Excerpted from: THE VIRGINIAN-PILOT/LEDGER-STAR
                 Sept. 13, 1994

      Polio, AIDS and the lessons of fairly recent medical history
                           By David Shirbman

   There still are people in this country who remember the iron lung.
They remember being careful of the dangers that lurked in a water
fountain, or a swimming pool.  They saw peril in movie theaters.  They
know that two of the most frightening words in any language are
"paralytic poliomyelitis."

   Now, as the nation's school children are returning to their
classrooms, it is sobering to remember that 40 years ago a team of
researchers led by Jonas Salk tested a polio vaccine on nearly 2 million
first-, second- and third-graders.  It was one of the great scientific
endeavors of all time, more spectacular in its applications and
implications perhaps even than Project Appllo.  It may have saved my
life.  It may have saved yours, too.

   And so in this season of anniversaries let us salute one other great
American achievement.  Like D-Day, this event serves as a generational
divide.  Those of us who lived in the polio years or knew its victims
are on one side.  Everybody else is on the other.

   I have often thought that this is why wars, medical and military, are
fought.  The point of these battles is to assure that the people who
follow do not live under the threats and tyrannies that produce them.
So it is with polio.  If you are so young that, as one gifted reporter I
know, you are not quite sure of the day, date and place of John
Kennedy's assassination, they you probably don't know what an iron lung
is either.  That's a measure of success.  There haven't been many iron
lungs in the newspapers recently.

   All this comes to mind because of a conversation I had with Jonas
Salk.  He is a hero of mine, in part because I am of the Salk generation
-- I think that an apt description of us -- and in part because in our
family polio was no stranger.

   It is still with us, whether in the memories of people who did not
survive the pandemic or in the way my father, stricken even as I was
being born, sometimes finds himself carrying his leg up the stairs as
if it were a heavy valise.  He is one of the lucky ones.

   Salk understands the impact of the disease and the vaccine on society.
They affected the character of the polio generation.  "So does a war,"
Salk says.  "So do economic conditions.  That's how we evolve, how we
understand challenges, how we overcome."

   But polio -- "the last of the great childhood plagues" as Jane S.
Smith put it in her history of the disease and the vaccine -- hasn't
been banished from the earth.  Lately there have been alarming accounts
that huge numbers -- as many as half of the 640,00 polio victims -- may
be suffering from new health difficulties related to their old polio.
These recurrent symptoms of the disease, known as "paralytic
poliomyelitis sequelae," are the ultimate nightmare for polio victims,
many of who struggled to move, then to walk, then to live nearly normal
lives.  These people are losing something they have fought very hard to
get.

   One of them is Dr. Lauro Halstead, the director of the post-polio
program at the National Rehabilitation Hospital.  Forty years ago
Halstead, now 58, had an iron lung.  Then he recovered.  He walked, he
played squash, he jogged, he even ran up stairs rather than take the
elevator.  It was a point of pride.

   Now he moves about in a motorized scooter like a small golf cart.
His legs have grown weaker again.  "I have lost a lot of what I had," he
says.

   No one knows why this dread disease is having such a terrifying echo
effect.  One theory is that the return of polio comes from physical
over-exertion, a phenomenon natural enough in those who thought they
might never be able to exert themselves at all.  The nerves that
remained after polio's march through the body may be doing more than any
nerves should.

   Polio and its return provide more than lessons of history and
medicine.  They provide lessons for life.

   The first is that, in the modern way, we have very short memories.
Listen to Halstead, a polio expert and twice the victim of the disease:
"We feel that we conquered polio.  All we conquered was acute polio
transmitted from kid to kid.  We found a cure for the infectious
disease.  We forgot about the people who were stricken before the
vaccine developed."

   The second lesson relates to the other epidemic of the postwar
period, AIDS.  The young generation is being reared with a fear of AIDS
that is a more terrifying mirror image of the fear of polio that their
parents and grandparents remember.  The homily to that generation comes
from Salk:

   "You can see" AIDS " as a dread disease or you can see it as a
challenge," he says.  "Polio was challenge.  I have an implicit faith
that we will solve it.  Why?  Because we have don this sort of thing
before."  Let us pray that history repeats itself.

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David Shirbman is Washington bureau chief for The Boston Globe.  Readers
may write to him at the  Boston Globe Washington bureau, 1130
Connecticut Ave. NW, Suite 520, Washington, D.C. 20036.
