THINKER'S ALMANAC - May 15

What one simple act introduced in 1847 reduced the mortality rate in a maternity ward from 20% to 1%?

Subject:  Status Quo Bias - Hand Washing

Event:  Ignaz Semmelweis introduces hygiene practices, 1847

All too often, what matters is not whether an idea is true or effective, but whether it fits with the preconceptions of a dominant cabal. -Rory Sutherland

In 1846, Dr. Ignaz Semmelweis became consumed by a problem.  Working as an obstetrician at Vienna General Hospital, he was troubled by the large number of mothers who died in his hospital after giving birth.  This was not a new problem; dating back to the 5th century, the father of medicine, Hippocrates, had described the ailment that inflicted mothers, known as puerperal fever.

One clue to a solution appeared when Semmelweis compared statistics in his hospital's two birthing wards.  One ward, attended by doctors, had a mortality rate of 20% while the other, attended by midwives, had a mortality rate of just 2%.

                                                                            Image by Kai from Pixabay 

Why, Semmelweis wondered, would the women who were attended by some of the finest doctors in the world, be more likely to die than those attended by midwives?

The answer came to Semmelweis after an unfortunate accident.  One day, one of Semmelweis’ mentors, Dr. Jacob Kolletschka was assisting one of his medical students in the dissection of a cadaver.  As the student wielded his scalpel, he accidentally nicked Kolletschka.  The cut drew blood, but did not appear serious at the time.  A few days later, however, Dr. Kolletschka died.  While Semmelweis mourned the death of his mentor, he also noticed that Kolletschka died of a fever that was eerily similar to the puerperal fever that had taken the lives of so many of the new mothers in the maternity wards attended by doctors.

Semmelweis realized at this point that doctors, including himself, would routinely do dissections and autopsies of human cadavers prior to working in the maternity ward.  Could it be, he wondered, that the hands of doctors carried cadaver particles that infected the mothers?

To test his hypothesis, Semmelweis instituted handwashing, instructing all doctors arriving from the dissecting room to wash their hands with hot water before entering the maternity ward.  On May 15, 1847, Semmelweis began this new hygiene regimen, and the results were remarkable:  the mortality rate for mothers dropped to 1.33 percent.

Despite having concrete evidence to support handwashing, Semmelweis’ procedure was not embraced by the medical establishment.  Semmelweis was just 28-years-old, and many older doctors resented being told that rather than healing their patients, they were killing them with their own unclean hands.

Through lectures and letters, he continued to attempt to persuade doctors that his discoveries were sound and that they would save lives, but he was mostly ignored and eventually ostracised.  Tragically, Semmelweis began drinking and suffered a nervous breakdown that resulted in his confinement in a Vienna insane asylum.  It was there that he died, ironically, of an infected wound on his right hand on August 13, 1865. He was just 47 years old (1).

It was only a few years later that Louis Pasteur’s germ theory would vindicate Semmelweis, identifying his cadaver particles as bacteria.

Semmelweis’s story is a powerful reminder of the status quo bias.  Old habits and dogma die hard, and although we think that an idea that is both true and effective will be adopted and accepted, this is not always the case.

Recall, Retrieve, Recite, Ruminate, Reflect, Reason:  What is the Status Quo Bias? How does Semmelweis’ story illustrate the power of the status quo bias?

Challenge - Ignaz Semmelweis Day:  In 2020, science writer Carl Zimmer recognized the contributions to medical science made by Semmelweis. Zimmer wrote the following Tweet:  “Every day is Ignaz Semmelweis day.”  Who would you argue is a person no longer living who should be remembered and honored for their contributions to making our lives better through science?

ALSO ON THIS DAY:

May 15, 1970:  On this day The Beatles released their last album, Let It Be.

Sources:

1-RadioLab. Dispatch 2: Every Day is Ignaz Semmelweis Day.  NPR.ogr 1 April 2020.