"Patricia Malone","Anne Shirley Carter", "Marie Barker" : penicillin heroines, but only for two months and long long ago ...

Marie Barker, dying, refused penicillin 1943

For two months during a six year long war, North America (at least its parental and grandparental half) temporarily turned away from looking at the front page pictures of healthy young sons and grandsons in uniform in their local newspaper.

Instead, from mid August 1943 till mid October 1943, their eyes were caught by the unlikely front page pictures (unlikely for newspapers at peace as well as at war ) of very sick young females, ranging from ages of two to their early twenties.

Daughters and granddaughters very much like their own.

All were either being saved from death because they had pried a little penicillin from the hard-faced men in the medical-pharmaceutical establishment --- or were dying because they had failed to move these men.

For two months these young women - some just babies themselves and some new mothers with new babies - were featured almost daily in most of the North American dailies and weeklies, usually with a photo prominent in the story.

It is the female-ness of these pictures, particularly set against the then steady front page diet of butch men with guns, that intrigues me.

The photos feature sick young women surrounded by other women : men are a comparative rarity.

Mothers and nieces comfort daughter and aunt, as in the above photo of Marie Barker. A baby is comforted by a mother (Katherine M Malone), a female nurse, or a female baby doll - as in the case of Patricia Malone.

(Though we do  also see photos of her comforted by the doctor (Dante Colitti) and father (Lawrence J Malone) who pushed to get her life saving penicillin.)

Doctor Mom was sending a message : to Congress, to the feckless AMA , NAS and OSRD and above all to the patent-obsessed Pharmaceutical industry.

One pharmaceutical leader, John L Smith, was pushed and prodded by his wife Mae to remember that penicillin, discovered in 1928, could have saved their precious daughter Mary Louise ---- if only some people had got off their fannies and thought about the children.

He responded by pushing his small firm to go all out to produce penicillin in world-saving amounts and by the Spring of the next year , the penicillin famine was well on to its way to being solved.

Patty, Anne and Marie all faded out of the story - their part in forcing men to finally make penicillin - 15 years late - for children was all conveniently underplayed by the men who wrote most subsequent penicillin histories.

But a penicillin history from a woman who was in the front lines of penicillin from its North American beginnings and knew John L Smith well (Gladys Hobby), never let her readers forget that it was those pictures of dying daughters that finally moved the men from killing to life-saving.

If only for a few months ....

Resetting the Allied moral compass so that it diverged from the Nazis, not merely followed a muted parallel course

It remains unknown whether Henry Dawson expected his quixotic wartime efforts (to "waste" weaponized penicillin on 'useless' SBEs ) to go as far as they ultimately did.

He certainly was extremely unhappy that America was treating its wartime 'SBE lives unworthy of life' in almost as bad a fashion as Nazi Germany was known to be doing to its SBEs and others seen as "useless mouths".

But did he suspect his assault on weaponizing penicillin would extend beyond the Allies' horrific wartime neglect of the poorer chronically ill ?

He probably couldn't have foreseen just how quickly the pipeline of ever-newer ever-better sulfa drugs would dry up or just how quickly so many strains of deadly bacteria would become resistant to any sulfa drug , leaving penicillin as the  only  wartime lifesaver between disease and death.

This meant de-weaponizing penicillin had consequences far beyond those people suffering from SBE and denied their only chance at life.

If weaponized penicillin had remained throughout the war successfully censored and had remained denied to the civilian world (as weaponized DDT successfully was, never let us forget) , it would have ranked as one of WWII's major war crimes, like Katyn Forest or Auschwitz.

Millions of people around the world during WWII would have died needlessly from massive infections that only penicillin alone could have stopped.

Penicillin in 1943 was not as it is today,  just one among dozens of antibiotics - it was the only one - and in addition, no new anti-bacterial sulfa drugs were coming along to replace the ones that bacteria had so rapidly grown resistant to.

Refusing to divert a tiny amount of war resources to make penicillin available to civilians - anywhere and everywhere - was to refuse them Life itself.

Worse, there was no trade-off  to debate ; penicillin, like sulfa before it, was no war-winning secret medical weapon, at least in its intended war-winning use at the front .

Brand new (front line) wounds either contain abundant alternative bacteria foods to the deadly sulfa 'food' (the Fildes theory, known since 1940) or contain abundant proteins to bind to penicillin and render it useless.

However penicillin, and sulfa, were very useful a little further back in the military hospital system, as a life-saving systemic in cases of possible blood poisoning.

The case against secret weaponized penicillin gets even worse.

As an impure natural drug, penicillin would have taken the Germans at least a year or two or three to successfully mass produce it , even if its virtues had been sung from the heavens by the American media in 1942.

But as a pure synthetic penicillin in supposedly cheap abundant mass production (an event that in fact as not yet ever occurred) the chemistry-minded Germans would have rapidly back-engineered the drug and synthesized it rapidly themselves.

Because remember it took 15 years of hard effort to purify natural penicillin enough to determine its structure - but only months thereafter to 'synthesize' it artificially.

Back-engineering that synthesis would also only have taken months.

Penicillin's real secret was just how difficult the mass production of natural penicillin could be if you set your mind on doing everything the hard way ---- not the OSRD-Merck-Oxford fantasy of secret synthesis.

Dawson certainly set up the stage for the Allies re-setting of their moral compass , from his endocarditis efforts from September 1940 to September 1943 : but it was the immediate outcry resulting from the Patty Malone and Marie Barker cases that forced them to actually do something concrete.

His gut instinct in 1940 ,that not treating the otherwise fatal subacute bacterial endocarditis would prove the acid test for the Allies' pernicious morality, certainly was correct.

But while he couldn't have foreseen how far his actions would impact, he wouldn't have been unhappy that they did so......

For female pioneers of wartime penicillin, 1910 was a very good year ...

Dorothy Crowfoot , Gladys Hobby and Nancy Atkinson were about the only women who played an independent role in the development of wartime penicillin.

Many, many, other women were involved in the production of penicillin : in fact biological (natural) penicillin production and testing was often seen as women's work par excellent : but none played an important independent scientific role that I am aware of, beyond these three women.

(I do however believe that Eleanor Chaffee, Patty Malone, Anne Shirley Carter, Marie Barker, Eleanor Roosevelt and above all Mae Smith played crucial roles in turning "penicillin the war weapon" into "the penicillin of hope.")

1910 : annus mirabilis 

Interestingly, all members of our tiny trio shared another thing in common : all three were born in the same year, 1910.....

The Allied battle for the world's 'hearts and minds' : NS-born Henry Dawson's patient-penicillin vs OSRD war-penicillin

Army is - wrongly - blamed for her SBE death

The idea that successful American governments need first to win over the 'hearts and minds' of people, before they rush to impose their objectives by legal and military fiat is an old, old , old one.

Presidents John Adams used the phrase "hearts and mind" in this sense early in the 19th century, long before Presidents FDR, Kennedy and Johnson made it famous in the 20th century - and before recent presidents George W Bush and Obama dragged it out of the archives to use in this century.

(And to share the blame around, their wartime Ally Britain also used the phrase during its 1950s war in Malaysia.)

When American finally joined The Coalition of the Willing  (December 1941), many of the world's nations still remained strictly neutral in the battle against Nazi evil , or were, at best,  nominal friends but in reality merely laying back on the oars.

The world's largest, richest, most militarily-advanced economies in the world (America and the British Commonwealth) had a real job on their hands trying to convince the neutrals (all much smaller and weaker than these two superpowers) that their interests would not be subsumed before the interests of these global colossus.

Unhelpfully, America and Britain's scientific and medical elite - centred in the American National Academy of Science (NAS) and the British Medical Research Council (MRC)  made the job much harder.

Reactionaries of all stripes (from Germany to America) had been determined to roll back the1930s move to Social Medicine (the claim that more poor people got sick than rich people because they were too poor to pay for adequate housing, food or routine medical care).

However, the dire effects of the Great Depression had put wind behind Social Medicine's sails and confounded the reactionaries.

Now - Thank God ! - war, or even just the possibility of war, gave the reactionaries new hope.

 Hitler killed off his first "useless feeder" the same week that he declared war on the Poles and soon his Aktion T4 program was killing Germany's weakest and smallest members by the tens of thousands.

In America, people like Dr Lewis Weed (a mid-level medical researcher) dropped his unsuccessful research to become a war-medicine advocate at the NAS and its action-oriented NRC (National Research Council).

War medicine wins opening rounds against social medicine

He locked horns with Dr Thomas Parran, the American Surgeon General from 1936 to 1948, who was a strong (and powerfully-positioned) advocate of social medicine.

A war medicine proponent advocates that any nation at war - even the richest, least attacked nation at war - needs to divert resources normally assigned to civilian medicine towards making bullets instead.

 In addition, much more money would have to be spent providing for the high medical requirements of an activity (war) whose stated aim is maiming and killing people on muddy fields miles away from the nearest hospital.

Limited research dollars would have to focus on war-related  medical needs ( such as finding new ways to keep factory workers and bomber pilots alert for long hours) and put before finding  new ways to keep elderly retirees alive) .

War medicine is, in a very real sense, 'eugenics in uniform' : the best citizens (those that are tested and rated physically and mentally to be A1) end up in the military and get top notch medical care at no cost.

Those citizens who fail these tests and end up as 4F, are second rate eugenically and get second rate medical care during the war.

Proudly promote this concept to the outside world - and America's still relatively free press during WWII did just that - and it comes across quite differently in those neutral nations still sitting on the fence with regards to whole-heartedly backing the Allied cause.

As individuals, the elites in these neutral nations could see themselves as A1s  --- but as nationalistically minded citizens they could only see their nations as 4Fs in America's eyes : mere inconvenient dirt beneath their advancing wheels.

When the Patty Malone vs Marie Barker debate broke in the United States media (basically, scarce penicillin for dying civilians : yes or no ?) , it broke even bigger overseas, as worried American and British diplomats noted.

Heartless or caring : the public image of the Allied cause had reached past the unimportant front pages and onto the most important page of any newspaper or magazine --- the women's page : home to Doctor Mom.

It suddenly mattered what the mothers and parents and grandparents from neutral nations thought of America and Britain's harsh dictates on penicillin.

Put your small neutral nation, say Eire or Turkey, in the place of the unfortunate Marie Barker and then ask yourself, how would you feel to just be Marie Barker-like 'incidental collateral damage' , on the pathway to the ultimate Allied Victory ?

And the Home Front within the Allied nations was just as caustic about their own governments' inactions : 'penicillin the miracle cure' had been around for 15 years and still no one in charge had bothered making enough of it for all ?

Don't the bosses know "there's a war on" ???!!!

And let us set this debate (occurring between the late Summer of 1943 and the early Spring of 1944) in its full context.

The western Allies still hadn't invaded Europe and left the heavy lifting of killing German soldiers to the beleaguered Russians.

Instead they were busy bombing Europe into rubble : busily killing civilians from both Axis and neutral nations alike.

The Germans and Allies had co-operated on censoring the results of the fire-bombing of Hamburg of July 1943, (right before the story of little Patty Malone broke) but on-site reports from neutral Swedish journalists had laid the whole horrific affair out on the newspaper pages of the world.

It had led to considerable unease - in neutral country and allied country alike.

Hadn't FDR himself raged that the bombing of civilians was a crime against all humanity and now weren't the Americans and British far out-doing the earlier Nazi efforts to bomb enemy and neutral civilians ?

Allied fire bombing of  innocent babies in occupied Europe - denying life-saving penicillin to innocent young moms in America so that their unfaithful husbands in Italy could be get a quicker ( via penicillin) cure for the Clap - it all didn't seem morally right.

Perhaps surprisingly, the American Army revealed far greater political and cultural savvy on this matter than American doctors and scientists were capable of.

The Army was sick and tired of being blamed for hogging all the penicillin and refusing to give any to the nation's dying babies.

'For Christ's Sake', they could rightfully protest, 'we can't get anywhere enough penicillin for our own dying boys, and we hadn't even heard of this stuff penicillin till a few months ago --- you ask the drug companies and the doctors what they were doing with the stuff for the last 15 years !'

Somewhere in the American Army Air Force some bright mind (s) decided to solve both PR problems (the fire bombing uproar and the penicillin uproar) at one stroke.

(And before you ask, no .)

No academic historian has yet brought us the true story behind this highly imaginative response: I see a great PhD thesis for some bright light.)

Soon, American Army "heavy" bombers were pulled off their bombing practises and were sent out on a still risky flight (because at top speed and at night) "pounding" across country with a tiny 8 grams of penicillin (instead of the normal 8000 pounds of TNT) to deliver to a dying ten pound patient.

Upon arrival, Klieg lights lit the tarmac as an ambulance, along a police escort with blazing lights and piercing sirens, raced to the hospital and the waiting doctor and patients.

Need I add to this purple-prosed drama that, thoughtfully, the local press had been notified well ahead of time ?

Quickly Army bombers were even on far more perilous missions of mercy, dangerously new cross-ocean flights, from places like San Francisco  all the way to Brisbane Australia or from New York to Havana, --- to save dying children.

In 1943, Martin Henry Dawson was dying ,but not quite dead yet, not by a long shot...

Life-saving penicillin had moved 180 degrees from being censored and rationed to being the subject of  radio, newsreel and pamphlet propaganda as an example - the example - of the better things ahead if only all joined in to hasten the Allied Cause.

Neutrals could reassure themselves that just like with dying babies and Martin Henry Dawson's useless-mouthed SBE patients, the Allies would do right by all, as they were doing so now for the least of these.

The Allied battle for the world's hearts and minds, had been won (unexpectedly) by the proponents of social medicine - thanks largely to the example of Martin Henry Dawson.

And decades before Joni Mitchell and Woodstock, the American Army Air Force itself turned its shotgun bombers into butterflies, above a wondering nation and world....