How Do You Solve A Problem Like Ignaz?

Eric Lis

Being at the forefront of science can get you into a lot of trouble. I’ve written before about how studying human anatomy could get someone arrested at various points in history, but violating customs and bodily taboos is just one way to get into trouble. Much more commonly throughout history, people have gotten into trouble by advancing theories which go against the prevailing wisdom and what’s “known to be true.” Most of the time, people who contradict “the truth” end up being mocked and derided for years before sometimes being proven right, as in the famous cases of men such as Barry Marshall, Stanley Prusiner, and others. Other times, the consequences are so horrific as to become almost comical (which doesn’t necessarily make them less horrific). To that effect, let me tell you a little bit about the life of Ignaz Semmelweis.

Semmelweis was born in Hungary in 1818 to a successful merchant family. He studied law as well as medicine and became a physician in 1844. He specialized in obstetrics and had a practice at a respected hospital in Vienna. While working there, he noted something interesting: two different clinics for pregnant women and newborns had vastly different mortality rates, and indeed, according to some reports, the mortality rate at one clinic was higher than it was for women who delivered their babies in the street outside. He began to study the two clinics to determine what might differentiate them and eventually identified that at one of the clinics, trainees would routinely go from working on autopsies to working on living patients. He concluded that perhaps the trainees were carrying some sort of contamination from the dead bodies which were causing illness in the living bodies, and when he required the trainees to wash their hands between one room and the other, the mortality rate suddenly dropped. Applying similar logic, he concluded that the fevers which afflicted some of the pregnant women were spread between them by their doctors and the doctors’ trainees, and these rates also dropped soon after.

Unfortunately, Semmelweis’ discoveries were unpopular. Even armed with evidence of the change in mortality, he was first ridiculed, then ignored, and finally kicked out of the hospital. Semmelweis had the misfortune of making his discovery just a few years ahead of the work of thinkers like Louis Pasteur, who provided evidence for the theory that bacteria and viruses caused illness and could be killed by, among other things, hand-washing. Semmelweis’ ideas therefore ran contrary to all established European medical knowledge — although, it must be noted, not necessarily counter all known medical knowledge, just the European stuff — and, worst of all, made some very important people look very foolish. He further got himself into trouble by the manner in which he fought for his cause; something of a storm-the-front-gates-in-broad-daylight paladin in temperament, Semmelweis wrote angry, attacking letters in public forums essentially calling his colleagues murderers. While he wasn’t entirely wrong, such letters were easily turned against him and allowed him to be dismissed as a raving lunatic. He received some support and made some attempts to publish his findings in respected medical literature, but the strongest objections to his work came generally from the oldest and most respected physicians of the era, who, not coincidentally, were also those most set in their ways. 

In the face of this profound mockery and rejection — mobbing, as we might call it today — Semmelweis probably became depressed and physically unwell. Reports indicate that he became increasingly “embarrassing” in public and likely developed problems with alcohol. In 1865, in his late 40s, Semmelweis was declared insane and forcibly confined to a mental institution, and from the surviving records it is quite hard to guess how much of this was the decline in his behaviour and how much was the medical establishment trying to shut him up. When he resisted being locked up, he was apparently quite enthusiastically beaten by the institution’s guards. As near as we can tell, it was probably this beating and the untreated wounds it left him that caused him to develop infection and die about two weeks later. 

Today, of course, Semmelweis is regarded as a visionary who made one of the most important contributions in the history of medical science, but that doesn’t change the fact that his disagreements with the powers-that-be of his era got him locked in an asylum and beaten to death. As Woodrow Wilson said, “if you want to make enemies, try to change something.”

As with some many hilarious terrible stories from history, Semmelweis’ story provides a lot of potential fodder for a storyteller. It illustrates the way that a young scholar can get into trouble by naysaying what senior thinkers believe. It illustrates the lengths which people in power may go to protect their beliefs, or their reputations, or their power. It illustrates how badly someone can be affected when they feel that the entire world is telling them that they’re wrong. This story could turn into a heck of a story in medieval fantasy. A group of PCs could be recruited to help a desperate researcher prove his theories, or protect him from assassins. They might be hired to break an unjustly-imprisoned man out of an asylum, or possibly be hired by the most respected healers of a kingdom to bring a “dangerous madman” in. Who is the villain when everybody involved in a conflict is Lawful Good in alignment and thinks they’re doing the right thing? Or, in a setting where healers tend to be clerics or wizards, a Semmelweis nearing the end of his life could be a powerful spellcaster filled with rage and teetering on the brink of becoming a deadly villain, all because of his thwarted efforts to save lives. How do PCs react to having to contain a mad caster who also happens to be the true victim of the story? 

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More than four years ago, Dr. Eris Lis, M.D., began writing a series of brilliant and informative posts on RPGs through the eyes of a medical professional, and this is the one that appeared here on April 10, 2016. Lis is a physician, gamer, and author of the Skirmisher Publishing LLC OGL sourcebook Insults & Injuries, which is also available for the Pathfinder RPG system