1 00:00:15,410 --> 00:00:22,450 Speaker 1: Pushkin Hello listeners, Happy Friday. Before we crack on with 2 00:00:22,490 --> 00:00:25,130 Speaker 1: this episode, I wanted to let you know that Pushkin 3 00:00:25,250 --> 00:00:29,850 Speaker 1: Plus subscribers can now hear an astonishing two part story 4 00:00:30,090 --> 00:00:34,690 Speaker 1: of disaster. A story of enormous egos and enormous mustaches, 5 00:00:34,970 --> 00:00:39,410 Speaker 1: of fraud and financial ruin, of hubris and despair. It's 6 00:00:39,450 --> 00:00:43,530 Speaker 1: a story of new technologies and of death on a 7 00:00:43,610 --> 00:00:49,610 Speaker 1: massive scale, and ultimately a story of understated genius. What's 8 00:00:49,650 --> 00:00:55,170 Speaker 1: this story all about? A war? A revolution? No, something 9 00:00:55,490 --> 00:00:59,810 Speaker 1: even bigger a canal. After you've finished listening to this 10 00:00:59,970 --> 00:01:03,650 Speaker 1: cautionary tale, you might like to check it out for Now, 11 00:01:03,730 --> 00:01:07,490 Speaker 1: on with our episode and a quest to understand how 12 00:01:07,570 --> 00:01:18,010 Speaker 1: the gruesome disease of yellow fever spreads. John Moran enters 13 00:01:18,090 --> 00:01:22,970 Speaker 1: Building number two. It's a simple timber hut with just 14 00:01:23,050 --> 00:01:27,810 Speaker 1: one room measuring fourteen feet by twenty. Dividing the room 15 00:01:27,890 --> 00:01:32,690 Speaker 1: in two is a fine, strong wire mesh with holes 16 00:01:32,730 --> 00:01:36,850 Speaker 1: of a fiftieth and an inch. Moran is wearing a 17 00:01:36,930 --> 00:01:40,850 Speaker 1: night shirt, nothing else. He lies down on the bed 18 00:01:41,930 --> 00:01:48,650 Speaker 1: around him buzz mosquitoes fifteen mosquitoes to be precise. Soon 19 00:01:49,330 --> 00:01:53,450 Speaker 1: one lands on his hand. He doesn't try to squish 20 00:01:53,490 --> 00:01:58,050 Speaker 1: it or flick it off. The mosquito slides its proboscis 21 00:01:58,090 --> 00:02:03,970 Speaker 1: through John Moran's skin and sucks his blood. On the 22 00:02:04,090 --> 00:02:07,050 Speaker 1: other side of the wire net from Moran and the 23 00:02:07,090 --> 00:02:12,530 Speaker 1: mosquitoes sits. Major Walter reed, he could tell you the 24 00:02:12,570 --> 00:02:17,210 Speaker 1: life story of every one of those mosquitoes. They've been 25 00:02:17,290 --> 00:02:20,490 Speaker 1: sucking the blood of people who are sick with yellow fever. 26 00:02:21,930 --> 00:02:25,610 Speaker 1: We're in Cuba, in an improvised U. S Army camp, 27 00:02:25,850 --> 00:02:30,770 Speaker 1: just outside Havana. It's the twenty first of December nineteen hundred. 28 00:02:31,810 --> 00:02:36,770 Speaker 1: Four days later, on Christmas morning, John Moran wakes up 29 00:02:36,810 --> 00:02:40,130 Speaker 1: with chills and a headache. He tries to eat his 30 00:02:40,250 --> 00:02:44,450 Speaker 1: Christmas lunch, but he has no appetite. By the afternoon, 31 00:02:44,810 --> 00:02:49,010 Speaker 1: his temperatures climbed to one hundred and three. Is it 32 00:02:49,250 --> 00:02:54,130 Speaker 1: yellow fever? Moran was twenty four years old. He'd come 33 00:02:54,170 --> 00:02:56,810 Speaker 1: to Cuba with the US Army, but left to get 34 00:02:56,850 --> 00:03:00,730 Speaker 1: a civilian job as a clerk. It pays better, and 35 00:03:00,810 --> 00:03:03,490 Speaker 1: Moran is trying to save money to take a degree 36 00:03:03,570 --> 00:03:08,410 Speaker 1: in medicine. A few weeks earlier, when Major Reid had 37 00:03:08,490 --> 00:03:10,930 Speaker 1: let it be known that he was looking for volunteers 38 00:03:10,970 --> 00:03:15,730 Speaker 1: for his mosquito experiments. Moran's old army friends had made 39 00:03:15,770 --> 00:03:18,730 Speaker 1: sure he knew about it. Reed will pay you, They 40 00:03:18,770 --> 00:03:23,890 Speaker 1: told him several months worth of salary. John Moran knew 41 00:03:23,970 --> 00:03:27,850 Speaker 1: very well how deadly yellow fever can be. It had 42 00:03:27,970 --> 00:03:29,490 Speaker 1: just killed the clerk who. 43 00:03:29,330 --> 00:03:30,770 Speaker 2: Worked next to him. 44 00:03:31,050 --> 00:03:35,370 Speaker 1: He thought about it, then went to introduce himself to 45 00:03:35,450 --> 00:03:40,290 Speaker 1: Major Reed. I want to volunteer, said Moran. And I 46 00:03:40,290 --> 00:03:43,170 Speaker 1: don't want money. I want to do it for science, 47 00:03:43,490 --> 00:03:47,810 Speaker 1: for humanity. Major Reed looked at John Moran. 48 00:03:49,090 --> 00:03:50,770 Speaker 3: I take my head off to you. 49 00:03:50,970 --> 00:03:55,410 Speaker 1: He said. John Moran was bravely taking a risk for 50 00:03:55,530 --> 00:04:00,090 Speaker 1: noble motives. Are we too scared to let people take 51 00:04:00,250 --> 00:04:05,050 Speaker 1: risks like that? Today? I'm Tim Harford and you're listening 52 00:04:05,810 --> 00:04:32,570 Speaker 1: to cautionary tales. What's it like to have yellow fever? 53 00:04:33,610 --> 00:04:38,970 Speaker 1: Here's one victim describing the onset of their symptoms. It 54 00:04:39,090 --> 00:04:42,970 Speaker 1: seemed as if every bone in my body had been crushed. 55 00:04:43,650 --> 00:04:47,370 Speaker 1: My spine felt twisted, and my head swollen, and my 56 00:04:47,490 --> 00:04:50,050 Speaker 1: eyes felt as if they would pop out of my head. 57 00:04:50,330 --> 00:04:52,530 Speaker 1: Even the ends of my fingers felt as though they 58 00:04:52,530 --> 00:04:56,090 Speaker 1: would snap off. If that's as bad as it gets, 59 00:04:56,530 --> 00:04:59,250 Speaker 1: you're one of the lucky ones. In a week or two, 60 00:04:59,450 --> 00:05:03,210 Speaker 1: you'll be okay again, But about fifteen percent of people 61 00:05:03,770 --> 00:05:08,970 Speaker 1: aren't lucky. Their illness develops a second, much more serious phase. 62 00:05:09,610 --> 00:05:14,250 Speaker 1: Your skin turns yellow from jaundice. You're delirious from fever. 63 00:05:15,050 --> 00:05:19,450 Speaker 1: You start to bleed, perhaps from your eyes or your gums, 64 00:05:20,290 --> 00:05:24,890 Speaker 1: or perhaps inside your stomach. So when you vomit, your 65 00:05:24,970 --> 00:05:31,690 Speaker 1: vomit black organs start to fail. There's no treatment. If 66 00:05:31,730 --> 00:05:36,370 Speaker 1: this second phase takes hold, your chance of surviving is 67 00:05:36,450 --> 00:05:40,770 Speaker 1: little more than fifty to fifty. No wonder. Yellow fever 68 00:05:41,130 --> 00:05:46,530 Speaker 1: once caused such terror in America's port cities. Outbreaks didn't 69 00:05:46,530 --> 00:05:50,530 Speaker 1: always spread far, but when they did, they were devastating. 70 00:05:51,370 --> 00:05:57,170 Speaker 1: In seventeen ninety three, yellow fever decimated Philadelphia, killing five 71 00:05:57,370 --> 00:06:02,410 Speaker 1: thousand people, one tenth of the population. In eighteen fifty three, 72 00:06:02,890 --> 00:06:06,290 Speaker 1: it did the same in Your Orleans. Where it came 73 00:06:06,330 --> 00:06:11,130 Speaker 1: from was clear enough ships from the Caribbean in the summer. 74 00:06:11,890 --> 00:06:17,450 Speaker 1: But once it had arrived, how did it spread? Was 75 00:06:17,490 --> 00:06:23,850 Speaker 1: it person to person contact? In Philadelphia, people stopped shaking hands, 76 00:06:24,370 --> 00:06:27,930 Speaker 1: Many shrank with affright at even the offer of a hand, 77 00:06:28,490 --> 00:06:33,010 Speaker 1: observed one writer. At the time, acquaintances and friends avoided 78 00:06:33,050 --> 00:06:36,610 Speaker 1: each other in the streets and only signified their regard 79 00:06:37,250 --> 00:06:42,050 Speaker 1: by a cold nod. Or did yellow fever spread through 80 00:06:42,250 --> 00:06:47,010 Speaker 1: something in the air. In New Orleans, the authorities burned 81 00:06:47,130 --> 00:06:50,970 Speaker 1: barrels of tar and whiskey to try to clear the toxins. 82 00:06:52,170 --> 00:06:57,410 Speaker 1: Or did it spread through contaminated objects. During the Civil War, 83 00:06:57,930 --> 00:07:03,530 Speaker 1: a Confederate doctor plotted an early attempt at bioterrorism. He 84 00:07:03,610 --> 00:07:06,890 Speaker 1: gathered clothes from people who died of yellow fever and 85 00:07:06,970 --> 00:07:09,890 Speaker 1: tried to ship them to cities in the North. He 86 00:07:10,010 --> 00:07:14,650 Speaker 1: even sent a suitcase full to Abraham Lincoln. The assassination 87 00:07:14,770 --> 00:07:22,490 Speaker 1: attempt failed. The doctor was later elected governor of Kentucky. 88 00:07:23,010 --> 00:07:27,050 Speaker 1: By nineteen hundred, the question of how yellow fever spread 89 00:07:27,410 --> 00:07:30,970 Speaker 1: had become urgent for the US Army. The US had 90 00:07:31,050 --> 00:07:35,370 Speaker 1: occupied Cuba, a hot bed of yellow fever. They had 91 00:07:35,410 --> 00:07:37,730 Speaker 1: to figure out what to do to keep the troops 92 00:07:37,770 --> 00:07:41,490 Speaker 1: as safe as possible. They set up a commission, at 93 00:07:41,530 --> 00:07:46,730 Speaker 1: its head, Major Walter Reid. It just investigated how typhoid 94 00:07:46,810 --> 00:07:51,210 Speaker 1: spreads on army bases. He had concluded rightly that preventing 95 00:07:51,250 --> 00:07:56,410 Speaker 1: typhoid was all about sanitation. Build the trenes wash hands. 96 00:07:57,330 --> 00:08:00,610 Speaker 1: But the army had been improving sanitation in Cuba, and 97 00:08:01,010 --> 00:08:05,610 Speaker 1: rates of yellow fever were staying stubbornly high. What worked 98 00:08:05,610 --> 00:08:10,050 Speaker 1: for typhoid didn't work for yellow fever, So what were 99 00:08:10,050 --> 00:08:15,490 Speaker 1: they missing? There were theories and puzzles, like the curious 100 00:08:15,570 --> 00:08:19,050 Speaker 1: case of the court martialed soldier. He was kept in 101 00:08:19,090 --> 00:08:23,290 Speaker 1: a cell on a military race, closely guarded, so they 102 00:08:23,330 --> 00:08:26,490 Speaker 1: knew for sure that he hadn't had contact with anyone 103 00:08:26,530 --> 00:08:31,490 Speaker 1: else who'd been ill. Yet still he caught it and died. 104 00:08:32,370 --> 00:08:36,130 Speaker 1: It was as if the disease had somehow flown in 105 00:08:36,210 --> 00:08:41,970 Speaker 1: through the bars of the cell window. Strange. Major Reid 106 00:08:42,210 --> 00:08:45,810 Speaker 1: chose colleagues to assist him. His old friend James Carroll, 107 00:08:46,250 --> 00:08:50,370 Speaker 1: a brilliant young doctor Jesse Lazier. They'd go to Cuba 108 00:08:50,770 --> 00:08:56,250 Speaker 1: and try to work it out. There was one theory 109 00:08:56,330 --> 00:08:59,530 Speaker 1: that could explain the case of the court martialed soldier. 110 00:09:00,090 --> 00:09:04,770 Speaker 1: For twenty years, a Cuban doctor had been tirelessly championing 111 00:09:04,850 --> 00:09:09,490 Speaker 1: his idea that a certain species of mosquito spread yellow fever. 112 00:09:10,290 --> 00:09:13,530 Speaker 1: It was plausible enough on the face of it. Another 113 00:09:13,570 --> 00:09:17,170 Speaker 1: species of mosquito had just been discovered to transmit malaria, 114 00:09:17,930 --> 00:09:21,850 Speaker 1: why not yellow fever too. The problem was that the 115 00:09:21,930 --> 00:09:25,330 Speaker 1: Cuban doctor had been trying for twenty years to prove 116 00:09:25,370 --> 00:09:30,730 Speaker 1: his theory, with no success. He bred mosquitoes and let 117 00:09:30,770 --> 00:09:35,090 Speaker 1: them feed on yellow fever patients. Then he persuaded nearly 118 00:09:35,130 --> 00:09:38,810 Speaker 1: one hundred people to be bitten by those mosquitoes. If 119 00:09:38,850 --> 00:09:42,330 Speaker 1: that seems like an insane thing to agree to, remember 120 00:09:42,370 --> 00:09:44,530 Speaker 1: that it can't have seemed that much of a risk. 121 00:09:45,210 --> 00:09:49,610 Speaker 1: Yellow fever was common, so were mosquitoes, and hardly anyone 122 00:09:49,690 --> 00:09:53,450 Speaker 1: bought the idea that the two were linked, And with 123 00:09:53,650 --> 00:09:58,490 Speaker 1: every new volunteer, the doctor's theory seemed less and less 124 00:09:58,650 --> 00:10:01,850 Speaker 1: likely to be true. Only a few of those bitten 125 00:10:02,010 --> 00:10:04,930 Speaker 1: got ill, and most of them had symptoms that were 126 00:10:05,130 --> 00:10:08,490 Speaker 1: hard to diagnose with confidence. They might have had a 127 00:10:08,530 --> 00:10:12,330 Speaker 1: mildcare of yellow fever, or it might have been something else. 128 00:10:12,650 --> 00:10:19,050 Speaker 1: It was hard to say. Just one volunteer unmistakably got 129 00:10:19,170 --> 00:10:23,090 Speaker 1: yellow fever soon after the mosquito bite, and who could 130 00:10:23,130 --> 00:10:25,890 Speaker 1: be sure that wasn't a coincidence. He might have got 131 00:10:25,930 --> 00:10:31,290 Speaker 1: it somewhere else. So the evidence wasn't promising, But Major 132 00:10:31,370 --> 00:10:34,850 Speaker 1: Reed and his colleagues wanted to test the theory for themselves. 133 00:10:35,370 --> 00:10:38,890 Speaker 1: They visited the Cuban doctor who gave them some mosquito 134 00:10:38,970 --> 00:10:41,410 Speaker 1: eggs hid bread. The eggs were. 135 00:10:41,370 --> 00:10:46,090 Speaker 4: A jet black color, one end rounded and blunt, while 136 00:10:46,130 --> 00:10:50,370 Speaker 4: the other is slightly pointed, the whole closely resembling a 137 00:10:50,490 --> 00:10:51,530 Speaker 4: cancheedah cigar. 138 00:10:52,730 --> 00:10:55,650 Speaker 1: Put them in water, said the Cuban doctor, and in 139 00:10:55,730 --> 00:11:00,250 Speaker 1: ten to twelve days you'll have mosquitoes. Reed put his 140 00:11:00,370 --> 00:11:05,410 Speaker 1: young colleague Jesse Lazier in charge. That made sense. Laziir 141 00:11:05,530 --> 00:11:10,490 Speaker 1: had worked on malaria. He knew mosquitoes hatched the eggs, 142 00:11:10,810 --> 00:11:14,770 Speaker 1: and kept each mosquito in its own test tube plugged 143 00:11:14,850 --> 00:11:17,930 Speaker 1: with cotton. He'd take them to a hospital with a 144 00:11:18,010 --> 00:11:21,610 Speaker 1: yellow fever ward, sit by the bedside of a patient, 145 00:11:22,290 --> 00:11:25,610 Speaker 1: remove the cotton plug, and put the open end of 146 00:11:25,650 --> 00:11:29,370 Speaker 1: the test tube to the patient's skin. He'd flick the 147 00:11:29,450 --> 00:11:33,330 Speaker 1: test tube to get the mosquito moving. Once the mosquito 148 00:11:33,490 --> 00:11:36,770 Speaker 1: had drunk its fill of the patient's blood, he'd plug 149 00:11:36,850 --> 00:11:42,170 Speaker 1: the test tube again. Could these mosquitoes now infect someone 150 00:11:42,250 --> 00:11:46,210 Speaker 1: with yellow fever? There was only one way to find out. 151 00:11:46,650 --> 00:11:49,530 Speaker 1: Lazir put a test tube on his arm and let 152 00:11:49,530 --> 00:11:53,450 Speaker 1: the mosquito feed on him. An army doctor said he'd 153 00:11:53,490 --> 00:11:56,850 Speaker 1: take a bite two. How risky was it really? The 154 00:11:56,930 --> 00:11:59,770 Speaker 1: Cuban doctor had done this to nearly one hundred people, 155 00:11:59,890 --> 00:12:04,450 Speaker 1: and almost all had been fine. The odds seemed firmly 156 00:12:04,610 --> 00:12:08,730 Speaker 1: in their favor. Days passed, and Lazir and the army 157 00:12:08,730 --> 00:12:14,690 Speaker 1: doctor remained in perfect health. Other soldiers volunteered too, nobody 158 00:12:14,770 --> 00:12:18,890 Speaker 1: got ill. Lazier was fast giving up on the theory. 159 00:12:19,210 --> 00:12:22,690 Speaker 1: He told his colleague on the Commission, James Carroll, and 160 00:12:22,810 --> 00:12:27,730 Speaker 1: now one of his carefully nurtured mosquitoes seemed about to die. 161 00:12:28,450 --> 00:12:31,210 Speaker 1: It had sucked the blood of one yellow fever patient, 162 00:12:31,850 --> 00:12:35,330 Speaker 1: but had since been refusing to feed again. It was 163 00:12:35,450 --> 00:12:39,770 Speaker 1: listless without another blood meal, it wouldn't last for long. 164 00:12:40,970 --> 00:12:44,690 Speaker 1: Carol had never believed in the mosquito theory. Put your 165 00:12:44,690 --> 00:12:47,370 Speaker 1: mosquito on me, he said, I'll see if I can 166 00:12:47,410 --> 00:12:52,810 Speaker 1: feed it to keep it going for you. There were 167 00:12:53,010 --> 00:12:58,530 Speaker 1: two things Jesse Lazier and James Carroll didn't know. They 168 00:12:58,530 --> 00:13:01,890 Speaker 1: didn't know that for a mosquito to pass on yellow fever, 169 00:13:02,370 --> 00:13:04,970 Speaker 1: it needs to have fed on someone in the first 170 00:13:05,250 --> 00:13:09,690 Speaker 1: three days of their infection. Lazier had often fed his 171 00:13:09,730 --> 00:13:12,610 Speaker 1: mosquitoes on patients who had been sick for longer than that. 172 00:13:13,650 --> 00:13:17,650 Speaker 1: Then it takes at least twelve days for the mosquito 173 00:13:17,770 --> 00:13:20,450 Speaker 1: to incubate the virus so it can pass it on 174 00:13:21,090 --> 00:13:25,450 Speaker 1: when it bites someone else. Laziir generally hadn't been waiting 175 00:13:25,490 --> 00:13:29,530 Speaker 1: that long before he put his mosquitoes onto healthy volunteers. 176 00:13:30,610 --> 00:13:35,170 Speaker 1: Lazier passed James Carroll the test tube with the ailing mosquito. 177 00:13:36,290 --> 00:13:41,050 Speaker 1: As it happened, precisely, twelve days had passed since this 178 00:13:41,210 --> 00:13:44,610 Speaker 1: mosquito had fed on a yellow fever patient. According to 179 00:13:44,690 --> 00:13:50,090 Speaker 1: Lazier's notes, a patient who had been on day two 180 00:13:50,210 --> 00:13:55,490 Speaker 1: of his illness, Carol, rolled up his sleeve. Lazier put 181 00:13:55,530 --> 00:14:00,650 Speaker 1: the test tube to Carol's arm. The mosquito didn't move. 182 00:14:01,770 --> 00:14:05,850 Speaker 1: Lazier tapped the test tube to rouse it. Still nothing. 183 00:14:06,890 --> 00:14:09,730 Speaker 1: Lazier shrugged and began to take the test tube away. 184 00:14:10,530 --> 00:14:13,930 Speaker 1: Give it here, said Carol. He held the test tube 185 00:14:13,930 --> 00:14:19,690 Speaker 1: to his arm and waited patiently until at last, the 186 00:14:19,770 --> 00:14:25,570 Speaker 1: sluggish mosquito fluttered onto his arm and slipped its proboscis 187 00:14:25,930 --> 00:14:31,290 Speaker 1: through his skin. Cautionary, tails will be back in a moment. 188 00:14:53,490 --> 00:14:57,530 Speaker 1: Three days after Jesse Lazier's ailing mosquito had fared on 189 00:14:57,690 --> 00:15:02,410 Speaker 1: James Carroll's blood, the mosquito was doing well. So was 190 00:15:02,530 --> 00:15:05,530 Speaker 1: James Carroll. He was enjoying a swim in the warm 191 00:15:05,610 --> 00:15:09,530 Speaker 1: sea off a Cuban beach when I felt as sudden 192 00:15:09,690 --> 00:15:14,810 Speaker 1: chill and a crushing headache. By the next day, Carol 193 00:15:14,970 --> 00:15:17,770 Speaker 1: had been taken to hospital. He was running a fever 194 00:15:17,930 --> 00:15:21,410 Speaker 1: of one hundred and five and trying to say something 195 00:15:21,450 --> 00:15:25,770 Speaker 1: about a mosquito. The nurse couldn't follow it. He must 196 00:15:25,810 --> 00:15:31,490 Speaker 1: be delirious. Jesse Lazier must have felt mortified. He had 197 00:15:31,570 --> 00:15:35,410 Speaker 1: failed time and again to produce a case of yellow fever. 198 00:15:36,130 --> 00:15:40,370 Speaker 1: Had he finally succeeded when he wasn't even trying? Laziir 199 00:15:40,610 --> 00:15:44,570 Speaker 1: sought out James Carroll's notebook. He wanted to see what 200 00:15:44,690 --> 00:15:47,970 Speaker 1: Carol had been doing for the last few days. If 201 00:15:48,050 --> 00:15:52,210 Speaker 1: Carol hadn't left the camp, which was fever free, that 202 00:15:52,290 --> 00:15:56,130 Speaker 1: would point convincingly to the mosquito as the cause of 203 00:15:56,170 --> 00:16:00,130 Speaker 1: the infection. But Carol's notebook said he had been visiting 204 00:16:00,250 --> 00:16:05,090 Speaker 1: hospital wards and autopsy rooms where yellow fever victims were dissected. 205 00:16:05,650 --> 00:16:10,170 Speaker 1: Skeptics would say that he could have got it anywhere. Still, 206 00:16:10,410 --> 00:16:14,490 Speaker 1: at least Lazier now had a lead a mosquito in 207 00:16:14,570 --> 00:16:17,130 Speaker 1: a test tube that might have given yellow fever to 208 00:16:17,250 --> 00:16:21,330 Speaker 1: James Carroll. Could that mosquito give it to someone else? 209 00:16:22,050 --> 00:16:26,650 Speaker 1: Lazier needed another volunteer, and he soon found one in 210 00:16:26,730 --> 00:16:31,570 Speaker 1: the army camp. The young soldier expressed curiosity about his work. 211 00:16:32,530 --> 00:16:35,010 Speaker 3: You're still fallen with mosquitoes. 212 00:16:34,410 --> 00:16:41,210 Speaker 1: Doctor, yes, said Lazier. Then will you take a bite? Sure, 213 00:16:41,690 --> 00:16:42,650 Speaker 1: replied the soldier. 214 00:16:43,570 --> 00:16:45,170 Speaker 3: I ain't scared of them. 215 00:16:45,290 --> 00:16:47,730 Speaker 1: The soldier said he hadn't been off the camp in 216 00:16:47,810 --> 00:16:53,370 Speaker 1: two months. That was perfect. Lazier brought the test tube 217 00:16:53,370 --> 00:16:56,730 Speaker 1: with the mosquito that had bitten James Carroll and put 218 00:16:56,770 --> 00:17:03,570 Speaker 1: it to the soldier's arm. Five days later, the soldier 219 00:17:03,610 --> 00:17:08,210 Speaker 1: began to feel unwell. It's hard to predict how badly 220 00:17:08,290 --> 00:17:12,370 Speaker 1: you'll get yellow fever. We now know there are different strains, 221 00:17:12,370 --> 00:17:16,210 Speaker 1: some deadlier than others, but the younger you are, the 222 00:17:16,250 --> 00:17:20,850 Speaker 1: better your chances. Children would often get it mildly and 223 00:17:20,890 --> 00:17:24,530 Speaker 1: then be immune for life. The soldier was young and 224 00:17:24,650 --> 00:17:30,010 Speaker 1: lucky his case was mild. James Carroll was older, and 225 00:17:30,050 --> 00:17:34,330 Speaker 1: he was having a rougher time, still in his hospital bed, 226 00:17:34,650 --> 00:17:38,770 Speaker 1: writhing in pain and burning up. Nurses giving him ice 227 00:17:38,930 --> 00:17:43,370 Speaker 1: cold enemies to try to bring his fever down. Jesse 228 00:17:43,530 --> 00:17:48,450 Speaker 1: Lazier was desperately worried about James Carroll, but he was 229 00:17:48,490 --> 00:17:52,890 Speaker 1: excited too. I rather think I am on the track 230 00:17:53,130 --> 00:17:56,930 Speaker 1: of the real germ, he wrote back home. But nothing 231 00:17:57,010 --> 00:18:01,370 Speaker 1: must be said as yet, not even a hint. And 232 00:18:01,410 --> 00:18:09,810 Speaker 1: then the story gets murky. The Yellow Fever COMMISSI remember, 233 00:18:10,050 --> 00:18:13,890 Speaker 1: was headed by Major Walter Reid. Where was Major Reid? 234 00:18:14,010 --> 00:18:18,930 Speaker 1: While all this drama was unfolding in Cuba? Reid was 235 00:18:19,010 --> 00:18:22,530 Speaker 1: back in America. He had to finish his big report 236 00:18:22,610 --> 00:18:25,690 Speaker 1: on typhoid and present it to his bosses in Washington, 237 00:18:25,770 --> 00:18:29,650 Speaker 1: d c. He got a telegram describing his old friend 238 00:18:29,810 --> 00:18:32,130 Speaker 1: James Carroll's bite and illness. 239 00:18:32,970 --> 00:18:36,650 Speaker 2: He wrote back, I cannot begin to describe my mental 240 00:18:36,730 --> 00:18:41,770 Speaker 2: distress over this most unfortunate turn of affairs. The next 241 00:18:41,770 --> 00:18:46,850 Speaker 2: piece of news was more positive. Carol at last had 242 00:18:46,890 --> 00:18:51,210 Speaker 2: begun to pull through. His fever was down. There'd been 243 00:18:51,250 --> 00:18:55,170 Speaker 2: none of the dreaded black vomit. He was weak, but 244 00:18:55,290 --> 00:18:58,930 Speaker 2: he'd live. Read fired off a letter. 245 00:18:59,570 --> 00:19:05,730 Speaker 5: My dear Carol Hip Hurrah, God be praised. I can 246 00:19:05,850 --> 00:19:09,250 Speaker 5: never recall such a sense of relief in all my life. 247 00:19:09,850 --> 00:19:13,170 Speaker 5: I shall simply go out and get boiling drunk. God 248 00:19:13,170 --> 00:19:14,130 Speaker 5: bless you, my boy. 249 00:19:14,930 --> 00:19:20,410 Speaker 1: And then another telegram Jesse Lazier had got yellow fever. 250 00:19:21,450 --> 00:19:31,650 Speaker 1: The message was blunt, severe case. What had happened? According 251 00:19:31,690 --> 00:19:36,010 Speaker 1: to Jesse Lazier, this is what had happened. He was 252 00:19:36,130 --> 00:19:39,530 Speaker 1: in a hospital at the bedside of a yellow fever patient, 253 00:19:40,010 --> 00:19:43,650 Speaker 1: holding a test tube to the patient's skin. The mosquito 254 00:19:43,730 --> 00:19:47,570 Speaker 1: in the tube had just started to feed. Then, said Lazier, 255 00:19:48,370 --> 00:19:52,010 Speaker 1: another mosquito that happened to be in the room landed 256 00:19:52,170 --> 00:19:55,730 Speaker 1: on his hand. He didn't want to move because he 257 00:19:55,770 --> 00:19:58,610 Speaker 1: had disturbed the insect in the test tube and have 258 00:19:58,730 --> 00:20:02,090 Speaker 1: to start all over again. And he thought the mosquito 259 00:20:02,130 --> 00:20:05,250 Speaker 1: on his hand was from a different species, one that 260 00:20:05,490 --> 00:20:09,650 Speaker 1: wasn't suspected of spreading the disease, so he let the 261 00:20:09,690 --> 00:20:18,810 Speaker 1: mosquito bite him. Historians think that isn't plausible. Lazia, remember, 262 00:20:19,250 --> 00:20:23,610 Speaker 1: was a mosquito expert. He'd studied malaria. He had been 263 00:20:23,610 --> 00:20:28,890 Speaker 1: spending day after day intently observing his mosquitoes in test tubes. 264 00:20:29,490 --> 00:20:35,170 Speaker 1: He affectionately called them his birds. In their book Yellow Jack, 265 00:20:35,690 --> 00:20:40,010 Speaker 1: the authors John Pierce and James Writer say it simply 266 00:20:40,050 --> 00:20:43,810 Speaker 1: does not make sense that Lazier did not recognize what 267 00:20:43,930 --> 00:20:49,010 Speaker 1: species of mosquito had landed on his own hand. What 268 00:20:49,210 --> 00:20:57,570 Speaker 1: historians think happened is this Jesse Lazier experimented on himself again. 269 00:20:59,090 --> 00:21:03,650 Speaker 1: Today he claimed he had been bitten by accident. September thirteenth, 270 00:21:03,970 --> 00:21:10,130 Speaker 1: nineteen hundred. Lazia's notebook contains a cryptic entry. Up till 271 00:21:10,170 --> 00:21:13,170 Speaker 1: then he had recorded the names of all his volunteers, 272 00:21:13,850 --> 00:21:16,650 Speaker 1: along with the history of the mosquitoes that fed on them. 273 00:21:17,890 --> 00:21:22,690 Speaker 1: This entry simply said, guinea pig number one in the 274 00:21:22,770 --> 00:21:27,050 Speaker 1: mosquito it had fed on a patient in the second 275 00:21:27,130 --> 00:21:32,170 Speaker 1: day of his illness, fourteen days earlier. If Lazier had 276 00:21:32,210 --> 00:21:36,330 Speaker 1: formed a theory about the timelines required to transmit yellow fever, 277 00:21:36,930 --> 00:21:40,810 Speaker 1: this was exactly the mosquito he'd have chosen to put 278 00:21:40,850 --> 00:21:47,290 Speaker 1: that theory to the test. It's possible, of course, that 279 00:21:47,370 --> 00:21:51,090 Speaker 1: Lazier had suddenly decided to feed one of his mosquitoes 280 00:21:51,570 --> 00:21:55,130 Speaker 1: on an actual guinea pig, but as nobody on the 281 00:21:55,130 --> 00:21:59,410 Speaker 1: commission had ever discussed doing experiments on guinea pigs, it 282 00:21:59,450 --> 00:22:04,130 Speaker 1: seems unlikely. We can only presume that guinea pig number 283 00:22:04,130 --> 00:22:11,250 Speaker 1: one was Jesse Lazier. Why it on himself and why 284 00:22:11,370 --> 00:22:17,210 Speaker 1: hide it? We'll never know. Five days after guinea pig 285 00:22:17,330 --> 00:22:22,210 Speaker 1: number one was bitten, Jesse Lazier began to feel unwell. 286 00:22:23,770 --> 00:22:25,810 Speaker 1: He sat down to write a letter to his mother, 287 00:22:26,010 --> 00:22:29,010 Speaker 1: who was taking care of his wife back in America. 288 00:22:29,970 --> 00:22:33,290 Speaker 1: His wife had just given birth to their second child. 289 00:22:33,890 --> 00:22:35,330 Speaker 1: He didn't mention his illness. 290 00:22:36,250 --> 00:22:38,930 Speaker 4: Dear little Houston must be very cute. 291 00:22:38,970 --> 00:22:44,770 Speaker 1: He wrote. Houston was their toddler. The next day, Lazier 292 00:22:45,010 --> 00:22:49,330 Speaker 1: was carried to the hospital. James Carroll had recovered enough 293 00:22:49,490 --> 00:22:54,930 Speaker 1: just about to shuffle over to Lazier's bedside. I shall 294 00:22:54,930 --> 00:22:59,330 Speaker 1: never forget the expression of alarm in his eyes, he said. 295 00:23:01,210 --> 00:23:06,290 Speaker 1: Lazier's illness moved quickly to the deadly second stage. He 296 00:23:06,370 --> 00:23:09,890 Speaker 1: thrashed around so much nurses had to call for soldiers 297 00:23:09,930 --> 00:23:13,090 Speaker 1: to strap his wrists and ankles to the bed. He 298 00:23:13,170 --> 00:23:19,250 Speaker 1: began to convulse and vomit. The vomit was black. Jesse 299 00:23:19,330 --> 00:23:32,050 Speaker 1: Lazier was thirty four years old when yellow fever killed him. 300 00:23:32,250 --> 00:23:35,850 Speaker 1: As Major Walter Reed prepared to return to Cuba, he 301 00:23:35,930 --> 00:23:38,650 Speaker 1: had a problem. It wasn't just that one of his 302 00:23:38,810 --> 00:23:41,690 Speaker 1: team was dead and another would need a long time 303 00:23:41,730 --> 00:23:45,930 Speaker 1: off to recover. Their self. Sacrifice had gone to waste. 304 00:23:46,850 --> 00:23:50,890 Speaker 1: They'd been brave in getting bitten, but they hadn't been scientific, 305 00:23:51,450 --> 00:23:55,050 Speaker 1: as Reid explained in a frustrated letter to the convalescing 306 00:23:55,290 --> 00:23:56,130 Speaker 1: James Carroll. 307 00:23:57,170 --> 00:24:00,770 Speaker 3: If you, my dear doctor, had, prior to your bait, 308 00:24:00,930 --> 00:24:03,730 Speaker 3: remained at the camp for ten days, then we would 309 00:24:03,770 --> 00:24:07,690 Speaker 3: have a clear case. But you didn't. You went just 310 00:24:07,810 --> 00:24:11,010 Speaker 3: where you might have contracted the disease from another sauce. 311 00:24:11,970 --> 00:24:16,050 Speaker 1: And what about Jesse Lazier. According to his own account, 312 00:24:16,490 --> 00:24:20,650 Speaker 1: he had been bitten while at a yellow fever hospital. 313 00:24:20,770 --> 00:24:24,570 Speaker 1: For goodness sake, that knocks his case out, wrote Reed. 314 00:24:25,330 --> 00:24:29,210 Speaker 3: I mean, as a thoroughly scientific experiment. 315 00:24:29,930 --> 00:24:33,050 Speaker 1: There was the young soldier Lazier had infected with the 316 00:24:33,050 --> 00:24:38,010 Speaker 1: same mosquito as Carol. His case was highly suggestive, but 317 00:24:38,090 --> 00:24:43,010 Speaker 1: not conclusive, not yet to remove any doubt. Walter Reed 318 00:24:43,170 --> 00:24:47,290 Speaker 1: was going to have to do more thoroughly scientific experiments, 319 00:24:48,370 --> 00:24:56,170 Speaker 1: and for that he'd need more volunteers. Cautionary tales will return. 320 00:25:07,210 --> 00:25:10,650 Speaker 1: Walter Reed needed a sight to construct a new camp. 321 00:25:11,330 --> 00:25:13,290 Speaker 1: It had to be in a part of Cuba that 322 00:25:13,570 --> 00:25:17,570 Speaker 1: wasn't known for yellow fever. He needed well drained land 323 00:25:17,810 --> 00:25:21,690 Speaker 1: with no stagnant water for mosquitoes to breed. He couldn't 324 00:25:21,770 --> 00:25:25,530 Speaker 1: risk stray mosquitoes buzzing in to mess up his experiments. 325 00:25:26,170 --> 00:25:29,770 Speaker 1: He found a two acre site and brought in brand 326 00:25:29,890 --> 00:25:33,010 Speaker 1: new tents and equipment so nobody could say they might 327 00:25:33,010 --> 00:25:36,930 Speaker 1: have been contaminated. He had the workers quarantined to make 328 00:25:36,970 --> 00:25:40,730 Speaker 1: sure they weren't harboring the disease. He then had them 329 00:25:40,730 --> 00:25:46,130 Speaker 1: tested for fever three times a day. The workers put 330 00:25:46,370 --> 00:25:51,250 Speaker 1: up the tents and two simple wooden buildings in honor 331 00:25:51,370 --> 00:25:56,930 Speaker 1: of their fallen colleague. They called it Camp Laziar. Building 332 00:25:57,010 --> 00:26:00,850 Speaker 1: number one had nothing to do with mosquitoes. Reid wanted 333 00:26:00,890 --> 00:26:05,050 Speaker 1: to disprove once and for all the idea that contaminated 334 00:26:05,130 --> 00:26:08,810 Speaker 1: clothing could spread yellow fever. It was a simple wooden 335 00:26:08,850 --> 00:26:13,970 Speaker 1: shed fourteen feet by twenty with shuttered windows. By now 336 00:26:14,250 --> 00:26:18,850 Speaker 1: it was November, the weather was cooling down. Reed wanted 337 00:26:18,850 --> 00:26:22,370 Speaker 1: a fair test in tropical conditions, so he had a 338 00:26:22,410 --> 00:26:26,090 Speaker 1: stove installed in the room to keep the temperature above 339 00:26:26,290 --> 00:26:32,330 Speaker 1: ninety degrees fahrenheit. Reed got three volunteers to go into 340 00:26:32,370 --> 00:26:36,490 Speaker 1: the dark and sweltering hut with a tightly sealed trunk. 341 00:26:36,810 --> 00:26:39,290 Speaker 1: It had sent from the yellow fever ward at a 342 00:26:39,330 --> 00:26:45,970 Speaker 1: nearby hospital. The trunk contained bed sheets and blankets, all 343 00:26:46,650 --> 00:26:51,530 Speaker 1: soiled with a liberal quantity of black vomit urine and 344 00:26:51,690 --> 00:26:56,650 Speaker 1: fecal matter. The three men cracked open the trunk and 345 00:26:56,770 --> 00:27:02,290 Speaker 1: straightway ran back outside, gasping and wretching, and got their breath, 346 00:27:03,050 --> 00:27:07,530 Speaker 1: stealed their nerves, and went back in. They took the 347 00:27:07,570 --> 00:27:11,330 Speaker 1: fetid sheets and blankets out of the trunk and gave 348 00:27:11,370 --> 00:27:15,170 Speaker 1: them all a good shake. If there were contagious particles 349 00:27:15,570 --> 00:27:19,010 Speaker 1: that ought to spread them around. Then they put the 350 00:27:19,050 --> 00:27:22,090 Speaker 1: sheets on the beds in the hut and slept on 351 00:27:22,170 --> 00:27:24,930 Speaker 1: them for twenty nights. 352 00:27:25,610 --> 00:27:27,850 Speaker 4: We all felt like we were coming down with yellow 353 00:27:27,930 --> 00:27:29,210 Speaker 4: fever every day. 354 00:27:29,530 --> 00:27:35,090 Speaker 1: Said one, but they didn't. It was conclusive proof that 355 00:27:35,170 --> 00:27:40,250 Speaker 1: this long held theory was wrong. The Kentucky Doctor's suitcase 356 00:27:40,530 --> 00:27:45,450 Speaker 1: could never have killed Abraham Lincoln Walter Reed had been 357 00:27:45,490 --> 00:27:49,090 Speaker 1: confident that the volunteers in Building number one were never 358 00:27:49,290 --> 00:27:55,170 Speaker 1: in danger of death, just discomfort. The mosquito experiments for 359 00:27:55,330 --> 00:28:00,970 Speaker 1: a different matter, Reid had studied Jesse Lazier's notebook. He'd 360 00:28:01,010 --> 00:28:05,210 Speaker 1: talked to the young soldier Lazier had infected, and he 361 00:28:05,210 --> 00:28:10,370 Speaker 1: had drawn the correct conclusion. He needed an incubation period 362 00:28:10,770 --> 00:28:15,850 Speaker 1: of at least twelve days. The new knowledge meant Reed's 363 00:28:15,890 --> 00:28:20,410 Speaker 1: experiments at Camp Lazier wouldn't be like Jesse Lazier's earlier, 364 00:28:20,530 --> 00:28:24,250 Speaker 1: more casual attempts, when the volunteers could take comfort in 365 00:28:24,410 --> 00:28:28,010 Speaker 1: odds of one in one hundred. Red knew that his 366 00:28:28,170 --> 00:28:33,090 Speaker 1: volunteers were very likely to get yellow fever. He wanted 367 00:28:33,090 --> 00:28:36,650 Speaker 1: them to know that. So Reid had a form typed 368 00:28:36,770 --> 00:28:41,090 Speaker 1: up spelling out the risks, and every time someone asked 369 00:28:41,090 --> 00:28:47,850 Speaker 1: a volunteer he got them to sign it. Informed consent 370 00:28:48,210 --> 00:28:54,810 Speaker 1: is standard practice. Now Reid was its pioneer. But why 371 00:28:54,850 --> 00:28:59,810 Speaker 1: would anyone sign We heard already the young idealist John 372 00:28:59,890 --> 00:29:05,330 Speaker 1: Moran explain his reasons for science and humanity, and Moran 373 00:29:05,450 --> 00:29:08,610 Speaker 1: didn't want the money, even though he was saving hard 374 00:29:08,650 --> 00:29:12,330 Speaker 1: to go to medical school, and in today's terms, Reed 375 00:29:12,490 --> 00:29:17,090 Speaker 1: was offering many thousands of dollars. Others did want the money, 376 00:29:17,450 --> 00:29:21,250 Speaker 1: and they had another pragmatic reason too. If you moved 377 00:29:21,290 --> 00:29:24,530 Speaker 1: to Cuba from a place without yellow fever, so you 378 00:29:24,530 --> 00:29:28,010 Speaker 1: weren't immune from childhood, you felt sure that you'd get 379 00:29:28,090 --> 00:29:32,090 Speaker 1: it sooner or later, So why not take your chances now, 380 00:29:32,610 --> 00:29:36,210 Speaker 1: knowing you'd have the most attentive medical care. The US 381 00:29:36,370 --> 00:29:44,730 Speaker 1: Army could offer. In March twenty twenty, the enormity of 382 00:29:44,810 --> 00:29:48,290 Speaker 1: the COVID pandemic was starting to dawn on the world. 383 00:29:49,250 --> 00:29:51,690 Speaker 1: Most of us were trying to make sense of the present, 384 00:29:52,370 --> 00:29:56,850 Speaker 1: but three academics were looking to the future. We're going 385 00:29:56,850 --> 00:30:00,930 Speaker 1: to need vaccines, they said, as quickly as possible. Those 386 00:30:01,010 --> 00:30:04,330 Speaker 1: vaccines were already being developed and would need to be tested, 387 00:30:05,010 --> 00:30:08,690 Speaker 1: but the traditional clinical trial might take a long time. 388 00:30:09,970 --> 00:30:13,130 Speaker 1: A big group of volunteers would receive either the new 389 00:30:13,210 --> 00:30:17,010 Speaker 1: vaccines or a placebo and would then go about their 390 00:30:17,090 --> 00:30:22,530 Speaker 1: daily lives. Some of them eventually would get COVID, allowing 391 00:30:22,610 --> 00:30:25,970 Speaker 1: scientists to figure out whether most of these cases were 392 00:30:26,010 --> 00:30:29,570 Speaker 1: in the placebo group, in which case the vaccine would 393 00:30:29,570 --> 00:30:33,130 Speaker 1: have worked. But since most people around the world were 394 00:30:33,170 --> 00:30:37,730 Speaker 1: trying very hard not to spread the virus, just waiting 395 00:30:37,850 --> 00:30:41,370 Speaker 1: for enough of those infections to happen by accident could 396 00:30:41,450 --> 00:30:47,370 Speaker 1: take months. Wouldn't it be quicker to deliberately expose your 397 00:30:47,450 --> 00:30:52,690 Speaker 1: volunteers to COVID. That's called a human challenge trial, and 398 00:30:52,730 --> 00:30:57,250 Speaker 1: they've often been used to develop other vaccines. Josh Morrison 399 00:30:57,410 --> 00:31:01,570 Speaker 1: ran a health nonprofit in New York. He thought ourd 400 00:31:01,650 --> 00:31:03,970 Speaker 1: volunteer to get COVID if it might speed up a 401 00:31:04,050 --> 00:31:07,370 Speaker 1: vaccine that could get life back to normal, would other 402 00:31:07,410 --> 00:31:12,370 Speaker 1: people too? He set up a website called One Day Sooner, 403 00:31:12,810 --> 00:31:17,410 Speaker 1: and words spread. Within weeks, tens of thousands of people 404 00:31:17,490 --> 00:31:21,770 Speaker 1: signed up to say they'd do it if someone asked them. 405 00:31:21,930 --> 00:31:25,570 Speaker 1: Some expressed motives much like John Moran's, They'd do it 406 00:31:25,610 --> 00:31:30,970 Speaker 1: for science, for humanity. Others were pragmatic. Like other yellow 407 00:31:30,970 --> 00:31:34,610 Speaker 1: fever volunteers. They said they thought they'd get COVID anyway, 408 00:31:34,810 --> 00:31:37,170 Speaker 1: and they liked the idea of getting it when doctors 409 00:31:37,170 --> 00:31:41,930 Speaker 1: and nurses would be watching them closely. But many decision 410 00:31:41,970 --> 00:31:46,330 Speaker 1: makers were wary about the idea of challenge trials for COVID. 411 00:31:47,050 --> 00:31:50,010 Speaker 1: They're usually used for diseases. We have a good idea 412 00:31:50,090 --> 00:31:54,690 Speaker 1: of how to treat at the time, we couldn't treat COVID. 413 00:31:55,410 --> 00:31:58,890 Speaker 1: So what said Josh Morrison? This is a global emergency. 414 00:31:59,570 --> 00:32:03,490 Speaker 1: We can't take the risk, said others. What if someone dies? 415 00:32:04,610 --> 00:32:08,050 Speaker 1: The debate rumbled on through the summer of twenty twenty. 416 00:32:09,250 --> 00:32:12,930 Speaker 1: Trials didn't happen for the first set of vaccines. They 417 00:32:13,010 --> 00:32:17,170 Speaker 1: were tested in the usual way. One Day Sooner became 418 00:32:17,250 --> 00:32:22,330 Speaker 1: an advocacy group for Challenge Trial volunteers. Later, they funded 419 00:32:22,370 --> 00:32:26,370 Speaker 1: researchers to ask how many lives might have been saved 420 00:32:26,530 --> 00:32:31,410 Speaker 1: if the first vaccines had come, say, thirty days earlier. 421 00:32:33,250 --> 00:32:38,650 Speaker 1: Sixty three thousand, the researchers estimated in the US and 422 00:32:38,930 --> 00:32:44,370 Speaker 1: UK alone. It's hard to be sure if Challenge trials 423 00:32:44,530 --> 00:32:48,570 Speaker 1: really would have given US vaccines thirty days earlier. But 424 00:32:49,050 --> 00:32:52,730 Speaker 1: this isn't really about COVID. It's about looking ahead to 425 00:32:52,770 --> 00:32:57,690 Speaker 1: the next pandemic and what we might learn one possible lesson. 426 00:32:58,370 --> 00:33:03,090 Speaker 1: Let's be more proactive about lining up challenge trials. Let's 427 00:33:03,130 --> 00:33:06,930 Speaker 1: be more hard headed about the trade offs when we 428 00:33:06,970 --> 00:33:10,570 Speaker 1: ask what if we have a trial and someone dies? 429 00:33:11,330 --> 00:33:14,530 Speaker 1: Let's also ask what if we don't have a trial 430 00:33:15,250 --> 00:33:20,410 Speaker 1: and sixty three thousand people die. We can't eliminate risk, 431 00:33:21,290 --> 00:33:24,530 Speaker 1: but we can take calculated risks in a way that 432 00:33:24,730 --> 00:33:29,730 Speaker 1: advances our knowledge. If we have another global emergency and 433 00:33:29,890 --> 00:33:34,730 Speaker 1: selfless volunteers again raise their hands, let's not allow their 434 00:33:34,770 --> 00:33:42,210 Speaker 1: bravery to go to waste. Jesse Lazier and James Carroll 435 00:33:42,650 --> 00:33:46,650 Speaker 1: wasted their bravery because they gave themselves yellow fever in 436 00:33:46,690 --> 00:33:52,290 Speaker 1: a way that scientifically proved nothing Whialter Reed was determined 437 00:33:52,410 --> 00:33:55,810 Speaker 1: not to waste the courage of his new volunteers, such 438 00:33:55,850 --> 00:34:00,450 Speaker 1: as John Moran. He needed to conduct experiments that nobody 439 00:34:00,450 --> 00:34:04,690 Speaker 1: would be able to nitpick. In Building number two, Red 440 00:34:04,810 --> 00:34:07,850 Speaker 1: wanted to put to rest the idea that led New 441 00:34:07,970 --> 00:34:12,650 Speaker 1: Orleans authorities to burn barrels of whiskey and tar, the 442 00:34:12,650 --> 00:34:16,370 Speaker 1: theory that yellow fever spreads through toxins in the air. 443 00:34:17,970 --> 00:34:21,690 Speaker 1: A fine, strong wire mesh ran down the middle of 444 00:34:21,730 --> 00:34:26,890 Speaker 1: the room. On one side fifteen mosquitoes and John Moran 445 00:34:27,730 --> 00:34:32,130 Speaker 1: on the other side. Not only read, but two more volunteers, 446 00:34:32,450 --> 00:34:36,570 Speaker 1: acting as controls. They slept in their half of the hut, 447 00:34:36,930 --> 00:34:41,570 Speaker 1: breathing the same air as John Moran. On Christmas Day, 448 00:34:42,250 --> 00:34:47,290 Speaker 1: John Moran got yellow fever. The other two never did. 449 00:34:48,650 --> 00:34:52,410 Speaker 1: Moran was young and lucky, His case was mild, and 450 00:34:52,450 --> 00:34:59,250 Speaker 1: he recovered. By early February nineteen oh one, Walter Reed 451 00:34:59,450 --> 00:35:04,170 Speaker 1: was ready to report the results of his thoroughly scientific experiments. 452 00:35:04,210 --> 00:35:07,650 Speaker 1: In a speech to a medical congress in Havana. He 453 00:35:07,770 --> 00:35:11,490 Speaker 1: explained how it proved that yellow fever didn't spread through 454 00:35:11,530 --> 00:35:16,010 Speaker 1: dirty objects, it didn't spread through the air, It spread 455 00:35:16,450 --> 00:35:17,410 Speaker 1: through mosquitoes. 456 00:35:18,570 --> 00:35:22,650 Speaker 2: The hall was Pecked, wrote Reed to his wife, the 457 00:35:22,730 --> 00:35:24,970 Speaker 2: applause long and hardy. 458 00:35:26,690 --> 00:35:31,130 Speaker 1: The authorities in Havana set up mosquito brigades to try 459 00:35:31,130 --> 00:35:34,490 Speaker 1: to rid the city of the mosquitoes that spread yellow fever. 460 00:35:35,250 --> 00:35:40,370 Speaker 1: They went from house to house. Most had no piped water. Instead, 461 00:35:40,930 --> 00:35:46,090 Speaker 1: people collected rainwater in open barrels. Mosquitoes laid their eggs 462 00:35:46,130 --> 00:35:50,090 Speaker 1: on the surface of that water. The mosquito brigades poured 463 00:35:50,250 --> 00:35:54,050 Speaker 1: oil on top. Just a thin film was enough to 464 00:35:54,050 --> 00:35:59,730 Speaker 1: suffocate the larvae. As the mosquitoes disappeared, so did the disease. 465 00:36:01,050 --> 00:36:05,570 Speaker 1: Over the previous ten years, Havana had averaged four hundred 466 00:36:05,610 --> 00:36:09,770 Speaker 1: and sixty two yellow fever deaths a year. In the 467 00:36:09,770 --> 00:36:18,170 Speaker 1: rest of nineteen o one, there were five. James Carroll 468 00:36:18,490 --> 00:36:22,250 Speaker 1: never fully recovered from his fight with yellow fever. His 469 00:36:22,410 --> 00:36:27,690 Speaker 1: heart failed. A few years later. Walter Reed died early too, 470 00:36:28,250 --> 00:36:32,810 Speaker 1: though not from yellow fever a ruptured appendix. His name 471 00:36:32,890 --> 00:36:36,810 Speaker 1: lives on in the Walter Reed National Military Medical Center 472 00:36:37,290 --> 00:36:42,290 Speaker 1: in Bethesda, Maryland. But I was curious what happened to 473 00:36:42,410 --> 00:36:47,170 Speaker 1: John Moran, the poster boy for selflessness with the dream 474 00:36:47,290 --> 00:36:51,930 Speaker 1: of being a doctor. I found an obituary from nineteen fifty. 475 00:36:52,970 --> 00:36:56,970 Speaker 1: Moran had lived to seventy four. He had settled in 476 00:36:57,010 --> 00:37:02,130 Speaker 1: Cuba and built a distinguished career as an oil man. 477 00:37:03,250 --> 00:37:07,330 Speaker 1: What happened to saving for medical school? Soon after his 478 00:37:07,450 --> 00:37:11,290 Speaker 1: bout of yellow fever? The obituary said, Moran took the 479 00:37:11,330 --> 00:37:14,370 Speaker 1: money he'd saved so far and invested it in a 480 00:37:14,410 --> 00:37:19,970 Speaker 1: get rich quick oil scheme. The scheme failed, Moran had 481 00:37:19,970 --> 00:37:23,330 Speaker 1: to give up on his ambition to study. He got 482 00:37:23,330 --> 00:37:26,650 Speaker 1: a job in the oil industry instead, and worked his 483 00:37:26,730 --> 00:37:31,690 Speaker 1: way up. I can't help wondering if he'd have felt 484 00:37:31,690 --> 00:37:35,450 Speaker 1: that need to gamble his savings, if only he'd taken 485 00:37:35,530 --> 00:37:41,610 Speaker 1: the payment from Walter Reed, he'd surely earned it. John 486 00:37:41,690 --> 00:37:46,930 Speaker 1: Moran risked his life for an experiment, then risked his 487 00:37:46,970 --> 00:37:53,090 Speaker 1: savings for his dream career. One risk paid off, one didn't. 488 00:37:53,490 --> 00:37:57,770 Speaker 1: That's the nature of risks. When Jesse Lazier and James 489 00:37:57,810 --> 00:38:00,730 Speaker 1: Carroll took the risk of being bitten by a mosquito, 490 00:38:01,570 --> 00:38:05,970 Speaker 1: we learned far too little because a proper scientific experiment 491 00:38:06,250 --> 00:38:10,130 Speaker 1: wasn't in place, And when the volunteers have one day sooner, 492 00:38:10,290 --> 00:38:12,330 Speaker 1: we're willing to take a similar risk. In the face 493 00:38:12,370 --> 00:38:16,650 Speaker 1: of COVID, we learned far too little yet again because 494 00:38:16,650 --> 00:38:21,970 Speaker 1: a proper scientific experiment just seemed too bold for policymakers 495 00:38:21,970 --> 00:38:26,570 Speaker 1: to approve. But there'll always be people who'll take risks 496 00:38:26,730 --> 00:38:31,010 Speaker 1: as a gift to help others. Shouldn't we be prepared 497 00:38:31,690 --> 00:38:46,730 Speaker 1: to accept that gift. The American Plague by Molly Caldwell 498 00:38:46,770 --> 00:38:50,450 Speaker 1: Crosby is a compelling history of yellow fever, as is 499 00:38:50,810 --> 00:38:54,570 Speaker 1: Yellowjack by John Pierce and James Writer. For a full 500 00:38:54,610 --> 00:38:57,890 Speaker 1: list of our sources, see the show notes at Timharford 501 00:38:57,930 --> 00:39:01,130 Speaker 1: dot com. If you enjoyed this tale, I recommend you 502 00:39:01,290 --> 00:39:04,250 Speaker 1: hop on over to pushkin Plus and check out my 503 00:39:04,410 --> 00:39:09,010 Speaker 1: brand new pair of episodes on the Panama Canal. Yellow Fever. 504 00:39:09,290 --> 00:39:12,890 Speaker 1: Greek's havoc on this mega project just one of many 505 00:39:12,930 --> 00:39:16,330 Speaker 1: obstacles faced by the French and the Americans on their 506 00:39:16,370 --> 00:39:25,010 Speaker 1: mission to dig a waterway across Central America. Cautionary Tales 507 00:39:25,090 --> 00:39:28,210 Speaker 1: is written by me Tim Harford with Andrew Wright. It's 508 00:39:28,250 --> 00:39:31,890 Speaker 1: produced by Alice Fines with support from Marilyn Rust. The 509 00:39:31,970 --> 00:39:35,370 Speaker 1: sound design and original music is the work of Pascal Wise. 510 00:39:36,170 --> 00:39:40,010 Speaker 1: Sarah Nix edited the scripts. It features the voice talents 511 00:39:40,050 --> 00:39:44,330 Speaker 1: of Ben Crowe, Melanie Guttridge, Stella Harford, Jammy Saunders and 512 00:39:44,450 --> 00:39:48,290 Speaker 1: rufus Wright. The show also wouldn't have been possible without 513 00:39:48,330 --> 00:39:53,170 Speaker 1: the work of Jacob Weisberg, Ryan Dilly, Greta Cohne, Eric's handler, 514 00:39:53,450 --> 00:39:57,930 Speaker 1: Carrie Brody, and Christina Sullivan. Cautionary Tales is a production 515 00:39:58,130 --> 00:40:02,770 Speaker 1: of Pushkin Industries. It's recorded at Wardoor Studios in London 516 00:40:02,970 --> 00:40:07,050 Speaker 1: by Tom Berry. If you like the show, please remember 517 00:40:07,090 --> 00:40:11,210 Speaker 1: to share, rate and review, tell your friends and if 518 00:40:11,250 --> 00:40:13,610 Speaker 1: you want to hear the show ad free, sign up 519 00:40:13,650 --> 00:40:17,290 Speaker 1: for Pushkin Plus on the show page in Apple Podcasts 520 00:40:17,610 --> 00:40:21,130 Speaker 1: or at pushkin dot Fm, slash plus