On the occasion of Ignaz Semmelweis´ birthday (July 1st ), the Semmelweis Foundation wants to present a second interview (see the one with Prof. Didier Pittet): Medical innovation is always accompanied by resistances – no life shows this better than that of Ignaz Semmelweis, is written in the recently published book by the scientist Anna Durnova. She gives us an insight into the truths, unloved number statistics and midwives in the historical and current context.
Mrs. Durnova, what’s so special about your book – is it a biography in the conventional sense? And what was your motivation for this project?
The book is not a classic biography. One motivation was the fact that there already exist enough comprehensive biographies of Semmelweis, and this book simply should shed new light on the history of fighting against puerperal fever. The other motivation was to pass on my own fascination for this conflict. A fascination that gives us for today’s medical development an essential lesson. The lesson is, that we look at the conflict not as an error but as an essential part of the establishment of scientific truths. In these conflicts the old – considered as safe knowledge – hits to a new knowledge and this is leading to violent clashes, as Semmelweis experienced them.
Semmelweis was assistant doctor at the Vienna Department of Obstetrics between 1846 and 1849. He noticed that his department has a much higher mortality rate than the department of the midwives. The observations brought him closer to the fact, that puerperal fever was related to the doctors, but he did not know exactly how. The historical sources often indicate that a substantial notice gave the incidence of his former colleague, the pathologist Kolletschka. His autopsy report was similar to those of the women. So he started to pay attention on the corpse poison on the hands. He ordered his colleagues to disinfect the hands with chlorinated lime solution. Death rates declined rapidly. A few months later however Semmelweis was fired and his thesis, that the dirt on the hands of the doctors is responsible for the misere was not accepted even many years after his death.
Are there any notes of how the midwives reacted to Semmelweis‘ discovery? Did they, unlike the doctors believe on his thesis, and what was their position?
This type of reaction does not occur in the book, because it´s primarily about the conflict and the gap within the medical community. It is exciting to watch how Semmelweis begins to doubt himself and how this leads to conflicts. In this regard, the midwives had a central, but rather passive role in the conflict. Semmelweis wanted to fight puerperal fever. His intention was not to blacken the doctors‘ guild and to say that midwives do a better job. At the same time, it was probably so that midwives felt confirmed by the fact, that not everything coming from the other side was quite perfect.
In your book, on page 168 you write that „the basin stood in the room of the hospital and in the room of discussion. They wanted to abolish it and turn off the discussion. The washbasins of modern times, the disinfection dispenser, nobody wants to abolish, but very often people make big bow around it.“ Why is it so difficult for the people to act conscientiously despite numerous awareness campaigns?
Several factors play a role. Experts say that the antibiotics have brought a sense of neglect. One has the feeling, that the infection can be combatted easily, what is often not entirely true.
To come back to your book: Who is the target audience, who should read it?
Every person, who wants to see behind the curtain of medical development. All who like reading exciting stories about the search for the truth. And also those who believe that science would be dry and factual. This, it is not at all!
Final question: How important do you think is Semmelweis today for midwives? Is he someone special, or just one of the many historical figures who worked in their field?
Although the midwives actually were not in the main focus of Semmelweis’ work, he had a symbolic effect. With his conflict, he pointed to the need to allow alternatives and discuss. I think that’s very important for the midwives today. Even in the constantly arising conflicts between doctors and midwives, the story of Semmelweis recalls, that doctors are not always the ones who are right. Errors in medicine are in fact an essential part of development.