Not enough to be right.

23 hours ago

3 min read

In 1846, whilst working in the Obstetrics department at Vienna General Hospital, Dr Ignaz Semmelweis was a disturbed man.

He observed that 18% of mothers died from 'childbed fever' after childbirth in a clinic staffed by physicians and medical students. Surprisingly, it was 9 times higher than in another clinic in the same hospital, staffed exclusively by midwives (2%).

Women preferred giving birth in the streets if they could not get admitted into the second clinic and avoid admission in the first clinic.

Semmelweis was puzzled that puerperal fever was rare among women giving street-births.

Then why the high rate of deaths in the first clinic?

After much study and statistical analysis, Semmelweis hypothesised that doctors routinely performed autopsies and moved directly to handle childbirths without washing their hands. This was the main reason they were transmitting some particles from the dead bodies to the mothers, causing the fever and killing them.

Semmelweis introduced mandatory handwashing with a chlorinated lime solution before examining patients in the Obstetrics department. The results were dramatic: maternal mortality dropped from approximately 18% to zero within months.

Having made a great discovery, an excited Semmelweis could not contain himself. He shared his discovery with his colleagues and seniors. Rather than acceptance and praise, Semmelweis's discovery was met with scepticism and open hostility.

Fellow doctors took offence at his suggestion that they were the cause of deaths. They condemned Semmelweis. Semmelweis lost his patience and composure, became rude and aggressive.

Because of his intense passion and integrity, the hospital did not renew his term when it expired in 1849. In 1850, he left Vienna and moved to Pest (Hungary), where he once again successfully minimised childbed fever fatalities.

A little sincerity is dangerous, and a lot of it can be fatal.

Semmelweis was outraged by the indifference of the medical profession and began writing open and increasingly angry letters to prominent European obstetricians, at times denouncing them as irresponsible murderers.

Semmelweis's contemporaries, including his wife, presumed he was losing his mind.

In 1865, nearly 20 years after his breakthrough, he was committed to a lunatic asylum. The guards there beat him up regularly, and he died within 2 weeks because of 'Septic shock', the very same cause he spent his whole life fighting against.

Louis Pasteur's germ theory vindicated Semmelweis's hypothesis only 15 years after his death, when it was finally accepted by the Western medical community.

Semmelweis is considered a pioneer of antiseptic procedures.

Today, hand hygiene is universally acknowledged as the most effective measure to prevent healthcare-associated infections. Semmelweis is celebrated as a pioneer whose persistence helped save countless lives.

What are the takeaways from this chapter in history?

A curious mind and keen observation are essential for achieving any scientific breakthrough.
Semmelweis’s life exemplifies the 7 Cs qualities needed to advance science: Curiosity, Courage, Challenge, Confidence, Concentration, Continuity and Communication.
Humans are inherently resistant to change, especially if they challenge entrenched beliefs.
'Educated professionals' are often arrogant. They are further blinded because of a psychological phenomenon known as cognitive dissonance.
A great discovery or strategy is useless unless we can communicate and persuade others to accept and adopt it.
Never lose our temper.
Communicate in a manner to convince. Avoid offending others who are essential for our success.
Western Medicine was dominated by Miasma Theory (disease spread through "bad air") and 4 bodily fluids rather than direct physical contagion by human hands. One cannot change 1,500-year-old thinking and practice quickly.