Women were dying from childbirth at hospitals. This 19th-century doctor figured out why.
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March of Dimes

Today, we know that washing our hands is one of the most important steps we can take to avoid getting sick and spreading germs.

But how we came to know that is pretty fascinating.

Image via iStock.


Handwashing is actually a relatively new practice — even for doctors.

In fact, one of the first doctors to realize how important handwashing could be — Ignaz Semmelweis — didn’t discover this fact until 1847. And even after he did realize it, the battle to convince the rest of the medical community wasn’t easy.

The 19th century has been described by some historians as “a golden age of the physician and scientist” because for the first time, doctors were expected to have scientific training.

They were also expected to use symptom-based diagnoses to solve medical ailments. And to do this, of course, medicine relied on understanding what was happening inside the human body to get at the root of disease.

So, autopsies became all the rage.

Not only did they form a critical part of a doctor’s training, but the doctors who regularly performed them were the most respected in the medical community. An unfortunate byproduct of this, though, was the erroneous belief that the dirtier the doctor, the better the doctor.

In fact, there are accounts of doctors going directly from their last autopsy to deliver a baby or treat a patient without changing their clothes.

Enter Hungarian doctor Ignaz Semmelweis.

A portrait of Ignaz Phillip Semmelweis. Image via Jeño Doby/Wikimedia Commons.

In 1846, Semmelweis had just started his new job at the maternity clinic at Vienna General Hospital.

At that time, women were dying at staggering rates in hospitals shortly after giving birth from “childbed fever,” a disease also called puerperal fever. It was a cruel infection, causing raging fevers, painful abscesses, an infection in the uterus and birth canal, sepsis, and then finally, death — all within about three days of the baby’s delivery. And it was the single most common cause of maternal death at the time.

Being a man of science, Semmelweis wanted to understand why so many women were dying in his clinic. So he studied two maternity wards in the hospital — one staffed by doctors and medical students, the other by midwives — and recorded the number of deaths in each ward.

Vienna General Hospital, where Semmelweis worked. Image via Josef & Peter Schafer/Wikimedia Commons.

His results showed that women died at a rate nearly five times higher in the ward staffed by doctors and medical students.

But it wasn’t until one of his colleagues, a pathologist, got sick and died after pricking his finger in an autopsy of someone who had died from childbed fever that Semmelweis realized that anyone, not just mothers, could get sick from puerperal fever, and the reason the midwives' ward had fewer deaths was because they didn't do autopsies.

He theorized that there must be some “cadaverous particles” or “morbid poison” that doctors were getting on their hands during autopsies. And the doctors in the ward were then transferring these particles inside the women when they delivered the baby, which then made the women sick.

Today, these “cadaverous particles” are known as bacteria, such as streptococcus pyogenes.

A photomicrograph of streptococcus pyogenes bacteria, which causes puerperal fever.  Image via the Centers for Disease Control and Prevention/Wikimedia Commons.

Semmelweis immediately ordered the medical staff to start cleaning their hands and instruments before delivering babies.

They were told to use a chlorine lime solution, not soap, until they could no longer smell the bodies they had dissected.

And it worked — chlorine is actually a great disinfectant. The rate of puerperal fever fell drastically in the doctor’s ward.

The first edition of Semmelweis' published findings. Image via István Benedek/Wikimedia Commons.

Unfortunately, the Semmelweis' colleagues did not embrace his findings — they were outraged at the suggestion that they were the cause of their patients' deaths. Semmelweis was fired from the hospital and eventually committed to an asylum. He died at the asylum two weeks later. (Several historians believe that he died, after being beaten at the asylum, from sepsis — an infection in the bloodstream caused by germs.)

It would take about 20 years before his ideas would start to be accepted by the medical community. And even then, it was "germ theory" — and the work of Louis Pasteur in the late-1860s — that really convinced anyone of the importance of hygiene and handwashing.

Over a 150 years later, though, Semmelweis is finally getting the recognition he deserves because the simple act of handwashing is one of the most important tools we have in public health.

And its benefits extend well beyond the hospital. Washing your hands reduces the chances of getting diarrheal illnesses by 31%, according to the Centers for Disease Control and Prevention (CDC). It also reduces the occurrence of respiratory illnesses — including colds — by 16 to 21%.

That’s why in the 1980s, the first nationally endorsed hand hygiene guidelines were released by the CDC, after a series of outbreaks of food-borne and health care-associated infections. And over the next few decades, a number of other guidelines have followed to stress the importance to the general public.

Image via iStock.

Today, the battle to promote this public health tool is still not over.

Diarrhea and respiratory infections remain leading causes of death in the developing world — claiming about 3.5 million children every year — because people either don't know how important handwashing is or don't have access to a reliable, clean water source. There are also still over 1.4 million cases of health care-associated infections around the world. But through education initiatives, NGOs all over the world are hoping to bring about change with this one simple habit.

Proper hand hygiene is still one of the best ways to fight these infections and diseases — and we have Dr. Semmelweis to thank.

The airline industry was one of the hardest hit by the COVID-19 pandemic, as global and domestic travel came to a screeching halt last spring. When the pandemic was officially declared in March of 2020, no one knew what to expect or how long the timeline of lockdowns and life changes would last.

Two weeks after the declaration, Delta pilot Chris Dennis flew one of the airline's planes to Victorville, CA for storage. He shared photos on Facebook that day of empty planes neatly lined up, saying it was a day he would remember for the rest of his life.

"Chilling, apocalyptic, surreal...all words that still don't fit what is happening in the world," he wrote. "Each one of these aircraft represents hundreds of jobs, if not more."

He added:

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The airline industry was one of the hardest hit by the COVID-19 pandemic, as global and domestic travel came to a screeching halt last spring. When the pandemic was officially declared in March of 2020, no one knew what to expect or how long the timeline of lockdowns and life changes would last.

Two weeks after the declaration, Delta pilot Chris Dennis flew one of the airline's planes to Victorville, CA for storage. He shared photos on Facebook that day of empty planes neatly lined up, saying it was a day he would remember for the rest of his life.

"Chilling, apocalyptic, surreal...all words that still don't fit what is happening in the world," he wrote. "Each one of these aircraft represents hundreds of jobs, if not more."

He added:

Keep Reading Show less
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Each year, an estimated 1.8 million people in the United States are affected by cancer — most commonly cancers of the breast, lung, prostate, and blood cancers such as leukemia. While not everyone overcomes the disease, thanks to science, more people are surviving — and for longer — than ever before in history.

We asked three people whose lives have been impacted by cancer to share their stories – how their lives were changed by the disease, and how they're using that experience to change the future of cancer treatments with the hope that ultimately, in the fight against cancer, science will win. Here's what they had to say.

Celine Ryan, 55, engineer database programmer and mother of five from Detroit, MI

Photo courtesy of Celine Ryan

In September 2013, Celine Ryan woke up from a colonoscopy to some traumatic news. Her gastroenterologist showed her a picture of the cancerous mass they found during the procedure.

Ryan and her husband, Patrick, had scheduled a colonoscopy after discovering some unusual bleeding, so the suspicion she could have cancer was already there. Neither of them, however, were quite prepared for the results to be positive -- or for the treatment to begin so soon. Just two days after learning the news, Ryan had surgery to remove the tumor, part of her bladder, and 17 cancerous lymph nodes. Chemotherapy and radiation soon followed.

Ryan's treatment was rigorous – but in December 2014, she got the devastating news that the cancer, once confined to her colon, had spread to her lungs. Her prognosis, they said, was likely terminal.

But rather than give up hope, Ryan sought support from online research, fellow cancer patients and survivors, and her medical team. When she brought up immunotherapy to her oncologist, he quickly agreed it was the best course of action. Ryan's cancer, like a majority of colon and pancreatic cancers, had been caused by a defect on the gene KRAS, which can result in a very aggressive cancer that is virtually "undruggable." According to the medical literature, the relatively smooth protein structure of the KRAS gene meant that designing inhibitors to bind to surface grooves and treat the cancer has been historically difficult. Through her support systems, Ryan discovered an experimental immunotherapy trial at the National Institutes of Health (NIH) in Bethesda, MD., and called them immediately to see if she was eligible. After months of trying to determine whether she was a suitable candidate for the experimental treatment, Ryan was finally accepted.

The treatment, known as tumor-infiltrating lymphocyte therapy, or TIL, is a testament to how far modern science has evolved. With this therapy, doctors remove a tumor and harvest special immune cells that are found naturally in the tumor. Doctors then grow the cells in a lab over the next several weeks with a protein that promotes rapid TIL growth – and once the cells number into the billions, they are infused back into the patient's body to fight the cancer. On April 1, 2015, Ryan had her tumor removed at the NIH. Two months later, she went inpatient for four weeks to have the team "wash out" her immune system with chemotherapy and infuse the cells – all 148 billion of them – back into her body.

Six weeks after the infusion, Ryan and Patrick went back for a follow-up appointment – and the news they got was stunning: Not only had no new tumors developed, but the six existing tumors in her lungs had shrunk significantly. Less than a year after her cell infusion, in April 2016, the doctors told Ryan news that would have been impossible just a decade earlier: Thanks to the cell infusion, Ryan was now considered NED – no evaluable disease. Her body was cancer-free.

Ryan is still NED today and continuing annual follow-up appointments at the NIH, experiencing things she never dreamed she'd be able to live to see, such as her children's high school and college graduations. She's also donating her blood and cells to the NIH to help them research other potential cancer treatments. "It was an honor to do so," Ryan said of her experience. "I'm just thrilled, and I hope my experience can help a lot more people."

Patrice Lee, PhD, VP of Pharmacology, Toxicology and Exploratory Development at Pfizer

Photo courtesy of Patrice Lee

Patrice Lee got into scientific research in an unconventional way – through the late ocean explorer Jacques Cousteau.

Lee never met Cousteau but her dreams of working with him one day led her to pursue a career in science. Initially, Lee completed an undergraduate degree in marine biology; eventually, her interests changed and she decided to get a dual doctoral degree in physiology and toxicology at Duke University. She now works at Pfizer's R&D site in Boulder, CO (formerly Array BioPharma), leading a group of scientists who determine the safety and efficacy of new oncology drugs.

"Scientists focused on drug discovery and development in the pharmaceutical industry are deeply committed to inventing new therapies to meet unmet needs," Lee says, describing her field of work. "We're driven to achieve new medicines and vaccines as quickly as possible without sacrificing safety."

Among the drugs Lee has helped develop during her career, including cancer therapies, she says around a dozen are currently in development, while nine have received FDA approval — an incredible accomplishment as many scientists spend their careers without seeing their drug make it to market. Lee's team is particularly interested in therapies for brain metastases — something that Lee says is a largely unmet need in cancer research, and something her team is working on from a variety of angles. "Now that we've had rapid success with mRNA vaccine technology, we hope to explore what the future holds when applying this technology to cancers," Lee says.

But while evaluating potential cancer therapies is a professional passion of Lee's, it's also a mission that's deeply personal. "I'm also a breast cancer survivor," she says. "So I've been on the other side of things and have participated in a clinical trial."

However, seeing how melanoma therapies that she helped develop have affected other real-life cancer patients, she says, has been a highlight of her career. "We had one therapy that was approved for patients with BRAF-mutant metastatic melanoma," Lee recalls. "Our team in Boulder was graced by a visit from a patient that had benefited from these drugs that we developed. It was a very special moment for the entire team."

None of these therapies would be available, Lee says without rigorous science behind it: "Facts come from good science. Facts will drive the development of new drugs, and that's what will help patients."

Chiuying "Cynthia" Kuk (they/them) MS, 34, third-year medical student at Michigan State University College of Human Medicine

Photo courtesy of Cynthia Kuk

Cynthia Kuk was just 10 years old when they had a conversation that would change their life forever.

"My mother, who worked as a translator for the government at the time, had been diagnosed with breast cancer, and after her chemotherapy treatments she would get really sick," Kuk, who uses they/them pronouns, recalls. "When I asked my dad why mom was puking so much, he said it was because of the medicine she was taking that would help her get better."

Kuk's response was immediate: "That's so stupid! Why would a medicine make you feel worse instead of better? When I'm older, I want to create medicine that won't make people sick like that."

Nine years later, Kuk traveled from their native Hong Kong to the United States to do exactly that. Kuk enrolled in a small, liberal arts college for their Bachelor's degree, and then four years later started a PhD program in cancer research. Although Kuk's mother was in remission from her cancer at the time, Kuk's goal was the same as it had been as a 10-year-old watching her suffer through chemotherapy: to design a better cancer treatment, and change the landscape of cancer research forever.

Since then, Kuk's mission has changed slightly.

"My mom's cancer relapsed in 2008, and she ended up passing away about five years after that," Kuk says. "After my mom died, I started having this sense of urgency. Cancer research is such that you work for twenty years, and at the end of it you might have a fancy medication that could help people, but I wanted to help people now." With their mother still at the forefront of their mind, Kuk decided to quit their PhD program and enter medical school.

Now, Kuk plans to pursue a career in emergency medicine – not only because they are drawn to the excitement of the emergency room, but because the ER is a place where the most marginalized people tend to seek care.

"I have a special interest in the LGBTQ+ population, as I identify as queer and nonbinary," says Kuk. "A lot of people in this community and other marginalized communities access care through the ER and also tend to avoid medical care since there is a history of mistreatment and judgement from healthcare workers. How you carry yourself as a doctor, your compassion, that can make a huge difference in someone's care."

In addition to making a difference in the lives of LGBTQ+ patients, Kuk wants to make a difference in the lives of patients with cancer as well, like their mother had.

"We've diagnosed patients in the Emergency Department with cancer before," Kuk says. "I can't make cancer good news but how you deliver bad news and the compassion you show could make a world of difference to that patient and their family."

During their training, Kuk advocates for patients by delivering compassionate and inclusive care, whether they happen to have cancer or not. In addition to emphasizing their patient's pronouns and chosen names, they ask for inclusive social and sexual histories as well as using gender neutral language. In doing this, they hope to make medicine as a whole more accessible for people who have been historically pushed aside.

"I'm just one person, and I can't force everyone to respect you, if you're marginalized," Kuk says. "But I do want to push for a culture where people appreciate others who are different from them."