THE GOOD DOCTOR

By Richard Lacayo

One good way to assess the great figures of medicine is by how completely they make us forget what we owe them. By that measure, Dr. Jonas E. Salk ranks very high. Partly because of the vaccine he introduced in the mid-1950s, it's hard now to recall the sheer terror that was once connected to the word polio. The incidence of the disease had risen sharply in the early part of this century, and every year brought the threat of another outbreak. Parents were haunted by the stories of children stricken suddenly by the telltale cramps and fever. Public swimming pools were deserted for fear of contagion. And year after year polio delivered thousands of people into hospitals and wheelchairs, or into the nightmarish canisters called iron lungs. Or into the grave. In the worst year of epidemic, 1952, when nearly 58,000 cases were reported in the U.S., more than 3,000 people died.

All of that is hard to remember, because by the time of Salk's death last week, of heart failure at the age of 80, polio was virtually gone from the U.S. and nearing extinction throughout the world. The beginning of the end for the virus can be dated precisely. On April 12, 1955, a Salk colleague announced that a vaccine developed by Salk and tested on more than 1 million schoolchildren had proved "safe, effective and potent." As a result of the nationwide effort of mass inoculation that followed, new cases in the U.S. dropped to fewer than 1,000 by 1962.

That triumph made Salk one of the most celebrated men of the 1950s. Streets and schools were named for him; in polls he ranked with Gandhi and Churchill as a hero of modern history. Though his fame was expertly fostered by the public-relations machinery of the National Foundation for Infantile Paralysis and its March of Dimes campaign, which helped finance Salk's work, national adulation was still an unexpected fate for a dedicated scientist in an unglamorous field.

The son of a New York City garmentworker, Salk was introduced to viral research as a medical student at New York University in the 1930s. After receiving his degree he moved to the University of Michigan to work with Dr. Thomas Francis Jr., one of his former professors. There he helped to develop commercial vaccines against influenza that were used by American troops during World War II.

After the war Salk headed the viral-research program at the University of Pittsburgh, where he gradually devoted his studies to polio. When he began his work, medical wisdom held that vaccines, to be effective, should use live viruses that had been rendered harmless in the laboratory. Salk believed it would be possible to make a vaccine using killed viruses; this method, he thought, was preferable since it carried less risk of actually causing the disease the vaccine was meant to prevent. When animal tests on an experimental vaccine proved successful, he moved on to human tests in which he and his family were among the first subjects to be injected.

That America's greatest hero was for a time a man in a white lab coat might have delighted Salk's peers in medical research. Instead many of them resented him as a man who reaped the glory for work that had been pioneered by less celebrated scientists all around the world. By 1962 Dr. Albert Sabin's oral vaccine, derived from live viruses, had become the preferred method of inoculation in the U.S., and Sabin was bitter about Salk's earlier triumph. Just a few years before his own death in 1993 Sabin claimed that "Salk didn't discover anything." Salk himself was often uncomfortable with the fuss made over him. He made a point of crediting others and tried to discourage use of the term "Salk vaccine."

In 1963 Salk was able to realize a lifelong dream when he became director of the Salk Institute for Biological Studies at a magnificent compound designed by Louis Kahn, on an oceanfront promontory in La Jolla, California. It attracted scientists in many fields to pursue biomedical research. In 1970, two years after divorcing his first wife, Salk married Francoise Gilot, the onetime companion and muse of Pablo Picasso and mother of two of Picasso's children.

When a new epidemic emerged in the 1980s, AIDS, Salk plunged into the effort to find a vaccine that would prevent people who are already infected with HIV from progressing to the full-blown disease. Though many scientists remain skeptical of Salk's approach, small-scale tests are under way.

But the greatest pleasure of Salk's later life, which he pursued in several books and in countless luncheon conversations at his institute, was to reflect on the large questions of human evolution and people's roles as "co-authors" with nature in their destiny--such as, for instance, his own. "I could have studied the immunological properties of, say, the tobacco mosaic virus,'' he once reflected, "published my findings, and they would have been of some interest. But the fact that I chose to work on the polio virus, which brought control of a dreaded disease, made all the difference.'' All the difference for him. And for hundreds of thousands of others too.

--With reporting by Paul Krueger/San Diego