Summary Of The Doctor's Plague

Book Review: The Doctor’s Plague The Doctor’s Plague, written by Sherwin B. Nuland, chronicles the fatalities, ignorance, disdain, and the eradication that childbed fever brought in the 19th and 20th century. Specifically, Nuland shows the progression of Ignác Semmelweis, the ‘research’ he did on childbed fever and his oppressors who were reluctant to believe the results. The book opens with a story of a woman pregnant, ready to give birth. She eventually is in labor and delivers in the hospital nearest to her, Allgemeine Krankenhaus in Vienna, Austria. Through her detailed and gruesome delivery, we sympathize with her and, as we know what the book is about, we pray she doesn’t die of childbed fever, but reluctantly she dies and leaves her
son without any parents. As the reader we know why all of these patients are dying, and wish we could go back in time to stop it. Nuland also chronicles the life of Semmelweis, and how he got to the hospitals where he was able to observe how this plague was occurring. Johann Klein was one of the biggest oppressors of Semmelweis. Klein was a grouchy man who was reluctant to change in the medical field as he was a director in the hospital for over twenty years. In fact, most people were against Semmelweis and his studies. Semmelweis came to the conclusion he believed that the doctors were the source of the disease spreading. In that century, doctors would study “pathological anatomy”, the study of sick organs in cadavers, this was happening in the morning and then the doctors would proceed to their patients immediately following without washing their hands or taking any sanitary measures.
Reading this in the 21st century we all know that this is why childbed fever was occurring, but doctors were appalled at the accusation that the disease was being caused by them.
Semmelweis eventually was given an advisor position at a hospital and implemented a rule that people were to wash their hands in a tub of chlorine water and change their clothes between the pathological anatomy in the morning and when they went to see patients. This helped the fatalities drop significantly from 81% down to as low as 1.2% where his method had been implemented and religiously followed. Even still with this proven observation, other doctors were still opposed to the idea they were the problem, and would not try Semmelweis’ method. After being fired from his job, Semmelweis moved back to Buda Pest from Vienna and didn’t pursue his studies much more. The book concludes with the last days of Semmelweis’ life, which, ironically, seemed to end with the disease that he had been trying to prevent throughout his professional life. He went insane the last two years of his life, possible Alzheimer’s presenile dementia, and was taken to a mental hospital by his wife Maria, where he died of a terrible infection.
Semmelweis did write down what his hypothesis was and the results he found but couldn’t publish it because it made no sense to anyone else who would read it. The information was all over the place and was not clear to convey to others. Had Semmelweis been able to write down his observations,
make actual experiments, and was not such an outsider to the world, I believe that he would have been taken more seriously and his work would have been more quickly accepted in the medical community.
This book was written to the people who are interested in history, and particularly the history of how common practices came to be ‘common’. Nuland connects to his audience by using a lot of description when talking about the medical side of the story. He uses stories that will appeal to a broad spectrum of people, which expands the audience of the book. Nuland also connects to his audience as a doctor by including large historical quotes of the description of medical terms like ‘disease’, and his language uses a more medical way of analyzing what was happening in the 19th and 20th century instead of a more personal opinion.
Nuland seems to use the OCAR story structure mentioned in Joshua Schimel’s Writing Science.
Using the elements opening, challenge, action, and resolution, Nuland exposes the problem of childbed fever through the heart-breaking story of a woman dying after giving birth. This is the challenge that Nuland is addressing including the progression of Semmelweis and his ‘research’. The action is toward the end when Semmelweis unexpectedly flies home to Buda Pest from Vienna, and the book concludes from there with the resolution of him dying. Since Semmelweis does not do proper experimentation like one would in the scientific process, there is no scientific process for Nuland to convey to his readers. However, Nuland does properly address, in order, Semmelweis’ discoveries and what he does to ‘test’ his observations, though he doesn’t perform a proper experiment, Nuland forms it into an experimental form very well for the
audience.
During this time in history there were not concrete definitions for the words contagion, infection, or disease. These words were leisurely thrown at different symptoms and they had to true meaning, they all basically meant the same thing. They did not have the same definition that we use today. These effect our understanding of germ theory today, because there is now new definitions. Contagion means that there is a bacteria or virus in your body that can be spread to another body by direct or indirect contact, infection means that there are foreign bacteria in your body that your immune system is fighting, and disease means an organ or part of the body is not functioning correctly. Germ theory today has much more specific identification and classifications. Compared to the 19th century, the 21s century, so far, is much more accurate when diagnosing someone with some type of disease, infection, or contagion. The medical field today is widely accepting of evolutionary knowledge, and the constant discoveries being made every day.