, then went to introduce himself to
Major Reed. I want to volunteer, said Moran. And I
don't want money. I want to do it for science,
for humanity. Major Reed looked at John Moran.
Speaker 3 (03:49):
I take my head off to you.
Speaker 1 (03:50):
He said. John Moran was bravely taking a risk for
noble motives. Are we too scared to let people take
risks like that? Today? I'm Tim Harford and you're listening
to cautionary tales. What's it like to have yellow fever?
(04:33):
Here's one victim describing the onset of their symptoms. It
seemed as if every bone in my body had been crushed.
My spine felt twisted, and my head swollen, and my
eyes felt as if they would pop out of my head.
Even the ends of my fingers felt as though they
would snap off. If that's as bad as it gets,
(04:56):
you're one of the lucky ones. In a week or two,
you'll be okay again, But about fifteen percent of people
aren't lucky. Their illness develops a second, much more serious phase.
Your skin turns yellow from jaundice. You're delirious from fever.
You start to bleed, perhaps from your eyes or your gums,
(05:20):
or perhaps inside your stomach. So when you vomit, your
vomit black organs start to fail. There's no treatment. If
this second phase takes hold, your chance of surviving is
little more than fifty to fifty. No wonder. Yellow fever
(05:41):
once caused such terror in America's port cities. Outbreaks didn't
always spread far, but when they did, they were devastating.
In seventeen ninety three, yellow fever decimated Philadelphia, killing five
thousand people, one tenth of the population. In eighteen fifty three,
(06:02):
it did the same in Your Orleans. Where it came
from was clear enough ships from the Caribbean in the summer.
But once it had arrived, how did it spread? Was
it person to person contact? In Philadelphia, people stopped shaking hands,
(06:24):
Many shrank with affright at even the offer of a hand,
observed one writer. At the time, acquaintances and friends avoided
each other in the streets and only signified their regard
by a cold nod. Or did yellow fever spread through
something in the air. In New Orleans, the authorities burned
(06:47):
barrels of tar and whiskey to try to clear the toxins.
Or did it spread through contaminated objects. During the Civil War,
a Confederate doctor plotted an early attempt at bioterrorism. He
gathered clothes from people who died of yellow fever and
tried to ship them to cities in the North. He
(07:10):
even sent a suitcase full to Abraham Lincoln. The assassination
attempt failed. The doctor was later elected governor of Kentucky.
By nineteen hundred, the question of how yellow fever spread
had become urgent for the US Army. The US had
(07:31):
occupied Cuba, a hot bed of yellow fever. They had
to figure out what to do to keep the troops
as safe as possible. They set up a commission, at
its head, Major Walter Reid. It just investigated how typhoid
spreads on army bases. He had concluded rightly that preventing
(07:51):
typhoid was all about sanitation. Build the trenes wash hands.
But the army had been improving sanitation in Cuba, and
rates of yellow fever were staying stubbornly high. What worked
for typhoid didn't work for yellow fever, So what were
they missing? There were theories and puzzles, like the curious
(08:15):
case of the court martialed soldier. He was kept in
a cell on a military race, closely guarded, so they
knew for sure that he hadn't had contact with anyone
else who'd been ill. Yet still he caught it and died.
It was as if the disease had somehow flown in
(08:36):
through the bars of the cell window. Strange. Major Reid
chose colleagues to assist him. His old friend James Carroll,
a brilliant young doctor Jesse Lazier. They'd go to Cuba
and try to work it out. There was one theory
(08:56):
that could explain the case of the court martialed soldier.
For twenty years, a Cuban doctor had been tirelessly championing
his idea that a certain species of mosquito spread yellow fever.
It was plausible enough on the face of it. Another
species of mosquito had just been discovered to transmit malaria,
(09:17):
why not yellow fever too. The problem was that the
Cuban doctor had been trying for twenty years to prove
his theory, with no success. He bred mosquitoes and let
them feed on yellow fever patients. Then he persuaded nearly
one hundred people to be bitten by those mosquitoes. If
(09:38):
that seems like an insane thing to agree to, remember
that it can't have seemed that much of a risk.
Yellow fever was common, so were mosquitoes, and hardly anyone
bought the idea that the two were linked, And with
every new volunteer, the doctor's theory seemed less and less
likely to be true. Only a few of those bitten
(10:02):
got ill, and most of them had symptoms that were
hard to diagnose with confidence. They might have had a
mildcare of yellow fever, or it might have been something else.
It was hard to say. Just one volunteer unmistakably got
yellow fever soon after the mosquito bite, and who could
(10:23):
be sure that wasn't a coincidence. He might have got
it somewhere else. So the evidence wasn't promising, But Major
Reed and his colleagues wanted to test the theory for themselves.
They visited the Cuban doctor who gave them some mosquito
eggs hid bread. The eggs were.
Speaker 4 (10:41):
A jet black color, one end rounded and blunt, while
the other is slightly pointed, the whole closely resembling a
cancheedah cigar.
Speaker 1 (10:52):
Put them in water, said the Cuban doctor, and in
ten to twelve days you'll have mosquitoes. Reed put his
young colleague Jesse Lazier in charge. That made sense. Laziir
had worked on malaria. He knew mosquitoes hatched the eggs,
and kept each mosquito in its own test tube plugged
(11:14):
with cotton. He'd take them to a hospital with a
yellow fever ward, sit by the bedside of a patient,
remove the cotton plug, and put the open end of
the test tube to the patient's skin. He'd flick the
test tube to get the mosquito moving. Once the mosquito
had drunk its fill of the patient's blood, he'd plug
(11:36):
the test tube again. Could these mosquitoes now infect someone
with yellow fever? There was only one way to find out.
Lazir put a test tube on his arm and let
the mosquito feed on him. An army doctor said he'd
take a bite two. How risky was it really? The
(11:56):
Cuban doctor had done this to nearly one hundred people,
and almost all had been fine. The odds seemed firmly
in their favor. Days passed, and Lazir and the army
doctor remained in perfect health. Other soldiers volunteered too, nobody
got ill. Lazier was fast giving up on the theory.
(12:19):
He told his colleague on the Commission, James Carroll, and
now one of his carefully nurtured mosquitoes seemed about to die.
It had sucked the blood of one yellow fever patient,
but had since been refusing to feed again. It was
listless without another blood meal, it wouldn't last for long.
(12:40):
Carol had never believed in the mosquito theory. Put your
mosquito on me, he said, I'll see if I can
feed it to keep it going for you. There were
two things Jesse Lazier and James Carroll didn't know. They
didn't know that for a mosquito to pass on yellow fever,
(13:02):
it needs to have fed on someone in the first
three days of their infection. Lazier had often fed his
mosquitoes on patients who had been sick for longer than that.
Then it takes at least twelve days for the mosquito
to incubate the virus so it can pass it on
when it bites someone else. Laziir generally hadn't been waiting
(13:25):
that long before he put his mosquitoes onto healthy volunteers.
Lazier passed James Carroll the test tube with the ailing mosquito.
As it happened, precisely, twelve days had passed since this
mosquito had fed on a yellow fever patient. According to
Lazier's notes, a patient who had been on day two
(13:50):
of his illness, Carol, rolled up his sleeve. Lazier put
the test tube to Carol's arm. The mosquito didn't move.
Lazier tapped the test tube to rouse it. Still nothing.
Lazier shrugged and began to take the test tube away.
(14:10):
Give it here, said Carol. He held the test tube
to his arm and waited patiently until at last, the
sluggish mosquito fluttered onto his arm and slipped its proboscis
through his skin. Cautionary, tails will be back in a moment.
(14:53):
Three days after Jesse Lazier's ailing mosquito had fared on
James Carroll's blood, the mosquito was doing well. So was
James Carroll. He was enjoying a swim in the warm
sea off a Cuban beach when I felt as sudden
chill and a crushing headache. By the next day, Carol
(15:14):
had been taken to hospital. He was running a fever
of one hundred and five and trying to say something
about a mosquito. The nurse couldn't follow it. He must
be delirious. Jesse Lazier must have felt mortified. He had
failed time and again to produce a case of yellow fever.
(15:36):
Had he finally succeeded when he wasn't even trying? Laziir
sought out James Carroll's notebook. He wanted to see what
Carol had been doing for the last few days. If
Carol hadn't left the camp, which was fever free, that
would point convincingly to the mosquito as the cause of
(15:56):
the infection. But Carol's notebook said he had been visiting
hospital wards and autopsy rooms where yellow fever victims were dissected.
Skeptics would say that he could have got it anywhere. Still,
at least Lazier now had a lead a mosquito in
a test tube that might have given yellow fever to
(16:17):
James Carroll. Could that mosquito give it to someone else?
Lazier needed another volunteer, and he soon found one in
the army camp. The young soldier expressed curiosity about his work.
Speaker 3 (16:32):
You're still fallen with mosquitoes.
Speaker 1 (16:34):
Doctor, yes, said Lazier. Then will you take a bite? Sure,
replied the soldier.
Speaker 3 (16:43):
I ain't scared of them.
Speaker 1 (16:45):
The soldier said he hadn't been off the camp in
two months. That was perfect. Lazier brought the test tube
with the mosquito that had bitten James Carroll and put
it to the soldier's arm. Five days later, the soldier
began to feel unwell. It's hard to predict how badly
(17:08):
you'll get yellow fever. We now know there are different strains,
some deadlier than others, but the younger you are, the
better your chances. Children would often get it mildly and
then be immune for life. The soldier was young and
lucky his case was mild. James Carroll was older, and
(17:30):
he was having a rougher time, still in his hospital bed,
writhing in pain and burning up. Nurses giving him ice
cold enemies to try to bring his fever down. Jesse
Lazier was desperately worried about James Carroll, but he was
excited too. I rather think I am on the track
(17:53):
of the real germ, he wrote back home. But nothing
must be said as yet, not even a hint. And
then the story gets murky. The Yellow Fever COMMISSI remember,
was headed by Major Walter Reid. Where was Major Reid?
(18:14):
While all this drama was unfolding in Cuba? Reid was
back in America. He had to finish his big report
on typhoid and present it to his bosses in Washington,
d c. He got a telegram describing his old friend
James Carroll's bite and illness.
Speaker 2 (18:32):
He wrote back, I cannot begin to describe my mental
distress over this most unfortunate turn of affairs. The next
piece of news was more positive. Carol at last had
begun to pull through. His fever was down. There'd been
none of the dreaded black vomit. He was weak, but
(18:55):
he'd live. Read fired off a letter.
Speaker 5 (18:59):
My dear Carol Hip Hurrah, God be praised. I can
never recall such a sense of relief in all my life.
I shall simply go out and get boiling drunk. God
bless you, my boy.
Speaker 1 (19:14):
And then another telegram Jesse Lazier had got yellow fever.
The message was blunt, severe case. What had happened? According
to Jesse Lazier, this is what had happened. He was
(19:36):
in a hospital at the bedside of a yellow fever patient,
holding a test tube to the patient's skin. The mosquito
in the tube had just started to feed. Then, said Lazier,
another mosquito that happened to be in the room landed
on his hand. He didn't want to move because he
had disturbed the insect in the test tube and have
(19:58):
to start all over again. And he thought the mosquito
on his hand was from a different species, one that
wasn't suspected of spreading the disease, so he let the
mosquito bite him. Historians think that isn't plausible. Lazia, remember,
(20:19):
was a mosquito expert. He'd studied malaria. He had been
spending day after day intently observing his mosquitoes in test tubes.
He affectionately called them his birds. In their book Yellow Jack,
the authors John Pierce and James Writer say it simply
(20:40):
does not make sense that Lazier did not recognize what
species of mosquito had landed on his own hand. What
historians think happened is this Jesse Lazier experimented on himself again.
Today he claimed he had been bitten by accident. September thirteenth,
(21:03):
nineteen hundred. Lazia's notebook contains a cryptic entry. Up till
then he had recorded the names of all his volunteers,
along with the history of the mosquitoes that fed on them.
This entry simply said, guinea pig number one in the
mosquito it had fed on a patient in the second
(21:27):
day of his illness, fourteen days earlier. If Lazier had
formed a theory about the timelines required to transmit yellow fever,
this was exactly the mosquito he'd have chosen to put
that theory to the test. It's possible, of course, that
(21:47):
Lazier had suddenly decided to feed one of his mosquitoes
on an actual guinea pig, but as nobody on the
commission had ever discussed doing experiments on guinea pigs, it
seems unlikely. We can only presume that guinea pig number
one was Jesse Lazier. Why it on himself and why
(22:11):
hide it? We'll never know. Five days after guinea pig
number one was bitten, Jesse Lazier began to feel unwell.
He sat down to write a letter to his mother,
who was taking care of his wife back in America.
His wife had just given birth to their second child.
(22:33):
He didn't mention his illness.
Speaker 4 (22:36):
Dear little Houston must be very cute.
Speaker 1 (22:38):
He wrote. Houston was their toddler. The next day, Lazier
was carried to the hospital. James Carroll had recovered enough
just about to shuffle over to Lazier's bedside. I shall
never forget the expression of alarm in his eyes, he said.
(23:01):
Lazier's illness moved quickly to the deadly second stage. He
thrashed around so much nurses had to call for soldiers
to strap his wrists and ankles to the bed. He
began to convulse and vomit. The vomit was black. Jesse
Lazier was thirty four years old when yellow fever killed him.
(23:32):
As Major Walter Reed prepared to return to Cuba, he
had a problem. It wasn't just that one of his
team was dead and another would need a long time
off to recover. Their self. Sacrifice had gone to waste.
They'd been brave in getting bitten, but they hadn't been scientific,
as Reid explained in a frustrated letter to the convalescing
(23:55):
James Carroll.
Speaker 3 (23:57):
If you, my dear doctor, had, prior to your bait,
remained at the camp for ten days, then we would
have a clear case. But you didn't. You went just
where you might have contracted the disease from another sauce.
Speaker 1 (24:11):
And what about Jesse Lazier. According to his own account,
he had been bitten while at a yellow fever hospital.
For goodness sake, that knocks his case out, wrote Reed.
Speaker 3 (24:25):
I mean, as a thoroughly scientific experiment.
Speaker 1 (24:29):
There was the young soldier Lazier had infected with the
same mosquito as Carol. His case was highly suggestive, but
not conclusive, not yet to remove any doubt. Walter Reed
was going to have to do more thoroughly scientific experiments,
and for that he'd need more volunteers. Cautionary tales will return.
(25:07):
Walter Reed needed a sight to construct a new camp.
It had to be in a part of Cuba that
wasn't known for yellow fever. He needed well drained land
with no stagnant water for mosquitoes to breed. He couldn't
risk stray mosquitoes buzzing in to mess up his experiments.
He found a two acre site and brought in brand
(25:29):
new tents and equipment so nobody could say they might
have been contaminated. He had the workers quarantined to make
sure they weren't harboring the disease. He then had them
tested for fever three times a day. The workers put
up the tents and two simple wooden buildings in honor
(25:51):
of their fallen colleague. They called it Camp Laziar. Building
number one had nothing to do with mosquitoes. Reid wanted
to disprove once and for all the idea that contaminated
clothing could spread yellow fever. It was a simple wooden
shed fourteen feet by twenty with shuttered windows. By now
(26:14):
it was November, the weather was cooling down. Reed wanted
a fair test in tropical conditions, so he had a
stove installed in the room to keep the temperature above
ninety degrees fahrenheit. Reed got three volunteers to go into
the dark and sweltering hut with a tightly sealed trunk.
(26:36):
It had sent from the yellow fever ward at a
nearby hospital. The trunk contained bed sheets and blankets, all
soiled with a liberal quantity of black vomit urine and
fecal matter. The three men cracked open the trunk and
straightway ran back outside, gasping and wretching, and got their breath,
(27:03):
stealed their nerves, and went back in. They took the
fetid sheets and blankets out of the trunk and gave
them all a good shake. If there were contagious particles
that ought to spread them around. Then they put the
sheets on the beds in the hut and slept on
them for twenty nights.
Speaker 4 (27:25):
We all felt like we were coming down with yellow
fever every day.
Speaker 1 (27:29):
Said one, but they didn't. It was conclusive proof that
this long held theory was wrong. The Kentucky Doctor's suitcase
could never have killed Abraham Lincoln Walter Reed had been
confident that the volunteers in Building number one were never
in danger of death, just discomfort. The mosquito experiments for
(27:55):
a different matter, Reid had studied Jesse Lazier's notebook. He'd
talked to the young soldier Lazier had infected, and he
had drawn the correct conclusion. He needed an incubation period
of at least twelve days. The new knowledge meant Reed's
(28:15):
experiments at Camp Lazier wouldn't be like Jesse Lazier's earlier,
more casual attempts, when the volunteers could take comfort in
odds of one in one hundred. Red knew that his
volunteers were very likely to get yellow fever. He wanted
them to know that. So Reid had a form typed
(28:36):
up spelling out the risks, and every time someone asked
a volunteer he got them to sign it. Informed consent
is standard practice. Now Reid was its pioneer. But why
would anyone sign We heard already the young idealist John
(28:59):
Moran explain his reasons for science and humanity, and Moran
didn't want the money, even though he was saving hard
to go to medical school, and in today's terms, Reed
was offering many thousands of dollars. Others did want the money,
and they had another pragmatic reason too. If you moved
(29:21):
to Cuba from a place without yellow fever, so you
weren't immune from childhood, you felt sure that you'd get
it sooner or later, So why not take your chances now,
knowing you'd have the most attentive medical care. The US
Army could offer. In March twenty twenty, the enormity of
(29:44):
the COVID pandemic was starting to dawn on the world.
Most of us were trying to make sense of the present,
but three academics were looking to the future. We're going
to need vaccines, they said, as quickly as possible. Those
vaccines were already being developed and would need to be tested,
(30:05):
but the traditional clinical trial might take a long time.
A big group of volunteers would receive either the new
vaccines or a placebo and would then go about their
daily lives. Some of them eventually would get COVID, allowing
scientists to figure out whether most of these cases were
(30:26):
in the placebo group, in which case the vaccine would
have worked. But since most people around the world were
trying very hard not to spread the virus, just waiting
for enough of those infections to happen by accident could
take months. Wouldn't it be quicker to deliberately expose your
(30:47):
volunteers to COVID. That's called a human challenge trial, and
they've often been used to develop other vaccines. Josh Morrison
ran a health nonprofit in New York. He thought ourd
volunteer to get COVID if it might speed up a
vaccine that could get life back to normal, would other
people too? He set up a website called One Day Sooner,
(31:12):
and words spread. Within weeks, tens of thousands of people
signed up to say they'd do it if someone asked them.
Some expressed motives much like John Moran's, They'd do it
for science, for humanity. Others were pragmatic. Like other yellow
fever volunteers. They said they thought they'd get COVID anyway,
(31:34):
and they liked the idea of getting it when doctors
and nurses would be watching them closely. But many decision
makers were wary about the idea of challenge trials for COVID.
They're usually used for diseases. We have a good idea
of how to treat at the time, we couldn't treat COVID.
(31:55):
So what said Josh Morrison? This is a global emergency.
We can't take the risk, said others. What if someone dies?
The debate rumbled on through the summer of twenty twenty.
Trials didn't happen for the first set of vaccines. They
were tested in the usual way. One Day Sooner became
(32:17):
an advocacy group for Challenge Trial volunteers. Later, they funded
researchers to ask how many lives might have been saved
if the first vaccines had come, say, thirty days earlier.
Sixty three thousand, the researchers estimated in the US and
(32:38):
UK alone. It's hard to be sure if Challenge trials
really would have given US vaccines thirty days earlier. But
this isn't really about COVID. It's about looking ahead to
the next pandemic and what we might learn one possible lesson.
Let's be more proactive about lining up challenge trials. Let's
(33:03):
be more hard headed about the trade offs when we
ask what if we have a trial and someone dies?
Let's also ask what if we don't have a trial
and sixty three thousand people die. We can't eliminate risk,
but we can take calculated risks in a way that
(33:24):
advances our knowledge. If we have another global emergency and
selfless volunteers again raise their hands, let's not allow their
bravery to go to waste. Jesse Lazier and James Carroll
wasted their bravery because they gave themselves yellow fever in
(33:46):
a way that scientifically proved nothing Whialter Reed was determined
not to waste the courage of his new volunteers, such
as John Moran. He needed to conduct experiments that nobody
would be able to nitpick. In Building number two, Red
wanted to put to rest the idea that led New
(34:07):
Orleans authorities to burn barrels of whiskey and tar, the
theory that yellow fever spreads through toxins in the air.
A fine, strong wire mesh ran down the middle of
the room. On one side fifteen mosquitoes and John Moran
on the other side. Not only read, but two more volunteers,
(34:32):
acting as controls. They slept in their half of the hut,
breathing the same air as John Moran. On Christmas Day,
John Moran got yellow fever. The other two never did.
Moran was young and lucky, His case was mild, and
he recovered. By early February nineteen oh one, Walter Reed
(34:59):
was ready to report the results of his thoroughly scientific experiments.
In a speech to a medical congress in Havana. He
explained how it proved that yellow fever didn't spread through
dirty objects, it didn't spread through the air, It spread
through mosquitoes.
Speaker 2 (35:18):
The hall was Pecked, wrote Reed to his wife, the
applause long and hardy.
Speaker 1 (35:26):
The authorities in Havana set up mosquito brigades to try
to rid the city of the mosquitoes that spread yellow fever.
They went from house to house. Most had no piped water. Instead,
people collected rainwater in open barrels. Mosquitoes laid their eggs
on the surface of that water. The mosquito brigades poured
(35:50):
oil on top. Just a thin film was enough to
suffocate the larvae. As the mosquitoes disappeared, so did the disease.
Over the previous ten years, Havana had averaged four hundred
and sixty two yellow fever deaths a year. In the
rest of nineteen o one, there were five. James Carroll
(36:18):
never fully recovered from his fight with yellow fever. His
heart failed. A few years later. Walter Reed died early too,
though not from yellow fever a ruptured appendix. His name
lives on in the Walter Reed National Military Medical Center
in Bethesda, Maryland. But I was curious what happened to
(36:42):
John Moran, the poster boy for selflessness with the dream
of being a doctor. I found an obituary from nineteen fifty.
Moran had lived to seventy four. He had settled in
Cuba and built a distinguished career as an oil man.
(37:03):
What happened to saving for medical school? Soon after his
bout of yellow fever? The obituary said, Moran took the
money he'd saved so far and invested it in a
get rich quick oil scheme. The scheme failed, Moran had
to give up on his ambition to study. He got
(37:23):
a job in the oil industry instead, and worked his
way up. I can't help wondering if he'd have felt
that need to gamble his savings, if only he'd taken
the payment from Walter Reed, he'd surely earned it. John
Moran risked his life for an experiment, then risked his
(37:46):
savings for his dream career. One risk paid off, one didn't.
That's the nature of risks. When Jesse Lazier and James
Carroll took the risk of being bitten by a mosquito,
we learned far too little because a proper scientific experiment
wasn't in place, And when the volunteers have one day sooner,
(38:10):
we're willing to take a similar risk. In the face
of COVID, we learned far too little yet again because
a proper scientific experiment just seemed too bold for policymakers
to approve. But there'll always be people who'll take risks
as a gift to help others. Shouldn't we be prepared
(38:31):
to accept that gift. The American Plague by Molly Caldwell
Crosby is a compelling history of yellow fever, as is
Yellowjack by John Pierce and James Writer. For a full
(38:54):
list of our sources, see the show notes at Timharford
dot com. If you enjoyed this tale, I recommend you
hop on over to pushkin Plus and check out my
brand new pair of episodes on the Panama Canal. Yellow Fever.
Greek's havoc on this mega project just one of many
obstacles faced by the French and the Americans on their
(39:16):
mission to dig a waterway across Central America. Cautionary Tales
is written by me Tim Harford with Andrew Wright. It's
produced by Alice Fines with support from Marilyn Rust. The
sound design and original music is the work of Pascal Wise.
Sarah Nix edited the scripts. It features the voice talents
(39:40):
of Ben Crowe, Melanie Guttridge, Stella Harford, Jammy Saunders and
rufus Wright. The show also wouldn't have been possible without
the work of Jacob Weisberg, Ryan Dilly, Greta Cohne, Eric's handler,
Carrie Brody, and Christina Sullivan. Cautionary Tales is a production
of Pushkin Industries. It's recorded at Wardoor Studios in London
(40:02):
by Tom Berry. If you like the show, please remember
to share, rate and review, tell your friends and if
you want to hear the show ad free, sign up
for Pushkin Plus on the show page in Apple Podcasts
or at pushkin dot Fm, slash plus
Host
Tim Harford
Popular Podcasts
On Purpose with Jay Shetty
I’m Jay Shetty host of On Purpose the worlds #1 Mental Health podcast and I’m so grateful you found us. I started this podcast 5 years ago to invite you into conversations and workshops that are designed to help make you happier, healthier and more healed. I believe that when you (yes you) feel seen, heard and understood you’re able to deal with relationship struggles, work challenges and life’s ups and downs with more ease and grace. I interview experts, celebrities, thought leaders and athletes so that we can grow our mindset, build better habits and uncover a side of them we’ve never seen before. New episodes every Monday and Friday. Your support means the world to me and I don’t take it for granted — click the follow button and leave a review to help us spread the love with On Purpose. I can’t wait for you to listen to your first or 500th episode!
Dateline NBC
Current and classic episodes, featuring compelling true-crime mysteries, powerful documentaries and in-depth investigations. Follow now to get the latest episodes of Dateline NBC completely free, or subscribe to Dateline Premium for ad-free listening and exclusive bonus content: DatelinePremium.com
Stuff You Should Know
If you've ever wanted to know about champagne, satanism, the Stonewall Uprising, chaos theory, LSD, El Nino, true crime and Rosa Parks, then look no further. Josh and Chuck have you covered.