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Book and Media Reviews
October 11, 2006

Historical Fiction

JAMA. 2006;296(14):1781-1786. doi:10.1001/jama.296.14.1785

We have all heard of how Edward Jenner inoculated young James Phipps in 1796 with fluid from a cowpox pustule, beginning the world's first public health vaccination campaign, but few of us know of Francisco Xavier de Balmis, royal physician of King Carlos IV. In 1803, Balmis led a three-year expedition with 22 orphan boys across the Atlantic to Spain's colonies in the New World, which were ravaged by smallpox. Intending to provide vaccine to the colonists, he sequentially inoculated each boy in order to maintain the vaccine and went on to save thousands from the smallpox scourge. In her new novel Saving the World, Julia Alvarez fictionalizes this fascinating episode, telling it from the point of view of the sole woman recorded as participating in the expedition. Isabel Sendales y Gómez, rectoress of the orphans, bears the physical and emotional scars of smallpox herself, having lost “mother and father and sister . . . and not just past but future loves.”