Friday, April 10, 2015

Bickel penicillin book vivid -- at cost in accuracy

Lennard Bickel's 1972 book, "Rise Up To Life", was the first book that covered the wartime saga of penicillin as it occurred around the entire world.

But it was also one of the first written by someone who was not an eyewitness to the actual events.

But Bickel, an Englishman who emigrated to Australia in mid life, was a very good journalist and interviewed all and everyone he could find from the wartime era and got lively quotes from all.

Unfortunately, as a journalist rather than a historian, he sometimes chose to sacrifice all the facts in order to keep things lively and vivid.

I believe that as a result, he chose to detail almost no pioneering penicillin patient -- unless they could be fully named in his account --- regardless how important they actually were in historical terms.

But even back in the more innocent era of the 1940s, peer reviewed medical articles tended to simply describe but not name patients -- or just given them unique numbers or initials.

Revealing full names was simply no indication of relative historic or scientific importance.

How this historical travesty all began :

Bickel, probably in 1971, interviewed American Gladys Hobby, who as a PhD in microbiology had personally witnessed many pioneering wartime penicillin events from late 1940 through to late 1945.

But she recalled them mostly from memory and a few personal papers.

In the early 1970s, she surely knew the birthdate, medical history and the initials (CA) for one patient from wartime's pioneering Patients Zero.

Because she had surely read - many times -  the medical article her friend and co-worker, the late Dr Martin Henry Dawson, had written in late 1944.

The Patients Zero were the first people ever in history to get injections of life saving antibiotics - doing so on October 16th 1940 from Doctor Dawson at New York's famous Columbia Presbyterian hospital.

But she had forgotten what name lay behind those initials CA.

Fatal SBE was their fate

For the first half of the 20th century, Rheumatic Fever was the leading killer of young people.

Most actually died a few years later, when their heart valves earlier damaged due to Rheumatic Fever, failed because of an attack by common and usually harmless mouth bacteria.

The dreaded SBE - then an invariably fatal form of endocarditis - was what was due to shortly kill this historic duo of patients.

Hobby remembered the other Patient Zero well enough.

Aaron Alston, a young black man from Harlem, had received quite extensive penicillin treatment from Hobby's teammates while Hobby was employed at the hospital but had still died in late January 1941, despite all her's and their best personal efforts.

Louise Good to the rescue

It wasn't till the 1980s, while writing her own book on wartime penicillin, that Hobby contacted a Columbia Presbyterian Hospital employee named Louise Good, who did have access to more detailed contemporary records.

Good revealed that CA was Charles Aronson and confirmed that Hobby was correct in believing that the other was Aaron Alston.

Charles Aronson was actually treated far more extensively with penicillin than Alston - but treated in 1944, when Hobby was then employed elsewhere.

Employed at Pfizer, which had earlier worked very closely with her and Dawson.

Still, she stayed in very close touch with Dawson's team and had certainly read the medical article describing CA's extensive second penicillin treatment.

But that wasn't the same as actually being there at his bedside, daily for months, to burn his real name permanently into her memory.

Bickel lays his thumb on the history balance

This was unfortunate, because Bickel - for reasons perhaps not altogether honourable - chose to focus only on Hobby's fully named patient, the one who died.

By not also including the patient with only initials, the one who survived his invariably fatal disease twice thanks to Dawson's penicillin, he tilted his account of Dawson's work to the side of failure.

Failure, rather than the actual facts - which was that five years of life-costing hard work by Dawson - and Dawson alone - had made an once common and then invariably fatal heart disease the most curable heart condition known.

Bickel's brief account of Alston's early death - followed by Dawson's 'early' death, became the gospel on the whole fascinating penicillin story at Columbia-Presbyterian and Pfizer to generations of writers.

I will satisfy the natural curiosity

I fully and truly understand the curiosity that drives people to inquire as to who is the real person behind mysterious initials .

That is why I have worked so hard to recover the lost story of CA - and of Alston and the handful of other patients of Dawson who were given full names names in Hobby's 1985 book, "Penicillin : Meeting the Challenge" ...

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