One of the lesser-known reasons for the eradication of smallpox was the desire of the doctors to eradicate vaccinia virus along with smallpox. Vaccinia gave a fairly high rate of complications, and it could make some people very sick or kill them. About one in a million people who got the vaccine during the Eradication died of it, and a larger number of people got very sick from it. The eradicators wanted to eliminate the need for vaccination, and the way to do that was to get rid of the disease. A study done by the WHO suggested that the world was losing one and a half billion dollars a year in economic damage caused by illness and complications from the vaccine.
William H. Foege is the doctor who pioneered ring vaccination. Foege, a tall, brilliant, deeply religious man, first used ring vaccination on a wide scale in Nigeria in November 1966, as an act of desperation, because he had run out of enough vaccine to immunize everybody in the area of a major outbreak. It worked surprisingly well, and as ring vaccinations proceeded and as outbreaks were choked off by rings of immune people, the eradicators began to believe that they really could wipe smallpox from the earth. The feeling was intoxicating to the eradicators. As it became clearer that the job could be done, D. A. Henderson became uncompromising as a leader. He inspired deep loyalty and affection, and he displayed the ruthlessness of a winning general. Henderson proved to be one of the geniuses in the history of management. There were normally only about eight people at headquarters, including secretaries, yet the program was a sprawling multinational operation (hundreds of thousands of health workers eventually were on salary, either part-time or full-time), and it operated all over the world, sometimes in countries engaged in civil war. His most important task was hiring the best people and giving them clear goals. Henderson’s way of firing people was to suggest to them that there were jobs that were less demanding. As he explained to me, “Unless you are in a position to be tough with people, you aren’t going to go forward.” Either you were marching along with D. A. Henderson or you were lying flat on your face and getting a massage with tank treads.
I once asked D. A. Henderson how he felt about his role in ending smallpox. “I’m one of many in the Eradication,” he answered. “There’s Frank Fenner, there’s Isao Arita, Bill Foege, Nicole Grasset, Zdenek Jezek, Jock Copeland, John Wickett—I could come up with fifty names. Let alone the thousands who worked in the infected countries.” Even so, Henderson was the Eisenhower of the Eradication.
John Wickett was a Canadian ski bum and computer programmer who turned up in Geneva in 1971, wanting to ski the Alps while earning a little money on the side working with computers. For some reason, D. A. Henderson hired him to eradicate smallpox. Henderson had an uncanny nose for human potential in the people he hired. Today, John Wickett is widely credited as having played a big role in the Eradication. “Eradicating smallpox was the most fun I ever had,” Wickett said to me. “It was fun because we actually did it and because D.A. was behind us. He could make the bureaucracy jump. When I had a problem with some bureaucrat, I’d say, ‘Do you want to talk to my boss?’ And I’d hear, ‘No . . .,’ and the problem would get fixed.”
Strange Trip
IN THE SUMMER of 1970, a twenty-six-year-old medical doctor named Lawrence Brilliant finished his internship at Presbyterian Hospital in San Francisco. He had been diagnosed with a tumor of the parathyroid gland and was recovering from an operation, so he was not able to go on with his residency. He was living on Alcatraz Island in San Francisco Bay, where he was giving medical help to a group of Native Americans who had occupied Alcatraz in a protest. He ended up doing some interviews on television from the island, and a producer from Warner Bros. saw one of them and offered him a role in a movie. The movie was Medicine Ball Caravan, about hippies who go to England and end up at a Pink Floyd concert. Larry Brilliant played a doctor. (“It was such a shitty movie I don’t even expect my kids to watch it,” he says.) The movie also featured Wavy Gravy, one of the founders of the Hog Farm commune in Llano, New Mexico. The Hog Farm commune had recently become famous for running the food kitchen at the Woodstock festival, where they also provided security. Just before the festival, Wavy Gravy had explained to the press that security would be achieved through the use of cream pies and seltzer-filled squirt bottles.
Medicine Ball Caravan was shot first in San Francisco and then in England, and during the shooting Brilliant and Gravy became friends. (“Wavy Gravy is my best friend. I was just talking with him this morning,” Brilliant said to me not long ago. “I should explain that Wavy Gravy is two things: he is an activist clown and also an endangered flavor of Ben & Jerry’s ice cream.”) In England, Brilliant and his wife, Girija, and Wavy and his wife, Jahanara Gravy—she’s from Minnesota and is said to have been Bob Dylan’s girlfriend and perhaps even the model for the “Girl of the North Country”—pondered what to do next in life. A terrible cyclone had hit the delta of the Ganges River in the Bay of Bengal, in what was then East Pakistan (now Bangladesh), and the eye of the cyclone had passed over an island named Bhola. A hundred and fifty thousand people had drowned when a tidal surge had covered the entire island. The Brilliants and the Gravys hit on the idea of buying a bus and carrying food and medicines to the devastated islanders.
“Wavy and I and our wives—who, remarkably, are still our wives—drove to Kathmandu,” Brilliant said. They started with a rotten old British Leyland bus that they bought cheap in London. They painted it in psychedelic colors and filled the bus with medicine and food and a bunch of hippie friends. They bought a second bus in Germany and equipped it similarly, and the Brilliant-Gravy bus entourage made its way slowly through Turkey and Iran. The buses wandered around Afghanistan for months, and they made it over the Khyber Pass, following the same road that Peter Los and his friends had driven a little more than a year earlier in their Volkswagen bus. The Brilliant-Gravy expedition wound slowly through Pakistan and crossed into India. Civil war had broken out between East and West Pakistan—this was the independence war of Bangladesh—and the border of Bangladesh had been closed, so they couldn’t get their buses into the country. They turned northward into Nepal, and eventually the buses pulled into Kathmandu. “Wavy got sick and ended up going back to the U.S. weighing about eighty pounds,” Brilliant says. The Brilliants abandoned their bus in Kathmandu and went to New Delhi, India. It seems that the Brilliants were pondering what to do next in life, and nothing was coming along.
One day, the Brilliants were at the American Express office in New Delhi collecting their mail, when they encountered a man named Baba Ram Dass. Baba Ram Dass had recently been Professor Richard Alpert of Harvard University, but he and a colleague, Professor Timothy Leary, had been kicked out of Harvard for advocating the use of LSD. Baba Ram Dass spoke glowingly of a holy man named Neem Karoli Baba, who was the head of an ashram at the foot of the Himalayas in a remote district in northern India where the borders of China, India, and Nepal come together. Girija Brilliant was captivated by Baba Ram Dass’s talk of the holy man, and she wanted to meet him, though Larry was not interested. Girija insisted, and so they went. They ended up living in the ashram and becoming devotees of Neem Karoli Baba, who was a small, elderly man of indeterminate age. His only personal possession was a plaid blanket. He was a famous guru in India, and the people sometimes called him Blanket Baba. The Brilliants learned Hindi, meditated, and read the Bhagavad Gita. Meanwhile, Larry ran an informal clinic in the ashram, giving out medicines that he’d taken off the bus when they’d left it in Kathmandu. One day, he was outdoors at the ashram, singing Sanskrit songs with a group of students. Blanket Baba was sitting in front of the students, watching them sing. He fixed his eye on Brilliant and said to him in Hindi: “How much money do you have?”
“About five hundred dollars.”
“What about in America? How much money do you have there?”
“I got paranoid,” as Brilliant explains it, “because these Indian gurus have a reputation for ripping off their students.” He answered: “I have five hundred dollars
in America, too.”
Blanket Baba got a sly grin and started chanting, in Hindi, “You have no money. . . . You are no doctor. . . . You have no money,” and he reached forward and tugged on Brilliant’s beard.
Brilliant didn’t know how to answer.
Neem Karoli Baba switched to English and kept on chanting. “You are no doctor . . . U N O doctor . . . U N O doctor.”
UNO can stand for United Nations Organization.
The guru was saying to his student (or so the student now thinks) that his duty and destiny—his dharma—was to become a doctor with the United Nations. “He made this funny gesture, looking up at the sky,” Brilliant recalled, “and he said in Hindi, ‘You are going to go into villages. You are going to eradicate smallpox. Because this is a terrible disease. But with God’s grace, smallpox will be unmulun.’” The guru used a formal old Sanskrit word that means “to be torn up by the roots.” Eradicated. The word unmulun comes from an Indo-European root that is at least ten thousand years old—the word is probably older than smallpox.
“So I said, ‘What do I do?’ And he said, ‘Go to New Delhi. Go to the office of the World Health Organization. Go get your job. Jao, jao, jao, jao.’ That means, ‘Go, go, go, go.’ ”
Brilliant packed a few things and left the ashram that night—the guru seemed to be in a rush to “unmulate” smallpox. The trip to New Delhi took seventeen hours by rickshaw and bus. When Brilliant walked into the office of the WHO, it was nearly empty. It had just been set up, and almost no one was working there. The government of India was then headed by Indira Gandhi, and she was skeptical of the Eradication program and had not yet approved it. The first person Brilliant met was the head of the office, Dr. Nicole Grasset. A French-Swiss woman who had been raised in South Africa, she was in her forties, raven haired, and dressed impeccably. Nicole Grasset has been described as a hurricane in a Dior dress.
“I was wearing a white dress and sandals,” Brilliant says. “I’m five feet nine, and my beard was something like five feet eleven, and my hair was in a ponytail down my back.” Grasset had no job to offer him, so Brilliant returned to the monastery and, having not slept in at least thirty-six hours, reported back to the guru.
“Did you get your job?”
“No.”
“Go back and get it.”
Brilliant was half dead on his feet, but the guru was looking as if he could become angry, and Brilliant did not want to have to deal with that. So he departed for New Delhi, another seventeen-hour trip, where Grasset was a little nonplussed to see the young man again so soon and looking so haggard. But nothing had changed.
“I went back and forth between New Delhi and the ashram at least a dozen times. All my teacher kept saying was, ‘Don’t worry, you’ll get your job. Smallpox will be unmulun, uprooted.” When at the ashram, Brilliant meditated. He would assume the lotus position, shut his eyes, and utter the sacred word Aummmmm.
Neem Karoli Baba would notice he was meditating, and he would walk up to Brilliant, yank an apple out from under his blanket, and throw it at Brilliant’s crotch. There would be a whack! and Brilliant’s Aumm would turn into Oww, God! My balls! and he would assume the “writhing lotus” position on the floor. The guru seemed to be hinting, Brilliant says now, that he needed to stand up on his feet and get back to the WHO in New Delhi, where his job awaited.
“On one of my trips, there was this tall guy sitting in the lobby of the WHO office. He looked up and said, ‘Who are you? What are you doing here?’ ”
“I’ve come to work for the smallpox program,” Brilliant replied.
“There isn’t much of a program here.”
“My guru says it will be eradicated. Who are you?”
“I’m D. A. Henderson. I’m the head of the program.”
Brilliant was surprised to see the head of the global program sitting on a chair in the lobby doing nothing in particular. He later came to feel that Henderson was a little bit like the Lion in the Narnia books by C. S. Lewis. The Lion appears at key moments in the story, and he is a powerful presence who drives everything, but often you don’t see him or realize what a force he is.
Henderson, for his part, was a little put off by Brilliant’s white dress and his talk of a guru predicting a wipeout of smallpox. That day, Henderson wrote a note in the employment record, “Nice guy, sincere. Appears to have gone native.”
Back at the ashram, Blanket Baba kept throwing apples at Brilliant’s testicles. The situation was actually rather complicated. Indira Gandhi was herself a devotee of Neem Karoli Baba, and she had visited him at the monastery, where she had bowed down to him and touched his feet and asked for his advice. Blanket Baba wanted smallpox pulled up by the roots, and he was annoyed at Mrs. Gandhi for resisting the efforts of the World Health Organization to get on with the job. In fact, Neem Karoli Baba was probably the most powerful and feared mystic among the leaders of India; many of them journeyed to touch his feet and seek advice when they assumed high office. He had advised Indira Gandhi in 1962, when China invaded Indian territory in the Himalayas not far from his ashram. He had told her not to go to war with China because, he said, the Chinese army would soon withdraw from India anyway. The Chinese did partially withdraw their army, and Blanket Baba got a reputation for being able to predict the future. Larry Brilliant’s trips to New Delhi were a small part of the guru’s continuing effort to help India realize its future. The uprooting of smallpox, in the view of the guru, was the duty of India and was the world’s destiny.
Brilliant thought he’d increase his chances of getting a job if he looked more Western, so every time he returned to New Delhi he trimmed off some of his beard and shortened his ponytail, and he began to replace articles of clothing. He ended up with medium-long hair and a short beard, and he was dressed in a checkered polyester suit with extra-wide lapels, a thick polyester tie, and a lime green Dacron shirt. He had made himself unnoticeable, for the seventies. By that time, Nicole Grasset had decided to hire him, and D. A. Henderson agreed that he might have some potential as an eradicator. He started as a typist.
Eventually, they sent Brilliant to a nearby district to handle smallpox outbreaks, where if he got into trouble they could pull him out quickly. He saw his first cases of variola major. “You can’t see smallpox and not be impressed,” he said. He began to organize vaccination campaigns in villages. He would go into a village where there was smallpox, rent an elephant, and ride through the village telling people in Hindi that they should get vaccinated. People didn’t want to be vaccinated. They felt that smallpox was an emanation of the goddess of smallpox, Shitala Ma, and that therefore the disease was part of the sacred order of the world; it was the dharma of people to have visitations from the disease. Brilliant haunted the temples of Shitala Ma, because inside those temples people with smallpox could be found praying and dying. He would look up the local leaders, take them to a temple, chant in Sanskrit with them, and then ask for their help in dealing with smallpox. Speaking in Hindi, he told people that his guru, Neem Karoli Baba, taught that smallpox could be wiped out: “Worship the goddess and take the vaccine,” he told them.
Brilliant traveled all over India with Henderson and the other leaders of the Eradication, and they came to know one another intimately. “D.A. read nothing but war novels and books about Patton and other great generals in history,” Brilliant said. “Nicole Grasset read nothing except scientific things. Bill Foege was reading philosophy and Christian literature—he’s a devout Lutheran. I was reading mystical literature.” They ran a fleet of five hundred jeeps. They had a hundred and fifty thousand people working for the program, mostly on very small salaries. For a year and a half, at the peak of the campaign, every house in India was called on once a month by a health worker to see if anyone there had smallpox. There were a hundred and twenty million houses in India, and Brilliant estimates that the program made almost two billion house calls during that year and a half. The Lions Club and the Rotary Club International paid huge amount
s of the cost of eradicating the virus in India. “Those business guys with their lapel buttons did this amazing thing,” Brilliant says.
After he helped to eradicate smallpox, Larry Brilliant did other things: he became one of Jerry Garcia’s physicians; he became the founder and co-owner of the Well, a famous early Internet operation; he became the CEO of SoftNet, a software company that reached three billion dollars in value on the stock market during the wild years of the Internet; he and Girija had three children; he became a professor of epidemiology at the University of Michigan; and, along with Wavy Gravy and Baba Ram Dass, he established a medical foundation called the Seva Foundation. Today, the Seva Foundation has cured two million people of blindness in India and Nepal. Along the way, Brilliant got to know Steven Jobs through their common admiration for Neem Karoli Baba. Jobs had gone to India to become a devotee of the guru, but by then Blanket Baba had gone incommunicado (he had died), so Jobs went off to study at another ashram. “Steve Jobs was a pretty nondescript guy in India, walking around barefoot with a shaved head,” Brilliant recalled. “Then he started Apple Computer. I said to him, ‘Steve, why are you wasting your time with this stuff? It isn’t going to go anywhere.’ ” Jobs later donated the first seed money to start the Seva Foundation.
“I’ve done a lot of things in life,” Brilliant said, “but I’ve never encountered people as smart, as hardworking, as kind, or as noble as the people who worked on smallpox. Everything about them—D. A. Henderson, Nicole Grasset, Zdenek Jezek, Steve Jones, Bill Foege, Isao Arita, the other leaders—everything about them as people was secondary to the work of eradicating smallpox. We hated smallpox.”
“D.A. once told me he thinks of smallpox as an entity,” I said.
“An entity, yes. To me, smallpox was a she, because of the goddess. You would think of her as having secret meetings with all her generals and staff, planning attacks.”