Some best practices are so ingrained that it’s hard to imagine a time before them. Buckle your seatbelt. Look both ways before crossing the street. ‘Just the tip’ is always a lie.
It’s been hard to get people to take some common sense advice during this pandemic, but hand washing was an easy one to get people on board with. The first guy who said “hey maybe wash your hands when doctoring” was beaten to death in an insane asylum.
And I thought twitter was rough.
Today’s Moment of Science… the tragedy of the Saviour of Mothers.
History shows that one does not simply walk into a hospital. You’re more likely to pick up MRSA at a hospital than just about anywhere else. Anesthesia is less than 200 years old, so surgery in the middle ages was not the propofol induced ride through a taco field of dreams that it is now. And in the 1800s, there was an astronomically high rate of perfectly healthy mothers dying after childbirth from puerperal fever.
Also known as childbed fever, obstetrician Ignaz Semmelweis was trying to figure out the cause of the outbreak. It was bad enough that women often tried to avoid giving birth in the hospital; ‘street births’ became a thing, and somehow a safer one than a hospital birth, the scientific term for which is ‘fucking yikes.’ Maternal fatalities at his hospital were far higher in the ward tended to by physicians than midwives. Semmelweis studied the differences between the wards, and tested several hypothesis.
Look. Um.
Not all of them were good hypotheses.
Women delivered on their side in the midwives’ ward and on their back in the doctors’ ward. Switching women to their side for the doctors didn’t help. He noticed a priest would go through the ward ringing a bell around the time when women fell ill, giving him the notion that the bell ringing frightened the women into a fever and death. He also suggested that women were so embarrassed by having their male doctors examine them that they were literally dying from embarrassment. Which makes me curious if he understood which of our more fun parts we mash together to make a baby.
After testing and failing several hypotheses, he had a revelation when a hospital pathologist died. Dr. Jakob Kolletschka performed an autopsy on a woman who’d died of childbed fever, and like a scene from act two of every plague movie with an expendable Kevin Spacey, he jabbed himself with a contaminated scalpel. When Semmelweis realized he’d died of puerperal fever, a lightbulb went off.
He realized the physicians were performing autopsies in the morning and going to deliver babies directly afterwards. We didn’t have germ theory yet, but he hypothesized they were bringing particles of some sort from the cadavers to the delivery room. His medical staff started washing their hands and sterilizing instruments, and fatalities in childbirth dropped substantially.
The “popular” version of this story, because we’re sick twisted fucks, is that he was institutionalized and beaten to death for suggesting handwashing. But reality is more complicated.
Semmelweis was not a great communicator. He didn’t formally publish the results of hand washing and sterilization for over a decade, and his writing was… meh. He was convinced all childbed fever was caused by doctors not hand washing sufficiently post-autopsy, despite the fact that it was a disease women had gotten via home births for ages.
He had turned bitter, angry, steering all discussions to childbed fever and handwashing. He wrote letters to doctors across Europe trying to convince them, but his tactic of telling them that they were – only slight paraphrase- dumbass murderers was unhelpful
The medical establishment as a whole rejected his ideas. Because it likely wasn’t just about the handwashing, it was what the handwashing represented; that they were responsible for the deaths through their ignorance, their ideas were wrong, and they had to change.
One theory is that Semmelweis went mad watching people reject handwashing. Another was dementia. Another is that he was suffering third stage syphilis, having treated countless patients at a free women’s clinic, presumably in a time before gloves. By his late 40s, his mental decline was apparent.
He was just 47 when he died in a mental institute in 1865, having been beaten to death by the guards.
This has been your daily Moment of Science, reminding you that we’re in a pandemic and you should wash your hands more often.
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