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 History.com, 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?
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First heard of this in a short film shown on TMC I think -That Mothers Might Live - seems so obvious now. I guess too many folks think hand washing is just in medical settings .