Master of His Fate James Tobin (free e books to read online .txt) 📖

The food or fluid in FDR’s mouth carried the virus into his throat, where it may have lodged in the tonsils. Or it may have gone down the throat and entered the twenty-foot-long coiled tube called the small intestine, which has a velvety lining that absorbs water and nutrients. The cells of that lining have microscopic branches. One virus, maybe many, bumped into those branches and stuck like a ball lodged in a tree.

A strange process began. The virus didn’t just hang on the branch of that unlucky cell. It connected with the branch like a key in a lock, then released its own genes into the cell. Inside, the virus commandeered the cell’s tiny machinery, and then, as if in a sorcerer’s factory, it began to churn out copies of itself—first by the dozens, then by the thousands, too many for the cell to contain. The cell exploded, sending new viral pioneers through the bloodstream.

Hour after hour, the process repeated itself. New viruses invaded new cells and cranked out more copies. One after another, the cells burst, sending more viruses downstream to find more cells to destroy.

The multiplying virus triggered a reaction from FDR’s immune system, the vast network of cells whose job was to swarm around viruses and bacteria and kill them.

But it seems that FDR’s immune system had never been very strong.

At his parents’ country estate at Hyde Park, New York, one hundred miles north of New York City, he had grown up as an only child, and his mother seldom allowed him to play with the few children who lived nearby. He didn’t go to school for the early grades. He was taught at home by private tutors. So he never caught many of the germs that most children pass around and develop a resistance to in their early years.

In high school and college he came down with scarlet fever, measles, mumps, and dozens of sinus infections and colds. On his honeymoon in 1905, he had hives—itchy lumps on the skin that can be caused by a sputtering immune system. While he was assistant secretary of the navy, he had appendicitis, two severe throat infections, influenza, double pneumonia, and tonsillitis. His boss at the navy department said FDR seemed to catch every bug that came along.

In most people who caught the poliovirus, immune cells would kill it and send it out of the body in the urine and feces before it could cause any trouble. In one person out of ten, there would be symptoms like the ones caused by an ordinary “flu bug”—fever and chills, a stomachache, a headache, sluggishness. But the immune system would win out, the symptoms would vanish, and the incident would be forgotten.

In Roosevelt’s case, the virus went up a wrong alley and passed through a filtering system that doctors call the blood-brain barrier. Normally, that barrier keeps harmful particles in the bloodstream out of the nervous system. But the poliovirus is small enough to pass through the filter. When it does, it turns dangerous.

The nervous system is a fabulously complex network of cables that carry electrical signals between the brain and the rest of the body. One set of cables transmits sensations—hot or cold, rough or smooth, wet or dry, painful or pleasant. A second set of cables controls the movements of the muscles. The signals move at unimaginable speeds through long, threadlike nerve cells called neurons. The cables are built in sections, each section linked to the next, strung by the billions through all parts of the body. The number of cellular cables in the body is flabbergasting—about one hundred billion. If the nerve cables in a single human body were laid out end to end, they would stretch for ninety thousand miles.

In the spinal cord, neurons come to junctions called horn cells. (The cells live in a part of the cord that looks a bit like the horn of a trumpet.) Some are in the front—the anterior horn cells. Some are in the back—the posterior horn cells. The posterior cells carry the signals of the senses—seeing, hearing, smelling, touching. The anterior cells carry the signals that tell the muscles what to do.

The poliovirus only locks with the anterior horn cells, the ones controlling muscle movement. No one knows why the virus works that way, but when it happens, just as in the intestines, the virus penetrates a nerve cell and cranks out so many copies of itself that the cell explodes and dies. Then the process repeats itself over and over, wiping out more and more anterior horn cells.

Imagine the brain sending a signal to the big toe of a healthy person’s right foot, telling the toe to wiggle. The signal flashes down the spinal cord to an anterior horn cell, which routes the signal smoothly down to the toe—and the toe moves.

But if the poliovirus has destroyed that horn cell, the brain’s electrical signal just stops. The toe never gets the signal. Nothing’s wrong with the muscles and bones in the toe. They can work. They just don’t.

A nerve cell that dies can never come back to life. But that’s not a problem as long as a person doesn’t lose too many. The body has many more nerve cells than it needs, including anterior horn cells. So other cells pick up the slack. They carry the brain’s signal to the toe, just by a different series of cables.

But if too many cells die, the signal begins to stutter, and little things start to go wrong—hypersensitivity in the sensory nerves, for example, and weakness in the limbs.

There were no news reports that Boy Scouts who attended the Bear Mountain campout had come down with infantile paralysis.

So why only FDR?

Here, too, Dr. Lovett could not have said much. It might have been just a million-to-one case of bad luck. But there were two reasons why FDR may have been particularly susceptible to the poliovirus.

First, he simply may have been born with a weak immune system. His tendency