Happy Friday!

Back in the 19th century (Which, if your brain is anything like mine, requires that you explicitly remember that means the years starting with 18), people only went to the hospital if they were going to die anyway.

At the time, people believed that disease and infection happened more or less spontaneously and spread through the air. If you've ever heard of the word miasma, that's what this refers to. When you fundamentally believe that infection is spontaneous and travels through the air, the only thing you can do is open windows. But then, if you do that, you might let the miasma in.

In other words, hospitals presented patients with a problem that even if they survived a procedure, they'd likely die of infection or disease. There are accounts of nurses pulling sheets back on patients recovering in bed to find mushrooms growing out of their wounds and mattresses.

Let me take this even further—the most desirable attribute in surgeons is physical strength. They wore heavy leather aprons caked with gore, smoked cigars to keep the smell of their work away, and prized themselves at the speed at which they could remove a limb. Nobody dared to perform any kind of surgery on the abdomen or head as it would lead to certain death.

I should also mention that anesthesia also didn't exist yet.

This century also saw rapid discovery and advancement in the medical field. Most people know about Louis Pasteur's development of germ theory. The theory clashed against the concept of miasma and was ignored for decades.

Ether was also discovered as one of the first anesthetics as well, and surgeons marveled at the prospect of amputating limbs from people who wouldn't thrash and convulse.

And then there was Joseph Lister. He was a man that changed medicine forever. He saw promise in Pasteur's work and replicated his experiments. He further concluded that because germs don't exist spontaneously, they could be controlled or eliminated, and if that were true, the mortality rates of hospital patients would drop. This all sounds very obvious, but each of these ideas was new, unproven, and at the forefront of science.

Lister wound up utilizing carbonic acid to clean his surgical tools. Patients survived. He then cleaned his hands with carbonic acid, and even more survived. In fact, he decreased the mortality rate of pregnant women by 90%.

Lister is the reason we know to wash our hands. Lister is the reason things are sterilized.

Lister performed the first surgery on a stabbing victim who survived to then testify in court as to who attempted to murder them. Prior to this, attempted murder was hardly a charge that police or the courts considered.

Yet, it would take decades for Lister's ideas and methods to be considered as anything other than lunacy.

For every miracle Lister performed, people attributed it to his skill and brilliance while saying his methods were ridiculous. Lister found it impossible to convince the medical community that washing your hands and instruments worked.

I want to pause here because despite my fascination with this topic, it's illustrative to me of the challenges we face when we introduce change. It's easy for us today to look at the idea of doctors not washing hands or instruments or sterilizing things as lunacy, but change usually looks obvious after the fact and never before.

Even when confronted with the type of evidence like the hospital Lister ran reduced mortality by 90% in pregnant women and was able to perform surgeries nobody else could, it convinced nobody. Even when papers were published with experiments to replicate, it was summarily dismissed. Not only did his peers reject it, but the larger European and American medical communities thought he was a fraud.

If Lister couldn't convince people to wash their hands to save someone's life, maybe it's ok to allow ourselves some grace with the changes we want to see in our lives and workplaces.

Back to the story!

It took almost 20 years for Lister's methods to spread in Europe and several decades more to spread to America. In fact, Lister was invited to the Chicago World's Fair not as a guest of honor but as someone American doctors wanted to humiliate. The rest of Europe was with Lister by then, but American doctors continued to hold out.

In the end, Lister found the only way he could convince the medical community was to train the next generation. As he got older, he shifted his focus to teaching younger doctors who only knew of his method. Those doctors spread across Europe and, in turn, taught new doctors.

Lister succeeded because he replaced his generation of doctors, not because the best idea won.

Sincerely,

Ryan