Abusive or Honest?

I recently finished reading the book, Breakthrough: How the 10 Greatest Discoveries in Medicine Saved Millions and Saved the World, which I got for free on my Kindle. The section about germ theory talked about Ignaz Semmelweis, of course, and his conviction that it was an “invisible particle” carried by physician to woman that was causing “childbed fever” to be a rampant problem in hospitals. (I appreciated that the book noted that mortality rates for women attended by midwives or giving birth in their own homes were very low compared to hospital-based physicians.) During the latter part of his life, Semmelweis became very agitated by the failure of his colleagues to recognize the validity of his theory of the cause of childbed fever and began sending them, “vicious letters.” An example included in the book was the following:

Your teaching, Herr Hofrath, is based on the dead bodies of women slaughtered through ignorance…If, sir, you continue to teach your students and midwives that puerperal fever is an ordinary disease, I proclaim you before God and the world to be an assassin…

The author goes on to explain that Semmelweis later died in a mental institution and that, “Ironically, some contend that Semmelweis’ final vitriolic attacks against his colleagues constituted a third key milestone: His abusive letters may have helped raise awareness years later, as other evidence for germ theory began to accumulate.”

I find it fascinating that his frustration and anger towards his colleagues is described as “abusive” and “vitriolic,” when Semmelweis wrote a book, presented papers, and spoke with other professionals at length about the issue and was dismissed and even mocked for his ideas. When his (correct!) theory continued to be ignored and women continued to die, isn’t he a little entitled to be angry and express that?! I think he was being honest in his letters, not abusive. It made me think of how women are dismissed as being “drama queens” for being upset about unnecessary cesareans and that the terms “birthrape” or “birth trauma” are viewed by some as too “extreme” and how the medical profession all too often continues to NOT practice evidence based maternity care with regard to a variety of issues from restrictions on freedom of movement, to continuous fetal monitoring without indication, to risky induction of labor procedures, to cesareans for “failure to progress.” In the future, these experiences and women’s and birth advocates’ “vitriolic” reactions to them may be viewed through the same lens in which I view Semmelweis’ attempts to share his findings—they were trying to tell people something really important after all.

In another section of the book, the author says, “Scientific medicine has never been shy to dismiss if not denigrate any perceived threat to its values or power.” We continue to regularly see this in maternity care today!

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