but he was quoting from philosophers, from poetry. now when i did drafts and speeches, when you see me on a speech, you'd see me sitting with a pile of books around. you know, i'm going up and going, you know, i'm trying to get this. :

>> said she a pleasure to talk to you. >> thank you so much.

[applause] >> thank you for coming. i'm going to start us off with maybe 40, 45 minutes and then have time for >> i will try to talk 40 or 45 minutes then have time for questions. i want to explain about "inside the outbreaks" i will show youas a little fell my took for about threend minutes and to go over very quickly, of my first bookol was for god's 10 treed the history of coca-cola my friend said candid you really write a book all about that soft drink? but it was very interesting. second was called victims of memories this was the most important in terms of socialides issues about the widespread practice of repressed memory

therapy and the disastrous effect and my third book was some common grounds probably the best selling book although they are in for dishes but this has the biggest legs that's is for good reasons. the next book was mirror merck -- mirror mirror a history of mirrors goingif from a pre-historic people - recognizing themselves in a mirror. of you think about it to know you are lookingom at yourself is something only humans or higher apes lowered dolphins or elephants can do and goes up to the hubble space telescope to cover art, and come a magic. my breakout book a

children's book so you know, any children or adults who would appreciate it, that is that. "inside the outbreaks" i did take over five and a half years to write this as my wife reminded me repeatedly. it was a labor of lovebo.iz about an organization called epidemic intelligence service and a friend of mine went through this my friend said you should write a history of the eis. i said think you. what is it eis?c he said it is the epidemic intelligence service i thought this is not faction faction -- nonfiction there really is? >> it is. began in 1951 part of thearte cdc and i will show you the guy who started it alexanderut

was the high a stage was then head epidemiologist at that time it was started at the communicable diseases center always the cdc. he had this idea he wanted to get young doctors out into the field immediately within 24ei hours in the notified hot there was an epidemic and had bags packed and ready to go. but nobody wanted to go into the field of public health and nobody realized this was an interesting are a because the new antibiotics appeared to ride out the bacterial diseases and we're getting more vaccines to do with the virus is. people said going into a dieing field? forget it. w he said i think you are wrong.

we he could not get anybody interested in joining the -- joining the group but fortunately we were in the middle of the korean war and there was a doctor draft. they did not want to go into the army and if they joined the eis it gave them announced they spent two s years in the program insteaden of the military by the timewar, the draft ended with the vietnam war, it was a well known organization and did not need said dr. draft. a bigger than life character, you will see when his daughter said he would walk into a room, you could feel the room tip towards him. he was there again, intimidating, eis officers were very afraid of him a prior i call this his

silver back goes. brilliant, a visionary, lead and the eis not only dealing with infectious diseases and microbes but other areas as well which i will talk about. here is a caricature of him and even some what had a sense of humor and played a wizard prepare every april the 1/2 day skit that is very sophomoric that is their way to let off a little steam after the very serious diseases they were doing with i was never able to follow because the state s or the countries they were going to work to nervous. but i did get to follow them with the assessment surveys

and programs they were doing in africa. so i went there which was a fascinating experience and i also went to kenya. when i was i t thin niger, let me q something up. a little movie. i had a digital camera and it occurred i could take movies. i was like debt magnet for the children and i put theing film it is very charming but i will warn you itan does have a very serious and saying and i put this on to youtube you can go to my website pendergrast.com and if you click on the outbreak some page then there is a

link to what you are about to see. and if anybody wants to get ahold of me just go to the website mark pendergrast.com and e-mail me is directly. we will play this. . ♪ ♪ish, ♪ ♪

>> you go to school and learn english? yes. your teacher's name? yes. okay. song ino hear a german. can you sing? note? [laughter] no. ♪ if you are happy and you know, it clap your hands ♪ a ♪ if you are happy and you know, 'r when it clap your y hands and ♪ ♪ if you are happy and you know, when and your face will show it clap your hands ♪ ♪ ♪

♪ ♪ ♪ ♪

[applause] >> so, you know, what i wrote here is the. >> what i wrote is true and you can see in their eyes how kids are universal andterv people are universal and one of the eis officers no matter where i go if their

lips are stretched a blue or sitting at a computer terminal, they want the same thing that is good for their family, they are trying to do the best that they can. some people are born into places where it is very un eco. i admire the program whengo government program which i said is probably the mostave important government program you'll never hear of but very well may have saved your life that you would not know it. that is the nature of public health in general. of these are the unsung heroes to go about their business without any fanfare and they don't get the recognition they deserve most of the time. i am pleased in this book that they do. each little section is a sub heading. it is basically a little

mystery story. so i try hard not to telegraph what that answer was seven 1/3 greeter to feel the same urgency or the puzzlement too whatever is causing whatever is killing people lowered diseases and they often did not know. this is almost the at random sample by give youin the adm house the book read stand in a way that best eis officers are the east generic characters although theyni have very different personalities. most of these in them we beginning we're in their late 20s and were white male doctors and over time that has changed now most areab about 34 on average and over

half are women become much 25% are minorities and tender 15 percent are from other countries it is almost a united nations down there in atlanta at the epidemic intelligence service and will read you a section and a low say louis hospital run by the salvation army coming 30 babies per month were born to unwed mothers the nurses and doctors ran the american operation withan complete prenatal care delivery and nurturing of the new warrants for car 7 april 79, 1967, one week-old baby developed a mild feverld then became slick with sweat and hissf tiny heart beatinghe rapidly. transferred to a major hospital jobless treated with antibiotics but diedree within 24 hours. s immediately after the

death, three more babiesther began to sweat profusely. they survived bobbling blood transfusions. blood cultures or negative four any known infection part of a hospital closed the nursery for 10 days for a thorough cleaning. one month later another baby died suddenly with the same and three more infants barely survived after transfusions. bab a second year eis officer randy was called in and found they were awful term pregnancies and appeared normal.sn't they were delivered by different doctors he was looking for something unusual. h maybe one doctor the maternal vaginal canal were cleaned with iodine delivery before and were all suction to a e same eye ointment and vitamin injections.

finally he found a possible cause since july 1966 surfaces and then there's three were cleaned with a disinfectant with fourth enol derivatives including shown to have newborns go into convulsions and a nursery was closed again and soak down and new lyndon's werelo purchased in the disinfectant discontinued. case closed. two months later august 29eat another baby at the st. louis hospital began to sweat profusely and the hospital immediately called of the cdc. randy had graduated from the eis so officer robert armstrong prepared to investigate using brandy's nosed used -- notice a chemical analysis found

traces of the finale hydrocarbon after a quick search he discovered that $0.10 chlorophenol used primarily as a wood preservative had caused exactly the same symptoms with other outbreaks. when he arrived at the small hospital armstrongi began in the attic. i found every box, a bag, a container and took them way apart. by the afternoon he had worked his way down to the basement laundry room where and a store room he found a large cardboard barrel and turned it around whitening agen. among its ingredients were the chemical. and the label warned not to be used in hospitals. a laundry lady told me they put 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 submitted as a control was 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 d and their officials did not see the necessity to recall the product. the usda was just a front for industry and armstrong went to the cdc director and after reviewing the data, he called the president and told him tole recall the product and it never sell it again in the united states for although the cdc had no regulatoryis power, he promised he would make a very public stink about ifre the executives did not agree.e. that was the end of that. but this book, i have not counted them, but many, many incidents such as this. intellectually it is veryñi stimulating and fascinating but if you were one of those parents who had a baby that died almost died, that is obviously what you would

focus on and i try to get that into the book as much as i could. let me just go through these slides again made go through thesehe quicker than others but let me see if i click on this coming can i go to the slide show, that was the logo. i love that come with it is the issue -- the issue was the whole in the bottom and because they call themselves the shoe leatherce epidemiologists. get into the field and experience things i found identifying with them. because they are similar to investigative journalist like what i do. i interview people but not very scientific way.

[laughter] and not as smart. but they do have a sense of humor. we used to do offensive biological warfare t p preparations and gas to stop it? and extend.e but eis people had an early alliance which made me - uncomfortable and made them his uncomfortable but there were fairly interesting thing this they did some experiments on prisoners and mentally ill patients, most medical people do that at the time. they no longer do that. this is an example of then early shoe leather epidemiologists. first class named ray on the left.

there was an outbreak in ohio and he said up until then i was working in hospitals i had never been out to to see where people were getting things. only when i went to people's homes that i began to see why they were getting what they did. >> when the vaccine can mount 1955 it was cause for a huge celebration some of you may remember when your parents in the early fiftiesie you did not let youro an children go to swimming pools lowered movie theaters widespread terror of polio. a shot that you could get to protect you and it did but unfortunately within two weeks, some of them began to get polio and were paralyzed in the same arm they got the injection.e

eis officer steadied frantically and quickly figureds e out one manufacturer vaccine, those that bring you your insect repellent, had not killed the vaccine. if it is killed, the body reacts as if itd is live but in this case they were giving children who live a vaccine. i discovered by the way not just one laboratory but also wyeth was giving children polio and eis officers wrote up a full report but it was the press and never allowed it to be suppressed. they took the vaccine off the market but he was afraid if it would be publicized people would be so afraid ofc. the vaccine it would kill the program. i disagree but understand the logic.

that put them on the map. 1958 seeing an opportunity to go overseas to become the international agency. the very first eis investigation and i wrote aboutn was 10 1/7 to react but to this was an opportunity bring a lot of people over. in east pakistan it became bangladesh but the eis never had money and still doesn't and it is a pathetic budget which is one point* of my book and i hope they geto th funded better part of the state department had to pay their way over. they were not the least bitted interested what do we care? and intel they found out the russians were sending out a team and of course, we had

to beat the russians. smallpox is a major theme in the book as chalet finding letters malcolm page wrote to his girlfriend and now his wife and it is hof and immediacy talking abouthi people running away how he could barely get wended theld my he is next to a woman they would usually stick their arm outpp the door because women were not supposed to be seen. ove he had to give himself the vaccine over and over to make sure it would not hurt them. there were not very many women. here is a outbreak can pr that i will skip over. they began to test theines injector that gives the of cam

vaccines they decided they can get rid of measles after that vaccine can mount and 67 and they couldn't but not for many, many years but is now finally gone from the united states.ur 1968, the biggest medical breakthrough the 20th century that isl unheralded, but cholera is a horrible disease that can kill you within 24 hourst from dehydration and giveyo such terrible diarrhea that you lose all five o nutrients and electrolytes and a diaper, the treatmentnd until then was simply to t givehe the i the trip to wat replenish the minerals you lose saying it was water that works but it is not available in many parts of the world and you have toura have the expert so in manyin places in rural areas 300 or

50% died. that etfs officers and little laboratory in bangladesh was testing the or rehydration solution that wouldis replace thethat electrolytes and fluid they were losing. that child is evacuating through a hole in endicott directly into the baht -- bucket and it is measured to make sure they'rf e getting exactly iser much of the solution as was being evacuated into the pocket and it saved her life and many other lives. this was the hospital they were doing that work later eis officers richard was

signedot they were supposed to be working on a vaccine but he realized, he would see the boats pull up with the patients and the bottom was full of excrement and watch the boats being turned over in the lagoon and washed out.. he said this is not a good. he did a study and show the cholera levels near the hospital was much higher andac places 50 miles away. he got them to clean their act up and that is the unintended consequence there actually spreading the abo disease they were supposed to be stopping. there is a lotsh aboute bangladesh. there was a terrible typhoon and one ofsa the first naturalf disasters they investigated.

there were quite a few and the subsequent years and what i concluded is it is very rare after a hurricane or a flood to have the infectious disease epidemic of love that is what people are worried about that quite often, you need watershelter, clean and out summers went on to a pioneer divvying five m&a and went on to become theoin dean of school of public health of johns hopkins. it is a relatively small program, a little over 3,000 with the enormous impact of where these people had gone on with said who, the ase foundation, the state health

departments all over the place and now other programs around the world that the alumni have because of their spreading the epidemiology. this is the first where george harrison have the concert and people were galvanized by what had happened. they sent electric blankets and vitamins a and tranquilizers and field hospitals and he said either people had drowned or were blown away or this was the worst injury they have from holding to a tree and had

aberrationsts and that was it. what they needed was food and shelter. fact is one of the interesting things i found about the epidemiologist, many times during the disaster trying to sort out what would go on like a refugee campre, like're doctors without borders would say why.y aren't to you doing something? why are you taking part in primary health care? but then they realized by taking a pay a broaied view to see where it needed to be applied that they wereble saving more lives. i began the buck with a little parable. several people told me this and picture two bodies book

team down the river you pull the amount, you are missing most of them as they float by and one doctor suddenly drops a person and runs upstream and the other one says would you doing? >> there will go upstream to find out what is causing this. this is one of the first environmental impacts the bob eis studied. one of the very first e members come of bob at mellon was called to examine what they thought was the st. louis encephalitishe u outbreak and turndown it was lead poisoning and started the first poison center in the united states. 1972, eis officer fell luck was called to el paso texas

because they have high levels in children and found there were huge amounts of lead in the dust around the lead smelter. i included this picture because i like the outfit they were wearing.g.rrthe [laughter] 1973. a very important figure in public health and has written a very interesting book about bios terrorism anwr and public health. but these guys are very young and getting beyonddid television.so he told me all the things hell did in the first six months so iy wrote that in the book.lla one thing really struck me. he did eight salmonella outbreak in a bar.

not very hard to figure out the potato salad was the culprit. interview everybody who was there and what they ate and everybody to a potato salad got sick and nobody who didn't eat potato salad did not get sick but most linguists are moreewh, complicated and could not figured out and the guy said first half of the check-in and i could get then i made the potato salad. cla did you washable? no. crosshe contamination is a classic mistake.ou k but it bothered him. if they had a restaurant inspection costing $15 that could have been prevented.t it said 15 people to the a hospital, lost time at work he figured it would cost

$30,000 and the article got into the "time" magazine and "the new york times" and then people started to runaround investigate restaurants. this is from another skit and some of them are quiteot funny. in 1975 they made a pilot movie starring maureen reagan is actually barber uric somebody pointed out, they never made thisd series and my book has been optioned for a television series. i think it would make a great series and the fantastic but the odds of it becoming one are probably relatively small but you should all call whenever executives you deeme co necessary. smallpox is the only disease we have completelynd eradicated from the world. we're on the verge of

eradicating polio although it is not clear if we will ever succeed. but smallpox eis officers were very much involved in west africa and the end game in indiana and bangladesh. i have a whole chapter on this because it is quite amazing what they went through. they had to travel by elephant or a 10 to zero hour many of them found people who did not want to be vaccinated that presents a dilemma of the tests you know, they may pass it on to others prefer now you could not get away with this but many forced vaccinations on people.d i there are interesting ethical issues.

although by 1977 the very last case of smallpox -- smallpox found in somalia. smallpox andns o 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. there is a big fear the buy-out terrorist could get aholdd of it but now it is gone that led to thew expanded program. there was almost a bit of humor or comic relief a supposed to be the most pristine water in the united states at crater lake and it had a terrible diarrhea epidemic broke my wife said on the book was finished it

is interesting there was too much diarrhea. [laughter] i said this is what happens. refusing to admit there is a problem kept having the very sick restaurant workers continue to work and pass it on to other people then the cdc was blamed for not closing the park earlier. they close the national park. of the first time it ever happened. the very next year, i call this the chapter of livingnnin dangerously. t because at the beginning there was a huge three year there was going to be the swine flu epidemic. it just shows how myopic the news media is to only look at what happened in the last

two minutes. but with the swine flu pandemic and it is also thank goodness not as dangerous a strain as we thought. but in this case 18 no private at fort dix new jersey went on a 5-mile forced march in the morningrnf as part of the training. did not feel well andf collapsed and died and turned out he had each one and one. so they thought it may be like 1918 and somewhat mild in the spring then then you take into this horrible killer in the fall. they decided to inoculate everybody in the united states. but it never came back. so the cdc looked very down an over this. but what did come, at first

they thought it was but legionnaires' disease in philadelphia and this was the bicentennial year and the veterans were falling over and dying of a mysterious ailment. there was widespread rumor it was bio terrorism or somebody and they could not figured out. eis officers spread all over pennsylvania to figure out. now this guy is in charge of the eis program and said he went into this room and the press was falling and nobody would come into the room him.one [laughter] and they were all scared one p photographer poked in the head to take the pitcher then ran away.ictu [laughter] what was causing legionnaires' disease was a bacterium that grew only in

the cooling towers and air-conditioning systems. and probably had been around for ever but had not proliferated affecting the human beings and this is one of the unintended consequences of technology. t w there is a lot of lessons to be p learned about what weyear have gone through over the last 60 years. also the first ebola outbreak. again eis officers were summoned and the officer said he just came out of the autopsy because somebody died of something else but after they got the swine flu i vaccine and they needed to make sure it was not from the vaccine. you get the call and it was

from his boss that says there is a new disease in the middle of nowhere that seems to have won a 2 percent mortality how would you like to fly over there? he said let me talk to my wife. i have to the kids andol hehe went and said when they got there, he went with another eis officer and they stopped in geneva on the way to consult with the who and other officers freak out and said he could not go. but joel when to ahead and they were totally sleep deprived was no sleep than 48 hours, rushed immediately to a meeting everybody isand talking in french which hen understood and it was in a remote area and they would send in a team faking zero

good they are organized then all eyes turn to them. they are the team. he ended up going. this is interesting. more and more important followers -- flowers coming from chile with a heavy pesticidenv lowered. there's a lot of weird t things you would not havee thought about but this, about the flowers later on as more and moreget produce came from mexico orre g latin america may get more a diseases as a result. within coleco back more toward local foods which i l think is a good ada because we're less likely but this

is something that has happened several times because of the liquid in a newer systems did not have proper ventilation and 116 year-old died because of it. this was a real example of thee impact. now his son goes to the university of vermont medical school and i have gotten to know her very well when she visitse her son. she was assigned to theid state of arizona with the flu epidemic and in the middle of that come a number of children began to die of reyes syndrome. i't don't know if you know, about that it does not happen very much anymore because of him. it was a disease that came in the middle of a flu

epidemic or chicken pox. children would get better then suddenly would projectile vomit and become disoriented, combative, fall into a coma and die. terrible death. children up to this point* were totally healthy. eis officers were workingn on this over several years and identified the disease in the first place. they could not figure out. seven children died and did a case control study and remarkable nobody had done this before. c this is where you want controls you're as similar as possible but did not get rye syndrome. sheet shows children from class is who got the flu and asked the parents what did they

have for medicis incoming eat come the cuts come nine heating system, of vaccinations, she was on a fishing expedition. she had a hard time of figuring al cotte pepto-bismol or cough medicine and had to go back to the pharmacy and when she looked up the charts, it's was aspirin that is the common denominator. some of the controls were given aspirin, but not as much. b that is like saying mom and apple pie and a 1962 advertisement for aspirin. nobody believed her she could not even get her article published at first.

but when they did f other studies it became clear she was right for the aspirin industry fought tooth and nail against putting labels on medications for children could be a hazard and delayed warning labels over five years then at least 300 more childrenmeut died of reyes syndrome and that is what wef th know about. it could have been over 1,000. this is one case where company put profit ahead of people's lives. also toxic shock syndrome. perfectly healthy 21 year-old women die paying while they were mistreating and turns out they were all wearing a particular type of tampon. the newam highly absorbent tampons caused by a staff infection.

that was proliferating and the eis officer recalled w they ask the company to withdraw and rely was a b tampon most implicated and they did not want to withdraw it to the ceo of procter & gamble got down on wha his knees and day good eis officers think what this means to our company we spend billions of dollars. what if you are wrong? the officer said what if it were your daughter? they with true -- withdrew the product.

i will stop here.angm there is so much more i could talk about. i will read the end of this then i have questions. i want to read the last book. >> 1951 alexander had theyr yo cold opportunity to find a small training program for young and epidemiologists to keep the eye out for biological warfare while responding promptly per car for up toe mention that is how he got the funding. he scared people because the communists were supposed to be spreading anthrax and polluting water did not have been a tow 2001 and then those officers to that now they are the premier frontline disease detectives. for the obscure government program producing remarkable results, perhaps in part bytr

remaining relatively small and the ball and flexible. one of the lessons of history is the impact that one per cent can have but creative intelligent and motivated individuals in the right environment and the outcome can save lives. eis officers had and impact far beyond thes. original numbers. today with public health health, though life-saving were performed around the world buy the shoe leather epidemiologist is more essentials than ever. the program has influenceded and defined epidemiology and public health are practiced.ac and i will stop there. i help you have questions. >> what is it about the

investigative journalism approach that you find it so rewarding, if at all? [laughter] >> like the eis officers trying to find the answers to questions. how route to they come to be the way they are? as i said, a human beings are the same. but yet come a different. >> it is interesting to seele what we tried to do or how we handle it. it is not just following people in africa but going to the archives it is like the suppressed paper about the wyeth polio vaccine. so it is like a little outcial

exploration and a perpetual treasure hunt and. >> you have written about a variety of topics and a special leave the book you seem to go in depth. but you don't happen a specialized knowledge of the subject and what is that like? to you have to play catch-up lowered just think of that? >> can-do become an expert on a topic that you write about and nothing? [laughter] an expert is somebody who finds out as much as they at someare point*, they get to know more people and i read everything i could findir about epidemiology and the interviewed all the peopleatio and they write a report

afterut each investigation which they made available when i was right tame my book about coca-cola, when do you know, when to stop praxair wasn't worried about becoming the expert but itkn seemedow endless you keep going and going and i researching the stupid soft-drink for the rest of my life. i could have. he said i found when you are interviewing people and they'd tell you who else you talk to and you have already talked to them and you hear stories you havele already heard, you should start writing. that is what i did. w >>ho but then interacting with people who are involved, i do have to do a lot of

preliminary research? >> no. >> no. i don't mind looking like anot complete idiot. i have common-sense programs march per gram not afraid tom say i don't understand. can you explain that better? i am not dumb. people respect that. if they get holier than thou on their high horse that isho their problem. not mine. it is not like i go in there totally blind you never hear

about that anymore and i never understood that. >> part of the of problem with the tampon is that it was super absorbent and in the factory, the staffas a infection it was a combination of but particularly bad type ofwo staff infection and going around for some reason and when they did studies, one-tenth at that time harbored this in the vagina fairly harmlessly but w when introduced in theha environment to proliferate, that is what caused the harm. there is nothing in 26 leave the matter but those were one of the factors that cause it too.

>> [inaudible] also not change is often as they should because it was more absorbent. >> very good point* they were wearing them longer and also the strain that hong down was multifamily meant that was like a wicked to brain microbes up.st any other questions? i did not get to cover a lot of stuff that we're running out of time. one more question? that is it. thank you for coming. [applause]

>> kurt vonnegut of the greatest american writer a hoosier and rubber too better and and a satire is and a political activist. and a husband and father and a friend and a friend to his fans and right back to his fans and wrote more than 30 pieces of works including plays, novels, short stories, some of the more familiar books is

slaughterhouse five which is one of his famous, cat's cradle and breakfast of champions. kurt vonnegut always brought in the midwestern roots and often wrote about indiana and indianapolis specifically and if i may read a quote common 85 ask me why should this library be here in indianapolis? , i found this great quote that says all of my jokes are indianapolis. all of my attitudes are indianapolis-based, adenoids are indianapolis. if i ever separate myself from indianapolis i would be out of business. what people like about me is indianapolis. we treat that as a green light to establish that here. we have the art gallery, a museum room, reading room, a gift shop