Patient ONE of the Antibiotics Era : how the saving of Charlie Aronson changed our world

During his lifetime, Dr Henry Dawson only gave penicillin to several dozen endocarditis patients, Charlie Aronson first among them ; only saved several dozen lives, Charlie among them.

Dawson's pioneering effort to inject Charlie with penicillin on October 16th and 17th 1940 (Dies Miribilis) certainly didn't directly save many lives.

But the moral fact that Dawson cared enough in the first place about Charlie-the-person, to pioneer in making and to giving him penicillin, has certainly saved tens and tens of millions of lives ever since Dawson's premature death in 1945.

If  only the greater cultural milieu surrounding Dawson and Charlie had been as willing - nay as eager - to save Charlie 'the 4F of the 4Fs' as Dawson was, it might also have been as willing - nay eager - to save the Jews of Europe as well.

Immaterial that Charlie was almost certainly Jewish as well : the point to Dawson was that Charlie was a fellow human being, end of story.

Social medicine, Dawson's domain, says that medicine is not just the narrow manipulating of bio-chemical activities to save lives.

It holds instead the view that most people die prematurely, not because their bodies failed or because medicines failed, but because the world around them see them as not worth much, so not worthy of much effort, time and expense to try to save them.

Doctors who challenge these utilitarian views by their voices and their actions indirectly save far more lives than do their equally competent colleagues who may directly save more lives, but who are content to only save the lives their culture deems worthy of saving.

The Allies (rather like the Axis, differing only in degree not in kind) divided the world of World War Two into three parts, like Gaul.

There were the enemy-oriented people and the allies-oriented people : themselves further divided into 1A allies and 4F allies.

Until June 1943, only enough American resources were going to be devoted to penicillin to ensure that the needs of the 1A allies would be met.

Then the American WPB (Wartime Production Board) made its most surprising decision ever : that a considerable portion of America's bomb and bullet making potential would be diverted instead to making lifesavers - penicillin lifesavers enough to save soldier and civilian alike.

This was not a decision followed by Britain , Canada and Australia.

They decided to divert only enough of their country's resources to penicillin-making to fill the needs of their armed forces at a minimal level.

Winston Churchill and his Tory-dominant government took the lead on this decision, by their broad hints and inaction (if nothing else), and the other Commonwealth nations chose to follow his lead rather than that of the WPB.

A single additional Lancaster bomber squadron is about three million pounds in 1943 money,(about a million pounds in planes , plus two million pound  more for the 500 members of the squadron , hangers, armaments, fuel etc).

This amount would have paid for enough new penicillin production facilities such that by early 1944 , Britain's could have supplied its civilians as well as its soldiers.

Ie, match the Americans' penicillin output, despite using a lower level of technology.

We know well enough the costs of a Lancaster squadron and  the costs of Glaxo's low tech but highly efficiently run bottle-penicillin factories , to be able to make this claim with a great deal of certainty.

Churchill, however, chose 'LANCs over PEN' and paid for it in the surprising election results of June 1945 ; the inequalities of  wartime health care provision being the number one reason most people chose the egalitarian Labour Party over the war-winning Tories.

America's super abundance of wartime penicillin allowed it to use penicillin as a tool of diplomacy , replacing British influence with that of the Americans at every turn : replacing Pax Britannica with Pax Americana,  again causing Churchill to "win the war but lose the world".

Dawson did not force the WPB to make the decision it did, though certainly his uniquely civilian oriented approach to penicillin treatment, starting way back in September 1940, must have played a part.

But the WPB pledge was just that : a pledge - it was up to industry to carry it out.

Industry was willing - even eager - to build high tech buildings out of extremely scarce materials now suddenly obtainable thanks to top-of-the-drawer allocation quotas for would-be penicillin producers.

Postwar, those buildings would give them an early lead on their competitors.

But they weren't so willing to make biological penicillin in those shiny new buildings, not with rumours than synthetic penicillin was just months away.

Dante Colitti forced their hand.

In August 1943, the junior staffer, a surgical resident at a small hospital a mile from Henry Dawson's hospital,  was about to get married and go on a honeymoon. He didn't have to go poke his nose into the affairs of a patient in the non-surgical part of the hospital.

But he did.

He was moved by what he had heard about the dying Henry Dawson a mile away being willing to steal government penicillin to save the weak and the small.

 And perhaps because Colitti himself was a lifelong "cripple", suffering from TB of the spine.

Dante decided to risk his own career by intervening over the other more senior doctors' heads on a patient that wasn't even his --- urging the patient's parents to call the Hearst newspaper chain directly, to ask them to help obtain the tightly rationed penicillin needed to save the baby's life.

The resulting day by day heart-rendering accounts and photos of the life-saving efforts for little Patty Malone finally - albeit 15 years late - put a human face on penicillin.

Suddenly the population woke up to the fact that they wanted/  needed  penicillin -right now ! - and what was their Congressman doing to see that it happened ?

Doctor Mom, in high dudgeon , can provoke fear even in generals, industrialists and Presidents and soon John L Smith, boss of the biggest potential penicillin producer (Pfizer) got the moral message as well.

The chain reaction : Dawson + Charlie : Dante Colitti and Patty Malone:  John L and Mae Smith and memories of their own dead daughter  + Pfizer : tons of and tons of penicillin by April 1944,  is clear enough .

Also clear enough is an ageless message : one person, even if they are dying, can indeed make a world-quaking difference .....

Penicillin Baby Patricia Malone survives !

In earlier posts I had mentioned that "The Penicillin Baby", little two year old Patty Malone, whose fight against a fatal staph disease had gripped all of North America for six weeks between August 12th and September 22nd 1943, had finally died of her disease in mid September 1943.

But perhaps it isn't true.

Was there a Parran-Hearst Telegram ? (You provide the penicillin, I'll provide the pictures)

"Operator, get me Washington, tell 'em I'm from Hearst..."

There is no firm evidence that Citizen Hearst ever sent that infamous telegram to the famous war artist Frederic Remington in Cuba.

We all know which telegram:  the one where Remington is sent out to illustrate the ongoing civil war in Cuba, but finds all is quiet and begs to go home.

Hearst supposedly telegraphs him to stay : "(If) you furnish the pictures, I'll furnish the war."


Hearst proceeds to puff up the accidental explosion on board the battleship The Maine as an act of sneaky warfare by the Spanish, ("Remember Pearl Harbour" 50 years ahead of schedule) and the rest is history: Yellow Journalism's finest moment.

Or is it ?

For a start, that particular telegram was apparently never sent.

But did the aging Hearst later intervene with US Surgeon General Thomas Parran in August 1943, to get penicillin to a dying baby girl in Manhattan ?

Was this Yellow Journalism's finest moment ?

The Pulitzer Committee apparently felt so - and it is worth noting that Pulitzer and Hearst were the most bitter of bitter enemies.

Consider what we know (or think we know).

Supposedly the whole thing started with a phone call from the distraught father (Lawrence J Malone) of a dying two year old girl called Patricia Malone, made to the city desk editor of the Hearst media empire's flagship newspaper, the New York Journal-American.

Actually Malone quickly fades back into the wallpaper , as do the nominal doctors for the baby girl.

Because in fact, Malone was set up for the call by a crippled Italian-American surgical resident named Dante Colitti, then working at the tiny Lutheran Hospital in upper Manhattan, about a mile from pioneering penicillin doctor Henry Dawson's hospital, Columbia Presbyterian.

The little girl was dying of blood poisoning and normally a surgical staffer - a mere resident at that - has no place in treatment decisions for that sort of illness.

But Colitti was raised right, with a good moral education and he couldn't stand by and let her die, when he knew that not a mile away, Henry Dawson was dragging babies like her back from the grave with his Floor G penicillin.

And Colitti had no cause to love the New York medical establishment which supported the limiting of penicillin to curing VD cases among the unfaithful husbands and boyfriends of the combat corps.

In the 1930s, he had been rejected from attending any New York medical school, by an informal quota system designed to keep out Catholics and Italians.

 (And Jews and Blacks and Asians and Women. Colitti's parents were recent immigrants to America).

Colitti had a permanently bent spine as a result of childhood TB and had to use crutches so it was probably the excuse given him for his rejection.

But Colitti knew that Henry Dawson, just a mile north of him, was working with a doctor who used crutches thanks to polio and another doctor who was missing an arm.

The only real difference was that these were Protestant men, with native-born parents.

Colitti paid a private medical college in Massachusetts to get his MD degree but no New York hospital would recognize any degree not granted by one of the quota-oriented establishment schools.

It was a closed loop.

But WWII led to a desperate shortage of medical staff and even New York's medical establishment had to let people like Colitti in to do the lowest medical jobs, at least until the war was over.

But the highly morally minded Colitti felt that if they had displayed no charity towards a cripple, that did not mean he would follow suit.

Hence his setting up of the phone call to the Hearst paper : he knew exactly who would cause the most noise.

The Journal-American photo-journalists were then world famous for their large, vivid, gripping front page photographs and a dying baby story was just made for their skills.

The Hearst editor got no where ( says the AP press agency) with the OSRD's Dr Richards or with the NAS Committee on Chemical Therapeutics.

But somehow or other the newspaper knew of the ongoing conflict between those who felt we could best win the war ("Hearts & Minds") through well publicized Social Medicine versus those that felt that secretive and rationed War Medicine would save more scarce resources for "Guns & Bullets".

Because the newspaper ultimately got the penicillin it needed from that supply reserved for the US Public Health Services (at that time, it only had a tiny amount of penicillin and it was only normally used for treating cases of VD among merchant seamen.)

Released by drug company Squibb upon the direct order of Thomas Parran, US Surgeon General and head of the US Public Health Services (then a relatively small and powerless body compared to its status today.)

Parran versus Weed over the fate of wartime penicillin

Parran was the de facto head of the Social Medicine forces, while the NAS's Lewis Weed was the voice of War Medicine.

Did Hearst or his senior staff know of this ongoing debate and approach Parran directly, dismissing his concerns about tackling the all-powerful OSRD and NAS by reminding him he had no love for the NAS's Weed anyway , and that if he would only provide the penicillin vials, Hearst photographers would provide the poignant pictures.

Yellow Journalism and the Yellow Magic then proceeded to make beautiful music together : because the Patty Malone Story ultimately spelled the end to the Age of Modernity ...