When we say that Henry Dawson's vision of wartime penicillin was 'inclusive', while that of Howard Florey was 'exclusive' , we are really getting at the key issue that divided all the world during, before and after WWII.
" Just who do we include in ; just who do we exclude out of our civil society's blessings ?"
Showing posts with label social medicine. Show all posts
Showing posts with label social medicine. Show all posts
Wednesday, September 11, 2013
Wednesday, August 21, 2013
War medicine was from Mars, Social medicine from Venus ?
The very word "war" medicine seems to stir something vaguely Mars-like, deep within the soul of the chickenhawk doctor or scientist.
Successfully conceiving ,in an academic lab at the University of Chicago, a way to reduce combat deaths from shock seems to transport one almost up to the frontline evacuation hospitals, directly under hostile fire.
Being there, doing it, roughing it , all sweaty and virile-like : medical science with the smell of the locker room and the men's shower stall about it.
By contrast, what can any doctor - any real doctor - actually do about those dying of subacute bacterial endocarditis (SBE) ?
These hopeless cases shouldn't even be occupying an acute hospital bed - particularly in wartime.
They should be handled by women - nurses - in a secondary hospice or in a palliative care situation at home.
And arthritis 'care' - not really medicine is it ? Helping impoverished old ladies too frail to bend over properly to get dressed and to do their toiletry.
Again - women's work. A job for personal care assistants and social work case workers. Social medicine.
But (Martin) Henry Dawson persevered , hung on in there , all through the war, treating those chronically ill with arthritis and the very 4Fs of the 4Fs, those dying of SBE .
Perhaps because he was that rarity : an American medical researcher in 1940 who already had a stirling war record in the front lines (in the medical corp, infantry and artillery), with a medal for valour and two serious war wounds to back him up.
The Military Cross winner from Venus, as it were ......
Successfully conceiving ,in an academic lab at the University of Chicago, a way to reduce combat deaths from shock seems to transport one almost up to the frontline evacuation hospitals, directly under hostile fire.
Being there, doing it, roughing it , all sweaty and virile-like : medical science with the smell of the locker room and the men's shower stall about it.
By contrast, what can any doctor - any real doctor - actually do about those dying of subacute bacterial endocarditis (SBE) ?
These hopeless cases shouldn't even be occupying an acute hospital bed - particularly in wartime.
They should be handled by women - nurses - in a secondary hospice or in a palliative care situation at home.
And arthritis 'care' - not really medicine is it ? Helping impoverished old ladies too frail to bend over properly to get dressed and to do their toiletry.
Again - women's work. A job for personal care assistants and social work case workers. Social medicine.
But (Martin) Henry Dawson persevered , hung on in there , all through the war, treating those chronically ill with arthritis and the very 4Fs of the 4Fs, those dying of SBE .
Perhaps because he was that rarity : an American medical researcher in 1940 who already had a stirling war record in the front lines (in the medical corp, infantry and artillery), with a medal for valour and two serious war wounds to back him up.
The Military Cross winner from Venus, as it were ......
Sunday, August 18, 2013
Wartime Manhattan : from Mars ... or from Venus ?
If I might be permitted to gently chide the citizens of Manhattan, may I suggest that they had done very little, themselves, to balance the horrific wartime image of their city created by being tagged as the place that 'birthed' the atomic bomb and its potential destruction of the entire world.
To the 911 bombers, it is the best known image of the borough.
(And by the way, it is only men, like the bosses of the best known wartime Manhattan Project , who talk about 'birthing the bomb' and think of naming it 'Little Boy'.)
Woman know better.
They actually do birth children and know that a bomb isn't a baby.
But little Patty Malone was a baby - and it was only the fearless challenging spirit of the native born Manhattanite that saved her life ... when a heartless government refused to help.
So, People of Manhattan, take a bow.
True, it was only men that did all the heavy lifting in saving this particular child, but I am convinced that her story moved millions of Doctor Moms to demand that their men get off the sofa and start making penicillin for real, right away.
In particular, her story moved one Doctor Mom with the real power to move mountains of inertia : Mae Smith.
She was the wife of the boss of Brooklyn-based Pfizer, John L Smith.
In the summer of 1943, his firm was best positioned (culturally) in the world to make the needed penicillin ---- all by its self.
But he was a very cautious and frugal man and he refused to do the right thing, rather than the financially safe and lucrative thing.
Until his wife reminded him, once again, that Dr Henry Dawson had always insisted that their eldest daughter would have remained alive, if only penicillin had been earnestly produced, not long after its discovery.
Learning of little Patty Malone plucked from death's door touched Smith's heart ; finally made Dawson's claim seem real to John L.
In a few short months, Pfizer was indeed producing enough penicillin for all those in the world dying of susceptible infections.
Abundant amounts of Pfizer Penicillin created an opportunity for America to practise influential penicillin diplomacy , replacing Pax Britannia with Pax Americana.
Britain and its Dominions had the most moral capital, from standing all alone against Hitler for years, and it had the moral first claim on penicillin.
But for want of a price of a single additional bomber squadron for Butcher Harris, the Conservative Party-dominated British government threw all that moral capital away, handed it over to the Americans on a platter, gratis.
That price, of just one bomber squadron among many, would have given Glaxo a Pfizer's sized plant, months before Pfizer.
By contrast, WWII is usually seen as the process that finally killed the hopes of the New Deal.
But I argue, that the New Deal's final act was actually its finest hour.
Britain's Ministry of Supply set the amount of penicillin it wanted produced during the war years to just be enough ( barely) for front line troops.
It forbade the bigger colonies like India to make their own penicillin (postwar export market considerations dominated official thinking.)
The supply amounts set by the gutless Dominions perfectly reflected Britain's niggardly attitude to the needs of their own civilians and the civilians of the occupied lands.
By contrast, in May 1943, one of the last big New Deal organizations created, the American WPB (War Production Board) , set the amounts of American penicillin it wanted produced so high that it could easily supply America ( military and civilian) and most of the world besides.
Thirties style "Social medicine" concerns had finally won out over the Forties "War medicine" niggardliness.
Henry Dawson's long, lonely defence of heightened social medicine in a time of war against an enemy who didn't believe in it even in peacetime had finally borne fruit : now America was preparing to combat the Nazis morally , as well as just militarily.
Venus Manhattan was in the driver's seat, along with Mars Manhattan ....
To the 911 bombers, it is the best known image of the borough.
(And by the way, it is only men, like the bosses of the best known wartime Manhattan Project , who talk about 'birthing the bomb' and think of naming it 'Little Boy'.)
Woman know better.
They actually do birth children and know that a bomb isn't a baby.
But little Patty Malone was a baby - and it was only the fearless challenging spirit of the native born Manhattanite that saved her life ... when a heartless government refused to help.
So, People of Manhattan, take a bow.
True, it was only men that did all the heavy lifting in saving this particular child, but I am convinced that her story moved millions of Doctor Moms to demand that their men get off the sofa and start making penicillin for real, right away.
In particular, her story moved one Doctor Mom with the real power to move mountains of inertia : Mae Smith.
She was the wife of the boss of Brooklyn-based Pfizer, John L Smith.
In the summer of 1943, his firm was best positioned (culturally) in the world to make the needed penicillin ---- all by its self.
But he was a very cautious and frugal man and he refused to do the right thing, rather than the financially safe and lucrative thing.
Until his wife reminded him, once again, that Dr Henry Dawson had always insisted that their eldest daughter would have remained alive, if only penicillin had been earnestly produced, not long after its discovery.
Learning of little Patty Malone plucked from death's door touched Smith's heart ; finally made Dawson's claim seem real to John L.
In a few short months, Pfizer was indeed producing enough penicillin for all those in the world dying of susceptible infections.
Abundant amounts of Pfizer Penicillin created an opportunity for America to practise influential penicillin diplomacy , replacing Pax Britannia with Pax Americana.
Britain and its Dominions had the most moral capital, from standing all alone against Hitler for years, and it had the moral first claim on penicillin.
But for want of a price of a single additional bomber squadron for Butcher Harris, the Conservative Party-dominated British government threw all that moral capital away, handed it over to the Americans on a platter, gratis.
That price, of just one bomber squadron among many, would have given Glaxo a Pfizer's sized plant, months before Pfizer.
By contrast, WWII is usually seen as the process that finally killed the hopes of the New Deal.
But I argue, that the New Deal's final act was actually its finest hour.
Britain's Ministry of Supply set the amount of penicillin it wanted produced during the war years to just be enough ( barely) for front line troops.
It forbade the bigger colonies like India to make their own penicillin (postwar export market considerations dominated official thinking.)
The supply amounts set by the gutless Dominions perfectly reflected Britain's niggardly attitude to the needs of their own civilians and the civilians of the occupied lands.
By contrast, in May 1943, one of the last big New Deal organizations created, the American WPB (War Production Board) , set the amounts of American penicillin it wanted produced so high that it could easily supply America ( military and civilian) and most of the world besides.
Thirties style "Social medicine" concerns had finally won out over the Forties "War medicine" niggardliness.
Henry Dawson's long, lonely defence of heightened social medicine in a time of war against an enemy who didn't believe in it even in peacetime had finally borne fruit : now America was preparing to combat the Nazis morally , as well as just militarily.
Venus Manhattan was in the driver's seat, along with Mars Manhattan ....
Thursday, March 7, 2013
Needed: a political - not Technological/Whig - history of wartime penicillin
Almost all histories of penicillin have but one plot : the dramatic, last minute come-from-behind victory of the little guy, HIGH TECH MAN, over the vast evil forces of Nature and fungi spores.
In pointed fact, the technical problems of producing life-saving penicillin was solved very quickly, basically done by one or two individuals with remarkably low level technology, by the Fall of 1941.
But even the most affluent members of the world could not reliably access life-saving penicillin for another five years and it still remains important to discover why.
And most of the world's poor couldn't access it for many more years after that ---- and in fact millions still die worldwide every year because properly prescribed antibiotics are beyond their economic reach.
The delays in delivering life-saving medicine were not technological in nature (the technological difficulties dog ate my penicillin homework) but rather political --- and ultimately moral.
It is not a coincidence that the only one of the four English speaking countries ( the four that produced 99% of WWII's penicillin) that was dominated by a Conservative Party also did by far the worst wartime job in getting penicillin to their dying civilians --- for whom penicillin was their only hope of survival.
I refer to Winston Churchill's UK government.
Penicillin rationing from 1942 onward, in all the Allied nations, was a deliberate choice made by government bureaucrats and politicians and company CEOs - not something imposed upon them from without by sheer technological necessity.
To still deny that - 75 years after the events and in light of all our archival knowledge - is to exhibit academic bad faith.
In 1943 that cosy consensus, about rationing penicillin and news about penicillin cures, broke up as some bureaucrats, politicians and CEOs in some countries decided to go all out to produce enough penicillin for everyone - in their own nation and beyond.
Others still much preferred that any spare national cash go to extra weapons and not into building extra penicillin plants.
They did not want to admit the absolute need for a medicine to save the lives of their own civilians , now needlessly dying of infections that the sulfa drugs had once cured.
Today, we have dozens and dozens of alternative antibiotics to suit almost any imaginable life-threatening infection.
But each of the half dozen successful sulfa drugs were best over a different narrow array of diseases - so if a patient had a strain resistant to the sulfa drug best suited to their disease, they generally had nothing left between them and death.
Except penicillin - effective against most all gram positive bacteria and much slower to gain strains resistance to it.
Simply put, diverting money that could have gone to building more penicillin bottle plants into building yet more military weapons instead, meant that Allied civilians died needlessly so more Axis civilians could die from Allied bombs.
Britain declared war on Germany in 1939, but thanks to a deliberate decision made by Winston Churchill, British soldiers were not fighting German soldiers on German soil till 1945 - and if he had had his way, British troops would never have set foot on German soil till after the German surrender.
The lives of Axis and Allied soldiers were spared, the lives of Axis and Allied citizens condemned, by this Churchillian decision.
However, his bomber-led vision for winning the war was probably not the main reason his government rejected building enough bottle penicillin plants in 1943 to supply soldier and citizen alike.
After the release of Beveridge Report in the Fall of 1942 - a report he didn't want his government to publicly release - the idea of his government facilitating the means to give life-saving penicillin to all that needed it seemed to smack of approving of the Beveridge Report.
Penicillin for all civilians needing it seemed the thin edge of a socialist edge.
America's equivalent of the Beveridge Report happened in the mid 1930s under the rubric of calls for more Social Medicine.
That report's main thrust was calling upon governments to actively commit to freeing citizens from freedom of want , particular freedom from want of life-saving medical care.
To Churchill's Conservatives, a government seeing to it that all dying citizens got penicillin would have been as repugnant in peacetime as it was in wartime.
It couldn't politically survive publicly advocating the denial of needed medicine to poorer dying civilians in peacetime, but under the spurious blanket claim of 'military necessity', a government could get away with it in wartime - as the American Republicans and Hitler both found out.
(Hitler only nerved himself to start killing Germany's 'useless mouths' after the war was underway and even appeared to back off as news got out and citizens protested.)
(During WWII, the dominant Republic core of the American medical establishment long denied life-saving penicillin to the mostly poor (aka Democrats) citizens dying of subacute bacterial endocarditis.)
I happen to think that telling the story of the ultimate abundance of wartime penicillin not as a victory over technological challenges but as a battle between different political ideologies is not only truer, but it is almost much more dramatic : a page-turner and good history.....
In pointed fact, the technical problems of producing life-saving penicillin was solved very quickly, basically done by one or two individuals with remarkably low level technology, by the Fall of 1941.
But even the most affluent members of the world could not reliably access life-saving penicillin for another five years and it still remains important to discover why.
And most of the world's poor couldn't access it for many more years after that ---- and in fact millions still die worldwide every year because properly prescribed antibiotics are beyond their economic reach.
The delays in delivering life-saving medicine were not technological in nature (the technological difficulties dog ate my penicillin homework) but rather political --- and ultimately moral.
Conservatives, Republicans & Nazis - and penicillin
It is not a coincidence that the only one of the four English speaking countries ( the four that produced 99% of WWII's penicillin) that was dominated by a Conservative Party also did by far the worst wartime job in getting penicillin to their dying civilians --- for whom penicillin was their only hope of survival.
I refer to Winston Churchill's UK government.
Penicillin rationing from 1942 onward, in all the Allied nations, was a deliberate choice made by government bureaucrats and politicians and company CEOs - not something imposed upon them from without by sheer technological necessity.
Academic 'Bad Faith'
To still deny that - 75 years after the events and in light of all our archival knowledge - is to exhibit academic bad faith.
In 1943 that cosy consensus, about rationing penicillin and news about penicillin cures, broke up as some bureaucrats, politicians and CEOs in some countries decided to go all out to produce enough penicillin for everyone - in their own nation and beyond.
Others still much preferred that any spare national cash go to extra weapons and not into building extra penicillin plants.
They did not want to admit the absolute need for a medicine to save the lives of their own civilians , now needlessly dying of infections that the sulfa drugs had once cured.
Today, we have dozens and dozens of alternative antibiotics to suit almost any imaginable life-threatening infection.
Unheard amid the din of war , the Sulfas started failing bad
But each of the half dozen successful sulfa drugs were best over a different narrow array of diseases - so if a patient had a strain resistant to the sulfa drug best suited to their disease, they generally had nothing left between them and death.
Except penicillin - effective against most all gram positive bacteria and much slower to gain strains resistance to it.
Simply put, diverting money that could have gone to building more penicillin bottle plants into building yet more military weapons instead, meant that Allied civilians died needlessly so more Axis civilians could die from Allied bombs.
Britain declared war on Germany in 1939, but thanks to a deliberate decision made by Winston Churchill, British soldiers were not fighting German soldiers on German soil till 1945 - and if he had had his way, British troops would never have set foot on German soil till after the German surrender.
The lives of Axis and Allied soldiers were spared, the lives of Axis and Allied citizens condemned, by this Churchillian decision.
However, his bomber-led vision for winning the war was probably not the main reason his government rejected building enough bottle penicillin plants in 1943 to supply soldier and citizen alike.
The Beveridge Report and Penicillin
After the release of Beveridge Report in the Fall of 1942 - a report he didn't want his government to publicly release - the idea of his government facilitating the means to give life-saving penicillin to all that needed it seemed to smack of approving of the Beveridge Report.
Penicillin for all civilians needing it seemed the thin edge of a socialist edge.
America's equivalent of the Beveridge Report happened in the mid 1930s under the rubric of calls for more Social Medicine.
That report's main thrust was calling upon governments to actively commit to freeing citizens from freedom of want , particular freedom from want of life-saving medical care.
To Churchill's Conservatives, a government seeing to it that all dying citizens got penicillin would have been as repugnant in peacetime as it was in wartime.
It couldn't politically survive publicly advocating the denial of needed medicine to poorer dying civilians in peacetime, but under the spurious blanket claim of 'military necessity', a government could get away with it in wartime - as the American Republicans and Hitler both found out.
(Hitler only nerved himself to start killing Germany's 'useless mouths' after the war was underway and even appeared to back off as news got out and citizens protested.)
(During WWII, the dominant Republic core of the American medical establishment long denied life-saving penicillin to the mostly poor (aka Democrats) citizens dying of subacute bacterial endocarditis.)
I happen to think that telling the story of the ultimate abundance of wartime penicillin not as a victory over technological challenges but as a battle between different political ideologies is not only truer, but it is almost much more dramatic : a page-turner and good history.....
Friday, February 8, 2013
Re-setting the Allies' moral compass : the acid test of penicillin for wartime endocarditis
Please correct me : but in all my research I could find no indication that in his 15 years of medical research before October 16th 1940, (and he was a world-class expert in the area of strep bacteria) Henry Dawson had never written or spoken one peep - not one peep - on the subject of endocarditis, a very common and deadly disease, usually caused then by a variant of strep bacteria.
Dawson was a scientist who spoke and wrote a lot , so his silence , until October 16th 1940, was surely hardly from lack of opportunity.
Nor was it bureaucratically and professionally easy, in October 1940 anymore than it would be today, to go from being the director of an outpatients' clinic on chronic arthritis to suddenly becoming the lead doctor on a totally new treatment of such an acute cardiac illness as subacute bacterial endocarditis (SBE).
At least not in a big teaching hospital, with all boundary-conscious specialists rigidly defined in each area.
So we are still left with the puzzle explaining why Dawson literally gave his life to suddenly treat and cure this hitherto incurable disease, endocarditis.
It helps to recall that as a paid up member on the side of Social medicine at a time when War medicine was in the ascendancy in the corridors of Columbia Presbyterian Medical Centre that Fall, Dawson's ears must have zeroed in on the disease quickly voted "the absolutely lowest priority disease in all War medicine" : and that SBE.
The overall consensus that that the SBEs consumed endless amounts of medical care, generally only to quickly die anyway.
Or if they did by some weird chance recover - this time - they couldn't much useful war work with their weakened heart and anyway would surely succumb to a second bout of SBE.
Dawson might even have agreed with this assessment , albeit reluctantly, before October 1940 : nothing, not even the much vaunted brand new sulfa drugs, did anything to extend the SBEs' chances.
But to Dawson, if not to any one else in the world, the written claims about this new , as yet untested, drug penicillin seemed to offer a way out.
It promised activity against SBE's green strep bacteria, good diffusibility and above all , near absolute non-toxicity.
The latter was critical because ("Blood, blood everywhere and not a drop to drink") ironically the heart's values have almost no internal blood supply and must be 'dabbed' by a drug filling the entire blood supply, as it whistles past the heart valves at break neck speed.
An internal "antiseptic" as it were.
Any drug strong enough to instantly push its way through the thick vegetation on the heart valves and quickly kill the strep within , as it rushed on by at 'breaking the speed limit speeds' was also strong enough to be toxic to the entire human body.
SBE was a "disease designed by a committee" : a committee of Devils creating a disease so devilish as to even frustrate God Himself.
SBE seemed an impossible cure -- surely a quick death following upon benign neglect was the most merciful choice ?
But none of the SBE experts seemed to feel as he felt ; none was willing to do the sort of heroic medicine required to at least give crude penicillin and SBE the old school try.
Did Dawson begin to feel that this indifference to the possibility of curing SBE, "the polio of the poor", was just an excuse?
Did he not buy the claim that the difficulties of preparing penicillin together with all the preparations for war medicine and for prioritizing medicine for the 1A fit was the real reason for inactivity on SBE ?
Or was it really just an excuse to roll back New Deal efforts to do something medically for the poorest and weakest (the 4Fs) among us ?
Were there not strong rumours about that the Nazis were also abandoning the poorest and the weakest among the German patients, also using the necessities of war to justify their actions ?
Whatever ethical speculation led him to his decision, it is a fact that on October 16th 1940, Henry Dawson made the wartime treatment of the weakest of the weak, the 4Fs of the 4Fs, the ultimate acid test for the moral compass of the Allied cause.
It took him years - and cost him his life - but he got that moral compass set right, right in the middle of a bloody war.
Finally, treating the SBEs, the least of these, as we would want ourselves to be treated, became the practise of the Allies, not just another plank in their hollow public rhetoric....
Dawson was a scientist who spoke and wrote a lot , so his silence , until October 16th 1940, was surely hardly from lack of opportunity.
Nor was it bureaucratically and professionally easy, in October 1940 anymore than it would be today, to go from being the director of an outpatients' clinic on chronic arthritis to suddenly becoming the lead doctor on a totally new treatment of such an acute cardiac illness as subacute bacterial endocarditis (SBE).
At least not in a big teaching hospital, with all boundary-conscious specialists rigidly defined in each area.
So we are still left with the puzzle explaining why Dawson literally gave his life to suddenly treat and cure this hitherto incurable disease, endocarditis.
It helps to recall that as a paid up member on the side of Social medicine at a time when War medicine was in the ascendancy in the corridors of Columbia Presbyterian Medical Centre that Fall, Dawson's ears must have zeroed in on the disease quickly voted "the absolutely lowest priority disease in all War medicine" : and that SBE.
The overall consensus that that the SBEs consumed endless amounts of medical care, generally only to quickly die anyway.
Or if they did by some weird chance recover - this time - they couldn't much useful war work with their weakened heart and anyway would surely succumb to a second bout of SBE.
Dawson might even have agreed with this assessment , albeit reluctantly, before October 1940 : nothing, not even the much vaunted brand new sulfa drugs, did anything to extend the SBEs' chances.
But to Dawson, if not to any one else in the world, the written claims about this new , as yet untested, drug penicillin seemed to offer a way out.
It promised activity against SBE's green strep bacteria, good diffusibility and above all , near absolute non-toxicity.
The latter was critical because ("Blood, blood everywhere and not a drop to drink") ironically the heart's values have almost no internal blood supply and must be 'dabbed' by a drug filling the entire blood supply, as it whistles past the heart valves at break neck speed.
An internal "antiseptic" as it were.
Any drug strong enough to instantly push its way through the thick vegetation on the heart valves and quickly kill the strep within , as it rushed on by at 'breaking the speed limit speeds' was also strong enough to be toxic to the entire human body.
SBE was a "disease designed by a committee" : a committee of Devils creating a disease so devilish as to even frustrate God Himself.
SBE seemed an impossible cure -- surely a quick death following upon benign neglect was the most merciful choice ?
But none of the SBE experts seemed to feel as he felt ; none was willing to do the sort of heroic medicine required to at least give crude penicillin and SBE the old school try.
Did Dawson begin to feel that this indifference to the possibility of curing SBE, "the polio of the poor", was just an excuse?
Did he not buy the claim that the difficulties of preparing penicillin together with all the preparations for war medicine and for prioritizing medicine for the 1A fit was the real reason for inactivity on SBE ?
Or was it really just an excuse to roll back New Deal efforts to do something medically for the poorest and weakest (the 4Fs) among us ?
Were there not strong rumours about that the Nazis were also abandoning the poorest and the weakest among the German patients, also using the necessities of war to justify their actions ?
Whatever ethical speculation led him to his decision, it is a fact that on October 16th 1940, Henry Dawson made the wartime treatment of the weakest of the weak, the 4Fs of the 4Fs, the ultimate acid test for the moral compass of the Allied cause.
It took him years - and cost him his life - but he got that moral compass set right, right in the middle of a bloody war.
Finally, treating the SBEs, the least of these, as we would want ourselves to be treated, became the practise of the Allies, not just another plank in their hollow public rhetoric....
Sunday, December 2, 2012
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 |
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....
Sunday, September 30, 2012
1940's ISOLATIONISTS abandoned Europe's 4Fs and America's 4Fs
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| 1A = 53% |
Then in the Fall of 1940, these same Isolationists, using the excuse of preparing for an European war - a war that they were actually working all out to avoid - pushed for an abandonment of Social Medicine , in favour of War Medicine.
Translation of this hypocrisy ?
In Eugenics-speak, this meant abandoning efforts to provide medical care to both the well-to-do 1As and the poorer 4Fs, in favour of research on making the 1As into better fighters.
Rooseveltcare as unpopular then as Obamacare is today
Actually, the Isolationists had high hopes that America's 1As would never have to fight : this was all just an excuse to roll back the clock on providing care for the 47% in 1940s America.
Rooseveltcare was no more popular then among the well-to-do than Obamacare is today. (Or Romneycare was in Boston a few years ago - but that is another story altogether isn't Mitt ?)
It was this Isolationist hypocrisy that I believe pushed Martin Henry Dawson over the edge into his all out effort to rescue some American 4Fs (his equivalent of 1915's Belgians), with 4F natural - impure- penicillin, as his rebuke to uncaring America.....
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