After being thoroughly taken by Dr. Mutter, I went on a medical history kick. Next stop: antibiotics.
The title of this book is a little misleading. While there is, indeed, a German doctor Gerhard Domagk that Hager returns to throughout the narrative, this is actually the story of the many doctors, labs, marketers, wars, countries, and strokes of luck that led to the discovery of the first antibiotic, sulfa, and how that changed the world–and the world of medicine.
Starting in the trenches of WWI, Hager details the devastation of gas gangrene on the troops. Once injured with manure-coated shrapnel in the muddy battlefields, gas gangrene set in, spread, and killed quickly. And there was literally nothing the doctors could do but watch all the young men die terrible deaths. Some leading doctors had good theories–some had even come up with effective treatments in other battlefield situations, like the Boer War–but the conditions of WWI were perfect for infection, an they didn’t really now why their previous interventions had worked, anyway, so their labors were fruitless.
On of the survivors of the Great War was Dr. Gerhard Domagk, who went on to become a renowned chemist whose mission was to prevent the suffering he saw in the trenches. He eventually started working at Bayer — yes, of Aspirin fame — a well-funded, well-oiled machine of a drug research center. But it was years of toil before he came across anything promising at all.
Meanwhile, the ready-made test cases of injured soldiers were gone after the war, so doctors turned to the other population that died of infection, often: recently delivered mothers. Childbed fever killed up to 1 in 4 women in maternity wards. While Domagk was testing his chemicals in animals and petri dishes, some doctors across the channel were doing their own tests, albeit without the same support and funding. Same goes for chemists in France, following in the footsteps of Louis Pasteur.
With the support of the German chemical industry, years’ worth of patience, and enough smart and dedicated doctors working on the problem, Domagk and his fellow chemists eventually found a “miracle” cure for the most virulent forms of infection: sulfa.
But once sulfa was proved to work, in an age where the FDA was toothless and doctors were more like guidance counselors and comforters than technicians, it was almost immediately over-prescribed. People took it “just in case” for everything. Of course, this worked on some things–meningitis, for instance. And of course, it didn’t work on other things. And, of course, overuse led to the first strains of antibiotic-resistant bacteria. Sigh.
And we all know what happens next: Hitler. Hitler was the worst. Just as sulfa had gained popularity and recognition as a proven cure for the worst infections; just as chemists and doctors were finally figuring out that antibiotics were a thing; just as Germany gained prestige for their precise, meticulous, world-changing drug research…the Third Reich kicked out all the Jewish scientists, banned animal testing (although they had no qualms against testing on humans for gods sake), and cut off all professional ties with other nations’ scientists–including the Nobel committee.
Domagk and two other German scientists were forbidden from accepting the Nobel Prize. Domagk, the man who had introduced the world’s first antibiotic and brought wealth and fame to the German pharmaceutical establishment, was arrested by the Gestapo for writing to the Nobel Committee after they invited him to Oslo. His letter said, basically, “I don’t know if I will be allowed to accept this prize; let me check with the Fuhrer.”
Anyway. This book covers not only this fascinating/devastating history, but also the way that sulfa changed the world. It was because of a rash of deaths from unregulated sulfa-based “medicines” that the FDA gained power and popular support to become the regulatory agency it is today. Sulfa introduced the world to the possibility of real cures for afflictions that were until then a given, painful part of life. Sulfa remade medicine into modern medicine and changed doctors’ professions from comforters to technicians and prescribers of drugs. Sulfa helped the Allies win the war. Where would we be without it?
I had to subtract a star because, honestly, the subject often held me more than the writing did. There were some fascinating anecdotes that just weren’t threaded into the overall story very cohesively, a few repetitions, and some sections where Hager just seems to lose steam or needed a tougher editor, maybe. Sometimes it felt like many vignettes, although interesting ones–I wanted clearer connections or transitions between the stories and characters.
That said, I really enjoyed how thorough and meticulous the reporting was, and loved how in-depth Hager gets into the characters’ lives, environments, and motivations. It’s not a read like Dr. Mutter’s Marvels–you’ll never mistake this one for a novel–but it is enlightening and inspiring.
And I think we can all agree: thank godtopus for antibiotics.
