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By Jo Gamm Witt
A young Hungarian, Jewish junior doctor working in a hospital in Vienna, named Ignaz Semmelweis, was indignant to discover why so many women were dying on their doctor-staffed maternity ward, while so many fewer were dying on their midwife-staffed maternity ward. After investigating various possible causes, he finally had an epiphany after his colleague cut “himself with a scalpel while performing a dissection” on a woman who had died from the fever, after which his colleague acquired the same fever and also died (only doctors performed autopsies, whereas midwives did not). Semmelweis then pondered whether “some kind of invisible particle” might have caused his colleague's death and whether invisible particles were “being transmitted from the hands of the doctors to the bodies of the mothers.” Semmelweis decided to test his theory by requiring all doctors delivering babies on the doctor-staffed ward “to wash their hands with a chlorine solution after dissections.” Death rates on the doctor-staffed maternity ward then plunged by 90%, an irrefutable result. Logically you’d think that the problem was solved, people would adopt hand washing, and thousands of lives would be saved. Yet, that’s not what happened. Instead the medical community rejected Semmelweis' ideas. This documentary indicates that “having the data on your side, being a brilliant investigator, is often not enough” because there’s also a social element involved--that “it's also about who Semmelweis was and who he wasn't.” Semmelweis was a JUNIOR doctor in a very hierarchical society and working in a very hierarchical profession. “He's the wrong person to be telling his profession full of grandees this quite difficult message that the cause of the death was something about them, even with that weight of evidence, even with women's lives being saved by that intervention.” A different article I read about Semmielweis further indicated that for social reasons his ideas were also rejected because of him being Hungarian and being a Jew (https://www.pbs.org/.../ignaz-semmelweis-doctor...).
Further in the documentary they then tell the story about Florence Nightingale’s connection between cleanliness and good health and about how she was viewed as a hero and her ideas readily accepted—“partly because of her personality,” but also because she was an “aristocrat in a deeply class-based society” and considered “a sort of genius with arguments and statistics.” It was also a matter of timing, in that Nightingale's work coincided “with a period of intense scientific discovery.” But the documentary also talks about it mattering how information is delivered. Semmelweis presented his argument for hand washing in statistical tables, just many pages of raw numbers, while Nightingale converted her data into vivid diagrams. And Semmelweis was viewed as having a difficult personality, being outrageously rude to powerful doctors who questioned him, and increasingly shrill and angry (https://www.pbs.org/.../ignaz-semmelweis-doctor...).
Interestingly it has been a work in progress over many years in discovering causes of diseases and how best to prevent them. True of any message, I guess sometimes it just has to be the “right” messenger in order for people to listen.
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