What follows is a cautionary tale, simple in its essentials, complex in its plural readings and outcomes. It begins as autobiography in the 1950s, when my family and hundreds of other neighbours in the affluent California suburb of Hillsborough lined up one fine Sunday afternoon at a local school to receive an oral dose of a vaccine that medical science touted as “the end of poliomyelitis”.
This viral scourge, which peaked in warm weather, was known to all for its pitiless power to destroy muscle tissue and turn healthy children into invalids. The March of Dimes provided constant reminders of what happened to kids who were unlucky. Pictures of children in braces and iron lungs were well known throughout elementary school. We collected our dimes to help them, worried about getting sick, and, on rare occasion, confronted polio within our own group.
In time, the work of Jonas Salk and Alfred Sabin did eradicate polio as an epidemiological curse. Medical science had aimed what appeared a magic bullet at a cruel adversary and scored a telling strike. The decline of polio, together with development of antibiotics that promised to vanquish other bacterial and viral infections, indicated in fact that medical science had finally gained the upper hand in the constant warfare against microbes.
Prior to these developments, in the depression-ridden 1930s Canadians and Americans alike took seriously the admonition to wash their hands, and make certain that open cuts and scrapes were fully cleaned before bandaging. “Herbert Hoover’s son died because of a simple infection,” I was told on several occasions when I had not done an adequate job. Iodine and methiolate might hurt like hell when applied directly to a wound, but it was a tiny price to pay to prevent something far worse.
By the end of the Second World War, however, penicillin and sulfa drugs seemed to presage a modern medical miracle. During the worst conflict in human history, thousands of soldiers injured in battle had survived because of these new scientific marvels. “Better things through chemistry,” promised Du Pont in its sponsors’ lead-in to the radio show, “Cavalcade of America”.
The postwar era witnessed several intersecting developments that promoted the idea that science and technology might overcome any and all public health problems that might emerge. The image of medicine centred upon kindly older men, doctors who cared and made house calls, a type epitomized a decade later by actor Robert Young in the role of “Marcus Welby, MD”. Young earlier played Jim Anderson in the popular radio sit-com, “Father Knows Best,” and in both roles he assayed the thoughtful American male ascendant -- experienced, cool and calm even in the most trying situations, and giving in the best ways. The path between “Father” and “Welby” was short, indeed. It was a path guided by science, by technology, by elites armed with the best medicine and the knowledge to put it to benign use.
“Better things through chemistry” was a fine mantra, so long as the chemistry and science did not overdo it. Look what science had done with the atomic bomb: won the war more quickly, for sure, and here were more “bombs” that would deliver disease the same fate accorded Japanese residents of Hiroshima and Nagasaki in August 1945.
For those who wanted to look at the bright side, sexually transmitted diseases, chronic lung and sinus infections, and bad-guy bugs like staph and strep seemed on the run. Many doctors and scientists predicted the day when all the infirmity these bugs caused -- ugly things ranging from strep throat, oozing staph infections following surgeries, and STDs like syphilis and gonorrhea -- would vanish.
For those who remained skeptical, people who wondered about atomic power and its baleful political and health effects -- things like the arms race and burgeoning cancers -- there remained many questions. For one thing, within the medical and scientific communities, many people who should have known better still smoked cigarettes and died from lung cancer. Corporate tobacco had its hooks into both scientific and medical neighborhoods. Advertisements touted cigarettes as a means to clear sinuses, calm throats, and relax before big events. Football and baseball programs were filled with testimonials to the medical value of cigarettes, as were popular magazines like Time, Life, and Maclean’s.
So the cautionary tale continues to its conclusion. In 1963 the U.S. Surgeon-General made the link between smoking and cancer clear, and fewer and fewer people smoked. But more and more Americans used antibiotics to ward off nasty bacteria (and viruses too, despite the axiom that antibiotics do no good whatsoever against viral agents). And the pharmaceutical corporations that emerged after 1970 grew larger and larger, becoming global vendors of miracle nostrums that we were told would cure maladies ranging from dandruff to athlete’s foot.
At the same time our food chain became increasingly subject to antibiotic treatments to protect cows, chickens, and farmed fish against bacterial adversaries and to make these cows, chickens, and farmed fish bigger and bigger.
It doesn’t take a David Suzuki to recognize that with the pharmaceutical profit motive run amok, and direct-to-consumer marketing becoming the order of the day, that bacteria (and viruses) -- which have been around a lot longer than we have -- would meet the challenge to mutate and hang out in areas where the sickest people happen to be.
That’s the story and the moral -- we’ve utilized a lot of magic bullets since 1945, and each one has exacted a significant cost. Our overuse of antibiotics invites opportunistic infections. Kingston General Hospital, and other hospitals throughout the United States and Canada, now kill rather than cure many people. Are you surprised? When you are ready to go to the hospital, you’d be well advised to check on cleanliness. Where are the bugs? Where are the superbugs? And who in the hell is washing their hands? Or not?
In our desire to vanquish disease, we have created new adversaries -- and as our reliance on antibiotics continues to grow, we risk even worse circumstances.
Antibiotics have made us stupid. The first thing that we must do -- to return to an old adage -- and the first thing we can demand that our hospital personnel must do, whether doctors, nurses, orderlies, custodians, or visitors, is to wash our hands. It’s a start, an important start.
Geoff Smith teaches courses on STDs and on drug wars and drug cultures in the School of Physical and Health Education at Queen’s University. This piece was originally published in the Kingston Whig-Standard 29 June 2005.
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