Thursday, October 31, 2013

Gladys Hobby : Calvinist on a catholic mission...


From September 1940 till December 1943, Dr Gladys Hobby, a devout Presbyterian on a catholic mission ("Penicillin-for-all") , daily visited the Green wards of Columbia-Presbyterian hospital, where the young victims of green SBE waited out their inevitable deaths.

Daily, she held aloft before them a petri dish just aglow with radiated golden penicillium mold, as if it were some marvelous medical monstrance.

As she and her tiny team undoubtedly believed it was.


She and the other three on that team hoped that the golden vision would inspire the SBEs' spirits and lift them up to hold on - and hold off their fate - while the team raced against time to save them.

The team goal was "Penicillin-for-all", even (nay, particularly) during a Total War : inexpensive, abundant penicillin, penicillin enough to save these lives of these young '4Fs of the 4Fs' , whose fate was so blithely dismissed along the mean corridors of wartime science.

Only one thing stood in the team's way : the obdurate opposition of the two most powerful wartime governments , those of America and Britain.

So no government grants, no helpful institutional support  (university presidents and deans don't have to be a weatherman to know the way the wind blows), only sullen opposition from their immediate bosses and general hostility from the Anglo-American medical establishment.

All that the team had going for it was the indomitable courage of its leader, Dr Martin "Henry" Dawson.

He himself was dying of an extremely debilating disease, Myasthenia Gravis, that in the early 1940s was usually fatal in four and a half years.

(With 'MG' we tend to think of respiratory arrest, crash carts and code blue but even in between these not-infrequent dramatic 'crisis',  life for a severe MG patient in 1942 was no bowl of cherries --- with the effects of the medications sometimes worse than even the disease itself.)

So Dawson himself was thus also on a race against time to complete his mission before he died.

Now, unlike Hobby, Dr Dawson was a lapsed (Scottish-Canadian) Presbyterian.

But even a lapsed Scottish Presbyterian remains a force of nature if they are convinced that it is their duty to to do what is right.

A duty-bound Scottish Presbyterian of the old school - albeit lapsed and dying and debilitated  : dear God,  the poor British and American governments never stood a chance.

So the team won the principle of "Penicillin-for-all" , even during Total War, and then something unexpectedly marvellous happened.

For it turned out that the true miracle of this miracle drug wasn't its biological specificity and non-toxicity , marvellous as they were.

No, the biggest miracle of "Penicillin-for-all" was its price , or rather lack of price.

This was a lifesaver that stopped life-threatening contagious infections in their tracks, a lifesaver as cheap as water, a lifesaver literally 'too cheap to meter' .

If penicillin had been so expensive only the well-off could afford it, many poor people world-wide would have remained infected with the most virulent strains, acting as the pools of supply that kept many life-threatening infections endemic or epidemic for milleniums.

But by stopping tens of millions of life-threatening infections world-wide because penicillin was so cheap, billions of the rest of us got that wonderful medical free ride known as Herd Immunity.

Finally the potentially threat from endemic and epidemic infectious fatal diseases that had hung over the heads of every family - rich or poor - for thousands of years like the Sword of Damocles were gone.

But this miracle almost didn't happen - we almost lost "Penicillin-for-all" thanks to a few profit-driven Big Pharma executives and a lot of mean-spirited doctors and scientists from the Allied side of the war.

Henry Dawson and his little band didn't do it alone of course - but every fire needs a tiny spark - sometimes many sparks.

The smallest Manhattan Project was that repeated tiny spark - and the lives of billions continue to be bettered for it ....

My recent electoral life



Darrell Dexter, the Nova Scotia provincial premier, totally ignored my mental telepathy request that he delay the election till the Spring of 2014.

In August, I had just started my commitment to being a full time primary care giver to an extremely lively one year old and so my commitment to her "small values" had to come before those of the adult voters in Halifax when the election was called September 7th.

So I stood for office ran than ran for it.

I was willing and eager to take part in every all-candidates -debates but there were none at all in metro and maybe one in a few rural ridings.

Apathy reigned --- many people were eager to throw out Premier Dexter and just waiting for the first day available to do so.

They didn't need speeches.

Unusually lucky for an Independent in Canadian politics, I did get a brief article about my platform in both of the province's two big papers.

Perhaps this is why I got a respectable 125 votes --- which was almost twice as much as my last outing as a Green.

(In Canada , candidates of registered parties get that fact printed on the ballot but Independents can't even use a single word to describe their philosophy).

So most independents are lucky to poll one or two percent unless they are extremely well known or running in a rural riding with low voter turnover.

Next election, in 2017, I should be able to mount a stronger effort on behalf of exalting 'small values' ...

The OTHER Manhattan Project only made moral arguments rather than A-Bombs : but its impact has been immense

Moral conservatives such as today's American Republican Party frequently argue that morally medical care (such as expensive life saving drugs like Avastin) should only go to those who have worked hard enough to afford them.

They maintain this argument ( hello Obamacare !) even if this means that these drugs as a result of this limited market demand will remain in limited production forever and so be expensive forever.


The opposite moral argument (as made by Dr Martin Henry Dawson in his battle with the Allied governments in WWII) calls for the government to greatly expands the lifesaver's potential market by initially subsidizing the drug so that it available to all regardless of income, geography, race ,gender etc.

It is claimed this will encourage new producers to come in and try and find ways to compete with the established producer by lowering their production costs and hence ultimately reduce the price of the drug to the consumer.

Penicillin G provides the best possible example of this argument, proving the validity of this economical argument beyond all measure.

But greatly expanding the universe of people with affordable access to lifesaving Penicillin G also had an unexpectedly profound impact on the entire world's health.

Unusually cheap abundant public domain Penicillin G saved the lives of many people who are ordinarily too poor or in two remote regions to be treated and who thus remained reserve pools of highly virulent - and contagious - strains of the bacterial diseases that were endemic or epidemic worldwide for millenniums.

In a form of quasi Herd Immunity, billions of us (I estimate ten billion of us so far) have indirectly benefited when tens of millions of us directly had their lives saved by penicillin G shots.

Dangerously contagious bacterial diseases that terrified our grandmothers, that hung like the Sword of Damocles over all households rich or poor, are no more.

Those of us under the age of fifty have never even heard of most of them and few doctors practising today have even seen a single case of them.

The Big Manhattan Project made the A Bomb and made a huge array of massive buildings - it was big in every concrete sense of the word.

By contrast, the other Manhattan Project, that of Dr Dawson, only made moral arguments (and a little home brew penicillin) rather than Bombs or Buildings.

But who can save that this project's impact  - 75 years on - is not way, way bigger than that of the project headed by Robert Oppenheimer and Leslie Groves.... 

Economics as if human survival really mattered


Unbridled growth, even at the cost of burning to death in our own carbon wastes.

This is what the mantra of "ever bigger is ever better" is leading us to.

What it is not leading to is ever greater happiness.

For if the richest and most powerful among us are not happy, who on earth can be ?

Some apparently.

They live and work in smaller walkable communities without - thanks to the likes of Skype and the internet - feeling at all cut off from the great wide world and distant friends and kin.

They use less carbon energy than you or I not because they restrain themselves like monks but because their life is set up spatially to use and need less carbon energy.

They don't miss what they don't need.

More green energy is not the solution to our carbon addiction : more, more, more is never much of a permanent solution - in tumour growth or in real world economics.

We must develop full happy lifestyles where we need less energy to be well off and happy.

Many small communities in the past developed some of the ways to do so ---- often centuries and millenniums ago.

But before Internet and telegraphs and radio , it came at the price of emotional isolation.

Marry the new Internet and those centuries old ways of living compactly and what will be actually born will be hard to predict - but I feel at least confident that it can't be any worse than the route-to-hell we are now taking ....

The very smallest Manhattan Project improved the lives of ten billion people


That is an awful lot of us , being positively affected by so few of them.

Many people today would like to do something to make our world a better place but are overwhelmed by the seemingly impossible odds against having any visible effect.

Take heart !

There was never more than three other people at a time involved with Dr Martin Henry Dawson in his five year long quest to bring forth  'penicillin for all'.

His tiny project had no government grants grants nor much enthusiastic institutional support from his own university.

 Even Dawson's immediate bosses opposed his efforts - but this was nothing to the resistance he got from the Anglo-American medical establishment.

That medical establishment was firmly enmeshed within the wartime governments of "win the war at all costs (to human rights)" FDR and Churchill.

Dawson himself was dying the whole time of his quest.

Dying of a particularly debilitating disease (Myasthenia Gravis , MG) , well before the days when patients with it could expect to make their way through semi-normal days.

Remember this was during a war that saw both sides mentally dividing the world into those worthy and those unworthy of life-saving food and medicine.

"Penicillin for all" fitted into neither side's plans.

Yet this dying doctor and his ragtag team , dismissed as '4Fs,Women and the Grace of God', took on the war's two biggest wartime governments - and won.

How ?

Well for a start, but only for a start, while Dawson was very quiet man (he oozed non-charisma in the land of the alpha male scientist !) he was also equally very stubborn.

Very,very, stubborn in a quiet 'head down' sort of way.

But in the end, he indeed proved that we individuals can even reverse course of the biggest stars in the human heavens .... if only we're stubborn enough.

Leni and Adolf won't have approved of his ends, but Dawson's enduring legacy of "inexpensive penicillin for all" was a signal triumph, indeed, of sheer human willpower......

Pen !!! Stat !!!!


In the house of the beta-lactams there are many mansions and one might think the most modest one might be occupied by the oldest beta-lactam, the only begetter , the original,  penicillin G.

But it 'taint necessarily so' .

Talking to an emergency ward nurse recently I asked her if they ever used penicillin G much these days.

"Oh my yes ",she said, but added with a smile, "we don't call it penicillin G any more."

"What do you call it then?" , I asked.

"We call it 'Pen Stat' and we say it like we might say 'Code Blue' ..."

Nice to know it is still in the medical armoire and still pulled out whenever the going gets tough and the tough get going : Pen !!!!! Stat !!!!!!

Calvinist, on a catholic mission....


From September 1940 till December 1943, Dr Gladys Hobby, a devout Presbyterian on a catholic mission ("Penicillin-for-all") , daily visited the Green wards of Columbia-Presbyterian hospital, where the young victims of green SBE waited out their inevitable deaths.

Daily, she held aloft before them a petri dish just aglow with radiated golden penicillium mold, as if it were some marvelous medical monstrance.

As she and her tiny team undoubtedly believed it was.


She and the other three on that team hoped that the golden vision would inspire the SBEs' spirits and lift them up to hold on - and hold off their fate - while the team raced against time to save them.

The team goal was "Penicillin-for-all", even (nay, particularly) during a Total War : inexpensive, abundant penicillin, penicillin enough to save these lives of these young '4Fs of the 4Fs' , whose fate was so blithely dismissed along the mean corridors of wartime science.

Only one thing stood in the team's way : the obdurate opposition of the two most powerful wartime governments , those of America and Britain.

So no government grants, no helpful institutional support  (university presidents and deans don't have to be a weatherman to know the way the wind blows), only sullen opposition from their immediate bosses and general hostility from the Anglo-American medical establishment.

All that the team had going for it was the indomitable courage of its leader, Dr Martin "Henry" Dawson.

He himself was dying of an extremely debilating disease, Myasthenia Gravis, that in the early 1940s was usually fatal in four and a half years.

(With 'MG' we tend to think of respiratory arrest, crash carts and code blue but even in between these not-infrequent dramatic 'crisis',  life for a severe MG patient in 1942 was no bowl of cherries --- with the effects of the medications sometimes worse than even the disease itself.)

So Dawson himself was thus also on a race against time to complete his mission before he died.

Now, unlike Hobby, Dr Dawson was a lapsed (Scottish-Canadian) Presbyterian.

But even a lapsed Scottish Presbyterian remains a force of nature if they are convinced that it is their duty to to do what is right.

A duty-bound Scottish Presbyterian of the old school - albeit lapsed and dying and debilitated  : dear God,  the poor British and American governments never stood a chance.

So the team won the principle of "Penicillin-for-all" , even during Total War, and then something unexpectedly marvellous happened.

For it turned out that the true miracle of this miracle drug wasn't its biological specificity and non-toxicity , marvellous as they were.

No, the biggest miracle of "Penicillin-for-all" was its price , or rather lack of price.

This was a lifesaver that stopped life-threatening contagious infections in their tracks, a lifesaver as cheap as water, a lifesaver literally 'too cheap to meter' .

If penicillin had been so expensive only the well-off could afford it, many poor people world-wide would have remained infected with the most virulent strains, acting as the pools of supply that kept many life-threatening infections endemic or epidemic for milleniums.

But by stopping tens of millions of life-threatening infections world-wide because penicillin was so cheap, billions of the rest of us got that wonderful medical free ride known as Herd Immunity.

Finally the potentially threat from endemic and epidemic infectious fatal diseases that had hung over the heads of every family - rich or poor - for thousands of years like the Sword of Damocles were gone.

But this miracle almost didn't happen - we almost lost "Penicillin-for-all" thanks to a few profit-driven Big Pharma executives and a lot of mean-spirited doctors and scientists from the Allied side of the war.

Henry Dawson and his little band didn't do it alone of course - but every fire needs a tiny spark - sometimes many sparks.

The smallest Manhattan Project was that repeated tiny spark - and the lives of billions continue to be bettered for it ....

FDR and Churchill heat Hitler and Tojo and then they try and take on Henry Dawson


Martin "Henry" Dawson, a dying doctor.

A lapsed Scottish Presbyterian, but of the old school, the kind  not easily stopped, not when they believed they were duty-bound to do what was right.

A lapsed Calvinist on a catholic mission.

 For Dawson's goal was "Penicillin-for-all".

Particularly at the height of a Total War in which - if you believed the newspapers - his Allied nation opposed the Nazis mostly for their nasty habit of mentally dividing the world in the deserving elect and the non-deserving non-elect.

Of course, in fact,  much of the Allied world mentally did the same - and publicly opposing Dawson's goal merely exposed this awkward fact.

Poor Frank and Winnie when they took on Henry : they simply never stood a chance....

better for America winning friends : A-Bomb or Penicillin-for-all ?


How was the post-war Pax Americana to be best created ?

Was it best to intimidate other nations into being friendly to America by reminding them who held the A-Bomb, and held it alone ?

Or was it best to freely give away 'Penicillin-for-all' , to hope to win other nations' respect by this example of America's open-hearted generosity ?

In other words, was it best for America to project itself as the Gordon Gekko side of Manhattan and reward the efforts of those 'Masters of the Universe', Robert Oppenheimer and Leslie Groves ?

Or was it best to project itself as the Emma Lazarus side of Manhattan and exalt the efforts of the smallest Manhattan Project , that of Henry Dawson, Karl Meyer, Eleanor Chaffee and Gladys Hobby ?

America, itself Janus-faced, never could make up its mind and ended up doing a little of both in the years since 1945 .

But now - post 9/11 and Ramzi Yousef- it isn't too late in the run-up to the 2016 presidential elections for both New York-based Hilary and Kristen to look at this old question again ....

The Manhattan Project for the small


Gather 'round kiddies, as teacher tells you how America burned a hundred thousand children to a crisp, along with their mommies and daddies and grandmas.

Oh wait ---------- darn !! ------ there's a subtitle !

Ah hem.

Now children , have you ever been so sick that you have to go to the doctor ? Well sometimes children are so very sick that the doctor even comes to their house - and at top speed to.


Yes, Ava, the doctor did remember to 'always wear her seatbelt'.

Then the doctor put a big needle in the child as fast as she could - yes, Sam it did hurt, just a little  - and she saved that child's life !

That is "Pen - e - cillin" and it is wonderful : in fact , The Wonder Drug.

But in your grandmother's time, they didn't have penicillin and medicine was very very expensive and people died and their families were very sad.

But this book tells us how that all changed, for the better,  all around the whole world - thanks to some very nice brave people in Manhattan.

How many of you have passed over the big bridge into Manhattan,  en route south to Disneyworld?

Well, it all happened right there - in a little yellow lifesaving house, just next to the great grey bridge....

Tired, Hurt or Huddled


Roche's Avastin-for-all versus Henry Dawson's Penicillin-for-all , what's the difference ?

Avastin is not in short supply and Roche sells it to all, regardless of race gender et al.

Penicillin G : ditto,ditto .

But Avastin costs $100,000 a year and only extends life an average of 4 months.

In bulk, Penicillin G is only about $1 for a two week long life-saving treatment.

And that should permanently stop a life-threatening bacterial infection cold in its tracks .

In addition, Penicillin G's wide use due to its extremely low, low cost helps prevent reserve pools of virulent strains from remaining in patients ordinarily too poor to purchase necessary but expensive medicine.

Ah, the twin miracle of The Miracle Drug.

First, its continuing non-toxicity and efficiency, 85 years after it was first discovered .

Secondly, its extremely low cost which allows it to provide a sort of quasi-Herd Immunity for the rest of us from age-old contagious bacterial infections.

If Gordon Gekko was a drugs salesman, he'd sell Avastin at a big mark-up; if Emma Lazarus was a drugs salesman , she'd sell bulk Penicillin G, at cost ....

World's most effective lifesaver is also the most beloved AND the cheapest


That's not at all like Big Pharma, the world's least beloved industry.

Usually their effective lifesavers cost a big fortune and their ineffective ones merely cost a small fortune.

By contrast, our beloved inexpensive penicillin G has seen wide use among the world's poorest patients and as a result  billions of us have had a 'free ride' :  a quasi-herd immunity to millennium old contagious bacterial infections like Rheumatic Fever.

Diseases today most of us under the age of 50 have never even heard of and most doctors have never seen.

But it almost didn't happen ; we almost lost inexpensive- penicillin-for-all

At the height of WWII, when the only other anti-bacterial agent, the Sulfa drugs, were visibly failing, Big Pharma in Britain and America held off mass production of the only alternative (Penicillin) until they had synthesized it and patented it.

Meanwhile , in the middle of that desperate world war, American and British diplomats sat down to leisurely haggle over how to divide the massive world profits on synthetic penicillin ; visions of post-war sugar plums dancing through their heads.

Now you don't have to be a student of foreign affairs to suspect that America is very, very, very reluctant to sign international treaties --- so this alone suggests how profitable the two superpowers thought patented penicillin would be.

That could only mean sticker shock at the drugstore cash register for ordinary families, of course.

And the world's poor ? Forget it !

One doctor bucked the combined Anglo-American scientific-medical establishment ,and eventually when even Doctor Moms joined in,  the American politicos smelling electoral disaster backed off.

The British politicians did not and the election shock of 1945 was the price they paid.

The story of the smallest Manhattan Project and its battle for inexpensive-penicillin-for-all is fascinating  ---- and almost totally unknown even to penicillin historians....

I'm today's go-to-expert on yesterday's battle over "penicillin-for-all" - by default


While I consider myself the world's leading expert on the wartime battle over the principle of penicillin for all, I also recognize I am also probably the only person in the world who gives a tinker's damn over that 75 year old battle.

A pity that.

Because there are still lessons for today in that old battle, particularly with regards to drugs now costing cancer patients $300,000 a year per person.

For when the wartime general public bested the scientific elites and Big Pharma over the principle of penicillin-for-all, it changed our whole world for the better, forever , in ways few then imagined.

Because penicillin remained totally in the public domain and now had the entire world's public loudly clambering for it, its cost fell quickly to record low levels for such an effective, safe lifesaver.

It was thus given to the poorest patient in the most remote parts of the world , people normally left untreated due to cost.

It thereby knocked out the traditional residual pools for virulent strains of bacteria that kept their names household scourges by remaining endemic or epidemic for millenniums.

Millions were directly treated by penicillin G to save their lives but billions of us indirectly benefited - free of charge ! - by a form of quasi-herd immunity.

As we move to rationing expensive drugs, let us ask ourselves if the example of the battle over wartime penicillin does not suggest a better way ...

Wednesday, October 30, 2013

Remembering when PENICILLIN was as expensive as Avastin is today



In 1943, penicillin-at-cost (at least so claimed Big Pharma and no one ever asked for or got firm proof as to their accuracy) was sold to the US government for $20 per 100,000 units .

The most meaningful way to describe the effect on a family's budget in 1943, if they had had the chance to actually buy the stuff, is to ask how it would have taken them at work to earn that $20.

In 1943, the median male wage earner took about a week to earn $20, the median female about two weeks.

In today's terms, that meant it would cost about $1000 for that dose of penicillin.

Admittedly, that single dose back then in 1943 saved many a life -cured ! - and they didn't need to have another dose again.

By contrast , today's Avastin is a fairly costly cancer drug that can extend life in some terminal patients , but only for an additional four months on average , and at a potential cost of $100,000 a year and up.

To work, it has to be taken constantly every 2 weeks until the patient either dies of the cancer or of old age.

But there are some bacterial diseases ,then and now, that were invariably fatal unless given enormous seeming doses of penicillin  - often the penicillin must being given every few hours, for periods of several months.

Still the cures of even supposedly fatal cases of extraordinarily persistent and antibiotic resistant endocarditis can happen - but it has taken up to a kilo of pure penicillin to do so.

That is equal to 17,000 doses of Penicillin G, each of of 100,000 units in strength !

That is $340,000 in 1943 dollars at 1943 prices and would have  taken 340 years for the average male worker back then to pay for it !

But in the 1943 era, the actual maximum amount of penicillin ever give to an endocarditis patient was a still quite hefty 15 million units  - costing a median 1943 worker 3 solid years of labour to buy.

Three years work for the median worker today in 2013 is at least $100,000 - IE, the average cost for Avastin patients and or their insurers, private and government.

So in 1943, the miracle drug Penicillin G was as expensive for some patients as Avastin and other miracle cancer drugs are today.

But what is the real current at-cost/ bulk price of 100,000 units of Penicillin G today,  in 2013  dollars ?

That would be 2 cents : and would take today's worker not one or two weeks of 40 hour each to pay for it, but rather only about 2 seconds to earn !

Clearly Penicillin G has gone from being the most expensive lifesaver in 1943 to being by far the cheapest lifesaver in 2013 - a lifesaver cheaper than water, a lifesaver too cheap to meter.

The Official History version of why it happens credits those wonderful people at Big Pharma.

If you find that at all credible, you really shouldn't be reading this blog.....

Thursday, October 24, 2013

Penicillin is not Avastin, but it could have been...

My book - The smallest Manhattan Project  - is about us , all 10 billion of us , here today or years dead, whose lives have been improved by the advent of inexpensive penicillin.

In a sense, this book is a rarity : one written from the patient's eye view of how that drug came to be ; a welcome change after decades of endless books exclusively devoted to how penicillin looked to the people who discovered and developed it.

Penicillin is frequently called the Miracle Drug but few consider that its biggest medical miracle was really in fact its cost, or rather 'lack of cost'.

Because the diseases that penicillin treats are contagious,  patients too poor to afford a cure remains a reservoir of the most virulent strains, waiting to infect the rest of us.

There actually were methods of preventing much of these diseases before the development of penicillin : they included the ready availability of good jobs, good food, cleaner and bigger homes, greater social respect.

Baring that, only the worldwide availability of a drug that would cure those diseases once they started up, at a price that almost all could readily afford , could reduce these diseases from being endemic or epidemic to just names in a dusty medical textbook.

That is why I can say, with absolute assurance, that even those of us who have never had a single treatment of beta-lactam (penicillin family) antibiotics are in better health today because the grandparent of them all, Penicillin G , is water cheap - literally a lifesaver "too cheap to meter" .

But it almost didn't happen , we almost lost "inexpensive penicillin".

We almost got an expensively patented synthetic drug more akin to Avastin and all those other $100,000 a year plus medications.

"The smallest Manhattan Project" is the story of a doctor ( himself slowly dying of another unrelated disease) who sacrificed his own health to see penicillin from the patient's point of view.

His name should be honoured for all time.

This, despite the fact that he did not discover penicillin and then neglect it (Fleming) nor did he start its re-discovery and eventual development, albeit while pursuing a pathway that nearly killed off that development (Florey).

Dr Martin Henry Dawson, for that was his name, merely said penicillin should be made available - now! - for every single patient whose life could be saved by it , even during the height of a Total War .

Nay, he went much, much further.

Dawson in fact said all should have access to life-saving penicillin, particularly in the middle of a Total War.

That was because that war was supposedly being fought against one opponent in particular, solely because that opponent's core philosophy said that 'some lives are more worthy than others'.

How could we continue to conduct that war with any moral vigour when our own medical establishment was 'me-tooing' Hitler's doctors ?

Now the mantra 'Penicillin for all who needed it regardless of their income level or skin colour' in the mid-1940s meant its mass production, given the vast amount of infectious disease endemic in those years.

And mass production has its myriad ways of driving production costs down, down , down --- as happily happened in the case of Penicillin G in almost textbook manner.

'Penicillin for all' quickly became 'inexpensive penicillin for all' and once that happened, penicillin began to work almost like the way a good public health vaccine program should work : the treatment of the many ultimately offering 'herd protection' to all the rest of us, free of charge.

Insulin is another drug frequently called a miracle drug.

But the sad fact is that it is far more common today than it was beforeinsulin was discovered, for a variety of reasons.

By contrast, the names of all those bacterial household scourges that so terrified our mothers and grandmothers are not even known to most of us under the age of 50, and most doctors practising today have never seen a case of them.

And that is just the sort of modern day miracle that Dawson's mantra of 'penicillin for all' can produce.

For the complex truth is that our choice of medical ethics has economic consequences and these in turn feedback and have medical consequences.

The case of what the mantra of 'penicillin for all' ultimately led to should be taught in every health economics and health ethics oriented university department for just those very reasons....

Tuesday, October 22, 2013

The light of the littlest red lighthouse can light up the world better than that of the greatest grey bridge

I wonder if Marjorie and Henry Dawson ever read the tale of The Little Red Lighthouse to their youngest child before Henry died in mid-1945 ?

That small and seemingly powerless-feeling child, born in 1941, was of the right age to especially appreciate the special message of the classic children's book, which first came out in 1942.

Particularly considering his father worked daily right beside the real life great grey bridge and the real life little red lighthouse.

If not, I hope the Dawson child eventually absorbed the lesson of that little book more directly, by learning more of his late father's own little Manhattan Project between 1940 and 1945.

Both the example of the book's story and the story of Henry Dawson's tiny Manhattan Project demonstrate to small children the reminder that a determined few, no matter how small in number or in power, can light up the whole world for the better .

And that little children shouldn't give up either, at the first hurdle...

Lifesaving 'too cheap to meter:' the legacy of the smallest Manhattan Project

Remember that solemn pledge from the biggest Manhattan Project ?

After killing a few hundred thousand civilians overseas, they promised to make up for it by offering us endless, abundant, safe electricity at prices 'too cheap to meter'.

They were joking, right ?!

By contrast, consider the legacy of the smallest Manhattan Project.

It has offered us decades of lifesaving at prices 'too cheap to meter'.

That is an amazing feat considering it was performed against the combined resistance from the biggest of the wartime Allied  governments and from many politically powerful firms in wartime's Big Pharma.

Penicillin, more than 85 years after its initial discovery, still can stop cold the toughest bacterial infections going, and do so at prices dirt cheap, offering us true life saving at prices too cheap to meter.

Contrast that to today's to cancer drugs,  averaging at costs between $100,000 to $350,000 a year, that can only promise to extent the average life by about four months.

This is because natural penicillin was born in the public domain, born the original genetic drug , and Man failed totally to synthesize it and expensively patent it.

Penicillin is often called the miracle drug and perhaps its biggest miracle was economic, not medical : it could be given the opportunity to save hundreds of millions worldwide because it wasn't priced like Avastin but rather was almost as cheap as water.

(A real miracle - and I repeat, it almost didn't happen, we almost lost inexpensive penicillin.)

That was because our busy wartime Allied bureaucrats and busy wartime drug executives spent zillions in scarce tax dollars to try to synthesize and patent penicillin rather than getting down to doing Job One with readily available natural penicillin.

Their Job One and Two and Three should have been saving lives in a worldwide war crisis.

Henry Dawson's 'Penicillin-for-all' did not just mean making it available to all at a steep price, like Avastin : it meant making it available to all patients, at a price even the poorest can afford...



Monday, October 21, 2013

"Code Slow", the wartime SBE patients and Hearst's "Code Yellow"

What really happens whenever a family directs a hospital that its relative receives the full and rapid CPR response ("Code Blue") in the event of their quickly fatal cardiac or breathing arrest ?

Most the time, the medical and nursing staff will do their damnest to bring that patient back from the imminent grave.

But at times, the medical and nursing staff will form a silent consensus that they will just pretend to "code blue" a patient, but will actually merely go through the motions.

This is known as "Code Slow" and it is a serious breach in medical ethics.

The staff do so because (a) they believe that particular patient isn't worth saving ----(b) or less controversially , they honestly believe that particular patient at this point in their illness can't really be saved by fullout CPR and will merely experience additional pain en route to their death.

Reasons (a) and (b) are often mixed confusingly in actual practise ---- patients judged (subconsciously) as less valuable are more often also judged less able to benefit from full out CPR on strictly medical grounds.

WWII 's own "CODE SLOW"


During WWII, the millions of young people worldwide who had e potential to suffer the invariably fatal disease known as "Subacute Bacterial Endocarditis" (SBE) as a result of endemic Rheumatic Fever, were viewed by both Allied and Axis medical elites alike as 'useless mouths' during a total war.

They consumed a lot of scarce medical care and even if 1% of the time their illness was checked , it always returned a few months later and no one was ever known to survive a second or third hospital stay while suffering SBE.

True, by early 1943, Martin Henry Dawson had cured a few SBE patients , at least the first time, with moderately high amounts of what little public domain penicillin was available between 1940 and 1943 , but the Allied medical elite decided his success had to be discounted at all costs.

For if his success with SBE was accepted and publicised , it would lead overnight to a sudden sharp public demand for enormous amounts of penicillin.

(The thinking being that ordinary doctors would believe that if penicillin can cure SBE, the Mount Everest of infectious disease, then surely to God it could easily cure their patient's less invariably fatal infection.)

This would guy the game for those who hoped to use penicillin as a secret weapon of war - keeping it secret from the Allied public and hence the Axis-friendly diplomatic corps, so it was only available  to the Allied side during the big D-Day push.

It would also guy the game for those who hoped to hold off the public demand for this miracle drug until it had been safely synthesized and patented, when Big Pharma would finally freely sell it to everybody dying of bacterial infections ---- provided the dying or their families also had big wallets.

The hope was to keep Dawson's success out of the public eye until penicillin had been both patented and had been a surprise success on D-Day - mostly by denying him anymore public domain penicillin to repeat his feats.

He was known as not the type to 'spill all' to the press if he was denied more penicillin.

The SBEs wouldn't be denied all medical care and simply left to die, tempting as that was, because that could backfire and clash fearsomely with the Allied talk of the Four Freedoms.

Instead, they would be "code slow"-ed to death : given enormous amounts of useless (and abundant) sulfa drugs so their families would think something useful was being done for them, when it actually was not.

Unfortunately for these schemers, a fiery Italian American doctor,Dante Colitti, armed with his own private grudge against a medical elite for being prejudiced against allowing Italian Catholic cripples to get medical licenses, was far more willing to go to the media.

He got the master of the Yellow Press, Citizen Hearst and his paper chain, to go full out on behalf of this miraculous Yellow Magic stuff.

The rest, as they say, is history.

For in the end, "Code Slow" proved no match against "Code Yellow" .

A "Good News Story" from the "Bad News War".....

Sunday, October 20, 2013

Birth of Modernity ?

Modernity was born the moment most of the educated West replaced a belief in the Theory of the Sublime with a belief in the Theory of the Germ , ie an event that occurred in the broadly defined '1880s'.


The Theory of the Sublime explains why humans fear - and should fear - only the awesomely big : God, the devil, earthquakes, volcanoes, hurricanes, lions, tigers, et al.

But after the advent of Darwin, Lyell, steam power, high explosives and the Higher Criticism, who could fear any of these ?

Still, when things go wrong - as they often do - who then to blame ?

Can't blame ourselves, could we ?

Conveniently, a bizarre theory emerged from Pasteur in France about the same time, suggesting that an invisible Fifth Column of tiny, weak creatures, most even incapable of basic movement , could nevertheless fell the biggest and smartest of beings with ease.

Think of Germs being a sort of Anti-Sublimity and you're on the right track.

No longer were our enemies big, external and highly visible, (first declaring war forthrightly, then pouring over the border to line up en masse in their bright red uniforms on a sunny daytime battlefield).

Instead germs , like biological franc-tireurs, shot their toxin bullets, - in our backs - at night, out of uniform, from behind fences.

Bacteria are nothing but tiny, weak, poor beings you sentimentalists say ?

No, no, a thousand times no !

They are unsporting guerillas and biological bomb-throwing anarchist terrorists.

War without mercy then upon our minorities of the weak and the small - for they are humanity's one true remaining enemy .....

Modern Era/Modernity: Matter/Anti-Matter

You have to admire the sheer audacity of Modernity as it sought a full compass rollback of the effects of the Modern Era, under the sheep's skin guise of daring to lead this counter-revolution under the name of Modernity !

Albeit it was a subconscious counter-revolution ---- all of its varied proponents went to their graves convinced they were furthering the pace of the Modern Era and merely working to destroy some of its dangerous foes.


So some of the Modern Era's most dangerous foes (and also its biggest supporters) were socialism, liberalism, communism, capitalism, fascism, democracy, totalitarianism.

Like some hair-brained firing squad, the entire world armed itself with intellectual rifles and formed a circle, with each ideology convinced that its opponent directly across the way was Modernity's worse enemy and the erstwhile 'friends' on either side of themselves were only a little bit better.

The Modern Era was notable for many things but it is possible to see that above all else was was truly new about it was the extreme mobility it brought to so many hitherto local human activities.

The increased reach, speed and universality of the flow in and out of local areas (and of entire sovereign nations) of capital, materials, products, patents, intellectual ideas, fashions and tastes, immigrants and warfare was extremely upsetting to most everybody at some time or other.

Reality now seemed seemed so complex, so diverse, so unpredictable, so rapidly changing as beyond human comprehension, let alone human control.

Modernity can thus be best seen as an intellectual claim that - contrary to this current false human sense about reality - a scientific study of Nature actually revealed that real reality was essentially simple, predictable and static, in uniformitarian equilibrium, and any change in it was so gradual as to appear invisible over the average human lifetime.

The Modern Era and Modernity were not one and the same train or even two trains running on parallel tracks, but two trains heading for a head-on wreck on the same track : WWI and WWII ....

Eugenics vs the Germ of Genius

What Popular eugenics in practise what its chief proponents consciously said it was ?

Or was its popularity due to its ability to address subconscious concerns its fans could not admit to consciously ?

It takes very little knowledge to realize that Popular eugenics presents a very oddly conflicted front face indeed.


Its most avid proponents were not among those at the very top of western society, nor those in the bottom either. It can't really be said they were found evenly scattered among those people in the middle either.

Instead its chief supporters were found those mostly highly educated - those highly educated judged in the formal sense, ie those certified so by those authorities conventionally accepted as being capable of doing so.

(Its support among autodidacts was never notably strong.)

So here we have the best educated members of society: well paid, well feed, healthy, socially powerful, etc --- terrified.

Terrified, beyond measure, by those were are uneducated, often deemed un-able to be educated (intellectually challenged as we say today) , in congenital ill health, poor, powerless.

Why would the powerful, a large majority in their society, be so fearful of those so powerless, a small minority in that same society.

The imbalance between the potency of the alleged threat and the fear it generated is hard for us to fathom today, particularly as this
irrational fear was strongest - not weakest - among those in society judged the most rational because they were most educated.

Ah - educated : the key to this puzzle.

It is not surprising that the least educated people also had the least power and income.

But it did not in fact follow that the wealthiest and most powerful people in the Modern Era (1885-1965) were also the most educated.

The best educated often held middle high positions : being doctors, scientists and professors rather than being the captains of industry and the prime ministers.

They were the highly educated and the competent rather than the inspired : few 'self made men' were among the leading proponents of Eugenics and popular eugenics.

Few famous entrepreneurs or inventors, few acclaimed writers,artists, performers and athletes, few untutored geniuses.

Few geniuses indeed.

For sheer genius : raw and untutored , able to arise anywhere among any family, was what these expensively educated but highly ordinary children and grandchildren of extraordinary fathers/grandfathers feared most.

Genius always threatens those in comfortable sinecures , secured through a long and expensive education and family connections rather than through sheer merit and talent.

Genius is just another word for the general principle of social mobility and advancement based on talent and merit.

After the first British Reform Bill's stormy passage in the 1830s, few in western society could openly support the idea that the job of a top ranking civil servant or general was the actual legal property of his family forever, regardless of whether his children and grandchildren was up for the job.

The idea of the nominal aristocracy lived on - one's children could go on being called Earl this or Viscount that, but the real power in the idea of an aristocracy was gone with this loss of an automatic right to dad's job as well as his mere title.

New aristocrats are , at the moment of their creation, always creatures of the merit principle : even the ability to buy a title for two million 1918 circa pounds speaks to an extraordinary ability to make an awful lot of money.

But often their children and grandchildren a very mixed bag.

Despite all the advantages that great wealth and privilege, together with a good education and good health, can bring , a few children are useless drones, most are merely well educated competents and a few are extraordinarily brilliant.

It is the same in all families rich or poor, at least potentially at date of birth: genius is born, at random, and not created through expensive education.

Popular eugenics denied this, claimed that the children of geniuses are geniuses and the children of village idiots were themselves idiots.

Forever and ever : it was fixed eternally in their genes.

But why then were Popular eugenics proponents so stuck on enforcing quotas to keep negroes, jews, women, catholics and immigrants out of universities like Harvard ?

Surely, by the eugenicists' own gene-fixated take on reality, these 'unfit' races of people shouldn't be able to get out of elementary school, let alone crowd the admission channels into top universities like Harvard .

But I claim, that at least unconsciously, these eugenicists really knew that talent and genius flourished anywhere and everywhere, essentially randoml.

Thus the poor negroes and poor South Boston catholics who did manage to make it into Harvard based on their marks and hard work were probably very formidable competitors indeed for those cushy sinecures these 'merely competent' Protestant scions had along taken to belong to them alone.

For professional jobs in the public service, and at non profit agencies like hospitals and teaching jobs in universities and high schools were the natural home of the 'merely competent' , 'merely ordinary', the base of the eugenicist movement.

But native born skilled tradesmen feeling threatened by hard working, more highly skilled , foreign tradesmen also filled the ranks.

Even unskilled anglo american 'white trash' might feel threatened that they would lose their dangerous, low paying jobs to negroes willing to do it for even lower wages and under even less safe conditions.

Those who realize that they are only ordinarily competent (and thus seek only the certainty of a comfortable work environment and a slow but steady career advancement) are always fearful of competitors who are more talented and more hard working .

But in the Modern Era, with its public ethos of a meritocracy, it was no longer possible to publicly say so.

Here the brand new Germ Theory came to the rescue.

Because if God was dead, so was the Devil. And Charles Lyell had proven that the formerly awesome natural catastrophes were but  local ,temporary and infrequent, ie manageable disasters.

High powered, accurately rifled, rapid repeater guns had put even the largest wild beasts on the endangered species list.

The sublime had been vanquished by Modernity - so where did evil and danger now exist in the world, to blame and thus explain away our own mistakes ?

The Germ Theory usefully claimed that things that were invisible, in fact invisibly tiny and weak, were like an internal Fifth Column able to easily destroy our health from within.

This metaphor allowed the biggest and strongest elephant tribe to credibly claim that a single baby mouse, weak  and thin from hunger, could nevertheless destroy them all.

People like the American Foster Kennedy or the German Adolf Hitler used the new Germ Theory to credibly claim that even a single handicapped baby must be killed because of the sheer threat it posed to the strongest of nations and races .

Potential competitors - geniuses or just merely extraordinary individuals rising far up the social scale on sheer merit could be usefully kept down, by the process of claiming that all the poorer classes were totally incapable of having talent - based on their genes, while all the well off had to have talent - based upon their genes.

Seeing the new theory of popular eugenics  as a lateral counter-attack on the equally new meritocracy principle can be a useful prism to explain the entire thrust of Modernity as a counter-attack on the processes of the Modern Era ....

Thursday, October 17, 2013

Crowd-sourcing critical previews ?

Thanks to the advent of the internet with its email systems and blog websites, along with the flexibility of ebook production, it can be a financial breeze to get continuous feedback on a book as it is being written, chapter by chapter.


In the bad old days, even sending just one book chapter off  in the post to some expert in a distant city for preview cost the author a lot in postage out and in and the response time was very slow.

And as for altering a book's text at the gallery proof stage - you paid dearly for every little change.

And even at second re-printing, if your book was lucky enough to get one - 95% never did - redoing the plate process for correcting just one little mistake was so costly, publishers found it cheaper to pay staff to 'hand tip in' (glueing) a small piece of paper noting the corrected errors to the inside front of every copy of the book rather than face that cost and difficulty.

Today, it is all different.

Posting a chapter on my blog , it can expect to get some critical comments from readers worldwide in an instant ---- eventually, maybe.

But if I email the link to the chapter on this blog to experts in the subject area that the chapter deals with and then plead to them to do their worst in tearing my facts and opinions apart, I might expect a few to actually respond --- it costs them and me nothing.

And my resulting ebook can still be endlessly and easily altered and amended, based on reader feedback, before it finally and officially goes off to Amazon to be made into Kindle.

Now I must find out how willing Amazon is to see Kindle books amended ---- after they have entered the great Kindle gene pool...

Wednesday, October 16, 2013

The little Project that Could

Once upon a time there was a little yellow penicillin factory located very near that Great Grey Bridge that connects Fort Lee, New Jersey and Upper Manhattan.

It wasn't a very big operation - particularly not compared to the huge war-dealing projects located all over the world in all the combat nations in those years between 1940 and 1945.

But the long term impact it has had on all of us is far greater than any of its much bigger wartime rivals --- even the one that produced The Bomb and promised us safe perpetually renewable electricity at prices too cheap to meter.

It is only natural for our children and grandchildren, being very small themselves, to feel that a small person or group can never best those much bigger than themselves.

But I think my book on the story of the smallest Manhattan Project can be an object lesson  to our children and grandkids that size isn't everything in matters moral --- that a strong heart and a fierce determination to do right can indeed move mountains.

If I can even move a handful of kids to grow up determined to do the right thing by all the smallest and weakest among us, I will feel that my book efforts will have been worth it....
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Tuesday, October 15, 2013

What "The smallest Manhattan Project" is about

This book is about us. Ten billion of us, here today or years dead, whose lives have been changed by the advent of antibiotics.

It almost didn't happen ; we almost lost Penicillin, the only-begetter of this wonderful revolution.

"The smallest Manhattan Project" is the true story of a dying doctor who fought off his own body - and his own wartime government - just long enough to help Penicillin get its moral groove back, winning us cheap, abundant, natural Penicillin for all.

Above all it is a reminder that when it comes to having the moral courage to change our whole world for the better, size doesn't begin to matter ....

Saturday, October 5, 2013

4F ... or Fifth Column ?

It sometimes seems to me that the weak and the small were the real main enemy - not those nice clean and orderly (if slightly pushy) Germans - to wartime America.

A nation many times the size of Germany or Japan, with twice as many people and a far richer economy, and separated by thousands of kms of cold deep water from its closest credible enemy, is always going to find internal enemies (Reds under Beds) far more convincing a threat than any distant external foe anyway.....


Thursday, October 3, 2013

"Irish Jimmy" Duhig and his Uisce Beatha : Penicillin as Orange Juice

I woke up the middle of last night to find I had a bad cold and so naturally got to thinking about its prevention and cure.

Its natural and unnatural cure and what all this had to do with the unknown history of wartime's crude penicillin.

Naturally, one avoids respiratory colds and worse by eating lots of fresh fruits and vegetables , drinking lots of liquids, getting plenty of rest, and living a secure existence in a well ventilated sizeable home.

One gets more and deadlier respiratory diseases living stressed lives in cramped, il-ventilated homes without adequate fresh fruit and vegetables.

The other way to avoid colds and such is to daily pop a lot of synthetic vitamin pills for your entire life.

You will then have become that most sought after client of Big Pharma : someone from (A) a sizeable group of people who have a (B) 'chronic' 'disease' and (C)  who can afford to buy the moderately expensive solution to the disease, daily, from a drug company for the rest of their lives.

Insulin for middle class diabetics was a big money spinner for Big Pharma , starting in the 1920s, for just those reasons ---- just as the mania for vitamin pills for the middle class was in the 1930s.

No mind that the middle class were hardly needing any vitamins, based on their adequate and varied diets based on the more expensive fresh products of Nature.

They may not have needed any tiny white synthetic vitamin pills .

But they did have enough money to buy them and they did have the necessary ingrained faith in "Science" that helped them swallow Big Pharma's claims regarding the need for daily synthetic vitamin supplements to succeed in this "busy, complex, Modern Age."

Now adequate Vitamin C is regarded as vital to prevent and limit colds.

We can get enough simply eating enough fresh vegetables but most  of us like to supplement this with a tasty morning glass of golden orange juice rather than dash down a tasteless dry little white pill of 100% pure synthetic Vitamin C.

Horrors ! said 1930s Big Pharma and its tame pill-pushing scientific "consultants".

That glass of orange juice or the even more basic orange or lime itself is so impure - containing merely a tiny fraction of one percent pure Vitamin C.

Who knows what bad toxins lurk within it ?

Well we now agree that the orange or lime holds only other goodnesses - like soluble and insoluble fibre.

Scientists knew this even back in the 1930s, but the majority had tagged along on a culture-wide Modernist mania for purity - racial and chemical - and couldn't see the fibre benefits for all their dark fears of possible unknown impurities in the innocent orange.

Nasty Reds lurking under "only innocent-looking" orange beds or groves.

Jimmy Duhig, along with Henry Dawson, Robert Pulvertaft and a very few others didn't buy all this : they thought that the golden solution of crude penicillin was the literal Water of Life, Aqua Vitae or Uisce Beatha , for their dying patients.

Even after 100% pure natural penicillin was available after the war, Dawson's co-worker Gladys Hobby, now a key employee of Big Pharma, was allowed to publish a scientific article seeking to demonstrate that crude penicillin was ,in some way, more effective than the pure stuff !

But back to our trios of modern-day James Linds.

Instead of waiting - perhaps centuries - for a patently-profitable synthetic penicillin pill , they did a James Lind and starting saving lives - right now ! - with the penicillium equivalent of Lind's natural lime juice for scurvied sailors : natural crude penicillium juice.

The fact that these still-unknowns saved many lives while the now-famous Howard Florey merely fiddled about trying fruitlessly to make synthetic penicillin merely reminds of the power of Big Pharma and their many scientific sycophants on Nobel Prize committees.....