>> booktv is on twitter. follow us for regular updates on our programming and news on nonfiction books and authors. twitter.com/booktv. >> coming up, mark pendergrass looks at the centers for disease controls epidemic disease intelligence service which is called on whenever there is a serious breakout in the united states and around the world. eis established in 1951 is credited with eliminating or helping to control threats posed by such diseases as wild polio, cholera and smallpox. this is in burlington, vermont. it's 55 minutes. [applause] >> thank you for coming.

i'm going to start us off with maybe 40, 45 minutes and then have time for questions. and i wanted to explain a little bit about inside the obviouses and i'm going to show you a little film i took the last 3 minutes and then we'll have than illustrated slide and things like and i would go over my other book. my first book was called forgotten country and coca-cola. it's a history of coca-cola. which a lot of my friends said could you write a book about that soft drink and it it turns out it was a thick book. the second book was called victims of memory. this is probably my most important book in terms of the social issues. it was of the widespread professed memory therapy in the 1990s and the disastrous effect it had. my third book was uncommon grounds, it's history of coffee. probably my bestselling book a

lot of them are in different issues and whatnot. this one has the biggest legs, i think. a lot of people are really interested in coffee for good reason. next book was mirror, mirror, a history of mirrors. this was very wide-ranging and it goes from prehistoric commoners recognizing themselves in mirrors which is something -- if you think about it, to know that you're looking at yourself in a mirror -- it's something that only humans and higher apes and dolphins can do. it goes all the way up to the hubble telescope and it covers, art, technology, magic. and i wanted to mention jack and the bean soup. this is my breakout book. it's a children's book. basically an elaborate book if you know any children or adults who would appreciate such a thing. that's that. inside the obviouses i did take over 5.5 years to write it as my

wife reminded me repeatedly. and it was really a labor of love. it's about an organization called the epidemic intelligence service and a friend of mine went through this and told me about it. first, he wrote an email and said you need to write an article about eis and i said thanks, andy. what is the eis and he told me it was the epidemic intelligence service. there's really such a thing? and it is. it's part of the cdc. it began in 1951 in the middle -- i'll show you the guy who started it. let me see. alexander was the head of

epidemiology. he had this idea that he wanted to get young doctors out into the field immediately, within 24 hours of being notified that there was an epidemic. they would have their bags packed. they would be ready to go. and it sounds exciting and it was exciting but guess what? nobody wanted to go under the field of public health. nobody realized that this was an interesting area because at that time it appeared that the new antibiotic were going to wipe out all the bacterial diseases. and that we were getting more and more vaccines. people said, alex, you're going into a dying field. forget it. he said, no, i think you're wrong. and he was correct. as you know, we haven't exactly vanquished all the microbes of the world but he couldn't get anybody to be interested in joining this group because it was considered a dead-end. fortunately, we were in the middle of the korean war. and there was a doctor draft.

and so the doctors didn't want to go into the army and when they joined the eis, it gave them an out. they spent two years in this program rather than two years in the military. by the time the doctor draft ended with the vietnam war, it had become a well-known organization. and they didn't need the doctor draft. any way, he was a bigger than life character. if you read the tube, you'll see that he sort of -- his daughter said that when he walked into a room, that you could feel the room tip towards him. he was arrogant. he was intimidating. the eis officers were very afraid of him. i called it his silver-backed pose. and he was also brilliant and visionary and he led the eis not only into dealing with microbes and infectious diseases but into

many other areas as well which i'll be talking about. and at this point, there's a little caricature of him and he had a somewhat of a humor. he played the wizard in one of these skits. every april they have a skit which is quite sophomoric and it's a little thing about diarrhea and they have to do it. it's their way of letting off a little bit of steam after all this very, very serious diseases they've been dealing with in the last two years. now i wanted to follow them in the middle of a happening epidemic and i never was able to do that because the state government was and the countries that they were going to do were too nervous. what i did get to do was to follow them in assessment surveys of programs that they were doing in africa. i went to niger which is a fascinating experience and i went to kenya. and i wanted to show you -- when

i was in niger, i couldn't go into the villages. let me cue something up for you here. i want you to look at this little movie here. i had a digital camera with me and it occurred to me, oh, gee, i could actually take little movies, you know, like you can with a digital camera and i was like a magnet of the children who would come up here and i took this film. and it's very charming but it has a very serious ending but i turned this into a youtube and if you wanted to look at this, you can go to my website, which is just my name, mark pendergrast.com and you if you click on the outbreak stub page and there's a link to what you're about to see. and also if anybody wants to get hold of me, it's easy. it's go to that website, my

name.com and you can email me directly. so let's play this. ♪ ♪ ♪ >> you go to school and you learn english, yes? yes.

your teacher's name is annise? okay. i want to hear a song in german. can you sing? no? [laughter] ♪ if you're happy and you know it, clap your hands ♪ ♪ if you're happy and you know it, clap your hands ♪ and if you're happy and you know it then your face is going to show it, if you're happy and you know it clap your hands ♪ ♪

♪ ♪ >> all right! that's wonderful. [applause]

>> so, you know, what i wrote here is true. and you can see in your eyes how really, you know -- kids are universal. people are universal. one of the eis officers i interviewed, wherever i go, whatever people that have lips stretched blue or whether they're sitting in front of computer terminals they all want the same thing. they want things with their family and they're all trying to

do the best they can. some people are born into places where it's very unequal. and so i really admire this program. it's one government program which -- as i said in the book, it's probably the most important government program that you never will have heard of, but it may very well have saved your life. but you wouldn't know it. and that's the nature of public health in general. is that these are really unsung heroes. they go about their business without any fanfare. and they don't get the recognition that they deserve most of the time. and so i'm very pleased that in this book i think they do. let me just tell you how it's organized. each little section of the book is a subheading. and it's basically a little mystery story. every little subhead. so i try very hard not to telegraph what the answer was 'cause i wanted the reader to

feel the same urgency and the same puzzlement as to what is causing whatever is killing people or causing terrible diseases. and they often didn't know when they were going into it so i'm going to read -- this is almost an at-random sample, but it will give you an idea of how the book reads. and in a way the eis officers are sort of are the generic leading characters although they have different personalities as you can imagine. most of these at the beginning were in their late 20s and most of them were white male doctors. over time, that changed. now most of them are about 34 on the average. over half of them are women. about 25% of them are minorities of one sort or another. and about 10 that to 15% of them are from other countries.

it's really almost a united nations down there in atlanta at the epidemic intelligence service is i'm going to read this profuse diofor rhesus in africa. in a little hospital run by the salvation army some 30 babies a month were born to unwed mothers. the nurses and doctors ran an immaculate operation with complete prenatal care, delivery and nurturing of newborns. on april the 17th, 19 six 7 a week old baby delivered a mild fever and filled with sweet. transferred to a major hospital nearby the child was treated with antibiotics but died within 24 hours. immediately after this death, three more babies began to sweat profusely. they survived following blood transfusions. blood cultures of the babies were negative for any known

infection. the hospital closed its nursery for 10 days for thorough cleaning. a month laterenlyno with the sa and three more infants barely survived after transfusion. second year, eis officer randy ikener was called in and he found that the babies had all been appeared normal. they'd all been delivered by different doctors. in other words, he was looking for something unusual and he wasn't finding it. maybe it was one doctor causing it. the maternal vaginal canal had been cleaned with a iodine compound before baby and all baby was suctioned with a bulb and given the same eye ointment injection. finally, he found the possible cause. since july, 1966, surfaces in the nursery had been cleaned

with a disinfectant including four derivatives which had been shown to have newborns go linens were purchased and the disinfectant had been discontinued. case closed. two months later, on august the 29th, another baby at the st. louis hospital began to c. ikener had graduated from the eis. it's a two-year program so officer robert armstrong prepared to investigate using ikener's notes. he noticed that chemical analysis of the baby's blood had found traces of the chemical. after a quick literature search, he discovered that a chemical used primarily as a wood preservative had caused exactly the same symptoms in other

outbreaks. when he arrived at the small hospital in the morning, armstrong began in the attic. i found every box, bag, container and i took them apart. by the afternoon, he had worked his way down to the basement laundry room where in a storeroom he found a large barrel. he turned it around, saw a label, a whitening agent. among its ingredients were the chemical. and the label warned not to be used in hospitals. lalaundry it in the washer for the terminal rinse for diapers and other hospital linens armstrong recalled. he asked them to stop using it. he called the health department, took samples and locked up the barrel. the chemical was easily absorbed through the skin especially a baby's wet skin.

after a previous outbreak of an infant illness in a north dakota hospital had locked suspicion, the company that made it added the cautionary label. the manufacturer denied any negligence. the label said it shouldn't be used in hospitals. armstrong was not persuaded. especially after his own blood found to have a relatively high level of the chemical. the st. louis hotel where he stayed during the investigation also used the chemical for its sheets and towels. while the u.s. department of agriculture had regulatory power over the laundry product, don't ask me why, the usda, their officials didn't see the necessity to recall the product, armstrong remembered. the usda was just a front for industry. that's a quote from him. armstrong went to cdc director david spencer.

after reviewing the data, spencer called the president of wyandotte and told him to recall the product and never sell it again in the united states. although the cdc had no regulatory power, spencer promised that he would make pub executive did not agree. that was the end of it. so this book has -- i haven't counted them but many, many incidents such as this. and, you know, intellectually it's very stimulating and fascinating. but if you were one of those parents who had a baby who died or almost died, that obviously is what you were focused gethate book as much as i could. so let me just whip through it and i may go through some of them quicker than others.

but there's some really interesting parts here. now, let me see. if i click on this, yeah, okay. can i go to the slide show and it will know after i go through these. da, da, da. oh, that was the logo. i love this logo. it's the shoe with a hole in the bottom of it. they call them shoe leather epidemiologists. in other words, they get out in the field and they go out and experience things and i found myself really identifying with them because in many ways they're similar to journalists, investigative journalists, which is what i do. i go out in the field. i interview people. but i just don't do it as scientifically and i'm not as smart as these guys but they do have a sense of humor. this is a picture of camp dedrick. we used to do offensive

biological warfare preparation in this country which is terrible and guess who stopped it, nixon did, in 1969. but the eis people had a very early alliance with them which made me uncomfortable and which made many of them uncomfortable, too. there were -- there were some fairly interesting things in the early history which i criticized them for. they did some experiments on prisoners and mentally ill patients. it was not just them. most medical people were doing that at the time. they no longer do that. thank goodness. this is an example of an early shoe leather epdeemologist. this was somebody who was in the first class. >> his name is rei ravenholt. this is a diphtheria outbreak in ohio. and i quoted him in the book. up until then i had just been working in hospitals. i had never been out to see where people were getting things. and it was only when i actually went to people's homes like this

that i began to see why they were getting what they did. come on. click. there we go. when the salk vaccine came out it was cause for a huge celebration. some of you may remember the time when your parents or if you were a parent in the early '50s -- you didn't let your children go to swimming pools or to movie theaters. there was widespread terror of polio and here was a magic bullet. you had this shot that you could get that was going to protect you and it did. and it did work. unfortunately, within two weeks of them beginning to get this to first and second graders some of them began to get polio. they were paralyzed in the same arm they got the injection in. eis officers went out and began to study it frantically and they quickly figured out it was one manufacturer's vaccine. they had not killed the vaccine. this is -- when it gets into

your body, your body reacts to the virus as if it's live but it's dead and it's perfectly safe and it makes antibodies and they were given children live vaccines. it wasn't just the laboratories. it was also wyeth was making vaccines that was giving children polio. and eis officers investigated that and wrote up a full report on it but langmuir suppressed it. they took the vaccine off the market. but he was afraid that if it was publicized, that people would be so afraid of the vaccine that it would kill the entire program. i disagree with that but i understand his logic. anyway, that put them on the map. the cutter institute. in '58 langmuir saw an opportunity to go overseas to become an international agency. until then a few of them went

overseas. one eis investigation i wrote about was the korean war in 1951 but this was an opportunity to bring a budget of people over there. there was a big smallpox outbreak in what later became bangladesh. the eis never had money. it still doesn't have money. they have a pathetic budget. one of my points of my book. i hope they get funded better. but the state department had to pay their way over in this case. they went to the state department and they weren't the least bit interested until they found out that the russians were sending a team of epidemiologists and, of course, we had to beat the russians. langmuir took all these guys over. and smallpox is the major theme in the book which we'll talk about in a minute. i actually found letters that malcolm page had written to his

girlfriend at the time, now his wife and i quoted them in the book. and it gives a real immediacy to this even though this was 1958. and he's talking about people running away and how he could barely get -- this is very unusual that he's actually next to a woman at all. they could stick their arms out the door because muslim women weren't supposed to be seen. and he had to give himself the vaccine over and over again to make them understand it wasn't going to hurt them. there weren't very many women as i mentioned. this was the outbreak in puerto rico. i'm going to skip over it. they began to test the jet gun injector that gives smallpox vaccines. eis office did this in brazil. they decided they could get rid of measles after the measles to the vaccine came out in '67 and they couldn't, not for many, many years finally go on from

the united states. in 1968, i think this was the biggest medical breakthrough of the 20th century. and it's sort of unheralded. but cholera is a horrible disease that can kill you within 24 hours from dehydration. it gives you such terrible diarrhea that you lose all of your vital nutrients and the treatment was simply to give it an iv drip to replenish the minerals that you were losing and the water which works but which is not available in many parts of the world. and you have to have an expert to install it, et cetera. in many places, in many rural areas where this is occurring, 20, 30, 40% of the people who contracted cholera died.

well, the eis officers in this case in a little laboratory in bangladesh, they were testing out something called oral rehydration solution which was to replace the electrolights and the fluids that they were losing. >> this is a cholera cot. that child is evacuating through a hole in the cot directly into the bucket. and you can see it's measured. and they would make sure that the child was getting exactly as much of the oral rehydration solution as was being vak waited into the bucket and it saved her life. and it saved many, many lives. this was the hospital that they were doing that work at. a later eis officer named richard levine was assigned there and they were supposed to be working on a vaccine for cholera which never worked very well. but he realized you know what? he kept seeing the boats would pull up with the cholera patients with the bottom just

full of ex cement and he would watch the boats being washed out in the lagoon and he thought this is not good. he did a study and he showed that the cholera level near the hospital was much higher than the cholera level of places 50 miles away. and he got them to clean their act up. so this is one of the unintended consequences of what they were doing. they were actually spreading the disease they were supposed to be stopping. there's a lot in the book about bangladesh. this is right before the revolution that created it. it was a terrible typhoon. this is one of the first natural disasters that they investigated. and there were quite a few of them in subsequent years and what i concluded from these was that it's very rare after a hurricane or a flood that you have an infectious disease epidemic, although that's what people are worried about.

but quite often what you really need is food, shelter, and clean water. and that was true in this case. and al summers, the guy who investigated this in the eis, he later went on to pioneer giving vitamin a to children to save their eyesight and their lives. and then he went on to become the dean of the school of public health at johns hopkins. that's one point that i wanted to make. it's a relatively small program. only 3,000 or so. a little over 3,000 have gone through it. but it's had an enormous impact because of where this people have gone on to. they've gone to work at the world health organization, at the gates foundation, in state health departments. they're all over the place and there are now 36 programs around the world that eis alumni have begun so they're spreading this methodology of shoe leather

epidemiology around the world and it's really had an impact. anyway, al summers said, you know, these people gave us the craziest things. this was the first real, you know, public -- where george harrison had the concert for bangladesh. people were really galvanized by what had happened to them. but they sent electric blankets. they sent vitamins. they sent outdated tranquilizers they sent crazy things. they sent field hospitals. he said we didn't need field hospitals either people had gotten drown or had been blown away or this was the worst injury they had. from holding onto a tree to survive during this typhoon, they had abrasions and that was it. but what they needed was food and shelter. and that's one of the interesting things i found about epideemologists and when they

were trying to sort out what was going on like a refugee camp or whatever, the doctors like, you know -- doctors without borders would be there and they would say, why aren't you guys doing something? why aren't you -- you're trained medically. why aren't you taking part in primary health care? but they began to be won over when they realized by taking a broad view and seeing where the help needed to be applied, they were saving more lives than zooming in. i began the book with a little parable that's sort of like this. where i won't read it to you. but the parable is -- and several of these guys i interviewed told me this. picture your -- two doctors are by a river and bodies are floating down the river. you're pulling the bodies out. you don't know what it's doing to people. you're missing most of the bodies and they're floating by. one of the drops suddenly drops the person they're attending and runs upstream. the other doctor says what are you doing?

he said i'm going to go up stream to find out what's causing this. that's what the epidemiologists are doing. this is one of the first environmental impacts that the eis studied. actually, one of the very first members, bob melon, he was called to examine what they thought was the st. louis encephalitis outbreak. and it turns out it was lead poisoning. and when he realized that, he started the first poison center in the united states. well, many years later in 1972, eis officer philip landrigan was sent to el paso, texas, because they had very high lead levels in the children. and he found there was huge amounts of lead in the dust around the lead smelter. i included this pictures because

i like the outfits they were wearing. this is 1973. barry levy is there on the left. again, he's become a very important figure in public health and has written very interesting book about war and public health and about bioterrorism. but when he was an eis officer -- and these guys, they're very young. he told me all the years he did in the first six months he was there, which is amazing. so i wrote all that up in the book. one of the things that he did that really struck me. he did a salmonella outbreak in a bar, hopps bar. and it wasn't very hard to figure out that it was the potato salad had been the culprit. you know, you interview everybody who was there and what they ate. and, you know, all the people who ate the potato salad got sick.

and nobody who didn't eat the potato salad got sick so you can figure it out. most things are more complicated than that. and he could figure out why it happened. he interviewed the guy, oh, yeah, i make potato salad -- first i had the chicken there in that bowl and then i cooked it and then i made the potato salad in the bowl. did you wash the bowl out first? no. cross-contamination, classic mistake. but it bothered m. he thought, you know, if they had had restaurant inspection which would have cost $15, this could have been prevented. how much did it cost? it took a lot of his time. it sent 15 people to the hospital. they lost time at work. he figured it cost about $30,000. but he wrote this up as an article and it got into "time" magazine and the "new york times" and it made -- and hopefully it created a few more people running around and investigating restaurants. this is one of the skits that i mentioned. i've been to several of them.

in 1975, they made a pilot movie starring maureen reagan, ronald's daughter. and it's actually robert uhrich somebody pointed out. they never made the television series. and my book has been optioned for a television series. i think it would make a great series. it would be fantastic. but the odds of it actually becoming one are probably relatively small. but i'll go to whatever television executive is. smallpox is the only disease we've completely eradicated from the world. we're on the verge of eradicated guinea worm and we're very close to eradicating polio. although it's not clear we'll ever see. but smallpox, the eis officers were very much involved in west

africa and then in the endgame in india and in bangladesh. i have a whole chapter on this which i think is quite amazing what they went through. they had to travel by elephant or dugout canoe. many people who didn't want to be vaccinated and this creates a moral conundrum but you know those people might pass it on others and nowadays you couldn't get away with it but at the time many people forced vaccination on people. so there's all kinds of interesting kind of ethical issues involved in this industry. nonetheless, they did manage by 1977, at the very last page of smallpox was found in somalia. there hasn't been any ever

since. they still kept the smallpox in freezers ultimately in atlanta at the cdc and in moscow. it turns out the russians were making it illegally and who knows where it is now. so there's a big fear bioterrorists may get hold of it. but for the time being it's gone. that led to an expanded program and that's an enormous impact on the world. this was sort of a bit of humor comic relief. crater lake is most to be the most pristine water in the united states. and it had a terrible diarrhea epidemic. my wife while she was complaining how long it was taking me to finish the book. it's a great book but there's too much diarrhea. take it out. i said, hey, this is what happens. anyway, the concessionaire

refused to admit to and had very sick restaurant workers who continued to work and passed it on to people. it's an interesting thing and then the cdc got blamed for it for not closing the park earlier. they closed the national park, the first time that it ever happened. the very next year in 1976, i called this chapter the year of living dangerously because at the beginning of the year, there was a huge fear that there was going to be a swine flu epidemic. in fact, all during the year, there was fear of this. i was surprised that the media -- it just shows how myopic our news media is and they only look at what happened in the last 2 minutes generally. but with this swine flu pandemic we've been having, and it is a pandemics, although thank goodness it's not as dangerous a strain as we thought it might be. but in this case, a private, an

18-year-old private at fort dix in new jersey went on a 5-mile forced march in the morning, you know, part of his training. he didn't feel well and he collapsed and he died. and he had flu and it turns out what he had was h1n1, which was swine flu. so they thought it might be like 1918 which was the last time we had a terrible swine flu and that it might be somewhat mild in the spring but would come back having mutated into becoming this horrible killer in the fall. so they decided to inoculate everybody in the united states. it never came back. so cdc looks really dumb over this. what did come right when they were looking for it and they thought at first it was swine flu was legionnaire's disease in philadelphia. now, this was the bicentennial year and here our veterans were falling over and dying of some mysterious ailment.

so there was widespread rumor that this was bioterrorism or communists or somebody doing this. and they could not figure it out. eis officers spread all over pennsylvania right to figure this out. >> this guy steve thacker is now in charge of the person who's in charge of the eis program at the cdc. he told me that he went into this room and the press had been following him and he turned around and nobody had come into the room with him. [laughter] >> they were all scared. one photographer peeked his head through to take the picture and left right away. it's a bacterium that grew only in cooling towers and air conditioning systems. so it had probably been around forever. but it hadn't proliferated and

affected human beings, and this is one of the unintended consequences of technology. there are a lot of lessons to be learned from reading this history of what we've gone through in the past 60 years or f the first ebola outbreak and then eis officers were summoned. there was a guy named joel breman who went to this one and he was told me he was just coming out of an autopsy because somebody had died of swine flu. he died of something else but it was after they'd gotten the swine flu vaccine and he needed to make sure that it wasn't from the vaccine and it wasn't. he gets a call and it was from his boss back in atlanta and he said there's this new disease in the middle of nowhere in africa. it seems to have 100% mortality. everybody is dying from it. how would you like to fly over there and try to solve it? and he said, well, let me talk

to my wife, you know, i have two little kids. and he did go. subcommittee told me that when they got there -- oh, he went with another eis officer, and they stopped in geneva on the way to consult with the world health organization and the other eis officer freaked out and said i can't go. and he went back. he went back to the united states. joel went ahead. he and a lab guy got there. they were basically totally sleep deprived. they hadn't had any sleep in 48 hours. so they are rushed immediately to a meeting and everybody is talking in french which joel understood. and explained that it was in this remote area. and that they were going to send a team in and he thought, oh, good, they're organized. they know what they're doing. thank goodness. and then all eyes turned to them and there was silence. and they were the team. [laughter] >> so he ended up going.

this was an interesting one. there were more and more imported flowers coming from chile. and it turns out they had very heavy pesticide load on them. so they investigated that. there's a lot of really weird things you never would have thought about, but this one about the flowers later on more -- as more and more of our produce came from mexico or from latin america, we began to get more and more diseases as a result. so i think we're going to be going more and more back towards local food now and i think that's a very good idea because we're less likely to have it. this is something that has happened several times too because of liquid manure systems. they didn't have proper ventilation and the poor 16-year-old who was working on

the farm died because of it. this was a real example of the impact that one person can have. karen starko's son is going to the university of vermont medical school. so identify gotten to know her fairly well when she comes to visit her son. that's her son. in 1978. she was assigned to the state of arizona and this was a flu epidemic and in the middle of the flu epidemic, a number of children began to die of reye syndrome. i don't know if you know about reye syndrome and it doesn't happen very much because of karen in large measure. it was a disease that usually came in the middle of a flu epidemic or chicken pox. children would be getting better and then suddenly they would begin to projectile vomit. they would become disoriented. they would become combative. they would fall into a coma and they would die. terrible, terrible death.

these were children who up until this point had been totally healthy. nothing the matter with them. eis officers had been working on this for several years, in fact, they identified the disease in the first place. but they couldn't figure it out. seven children died and she did a case control study. it's remarkable that nobody had done this before. a case controlled study is where the cases are these seven children and you want control as similar as possible but who didn't get reye children so she chose two children in the classes but had flu but recovered uneventfully and she asked the children what had the children had for medicine. what had they had to eat, what kind of pets were in their houses. what was the heating system? what vaccinations had they gotten because she was on a fishing expedition. she didn't know what had caused it. and when she went -- she had a hard time figuring out what was

in their medication because what's in pepto-bismol or what's in the cough medicine. and she had to go back to the pharmacies and figure it out. and when it all came down, and she looked at the chart, it was aspirin that was the common denominator that the cases had. some of the controls were also given aspirin but not as much. so nobody could believe this. it was mom and apple pie. this was a 1962ad for aspirin. very typical. if you've got a cold, give your child aspirin. and so nobody believed her. in fact, she couldn't even get her article on it published at first. but when they did other studies, it became clear she was right. it was aspirin. and the aspirin industry fought tooth and nail against putting labels on medications for

children containing aspirin. and they delayed warning labels for five years. during those five years at least 300 more children died of reye syndrome and that's the ones we know about. there were probably well over 1,000. so this is one of the cases where companies put profits ahead of people's lives. there were other cases. this is another case. toxic shock syndrome. perfectly healthy 21-year-old women were dying while they were men tour ating and they were a tampon, a certain type of tampon a new highly absorbent tampon and it was caused by a staph infection that was proliferating in this sort of perfect little factor. this is the picture of the ones

who were working on it. they asked the company to withdraw rely which was made by proctor & gamble. rely was the tampon that was the most problems but not the only one. the ceo got on his knees and begged the eis officer, i beg you, think what this means to our company. we spent billions of dollars on this. what if you're wrong? and the eis officer said, what if it were your daughter? what if you're wrong? so they withdrew it. i'm going to stop here, i think. there's so much more i could talk about. but let me just read you the that little end of this and then we've got time for some questions. i'm sorry i went on a little bit

long. i wanted to read you the last chapter in the book here. in 1951, alexander langmuir seized a cold war opportunity to fund a small training program for young epidemiologists. who would keep an eye out for biological warfare while responding promptly to unintended epidemics. that's how he got the funding for it. he scared people because the communists were supposed to be polluting our water and spreading anthorax. it didn't happen until 2001 with the anthrax letters and then that was the eis officers doing that, too. today, these eis officers are the world's premier front line disease detectives. for an obscure government program, the epidemic intelligence service produced remarkable results. perhaps it has done so in part by remaining relatively small, nimble and flexible. one of the lessons of the eis history is the impact that one person can have. put creative, intelligent, well trained motivated individuals

into the right environment and the outcome can save lives and lead to vital careers. eis officers and alums have an impacts far beyond their original numbers. today, with global public health bedeviled by substantial threats, the life-saving world performed around the world by these shoe leather epidemiologists is more essential than ever. the eis and its offspring have showed how public health is practiced on our planet. and i will stop here and i hope you have some questions. yes. >> what is it about the investigative journalism approach that you have to your book that you find so rewarding? if you find it rewarding at all? >> yeah. it's sort of like the eis

officers. you're trying to find some answers that you're trying to pose. how did they come to be the way they are. as i said before, human beings are the same and yet different. you know, we all want kind of the same thing but it's fascinating what we choose to do and in what ways we handle it. one of the exciting things is going into an archive. it's not just going and following people in africa and you come across something that is -- like that -- the press paper about the wyeth polio vaccine. wow, this is great. i'm going to use that. so, you know, it's like a little expiration. it's sort of like a perpetual treasure hunt. any other questions. yes? [inaudible] >> it's written about a variety of topics and i'm wondering because especially of the

book -- [inaudible] >> when you begin these, you don't have any specialized knowledge of the subject. and what's that like when you find that you need -- [inaudible] >> so in other words, how do you become an expert on a topic that you've chosen to write about and you don't know anything about it? well, you know, an expert is somebody who finds out as much as they can and at one point they get to know more than most people about it. in this case, you know, i read everything that i could find about epidemiology. i interviewed all these people. i read all of their epi-aids. they had these -- they write a report after each of their investigations, which they made available to me. it's wonderful. like a treasure trove. you know, i asked the same question that e.j. cannes wrote about coca-cola. i said when do you know when to

stop? so i wasn't so worried about becoming an expert. but it just seemed endless. you know, you just keep going and going and going. you could spend the rest of your life researching this stupid soft drink, you know? and i could have. and he said, well, what i found is that when you start to interview people and they tell you who else you should talk to and you've already talked to them, and they tell you stories you've already heard, then you should start writing. and that's very good advice. and that's basically what i did. [inaudible] >> interacting with people who are experts who are involved, you have to raise your own -- did you have to do a lot of preliminary research to do the research? >> no. the question was, did i have to do preliminary research so i didn't look like a complete idiot when i interviewed the experts? no.

i don't need looking like a complete idiot. i'm a smart guy. i have commonsense. and i'm not afraid of saying, i don't understand that. can you explain that better. i'm not dumb. i can understand it. and people respect that. if they get all holier than thou and get up on their high horse, that's their problem. i've read a fair amount usually before that. yes. >> i always wondered back with the rely tampon issue, what was the manufacturing defect in that, that made that? especially alitoial because you never hear of that anymore. they must have designed it differently? i never really understood that. >> part of it -- i would have to go back to that slide. part of the problem of the rely

tampon. number one, it was super absorbe absorbent. it was an anaerobic factor. the staph infection. it was a particularly bad type of staff cockal infection that was going around for some reason and when they did studies of women about a 10th of them at that time, harvard did, in their var vagina a fairly harmless place. but when it was introduced in an environment where it would proliferate, that's what caused the harm. so there was nothing intrinsically the matter with rely tampons it was a combination of factors that caused it. [inaudible] >> very good good point.

they were wearing them longer. and they discovered that was a factor. they also had the little string that hung down, it was a multifilament string and so it was sort of like a wick that would bring more microbes up. any other questions? i didn't get to cover a whole lot of stuff. but i think we're pretty much running out of time. one more question. that's it. good. thank you so much for coming. [applause] >> mark pendergrast is the author of many books including uncommon grounds the history of coffee and how it transformed our world. for more information, visit his website, markpendergrast.com. >> visit booktv.org to watch any of the programs you see here online. type the author or book title in the search bar on the upper left side of the page and click search.

you can also share anything you see on booktv.org easily by clicking share on the upper left side of the page and selecting the format. booktv streams live online for 48 hours every weekend with top nonfiction books and authors. booktv.org. >> kleo, pascal, globe warring, not global warming. >> it's a little bit of an extreme title but the situation is quite extreme. a lot of the analysis around climate change thought it was going to get a little warmer and temperatures rise on. it doesn't go on what that means of political issues and geopolitical issues. we're starting to see it a little bit in the arctic where there's conflict where there hadn't been before and there are climate where they are not there. china knows it's going on in the

arctic caused by climate change and they want a piece of habitation it's rechanging global politics and economics is acting out. it's a little bit disconcerting. >> why would china have an icebreaker and what's going on in the arctic that we should be concerned about. >> there's major oil and gas fields in the arctic. a lot of them are in russia. the pipelines in russia like the alaska pipelines are from that youing permafrost. so part of the pipeline goes down you've lost your delivery system. it makes sense in that situation to start to shifting. if russia starts to shift the shipping that means they are not tied to deliver to europe and they can deliver to china. they can continue to supply without the revenue stream. china increasingly wants a piece of that action. especially the russian arctic oil and gas action. >> what is your background. how did you involved in this issue. >> i was a journalist for a long time and i was doing foreign

correspondence and i was going to places like tu-belleau in the pacific. i started to wonder what does that actually mean? you know, if it disappears does it cease to exist as a country? does it lose its seat in the u.n. and does does it matter? now, hillary clinton was just in american samoa of all places. it is area is getting quite extreme. if you are getting countries that extreme, that force starts to shift in ways that we haven't really considered and perhaps should be considering. >> cleo pascal global warring is the