The Forgotten Epidemic that Remains One of Medicine's Greatest Mysteries
By: Molly Caldwell Crosby

My grandfather died of the Spanish Influenza, an epidemic that hit the world in 1917, and which finally burned out around 1920. It was a severe and deadly flu that killed somewhere between 50 and 100 million people - something in the neighborhood of 3% of the world population. More than 500 million became ill, and some of them lived to suffer another, less noted epidemic, encephalitis lethargica, the so called "sleeping sickness (or sleepy sickness)."

So Molly Caldwell Crosby's book relating the story of this "other" epidemic was of great interest to me. I had read about the Spanish Flu (so called because Spanish King Alfonso XIII contracted it, and Spain was one of the few countries to openly report on the epidemic's spread and effects) because of my grandfather, but I had never heard of this other mysterious flu.

While I had seen the movie, Awakenings (1990, taken from a book by Oliver Sacks of the same name), I didn't realize that the cases of Parkinsonism or catatonia in that film were actually cases of post-viral sequelae of encephalitis lethargic.

Essentially, the disease, which is characterized by high fever, sore throat, headache, double vision, sleep inversion, catatonia and lethargy, can be followed, cruelly,  as much as a year later by post-encephalitic Parkinson's disease. The sufferer begins the characteristic tremors of Parkinson's, which eventually become so severe as to literally halt all movement because the muscles are in such a rigid state of excitement.

The story of the epidemic is fascinating, and Crosby does a good job of providing details and background information that enrich her tale. She writes as an omniscient observer, providing sensory impressions and thought processes as if she were a fly on the wall for the events she describes. While this is a risky technique in a non-fiction book, it works well here, helping draw us into the early 20th century world in which this disease took hold.

What doesn't work so well is some of her writing. She is a florid author, seasoning her sentences liberally with adjectives and adverbs, but over and over again I ran up against something like this: "It took a moment for Tilney to adjust his eyes from the bright light of snow to the dark house..."

Of course, we don't adjust our eyes - they do it themselves. And it goes without saying that snow itself has no light, it merely reflects it. This and dozens and dozens of other examples of just poor writing stopped me, forcing me to read the sentence again and again, wondering why I was having trouble with them.

The other complaint I have about Crosby's approach to her book is that while it seems to be organized  in an accessible way - by case - it actually tries to also organize by physician and timeline. It was easy to get lost - a section would start out being about a particular patient, then digress to a narrative about a doctor, then back to a description of New York City, before finally returning to the by now almost forgotten patient.

Don't get me wrong, the sections themselves are quite wonderful: her insights and the bits of information she sifts through and selects are fascinating. Her description of early 20th century New York alone with worth the read. But it almost seems that in an attempt to flesh out a sparse story - what causes the disease, how to treat it, whether it's likely to come back, all are unknown - she lost her focus, and created ways to share a pile of facts, figures, and observations, without benefit of a coherent narrative.

Still, the disease makes an excellent villain, attacking as it does the young and vibrantly healthy, and reducing their lives to misery, self mutilation, institutionalization, even insanity. Not only would the disease make people sleep for days and weeks and a time, able to be roused only briefly, but many patients became rigid, or began to harm themselves - in one notable case, a young girl plucks out her own eyes, with no apparent sensation of pain, yet fully aware that she is doing something monstrous.

And as mystery stories go, this is a good one - you just can't make something up like this!


Terry Kate said…
I would love to have you join us at the Book Bloggers and Publishers Online Conference April 13-17.
I try not to leave this as a comment, but could not find your email.
Hope to hear from you,
Terry Kate
romanceinthebackseat @

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