Wednesday, May 06, 2020

Why Are We Practicing Social Distancing?

Okay, time for one more story. It's about a Hungarian named Ignaz Semmelweis. He lived in the 1800s and he was a doctor and a scientist. In the year 1847, he was working at Vienna General Hospital. Like most hospitals, Vienna General Hospital had a midwife clinic where babies were delivered by midwives, but it also had a Obstetrical Clinic, where babies were delivered by doctors. Today, if you were given a choice, you'd probably choose the doctor. But not back then. See, the Vienna General Hospital Obstetrical Clinic had a reputation. Everyone in Vienna believed women who went to the doctors would die. How they picked which clinic you went to was based on what day of the month it was, but women would fight to go to the midwives instead of the doctors. Some women even had their babies on the street rather than set foot in the Obstetrical Clinic. Looking back on records now, we can see that this reputation was deserved. Women in the Obstetrical Clinic were three times more likely to die than women in the midwife clinic. This troubled Ignaz Semmelweis. He realized that even the women on the street were surviving better than the women in his OB clinic. He began a devoted study of the corpses of women who had died in the Obstetrical Clinic. He was determined to figure out what was causing these deaths and stop it. He would go to the morgue whenever he could sneak in time between deliveries. Most of the medical students would do the same. Then, one day, while using a scalpel to examine one of the corpses, Semmelweis accidentally cut his friend, Jakob Kolletschka, with the scalpel.
Kollectschka became ill. And the more ill he became, the more that Semmelweis realized he was dying with the same symptoms as the women. Kollectschka died on the 13 March 1847, and everything about his death drove home that he had died in the same way as the women in the OB clinic. Semmelweis began to develop a theory. He proposed that some sort of "cadaverous particles" were traveling from the corpses to the delivering women, and that these were causing the illnesses and deaths. He proposed a rigorous regimen of handwashing be instituted across the hospital. In 1846, the mortality rate among all women in the OB clinic had been 11.4%. In April of 1847, it had been 18.3%--literally almost 1 in 5 women who gave birth there died. He implemented the handwashing procedures in May. In June, the mortality rate dropped to 2.2%. In July, the mortality rate dropped to 1.2%. In 1848, they had two months where the mortality rate was zero, something they'd never accomplish before in either ward. You would think this would have changed medicine forever. But doctors, like most of us, are a stubborn lot, and resistant to new ideas. Semmelweis was mocked and ridiculed until he was eventually driven into an asylum after a nervous breakdown. Handwashing wasn't widely accepted until Luis Pasteur developed a more fully fleshed out germ theory years later. But the moral of this story isn't about handwashing. I've seen a lot of posts on social media that say things like, "We are practicing social distancing so that the scared among us can feel safe." or "You should be able allowed to decide what level of risk is acceptable to you, and I should be allowed to decide what level of risk is acceptable to me." There is an uncomfortable reality in Semmelweis's story that is obvious to us, as wise modern readers looking back on the problem. If you asked a doctor what was causing the deaths of the women, he might say, "Germs." But if you asked a philosopher, he might say "Semmelweis." It was Semmelweis who was carrying the disease back and forth from the cadavers to the women. It was Semmelweis who infected their bodies and made orphans of their children. He didn't want this. His deepest wish was to stop it from happening. But germs and viruses don't work based off feelings. You aren't being asked to wear masks and close businesses and stay home because of the chance that healthy, young, vibrant you will become like the women in Vienna General. You are being asked to do these things because of the chance that healthy, young, vibrant you will become like Ignaz Semmelweis. For all his work with women who died, Semmelweis himself never contracted the disease. You aren't being asked to stay out of the park because you, alone, are going to die of being outside. You are asked to stay out of the park because if everyone in your town who isn't working all rushed to the park with their children, the overcrowded park could become Vienna General. There are times in our lives when, in order to continue to secure the blessings of freedom for ourselves and our posterity, we have to promote the general welfare and provide for the common defense. I encourage you to read more about the sacrifices that were made by those who have gone before you. Read about World War II, not just about the battles, but about the sacrifices made on the home front. About the ways that Mothers struggled, they ways that families did without, the way that time and money and sweat went into helping the boys at the front bring freedom and liberation to Europe. Now, all of that said, are there overreaches in many of the current plans? Absolutely. Do we need to worry about politicians seeking to extend necessary elements of the plan past the outbreak? Of course we do. But let's talk about them like grown-ups, who recognize that there aren't easy answers, that solutions will be complicated, and that there really is a crisis facing the nation.