Can Washing Your Hands Save a Life? — The Doctor Nobody Believed

Crossing off the differences

In 1847 a young Viennese doctor, Semmelweis, started like a detective. He listed every difference between the two wards and crossed them off one by one. Delivery position? Changed it — no difference. The priest walking through ringing a bell and frightening the mothers? Stopped the bell — no difference. Weather, crowding, food — all the same.

One difference remained: the people. The doctors and students dissected corpses in the morning and came to the delivery room with the same hands. The midwives never touched a corpse.

A colleague's death

Certainty came from grief. A fellow doctor cut his hand on a student's scalpel during a dissection. Days later he died. And the way he died was exactly the way the mothers were dying.

Something passes from the corpse. Invisible, nameless, but it passes. He made the doctors wash their hands in chlorinated water before entering the ward. Deaths fell from ten in a hundred to under one.

Why nobody believed him

The numbers were plain. They were not accepted. There were two reasons.

One was pride. To say your hands killed mothers was to say a gentleman's hands were dirty. Doctors heard it as an insult. The other runs deeper: he had no reason. He said something passed, but he did not know what. Nobody had yet joined this to the swimming things the merchant saw in piece 1.

He was pushed out of the hospital. He fought by letter, by book, and at last by anger. He died in an asylum at forty-seven. The year he died, mothers across Europe were still dying from their doctors' hands.

The man who gave it a name

Twenty years later, Pasteur of piece 2 said it: what sours wine is a microbe, and what sickens people is a microbe. But this was still half an answer. There was no way to point at which microbe caused which disease. Finding a germ in a sick body does not make it the culprit. It might just be visiting.

A German country doctor, Koch, built the method. He started with a microscope his wife gave him for his birthday. He set four steps for catching the culprit: the germ must be found in every case; it must be grown on its own; the grown germ must cause the same disease in a healthy body; and the same germ must come out again.

Growing it alone was the hard part. In liquid, everything mixed. His assistant's wife suggested agar, the stuff she used to set jam. On jelly, the germs grew as separate dots, each from a single cell. That is the petri dish in every hospital today. In 1882 he caught the tuberculosis germ, at a time when one European in seven died of it.

The twenty seconds

Soap does not kill germs. It lifts them off. Germs cling to the film of oil on your skin. Soap dissolves the oil, the germs lose their grip, and running water carries them away. Water alone removes less than half; soap without running water is not enough either.

Twenty seconds is 'Happy Birthday' sung twice. Palms, backs, between the fingers, thumbs, under the nails. Doctors learned it, and now so do we. It was all Semmelweis ever asked.

A little further in

And so hospitals changed

With Koch's method the germs of cholera, diphtheria and plague were caught one after another. In Britain, Lister sprayed antiseptic on instruments and wounds and halved the deaths after surgery. Gloves, masks, boiled tools, white coats — the modern hospital took shape within those twenty years.

But here a strange question appears. If washing saves lives and disinfecting saves more, wouldn't disinfecting your whole body all day be best? No. As the tool in piece 1 showed, tenants live on us. Evict them all and anyone can move into the empty rooms. The next piece is about those tenants — and it corrects the myth that good and bad germs are fixed for life.

The question that remainsIf numbers that plain went unbelieved for twenty years — which plain numbers are we refusing to believe now?