Tuesday, June 16, 2015

Dr Henry Dawson goes 'off the reservation' --- and Thank God too !

About ten billion of us, in the seventy years since October 16th 1940, have had good reason to be undyingly grateful for their decision, but there can be little doubt that some of Henry Dawson's senior colleagues went to their graves regretting the day they let this particular Indian off the reservation.

For ten years they had delayed - no 'fast track' for our Henry - content to let him paddle about in the gentle hospital backwaters of studying avirulent bacteria and running a day clinic for people with arthritis.

But finally judging him as harmless as the obscure bacteria he choose to study, they made Dawson an associate attending physician - the equivalent in the biggest elite teaching hospitals of being granted tenure in a university.

They all knew there was still some risk.

No one ever died from mistakes made by physicians studying harmless bugs or dealing with the aches and pains of the elderly arthritic - but now Dawson was to be ultimately responsible for all the fast-paced decisions made on a busy acute care ward.

However the intellectually stubborn but personally very diffident Dr Dawson was not really expected to do anything out of character.

Unfortunately 'character', like so many things in life and pace Stephen Jay Gould, is something best studied as a totality.

Because his oldest acquaintances could have warned them that while indeed Henry Dawson was usually a quiet study, it was also equally true that about once every decade, he tended to quietly throw off the traces and just go for it.

'Sneaky' some said - and he was sneaky on these rare occasions, but sneaky in a cautious, lawyerly sort of way - doing nothing so obviously wrong that you could pin him down for it.

Take today as an example.

To better facilitate America's first ever peacetime draft registration, Columbia University and its allied teaching institutions, among them its flagship Presbyterian Hospital, had declared a day off for teaching and all non-essential medical procedures.

Very few of Dawson's senior bosses were even in the hospital this morning, let alone roaming the wards, performing their normal overseeing of the mid-level associate and assistant physicians, along with the bottom feeding residents and interns.

Later, he insisted to his seniors with the straightest of faces, that the only reason he initiated this undiscussed injection of an untested drug on this day was because it was a very rare day off from teaching and the arthritis clinic and so he could spend a little more time on 'his' ward.

Dawson's mask-like stolid face was always frustratingly hard to read but few of his colleagues doubted that inside, he was secretly grinning from ear to ear.

But in truth, Dawson had even told his three colleagues on this drug project why his sudden decision to break their agreed upon protocol to only inject the new drug four months hence when it undoubtedly would be synthetic, pure and abundant.

For to Henry, October 16th was a date so heavily freighted in personal emotion, he couldn't begin to break his austere Scottish Presbyterian reticence, even to open up to these three close friends and colleagues.

For on that date in 1915, the world's newspaper readers in the overseas world beyond Europe all learned about the execution by the Germans of yet another Belgian, Phillippe Baucq - one of hundreds of hundreds since the dastardly Germans invaded the neutrality of poor bleeding little Belgium.

It was the Germans' betrayal of their own signed agreement not to invade neutral Belgium that had led the British Empire into war against Germany and her allies.

That and the horrors - endless murders, rapes, burnings and sackings - that Germany had dealt tiny Belgium but hadn't dared to do on the much larger French nation it also invaded.

A bully and a coward.

Now Baucq had been executed --- and along with him a gentle middle aged British nurse.

In the context of its time, Edith Cavell's execution is best understood then as the final straw in a long litany for many in the world - particularly throughout the English speaking world.

Hard recruiting statistics confirm that tens of thousands around the world decided moments after they first opened their newspapers that October morning to join up to fight the Germans - many (like Henry) joining the medical corp in open emulation of Miss Cavell.

October 16th 1940 thus marked the twenty fifth anniversary of Dr Dawson's medical career, the day a promising law student threw it all in to become a buck private and medical orderly in a frontline military hospital.

He signed up to help the helpless - originally the poor bleeding little Belgians.

And all through his medical career, he had sought to help the small, helpless and overlooked - in between the wars this was the chronically ill poor, always a very low priority on the big elite teaching hospitals.

The largely right wing American medical community had been generally opposed to America going to war to help the bleeding poor little nations of Europe.

That had been painful enough for Henry Dawson.

But now these chicken hawk hypocrites had suddenly discovered new virtues in the cause of "War Medicine".

This was medicine designed to keeping American's frontline fighting men healthy and 1A, just in case American ever had to go to war to defend itself.

In reality, the conservative medical elites were just barefacedly using the need to divert resources towards war medicine preparation as an excuse to kill the left wing medical community's ongoing efforts to promote "Social Medicine".

These were claims that morally all medical efforts should be directed at everyone, even to the poor and sick (Life's 4Fs), even if they couldn't pay for all of it.

Think of it as what Obamacare should have been, but arriving seventy five years earlier.

October 16th back in 1915 was a date devoted to defending Life's 4Fs - in this case the poor Belgians.

But this October 16th in 1940 was to be a day devoted to registering and honoring all of Life's 1As ---- and towards throwing aside Life's 4Fs.

(Let us not forget that the Nazis only began their killing of the unfit on the very day they declared war in September 1939 - being neither the first nor the last nation to use 'the war' as a feeble excuse to kick the poor and the weak to the curb.)

That registration would even include Dawson's two injection-receiving patients, living under a sentence of almost certain death from invariably fatal SBE endocarditis caused by Rheumatic Fever.

Despite this , the government figured they might just recover - that one chance in one hundred faint hope clause - and hence become suitable cannon fodder.

Dawson knew from his WWI military hospital experience that no army would ever willingly accept a recruit who had had SBE.

These were Life's 4Fs of the 4Fs and extensive care for them, in an atmosphere of preparing for war, was discounted by most of the medical world - they'd be too weak to do useful war factory work even if they did survive.

More likely these SBEs would just consume enormous amounts of scarce medical care and then die anyway --- best then a policy of benign neglect and let Nature take her course.

This was America's variant on the Aktion T4.

Which is why that Dawson so deliberately picked these two 4Fs of the 4Fs - two poor, working class youths, one Black, one Jewish, to usher in the Age of Antibiotics - the two he choose to give history's very first penicillin injections to.

And why he so deliberately choose a day devoted to honoring the 1A to honor the 4F as well.

For twelve long years, doctors around the world had agreed not to inject live-saving but fungi-made yellow slime into human veins, at least not until it was man-made, patented, pure, synthetic.

Now Dawson had let the genie out of the bottle and there was no putting it back - to this very day, penicillin antibiotics are still Dawson's fungi-made sort, not man-made.

With two quiet small injections, mere 'noises off' in a day of high drama centred around America's first ever peacetime draft registration, Dawson fired a moral shot across the bow of a world hellbent on attending to the whims of the mighty and ignoring the cries of the weak.

His shot is still echoing ...

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