Overcoming Fear of the New and the Semmelweis Reflex

semmel

A false enchantment can all too easily last a lifetime.    – W.H. Auden

 

Once upon a time there was a Hungarian doctor in Vienna. He noticed that when he washed his hands between patients, more women survived childbirth. The public called it miraculous and named him “The Savior of Mothers”. As a result, many doctors sought his advice on how to save lives. But that’s not what really happened.

The story of Dr. Ignaz Semmelweis is all true except the ending. The real story ends like this: Doctors hated and reviled him for telling them to wash their hands. The medical community insisted that disease and death were caused by Miasma, invisible foul vapors, despite 200 years of evidence of germs. Though Semmelweis drove his clinic’s mortality rate down from 18 percent to 1 percent, doctors stubbornly refused to wash their hands. They considered it demeaning to gentlemen and continued to pass on fatal infections. The cleanly doctor was committed to an insane asylum and beaten to death.

At the same time, in northern England, not far from the shadow of Hadrian’s Wall, anaestheisologist John Snow, like his Game of Thrones homonym, was justifiably suspicious of the existing power structure and went his own way. He personally chloroformed Queen Victoria to prove his theories on obstetric anaesthesia.

Snow’s greatest accomplishment was examining London’s cholera epidemic, which killed over 600 people, and tracing it back to some dirty diapers in Soho. His proof was the perfect health of drunken monks, who only swilled beer and refused to touch the public water supply. Just as with Semmelweis though, the government, medical and business communities that could have prevented the outbreak refused to accept the concept of infection because it was too gross to think about.

After a few decades, someone with more savoir-faire explained why disgusting things are bad and the life-saving techniques that these two suggested became standard operating procedure. Of course, by then it was far too late for Semmelweis and Snow and all the patients they could have saved.

Wikipedia, a reliable source for amusing and misplaced commentary, stated wryly, “It has been contended that Semmelweis could have had an even greater impact if he had managed to communicate his findings more effectively and avoid antagonising the medical establishment.” In other words, blame the victim.

The wiki-point here is salient, though. The hero of these stories, conspicuous by its absence, is marketing. The Semmelweis Reflex, the automatic and extremely common rejection of beneficial knowledge because it seems wonky, can only be counteracted by creative storytelling. In the case of germs, the concept of infectious disease at last found its champion in the story of Louis Pasteur.

Pasteur was also ridiculed for his ideas about “contaminated microbes.” A paper expressing the voice of the medical establishment sneered,

I am afraid that the experiments you quote, M. Pasteur, will turn against you. The world into which you wish to take us is really too fantastic.”

The reversal in medical reasoning came at last from a publicity stunt. In order to embarrass Pasteur publicly and expand their market reach in readership, The Veterinary Press sponsored a high profile display of fifty sheep injected with anthrax, like a 19th century reality show. 25 sheep were inoculated by Pasteur and the others were left on their own. The unprotected sheep were dead within two days, voted off the planet by microbes. No one cared about the passing of sheep but Pasteur was crowned the celebrity winner. On June 3, 1881, The Times in London ran a story by Henri de Blowitz that began like this:

A celebrated experiment

An invitation having been sent to me, I went today to Pouilly-le-Fort to see some very important experiments on the farm of M. Rossignol, a veterinary surgeon. Pouilly-le-Fort, which is a few miles from Melun, in the Department of Seine et Marne, is a large farm reached by one of the splendid roads, lined with limes and acacias, which intersect that flourishing department. Just now a harvest is expected that is called ‘electoral’, the peasants often being influenced in their votes by a good or bad harvest, voting, according as it turns out, for or against the government.

M. Pasteur, one of the scientific glories of France, made to-day experiments in connexion with his latest researches on that malady dreaded by agriculturists, called ‘charbon’, a sickness which rages more especially among sheep, the mortality of which produced by it is estimated in France at several million francs a year….

The story, with all apologies for the inevitable pun, went viral. Newspapers and magazines of the day picked up on the entertainment aspect of the piece. The causally tossed off epithet “one of the scientific glories of France” became permanently attached to the name of Pasteur and acceptance of his ideas was assured. Thus deadly infections by microscopic organisms were conquered not by evidence but good press.

The Semmelweis Reflex is one of the strongest, most basic human tendencies. It is absolutely necessary and essential to survival because it has protected our species from a relentless barrage of dodgy schemes. Extraordinary claims must require extraordinary evidence, as Carl Sagan said. However, evidence will never be enough, even it could save your life. Peripetaia, the aha moment, eurekas all require a force stronger than the reflex, and that power only resides in good stories. 

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