On literature, science, and polio (for Jon Cogburn)

At a few occasions here at New APPS, Jon Cogburn and I have respectfully disagreed on the usefulness of literature for becoming a better philosopher, and in fact a better person more generally. He views literature as contributing significantly towards one’s philosophical development, while I have my doubts (to put it mildly). More generally, I believe that even great literature can have a rather negative effect on one’s personal development, in particular with respect to emotions and love, for many of the reasons discussed by Alain de Botton in this surprisingly good essay. According to de Botton, the wide majority of books on the topic focus on unrequited love, thus not preparing readers for what to do when you happen to hit upon a real-life relationship.

Suddenly, literature ceased to be any useful guide to what to expect. All that my books had prepared me for was an image of continuous perfection, a "happy love" that was essentially without any movement or action. 

But from time to time, I come across a novel which truly reveals something about real-life experiences, and as it turns out this often happens when I read Philip Roth’s books. Rather than starting with a story and then filling it in with bits and pieces of reality, my impression when reading his books is that he actually starts with reality and then finds a story to go with it. As is well known, Roth relies extensively in his own life experiences, in such a way that many of his books are seen as essentially semi-autobiographical. Now, while on holiday a few weeks ago I read his latest novel, Nemesis, which is in the fourth and last installment in a series of short novels, known as Nemeses.

Nemesis is about the polio epidemic in the Newark area in 1944; this novel too is intensely inspired by his own experiences, in this case as a Jewish boy growing up in New Jersey. The book offers a moving depiction of the unbearable fear of an unusually harsh polio epidemic during the summer of that year. At the time, summer, presumably the most careless season of the year for youngsters, actually brought along the frightening threat of polio (a typical summer disease). It narrates the story of Bucky Cantor, a young gym school teacher turned playground superintendent for the summer. What do you do in this position, when so many of the children you are supposed to look after fall prey to polio, but science has nothing to offer by way of advice? What about your own fear of being struck by the disease, vis-à-vis your sense of duty towards the children?

While it is thought to have existed among humans for many centuries, for reasons still unknown, polio attained epidemic dimensions only in the 20^th century. It then became a truly dreaded disease, in particular in that it affected primarily children; a large number of those who contracted the disease then became physically disabled for life, and a significant number of patients died from lung paralysis. Polio had such devastating effects, and affected such large numbers of people, that finding a vaccine for the poliovirus became one of the most pressing tasks for medical research in the mid-20^th century. Too many lives were being destroyed. As is well known, in the early 1950s Jonas Salk developed a vaccine based on the inactivated (dead) virus, which is administered by injection; it was officially announced in 1955. A few years later, in 1957, trials for the Sabin vaccine began, which was eventually licensed in 1962. The vaccine developed by Albert Sabin is an oral vaccine, thus of easier administration, and is based on attenuated forms of live poliovirus.

The discovery of effective and reliable vaccines for polio is without a doubt one of the most remarkable advancements in medical research of the 20^th century, certainly in terms of the amount of human suffering these vaccines have been able to prevent. Polio has now been eradicated in almost all countries, remaining endemic only in Nigeria, India, Pakistan and Afghanistan. Nevertheless, vaccination must continue even in polio-free areas, as wild versions of the poliovirus can be imported into humans again at any time. A noteworthy development in recent years is that some countries have decided to replace the Sabin vaccine, which has been the most widely used one since its discovery, with the Salk vaccine; while generally more effective, the former can cause vaccine-induced polio because it is based in live forms of the virus, while the latter does not. Now that the risk of epidemic is much less significant, the Salk vaccine seems to represent a better trade-off between the protection it offers and the risks involved. (On public health matters, I can rely on the special consultancy of my mother, a medicine professor in Sao Paulo who, among other things, leads the team that advises the Brazilian ministry of health on all kinds of vaccine-related issues.)

Naturally, before reading Roth’s Nemesis, I was aware of the polio ravage in the 20^th century, but it just felt like an abstract, remote past. Vaccination campaigns continue, but for those who did not have first-hand, personal experience of what it was like to live in fear, it is quite hard to appreciate how much better polio-free life is. And this is where literature comes in; Roth’s book brings the reader back to the time when polio was such a palpable, terrifying threat, when it had a real and devastating impact on people’s lives. It makes us acutely aware of what an extraordinary scientific feat the discovery of the polio vaccines was; with such a vivid report of what it was like to live with polio lurking around, it is possible to truly appreciate how life-changing science can be, sometimes for the much, much better.

So yes, I guess Jon is (mostly) right after all.