1 00:00:01,920 --> 00:00:06,560 Speaker 1: Welcome to Brainstuff, a production of I Heart Radio, Hey, 2 00:00:06,600 --> 00:00:10,680 Speaker 1: brain Stuff, Lauren Volga bam here. Even when there isn't 3 00:00:10,680 --> 00:00:13,319 Speaker 1: a pandemic on we all know we're supposed to wash 4 00:00:13,360 --> 00:00:16,560 Speaker 1: our hands, especially before we eat or after we've touched 5 00:00:16,680 --> 00:00:20,800 Speaker 1: something gross. But that wasn't always the case. As recently 6 00:00:20,880 --> 00:00:23,639 Speaker 1: as the eighteen hundreds, a doctor was mocked for even 7 00:00:23,720 --> 00:00:27,000 Speaker 1: suggesting that physicians wash their hands before working with patients. 8 00:00:27,560 --> 00:00:31,000 Speaker 1: And that, dear listener, is how we begin the strange 9 00:00:31,040 --> 00:00:34,960 Speaker 1: and sad story of Ignatz Smilvis, a nineteenth century doctor 10 00:00:35,120 --> 00:00:39,720 Speaker 1: sometimes called the father of infection control some of weis 11 00:00:39,840 --> 00:00:43,400 Speaker 1: was born in Hungary in eighteen eighteen, and after graduating 12 00:00:43,400 --> 00:00:46,160 Speaker 1: from medical school, he started a job at Vienna General 13 00:00:46,200 --> 00:00:49,880 Speaker 1: Hospital in Austria in eighteen forty six. There he became 14 00:00:49,920 --> 00:00:52,279 Speaker 1: a ghast at the mortality rate of new mothers in 15 00:00:52,280 --> 00:00:55,440 Speaker 1: one of the hospital's wards. In this ward, up to 16 00:00:55,560 --> 00:00:58,280 Speaker 1: eighteen percent of new mothers were dying from what was 17 00:00:58,360 --> 00:01:02,240 Speaker 1: then called child bed fever or pure pearl fever. We 18 00:01:02,360 --> 00:01:04,680 Speaker 1: know today that this is a fever caused by infection 19 00:01:04,720 --> 00:01:08,600 Speaker 1: of the reproductive or urinary tract in new mothers. Yet 20 00:01:08,720 --> 00:01:12,000 Speaker 1: in another of the hospital's wards, where midwives instead of doctors, 21 00:01:12,040 --> 00:01:14,760 Speaker 1: delivered all of the babies. Only about two percent of 22 00:01:14,800 --> 00:01:20,080 Speaker 1: mothers died of this then mysterious fever. Zemolweiss began reasoning 23 00:01:20,120 --> 00:01:22,600 Speaker 1: his way to the root of the problem. He considered 24 00:01:22,640 --> 00:01:26,880 Speaker 1: climate and crowding, but eventually ruled those factors out. In 25 00:01:26,920 --> 00:01:29,839 Speaker 1: the end, the midwives themselves seemed to be the only 26 00:01:29,920 --> 00:01:34,880 Speaker 1: real difference between the two wards. Then Zemovieis had an epiphany. 27 00:01:35,120 --> 00:01:38,520 Speaker 1: One of the hospital's doctors, a pathologist, accidentally nicked himself 28 00:01:38,520 --> 00:01:40,959 Speaker 1: with a scalpel that he had used during an autopsy 29 00:01:41,080 --> 00:01:44,399 Speaker 1: of one of these unfortunate mothers. The doctor was sickened 30 00:01:44,400 --> 00:01:48,640 Speaker 1: with childbed fever, and he died. Zemoweis made the connection 31 00:01:48,720 --> 00:01:51,760 Speaker 1: that doctors were performing autopsies on patients who had died 32 00:01:51,760 --> 00:01:55,480 Speaker 1: of childbed fever and then immediately afterward going to deliver 33 00:01:55,560 --> 00:01:59,240 Speaker 1: babies without stopping to wash their hands. He suspected that 34 00:01:59,280 --> 00:02:02,400 Speaker 1: this was the sore of the deadly problem. But we 35 00:02:02,480 --> 00:02:06,040 Speaker 1: spoke via email with Dana Tolozievski, a philosophy professor at 36 00:02:06,080 --> 00:02:09,160 Speaker 1: Purdue University whose name I hope I am pronouncing correctly. 37 00:02:09,919 --> 00:02:13,359 Speaker 1: She explained basically his hypothesis here was that it was 38 00:02:13,440 --> 00:02:17,000 Speaker 1: cadaveric matter from the scalpel that entered the pathologist's blood 39 00:02:17,040 --> 00:02:20,160 Speaker 1: and caused the infection, and that same material could be 40 00:02:20,200 --> 00:02:22,519 Speaker 1: transferred to the women on the hands of the doctors, 41 00:02:22,919 --> 00:02:25,680 Speaker 1: because the doctors would do autopsies and then go straight 42 00:02:25,720 --> 00:02:27,959 Speaker 1: to examine the women who had given birth without washing 43 00:02:28,000 --> 00:02:31,480 Speaker 1: their hands, changing their clothes, or basically taking any hygienic 44 00:02:31,520 --> 00:02:35,280 Speaker 1: measures at all. He then tested this hypothesis by requiring 45 00:02:35,320 --> 00:02:38,120 Speaker 1: people who had performed autopsies to wash their hands with 46 00:02:38,240 --> 00:02:41,920 Speaker 1: chloride of lime, a disinfectant, before attending the women, and 47 00:02:42,200 --> 00:02:45,360 Speaker 1: after this the mortality rate in the first clinic fell 48 00:02:45,440 --> 00:02:49,440 Speaker 1: to that of the second. You'd think that Simulweis's fellow 49 00:02:49,480 --> 00:02:52,840 Speaker 1: doctors would have lauded him for this discovery, but you'd 50 00:02:52,840 --> 00:02:56,600 Speaker 1: be wrong. You see, in the eighteen forties, germ theory 51 00:02:56,680 --> 00:02:59,880 Speaker 1: hadn't been conceived yet. That's the theory that diseases are 52 00:03:00,000 --> 00:03:03,560 Speaker 1: caused by organisms not visible to the naked eye. People 53 00:03:03,639 --> 00:03:06,840 Speaker 1: still suspected that diseases transferred from one person to another 54 00:03:07,040 --> 00:03:11,560 Speaker 1: via toxic odors, not bacteria or viruses. This was called 55 00:03:11,680 --> 00:03:15,480 Speaker 1: miasthma theory. In washing their hands They probably wanted to 56 00:03:15,560 --> 00:03:18,200 Speaker 1: be rid of whatever was causing a bad odor, not 57 00:03:18,280 --> 00:03:20,960 Speaker 1: to kill germs that might wreak havoc on them or 58 00:03:21,120 --> 00:03:25,840 Speaker 1: someone else. We also spoke ya email with Michael Millinson, 59 00:03:26,160 --> 00:03:30,080 Speaker 1: an adjunct professor of medicine at Northwestern University. He said 60 00:03:30,440 --> 00:03:34,320 Speaker 1: physicians of Zimbovice's time simply did not understand or believe 61 00:03:34,440 --> 00:03:37,920 Speaker 1: that something microscopic could be wreaking such havoc on their patients. 62 00:03:38,400 --> 00:03:42,040 Speaker 1: They literally believed their own eyes. Lest we feel too smug, 63 00:03:42,320 --> 00:03:44,960 Speaker 1: consider how many people currently embrace a lack of COVID 64 00:03:45,080 --> 00:03:49,200 Speaker 1: nineteen deaths among people like me geographically, racially, economically, or 65 00:03:49,280 --> 00:03:53,400 Speaker 1: otherwise as evidence that scientists are overestimating the pandemics risk. 66 00:03:54,240 --> 00:03:58,520 Speaker 1: Better handwashing regiments dramatically improved death rates at the maternity ward, 67 00:03:59,040 --> 00:04:02,440 Speaker 1: but some of vices colleagues were at best miffed at 68 00:04:02,440 --> 00:04:05,880 Speaker 1: the implication that their ignorance was killing their own patients, 69 00:04:05,920 --> 00:04:08,960 Speaker 1: and perhaps the implication that midwives were better at delivering 70 00:04:08,960 --> 00:04:12,880 Speaker 1: babies than they were. It didn't help that Zemmolwei's essentially 71 00:04:13,000 --> 00:04:15,160 Speaker 1: laid the deaths of the ward's mothers at the feet 72 00:04:15,160 --> 00:04:18,960 Speaker 1: of his superiors. His own supervisor countered that the hospital's 73 00:04:19,040 --> 00:04:21,720 Speaker 1: new ventilation system must be the reason for the decline 74 00:04:21,760 --> 00:04:26,920 Speaker 1: in maternity deaths. Also, Zemmoweiss was a Hungarian in Austria, 75 00:04:27,279 --> 00:04:30,360 Speaker 1: a foreigner working in a country in the throes of xenophobia. 76 00:04:32,040 --> 00:04:36,200 Speaker 1: So those doctors rejected his theories and Smovie's himself as 77 00:04:36,320 --> 00:04:40,080 Speaker 1: being inferior. They opted to stick with their miasma theory, 78 00:04:40,279 --> 00:04:42,839 Speaker 1: and for good measure, in eighteen forty nine did not 79 00:04:43,080 --> 00:04:48,640 Speaker 1: renew Zemmelweis's appointment. Zemoviis eventually got a medical position in Budapest, 80 00:04:48,720 --> 00:04:52,280 Speaker 1: where he, according to the British Medical Journal Quote, publicly 81 00:04:52,360 --> 00:04:56,479 Speaker 1: harangued doctors and nurses about handwashing and reduced paternal mortality. 82 00:04:58,400 --> 00:05:00,920 Speaker 1: He eventually published a book on this object some fourteen 83 00:05:00,960 --> 00:05:04,400 Speaker 1: years later, but it was poorly written and poorly received. 84 00:05:05,560 --> 00:05:09,200 Speaker 1: Possibly experiencing a mental disorder or extreme stress from his 85 00:05:09,240 --> 00:05:12,800 Speaker 1: rejection by the medical establishment, Zemmoweis ended up a patient 86 00:05:12,880 --> 00:05:16,440 Speaker 1: in an asylum in eighteen sixty five. Weeks later, he 87 00:05:16,560 --> 00:05:18,400 Speaker 1: was dead of an infection from a wound that he 88 00:05:18,440 --> 00:05:21,559 Speaker 1: received in the facility. He was just forty seven years old. 89 00:05:23,160 --> 00:05:26,840 Speaker 1: Zemoweiss left behind a monumental legacy, but the tragedy of 90 00:05:26,839 --> 00:05:30,160 Speaker 1: his story has made it garner a few myths, one 91 00:05:30,200 --> 00:05:33,000 Speaker 1: of those being that Zemmoweiss was the first to suggest 92 00:05:33,000 --> 00:05:38,359 Speaker 1: a theory about doctors transmitting germs. Galiziaski said he wasn't 93 00:05:38,440 --> 00:05:42,200 Speaker 1: really a pioneer. Other people before Zemalweiss had hit upon 94 00:05:42,240 --> 00:05:45,000 Speaker 1: the idea that child bed fever could be transmitted from 95 00:05:45,080 --> 00:05:49,200 Speaker 1: doctor or midwife to patient. For example, Alexander Gordon of 96 00:05:49,240 --> 00:05:53,600 Speaker 1: Aberdeen showed in sevent that childhood fever was almost always 97 00:05:53,600 --> 00:05:56,480 Speaker 1: transmitted by doctors or midwives, and also that it was 98 00:05:56,520 --> 00:05:58,880 Speaker 1: connected to a kind of strupp, a cockle skin rash. 99 00:05:59,520 --> 00:06:02,200 Speaker 1: He so thought that the best treatment was copious bleeding. 100 00:06:03,040 --> 00:06:06,240 Speaker 1: In the States, famously, there was Oliver Wendell Holmes, who 101 00:06:06,279 --> 00:06:08,320 Speaker 1: was a physician but is now much better known as 102 00:06:08,360 --> 00:06:11,039 Speaker 1: a poet, who wrote a very elegant essay called the 103 00:06:11,040 --> 00:06:14,880 Speaker 1: Contagiousness a Pureborough Fever in eighteen forty three, a year 104 00:06:14,920 --> 00:06:19,800 Speaker 1: before Zemowis even completed his m d. Another misunderstanding is 105 00:06:19,839 --> 00:06:24,160 Speaker 1: that doctors of his time outright rejected Zemoviss's ideas about handwashing. 106 00:06:24,560 --> 00:06:28,839 Speaker 1: They didn't entirely, They just attributed coming down childbed fever 107 00:06:28,960 --> 00:06:32,600 Speaker 1: to a range of variables such as predisposition, environment, and 108 00:06:32,720 --> 00:06:38,200 Speaker 1: many other factors. To Liziski said, because people already had 109 00:06:38,240 --> 00:06:41,960 Speaker 1: such a long list, adding cadaverick or decomposing animal matter 110 00:06:42,240 --> 00:06:45,520 Speaker 1: really wasn't a big deal to them, and lots of people, 111 00:06:45,680 --> 00:06:48,320 Speaker 1: some of them pretty big shots, did add this to 112 00:06:48,360 --> 00:06:51,880 Speaker 1: their list and started disinfecting their hands, so it's just 113 00:06:51,960 --> 00:06:56,440 Speaker 1: not true that that part was universally rejected. Later in 114 00:06:56,480 --> 00:06:59,440 Speaker 1: the eighteen sixties, Louis Pasteur started working on what would 115 00:06:59,440 --> 00:07:04,680 Speaker 1: eventually become the theoretical explanation behind Zimbilvice's observations, and in 116 00:07:04,720 --> 00:07:08,000 Speaker 1: the eighties, thanks to the pioneering work of Joseph Lister 117 00:07:08,080 --> 00:07:11,920 Speaker 1: and others, people started using antiseptic techniques in surgical and 118 00:07:12,040 --> 00:07:15,400 Speaker 1: maternity wards, which is when mortality rates from child bed 119 00:07:15,440 --> 00:07:18,720 Speaker 1: fever really began to fall, along with many other inhospital 120 00:07:18,800 --> 00:07:23,680 Speaker 1: mortality rates. But even after scientists realized that Zimilvis had 121 00:07:23,680 --> 00:07:27,040 Speaker 1: been right all along about hand washing, this simple act 122 00:07:27,160 --> 00:07:31,560 Speaker 1: still remains a challenge throughout society. That's partially because even 123 00:07:31,600 --> 00:07:34,520 Speaker 1: though we now know that germs are there, we human 124 00:07:34,560 --> 00:07:37,840 Speaker 1: beings still sometimes trust what we see and discount what 125 00:07:37,880 --> 00:07:42,680 Speaker 1: we can't. A January poll found fort of Americans don't 126 00:07:42,720 --> 00:07:45,600 Speaker 1: always wash their hands after going to the bathroom, Even 127 00:07:45,640 --> 00:07:48,960 Speaker 1: doctors and nurses may rationalize their own behavior has nothing 128 00:07:49,000 --> 00:07:53,680 Speaker 1: to do with spreading disease. Millinson said, patients get infections 129 00:07:53,720 --> 00:07:56,360 Speaker 1: for many reasons. They come into contact with many people 130 00:07:56,400 --> 00:08:00,480 Speaker 1: and many objects, and have compromised immune systems, and by definition, 131 00:08:00,640 --> 00:08:03,080 Speaker 1: those who forget to wash or don't do it properly 132 00:08:03,320 --> 00:08:08,160 Speaker 1: don't know that they forgot or were ineffective. Millinsen points 133 00:08:08,160 --> 00:08:11,120 Speaker 1: out that there is still no requirement that hospitals reach 134 00:08:11,160 --> 00:08:14,400 Speaker 1: a certain threshold on hand hygiene, only that they have 135 00:08:14,440 --> 00:08:18,320 Speaker 1: a program in place to improve it. He said, almost 136 00:08:18,360 --> 00:08:21,720 Speaker 1: as bad, the US Centers for Disease Control doesn't monitor 137 00:08:21,800 --> 00:08:25,080 Speaker 1: a national hand hygiene rate in hospitals, which often hovers 138 00:08:25,120 --> 00:08:28,560 Speaker 1: in the ten to forty percent range. On average, US 139 00:08:28,600 --> 00:08:31,559 Speaker 1: healthcare providers clean their hands less than half the times 140 00:08:31,560 --> 00:08:34,120 Speaker 1: that they should, according to the most recent CDC study, 141 00:08:34,200 --> 00:08:38,400 Speaker 1: which was eighteen years ago. It's too soon to have 142 00:08:38,520 --> 00:08:41,679 Speaker 1: numbers on how the COVID nineteen pandemic has affected hand 143 00:08:41,760 --> 00:08:45,720 Speaker 1: hygiene in hospitals, though anecdotal evidence suggests it's put healthcare 144 00:08:45,720 --> 00:08:49,880 Speaker 1: providers on high alert during this time, semovices even seeing 145 00:08:49,880 --> 00:08:52,480 Speaker 1: a resurgence in pop culture. He was honored with a 146 00:08:52,520 --> 00:08:55,840 Speaker 1: Google doodle in March, and an opera about him, which 147 00:08:55,840 --> 00:09:01,840 Speaker 1: premiered Ineen, was live streamed in May. Finally, there's this 148 00:09:02,000 --> 00:09:06,040 Speaker 1: bright spot, Millinson equipped I like to tell provider audiences 149 00:09:06,160 --> 00:09:08,760 Speaker 1: the good news is that we've made significant progress since 150 00:09:08,800 --> 00:09:11,880 Speaker 1: Samuel Vis's time. We no longer put people who insist 151 00:09:11,920 --> 00:09:20,160 Speaker 1: on doctors washing their hands into an insane asylum. Today's 152 00:09:20,160 --> 00:09:22,840 Speaker 1: episode was written by Nathan Chandler and produced by Tyler Clang. 153 00:09:23,040 --> 00:09:24,719 Speaker 1: For more on this and lots of other topics, visit 154 00:09:24,720 --> 00:09:27,200 Speaker 1: how stuff works dot com. Brain Stuff is production of 155 00:09:27,240 --> 00:09:29,760 Speaker 1: iHeart Radio. For more podcasts in my heart Radio, visit 156 00:09:29,800 --> 00:09:32,520 Speaker 1: the iHeart Radio app, Apple Podcasts, or wherever you listen 157 00:09:32,559 --> 00:09:33,480 Speaker 1: to your favorite shows.