Boring but effective

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OK, so this is going to be a boring story.

Well, maybe not the story itself—but the conclusion. But that’s OK. Right now, boring is good.

It starts in the mid-1840s. By that time, the Vienna General Hospital was already about 150 years old, and it was so large that it had two maternity wards: one led by physicians, and another that was led by midwives.

The patient count in each maternity ward was about evenly split, but over time it became clear that there was a stark difference in care.

Specificially, women who gave birth in the midwife ward had about a 3.6 percent chance of dying during or after childbirth.

But for women in the doctor-led ward, the chance of death was almost three times as high: 9.8 percent.

This was troubling of course, and a doctor named Ignaz Semmelweis who worked in the doctor-led ward set out to determine the cause.

His first theory was to blame the priest who would pass through each day in the doctor-led maternity ward, ringing a bell and offering a prayer for the dead.

Perhaps, Semmelweis wondered, simply the sound of the bell and, being reminded of their mortality, led women in that ward to die at a higher rate?

HE had the priest “rerouted,” as Becky Little wrote earlier this year on, but it made no difference.

Then, a personal loss led to Semmelweis’s scientific breakthrough. It was something that seems obvious now—but, I guess we had to learn it sometime.

In 1847, a fellow doctor and friend of Semmelweis’s named Jakob Kolletschka cut his hand with a scalpel during an autopsy, and died of an infection.

Semelweis theorized now that perhaps the fact that doctors were going back and forth between performing autopsies and assisting in childbirth — with zero hygiene in between — might have something to do with the higher death rate.

So, Semmelweis ordered the doctors to start washing their hands with chlorinated lime after performing autopsies.

The doctor-led maternity ward must have smelled like a modern-day swimming pool, but sure enough, the mortality rate fell to basically the same level as the midwives’ ward.

Now, as Little tells the story — and she had pretty good timing for an article about hand-washing, since she wrote this in early March, just before the pandemic really took hold — Semmelweis’s theory didn’t immediately take hold beyond Vienna.

For one thing, while he was apparently a pretty good medical detective, Semelweis was a stubborn man with weak persuasive abilities, and his scientific articles about the theory rambled.

Also, the doctors (all men) weren’t exactly eager to entertain the theory that their negligence caused a higher death rate than the midwives (all women).

Of course, Semmelweis wasn’t the only hand-washing advocate.

In the United States for example, Dr. Oliver Wendell Holmes (father of the future Supreme Court justice) had advocated for hand-washing among doctors in an 1843 paper. And, in Britain, Florence Nightingale’s guide for nurses called for every nurse to “be careful to wash her hands very frequently during the day.”

But, in context of the time, the idea of washing hands for doctors was a big deal. (The next big step, sterilizing instruments in surgery, didn’t take hold as a really widespread practice until nearly the 20th century.)

Anyway, I don’t know about you, but I’ve been a lot more careful about washing my hands over the last six months than ever before. And, it’s interesting to think that something so simple could ever have been so controversial.

It’s boring, but it works. And as the days get shorter, the nights get longer, the talk of another outbreak grows, and we all get stuck in our homes even a bit more than before—it’s not a bad reminder.

There are 14 days until the U.S. presidential election. As of last night, 30,242,866 Americans had already cast their ballots. Have you voted yet?

7 other things worth your time

  • Guaranteed, this will be a movie. How did the FBI and other authorities catch alleged extremists plotting to kidnap a governor? They recruited informants on the inside—group members who agreed with the ideology, but for whom the idea of committing violent crimes just went too far. Now, explained the head of Michigan “volunteer militia” with 200 members: “We just assume that somebody in the group is an informant at all times. If you think that way, you’ll never say something dumb, like, you know, ‘Hey, I got a map for the governor’s house.’” (WSJ, $)

  • A quarter of “higher income” American workers now say they’ve considered quitting their jobs as a result of the pandemic; among lower income it’s 39 percent. (AP)

  • Wales says it’s instituting a two-week total lockdown starting Friday, and Poland is turning its 58,000-seat national stadium in Warsaw into a temporary Covid-19 hospital, as fears of a European resurgence grow. But, believe it or not, there’s a Covid-free place in North America right now: the isolated Canadian territory of Nunavut, (Reuters, Globe and Mail, BBC)

  • Researchers say cold-water swimming could delay the onset of dementia for several years. The researchers say the goal isn’t necessarily to get people to swim in cold water, but instead to create a drug that would replicate the physiological effect. (The Independent)

  • Know a pharmacy tech who needs a job? CVS is hiring 15,000 pharmacy technicians as they ramp up to prepare for a Covid-19 vaccine. (CNBC)

  • The U.S. Supreme Court split 4-4 in a GOP challenge to Pennsylvania electoral law, which means the law stands, and votes received up to 3 days after the election in that crucial swing state will still count. Meanwhile, Texas gets the prize, so to speak, for being the hardest state in America to vote in. Ironically, just under 4.1 million Texans have already voted this year, which represents 45 percent of the state’s total votes in 2016. (CNN, Houston Chronicle)

  • Today, at least in theory, is the last-ditch deadline for Democrats and Republicans in Congress to agree on a stimulus bill before the election. If it doesn’t happen by Tuesday—again, so they promise, anyway—we won’t see one until after Nov. 3. (USA Today)

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