From Absurd to Standard — Lesson in Changing Opinions From Medical Science

Habits and dogma are among the most impossible of things to change. This is true even for the most rational of people, scientists. In medical science, getting doctors to change has always proved difficult even in the face of evidence. In 1846, Hungarian doctor Ignaz Semmelweis observed that women were dying from fevers soon after giving birth. He was particularly disturbed that it seemed to happen more frequently in the areas where doctors worked compared to where just midwives worked.

After a period of observation, he tested several hypotheses. This ranged from a priest ringing a bell, to the smell in the air. After testing a few of these without success, he settled on the possibility that the cause of these deaths were him and his colleagues. Back then, doctors would conclude work on a cadaver — a dead body — then go on to deliver a baby. The midwives who had less maternal deaths, didn’t do this cadaver work. Noticing this difference, he suggested the absurd idea, at the time, that Doctors wash their hands with chlorinated water between these two acts. He was met with stiff opposition and scorn. You see, Semmelweis’ colleagues wore their stains and dirty hands with pride. It was a sign of work and accomplishment. How dare the upstart challenge their authority, status and knowledge.

He succeeded only in enforcing hand-washing in his immediate team. This indeed caused a fall in number of deaths, proving him right. Despite all his efforts, his colleagues never adopted hand-washing and it was abandoned by his own team when he was relieved of his position. Semmelweis reportedly ended up angry and strange. He was eventually committed to an asylum where he would go on to die at the age of 47. It wasn’t until years later, with the work of Louis Pasteur and Joseph Lister, that Semmelweis’ beliefs gained ground and became accepted as common practice.

Today the thought of a doctor examining a dead body then coming to deliver without washing her hand is absurd. The absurd has now become standard.

Semmelweis and his colleagues lived in the 19th century, a time of limited knowledge. Surely something like this couldn’t happen in more recent times?

In the mid 1980’s, Australian doctor, Barry Marshall was carrying out work on peptic ulcer disease and stomach inflammation. After studying the problem for sometime, he hypothesized that a certain bacteria was able to exist in the stomach and cause inflammation. This inflammation often manifests as heartburn or pain in the upper stomach area and may lead to ulcers. ‘Absurd’ is what everyone thought at the time. They had good reason to think this. The environment in the stomach is so acidic that it was thought impossible for bacteria to survive. The stomach’s acidity compares with acids used in occasional attacks that often leave victims disfigured. Dr Marshall however wasn’t deterred by the absurdity of his claims. He’d done the work, seen the evidence and was convinced. His conviction led him to do something absurd, he drank a glass full of the bacteria in question. Within a few days, he developed symptoms of stomach inflammation confirmed on examination of his food pipe with a flexible telescopic camera. This proved his absurd claim that a bacteria can exist in the acidic stomach and cause inflammation. Needless to say, Dr Marshall went on to win a Nobel prize and impact a large part of medical science.

An idea that was once absurd is now standard.

When approaching a problem that’s related to habit and dogma, the prospect of change is almost impossible. Even in the face of data, many intelligent people will still continue old habits and retain long standing beliefs. In Semmelweis’ case, he failed to effect change. It wasn’t until subsequent work by others helped propagate what his data had shown earlier years earlier. Unfortunately, in the intervening period, many more women died and children were needlessly left motherless. Marshall’s work may have gone down the same route had he not taken to something absurd. He was willing to put his own health and well-being at risk to prove what his data had shown and what he believed to be true. These parallels suggest that to make a monumental change in a field of endeavor you must be willing to put your whole life and well-being on the line. For if what you believe and espouse is indeed true, your doggedness will eventually make it standard belief. Absurd doggedness will help people take more notice and make them more likely to change. The initially absurd truth becomes standard when the cumulative doggedness that espouses it itself becomes absurd. Be absurd in your doggedness to convert the absurd truth to the standard.

* The details of the accounts of Dr Semmelweis’ and Dr Marshall’s work is abridged intentionally. More information about them is available here and here respectively.

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