Who Goes First:
The Story of
Self-Experimentation
In Medicine

Lawrence K. Altman
(Random House)

Altman has a story to tell, and it can be glimpsed through the murk. It's not necessarily pleasant reading, however: doctors and researchers chowing down on staphylococci-infected sponge cake, plugging diseased mosquitoes into their arms, nibbling on scabs like potato chips, wrapping themselves in bedclothes contaminated with victims' "black vomit, urine, and ... bloody stools."

But the stakes are high, and the diseases are hugely tragic:

In the nineteenth century, eighty-five percent of Europeans who ventured into tropical West Africa died of malaria or suffered permanent complications from it. The risk was so high that life insurance policies were canceled for anyone travelling to that region.

Or:

Schistosomiasis was then, as it is now, the second most common disease in the world, behind malaria. It occurs in seventy countries and infects at least 125 million people. Moreover, at least one billion people live in areas where they are at daily risk of getting schistosomiasis every time they deposit their excreta and then use the same water supply to do their daily chores. Africans in at least twenty-five countries...risk getting schistosomiasis each time they dip their hands into water to do their laundry or to catch fish.

(It says something about politics and the narrow nationalistic bent of epidemiology that these two diseases threaten a half a billion people --- while AIDS, with a thousand times the media coverage --- has, to date, infected nowhere near that number.)

Dr. Altman tells of many unknown heroes in self-experimentation: Claude Barlow, Arthur Looss, Maurice Hall, David Clyde. He also comments acidly on the unjustly famous Walter Reed: three of his colleagues exposed themselves to mosquitoes bearing the yellow-fever virus. One, Jesse Lazear, died of it. A second, James Carroll, was permanently weakened by it.

Reed? The day he was scheduled to experiment on himself, he disappeared --- and by the time he returned he refused to go through with it. Yet he got the glory --- while his compatriots sickened or died.