Walter Reed

Virginia’s All-Time “Top Doc.”

Photography Courtesy of Historical Collections & Services, Claude Moore Health Sciences Library, University of Virginia

When the United States declared war on Spain in 1898 and prepared to invade Cuba, the Army faced its worst nightmare. A war in the tropics promised massive epidemics of typhoid and yellow fever beyond anything Americans had ever experienced. These murderous diseases had ravaged the western hemisphere for centuries, killing more than 100,000 people in the U.S. alone. But the new science of bacteriology offered some hope for a breakthrough, so the surgeon general ordered Maj. Walter Reed, the Army’s leading bacteriologist and a native Virginian, to try to solve the mystery of how these scourges spread.

Dr. Reed’s work ultimately rescued the world from two of its most vicious diseases. Though a humble man, he might reasonably have expected a promotion to colonel and perhaps to surgeon general. A Nobel Prize was likely. But two years later, the modest David who had faced down two Goliaths was felled by appendicitis. He died of complications in 1902 at the age of 51 and was buried at Arlington.

Reed would be honored, though. In 1905, Congress authorized the building of a medical complex in the northern corner of Washington. The heart of the complex—named the Walter Reed Army Hospital—accepted its first 10 patients in 1909.

Last year, that facility, which for more than a century had cared for the nation’s active and retired military and their families and educated generations of doctors in graduate medical programs, merged with the naval hospital seven miles away in Bethesda, Maryland, to become the new Walter Reed National Military Medical Center.  

Reed was born in 1851 in a two-room house in pastoral Gloucester County. Reed’s father was a Methodist minister who moved every couple of years, so the boy grew up in Farmville, Bedford County and Charlottesville, where he finished high school at the age of 16. Because two of his older brothers were students at Mr. Jefferson’s university, he was allowed “by special dispensation” to attend classes there despite his youth. After a year of Latin, Greek, history and literature, he decided to become a doctor.

“Medical schools were not standardized until 1910,” explains Joan E. Klein, curator for Historical Collections at the University of Virginia Health System. “A medical degree at UVA typically took nine months or until you passed the comprehensive exam. That was twice as long as most med schools of the time.” The bookish boy plowed through anatomy, chemistry and pharmacy, often sleeping only three or four hours a night. “He graduated third in the class of 1869,” says Klein, “one of two students known to have earned a medical degree at 17.”

Clinical experience came next. UVA had no hospital, so Reed had never seen a patient until he went to Bellevue Hospital Medical College in New York City, one of the country’s leading teaching hospitals. A year later, he earned a second M.D. Annoyed by his youth, Bellevue refused to award the degree until he had turned 21.

Meanwhile, the teenager from rural Virginia practiced medicine in the teeming immigrant ghettos of Brooklyn. The genteel poverty of his youth in no way prepared him for the filth and destitution of the slums or the epidemics that ravaged its population. After a few years in grimy New York, Reed longed to leave. “These great cities have lost the fascination which formerly held me so fast,” he wrote in 1874. But what could a poor doctor with no connections do? He saw no chance of supporting himself back in Virginia with its crippled post-Civil War economy.

The military beckoned. A career as an Army doctor offered financial security, something he needed before he could propose to his sweetheart, Emilie Lawrence. If he could pass the examinations, he wrote Emilie in the summer of 1874, and if he could “find some damsel who was foolish enough to trust me, I think I would get married, and settle down.” Six months later, he passed the five-day, 30-hour exam and became 1st Lt. Walter Reed of the U. S. Army Medical Corps.

There was no more exciting time to be a doctor. Germ theory was on the march, and scientists like Louis Pasteur and Robert Koch were creating the field of microbiology, which at long last explained the origins and spread of disease. Microorganisms—not bad air or unbalanced humors—caused disease. Vaccines were being developed. Reputations were being earned. But Reed was missing all of it.

For 15 years, he and Emilie were stationed at a series of primitive frontier forts where he practiced old-time army medicine. Usually the only doctor within hundreds of miles, Reed cared not only for the soldiers and their families, but for any civilians and Indians who asked for help. He treated wounds, performed surgery, delivered babies (including his own son and daughter), and fought cholera, malaria, typhoid, and dysentery as best he could. Yearning to join the front lines of the war on disease, Reed chafed at his isolation.

Not until he was almost 40 was Reed finally posted to Baltimore, where he could study bacteriology at the new Johns Hopkins Hospital. Within three years, he had become one of the most respected pathologists in the Army. Surgeon General George Sternberg selected him to teach bacteriology at the Army’s new medical school, training civilian doctors to practice Army medicine and public health. Reed’s reputation for accuracy and originality soared. When Sternberg needed someone to tame typhoid fever, Reed was his choice.

Typhoid fever had terrorized mankind for centuries. Europeans brought it to the New World where it killed thousands of Jamestown colonists and ravaged America’s cities and Army camps for the next 300 years. This time, it struck before the troops had even shipped out. Stateside training camps became cesspools of disease, killing more soldiers than the Spanish ever would. Those who survived the training camps arrived in Cuba to face a barrage of tropical diseases deadlier than bullets. If the Spanish had not surrendered after seven weeks, no one fit to fight would have remained on either side. Combat during “the splendid little war” killed 379 American soldiers. Disease, mostly typhoid, killed over 5,000.

Sternberg asked Reed to determine how typhoid spread. They already knew its cause. A few years earlier, German scientists had discovered the bacterium, but how it spread was still an enigma. Reed’s deliberate investigation found that the bacteria spread by fingers, feces, and flies—through direct human contact—and contaminated drinking water. Sanitation measures, when enforced, could prevent the spread of typhoid fever.

But cleanliness did nothing to slow yellow fever, which was thought to be even worse than typhoid. So frightened were people of “Yellow Jack” that some doctors purposefully misdiagnosed it, and some newspapermen refused to print news of an outbreak for fear of public hysteria. Victims first developed a fever, aches and nausea, at which point, the lucky ones recovered and were forever immune. But over half died a gruesome death that included bleeding from the nose, mouth, and eyes, extreme pain, high fever, delirium, black vomit, convulsions, and yellowing skin—hence the name. Common treatments included mustard plasters, the fumes of burning tar and cannon fire to chase away the contamination. Nothing ended an epidemic; nothing, that is, except the first frost.

Thrilled with Reed’s triumph over typhoid, Surgeon General Sternberg sent him to occupied Cuba in the summer of 1900 to tackle yellow fever. Everyone assumed the two diseases were similar. In fact, they could not have been more different.

Yellow fever had always been mysterious and unpredictable. “Everyone knew” it was caused by a bacterium, but no scientist had been able to find one in the blood of infected people. “Everyone knew” it was spread by contaminated bedding or clothing. The problem was, yellow fever refused to cooperate with what everyone knew. Only Carlos Finlay, a Cuban doctor, persisted in thinking outside the box. He theorized that yellow fever was spread by mosquitoes. The medical world laughed off Finlay’s hypothesis. His fellow doctors dismissed him as a “crank” and a “crazy old man,” calling him “mosquito man”—and not always behind his back.

Twenty years earlier, Reed, too, had dismissed Finlay’s theory. Now he wasn’t so sure. He had seen a lot of epidemics in his Army career, and yellow fever just didn’t behave like the rest. Where Finlay’s experiments had been inconclusive or flawed, “Reed was very methodical in his approach,” says Dr. John R. Pierce, a retired pediatrician and former director of medical education at Walter Reed Medical Center who co-authored the 2005 book Yellow Jack. “He was a very bright guy, thoughtful and hard-working, but his real genius was in pulling together bits and pieces of others’ work.”

Since no animals were known to be susceptible to yellow fever, human guinea pigs were necessary. A call for volunteers, who were paid $100—nearly $3,000 in today’s money—resulted in several willing men, most with little concept of the danger. So great was Reed’s reputation that some soldiers who knew the danger very well nonetheless volunteered, refusing compensation.

Carefully isolating mosquitoes and humans from any other source of infection, Reed conducted two experiments at once. He quarantined seven volunteers in a hut, where they lived and slept with sheets contaminated with vomit, feces and blood of yellow fever victims. None developed yellow fever, thus proving that yellow fever was not contagious. In another hut, he experimented with active cases, uninfected volunteers, and mosquitoes “loaded” with blood of yellow fever victims. Fourteen volunteers developed yellow fever. Miraculously, they all recovered.

The mosquito experiments proved that a female of one particular species was the agent that spread the disease. What made connecting the dots so fiendishly difficult was the timing. A mosquito flying directly from an infected person to a well person could not spread the disease. It was necessary for the virus to incubate for at least 12 days inside the mosquito’s digestive tract; only then would its subsequent bites cause yellow fever.  

Working from Reed’s discoveries, the Army began eliminating mosquito breeding areas and placing yellow fever victims in screened quarantine.Within weeks, the number of cases declined until Havana was free of the disease for the first time in centuries.

Back home, Reed tried to convince health officials to adopt similar measures. But the Army couldn’t issue orders to the civilian world, and there was considerable resistance. Mosquitoes? The idea was just too absurd. The Washington Post called Reed’s work “silly and nonsensical.” Not until several years after his death were Reed’s conclusions widely accepted.

“Reed was not nationally known until the last part of his life,” says Dr. Pierce. In an era before Army pensions existed, Reed’s friends formed an association to raise money for his widow. Says Pierce: “People like J.P. Morgan and John D. Rockefeller contributed. They understood.”

Reed understood too. Triumphant, he had written Emilie from Cuba on the last day of 1900, when he had ironclad proof of yellow fever’s link to the mosquito. “The prayer that has been mine for 20 or more years, that I might be permitted in some way to do something to alleviate human suffering, has been answered!” •

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