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- July 02, 1984
- Vol. 22
- No. 1
The Doctor Whose Vaccine Saved Millions from Polio Battles Back from a Near-Fatal Paralysis
The performance over, he lowered himself back into the chair—again, no hands—spreading his arms to a visitor in the gesture of an entertainer inviting applause. "The things we take for granted, we lose them," he said quietly, "and then when we get them back, to me, it's a miracle."
Miracles seem to attend this man. The oral vaccine that Albert Sabin developed has virtually eliminated poliomyelitis in the developed nations, sparing an estimated six million human beings from crippling paralysis over the past two decades. In 1982 and 1983 he was working to save even more lives, supervising initial tests in Mexico and Brazil of an aerosol immunization against measles, which kills 1.5 million children in underdeveloped countries each year. But just 13 months ago Sabin's miracle working seemed to have ended, as a terrible kind of counterfeit polio seized his body and death's hand touched his respiratory system.
The affliction was a rare neck-ligament calcification that squeezed down on Sabin's spinal cord, causing him first to stagger and fall, then sending waves of agony through his body. An operation at Johns Hopkins University Hospital in Baltimore appeared to relieve him. But suddenly, he recalls, "I had this terrible pain—the most excruciating of my life. I couldn't bear it."
A week later came the worst. "Just like a bolt, I became paralyzed from the waist down," says Sabin. "My feet, legs, hips felt just like wood. I had no medication for my pain. The doctors were afraid it might interfere with my respiration. I was beyond myself, yelling, 'Get me the hell out of here!' "
Pneumonia crept into his body, blocking his lungs with a sticky secretion as the paralysis rose like a lethal tide, immobilizing his arms and weakening what Sabin calls "my breathing apparatus," in wicked imitation of the virus to whose conquest he had devoted more than 50 years. Heloisa Sabin, a small, wonderfully seaworthy woman who became his third wife 12 years ago, hovered in his hospital room as the drama reached its climax. "He tells me his lungs are filling with mucus and he is going to die," she says, in the accent of her native Brazil. "I tell the doctors, and they say, 'Albert, you are not going to die in this hospital at Johns Hopkins.' Two days later, he dies! I was there. An attendant was trying to feed him, and I saw the eyes turn up, the blank of the eyes."
All Sabin's vital signs had shut down. The attendant ran to the door shouting, "Dr. Sabin is dead!" And dead he would have remained but for the resuscitation team that arrived in moments to pound on his heart, put a tube down his throat to suck out the mucus and get his system going again. "This," says Sabin, "in spite of the fact that in 1972 I had a coronary bypass. I had a heart that was a plumber's job.
"I lay there for 10 days without sleep," he continues. "I had this clock on the wall. I would watch it—two hours, 12 hours, 48 hours. And I wanted to die. Excruciating pain. And, yes, sure, I asked that question: 'Why me?' I thought it was ironic. But I don't stew about such things. I'm sufficiently in equilibrium with myself to ask, 'Who the hell cares?' "
The answer seems to be that a great many people care about this unquenchable man. During treatment last fall, as his pain ebbed and the paralysis began to loosen its grip, network television showed him convalescing at the National Institutes of Health in Bethesda, Md. Soon afterward thousands of sacks of get-well letters arrived. "There was one from a stripper named Patty, with nude pictures," chuckles Sabin. Then he adds proudly, "Some letters came from as far away as New Guinea."
For Sabin the life's journey that would capture so much of the world's grateful affection brought him from Russia to Ellis Island 64 years ago. His family settled in Paterson, N.J., where Albert picked up enough English to march handsomely through high school and enter New York University's College of Dentistry under the sponsorship of a dentist uncle who offered tuition if Sabin would come into his business.
The bargain turned out poorly for the uncle but wonderfully for mankind. Sabin hated everything about dental studies—except the courses in physiology and neurobacteriology, which so fired his mind that he transferred to NYU College of Medicine, set on a career in disease research. His uncle, outraged, cut off tuition. But Sabin had caught the eye of NYU bacteriologist William H. Park, who helped scare up scholarships. In 1931, the year Sabin graduated, New York was hit by a polio epidemic, and Park pushed him into polio research. Sabin began by exploding the validity of a skin test that purported to show if a patient was immune to the disease. "It was wrong," he says. "No one was immune."
Throughout the '30s Sabin continued his research, settling in 1939 at the Children's Hospital Research Foundation at the University of Cincinnati, his base for the next 30 years. It was there, primarily, that he worked through the painstaking process of breeding the virulence out of the three types of polio virus that cause paralysis. It was there that he tested early batches of the oral vaccine on himself and his family. And it was from there that he set off on a series of journeys to help disseminate the serum to Europe, Asia and Latin America for the mass-immunization programs that proved the power of his vaccine to stop polio.
Sabin possesses not a shred of false modesty. The walls of his Washington apartment are covered with citations, honorary degrees, gift paintings and other tributes to Albert Sabin. Framed photographs show Sabin with Richard Nixon, Sabin with LBJ, Sabin with Golda Meir. Above his desk is Sabin's favorite, the citation for the National Medal of Science, which he received in 1970. "It makes me feel good," he declares, "because it says, contrary to what's been written in some newspapers, that I developed the vaccine, not a vaccine, that has eliminated polio as a major threat to human health."
The distinction is both personal and scientific. The first effective polio vaccine, which went into general use in 1955, was not Sabin's oral preventive but an inoculated vaccine developed by Dr. Jonas Salk. The Salk vaccine was based on killed viruses, whose virulence had been destroyed in the laboratory. Injected into the bloodstream, the Salk vaccine creates antibodies that ward off polio, at least for a time. And although the Salk vaccine is still in use, a patient taking it needs boosters and may still transmit the disease to other people.
The basis of Sabin's oral vaccine, which can be swallowed in a glass of orange juice or a piece of candy, is a living polio virus with the paralyzing agent meticulously bred out. A Sabin vaccine recipient becomes indefinitely immune to all virulent forms of the disease and even harmlessly transmits the virus to others, who develop their own immunity as a result.
The Sabin vaccine had its introduction in the U.S. in 1959 and 1960, after trials on some 10 million people abroad. The results were spectacular: Paralytic polio cases dropped from 26 per million in 1960 (already down from 135 because of the Salk vaccine) to 2.4 per million in 1965. They now stand at only four per 100 million, with the residual cases apparently brought in by immigrants.
Unhappily, the war against polio ignited a still-smoldering antagonism between advocates of the two vaccines. Salk partisans have claimed,. without real evidence, that the Sabin vaccine has caused cases of paralytic polio. And Salk himself has come to see the killed-virus vaccine as a kind of potential cure-all. "I even look forward to the day," Salk said recently, "when the principle of the killed virus will be used in a single vaccine against virtually all the viral diseases of man."
You do not talk this way in a world containing Albert Sabin. He dismisses as "lousy and untrue" the notion that his own vaccine ever caused crippling polio. And as for Salk's faith in an all-purpose, killed-virus vaccine, he will say only, with a futile attempt at restraint, "I think I'd better not comment on that because it is totally irresponsible, totally without foundation."
Colleagues say Sabin has never had much use for ideas he considers unsupported by data. "He's not enormously tolerant," says Dr. Dorothy Horstmann, professor emeritus of epidemiology and pediatrics at Yale. "He's a fighter—sharp, demanding and precise—and he's usually right."
When the American Medical Association asked him in 1966 to evaluate the antiflu drug Symmetrel, Sabin concluded bluntly that it had no effect "on human beings in the natural state"—in other words, the everyday world. In 1975, when Gerald Ford flew him to the White House to help kick off a national swine-flu vaccination campaign, Sabin declined to tell the President what he wanted to hear. "I said the whole program was unfounded," Sabin recalls. "There was no basis for vaccinating everybody." The campaign went ahead anyway, with disastrous consequences. "About 2,000 people were left permanently paralyzed because of reaction to the shots," he says angrily. "There are about $4 billion in lawsuits against the U.S. government right now because of these cases."
Sabin can be equally severe with himself. After 12 years of lab work on cancer, following the general release of his polio vaccine, he announced in 1973 that herpes-simplex viruses could cause cancer. The news was electrifying: With the identification of a viral cause of cancer, medical research might have been a giant step closer to preventing the disease. But when subsequent experiments convinced Sabin his conclusion was flawed, he published a retraction. "It's my duty," he said.
Even Sabin's close friends and colleagues are not spared the laser beam of his vigilance in behalf of accuracy and scientific responsibility. "You can get 13 no-no-no's in one sentence," chuckles Dr. Robert Chanock, the lab chief at the National Institute of Allergy and Infectious Diseases. "He can spot flaws in other people's data faster than anybody I've ever seen. I remember, once at a symposium a slide with about 50 numbers flashed onto a screen. As the slide hit the projector, Albert was on his feet shouting, 'What data did you have that allowed you to reach that conclusion?'
"He really comes on," says Chanock, "but his mood can change. It's as though you were in the mountains driving through a snowstorm and went through a pass and came out and the sun was shining. That's Albert. He can change like that."
True enough. Just moments after scolding an unwary visitor for the sin of being scientifically imprecise, he guides him cheerfully through his memento-filled home. Among the artifacts: two old photographs of an attractive, dark-haired woman, perhaps in her late 20s. It is the first Mrs. Sabin, who bore two daughters during the 31 years of their marriage—and committed suicide by an overdose of sedatives in 1966. "Tragic, tragic," says Sabin. Then, with a shrug, "Esta vida—that's life." And that is all he will say. Nor will Sabin discuss a brief second marriage that came and went toward the end of the '60s.
He is, however, as mellow as a May morning whenever his mind or eyes turn to Heloisa Sabin, who manages never to be more than a few steps from the man to whom she is clearly and patiently devoted. "She looks like a girl," he says, gesturing grandly toward the pretty, gray-haired woman setting out the ingredients of an elaborate chef's salad for lunch. "She has two sons with beards, and when they go out they all look the same age." Then the compulsion for accuracy takes hold. "But she isn't a girl, she has five grandchildren of her own."
These various pronouncements roll past Mrs. Sabin like wavelets on a pond, as her husband ceremonially stirs the components for the salad, then serves it. "People ask me how is it to be married to a savant like Albert," she says, taking her plate. "It's exciting—ah, very good salad, Dr. Sabin."
He acknowledges the compliment while eating prodigiously. "There are two sure signs of my recovery," he says, scraping his plate, "my appetite and the fact that I get mad at injustice, just blow up watching the news on TV. To have mercenaries in Nicaragua under the CIA! It's the same as when Russia came into Hungary with its tanks. The point is I know the conditions in these countries. In my medical travels I made it a point to find out. And we misconstrue revolutions, which may be the function of poverty, hunger.
"You know," he continues, "my family came here from Russia in 1920, after many were killed in pogroms. And my 60 years in the U.S. mean more to me, probably, than to someone born here. So I always want the U.S. to be in the right—as I see the right."
Thereupon Sabin smoothly shifts gears from global judgments to his own condition and outlook. "For a while in the hospital I didn't care what was happening. Heloisa would bring me newspapers, and I'd tell her to take them away. But now," he says, patting the table with the flat of his hand, "I'm glad I'm alive again. I think I may recover completely, and I may be able to influence certain things—see that polio is wiped out forever from the Third World countries. And see that measles is wiped out too."
Sabin is not simply waiting for his recovery. He seems to have set his own timetable and is all but forcing his waning affliction to conform. Last January, still hospitalized and confined to a wheelchair, he testified before Congress on cutting the cost of medical care for the aged. In March, walking with his wife's support, he attended a symposium in Washington on German measles. On June 4 he stood for a half hour to speak on viral diseases at the NIH. And on an average day his phone rings repeatedly with questions or messages from researchers with whom Sabin is in close touch about resuming the measles crusade in Latin America.
The key to the attack on measles is the aerosol immunizer Sabin developed. And the primary targets are babies up to 6 months old, who are often fatally vulnerable to the disease in tropical countries. The program, with Sabin as a consultant, is in the planning stages at the Centers for Disease Control, in Atlanta. Characteristically, Sabin is determined that the medical troops will not set off too late with too little. "This should start rapidly, with mass programs," he exclaims. "Otherwise it'll be just charity and no good."
At a time when any other man his age might be content to play the medical legend, Sabin's eye is on unfinished business. "I'm concerned with what has not been done," he says. Then, with rising animation, he unconsciously defines the life of Albert Sabin: "I'm not like the scientist who quits when he gets the knowledge. I'm concerned with human welfare. I've got to go from the beginning to the end."
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