When the death of thousands isn't enough

"In 1846, large numbers of women and babies were dying during childbirth in Vienna. The cause of death was puerperal fever, a disease that swells then kills its victims. Vienna's General hospital had two maternity clinics. Mothers and newborns were dying in only one of them. Pregnant women waited outside the hospital, begging not to be taken to the deadly clinic, often giving birth in the streets if they were refused. More women and babies survived labor in the streets than in the {deadly} clinic. All the deaths came at the hands of doctors. In the other clinic, midwives delivered the babies" (pg 72, bolding mine).

This, an excerpt from the book How to Fly a Horse, by Kevin Ashton. Earlier in the book, Ashton writes, "Thinking is finding a way to achieve a goal that cannot be attained by an obvious action," and which is now underlined, along with a few other quotes on several other pages. Ashton is writing this book in hopes of squashing the belief that creation, invention, and discovery are only set aside for a select few, and that that happen in a moment of intense inspiration. "Creation," he writes, "is a destination, the consequences of acts that appear inconsequential by themselves but that, when accumulated, change the world. Creating is an ordinary act, creation its extraordinary outcome" (pg 23), and it can be done by anyone, not just the elite or the ultra brilliant because, "Everyone is born creative; everyone is given a box of crayons in kindergarten. Being suddenly hit year later with the 'creative bug' is just a wee voice telling you, 'I'd like my crayons back, please'" (pg 18).

Is this why doctors - not midwives, were responsible for the deaths of hundreds of mothers and newborns in the 1800's Vienna? Because they considered themselves the elite and professional and no longer in need of curiosity? Innovation? And discovery? 


Ashton continues. "Vienna General was a teaching hospital where doctors learned their trade by cutting up cadavers. They often delivered babies after dissecting corpses. One of the doctors, a Hungarian named Ignaz Semmelweis, started to wonder if the puerperal fever was somehow being carried from the corpses to the women in labor. Most of his peers thought the question preposterous. Carl Edvard Marius Levy, a Danish obstetrician, for instance, wrote that Semmelweis's 'beliefs are too unclear, his observation too volatile, his experiences too uncertain, for the deduction of scientific results.' Levy was offended by the lack of theory behind Semmelweis's work. Semmelweis speculated that some kind of organic matter was being transferred from the morgue to the mothers, but he did not know what it was. Levi said this made the whole idea unsatisfactory from a "scientific point of view." 

"But, from a clinical point of view, Semmelweis had convincing data to support his hypothesis. At a time when doctors did not scrub in or out of the operating room, and were so proud of the blood on their gowns that they let it build up throughout their careers, Semmelweis persuaded the doctors of Vienna to wash their hands before delivering babies, and the results were immediate. In April 1847, 57 women died giving birth in Vienna General's deadly First Clinic - 18 percent of all patients. In the middle of May, Summelweis introduced hand washing. In June, 6 women died, a death rate of 2 percent, the same as the untroubled Second Clinic. The death rate stayed low, and in some months fell to zero. In the following two years, Semmelweis saved the lives of around 500 women, and an unknown number of children."

"This was not enough to overcome the skepticism. Charles Delucena Meigs, and American obstetrician, typified the outrage. He told his students that a doctor's hands could not possibly carry disease because doctors are gentlemen and 'gentlemen's hands are clean'" (pg 73).

Which also means, ironically, that the most deadly clinic was probably made up of all men, while the second clinic, the safer and more reliable one, was filled with older women - midwives - who relied on the practical experience they received in delivering many children. Women who weren't so concerned about the blood on their gowns as they were about the babies being born and the mothers who carried them. 

"Semmelweis did not know why hand-washing before delivery saved lives- he only knew that it did. And if you do not know why something saves lives, why do it? For Levy, Meigs, and Semmelweis's other 'gentlemen' contemporaries, preventing the deaths of thousands of women and their babies was not reason enough" (pg 73).

If this is a gentleman, I hope to never be confused as one again. Sheesh.

"As the medical community rejected Semmelweis's ideas, his moral and behavior declined. He had been a rising star at the hospital until he proposed hand-washing. After a few years, he lost his job and started showing signs of mental illness. He was lured to a lunatic asylum, put into a straightjacket, and beaten. He died two weeks later. Few attended his funeral. Without Semmelweis's supervision, the doctors at Vienna General Hospital stopped washing their hands. The death rate for women and babies at the maternity clinic rose by 600 percent."

What a tragic ending and lack of recognition to a man who saved thousands of lives. 

Why did so few attend his funeral? Why did so few listen to his advice? And why was the practice of washing hands so difficult to embrace?

"Because," Ashton write, "When you bring something truly new to the world, brace. Having an impact is not usually a pleasant experience. Sometimes the hardest part of creating is not having an idea but saving an idea, ideally while also saving yourself."

This tragic truth seems to affirm itself throughout history, and the root cause of it all seems to be pride.

Ashton concludes this section with this. "William Syrotuck analyzed 229 cases of people who became lost, 25 of who died. He found that when we are lost, most of us act the same way. First, we deny that we are going in the wrong direction. Then, as the realization that we are in trouble seeps in, we press on, hoping chance will lead us. We are less likely to do the thing that is most likely to save us: turn around. We know our path is wrong, yet we rush along it, compelled to save face, to resolve the ambiguity, to achieve the goal. Pride propels us. Shame stops us from saving ourselves" (pg 90). 

I can imagine that, for those doctors, to start washing hands - and to commit to it - would be to admit fault, that those deaths were in fact their fault. And I can also imagine that that truth would be drastically hard to swallow. So they pressed on, hoping chance would free them from guilt. 

To turn around - to repent - means to admit fault and to acknowledge that, somewhere along the way, we made the wrong turn. Every wanna-be hero is brought to this point. The hero hits the breaks and turns the wheel; the tragic hero continues on, propelled by pride, as hundreds of women and children needlessly pass away. 


For more on . . .

-N- Stuff  :  The DR Who Championed Hand-washing  :  Humilitas  :  Hero's Journey