Sunday, December 15, 2013

Dawson's Follies...

... have improved the lives of ten billion of us , so far.

Dateline Manhattan : Something green and life-nurturing is brewing down the mean corridors of wartime science...

In the stereotyped description of  the biggest teaching hospitals of the mid twentieth century, there is always a strict hierarchy cum pecking order of prestige, power and authority.

At the top were the surgeons, particularly those who had combine high technical skill with the cool ability to save lives under very rushed emergency conditions ; brain surgeons operating on newly discovered operable brain tumours probably being at the top.

At the bottom were the staff in the hospital's day or outpatient clinics, dealing with chronic non-life-threatening conditions - aging-related (osteo) arthritis patients being the classic example.

Henry Dawson was the director of one such arthritis day clinic, at New York's world famous CUMC (Columbia University Medical Centre).

But this clinic work was not the reason why his bemused colleagues referred to his 'Follies' , far from it.

His was a pioneering clinic and he was a nationally and even internationally respected expert in arthritis, well regarded for his common sense caution over the possibility of  quick cures.

Not much for a prior hypothesises, he preferred the naturalist's method of gathering all sorts of data from hundreds of cases, to see if any common 'tendencies' emerged.

No, it was Dawson's private (non-day job, non-grant approved) scientific interests that bemused or angered his fellow medical scientists.

A traditional boon granted to the staff of hospital labs was the right to work on their own private research projects on equipment and in lab corners not in current use.

A boon usually available to the staffer in his off-work hours : evenings, weekends and holidays (hence the term EWH Research).

His day job bosses didn't directly oversee this research if the staffer had something like tenure and nor did senior members of the discipline ride shotgun on it by controlling the issuing of grant money, as is done today.

Nevertheless , the hope was that while this private research might be on the fringes of conventional science, its aim was ultimately to be useful.

And here Dawson seemed to have crossed some sort of line.

He was seen as being too interested in both avirulent commensal bacteria and in avirile 4F patients.

An applied scientist if there ever was any, a medical researcher was expected to be only concerned with virulent pathogens , ones that actually could kill or harm patients.

'Best leave the study of avirulent bacteria to the basic scientists in university biology departments'.

And so between the Spring of 1939 and the Winter of 1941 , the medical elite in America steadily moved staff and money away from the New Deal's emphasis on social medicine - helping to heal the avirile 4Fs in society - towards medical research directed towards helping 'our soon to be fighting boys' (the virile by definition 1As from the draft boards) .

This elite, being mostly Republicans sympathetic to popular eugenics and thus privately and publicly hostile to FDR's social medicine, they eagerly welcomed using the excuse of preparing for the upcoming war to shift emphasis away from this silly 'socialized medicine' stuff .

And they even had FDR's backing , as he publicly said he was no longer Doctor New Deal but now Doctor Win the War.

But Dawson's comeback was that using the excuse of 'war necessity' to throw the weak under the bus was exactly what Hitler did (in his notorious Aktion T4 program) and weren't we supposed to be opposed to his values ?

So his bosses grumbled and restrained but his not stop the work of this respected tenured polite member of their staff.

In the end he was forced to use the corridors of his hospital to house the five gallon bottles of agape penicillium he had brewed up.

But he still could extract enough under these conditions so hostile to the production of penicillin , to treat his pioneering series of  '4Fs of the 4Fs'.

These were young men with subacute bacterial endocarditis (the invariably fatal SBE that tended to befall the survivors of the then endemic Rheumatic Fever) that wartime medicine had directed should be 'code slowed' into an early grave.

Himself dying from an autoimmune disease, Dawson kept at it, in the face of the overt hostility of his colleagues.

Eventually, ordinary GPs, patients' families and ordinary journalists all "ACTED UP" on behalf of his project to see  that wartime penicilin  was made available to all those dying who could benefit from it.

Dawson died as the European part of the war was ending but not before knowing his tiny EWH project had changed world history.

Ten billion of us, to date, can only agree ....

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