Entertaining Demise

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Keeping an open mind toward discovery

 

“It is only through labor and painful effort, by grim energy and resolute courage, that we move on to better things.” – Theodore Roosevelt.

In the mid-1840s, the city of Vienna had a problem. At the heart of the Austrian-Hungarian Empire, women were dying mysteriously from a fever shortly after birth.

The Obstetrics wards in the city were puzzled by what was going on.

At the Vienna Hospital, there were two maternity wards. The first clinic had a 10% mortality rate. The second clinic had a 4% mortality rate.

This disparity was so notorious that people knew the reputation of the worst ward and begged to not go there, sometimes opting for births outside the clinic.

Surprisingly, these ‘street births’ also had a rare occurrence of fever.

Whatever was causing the fever was a particular characteristic of the hospital, and the first clinic had more of it.

At first glance, both clinics had the same equipment and techniques.

Even more unusual was that the second clinic was more crowded.

What else could be going on?

One noticeable difference became apparent to a senior resident in the hospital. In the first clinic, the teaching service was for medical students, and the second clinic had midwives.

During an autopsy, which medical students did widely at the time, a friend of this senior resident was poked by a student’s scalpel. His friend died soon after. However, a sad moment became one of insight. His friend’s disease mirrored the course of the women dying from the fever. The senior resident knew that the midwives at the second clinic didn’t do autopsies.

Could there be a link between autopsy contamination and the fever?

This senior resident proposed something wild for the time: hand washing.

The mortality rate went down precipitously at the hospital.

The medical establishment lauded him and gave him the Nobel Prize the year after.

Just kidding. The senior resident’s ideas would be rejected by many, and he was mocked for suggesting that people wash their hands. He was eventually let go by his hospital and took work elsewhere. One fellow doctor called his ideas “the Koran of puerperal theology.” Nice to see that wordplay doesn’t change in some regards.

Undeterred, he maintained his practice in other facilities, achieving positive results.

Check out what a popular treatment course was in those days. I’ll give you a hint: It was likely one you would find in the times of the Ancient Greece and Rome. It was called humorism. You may have come across it a couple of times during schooling, but to give you a little recap, humorism states that the body is made up of four fluids or humors: blood, phlegm, yellow bile, and black bile. An imbalance of any of these humors causes disease.

So, for example, if there was a concern that too much blood was in a person’s system, bloodletting would be performed, famously with little crawlers called leeches. It worked well for George Washington. (It didn’t.)

Even the most significant scientific minds are fallible and can be limited by the knowledge and understanding of their time.

Issac Newton, who we all know from calculus, laws of motion, and gravity, held pseudoscientific beliefs such as the importance of alchemy, a discipline from medieval times aiming to turn base metals into gold leading to the discovery of a universal cure for disease and prolonging life. There are many, many examples. Just kick some tires around, and you’ll find some interesting things (cough, eugenics, cough).

If you thought this piece would be a COVID pile-on, sorry to disappoint. I’m more interested in the biases we all have regarding new information.

Science relies on constant questioning, testing, and refinement to progress and uncover the truths of the universe.

Disciplines often rely on placeholders when roadblocks appear to maintain coherence until stronger evidence emerges, leading to updated understanding.

So what does that say about us?

Increasing knowledge should allow us to be more skeptical and humble of what we know and come across rather than confident.

I often think about the realities of change and what that looks like for the individual and larger groups.

Belief perseverance is powerful, and we see it all over the place.

You can give the world fire, but if they receive it without the proper context—the right story, they will continue to play in the dark.

Beliefs of the day manifest in ways that continue to morph throughout the years. For example, during the mid-1800s, cleanliness was a trait of those with higher societal standing. This may seem laughable now with increased context and proximity to one another. Also, if we were to go back to the days of Julius Caesar, Napoleon, or even Franklin Delano Roosevelt, we would say nah, this ain’t it. You could imagine someone’s feelings got hurt when Semmelweis suggested they needed to wash their hands. Definitely doesn’t happen today. Nope.

There are things we know will improve our lives. There are things we could do each day that will get us closer to that goal. But we don’t. Instead, we continue as we are because we are comfortable. It is a daily battle, and the war is lost if we are not careful.

Delivery of a message is important, too. Humans are, well, human, and they have emotions. They are more willing to respond to things if they are in a proper state for a particular message. It doesn’t have to be a good emotion, either. We all know cases in which negative emotions can motivate, too. One doesn’t have to think too hard.

So, what happened to that former senior resident?

Ignaz Semmelweis did what any person would do when facing a professional onslaught. He lashed out. He fought fiercely for his ideas. One may argue that he wasn’t the most skillful or diplomatic in his messaging, but he used the process to get good results in the ensuing hospitals he worked at. The beatdown took a toll on his mental health. There could have been other factors at play, but what is known is that he was determined to be at risk to himself and others by those around him and committed to an asylum.

When he tried to leave the facility, he was beaten by the asylum personnel. He was placed in a straitjacket and confined to a darkened cell. He was given the finest treatments, such as dousing with cold water and castor oil, you know, humorism. He died after two weeks in the asylum, ironically because of what he was trying to cure. On his right hand, he had an infection which turned septic.

Although people in the places he worked continued to ignore his process and results, leading to increased mortality, his work was not in a vacuum. Pioneering nurse and social advocate Florence Nightingale emphasized clean water, waste management, and personal hygiene to prevent contagious diseases during the Crimean War (1853-1856). In 1854, physician and early epidemiologist John Snow established a link between contaminated water and disease transmission during a cholera outbreak in London. The ideas started to catch on and solidify across Europe and globally.

In just a couple of decades, Semmelweis’s ideas would be verified through the work of Louis Pasteur in the 1860s, Robert Koch in the 1870s, and others in the development of Germ Theory, setting the placeholder of humorism aside and laying the groundwork for further innovations in personal hygiene and sanitation, which I am sure we are all thankful for today.

Semmelweis’s plight gave rise to many dramatized versions of his life, the “Semmelweis reflex”—the dismissal of new ideas that challenge established norms, and a reminder: true scientific progress requires embracing failure and constantly reevaluating our understanding in the light of new evidence.


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