October 15 1940 : a Fighting 69er fights SBE instead ?

Almost everyone dimly recalls hearing about New York's famous "Fighting 69ers" / "the Fighting Irish" - an infantry regiment more formally known as the 165th (infantry) Regiment, New York State National Guard,--- part of New York State's 27th Division.

Though a state regiment, it in fact recruited exclusively from NY City.

On October 15th 1940, the day before America's first ever peacetime draft registration, the day before History's first ever antibiotic shots, it was 'federalized' and began moving to the US Army's Fort McClellan in Alabama.

And there by hangs yet another intriguing tale in the wartime penicillin saga.

When the upward causation of 'invariably fatal' SBE meets the downward causation of Dawson's agape penicillin

Let us accept - for the sake of the argument - the unproven assumption that many kids could even get SBE disease out there in the Social Darwinists' belovedly savage "Nature" that existed before Christian compassion peed on their picnic.

75 years ago, on a day supposedly devoted to 1As, two New York City 4Fs made medical history instead

It is an irony beyond all measure that on America's first ever peacetime Draft Registration Day, October 16th 1940, a day designed to separate the 1A sheep from the 4F goats, two 4Fs (a black man from Harlem and a Jew from the Bronx) instead made medical history by ushering in our current Age of Antibiotics !

And they made history not by accident of sheer coincidence either.

Mostly poor people ALL OVER THE WORLD denied life --- by wartime's Republican-dominated NAS death panel

American doctor-run death panels did exist and they did sentence people to an inevitable death based on mostly eugenic driven considerations.

It happened during WWII.

The patients denied access to penicillin (that was the only thing that could save their lives) were all suffering from subacute bacterial endocarditis (SBE) that was then a leading cause of death for poor, minority and immigrant youths - the final deadly stage of childhood attacks of rheumatic fever.

Actually the entire spectrum of possible ways to die from rheumatic fever (known as Rheumatic Heart Disease or RHD) was the leading cause of death for school age children and youths in all of the industrialized world - far far more than polio for example - and would remain so till the 1960s.

But you won't know this unless you were very poor ; it wasn't a middle class disease.

Now this story of the wartime bureaucratic denial of penicillin to SBE patients isn't totally unknown to students of the history of wartime penicillin - but most think that this diktat was limited to American patients only.

But I have been tracing how the same American-originated list of diseases to be treated (or not) by GPs using this new penicillin kept re-appearing world wide, always with virtually the same wording.

So far I have traced the publication of this diktat (intended to apply to all GPs) in journals or newspapers in Canada, Britain, Australia , and now New Zealand.

The New Zealand newspaper report in June 1944 was franker than most - the nation wasn't making its own penicillin but was wholly dependent on penicillin given to it (via Australia) by America.

But the report indicated that the penicillin gift came with strings - the Kiwis had to agree to refrain from using the medication on diseases that were being ignored in America and in all the other Allied nations.

The disease the Kiwis and all the others were specifically told to ignore was SBE.

The NAS panel headed up by Dr Chester Keefer - himself an expert on SBE - was in a dispute with Dr Martin Henry Dawson and his supporters who was insistent their numerous patient cures indicated that penicillin and only penicillin could cure SBE and do so completely.

(Dawson and his supporters were 100% right by the way !)

If news came to American SBE patient families that in New Zealand SBEs were being treated and cured by penicillin, Dawson would have a further ammunition to inadvertently embarrass Keefer.

Inadvertent because while Dawson was a rank amateur on SBE until he started in with penicillin (and was anyone never one to be mean to fellow scientists),  Keefer had made SBE's cure his life's work.

But Keefer had backed the wrong horse as to the best drug to cure SBE and wasn't willingly to publicly back down and grant that Dawson was right.

Keefer had other more public excuses for his denying penicillin to SBEs , but this was the real reason ...

How big is the metropolitan New York City area ?

For people like newspaper reporters, sales reps and professionals delivering a lecture or paper, the furthest extent of metro NYC is pretty easy to measure.

If you can get into work early, check in and then take a car or train to the location, do some useful business and then return late to the office, and then still later home to sleep in one's own bed, it's still metro.

Rising early and home late may be hellish and the checkins at the office bookending your work day may be mere tokens but it avoids that expensive hotel room and best of two days (or more) away from family and office.

The time of day for your key business is paramount - an evening lecture or presentation makes the circle of distances evoke by words 'metro NYC 'very much much smaller.

Measuring the extent of metro NYC is important in the tale of the Gotham Eight because metro residents shared a lot in common with Dr Dawson and his team.

Metro residents all heard NYC radio, possibly watched - even then - NYC TV , read the big NYC papers , understood all the local NYC area references , took in big NYC movies and musicals and sports events.

You were among your own kind, sharing a common metro culture - even in fairly frequent (because it was relatively inexpensive) all important 'personal' contact.

By contrast, Dawson's infrequent but extended wartime trips ( all prior to his late 1942 success with SBE) to such places as Baltimore, Washington DC, St Louis , Louisville, California , even his native Nova Scotia took him into fairly alien terrain.

In wartime conditions of restricted travel and censorship, and given his rapidly declining health, Dawson's post November 1942 success with penicillin for SBE was not known beyond metro NYC's medical and research community.

But a community he had been very active in , for almost twenty years.

And fortunately for all of us , the small wartime fish bowl he was stuck in (metro NYC) was a community with more people than most 1940 nations, living in close proximity with good intersecting communications and was home to much of the regional, national and global media.

So while it is true that word of his SBE successes spread only locally inside the fish bowl via local medical gossip (noting that in wartime gossip becomes much more important and much more believed) , only London could really equal metro NYC as a fortunate and powerful fish bowl to be stuck in....

'There's just something about a Mercury ' : how the potential of a young black man kickstarted penicillin and has benefitted ten billion of us ever since

Can we still - 75 years on - get some sense of the personality of the very first person in history to get an antibiotics injection ?

Fortunately , yes.

But why then should we even care ?

Because, children , just because.

Because the normally reserved doctor who kickstarted natural lifesaving penicillin-for-all (the medical approach that has benefited about ten billion of us since 1940) personally wrote and told Nobel winning Ernst Chain that this patient's personality and potential had directly inspired him to take up his penicillin crusade.

When the personality of a young black man inspired medicine's biggest ever paradigm shift, an event that saved my life and that of many in my family, of course I want to know all I can about this wonderful person.

And if you have ever had a family member saved by antibiotics and if you have even an ounce of gratitude within you, so should you.

So here is a long "letter to the editor" that A. (Aaron) Leroy Alston wrote , addressed to the black-oriented New York Age newspaper in early April 1939.

That is just 18 months before he received that historic first ever needle.

And it allows us to learn something of the patient who inspired a doctor to change our whole world for the better , forever .

Words of first patient in history to get an antibiotics injection

Aaron, a young black man with a high school graduation certificate , held a good day job in an insurance company at the height of the Great Depression.

This is quite impressive because the Depression was a tragic event for most Americans but certainly hit black Harlem extra extra hard.

He was also a winning track star who then founded the Mercury Athletic Club.

The club, with him as coach, manager, pr rep and fundraiser , focused on seeing that Harlem's black female runners finally got a chance to compete in the big races.

They did very well, as he says in this letter to the editor - for the first time black girls were being judged as the best runners in America in various categories.

Who knows what further good young Aaron might have done if only Alexander Fleming had tried harder, earlier, to see to it that penicillin become a real lifesaver.

True, (Martin) Henry Dawson in October 1940 did kickstart the process to make penicillin into a cheap abundant lifesaver that was available to all .

But though Dawson was inspired to do so by seeing all of young Alston's great potential going with him if he should die,  Dawson had made too little penicillin - at that time - to save Aaron.

So young Aaron died. But he was not a victim or a loser.

He had already done a lot.

And I sincerely believe that for all the good he might have gone on to do over a long life, if he hadn't contracted invariably fatal SBE endocarditis, it would never have matched what he did do as a dying patient.

For when his buoyant-personality-in-the-face-of-imminent-death met a doctor looking for a way to help retain social values in the middle of a big war, our whole world started to change for the better.

Who among us - including the fictional trio of Anne of Green Gables, Pollyanna and Rebecca of Sunnybrook Farm - can claim that great honour ?

Charlie and Miss "H" : these Lazruses of Manhattan defied the odds time and again to offer hope to a war-weary world

"Dead Men Waiting" or "Dead Women Waiting" is the way most staff in hospital regarded the the  patients in the Green Wards where earlier Rheumatic Fever sufferers with green strep in their heart valves waited out their turn to die.

Dr Martin Henry Dawson was determined that his hand-grown penicillin could help them to beat those odds and return these lazaruses to health , to give them a fair crack at enjoying their three score and ten here on Earth.

His struggle - partly against the disease , mostly against his own colleagues and wartime  government - cost him his own life , but in the end he succeeded against all measure of imagining , improving not just the future of the SBEs but of the entire world itself ....

Charlie and Miss "H" : The lazarus SBE patients of New York who beat the odds time and again to go on surviving

"Dead Men Waiting" or "Dead Women Waiting" is the way most staff in hospital regarded the the  patients in the Green Wards where earlier Rheumatic Fever sufferers with green strep in their heart valves waited out their turn to die.

Dr Martin Henry Dawson was determined that his hand-grown penicillin could help them to beat those odds and return these lazaruses to health , to give them a fair crack at enjoying their three score and ten here on Earth.

His struggle - partly against the disease , mostly against his own colleagues and wartime  government - cost him his own life , but in the end he succeeded against all measure of imagining , improving not just the future of the SBEs but of the entire world itself ....

Big Pharma -Kos : sacrificing WWII's bumpy SBE patients as scapegoats to restore a streamlined conscience

Pharmakos were those unfortunates in Ancient Greece who happened to be poor and crippled and without any local, prosperous, relatives to succour them, who were thus forced into slavery, begging or petty criminality.

When a crisis arose and the normally smoothly streamlined social sphere developed strains and cracks, the Pharmakos were scapegoated restored it.

Social 'bumps' (the Pharmakos) were beaten out - metaphorically as well as in actuality - to return streamlining and normalcy.

This was done by a sacred solemn ritual of executing, expelling or beating a physically, mentally or culturally deformed (misfitting) individual , preferably one without any powerful relatives close by to exact possible vengeance.

I have always wondered why the wartime American NAS felt it was so very very important to strenuously deny penicillin to the very small number of SBE patients asking for it between the summer of 1942 and the summer of 1943.

They were the only patients denied lifesaving penicillin for a condition where penicillin was not just a cure but the only cure.

(I have absolutely no qualms about denying penicillin (limited or not) to dying patients against which penicillin had no possible effect - viral diseases for one.)

One of the biggest social strains a war produces on the home front is the inequality of individual and family sacrifice - who goes to war and gets shot - who stays home and gets promoted ever upwards into the slots of those away fighting overseas.

I believe that the upwardly mobile chicken hawks on the NAS Death Panels turning down these SBE requests (and thus sentencing innocents to a quasi-judicial death) may have unconsciously felt they were thus 'dealing death' just like those of their age group who had been or were in combat zones - salving in a complex way their own internal social strain and bumpiness.

Who can tell ...?

Aaron Alston , penicillin's first SBE patient but second to get the historical injection

The known published facts are few

All the contemporary (1945 era) newspaper and book accounts - written by (or coming second hand from) participant eyewitnesses to the events themselves - make it clear that Martin Henry Dawson's first SBE/penicillin patient was a "negro" "man".

And that his name was"Aaron Alston" and that he subsequently "died".

The available record of the amounts and dates that Aaron received Dawson's penicillin - as published by key Dawson team member Dr Gladys L Hobby in her 1985 book on penicillin , Penicillin : Meeting the Challenge , ceases near the end of January 1941.

And that is all the published accounts show.

But now for new research and reasoned suppositions...

We can say that 1940s medical statistics indicate that Alston was a more likely than not a young adult when he entered the hospital with SBE .

It is clear from the census that the names Aaron and Alston is a combination found in a fair number of men in America in the first half century of the 29th century.

However , the censuses generally indicates they are usually negro and that their residences seem centred in the South - from rural Carolina into urban black centres like Washington and Baltimore.

But in the critical 1940 census , there is no Aaron Alston recorded in New York City or in nearby New Jersey and Connecticut.

Now the first SBE patients that Dawson dealt with in the public wards of his upper Manhattan Columbia University Presbyterian Hospital were simply there because they were poor and his hospital happened to be close to where their family lived or close to where they lived when they took ill.

They were not drawn there from great distances because Dawson was then a famous and successful expert in this nearly 100% invariably fatal disease.

Far from it , he hadn't in fact handled any SBE cases up to then as the lead doctor.

Alston almost certainly had to be residing within a three or four miles circle of the Presbyterian hospital, at most , at the time he took ill. But the census does not show this.

He may have moved to New York City after April 1940 and before September 1940 : because southern blacks were still coming north to the unofficial American black capital of Harlem , though there was rarely gold for them at the end of its tattered rainbow.

Harlem is well within the catchment area for the Presbyterian's public wards.

We seemed to have failed to find out anything more about Mr Alston.

But as it happens, the New York City individual death records up to 1948 have been hand indexed on computer by many volunteers and made available via Ancestry.com.

They show an Aaron Alston , born about 1911 , (that is about age 29 on date of his admission to the hospital in September-October 1940) has having died on Jan 25th 1941 in Manhattan.

I am not sure that the original  death record will reveal more more - but perhaps a last address in New York and the name of next of kin and their home town , but I feel 100% certain this is our Mr Alston.

All we have really confirmed so far is that he was indeed a young man at time of his admission , as expected.

Why first patient but second to get the historic penicillin injection

Now while I am certain that Mr Alston was first SBE patient Dawson intended to treat with penicillin, I think he got it moments after Charles Aronson , the other SBE patient to get the historic penicillin injections on October 16th 1940.

Dawson's first major paper on penicillin and SBE was significantly the first penicillin paper not written by him with the help of the very reticent (as he himself was !) Dr Gladys Hobby, his lab chief.

Co-written instead with young Dr Thomas H Hunter, it positively gushes - for Dawson anyway - in giving forth the ages, initials of their name, gender, ethnicity,  dates of treatment, medical condition etc of all the SBE patients that Dawson had treated.

This was a style that Dawson had never shown before in 20 years of writing many, many medical articles.

Some doctors ("clinicians") simply tend to write articles that minutely detail the very 'grain' of  one (person's) case - while others ("researchers") prefer to report on the general conclusions drawn from treating one hundred similar cases.

(Both are valuable to doctors and scientists - but biographers won't be human if they didn't prefer the intimate details of the first type of articles !)

Dawson gets a chance in mid April 1944 to treat Charles Aronson a second time with penicillin for SBE .

This was because the little penicillin Charles had gotten in October 1940 had helped him survive his first bout of SBE.

He thus became that rare successful SBE case (about one in a hundred) that did so , back then.

Dawson indicates  in 1945 , that Charles had first entered the Presbyterian three and a half years earlier - ie mid October 1940 , confirming the common assumption that he was a very late addition to Dawson's Penicillin SBE program.

(Dawson knew he had too little penicillin to even treat Alston adequately, but he kind-heartedly treated both.

He was hoping perhaps that any small sign of a clinical response from either one of them might move Big Pharma to step up to the plate and mass produce the stuff --- for Aaron, Charlie and everyone else.)

Literally : the last shall be first 

But did Dawson really add Charlie at the last minute out of kind-heartedness alone ?

I believe the real reason was because Charlie was such a late addition to his ward's SBE patients.

When a new patient arrived with suspected SBE - a relatively slow killer, first a number of blood tests over a number of days must show the continued and not merely transitory presence of green strep in the blood stream to match all the other classic clinical signs of SBE,.

Then the ethical response is to immediately start treatment with the newest miracle drug , sulfa, and pray.

This is what happened to Aaron, who had been in the ward about a month when he first got his penicillin.

But because Charlie was such a late addition, there hadn't been time to start treatment with sulfa drugs .

So if Charles was treated with penicillin alone and did show a clinical improvement, Dawson's sulfa worshipping naysayers (and their lineup began around the block) could not say it was all due to their established sulfa , not his new penicillin.

(Remember that a lot of middle-aged doctors , the same age as Dawson , had first made their mark as early sulfa drug pioneers - any new miracle drug meant their acclaim was over. )

Behind the polite rancour of academic/scientific 'critiques' is often a lot of half-hidden ego and income concerns.

Dawson recalled, in his 1945 article , that the 1940 Charles was treated with penicillin on October 16 and 17th and then immediately (first) "started" on sulfa on October 22 and that he responded so well that he was released in December and was illness free for three plus years.

Ethically, Dawson would never have wasted half of his tiny amount of penicillin he intended for Aaron on Charles --- if he was already responding well to sulfa.

I think the reason it became so urgent to treat Aaron in mid-October (well in advance of the Dawson team's own original timetable for starting clinical trials) was because he had already been treated with sulfa and it had failed.

And maybe even made him extremely sick  because allergies to sulfa are common and serious.

But treating Aaron alone risked having any penicillin success disputed by the pro-sulfa lobby and this would only forestall drug company involvement - hurting Aaron as well as all others.

Hence Charlie not only getting treatment but getting treated ahead of Aaron , if only by moments.

Ask anyone : nothing starts off a (soon to be citation classic) medical article quite like an opening sentence like this one ---

"The first patient  ever treated with systemic penicillin had (then invariably fatal) SBE , but had not yet had time to start a sulfa treatment, however he responded so well to the penicillin that he has now been home fully recovered for over six months months."

In fact Dawson saw no clinical response at all between cases of endocarditis and penicillin for one and a half long years and he didn't save anyone with the disease purely on penicillin alone until two years later.

But Charles's recovery might have been helped by the morale uplifting affect of simply knowing that he was Patient One of a touted new Miracle drug .

I can only hope that my research efforts eventually help Aaron Alston's relatives to gain some comfort from his short life.

They will learn that he helped bring penicillin into this world and that while it didn't help him personally, it has directly and indirectly helped ten billion of us in the seventy five years since he first received it.....

Repaying, with gratitude, Henry Dawson's selfless act of Agape

Thanks to her genes, my mother and her children never met a strep disease we didn't like and if it weren't for Henry Dawson's selfless act of Agape, it is possible that I won't even be here today.

Grateful ?! Of course, I'm bloody grateful !

Grateful enough to be glad to spend tedious years tracking down the missing history of the man who improved our lives and the lives of ten billion others since 1940.

My mother was born in October 1928, the same time Alex Fleming started messing about with penicillin and the same year Gerhard Domagk started on the path that led to the sulfa drugs.

She was about seven or eight, around 1936, when she got GN (glomerular nephritis) after a case of strep throat.

In children her age, this relatively common auto immune reaction of certain people to certain strains of  GAS strep, only damages their kidneys for a few months and recovery appears to be full.

Prompt treatment with sulfa, then very new on the market, would only have helped if given at the time of the strep throat - an event then very unlikely to happen with any child.

But sometimes with GN the damage left behind is permanent and in certain circumstances leads to a chronic form of this kidney disease.

In 1947-1948, my mother was in newly communist Hungary, studying under extremely impoverished circumstances.

She got sick with GN nephritis again (a condition much more serious in adults) and was given sulfa - and got a severe sulfa allergy reaction and so was taken off it.

The Cold War meant Hungary didn't have much penicillin.

As a result, her kidneys and high blood pressure never seemed to have fully recovered and in fact got worse and worse.

Usually as a result of the extra strain put on her kidneys and blood pressure with each new pregnancy (she had seven).

It didn't help she literally had each pregnancy (except for the last two) several thousands of miles away from the last one, each time with different doctors and no back medical records to check.

In the Spring of 1962, she was dying of acute kidney infection and after throwing everything at her, the doctors tried a single course of streptomycin and saved her life .

She was permanently deaf in one ear as a result (a common side effect) but she never ever complained.

Many, many times she told me , "Why complain - that antibiotic saved my life - if I had died your father would have been left with four very young kids and a brand new baby - and him still a grad student."

I didn't then connect her adult disease with her childhood disease because she never told me - only telling of her childhood disease in girl talk with my partner Rebecca and I believe, my sister Margo or Tracy.

My only known childhood encounter with strep was tonsillitis acute enough that my swollen tonsils so affected my voice that I sounded like I was a midget on helium.

But after they were removed, that seemed to have ended me having childhood strep throat instead of ordinary colds, though it is hard to tell for sure.

But my sister Kathi got the once deadly strep disease SF (scarlet fever), a childhood disease that is very highly contagious.

So the authorities came and put a big black Q on a bright yellow back upon our door to indicate we were under legal quarantine and so no one could visit us and we kids had to stay in our yard for weeks.

Kathi got antibiotics at the time but continued to have severe chronic tonsillitis until her teen years.

She has had serious medical problems all her adult life -- they don't seem to be directly related to her love affair with strep bugs -- but there is still a lot we don't know about GAS bacteria.

Next to meet the streps was my brother Bruce. He too had tonsils big and bad enough to make the doctors want to take them out.

But more seriously, one day he suddenly dropped to the carpet in our Victoria BC living room complaining he didn't feel good.

Rushed to a doctor, it was quickly revealed that he had RF (rheumatic fever) because of his persistent heart murmur. Persistent as in he still has it 55 years later.

RF is still deadly today, still potentially fatal, but fortunately rare - at least in in the industrialized world. But until 1960, it was still the leading cause in the industrial world
of school age children having long hospital stays ,dying or facing a lifetime of potentially fatal heart worries.

Yes, RF not Polio!

 Severe Polio was relatively uncommon and inclined to be a middle class suburban disease, while RF traditional hit the urban and rural poor, minorities and immigrants (the so called "Polio of the Poor").

Just guess which disease got by far the bigger press when I was growing up in the 1950s ?

By the time my mother was born and growing up, dying of RF was less common for kids in urban settings, even if poor.

How it did kill them was the fact that the same permanently damaged heart valves that left their mark with their irregular murmur, also became the attractive home for the kind of strep bacteria that form that unattractive green film on unbrushed teeth.

This much different strep from deadly GAS strep was usually harmless.

But it grew as successfully on heart valves (normally impossible for bacteria) as it did on teeth and its little home on the valves would eventually kill all patients, in a great variety of ways, before Henry Dawson got involved.

It was called subacute bacterial endocarditis but not even doctors ever called it that : it was SBE and spoken of in a whisper or a sigh : as in 'invariably fatal SBE'.

SBE usually started killing former RF patients in their late teens and twenties but it could hit babies and the elderly.

RF and SBE packed quite a punch in both the death and terror department.

This is because unusually, both could come back again and again, each time leaving more damage which only made the next attack far more likely.

Because the deadliest strains of RF and SBE came and went intermittently while strep throats were an inevitable fact of life for child and adult, literally no one was potentially free of falling to this combo until they were safely in their forties.

If my mother had gotten severe RF instead of GN, she was statistically likely to get her first, and usually fatal, bout of SBE in her teen years, during WWII.

The Allied medical authorities around the world ignored the fact that Dawson was curing this hitherto invariably fatal disease with penicillin and proclaim that no one, (potentially including my mother) with SBE was to get penicillin and was to be pretend- treated with useless Sulfa doses and left to die (the notorious so called 'Code Slow').

If my mother had had SBE in Canada during WWII and left to die, I won't have even been born.

But she , thank God, didn't get RF or SBE and I was born, only to get her disease GN, was I was 18.

GN for adults is more serious than for children and my abnormal chemical readings, recorded by a brand new hospital machine on paper with a wet ink pen, were impressive indeed.

The technician told my family doctor that some of values recorded were so literally 'off the paper' that the tech had to shut off the machine for fear it would break.

But the kidney disease seemed to have cleared itself by the time I got to hospital six months later --- just as well , as in adults it can lead to renal failure deaths or permanent dialysis.

Only partly my fault for the unusual delay - but of course as a young teenage male I hadn't gone to my doctor until a month after I first got my sore throat, by which time the bacteria was gone but I had so much edema and high blood pressure that I walked like a very old and sick man.)

Characteristically, I was too cheap to consider a taxi and slowly, slowly,slowly walked the mile downhill to my doctor's office --- and back up the hill again afterwards !

Now, unfortunately, in some cases, GN is accompanied by acute haemorrhagic cystitis in a sort of syndrome - and that will be me !

Severe or mild, this bladder condition, if it is permanent, is a life-altering condition.

I will spare you all the embarrassing personal effects, but if you look it up online, I can assure you I have had them all as described here - though fortunately in relatively minor forms.

Now generally me and my family have survived this family tendency to form auto immune responses to GAS strep fairly well - this is mostly down to the fact that the most virulent strains of this bug were knocked back by the fact that unusually cheap penicillin g allowed people normally too poor to receive treatment to get the antibiotic.

So, finally, the reserve pools of virulent GAS found among poor and isolated populations that kept these diseases endemic or epidemic for millenniums ,were wiped out or severely cut down to a minimum.

So when we did get these diseases , we got a less frequent and less virulent strain and we got prompt antibiotics to wipe the diseases out in ourselves.

But this would never have happened without Henry Dawson's moral cry that wartime penicillin must be made available to ALL humanity.

When the general public bought into his radical un-Republican, un-Conservative notion, a vast potential market opened up and as profit-seeking firms flooded in, ways were found to cut the cost of penicillin G from the equivalent of today's Avastin ($100,000 a year) to a price cheaper than water, literally too cheap to meter.

When dealing with a medicine that cures a contagious disease, a cheap drug is also an effective drug - by curing even the poorest and thus wiping out the traditional reserve pools of virulency, this produces a quasi-herd immunity for all the rest of us ---- free !

Henry Dawson gave his life to save only ten from a heartless government, but ten billion have benefited since.

I think there is still a lesson here for all , 75 years on, for all of us involved in Obamacare-like disputes over why provide health care for those who can't pay.

I hope to offer my book for free, or if that is not possible, at least ensure I don't profit from any book sales.

Selfless ? Hardly - I merely intend to give up any book profits - by contrast Henry Dawson "GAVE ALL" ....

"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".....

ALL life is worthy of life as a full citizen or are just SOME judged 'worthy' ?

Nazi Germany - even at the depths of its imminent defeat - treated its full citizens well : recall that POW Kurt Vonnegut was working in a Dresden factory that made food supplements for pregnant mothers at the time of that city's Allied firebombing in February 1945.

But its non full citizens it killed outright or worked to death as starved slaves.

'Life worthy of Life' - 'Life unworthy of Life' are infamous German cum Nazi catchphrases that have come to symbolize THEM, so as to separate US for any shared responsibility for the horrors of  the
eugenic mass murder of WWII.

But when we re-cast those catchphrases as' life worthy or unworthy of life as full citizens' , we become uneasily aware that no society in the early 1940s was free of the sin of treating some of its members as less than fully human.

None .

When Henry Dawson proved this up for the Anglo Allies over their denying of life saving penicillin to young SBE patients deemed useless for the war effort - judged just 'useless mouths' consuming valuable medical resources - he made it clear to many just how close the Nazis and their erstwhile opponents really were, morally......

Dying life unworthy of wartime penicillin was Life unworthy of Life

"all Life is worthy of Penicillin"

The infamous term "Life unworthy of Life", created by a German psychiatrist Alfred Hoche in the 1920s , is generally thought of as bring used exclusively by the Nazis.

Used by them during a Total War to justify killing everyone from working class Aryan babies with developmental issues to the entire Jewish population of Europe.

But the term had a much greater transnational appeal than that .

Prominent American psychiatrist Foster Kennedy thought , in 1941 and 1942, during that same Total War, that the USA would be justified in killing its little Aryan babies with developmental issues.

Shamefully, America's leading psychiatric journal actually agreed with him and only one psychiatrist disputed his thesis.

And the Allies' medical establishment, led by Dr Chester Keefer and his NAS committee, used this idea to justify denying SBE-curing penicillin to young people dying of SBE all over the Allied world,  because they felt that even a cured SBE patient was still useless to the Total War effort.

("Life judged unworthy of Penicillin.")

By contrast, Henry Dawson and a handful of other doctors worldwide supported, and fought for, the notion that "All Life is worthy of Penicillin" - even in , particularly in , a Total War supposedly  fought precisely against the evil idea that some Life was, ipso facto, unworthy of Life.....

WWII was a conflict within nations and within INDIVIDUALS ... as well as between nations

War ,to give it a quick definition, is a violent conflict conducted between nations, not between individuals.

But the intensity of commitment with which individuals and groups within any nation fight in that nation's war can vary immensely --- perhaps never more so than during WWII.

(We are not considering the rare case when a citizen is in total non-compliance with their nation's war decisions, by becoming a complete conscientious objector or a traitor.)

The existing WWI paradigm ,within which all existing history on that war has been written to date , never denies that each nation had a somewhat divided mind between 1931-1945 on various war issues.

Still writers accepting of that paradigm tend to focus exclusively on the nation against nation conflict and - I claim ! - seriously distort what was really going on and what was truly fundamental in a 'long history' view.

These writings tend to limit the war's big moments to a military battle between the modern age's various ideologies : liberal capitalist democracies versus race (Japan, Germany,and Italy's fascism) and class based (communist Russia) dictatorships.

There is no denying that for the world's population living inside the modern age bubble seventy five years ago , it was the differences between the various strands of modern thought that so dominated their minds.

But what excuse have we historical-minded authors , living seventy years after that bubble began breaking, to be 'captured' by our protagonists' ways of thinking ?

Historians like to claim lots of time is necessary between historian and event to render the beginnings of an objective assessment of it.

Isn't seventy five years (and more) time enough to look anew at WWII ?

To see it no merely as a Modern war, but in fact the last Modern war, and the beginnings of the post-Modern world ?

If we look again at the three big Modern ideologies : liberal capitalist imperialism, fascist cum racial imperialism and communist imperialism, we could today try to see that what they had in common , as opposed to what divided them.

What they held in common was an exclusivist or imperialist worldview that divided all the world into those deserving and those undeserving of the basic rights of humanness.

Does it really matter now, except in the details, whether or not their 'undeserving' included blacks or Jews or well off peasants ?

A Leningrad communist harshly criticizing another young communist for sharing her ration with her dying grandmother, saying the grandmother can contribute nothing to the struggle against the Nazi siege, but that young girl could and she needed all that food to keep up her strength.

A Nazi plan to kill off all German mentally challenged children in taxpayer-supported institutions so that their hospitals and staff could be used instead to look after moderately wounded soldiers capable of returning to the front.

An Allied medical establishment ( take your pick : America, the UK , Canada or Australia ) callously saying SBE was not 'a war disease' and so wives dying from it must be denied life-saying penicillin, so erring husbands with VD can return to fight on the front-lines.

This modern age utilitarianism and instrumentalism run wild - can you really tell its practitioners apart,  without a label ?

But there was an individual-based counter-reaction against it.

People all over the world between 1931 and 1946 began to internally wrestle with the morality of a exclusivist versus inclusivist worldview.

Admittedly tiny in numbers at first when it came to open rebellion against the Modern worldview, this critique came to centre on the idea that wartime penicillin should be offered to all and any.

We do know it received widespread public support, from August 1943 onwards,  at a time when the polls said that most peoples' hearts were still hardened against treating the Jew or black as fully human .

SBE, a rheumatic heart disease, was primarily a poor person's disease : the people who got it tended to be the poor among the visible minorities and immigrants.

The world's daily press correctly sensed it first.

They sensed the widespread public support for the idea these young patients with SBE should be saved, war or no war ---- number one by making a lot lot lot more penicillin than had been produced during the 15 years to date.

By 1949, the once-radical change was complete and modern exclusivity was being replaced plank by plank by our current post-Modern inclusivity.

So, for example, the  idea that it was right that enemy children should die because members of the Allied population had cut their penicillin for illicit gain was now widely viewed by film-goers as the ultimate of all possible evils,  as indicated by the viewer love of  a film that still ranks in the top ten of all time : "The Third Man" .

If only Henry Dawson was still around in 1949, to see what change in the public morality that he had wrought ....

WWII: Bullies and Bystanders vs Innocents and Intervenors

NYC-based Dr Henry Dawson in 1941 was clearly an intervenor with his 'inclusive' penicillin (and may I point out that adult intervenors (as I well know) were often bullied themselves as children).

 SBE patients , such as his patients Charlie and Miss H were clearly the innocents.

NYC-based Dr Foster Kennedy in 1941 was clearly a bully, particularly telling that he would use the excuse of the shortage of staff and resources during an upcoming war as an excuse to finally implement his long held plan to kill all the deformed children.

Shades of Adolf Hitler in an exactly similar setting.

His active verbal supporters at the very top of the world's largest and most influential mental health body, the American Psychiatric Association, were clearly the stone-hearted bystanders a bully needed to get away with his deeds.

In the wider world of WWII, one can easily spot the bullies, the innocents and stone hearted bystanders (aka Neutrals)  as individuals and as (almost) entire nations.

But sadly, no one nation stands out as a whole hearted intervenor.

That noble task is left to a few in all nations, to try and heal the hearts of the stone-hearted majority by rousing their consciences  to the sad and unfair fate of the small and the weak in face of bullies.

Bullies like Hitler, Stalin, Tojo and sometimes even people like Churchill and others on the Allied and Neutral side.....

So I am a punster , is that such a crime !?

Stone-heartedness : physical or moral affliction or both ?

I am sure a gene is responsible.... or its early neural damage while a child-to-be is still resting on the placenta.

Whatever.

Punning can't be cured - only endured.

So my 'stone-hearted' : a play on the stone-like calcined formations on the heart valves that defines the SBE disease that Henry Dawson eventual cured with his 'inclusive' penicillin ?

Did Dawson merely want to see these teenagers and youth enjoy all the courting and dancing that all the others their age enjoyed : 'dancing' over stone (hearted valves) ?

Did he merely hate to think of the SBEs slowly dying inside mentally and emotionally as well as physically, as their medical condition forbade them doing anything vigorous and youth-like , in case it hastened their inevitable early end ?

Or is my title a broad hint that Dawson's real target was much bigger than the few dozen lives he saved directly : was his inclusive penicillin really aimed at curing all of the morally stone-hearted ?

That is to say, the majority of us between 1931 and 1945.

The us who were so determinately indifferent to doing anything concrete to save our weaker and smaller neighbours when they were under attack by big bullies like Hitler , Stalin and Tojo ?

The same morally stone-hearted of us who refused to allow any live-saving penicillin go to the physically stone-hearted SBEs ?

Or all of the above .......?

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 ......

Henry Dawson, Champion of the Second Chance ... and the Second Glance

Manhattan-based doctor (Martin) Henry Dawson championed the smallest, weakest and poorest of beings all his life.

On one hand, they were human beings, such as the institutionalized chronically ill at Goldwater Hospital.

Or discarded young people , dying needlessly from subacute bacterial endocarditis (SBE).

In both cases, he wanted to give them a second chance at a near normal life in what was, after all, the famed City of the Second Chance.

On the other hand, sometimes his focus was upon microbe beings, creatures about whom it can't really be said that he wanted to ensure their continued survival - he felt they did that well enough on their own !

Instead, he merely wanted all of us to take a Second Glance at just how well these incredibly tiny ,delicate, immobile sacs of water managed against extremities of physical conditions and the potent threat of the human immune system and modern medicine.

Starting in the 1920s, he pioneered studies of their survival techniques such as HGT, Quorum Sensing, Molecular Mimicry and Biofilms : still cutting edge science even today, eighty years later.

His subtle point was that if these, the smallest of the small, can manage survival so well than perhaps small human beings and small human nations can also manage equally well, if we just let them live rather than trying to enslave and kill them in the name of  a Progress that must always be Bigger , to be Better.

The Allied governments  never one to miss a chance to match the Axis in moral turpitude , wanted wartime penicillin to remain a secret available only for the 1As - "Penicillin from New York's Cold Spring Harbour's Eugenics lab" , as it were.

The tired, poor huddled 4Fs

Dawson was equally bull-headed in wanting to see the Nazis combatted morally as well as militarily, by demonstrating just how well we looked after our tired poor and huddled 4Fs,  even during a Total War : "Penicillin from New York's Emma Lazarus", as it were.

Janus-like Manhattan tried both approaches at first ,  very  strongly favouring the eugenic approach, until a few good Manhattanites rose up in protest.

Then wartime Manhattan was revealed to also come from the Venus of love and peace as well as from the Mars of anger and war.

Finally ... a Good News Story from the Bad News War.

It's Milton's AGAPE not the Greek AGAPE...

I have been going backwards and forwards in my mind - and in my heart - about the exact spelling (and pronunciation)  of my book title.
Agape with a macron (a long flat line as a accent) over the "e" at the end of the word signals the Greek word and meaning : pronounced a-GAP-eh, all slurred together.

 A word, used mostly by Christians, to mean an openness to others' needs.

Agape, without the macron, is a word invented by the famous Christian poet John Milton, from the word "gape" : to stare, open- mouthed.

A + gape gave us "agape", to be in the state of open-mouth-ness, in wonder,awe and eagerness.

Pronounced :  (soft a)  A   gape , with a small separation between A and gape.

As I have said in previous blogs, Dr Francis Peabody said that  a-GAP-eh ,to be truly effective in helping someone in need , requires our mind as well as our heart.

We must care about an individual, in all their unique individuality, if we are to be effective in caring for that individual's needs.

Dr Henry Dawson had spent a dozen years, from 1927 to 1939,  listening - really listening - to the strivings of Life's smallest and weakest beings, the microbes.

 So he was in an excellent position, starting in September 1940, to effectively care for some of the wartime world's smallest and weakest human beings.

 They were "the 4Fs of the 4Fs" , the many young SBE patients dying needlessly of wartime benign neglect, by direct orders from the top of the Allied medical-scientific establishment.

His heart was open (agape) to the needs of the SBEs, but so were the hearts of many other doctors before him.

But unlike them, his mind was also open (agape) to the solution : medicine made by foul-smelling microbe feces , aka natural penicillin.

So Milton's Agape fits Dawson's efforts more completely than does the Greek Agape' from the New Testament, which also fits, but only partially so.

Similarly, my book's sub-title could refer the Gospel message (Good News).

Or it could merely repeat a cliche from contemporary news-reporting : with newscasters always trying to finish off the mostly grim news of the broadcast by ending with a "brite" or a "Good News Story" : a lighter toned, uplifting story.

One immediately thinks of the Anne Murray song, "A Little Good News", written by Rocco, Black and Bourke.

Its arresting opening referenced "Bryan Gumbel talkin' about the fightin' in Lebanon" --- a totally unexpected something cum hook  I am sure immediately caught the ear of every songwriter on the planet.

My book's title and sub-title doesn't preclude someone thinking of them as terms from the New Testament of two thousand years ago ,  but I wish to say that for me at least,  it is a variant of that old eternal message, but dressed in current post-modern garb....