Sunday, April 5, 2015

Antibiotics' Patients Zero, part 2

In the end, finding out about the Patient Zero I knew the least about, Aaron Alston, turned out to be by far the easiest.

But first I had to make all sorts of naive mistakes.

I knew that if an acute case of Rheumatic Fever attacks a young child's heart, they can quickly die, without prompt and appropriate medical intervention.

But if they don't die, most of the attacked heart tissue will more or less heal - unless the area attacked is the very delicate and extremely vital heart valves.

You can literally hear damaged heart valves.

Many people have harmless heart murmurs but these particular stethoscope sounds tell a doctor that the valves are damaged and the entire heart is straining in overtime, to pump blood through these only partially closed/open doors.

So doctors will then strongly advise the parents to not tax this particular child's heart.

So no strenuous sports - later on, no vigorous dancing, no passionate sex acts, pregnancies are very dangerous, chasing after toddlers is too stressful, etc.

While my brother Bruce had childhood Rheumatic Fever and was left with a heart murmur and damaged valves, ironically enough he was the only athletic member of our extended family !

Though small, he was eager to try out for high school football and was a city level long distance running champion.

So you'd think I would have known better about Rheumatic Heart Disease (RHD) and young athletes.

In my defence, I had just assumed that the heart valves of Rheumatic Fever patients who go on to develop life-ending subacute bacterial endocarditis (SBE) were far more damaged than most RHD patients - so obviously far less capable of championship level athletics.

But this simply isn't so - SBE, like cancer, has a pronounced stochastic (for PhDs) or random (for ordinary folk) nature to it : sheer bad luck as well as bad valves plays a part.

Dawson treated patients who got SBE fifty or more years after their childhood heart valves were first damaged and some who got SBE only a year or two after first getting Rheumatic Fever.

But most patients get SBE ten or twenty years after their valves are first attacked.

Still, when I did find an Aaron Alston finishing in the top level in NYC wide races in 1930, ten years before my Aaron Alston first got SBE, I dismissed that it might be him.

I also got search results for A. Alston too : an A. Leroy Alston also winning athletic events.

I just felt I had got nowhere with Alston - the lack of his birthdate was so crippling.

As I described in an earlier blog, knowing first and last name, residence in greater NYC area in 1940, and birthdate, usually means that 140 million possible American patients is reduced down to one or two.

Without a birthdate, it goes up to at least a hundred possible names.

But in 2014, I suddenly realized I probably did have a death date on him as well.

For his brief medical history made it clear he was going to get all the penicillin Dr Dawson's team had (they were making themselves) but suddenly all the penicillin was switched to another patient.

Alston had obviously died, died in mid January 1941, and almost certainly while undergoing treatment in Dawson's hospital, ie in the borough of Manhattan.

Now a search for an index of NYC death certificates seemed easier.

Well, thanks to many tireless volunteers, it certainly was.

I din't really need a specific borough or specific day or month - a volunteer-run online death index for NYC in the first half of the twentith century, didn't show tons of deceased Aaron Alstons in all of 1941 in all boroughs - just him !

With his death certificate number in hand and because he had died before 1948, I a white stranger from Canada could order up the death certificate of someone who was probably a black man from Harlem.

When the certificate copy arrived, it wasn't as detailed as many death certificates I had seen - but his mother's maiden last name Glaze was one I had never seen - rare maybe enough to find her on on Google Search ?

I kept typing in Louise Glaze Harlem or variations thereof and presto one evening, a website came up of her nephew talking about her - i had found one of Aaron's living cousins !

I phoned him (Claude Jay of Harlem My Love) and first I astounded him and then he astounded me --- because he knew of Aaron as Leroy - or more formally as A. Leroy Alston.

He said he was a big athlete.

A person who used his middle name and not his first name - well who would have thought ?!

Well, my wife's huge family has many who do just that - and Dr Martin Henry Dawson was alway Henry - from birth.

Armed with this unexpected information, I soon found tons of material on Aaron Leroy Alston - some in his own voice.

And Claude made it clear Aaron had hundreds of living relatives all over the US.

I astounded Claude again - discovering Aaron Leroy wasn't widowed as his mom said on the death certificate - Claude thought he was always single.

Instead Leroy and Charlotte Lee had been married in the good times of 1930 but the couple were living back with their separate mothers in 1940 when Leroy was too sick to provide an income.

(Both families, once doing okay, were unbelievably poor in 1940 thanks to the Great Depression, racism and early deaths/severe illness of breadwinners.)

I gave all my information to Claude and tried not to research too much further.

I don't feel, as a white Canadian, that I should tell the story of a black man from Harlem - Claude is a relative, journalist, activist and author - he'll tell the full story well I am sure.

Now I turned my hand to another named SBE patient of Dawson - known only as Mr Conant.

(I came to assume that the highly unusual use of that word Mr meant he probably wasn't a young black or Jewish charity case but that he was a private patient, middle class,middle aged and white, from outside NYC)and treated in January 1941.

I searched for a middle aged dead Mr Conant, Manhattan, early 1941, in the NYC death index and up came George M Conant.

Google gave me him in spades - his small town daily describing his SBE illness and his treatment at Columbia Presbyterian at the right dates.

I found Dawson's death certificate and that of little Patty Malone as well - but no Charles Aronson.

That was because he had survived into 1949 at least and NYC death certificates after that date were hard to locate and even harder to gain a legal right to access...

Now read Antibiotics' Patients zero, part 3

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