Could the Flu Pandemic of 1918 Pay Us Another Visit? (Pedcast Book Review)

Pale Rider

By Laura Spinney

Hachette Books

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Welcome to this book review edition of Portable Practical Pediatrics. I’m your host, Dr. Paul Smolen also known as Doc Smo. I just finished reading a fascinating book titled, Pale Rider, by British journalist Laura Spinney, a work in which she gives her readers a detailed look at the effect of a global influenza pandemic that is known today as The Spanish Flu of 1918. Ms. Spinney makes the case that this single event was the worst human tragedy in human history, killing an estimated 50-100 million people; a number greater that the number of deaths in both WW1 and WW2 combined! How did this tragedy happen and could it happen again?  Is this tragedy relevant for today’s world population including your children? Find out and hear my review of this Pale Rider in this edition of Portable Practical Pediatrics, which is being brought to you by Audible, a place where you can sit back, rest your eyes, rev up your imagination, and listen to great books like Pale Rider. Consider joining today by clicking the banner displayed on my website, accompanying this post.

Musical Intro

The Spanish Flu From Every Angle

Readers of Pale Rider will quickly realize that the author is a journalist due to her attention to detail and historical context. She points out that the Spanish Flu occurred within the backdrop of WW1, contributing to the spread and intensity of the disease. Ms. Spinney ferrets out an amazing amount of detail about the route of spread, susceptibility of different populations around the world, survival rates of different ethnic groups, available medical therapies of the time, and mortality rates. The author also goes to great length to describe the discovery and isolation of the influenza virus, its biology, and the history behind the development of an effective preventative vaccine. I have a medical degree and have more than a cursory understanding of the biology and natural history of viral infections, yet I found that the author’s description of the basic science behind of Spanish influenza infections absolutely fascinating and quite informative. Readers will also learn how influenza got its name, how it help usher in the concept of universal healthcare, and how the Spanish Flu helped push scientist’s and physician’s understanding of disease, culminating in the modern paradigm of the germ theory.  Come to think about it, there are very few questions about the Spanish flu that Ms. Spinney did not address. Her book is very rich with detail and insight.


The Magnitude of the Disease

The Spanish Flu has been earned the title of the greatest human tragedy in known human history and many fear that it could happen again on an even bigger scale.  According to infectious disease experts of today, the world’s next influenza pandemic is not a matter of if  but when.  Understanding as much as possible about how the Spanish flu was able to slaughter 2.5%-5% of the world’s mostly young healthy population is crucial to keeping it from happening again.  Think about the magnitude of the crisis if 5% of today’s 7 billion inhabitants of earth were to succumb to a global influenza pandemic; a disaster that translates to an increase in world deaths from the current 55 million/year to a whopping 350 million deaths/year.


Overall, I found Pale Rider a book that is very informative, thoroughly researched, and extremely relevant to today’s world; a fascinating read and a book that will be very appealing to inquisitive readers with a strong interest in the history of disease and world history. But, readers who aren’t ready to digest a great amount of historical detail may want to shy away from this book, however.

Ms. Spinney has accomplished the monumental task of putting together a very detailed and thorough account of how the Spanish Flu changed the world while describing its impact on historical.  One criticism however; I feel that naming her book after a line in an obscure literary book, Pale Horse, Pale Rider, by Katherine Porter, was a mistake. Her title does not help in the understanding the subject of the book nor its effect on society.  That said, Pale Rider is a well-written thoughtful examination of an important event in our recent history, with great relevance today’s world population.  I recommend it for readers with a strong interest in history and disease. I give it 4.0/5 Doc Smo stars.

Thanks for joining me today. If you enjoy talking and learning about child health with pedcasts, tell a friend or share an episode. And consider subscribing to my podcast and writing a review on iTunes. That helps others find my blog and podcast. This is Doc Smo, broadcasting from studio 1E, hoping you now have a clue, about the great pandemic called the Spanish Flu.  Until next time.

Many thanks to Drs. Monica Miller and Charlotte Rouchouze for their help in preparing this pedcast.