Saturday, February 26, 2011

Positive Quiddity: Dr. Jonas Salk

Jonas E. Salk (October 28, 1914 – June 23, 1995) was an American medical researcher and virologist, best known for his discovery and development of the first safe and effective polio vaccine. He was born in New York City to parents of Ashkenazi Jewish Russian immigrant families. Although they themselves did not have much formal education, they were determined to see their children succeed. While attending New York University School of Medicine, he stood out from his peers not just because of his academic prowess, but because he chose to do medical research instead of becoming a physician.

Until 1955, when the Salk vaccine was introduced, polio was considered the most frightening public health problem of the post-war United States. Annual epidemics were increasingly devastating. The 1952 epidemic was the worst outbreak in the nation's history. Of nearly 58,000 cases reported that year, 3,145 people died and 21,269 were left with mild to disabling paralysis, with most of the victims children. The "public reaction was to a plague", said historian William O'Neill. "Citizens of urban areas were to be terrified every summer when this frightful visitor returned." According to a 2009 PBS documentary, "Apart from the atomic bomb, America's greatest fear was polio." As a result, scientists were in a frantic race to find a way to prevent or cure the disease. U.S. President Franklin D. Roosevelt was the world's most recognized victim of the disease and founded the organization that would fund the development of a vaccine.

In 1947, Salk accepted an appointment to the University of Pittsburgh School of Medicine. In 1948, he undertook a project funded by the National Foundation for Infantile Paralysis to to determine the number of different types of polio virus. Salk saw an opportunity to extend this project towards developing a vaccine against polio, and, together with the skilled research team he assembled, devoted himself to this work for the next seven years. The field trial set up to test the Salk vaccine was, according to O'Neill, "the most elaborate program of its kind in history, involving 20,000 physicians and public health officers, 64,000 school personnel, and 220,000 volunteers." Over 1,800,000 school children took part in the trial. When news of the vaccine's success was made public on April 12, 1955, Salk was hailed as a "miracle worker", and the day "almost became a national holiday." His sole focus had been to develop a safe and effective vaccine as rapidly as possible, with no interest in personal profit. When he was asked in a televised interview who owned the patent to the vaccine, Salk replied: "There is no patent. Could you patent the sun?"

In 1960, he founded the Salk Institute for Biological Stuies in La Jolla, California, which is today a center for medical and scientific research. He continued to conduct research and publish books, including Man Unfolding (1972), The Survival of the Wisest (1973), World Population and Human Values: A New Reality (1981), and Anatomy of Reality: Merging of Intuition and Reason (1983). Dr. Salk's last years were spent searching for a vaccine against HIV.

Early life

Jonas Salk was born in New York City on October 28, 1914. His parents, Daniel and Dora Salk, were from Russian-Jewish immigrant families, and did not receive extensive formal education. According to historian David Oshinsky, Salk grew up in the "Jewish immigrant culture" of New York. He had two younger brothers, Herman and Lee. The family moved from East Harlem to the Bronx, with some time spent in Queens.

Education

High school

When he was 13, Salk entered Townsend Harris High School, a public school for intellectually gifted students. Named after the founder of City College of New York (CCNY), it was, wrote Oshinsky, "a launching pad for the talented sons of immigrant parents who lacked the money—and pedigree—to attend a top private school." In high school "he was known as a perfectionist...who read everything he could lay his hands on", according to one of his fellow students. Students had to cram a four-year curriculum into just three. As a result, most dropped out or flunked out, despite the school's motto "study, study, study." Of the students who graduated, however, most would have the grades to enroll in CCNY, noted for being a highly competitive college.

College

Salk enrolled in City College of New York from which he earned a Bachelor of Science degree in 1934. Oshinsky writes that "for working-class immigrant families, City College represented the apex of public higher education. Getting in was tough but tuition was free. Competition was intense, but the rules were fairly applied. No one got an advantage based on an accident of birth."

At his mother's urging, he put aside aspirations of becoming a lawyer, and instead concentrated on classes necessary for admission to medical school. However, according to Oshinsky, the facilities at City College were "barely second rate." There were no research laboratories. The library was inadequate. The faculty contained few noted scholars. "What made the place special", he writes, "was the student body that had fought so hard to get there . . . driven by their parents. . . From these ranks, of the 1930s and 1940s, emerged a wealth of intellectual talent, including more Nobel Prize winners - eight - and PhD recipients than any other public college except the University of California at Berkeley." Salk entered City College at the age of 15, a "common age for a freshman who had skipped multiple grades along the way."
As a child, Salk did not show any interest in medicine or science in general. He says in an interview with the Academy of Achievement, "As a child I was not interested in science. I was merely interested in things human, the human side of nature, if you like, and I continue to be interested in that.

Medical school

According to Oshinsky, NYU based its modest reputation on famous alumni, such as Walter Reed, who helped conquer yellow fever. Tuition was "comparatively low, better still, it did not discriminate against Jews, ... while most of the surrounding medical schools – Cornell, Columbia, University of Pennsylvania, and Yale - had rigid quotas in place." Yale, for example, accepted 76 applicants, in 1935, out of a pool of 501. Although 200 of the applicants were Jewish, only five got in.

During his years at the New York University School of Medicine he stood out from his peers, according to Bookchin, "not just because of his continued academic prowess—he was Alpha Omega Alpha, the Phi Beta Kappa Society of medical education—but because he had decided he did not want to practice medicine." Instead, he became absorbed in research, even taking a year off to study biochemistry. He later focused more of his studies on bacteriology which had replaced medicine as his primary interest. He said his desire was to help humankind in general rather than single patients. And as Oshinsky writes, "it was the laboratory work, in particular, that gave new direction to his life.”

Post-graduate research

During his senior year in medical school he chose a two-month elective to work in the laboratory of Dr. Thomas Francis. Francis had recently joined the faculty of the medical school after working for the Rockefeller Foundation, where he had discovered the Type B influenza virus. According to Bookchin, "the two month stint in Francis's lab was Salk's first introduction to the world of virology - and he was hooked."

After graduating from medical school he began his residency at New York's Mount Sinai Hospital, where he again worked in Francis's laboratory. Few hospitals in Manhattan had the status of Mount Sinai, particularly among the city's Jews. Oshinsky interviewed a friend of Salk's, who said, "to intern there was like playing ball for the New York Yankees ... only the top men from the nation's medical schools dared apply. Out of 250 who sought the opportunity, only a dozen were chosen."

According to Oshinsky, "Salk quickly made his mark." Although focused mainly on research, "he showed tremendous skills as a clinician and a surgeon." But it was "his leadership as president of the house staff of interns and residents at Mount Sinai that best defined him to his peers." The key issue for many of them in 1939, for example, was not the fate of the hospital, but rather the future of Europe after Nazi Germany's invasion of Poland. In one instance, "several interns responded by wearing badges to signify support for the Allies”, but the hospital's director told them to remove them lest they upset some of the patients.

The interns then took the matter to Salk, where he said that "everyone should wear the badge as an act of solidarity." One intern recalled, "Jonas was a very staunch guy. He never took a backward step on that issue or any other issue of principle between us and the hospital." The hospital administrators backed off and there was no further interference from the director.

Research career

At the end of his residency, Salk began applying for permanent research positions. But he discovered that many of the jobs he desired were closed to him due to Jewish quotas, which, according to Bookchin, "prevailed in so much of the medical research establishment." Nor could he apply at Mount Sinai as their policy prevented hiring their own interns. As a last resort, he contacted Dr. Francis for help. But Francis had left NYU a year earlier after accepting an offer to direct the University of Michigan's School of Public Health.

However, "Francis did not let him down", writes Bookchin. "He secured extra grant money and offered Salk a job" working on an army-commissioned project in Michigan to develop an influenza vaccine. He and Francis eventually perfected a vaccine that was soon widely used at army bases, where "Salk had been responsible for discovering and isolating one of the flu strains that was included in the final vaccine.

By 1947, Salk decided to find an institution where he could direct his own laboratory. After three institutions turned him down, he received an offer from William McEllroy, the dean of the Univeristy of Pittsburgh Shool of Medicine, which included a promise that he would run his own lab. He accepted, and in the fall of that year left Michigan and relocated to Pennsylvania. But the promise was not quite what he expected. After Salk arrived at Pittsburgh, "he discovered that he had been relegated to cramped, unequipped quarters in the basement of the old Municipal Hospital”, writes Bookchin. As time went on, however, he began securing grants from the Mellon family and was able to build a working virology laboratory, where he continued his research on flu vaccines.

He was later approached by the director of research at the National Foundation for Infantile Paralysis and asked if he would like to participate on the foundation's polio project, which had earlier been established by President Franklin D. Roosevelt, at the time thought to be a victim of polio himself. He quickly accepted the offer saying he "would be happy to work on this important project."

In 1956, Wisdom magazine ran a cover story about Salk, summarizing some of the reasoning behind his desire to do research:

There are two types of medical specialists. There are those who fight disease day and night, who assist mankind in times of despair and agony and who preside over the awesome events of life and death. Others work in the quiet detachment of the laboratory; their names are often unknown to the general public, but their research may have momentous consequences.
The Worst Disease of the Postwar Era

Polio was a medical oddity that baffled researchers for years. It was first recorded in 1835 and grew steadily more prevalent. It took a long time to learn that the virus was transmitted by fecal matter and secretions of the nose and throat. It entered the victim orally, established itself in the intestines, and then traveled to the brain or spinal cord.

At the start of the 20th century, during the 1914 and 1919 polio epidemics in the U.S., physicians and nurses made house-to-house searches to identify all infected persons. Children suspected of being infected were taken to hospitals and the child's family was quarantined until they were no longer potentially infectious, even if it meant they could not go to their child's funeral if the child died in the hospital.

There are many famous polio victims, most of whom were able to overcome their disabilities, while others were less fortunate: Itzhak Perlman, one of the world's finest violinists, was permanently disabled at age four, and still plays sitting down; actor Donald Sutherland; writer Arthur C. Clarke; writer Robert Anton Wilson; actress Mia Farrow; singer-musician Neil Young; Olympic dessage rider Lis Hartel; actor Alan Alda; musician David Sanborn; singer Dinah Shore; singer Joni Mitchell; former Supreme Court Justice William O. Douglas; director Francis Ford Coppola; nuclear physicist J. Robert Oppenheimer; actor Lionel Barrymore; and Congressman James H. Scheuer.

No comments:

Post a Comment