Monday, January 25, 2016

"Off the Grid" Penicillin

The bad things that happen when academics prefer easily obtainable secondary sources over hard-to-get primary accounts

A prolonged troll through the day to day, year by year, archival records of Washington's National Academy "Committee on Chemotherapeutic Agents" (COC) and Vannevar Bush's Office of Scientific Research & Development's "Committee for Medical Research" (CMR) is profoundly depressing.

And it leads one to sharply question the underlying - shared - thesis beneath nearly everything written on wartime penicillin to date.

It can only lead one to the conclusion that these two lead agencies did not work to speed the pace of wartime penicillin - far from it.

Instead the pair far acted more like classical peacetime 'blocking institutions' than like inspired and badly frightened wartime agencies driving strategic innovation before the enemy gets to it first.

These are only two out of three agencies controlling the worldwide fortunes of wartime penicillin - but when I examine the daily records of the third, the British Medical Research Council (MRC), I expect it to have played a much lesser role overall.

Supposedly totally oriented in wartime to military needs, the three actually worked tirelessly and deftly to keep the vast military body of expertise from getting its hands anywhere near this potentially Nobel winning new substance from November 1939 till April 1943.

If you are doing the math, that is more than half of the entire six year long course of WWII !

Equally, freelance clinical, biological and chemical researchers who sought to do anything not yet in the prescribed and rigid protocol were censored and harassed.

Yet too often their radical ideas were the true road ahead, not the blandly conventional approaches of 'science by committee' at its worst.

Dawson & SBE, Queen and military cases of Osteomylitis,Mahoney and Syphillis are all huge successes for penicillin - in fact its biggest successes.

Yet all three approaches were originally rejected by these blocking organizations and only after our three rebels 'home brewed' their own crude penicillin to prove up their cases, did the blockers step in...... and then dare to steal the credit !

If only the OSRD & Dr AN Richards had listened to (and not lied to) Milislav Demerec in 1942, the dramatic story of wartime penicillin would have lost most of its drama --- for it was Demerec's discounted innovation that largely gave us our multi-trillion dollar biotech industry that we have today.

And as for freelance industrial firms with new approaches and greater eagerness to push the production envelope, they too were discouraged at every turn - particularly, once again, by wartime penicillin's Abominable No Man (OSRD CMR chief Dr AN Richards).

And beyond discouraging individual efforts from the military aimed at using penicillin to save lives on the battlefield, these agencies also tried to ward off any other government agencies from gaining too much political credit for their own freelance efforts to advance the success of wartime penicillin.

The Royal Navy quietly and efficiently made its own homebrew penicillin in 'off the grid' remote Somerset and then had to fend off snide comments from the unhappy unholy triad of Oxford-British Army-Ministry of Supply.

You rarely learn of the Royal Navy success in any academic histories of wartime penicillin.

Equally, Vannevar Bush and the OSRD successfully got away with claiming credit for work done by other competing agencies.

For example, the USDA spent far more money on penicillin research at its NRRL Peoria site than did the OSRD - but you'd never know this if you simply trusted academic accounts about the NRRL.

And claiming credit for the truly vital work that the similiar-sounding OPRD of the WPB (War Product Board) advanced was routine for the OSRD.

I think the reason why the OSRD et al got away with their Big Lie among the academics is because there is confusion over what is a primary source, in historians' terms.

(Here the voices of my teachers, David Sutherland and Judy Fingard hover on each of my shoulders, whispering "trust only the primary primary documents".)

I learned long ago that an institutional account of itself - be it a footnoted multi-volume book or a brief informal talk before a chicken a la king service club - is only in one sense, a primary source.

It is indeed a primary source as to the deceitful PR and bumpf and propaganda that an institution puts out about itself - an untrustworthy autobiography/memoir of an institution.

It is selective, usually derives from indirect second hand experience and it is colored and controlled by strong myths that evolved after the fact.

But trolling the vast depths of an institution's archival records, gives a much better feel for the day to day reality at the time - the dross being perhaps even more valuable than the 'gotcha' nuggets.

(I say this despite being aware that often the most vital (cum later embarrassing) decisions were never recorded on paper or if they were, were removed and 'lost' after the war.)

How you can tell when a historian is lying : the lips of his missing footnote aren't moving

I didn't expect to say these sort of mean things when I started researching a small aspect of the overall wartime penicillin story (or so I thought initially.)

But too often I came upon a really big development in wartime penicillin without any footnote to its primary source (or a footnote only to an informal post-event account, again with out footnotes).

When even well known and minor events are well-footnoted to a primary source, this absence of footnoting was bound to make me suspicious.

Case in point : Major Frank B Queen.

Supposedly - as all histories of penicillin explain - a single letter from him sparked the most decisive change of all for wartime penicillin - the move to heavy American military involvement and American mass production.

Once having been and army reservist and with my extended family having about two dozen members who had careers in the regular forces, navy, air force and army from bottom ER to high level Navy Captain, I was extremely suspicious from the get go.

The COC & CMR, who had smoothly fended off requests for penicillin from well connected colonels connected to various general Staffs, were now instantly responding with full support to a civilian doctor made a temp wartime major and working in the then ultimate wilderness of Utah ?

That isn't the way any ten million strong chain of command structure ever works - in peace or in war.

And the letter from Queen to Keefer, head of the COC, was never directly quoted or footnoted.

I was unable to find it in my trolls through the archives of COC & CMR & WPB in Washington DC.

Dross a plenty was preserved but not this epoch-changing letter.

But I was fairly sure that I knew what it was about - for David Rothman's book "Strangers at the Bedside" had said, in mere passing (for his book was not part of the penicillin history industry) that Queen had written for advice in making his homebrew crude penicillin grow better.

Queen was trying to save the lives and limbs of Pacific War GIs languishing between life and death foe years, due to severe chronic osteomylitis (hard to reach infections deep inside major bones.)

The MRC, COC and CMR were all prepared - as committee science is wont to do -to refight the medical battles of WWI : gas gangrene.

But thanks to blood transfusions and sulfa, that wasn't happening and the formerly mortally wounded were now surviving, just barely, for years in expensive hospital beds, with chronic severe deep osteomylitis that sulfa and blood transfusions could only hold off but never cure.

Queen recognized this and figured easily made crude liquid penicillin could be poured into these deep wounds to bring relief.

I suspected all this from Rothman's casual remark but couldn't prove it from Halifax.

Once in Washington, I had no luck (no surprise !) finding Queen's original letter to Dr Keffer of the COC.

But Queen was a former postgrad of the CMR's Richards and crucially he was present at the very apex of Richard's long gone glory days as a world class academic researcher.

So his letter to Richards, written not long after his first letter to Dr Keffer, is very informally friendly and chatty.

In it, he indicates that yes he did apply crude penicillin to his osteomylitis cases, crude made by Dr Robert E Hoyt, PhD, from the pathology department at U of Utah. 

It was the fact that Hoyt was leaving to go to make penicillin at an industrial level at Harrower Labs in far off Glendale California that prompted Queen to cry out for help in making crude penicillin himself inside the Army's big Bushnell hospital at Brigham City Utah.

Now imagine the headline this could have thrown up in the 1943 (or 2013) Hearst newspaper and magazine chain if it had gotten out.

"Army hospital doctor forced to make crude homemade penicillin in a tub because Washington (beltway) bureaucrats refuse pharmaceutical company penicillin to save lives & limbs of brave Marine and Army heroes of Guadalcanal languishing, uncured, in great pain for years"

Simply put, Keefer and Richards panicked at the mere thought of the sort of headlines if the story of Queen's crude got out and went to Army Surgeon General James Magee (who up to then had fully supported their refusal to give any penicillin to the military).

Magee too was in a panic, albeit for another reason.

He was about to be forcibly retired, because the Army top brass had disliked him for years and now with the possibility of a 1943 invasion of Western Europe suddenly removed at the Casablanca's Conference, were willing to fire him and make some drastic changes regarding both the fast-fading sulfa and its possible replacement penicillin.

Magee suddenly decided to switch sides and get on the side of history - get ahead of history in fact - for Queen, if only he kept his mouth shut about the crude, could become a good thing, not a bad thing.

But Queen casually mentioning Robert E Hoyt's name in one preserved letter was enough, because it eventually allowed me to find the extremely obscure wartime article from Queen, detailing Hoyt's work with crude penicillin.

So I still don't have that vital letter - but I now do have all its vital details in the form of an abstract from this article, soon winging its way to me :

God, I love my job !

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