SYMHC Classics: Walter Reed

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Speaker 1: Hello and Happy Saturday. Walter Reid is getting a quick mentioned in an upcoming episode of the show, so we thought we would bring out our episode on him as Today's Saturday Classic. He was a U. S. Army doctor who did research into diseases like malaria, typhoid, and yellow fever. This episode originally came out on November Enjoy Welcome to Stuff You Missed in History Class, a production of I Heart Radio. Hello and Welcome to the podcast. I'm Ray Cbe Wilson and I'm Holly Fried. So most people, at least in the United States have probably at least heard of Walter Read, if only for the name of the Army Medical Center before it became kind of notorious due to a really huge neglect scandal in the late two thousands. It had previously made a name for itself as the heart of military medicine in the United States. UM The Army Medical Center actually closed in twleven and was replaced by Walter Read National Military Medical Center. So it's probably a surprise to no one that you know, the major military medical center in the United States was named for an Army doctor, and that was Walter Read. Walter Reid did truly ground breaking work into the causes and prevention of yellow fever, which was a hugely destructive disease to the American military and to other militaries and to civilians outside of the military world um, both within and outside of the United States. But he really didn't do this all on his own. His accomplishments really built on a foundation of other doctors and other researchers. But even so it had a huge and drastic impact on public health UH and on the American military's ability to work in tropical locations which had previously been fraught with all kinds of health problems. So Walter Reed was born on September thirteenth of eighteen fifty one to Lemuel Sutton and Faraba White Reed. Lemuel was a Methodist minister, and Walter had four older siblings, three brothers and one sister named Laura, who was the oldest. Because the elder Read was a minister, the family spent most of Walter's childhood moving from place to place as the Methodist Church assigned him to different congregations. Walter's older brothers, two of them Tom and James, fought for the South during the Civil War, which ran through Walter's early teenage. Years after the war was over, Lemuel requested that he be moved to Charlottesville, Virginia. He wanted his sons to be educated, and living in Charlottesville meant that they could go to the University of Virginia, and his request was indeed granted. Unfortunately, though, Walter's mother died not long after they arrived in Charlottesville, and she was only forty one at that point, Walter was only fourteen, and it might have been her death that prompted him to really throw himself into his studies. He was just an exceptional student even before he started college. As sort of a side note, his father also remarried pretty quickly, and the rest of the family quickly became very fond of his new wife. Not long after his mother's death, Walter, now fifteen at this point, started school at the University of Virginia. Students normally could not enroll until they were sixteen, but exceptions were made if they had older brothers attending, and two of Walter's three older brothers were already in school there. Although it turned out that Walter was the only one of them to graduate. He originally intended to study classics, but he soon made the move to the medical program instead. This actually was largely due to financial and time reasons. It was faster and thus cheaper to get an m d than an m A, which probably seems extremely strange to people who are familiar with how much it takes to get a medical degree today, and Walter's medical training touches on a number of previous podcast subjects. So cadevers used for study were provided to the school by resurrectionists who stole them from local graveyards, which we talked about in our episode on the Doctor's Riot, And like many of the other historical doctors we've talked about, Walter's first round of medical study included almost no practical or clinical work. So when he graduated on July one, eighteen sixty nine, after just two years, and also as one of the youngest people to do it, he had to pursue another degree so that he could get more actual hands on experience being a doctor. And first the young doctor Reid went to New York, where he enrolled in Bellevue Hospital Medical College. He got another MD there in eighteen seventy, and since he'd taken care of most of his science and medical classes in Virginia. This was mostly hands on study, and then he went on to do internships at hospitals around New York. A lot of reads work during this time was with poor people in communities that didn't have a lot of medical resources, so he became increasingly aware of the kinds of diseases that really caused crises in the world of public health. Typhus, typhoid, and yellow fever, for example, were all diseases that could just ravage poor communities, and he started working to understand all of them. This was particularly true during the four months he spent working at King's County Hospital in Brooklyn, New York, in eighteen seventy one, because that was a facility specifically for the poor. By eighteen seventy three, and at this point he was only twenty two, Read joined the Brooklyn Board of Health as an assistant sanitary officer, and this meant that he was too busy to start a private practice, and he was still so young that people didn't really seem to take him seriously. Reid started a doubt that he would ever be able to make the kind of change he wanted, since he could not seemed to get people to respect his knowledge in the medical field. So seeing that he wasn't going to be able to make the kinds of strides that he really wanted to, he eventually decided to join the Army Medical Corps, which were a multi day multidisciplinary affair in January of eighteen seventy five. Afterward, he was commissioned as a first lieutenant at the age of twenty four. And as all of this uh professional development was going on, Reid had been courting a woman named Emily Lawrence, primarily through letters. He had met her while visiting family in Murfresboro, North Carolina, in eighteen seventy four, and he married her on April eighteen seventy six. Before he left for Arizona Territory with the Medical Corps, he actually dinnerd quite a lot about getting married. He had some worries about what life was going to be like for the wife of a frontier army doctor. Um, he just sort of seemed concerned earned in a lot of ways, and so she had to do some convincing, including kind of implying that perhaps someone else was interested in her, so maybe he ought to get his act together. Um. So, when he did finally propose it was pretty sudden, he basically proposed, and then they wedged the wedding into a window of time when he could actually make it to Murfreysboro to have the ceremony. The newly weds didn't actually get to live together until the following November, when Emily met him in San Francisco after taking a train which was a side note had some sort of wreck along the way across the country. And this was just the first of many separations they would endure due to his work, and they wrote each other volumes of letters during these times apart. It was also the first of many adventures in their marriage, because, as we mentioned earlier, a lot of his early career in the Medical Corps involved him being a frontier doctor. He was moved from one post to another, and often their existence was really difficult and isolated, and a lot of the hospitals that he worked from were basically temporary structures meant to sort of serve a temporary need out on the frontier. They eventually had a son named Walter Lawrence and a daughter named Emily, who they called Blossom. Walter sor most likely delivered his son himself, as at that point they were stationed at for Apache on the frontier. Also living with them for many years was a young Native American girl named Susie, who Read had treated for serious burns after some sort of inter tribal battle. Susie wound up living with the family for about fifteen years. She was sort of a combination surrogate daughter and help around the house. At first, Read was a frontier Army doctor, as we said, moving from garrison to garrison mostly around the American West, and these remote outposts did not have the sorts of facilities or resources that Read needed to continue his studies of bacteriology and pathology, so he requested a leave of absence. As Tracy said, a lot of these facilities were just temporary setups, so they were not going to have a lab where he could really do this work. Instead, he ended up transferred to Baltimore at a couple of points, which allowed him to work at Johns Hopkins University Hospital Pathology Laboratory. Two really monumental things happened in Read's life in eight and we're going to talk about them. After a brief word from a sponsor to get back to Walter Read, a couple of big things, as we said before the break changed in his life. In one George Miller Sternberg became the Surgeon General, and to the new Surgeon General established the Army Medical school. I did this kind of discreetly because Congress was reluctant to spend money in the wake of a financial panic. That year, Walter was named to the Army Medical Schools faculty. At this point, Read had been promoted up through the ranks in the military to major. He was also appointed to be the curator of the Army Medical Museum and had become a faculty member at Columbian University, which would eventually become George Washington University. So after years of moving from place to place, he and the family went to Washington, d c. And while he continued to travel for his work, this put an end to constantly uprooting the family to go to a new outpost. His early interest in public health played out in a study of the diseases that were most problematic to the military. So he studied typhoid, cholera, malaria, which was still pretty prevalent in the U S at the time, and yellow fever. In he studied a malaria outbreak that happened at Fort Myer and at the Washington Army barracks. It was actually a fair amount of medical work going on at this time that correctly identified the cause of laria as a parasite that was spread by mosquitoes. But you know, the world of information spread being much uh more limited than it is today, this had not caught hold everywhere yet, and Read in particular didn't think that the mosquito was the culprit, in part because he had spotted a number of errors in the latest paper that was promoting that connection. Instead, he thought it was bad air, which is not surprising. A lot of people thought it was bad air. And the world malaria comes from Italian terms for bad air. And while he was definitely on the wrong track, he did dispel the idea that malaria was water born. He pointed out that healthy people in Washington were using the same water source as six soldiers in Fort Meyer and that saw the highest number of malaria cases in years, even though a water filtration program was in place. His research wound up looking at all kinds of factors and found all kinds of path turns and who got malaria and when. So, even though he never arrived at the correct conclusion from all of it, it was useful data to have. The Spanish American War broke out in and it only went on for roughly three and a half months, and in the end the United States had temporary control of Cuba and had troops station there, But this came with a number of problems. Cuba's tropical climate was home to several diseases that US troops had little or no natural resistance to. Walter Read did extensive work pertaining to two of them, typhoid and yellow fever. During this period, the Secretary of War appointed a medical board that he directed to study diseases that were prevalent on Cuba. The Surgeon General also established a board specifically to study yellow fever, and for that board, Read was tapped to be head. He traveled back and forth between Washington and Cuba several times over the next several years working with these diseases. UH first typhoid fever, so not to be confused with typhus, which is spread by fleas. Typhoid fever is caused by bacteria Salmonilla typhee, which is spread through feces. Today, there is a vaccine for it, and it's usually treatable with antibiotics, but that was not true in the eighteen hundreds. So typhoid is carried in the stools of infected people and it's transmitted by contact in one way or another with those infected stools. So that can mean flies crawling around on feces and then crawling around on food. It can also be transmitted when water or milk or are contaminated with infected feces, and people can continue to spread it even after they've recovered allah the infamous typhoid Mary. At this time, the military had huge sanitation procedures in place to try to prevent the spread of typhoid, but many of them just weren't effective. They had to do with cleanliness and disposal of waste, but it's still spread from one infected person to another. Camps would be relocated entirely for fear of contaminated water sources, although Reid was definitely involved in study and trying to come up with plans for how to prevent the spread of the disease, like new latrine designs to try to keep the waste away from other things. The primary researchers on it were Victor Vaughan and George Sternberg, and unfortunately their work didn't really get to a satisfactory conclusion. During Red's lifetime. They didn't manage to wipe out typhoid. It was basically endemic in the military, and efforts to clean up after it just were not enough. In the end, vaccines, which were developed not long after the turn of the century, did a lot more to stop the disease than all of their hygiene efforts, which were just not sufficient. In the end, he took a much greater lead in the fight again yellow fever, and his work with yellow fever wound up being a lot more effective than the work of the team was doing to try to control typhoid. Yellow fever was a huge problem in Cuba as well as in parts of the United States. In less tropical parts of the world, the disease was fairly seasonal, with huge outbreaks when the weather was warm. It's a hemorrhagic disease that causes fever, joint pain, vomiting, hemorrhaging, bloodshot eyes, and jaundice. Yellow fever had two nicknames. One was yellow Jack, which obviously was because of the jaundice, and the other one and heads Up. This is gross, was the black vomit, because in the end stages of the disease, people would bleed into their digestive systems and then they would throw that up, and what they threw up was black because of the enzymes interacting with the blood. One of the worst parts of the disease was that the symptoms often cleared up after a few days, which made people think they were going to survive, but then the symptoms come back as the liver failed and the internal hemorrhaging started. It was absolutely horrifying, and the mortality rate was up to The prevailing theory before Walter Reid really got involved was that yellow fever was spread by fomites. And if you've ever played plague, inc You know that these are external objects that are capable of hanging onto and spreading disease. So when Native Americans contracted smallpox after being given blankets that had been used by smallpox patients, the blankets were fomites. However, some doctors already thought yellow fever was spread by mosquitoes before Walter Reid got involved. Cuban doctor Carlos Juan Finlay had first theorized that yellow fever was spread by mosquitoes as early as eighteen eighty one. He did a hundred and four different experiments between eighteen eighty one and to study the diseases spread. Most of Finlay's subjects were immigrant workers who allowed themselves to be bitten by miss eatos that had bitten yellow fever patients. And it may seem kind of weird that people would be okay with this exposure without some kind of other incentive to to make it more enticing, but yellow fever was so widespread that pretty much everybody thought if you were in Havana long enough, you would eventually get it. So a lot of people were, like, I might as well get it over with and actually have a doctor nearby if it's going to happen to me, and like even figured out which specific species he thought was at risk. This was a common household mosquito that the time was called q lex fasciatus, and now it's called adies agyp die, and I hope I have pronounced that remotely right. But people did not take him seriously. This was in part because some of his experiments failed. He thought the mosquito bite was basically akin to a dirty needle. It was taking infected material from one person and putting it into another person. He also thought the sickest patients were going to be the ones most likely to transmit the disease to the mosquito. So this is not actually how yellow fever spreads, and we'll talk about that more in a moment, but that meant that, you know, a lot of his experiments did not result in somebody getting yellow fever, and people were sort of like, well, you're claiming it's the mosquitoes, but the mosquito, but that guy, he's not sick, so you don't know what you're talking about. Walter Reid, for his part, worked with a team of other doctors, including Jesse Lizier, Aristides Eggramante, and James Carroll. They worked not just off of Finlay's mosquito theory, but also off of actual mosquito eggs that Finlay had collected. He'd figured out that if you dried out mosquito eggs, they would still hatch and mature with the right temperature and humidity. So using Finlay's harvested mosquito eggs, uh Read and his team ran a series of experiments. They hatched the mosquitoes from the eggs, and then they allow them to bite someone who was infected with yellow fever. This was an extremely tedious, time consuming process. They would put the mosquito in a test tube, then put the test tube mouth down on somebody's skin, and then like wait for the mosquito to get to biting. Uh. They'd sort of tap the side of the test tube if the mosquito was just perched on it not really doing anything. But really, this is like hurting cats. Mosquitoes do not feed on people on cue. This reminds me of an episode of um Why am I blanking Out? On the name of MythBusters. They were trying to get a skunk to spray them and they just couldn't. It's kind of like nature doesn't always do what you want in a lab like yes. Well, and it will also remind people of the Saw Bones episode about self experimentation because they talk about this part in in that episode. If you are a Sawbones fan, uh. And the team approached this in a methodical way, as methodical as you can be well trying to tap on a mosquito to get it to bite someone, uh, And in a vast departure from much of the other research that we talked about on this podcast, they did not use unwilling organs and prisoners as test subjects. They used volunteers. These people gave their consent beforehand, and they were compensated for their participation a hundred dollars just for participating in another and another hundred dollars if they actually got sick. Um. This was basically revolutionary in the field of medical research. It's probably the first time that informed consent became a thing in Western medical study and research. And through these experiments they discovered a number of things about yellow fever transmission, including why some of Finley's experiments failed. It became clear as they went that mosquitoes could only pick up the virus from a sick person's blood two or three days after infection, and it took two weeks of for enough of the virus to reproduce inside the mosquito for someone it bit to get sick, So there was an incubation and period that had not been accounted for, and after that the mosquito could then spread the disease for a couple of months. As a side note, this is why mosquitoes don't transmit HIV. HIV doesn't reproduce inside a mosquito's body. The way yellow fever does. And this research was overwhelmingly successful, but it came at a cost. James Carroll, one of the researchers we mentioned earlier, was infected with yellow fever and he almost died. And this is reportedly because the mosquito in question had not eaten in about three days of them trying to coax it to bite someone, and they were afraid that if the mosquito starved to death, they were going to lose important data. So in sort of an act of just desperation, what reportedly happened is that James Carroll let it bite him. There's this whole other weird thing in my head swirling about the idea of trying to keep mosquitoes as pets, almost for medical research, and it's very strange to think about um. And Jesse Lizier was infected with yellow fever and he in fact did die. It's unclear whether this was part of an experiment or if this was an accident. Reports are contradictory. Some say that he did infect himself on purpose, and others say that he was bitten by a mosquito while working and thought it was a species that did not carry malaria. Regardless, his work before his death was absolutely critical to this experiment, and he left notebooks full of accurate, detailed data when he died, and without these notebooks the project probably would have failed. It could not have continued without his knowledge. Their research did not immediately gain traction. Back in the United States, an Italian doctor named Giuseppe Cinerelli had theorized that a basilus caused yellow fever, and even after this was disproved quite conclusively, he continued to insist that his basillis be named as the culprit. And this distracted from the real problem. Yeah, and when we say conclusively disproved, it involved things like during autopsies of people who had definitely died of yellow fever, his bacillus was not present, and we were like, this is not it. But his advocacy for his bacillus, which it was called his bacillus um, really sidetrack things. Um. However, soon the army instituted mosquito control programs and yellow fever rates and Havannah plummeted. The United States Army was also soon able to get into areas where they previously couldn't because yellow fever was just too entrenched. And basically trying to send troops there would have just caused everyone to get sick and die. An example is that the building of the Panama Canal really couldn't have happened without mosquito control programs to control the spread of yellow fever. Reid came back from Cuba in one and he continued to lecture on yellow fever. He received honorary degrees from Harvard and the University of Michigan. He was named Librarian of the Surgeon General's Library in November of nineteen o two. Walter Reid died on November twenty three, nineteen o two, after developing parrotnitis, which followed a case of appendicitis, and his death came as somewhat of a shock. At least the illness is severity came as a shock. His symptoms just weren't as serious as would have been expected for a case of appendicitis that was advanced as advanced as his was. So uh when he became it became clear that he was critically ill. People were really shocked by it. A vaccine for yellow fever was developed in the nineteen twenties, and, as we noted earlier, while to read Army Medical Center was named for him and for his work. I knew very little of him prior to this, so I'm glad you picked this one. Hey so much for joining us on this Saturday. Since this episode is out of the archive, if you heard an email address or Facebook U r L or something similar over the course of the show, that could be obsolete now. Our current email address is History Podcast at i heart radio dot com. Our old how stuff Works email address no longer works, and you can find us all over social media at missed in History. And you can subscribe to our show on Apple podcasts, Google podcasts, the I heart Radio app, and wherever else you listen to podcasts. Stuff You Missed in History Class is a production of I heart Radio. For more podcasts from I heart Radio, visit the I heart Radio app, Apple podcasts, or wherever you listen to your favorite shows.