A Complete Medical History


It’s October and while the leaves are turning and the days are shortening and the weather is nearing perfection for another few weeks, only one thing is on my mind. Halloween.

It’s ridiculous, yes. Nurses and interns will be setting their favorite decorations out, much to the chagrin of those curmudgeonly MD’s. At least, a skeletal decoration actually has some place in a medical office. I recommend the spider that’s on a motion-sensor and drops down in front of you. That’s a classic.  Yes, pranks and candy galore, everything a serious place like a doctor’s office needs.

Despite the fun and games that is Halloween, however, I found myself last month interested in something else that has to do with Halloween…being scared. While this column isn’t an entertainment column and doesn’t afford me much chance to talk about my love of movies, I have to tell you, I love them. Not all of them, I’m picky. However, it’s where I find the most common ground with strangers on a plane or waiting in line at the coffee shop. I love Superman, Die Hard, Star Wars, and Indiana Jones, and I am obsessed with James Bond. I also love being scared. But I’m not much for horror movies. It’s not that I don’t respect Jason and Freddy’s place in film history; it’s just not a genre I can get behind.

So when I recently saw the film Contagion, about a lethal virus that has its way with us puny humans, I immediately became frightened by one word. Pandemic! In Contagion, Matt Damon and company fight to survive in a society decimated by a disease that spreads with flu-like ease and kills with the speed of Ebola. Lovely. It’s not a terribly sensationalized film and at least, to me, felt very realistic. I tried to imagine the actual numbers. For simplicity, let’s assume there are approximately seven billion people on the planet. Now, wipe out a billion of them as is supposed in the film and that’s 14%. That’s a pretty frightening number.

Our species is tough. We’ve conquered every part of the planet—from the depths of the seas to the top of Mt. Everest. We’ve figured out ways to take out vital organs and replace them with artificial ones, and we’ve even come up with little devices that let us see our relatives live from thousands of miles apart. Yet these tiny life forms, these invaders from inner-space, are really in charge. 

The Bubonic plague, which lasted for a mere two years from 1348 to 1350, killed an estimated seventy-five million people. Estimates suggest that up to 60% of Europe’s population were killed. Granted, without the use of television and social media, the Europeans for the most part probably never knew what hit them. It is possible that the global population dipped perhaps as much as 25%. Assuming it lasted exactly two years, that’s over 3 million dead per month…781,000 a week…100,000 a day, every day…for two years.

It would take Europe another 150 years to recover until the plague disappeared in the 19th century.

The most recent and harrowing example of a global pandemic comes from the early 20th century when the “Spanish Flu” is said to have killed millions over the course of a year. It was of a violent nature, which included hemorrhaging from the nose, stomach, and intestines. Older estimates believed the death toll to be between 40 and 50 million, while newer estimates suggest between 50 and 100 million dead. On the low end of that estimation, the number is still 137,000 dead per day for a year. It killed 25 million the first twenty-five weeks. To put it in perspective, AIDS killed 25 million worldwide in the first 25 years after its discovery.     

Some of the other numbers aren’t quite so frightening, but they may still surprise you. Measles has continually killed an estimated 1.3 million people a year for the past 150 years. In 2000, that number was down to 777,000. In the 20th century, tuberculosis killed 2 million a year and is still a problem in many developing countries.          

These days, our modern day outbreaks seem laughable. In 2009, with the outbreak of Swine Flu, I recall a friend of mine sending me an email with a link to In bold black letters, against a deep red background, read the words “Yes. Panic.”  Our media has made the plotline fairly predictable. Alarming maps, followed by 24-hour cycles of expert analysis, followed by shots of the CDC in Atlanta, and then footage of this year’s flu shot being pumped out of manufacturing facilities.

This generation hasn't seen anything yet. Over a period of eight months from the fall of 2002 throughout the summer of 2003, the world was gripped by one word: SARS. Severe Acute Respiratory Syndrome. How does it stack up against Measles? TB? Flu? Plague? 8,400 cases. All of that media attention and hype and worry and fear over 8,400 cases seems pretty…well…not all that frightening. With 916 SARS deaths worldwide, the numbers simply don’t compare to histories greatest pandemics.

What does this mean for us? I’m not sure. I don’t know if you can compare pandemics to other disasters like earthquakes or volcanoes. The news media and the scientists behind those disasters love to remind us that we’re overdue for the big one. And we should not forget about the impending doom of a giant killer asteroid. Have a Happy Halloween. 


Zach England is a native of Knoxville, Tenn., and currently resides in Las Vegas, Nev. His interest in medicine stems from a family history in the profession, as his father is local Knoxville physician W. David England, MD. Send your ideas and comments to Zach at



Login and voice your opinion!