Apr 1, 2020

Dispatch 2: Every Day is Ignaz Semmelweis Day

It began with a tweet: “EVERY DAY IS IGNAZ SEMMELWEIS DAY.” Carl Zimmer — tweet author, acclaimed science writer and friend of the show — tells the story of a mysterious, deadly illness that struck 19th century Vienna, and the ill-fated hero who uncovered its cure … and gave us our best weapon (so far) against the current global pandemic.


This episode was reported and produced with help from Bethel Habte and Latif Nasser.

Support Radiolab today at Radiolab.org/donate

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JAD ABUMRAD: Okay. Hey I’m Jad Abumrad. This is Radiolab dispatch number two. 

 

[MUSIC IN]

 

JAD: This is a story that we’re all living out 20, 30, 50 times a day, in 20 second bursts.  It’s a story I didn’t really know about but when this whole corona crisis was new, just -- I mean it seems like it’s been years, but just two weeks ago. One of the first people I called was…

 

CARL ZIMMER: Mr. Abumrad.

 

JAD: Mr. Zimmer. Oh, it’s good to hear your voice.

 

[MUSIC OUT]

 

JAD: Was Carl Zimmer. He’s a science writer, regular guest on the show.

 

JAD: How’re you doing? Everyone okay? 

 

CARL ZIMMER: You know. It’s -- we sort of like, you know, fluctuate. You know.

 

JAD: Yeah.

 

JAD: Called him up cus I just wanted to get a basic read on what science we should be paying attention to and covering. So I was asking him questions about vaccines and treatments.

 

CARL ZIMMER: Hold in a second.

 

JAD: There were many parenting interruptions.

 

CARL ZIMMER: I assume you washed your hands?

CHILD: Yup. 

CARL ZIMMER: Alright.

CHILD: [muffled speech] 

 

CARL ZIMMER: I know. Roll your eyes, roll your eyes. See, this is what I'm talking about.

 

JAD: Yeah, there you go.

 

JAD: Anyhow, we were talking about science and in the flow of things, he throws out this name.

 

CARL ZIMMER: Ignaz Semmelweis. I found a profile of Ignaz Semmelweis and I just sort of put it on a tweet and I said, you know, “Every day is Ignaz Semmelweis day." You know, like…

 

JAD: Who’s this?

CARL ZIMMER: Ignaz Semmelweis, you know,  just the whole -- the whole epic story.

JAD: No. What is this? What is this epic story?

CARL ZIMMER: I mean…

JAD: And then he told me…

[MUSIC IN]

JAD: This crazy story of a 2,000-year-old medical mystery that involves life, and death, and dogma, and disease, and sacrifice and the price of knowledge. And I was like woah, woah, whoa, whoa, whoa. Get a USB mic. I’m gonna call you back. 

[MUSIC OUT]

 

CARL ZIMMER: Okay, just from the start?

JAD: Ok, so, so who is Ignaz Semmelweis?

 

[MUSIC IN]

CARL ZIMMER: So, Semmelweis was born in 1818 to a family, ran grocery stores in Budapest in Hungary.

JAD: He was the fifth of nine kids.  

CARL ZIMMER: And he was, you know, you hear these words described about him, you know, a lighthearted guy, popular, jocular. Seemed like a very pleasant man. 

 

JAD: At least at the beginning.

 

NANCY TOMES: When you look at his face in the earliest photographs we have, he looks very intense. 

 

JAD: This is Nancy Tomes, historian of medicine at Stony Brook University. 

 

NANCY TOMES:  Dark hair, dark mustache. He, to my mind, must have had a fine figure as a doctor, with that impressive face and those haunting eyes.

 

JAD: It is true. He has a very smiley mouth in those early pictures but his eyes are like searchlights.

 

[MUSIC OUT] 

 

CARL ZIMMER: But in any case, Semmelweis, at first he thought he’d become a lawyer but then he switched to medicine. He just had a really good medical class, I guess, at university and decided, "That's what I want to do." And so he then traveled to Vienna because he wanted to go to the best medical school he could. And he started work there.

 

JAD: Okay, so Vienna Hospital, this is where the mystery unfolds.  Can you just sort of set the sce…

 

TEJ: [inaudible]

 

JAD: Tachey, I’m on a... Oh, that's beautiful. I'm in an interview right now, babe. Can you…

 

TEJ: Dad, what’s your password? 

 

JAD: It's a -- sorry, Carl. It's a -- Ask mom to type it, all right?

TEJ: Okay.

JAD: That's just parenting in the pandemic. OK, so Vienna General Hospital, set the scene.

CARL ZIMMER: We should be picturing the Vienna General Hospital around 1846.

[MUSIC IN]

JAD: Okay.

CARL ZIMMER: This is a magnificent hospital. Vienna is one of the intellectual centers of the world. This may be one of the greatest hospitals on earth. Its professors are revered as holding all the wisdom of medical lore.

JAD: And by the way, this was a moment when science itself, at least as we understand it now, was just getting going.

NANCY TOMES: Yes.

JAD: Data.  Empiricism. 

NANCY TOMES: Observation. 

JAD: Statistics.

 

NANCY TOMES: One of the big changes in the history of science coming about moving from the old to the new was simply using your eyes and paying attention.

JAD: So you had all of these young doctors, like Semmelweis, coming to this hospital, with the idea that we’re gonna embrace this new era. The body contains all these secrets. and in order to learn those secrets we’ve got to look inside, do dissections. See what it can teach us, so that we can understand how disease affects organs. So that we can then learn how to treat them in living people.

CARL ZIMMER: Okay. And so Semmelweis…

JAD: Arrives in Vienna, 1844.  

 

CARL ZIMMER: You know, he’s kicked around a bit at the medical school trying to figure out what his specialty would be. Did a lot of autopsies to learn about medicine and then he was assigned to obstetrics.

JAD: The delivering of babies. And so Iggy’s routine became that he -- in the morning, he would dissect bodies, as part of his training. And in the afternoon and evening, he would deliver babies.

CARL ZIMMER: So he got to -- got to become an expert on childbirth.

JAD: One thing to keep in mind...

NANCY TOMES: At this point, women did not go to hospitals to give birth routinely in this time period. The women who went there were so poor that they needed the assistance.

JAD: Nancy says if you were a pregnant woman at this time, and you had any money at all...

NANCY TOMES: You gave birth at home. And in fact, many of the women giving birth in these maternity clinics, not just in Vienna but in other big cities in this time period were, might be single women who had become pregnant. They might be prostitutes. They would exchange that care during labor for the right of the medical personnel to use them as teaching material. So it was a teaching hospital.

JAD: But not all of the hospital was for teaching. There were -- this becomes important later. There were two delivery wards in this hospital. One was run by female midwives.  And the other was run by doctors. Ok.

 

CARL ZIMMER: So the division with the doctors, the First Division, was the very high status one...

 

JAD: You know where they were advancing the sciences. 

 

CARL ZIMMER: Combining what they were learning with autopsies with, you know, doing childbirth. 

JAD: That’s where Ignas Semmelweis trained and we can imagine he probably delivered several thousands of babies.  And very early on, he was struck by a horrible fact. Many of the young women who gave birth in his delivery ward died, right after they delivered. 

[MUSIC IN]

CARL ZIMMER: He was really haunted by all these women who were dying in front of him. I mean, it really got to him. It hit him very hard. And it was just relentless. You know, just a large number of these healthy, young women would come to the hospital to give birth and then suddenly die in one of the most horrific ways you can imagine. 

JAD: They’d give birth, then develop a fever. that fever would keep climbing, until they were hallucinating, convulsing, filling with bile, losing blood. And then ultimately passing away.

CARL ZIMMER: And he writes about how much this haunted him because, you know, every time that there was another patient who was dying, [BELL] they would call the priest and [BELL]  every time a priest would come into the hospital they'd ring a bell. 

[CARL ZIMMER AS IGNAZ SEMMELWEISS: It had a strange effect upon my nerves, when I heard the bell hurried past my door; a sigh would escape my heart for the victim that once more was claimed by an unknown power.]

[BELL] Yeah, so every time he heard that bell it just made him shudder. 

[CARL ZIMMER AS IGNAZ SEMMELWEISS: The bell was a painful exhortation to me to search for this unknown cause with all of my might.]

CARL ZIMMER: Cause he knew that they were losing another young woman.

JAD: That unknown power that was claiming all these lives, was a disease with a strange name. 

CARL ZIMMER: Puerperal fever.

JAD: Puerperal fever.

CARL ZIMMER: Puerperal fever.

JAD: It’s not purple, as in the color. It’s puerperal fever, which comes the latin puerpera, which means “woman whose given birth.” At some point it was called “childbed fever” but it went back a long way.

CARL ZIMMER: It had been described for thousands of years. I mean, Hippocrates actually describes it.

[MUSIC IN]

[CARL ZIMMER AS HIPPOCRATES: If, however, the purgation of the puerperium does not take place…


JAD: Even in the 5th century BC, Hippocrates, father of medicine, described the fevers, described the symptoms. He thought something had putrefied in the mother.

CARL ZIMMER: Yes.

JAD: Other physicians…

[CARL ZIMMER AS OTHER PHYSICIANS: A cold air inadvertently received into the uterus, which closes the orifices of the vessels…]

JAD: Thought maybe it was the air in the delivery room. 

DANIEL MORIGUCHI: In the period it is widely accepted that the qualities of the air play a role in determining disease.

JAD: This is Daniel Moriguchi, historian of science, Cambridge University.

JAD: Oh interesting. 

DANIEL MORIGUCHI: Some people argue that there is seasonal variation in a number of women being afflicted...

JAD: In other words, maybe it was the weather. Some people argued it was the moral standing of the women. 

DANIEL MORIGUCHI: Because if you are immoral, you tend to be dirty. If you are dirty, both morally and physically, then you live in squalid conditions. 

 

JAD: All kinds of crazy theories.

 

CARL ZIMMER: Some people even thought that the problem was, is that the milk that expectant mothers were producing to nurse their children was somehow getting routed into their abdomen or their uterus.

JAD: Oh, wow.

CARL ZIMMER: And in a weird way, you can kind of see how they could think of something as crazy as that. And that's because when doctors would examine these dead mothers, open up their abdomens, they saw this huge amount of pale liquid that looked to them a little like milk. But it was pus.

 

JAD: That is legitimately disgusting but the point is, this mystery had been plaguing doctors and scientists for thousands of years. And it just so happened that whenIgnaz Semmelweis was in delivery ward number one, it was a really big problem.

CARL ZIMMER: You know, sometimes 30% of the women giving birth at the hospital in a month die of this fever.

JAD: That's a huge number.

CARL ZIMMER:  Huge -- it would fluctuate. And some months it would be 7% but still, you know, so everybody knew that this was a problem and so the question was, "Well, what's causing this?" And, "How can we address it?" 

[BELL]

 

JAD: I imagine that every time he heard that bell, Ignaz Semmelweis thought, “I’ve got to get to the bottom of this.” And so, [BELL] in between his morning dissections and his afternoon delivery shifts, he would visit the hospital archives. 

 

CARL ZIMMER: The Vienna General Hospital might not have understood what puerperal fever was but they were really good at keeping records. So he looked at their records and some things really popped out for him.

 

JAD: First of all...

 

[CARL ZIMMER READING HOSPITAL RECORDS: Despite a general impression to the contrary, neither the incidence nor the mortality of puerperal fever was related to weather.]

 

CARL ZIMMER: You know there was no connection with weather.

 

JAD: Cross that off the list.  

 

CARL ZIMMER: You know, he could rule things out.

 

JAD: But here was the really big thing he noticed...

 

[PAGE FLIP]

 

[CARL ZIMMER READING HOSPITAL RECORDS: Observation number one…]

 

JAD: If you remember, there were two different delivery wards.  

 

[CARL ZIMMER READING HOSPITAL RECORDS: The same number of deliveries took place in each of the hospital’s two obstetrical divisions, usually between 3,000 and 3,500.] 

 

JAD: Division number 1 were doctors, number 2 were midwives. 

 

[CARL ZIMMER READING HOSPITAL RECORDS: In the First Division, an average of 600 to 800 mothers died each year from puerperal fever; in the Second Division, the figure was usually about 60 deaths.]

 

CARL ZIMMER: Semmelweis like runs the numbers and he's like, "My God, like 20% of these women are dying where the doctors are in charge and about 2% are dying when the midwives are in charge."

 

JAD: Really?

 

CARL ZIMMER: Yeah.

 

JAD: So the death rate is 18 percent higher when the doctors are delivering the babies?

 

CARL ZIMMER: Ten times higher, think of it that way. About 10 times a bigger risk…

 

JAD: Wow.

 

CARL ZIMMER: Of dying when some of the best doctors in the world are delivering your baby.

 

JAD: Naturally, Ignaz was like, “Why would that be?”  

 

CARL ZIMMER: Why would it be so different? He was just looking and looking and looking. Like, what could explain this? What could explain this?

 

[MUSIC OUT]

 

JAD: Shortly after, he has this beg aha moment and solves the 2,000-year-old mystery. That’s after the break. 

JAD: I’m Jad Abumrad. This is Radiolab. So it’s 1847. Iggy Semmelweis is flummoxed.  He’s noticed a very distressing pattern that there are two delivery wards in the hospital. Division 1, you have the best and brightest doctors in the world. Division 2, you have female midwives. He runs the numbers and finds that women giving birth in his delivery room, Division 1, die at 10 times higher rate than Division 2. And he has no idea why this would be. These are supposed to be the best doctors in the world. But then, he has an ah ha moment. 

 

CARL ZIMMER: What really seems to really have made it all click in place was not the death of one of these patients but the death of one of his professors. 

 

JAD: A man named Jacob Kolletschka.

 

CARL ZIMMER: He had this mentor who had taught him about medicine and how to do an autopsy, how to do forensic pathology, all of that stuff. And during one autopsy this professor was with a student...

 

JAD: He and the student were bent over a cadaver.

 

CARL ZIMMER: And the student was, you know, cutting open a cadaver under his guidance…

 

JAD: Making some incisions...

 

CARL ZIMMER: And then just accidentally [KNIFE] nicked him with the knife.

 

JAD: Nicked the professor?

 

CARL ZIMMER: Yeah.

 

JAD: Apparently the student’s hand slipped or something and he caught his professor on the finger. 

 

CARL ZIMMER: So the student nicks the professor with the knife, just a tiny little scrape. And then suddenly...

 

[MUSIC IN]

 

JAD: Within a few days, his mentor...

 

CARL ZIMMER: He dies a terrible death. 

 

JAD: But a terrible death that seemed familiar. 

 

[CARL ZIMMER AS IGNAZ SEMMELWEIS: Totally shattered, I brooded over the case with intense emotion until suddenly a thought crossed my mind; at once it became clear to me that childbed fever, the fatal sickness of newborn and the disease of Professor Kolletschka [BELL] were one and the same.]

 

JAD: He realized, oh my God, this disease, is the same one I’ve been seeing in the delivery room. With the mothers, we didn’t know why it was happening. But here, we know the cause. It was the student. The student's knife. A knife that first had been in a dead body and then had cut his professor’s finger. 

 

[CARL ZIMMER AS IGNAZ SEMMELWEIS: The fact of the matter is that the transmitting source of those cadaver particles was to be found in the hands of the students and attending physicians.]

 

CARL ZIMMER: When that professor died it all clicked into place, because what do these doctors do? These doctors, in the morning, might have their hands deep in a cadaver. 

 

JAD: Oh.

 

CARL ZIMMER: And then in the afternoon, they would walk over to a pregnant woman and start delivering a baby with the same hands.

 

JAD: Oh, that's haunting. So they’re literally carrying death into the place where a life begins. 

 

CARL ZIMMER: Yes, they were. They absolutely were. And so, I mean, the way that Semmelweis described it was that when a doctor was finished with an autopsy he had cadaver particles on his hands.

 

JAD: Oh.

 

CARL ZIMMER: So Semmelweis called these “cadaver particles.”

 

JAD: Oh, that gives me chills, just thinking about that.

 

CARL ZIMMER: Yeah. He didn't call them bacteria or viruses or anything. He didn't know what those things were. And when he put all this stuff together and came up with the idea of cadaver particles, he thought, “Oh my God…”

 

[CARL ZIMMER AS IGNAZ SEMMELWEIS: Because of my convictions, I must here confess that God only knows the number of patients who have gone to their graves prematurely by my fault.]

 

[MUSIC]

 

CARL ZIMMER: I have been sending women to their graves. 

 

JAD: He immediately realized the brutal paradox of his situation. He’d been trying to do the right thing. Advance the science, save lives. But he had done the opposite. In fact, the doctor who worked in the delivery ward before he got there, who was widely recognized as a lazy scientist, didn’t do dissections. And as a consequence, more women survived. Semmelweis shows up, starts doing dissections, as he believed was his duty, and deaths spike.

 

DANIEL MORIGUCHI: Semmelweis is very much aware of that paradox that it’s with the rise of scientific medicine, that childbed fever is really coming into place. And he basically says that, you know, me being the conscientious scientist is the reason why many mothers died before I realized that I was the cause of their disease.

JAD: But in addition, it is his scientific method and his scientific way of thinking that allows him to recognize that. So there's some kind -- It's very, it's very I don't know. 

DANIEL MORIGUCHI: It’s, yeah. It is interesting, right? I mean it's -- the whole 19th century's a little bit like that, right? You know, with the rise of global circulations, the spread of steamships and you get at the same time cholera.

JAD: Mm-hmm (affirmative).

DANIEL MORIGUCHI: So the spread of knowledge and the spread of diseases is -- you know, they are often connected, yeah.

JAD: Okay, so what happens next is that Ignaz Semmelweis starts telling his colleagues, “We’ve been killing women.” 

 

CARL ZIMMER: And actually like, a number of the younger set think he’s right. And it was very hard for some of them. And in fact, there was one doctor, named Michaelis, who -- you know he had delivered the baby of his own niece and she had developed puerperal fever. And the realization that he was probably responsible for the death of his niece just became too much and he committed suicide.

JAD: Oh wow. 

JAD: As for Ignaz Semmelweis...

CARL ZIMMER: He immediately said, "Okay, well what could I -- knowing this, is there something that I could do at the hospital to stop it?" 

[MUSIC IN]

CARL ZIMMER: He actually, he started to do these experiments. He was very familiar with the smell of death, obviously, because he was working with cadavers all the time, cutting them open. And you know, they didn't have particularly good ways of preserving them, so it was a pretty nasty business. And he was -- his sense of smell is very tuned to the smell of a corpse. So he figured, "Well, if I can get these cadaver particles off my hands, maybe then I will be safe as a doctor to go deliver babies." And so he did try things out. You know, he tried out different ways of disinfecting his hands, and he would just sort of basically smell his hands. And then if the odor of death after an autopsy went away, he'd be like, "Okay, this is good.” He settled on basically bleach.

JAD: He would take some bleach and some water and create a solution. It wasn’t a whole lot of bleach. Not enough to burn your skin but it was enough to burn off that stench and to take care of those cadaver particles.

CARL ZIMMER: And so Semmelweis by now was in charge of a lot of the births that were happening at Vienna General Hospital. And he just said, "Okay, new rule, folks. After you do your autopsy and before you deliver a baby, I've got this bowl here. Wash your hands. Disinfect your hands."

[MUSIC IN]

JAD: And what happened? 

CARL ZIMMER: He kept track. And he basically, like, brought the death rate to -- pretty much to zero. I mean, he couldn't completely eliminate it, but he got pretty close. There were some months where like no women died at all. None.

JAD: And it is here that Ignaz Semmelweis reaches his disinfected hands into the present because all those PSAs we’re hearing these days about washing your hands, they really begin in this moment with a Hungarian guy realizing that hand washing -- the simple act of rubbing your hands together with some soap, or bleach -- would be the key to the 2,000 year old mystery of puerperal fever. If only he could have lived to see Carl’s tweet. Or seen Steph Curry and LeBron James urge their millions of followers to wash hands but alas, he could not. He was stuck in his own time. And beyond his clinic, the idea didn’t really catch on. 

NANCY TOMES: Poor Ignaz Semmelweis. Oh, oh, what a sad story.

JAD: There is a final tragic chapter to this tale.  And this one can be told many different ways.

NANCY TOMES: Yep. Very complicated and a lot of pretty intense controversy...

JAD: Nancy Tomes says Semmelweis’ end is something historians still argue about, sometimes quite fiercely and version of events is that classic, very familiar science history where you’ve got a guy who saw something, had an insight, but then the dogma pushes back.  

NANCY TOMES:  Absolutely. It's the Galileo narrative. Yes.

JAD: Along those lines, we know that after his big breakthrough, and he collected all kinds of data, he was very scientific in many respects, we know Ignaz Semmelweis began writing letters.

DANIEL MORIGUCHI: He starts writing to everyone in Europe. He says, "I figured this out. You need to institute hand washing and you need to accept my theory." 

JAD: As I mentioned, there were doctors that believed him. The younger doctors mostly...

CARL ZIMMER: However, they weren't running the hospitals, they weren't running the medical schools. And so the older generation pushed back really hard.

JAD: Pushed back how? Like, “don’t tell me what to do young person” kind of thing?

CARL ZIMMER: Well, imagine -- imagine that you are one of the most respected doctors in obstetrics like in the world. and you've delivered thousands and thousands of babies. You know what you're doing. And then a 28-year-old, who has barely gotten started in the field of medicine, says you are responsible for the death of countless women because of these, you know, mysterious things called cadaver particles. It was ridiculous.

NANCY TOMES: And then to imply that an educated upper class Viennese physician could have been -- had -- so dirty that they were transmitting this terrible infection, I think that is definitely an element, at a more subterranean personal level, “Don’t tell me I’m dirty.”

JAD: Nancy says part of it was that the older doctors were offended, “Are you calling me filthy?” 

CARL ZIMMER: You know and Semmelweis was, you know, was not very, not terribly diplomatic...

JAD: He would reply to these doctors, “No I’m not calling you filthy, I’m calling you a murderer.” 

CARL ZIMMER: Just being really blunt about it. He, you know, he would write letters to doctors and just say like, "You, sir, you are, been a partner in a massacre." 

DANIEL MORIGUCHI: And he starts writing more and more bitter letters, and thinks that everyone who disagrees with him must be an evil person.

CARL ZIMMER: You get the idea that this may have turned from that, you know, jovial, popular guy to kind of a monomaniac. 

JAD: And this gets us to the second version of events, that the reason Ignaz Semmelweis big breakthrough didn’t breakthrough, at least not in his lifetime, is that it’s as much his own fault as anyone else’s. Sometimes historians tell his story as an example of what not to do in terms of communicating science. He railed against his colleagues. Called them names

CARL ZIMMER: Certainly not a great way to win a lot of friends..

JAD: And some of them, according to Daniel Morguch, had legitimate scientific questions. Like, “Okay let’s wash hands. Fine. But can you explain to us why washing hands works? And why every so often, it doesn’t?”  

DANIEL MORIGUCHI: First of all there is the issue that certain mothers still die after the institution of hand washing.

JAD: Hmm.

DANIEL MORIGUCHI: Not all cases of childbirth fever disappear as a result...

JAD: Physicians wanted to know, could he explain that? Isn’t it possible that there’s more than one cause here? What are these cadaver particles? Has he ever seen them? With a microscope? If they really are these contaminating agents, shouldn’t the babies get sick as much if not more than the mothers? And that’s not happening and we don’t know why. Semmelweis just didn’t have the patience to deal with these questions.

CARL ZIMMER: And, the problem was that he -- in the early 1860s, he seems to go into a rapid decline. You can see pictures of him, you know this is a man in his early forties, and the pictures just show this man starts to look like he's in his sixties or seventies. He -- something terrible was happening. And he -- his personality changed in all sorts of ways. He was already, could be a pretty irascible person, but he just started acting very strangely. 

 

JAD: At a meeting where he was supposed to give a report, he would just start reading a random piece of paper, completely confused. 

CARL ZIMMER: He was married and had a family but he just started like living openly with a prostitute. Something had gone terribly wrong. And so eventually his family decided they had to bring him to an asylum in Vienna.

 

JAD: He was 47.

 

NANCY TOMES: That's a pretty startling mental decline.

 

JAD: The cause of that decline, again, is something historians debate. 

 

CARL ZIMMER: People have speculated on it. There had been some theories that it was syphilis. 

 

NANCY TOMES: Certainly, syphilis just basically eventually turns your brain into mush.

 

CARL ZIMMER: More recently someone thought it was Alzheimer's disease, you know, very early onset. 

 

NANCY TOMES: It looked very much like Alzheimer's.

 

CARL ZIMMER: In any case, he was institutionalized, but he didn't last more than two weeks.

 

JAD: Oh wow. He died -- he died in that institution?

 

CARL ZIMMER: Yeah. So it seem -- it seems that what happened was that he was getting just uncontrollable and kind of violent by the time he was institutionalized. And, you know, this was a pretty dark time for people with mental illness. So the guards of the asylum basically just beat him to death. I mean, they beat him badly, and then he probably developed an infection in some of those wounds and that did him in.

 

JAD: Ah, that’s kind of a sad irony.

 

CARL ZIMMER: It is ironic, yeah, that he probably died of an infectious disease himself, a very rapid, devastating infection.

 

[MUSIC IN]

 

JAD: Let me tell you what I take away from this story. This is maybe a third way to see it. That here was a moment where we, not just Semmelweis, all of us, were trapped in a middle space. A kind of tragic gap. We had learned a thing, but it wasn’t enough. Semmelweis knew something was making these women sick, he called that something cadaver particles. Didn't use the word bacteria because he didn't know about bacteria.  Only a couple years later, Louis Pasteur would come along and say, “Bacteria! That’s what those cadaver particles really were,” and he would offer a comprehensive new idea called germ theory that would change everything. Semmelweis was unfortunately the moment before that. In many ways, we’re in that moment too, now. We know the enemy, we know it’s shape, we can draw pictures of it. We track it’s mutation rate. 

But we can’t tell you why it attacks some people so harshly and others barely. We certainly don’t know know how cure it. We just don’t know enough, yet. But we do know one thing. And it’s the same thing Ignaz Semmelweis taught us back in 1847.

CARL ZIMMER: Your hands are limousines for pathogens. You deliver them to their next home. The virus that causes COVID-19 is coronavirus. It's got a membrane around it that's kind of oily. And it breaks up in soap.

JAD: Hmm.

CARL ZIMMER:  So all you need to do is soap your hands for a good 20 seconds. Sing Happy Birthday twice. Soap, soap, soap, soap, soap. Then rinse it off well and dry it off well. And you haven't just rubbed off viruses, you have actually split open coronaviruses. They can't harm you, they can't harm anybody.

JAD: That's very satisfying, the way you just described that.Washing hands then becomes a kind of an act of war.

 

CARL ZIMMER:  Yeah.

 

JAD: Next time you wash your hands, think about that. That this mundane act was fought for and died for. That there are hundreds of years of life and death and ignorance and knowledge all right there, co-mingling with the soap and water.

 

[WATER] [HAND WASHING] 

[MUSIC IN]

 

CHILD: Kill the germs! Kill the germs! Kill the germs! Kill the germs! Kill the germs! Kill the germs! Kill the germs! Kill the germs!...

 

[ARCHIVAL CLIP: Soap has a special way of cutting the oil. It breaks the oil up into tiny drops and surrounds it…]

 

[ARCHIVAL CLIP: Wash your hand Roger. Wash your hands Roger...]

 

[ARCHIVAL CLIP:  Soap lather permits water to penetrate the skin pores and wash away dirt and other foreign matter…]

 

[ARCHIVAL CLIP:  Lavish Promise gets them clean with one more…]

 

[ARCHIVAL CLIP: Did you ever think how fun it is just to be alive when you feel healthy and well?...]

 

[ARCHIVAL CLIP: So if I just wash my hands I can protect myself?...]

 

[ARCHIVAL CLIP: Hands clean the first time…]

 

[ARCHIVAL CLIP:  Wash your hands.]

 

[ARCHIVAL CLIP: Wash…]

 

[ARCHIVAL CLIP: Wait a minute. I think you should wash your hands...]

 

[ARCHIVAL CLIP: That’s it! That’s it! Ahh!...]

 

[ARCHIVAL CLIP: Wash your hands like your life depends on it...]

 

[ARCHIVAL CLIP: Lava, lava las manos…]

 

[ARCHIVAL CLIP: This just in: wash your hands! I heard it from my parents. Jimmy, did you watch your hands?...”

 

[ARCHIVAL CLIP: Oh well. Someday Billy you’ll find out why people wash with soap…]

 

JAD: Big thanks to Carl Zimmer for spending so much time on the phone with me the past few days and a hat tip to the late Sherman Newland, who wrote a biography of Ignaz Semmelweis, a great biography called A Doctor’s Plague. A lot of the information in this segment was taken from that book. This story was produced with Bethel Habte and Latif Nasser. I am Jad Abumrad. Thank you for washing. 

 

LANA: This is Lana Toll, washing her hands in Overland Park, Kansas. Radiolab is created by Jad Abumrad with Robert Krulwich and produced by Soren Wheeler. Dylan Keefe is our director of sound design. Suzie Lechtenberg is our executive producer. Our staff includes Simon Adler, Becca Bressler, Rachael Cusick, David Gebel, Bethel Habte, Tracy Hunte, Matt Kielty, Annie McEwen, Latif Nasser, Sarah Quari, Arianne Wack, Pat Walters and Molly Webster. With help from Shima Oliaee with Harry Fortuna, Susan Sandbach, Melissa O’Donnell, Tad Davis and Russel Gragg. Our fact checker is Michelle Harris. 

 

 

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