Two cases of culpable homicide (1)
Kenneth Roy
Two cases of culpable homicide (2)
Bob Cant
J G Farrell
I remember him playing rugby at school, a strong-running centre three-quarter , but the world got to know him as arguably the best writer in the English language of the 20th century. His three major completed novels, ‘Troubles’, ‘The Siege of Krishnapur’ and ‘The Singapore Grip’ tell of tragic resistance to irresistible forces, of old regimes being overcome by new, of heroism and stupidity, of the fall of empire.
Alas, J G Farrell in his own life was confronted and eventually overcome by irresistible forces. As an undergraduate in Oxford in 1957 he caught poliomyelitis and spent months in an iron lung, his muscles paralysed to the point that he could not breathe unaided. Others of my age will remember the fear when these winter polio epidemics arrived and we were forbidden to go to the cinema or play sport for risk of catching it. Jim Farrell was left with serious muscle weakness and in 1979, at the peak of his fame and the age of only 44, he was washed by a wave into the sea while fishing in Ireland and drowned.
The history of medicine is full of tragic stories of discoveries made just too late for some great people, and in Farrell’s case the polio vaccine, produced initially in injectable form by Jonas Salk, was introduced for trial in the same year that he caught the disease. The oral vaccine produced by Albert Sabin was licensed in 1962 and allowed the hope that its simplicity of use and effectiveness would allow eradication of this terrible disease.
Following its success with smallpox, WHO public health campaigns have eradicated poliomyelitis from Europe and the Americas and indeed now it is only endemic in three countries in the world. Polio is a distant memory for elderly doctors in the West, but those who suffered from it and survived carry a legacy of paralysis, pain and incapacity through their lives. Until it is eradicated completely it will remain a threat, since mass vaccination is no longer routine in many polio-free countries, including the UK.
The word vaccination is derived from vacca, the Latin for a cow, since effective and safe protection against smallpox (variola, from the Latin for a pustule) became possible after the observations of Edward Jenner on cowpox infection at the end of the 18th century. Prior to this, prevention had been based on inoculation of small amounts of smallpox pus itself, an obviously hazardous procedure, but Jenner showed that cowpox pus was safer and effective.
Since its introduction against smallpox, the use of vaccines has always provoked opposition by the unsophisticated, the uneducated, the superstitious and cranks. Opposition is often based on rumours of harmful side effects, as with the disgraceful MMR saga, but sometimes moral or religious reasons are put forward against what are regarded as unnatural practices. Christians have played their part in this in the past, including the Calvinists in Scotland, but recently this has reached levels of unimaginable horror and stupidity in Pakistan which, with Nigeria and Afghanistan, is one of the three countries where the disease is still endemic.
The murders, apparently by Islamists, of nine young volunteers administering oral polio vaccine to children as part of the WHO campaign to eradicate the disease, seem to have been provoked by rumours (gaining credence from the part played by a doctor in tracking down Osama bin Laden) that the workers were US spies and that the vaccine was intended to sterilise the children. WHO has temporarily had to cease the programme and the polio virus will continue to kill and maim children in Pakistan. It makes one despair of humanity.
Professor Anthony Seaton is an emeritus professor in the school of medicine and dentistry at the University of Aberdeen
