Jonas Salk Gives Away the Polio Vaccine

The smell of the ward never left my hands, not even after the third washing. Carbolic soap, and under it the metal smell of the machines, the iron lungs breathing for children who could no longer breathe for themselves. I worked the polio ward before anyone outside Pittsburgh had heard the name Jonas Salk spoken with any weight, back when summer meant something different than it does now, when the arrival of warm weather was measured not in relief but in dread. Mothers kept their children from swimming pools. Movie theaters emptied. A cough in July carried a different kind of silence behind it than a cough in December.

I remember a boy no older than nine, brought in on a Tuesday, still wearing his football jersey because nobody had time to change him before the ambulance came. The day before he'd been running routes on a scrubby lot two blocks from his house. Now he lay in the tank respirator up to his neck, the rhythmic hiss and sigh of the machine breathing for him, and he screamed because he did not understand why his legs would not answer him, why his own body had become a stranger overnight. When his legs still worked he kicked the metal wall of the lung out of pure fright, a hollow sound that traveled the length of the ward. I have never forgotten that sound. I don't think any of us who heard it ever did.

We washed our hands raw. That was the whole of our armor. No one told us there would be more protection than soap and water and the discipline of scrubbing after every single contact, because there wasn't any more. The disease moved through families, through swimming holes, through church picnics, and it did not care whose child it took. It had already reached into the White House once, years before I ever set foot in that ward — a rising young politician struck down in the prime of his ambition, left paralyzed from the waist down, a man who would go on to found a charity that asked not for a few rich men's fortunes but for dimes, millions of dimes, from ordinary people terrified enough to give what little they had.

By the time I was changing dressings and monitoring pressure gauges, two names had begun to surface in the newspapers and in the hushed, hopeful talk of doctors on rounds. One was Albert Sabin, a careful man in Cincinnati who believed answers came slowly, block by block, the way a scientist builds a cathedral stone by stone and expects to die before the roof goes on. The other was the man down the hall from where I worked, in the University of Pittsburgh's virus laboratory, a younger researcher who moved faster than anyone thought wise. Dr. Salk. I would see him some mornings, coat still on, moving through the corridor like a man who had already spent the whole night thinking. He did not carry himself like someone chasing glory. He carried himself like someone who was late for something urgent that only he understood the shape of.

The science, as it was explained to those of us who were not scientists, sounded almost too simple to trust. The virus entered through the mouth, traveled the bloodstream, and did its damage in the nerves. Other men had already done pieces of the puzzle — Enders had shown how to grow the virus in quantity, Hammon had shown that antibodies already circulating in the blood could stop it cold, Howe and Morgan had found a way to kill the virus without killing its power to provoke the body's own defenses. Dr. Salk's task, as I heard it put once by one of his own research associates, was to take all of those separate pieces other men had forged and weld them into something that could be given to a child's arm without risk of giving that child the disease it was meant to prevent.

It began, in practical terms, with monkeys. Crates of them, flown in from India and the Philippines, forty-two dollars apiece delivered to the laboratory door. Their kidneys became the broth in which the polio virus was grown, coaxed to multiply far beyond its natural strength, and then killed — carefully, exactly, with formaldehyde measured to destroy the virus's ability to spread while somehow leaving intact its ability to teach the body's blood what an enemy looked like. Three strains went into the mix, Brunhilde and Lansing and Leon, so that whichever one might come knocking at a child's door, the body would already have the face memorized.

I did not understand the chemistry. I understood the stakes. Every vial that left that laboratory was going to end up, eventually, in the arm of somebody's son or daughter, and there was no room in that equation for a mistake. Word moved through the hospital in fragments — trial injections here, monitored blood draws there, small studies growing into larger ones, until finally the scale of what was being attempted became impossible to ignore. Nearly two million children, the papers would later say, were drawn into what people started calling the largest medical experiment in the history of the country. Some received the real vaccine. Some received a dummy shot that did nothing at all. Some were simply watched, unknowing controls in a drama they would never fully grasp until years afterward, when their own children asked what a "polio pioneer" button pinned to an old sweater had meant.

I remember the tension of that spring of 1955 the way you remember weather before a storm, a pressure in the air that had nothing to do with barometers. Parents who had spent years keeping their children from public pools now stood in line at schools and churches to have those same children rolled up their sleeves. There was no vaccine yet on the market. There was only trust, offered forward into uncertainty, the way desperate people offer trust when the alternative is doing nothing at all.

The verdict, when it came, came not in Pittsburgh but in Ann Arbor, Michigan, on the twelfth of April. I was not in that auditorium. Almost nobody who lived through that day was. But word of it moved through the country with a speed that had no precedent, and within the hospital that morning it moved through us like electricity finds water — instantly, and everywhere at once. Dr. Thomas Francis, the epidemiologist chosen to judge the results with cold statistical honesty, stood before some five hundred scientists and a hundred and fifty reporters and read his findings for an hour and a half in a voice that, by every account, never once rose or wavered. The vaccine worked. Up to ninety percent effective. Side effects minor, and few. The scientists in that room, men trained their whole careers to withhold enthusiasm until the data demanded it, rose to their feet in an ovation that would not have suited their usual reserve.