In the end, finding out about the Patient Zero I knew the least about, Aaron Alston, turned out to be by far the easiest.
But first I had to make all sorts of naive mistakes.
I knew that if an acute case of Rheumatic Fever attacks a young child's heart, they can quickly die, without prompt and appropriate medical intervention.
But if they don't die, most of the attacked heart tissue will more or less heal - unless the area attacked is the very delicate and extremely vital heart valves.
You can literally hear damaged heart valves.
Many people have harmless heart murmurs but these particular stethoscope sounds tell a doctor that the valves are damaged and the entire heart is straining in overtime, to pump blood through these only partially closed/open doors.
So doctors will then strongly advise the parents to not tax this particular child's heart.
So no strenuous sports - later on, no vigorous dancing, no passionate sex acts, pregnancies are very dangerous, chasing after toddlers is too stressful, etc.
While my brother Bruce had childhood Rheumatic Fever and was left with a heart murmur and damaged valves, ironically enough he was the only athletic member of our extended family !
Though small, he was eager to try out for high school football and was a city level long distance running champion.
So you'd think I would have known better about Rheumatic Heart Disease (RHD) and young athletes.
In my defence, I had just assumed that the heart valves of Rheumatic Fever patients who go on to develop life-ending subacute bacterial endocarditis (SBE) were far more damaged than most RHD patients - so obviously far less capable of championship level athletics.
But this simply isn't so - SBE, like cancer, has a pronounced stochastic (for PhDs) or random (for ordinary folk) nature to it : sheer bad luck as well as bad valves plays a part.
Dawson treated patients who got SBE fifty or more years after their childhood heart valves were first damaged and some who got SBE only a year or two after first getting Rheumatic Fever.
But most patients get SBE ten or twenty years after their valves are first attacked.
Still, when I did find an Aaron Alston finishing in the top level in NYC wide races in 1930, ten years before my Aaron Alston first got SBE, I dismissed that it might be him.
I also got search results for A. Alston too : an A. Leroy Alston also winning athletic events.
I just felt I had got nowhere with Alston - the lack of his birthdate was so crippling.
As I described in an earlier blog, knowing first and last name, residence in greater NYC area in 1940, and birthdate, usually means that 140 million possible American patients is reduced down to one or two.
Without a birthdate, it goes up to at least a hundred possible names.
But in 2014, I suddenly realized I probably did have a death date on him as well.
For his brief medical history made it clear he was going to get all the penicillin Dr Dawson's team had (they were making themselves) but suddenly all the penicillin was switched to another patient.
Alston had obviously died, died in mid January 1941, and almost certainly while undergoing treatment in Dawson's hospital, ie in the borough of Manhattan.
Now a search for an index of NYC death certificates seemed easier.
Well, thanks to many tireless volunteers, it certainly was.
I din't really need a specific borough or specific day or month - a volunteer-run online death index for NYC in the first half of the twentith century, didn't show tons of deceased Aaron Alstons in all of 1941 in all boroughs - just him !
With his death certificate number in hand and because he had died before 1948, I a white stranger from Canada could order up the death certificate of someone who was probably a black man from Harlem.
When the certificate copy arrived, it wasn't as detailed as many death certificates I had seen - but his mother's maiden last name Glaze was one I had never seen - rare maybe enough to find her on on Google Search ?
I kept typing in Louise Glaze Harlem or variations thereof and presto one evening, a website came up of her nephew talking about her - i had found one of Aaron's living cousins !
I phoned him (Claude Jay of Harlem My Love) and first I astounded him and then he astounded me --- because he knew of Aaron as Leroy - or more formally as A. Leroy Alston.
He said he was a big athlete.
A person who used his middle name and not his first name - well who would have thought ?!
Well, my wife's huge family has many who do just that - and Dr Martin Henry Dawson was alway Henry - from birth.
Armed with this unexpected information, I soon found tons of material on Aaron Leroy Alston - some in his own voice.
And Claude made it clear Aaron had hundreds of living relatives all over the US.
I astounded Claude again - discovering Aaron Leroy wasn't widowed as his mom said on the death certificate - Claude thought he was always single.
Instead Leroy and Charlotte Lee had been married in the good times of 1930 but the couple were living back with their separate mothers in 1940 when Leroy was too sick to provide an income.
(Both families, once doing okay, were unbelievably poor in 1940 thanks to the Great Depression, racism and early deaths/severe illness of breadwinners.)
I gave all my information to Claude and tried not to research too much further.
I don't feel, as a white Canadian, that I should tell the story of a black man from Harlem - Claude is a relative, journalist, activist and author - he'll tell the full story well I am sure.
Now I turned my hand to another named SBE patient of Dawson - known only as Mr Conant.
(I came to assume that the highly unusual use of that word Mr meant he probably wasn't a young black or Jewish charity case but that he was a private patient, middle class,middle aged and white, from outside NYC)and treated in January 1941.
I searched for a middle aged dead Mr Conant, Manhattan, early 1941, in the NYC death index and up came George M Conant.
Google gave me him in spades - his small town daily describing his SBE illness and his treatment at Columbia Presbyterian at the right dates.
I found Dawson's death certificate and that of little Patty Malone as well - but no Charles Aronson.
That was because he had survived into 1949 at least and NYC death certificates after that date were hard to locate and even harder to gain a legal right to access...
Now read Antibiotics' Patients zero, part 3
Showing posts with label george milton conant. Show all posts
Showing posts with label george milton conant. Show all posts
Sunday, April 5, 2015
Sunday, March 1, 2015
First injection of penicillin into patients : October 16th 1940 New York
The first penicillin needle into a patient, ushering in our present Era of Antibiotics, was one of the most signal events in all medical history and it happened exactly 75 years ago this Fall.
Yet, until this present article, even the barest of its bare facts have never been publicly reported accurately - not even by the three key team leaders that first performed them !
Here is how it went, based on cross-checking the various published report by the three team leaders against public records and newspaper accounts:
On October 15th 1940, after a hectic six weeks learning from scratch just where to find the right strain of penicillium and then how to coax the temperamental fungus to produce raw penicillin juice, the three key members of the tiny team at New York's Columbia Presbyterian Medical Centre were finally ready.
The team leader (Nova Scotia born and raised Dr Martin Henry Dawson) would inject the penicillin into himself, a healthy volunteer, to test whether the never-before injected drug was dangerous to human life once in the bloodstream.
If he survived unharmed, the team planned to use the free time provided the next day by the university's registration of students and young staff in America's very first peacetime Draft to inject some penicillin into two young male patients dying of then invariably fatal SBE.
More formally known as subacute bacterial endocarditis, SBE was the then common disease that made Rheumatic Fever the leading killer of the young.
So only October 16th (in between the two dying boys being registered for the Draft) and once again on October 17th 1940, Dr Dawson injected some of the team's hospital brewed penicillin into the two young men.
One was a young black star athlete , Aaron Leroy Alston born 1910 and residing on St Nicholas Avenue in Harlem and the other was a deathly-sick-all-his-life young Jewish man, Charles Aronson, born 1913 and residing on Vyse Avenue in the Bronx.
Next, the two young men got a much longer and and a much larger regime of oral Sulfa drugs.
Unexpectedly, the Sulfa worked on the sickly Aronson and he went home apparently cured, on a maintenance dose of Sulfa, in late December.
His cure held and he survived alright for three and a half years until another bout of SBE brought him back to Dawson.
This time Dawson had plenty of penicillin to cure SBE reliably and he did so again with Aronson.
Unfortunately, star athlete Alston did not respond to Sulfa drugs (more accurately his particular strain of SBE-causing Viridans Strep didn't respond) and Dawson started him again on a larger and longer regime of stronger injected penicillin on December 31st 1940.
He died mid-treatment in mid January 1941 and his tragically short sports career was celebrated and mourned by many sports fans across the city.
The penicillin brewed for him but not used was given to a third patient, a young middle class salesman in his thirties from upstate New York - Middletown to be precise ; his name George Milton Conant.
He got at least one course of Dawson's penicillin in late January.
He died on May 31st 1941 -nearly a month after Dawson gave a cautious report May 5th on his treatment of four SBE patients with penicillin , delivered before a huge convention of medical researchers at Atlantic City and given extraordinary wide coverage in the news media.
I (and even the team itself) know nothing of the fourth patient - but Dawson's May 5th report specifically says four were treated ( thus treated between between October 16th 1940 and late April 1941).
(It is is worth remarking, given the canonical status and wide circulation of this newspaper, that The New York Times' science correspondent William L Laurence (who wrote the famous eye-witness account of the first atomic explosion ,"Dawn Over Zero") reported the next day that he had heard Dawson saying that he had treated 4 patients suffering from SBE with his penicillin.)
As of the May 5th date, we know for sure that only one patient had definitely died but Dawson refused to crow about his small successes ---- or give specifics of just when the first injections were given and to how many patients.
Dawson later referred , in his 1944 JAMA article, to treating five SBE patients with early hospital brewed penicillin, of a potency not stated.
This allows us to assume that the fifth patient was probably treated very early in the Fall of 1941.
Because that was before Dawson had been introduced, after a visit from Norman Heatley, to the idea of calibrating the biological activity of penicillin by using Oxford units - as we still do to this day.
(The team seems to have stopped making penicillin during the high summer months because the temperature in the hospital, anywhere than in a bottom basement room, was far too high to successfully grow penicillium that would give off penicillin juice.)
Later he and his fellow team mates bacteriologist Dr Gladys Hobby and chemist Dr Karl Meyer would all give partially accurate and incomplete public accounts of those early (clearly non-dramatic) days - so who could blame the lay press or science historians for repeating their errors and adding some of their own ?
Yet, until this present article, even the barest of its bare facts have never been publicly reported accurately - not even by the three key team leaders that first performed them !
Here is how it went, based on cross-checking the various published report by the three team leaders against public records and newspaper accounts:
On October 15th 1940, after a hectic six weeks learning from scratch just where to find the right strain of penicillium and then how to coax the temperamental fungus to produce raw penicillin juice, the three key members of the tiny team at New York's Columbia Presbyterian Medical Centre were finally ready.
The team leader (Nova Scotia born and raised Dr Martin Henry Dawson) would inject the penicillin into himself, a healthy volunteer, to test whether the never-before injected drug was dangerous to human life once in the bloodstream.
If he survived unharmed, the team planned to use the free time provided the next day by the university's registration of students and young staff in America's very first peacetime Draft to inject some penicillin into two young male patients dying of then invariably fatal SBE.
More formally known as subacute bacterial endocarditis, SBE was the then common disease that made Rheumatic Fever the leading killer of the young.
So only October 16th (in between the two dying boys being registered for the Draft) and once again on October 17th 1940, Dr Dawson injected some of the team's hospital brewed penicillin into the two young men.
One was a young black star athlete , Aaron Leroy Alston born 1910 and residing on St Nicholas Avenue in Harlem and the other was a deathly-sick-all-his-life young Jewish man, Charles Aronson, born 1913 and residing on Vyse Avenue in the Bronx.
Next, the two young men got a much longer and and a much larger regime of oral Sulfa drugs.
Unexpectedly, the Sulfa worked on the sickly Aronson and he went home apparently cured, on a maintenance dose of Sulfa, in late December.
His cure held and he survived alright for three and a half years until another bout of SBE brought him back to Dawson.
This time Dawson had plenty of penicillin to cure SBE reliably and he did so again with Aronson.
Unfortunately, star athlete Alston did not respond to Sulfa drugs (more accurately his particular strain of SBE-causing Viridans Strep didn't respond) and Dawson started him again on a larger and longer regime of stronger injected penicillin on December 31st 1940.
He died mid-treatment in mid January 1941 and his tragically short sports career was celebrated and mourned by many sports fans across the city.
The penicillin brewed for him but not used was given to a third patient, a young middle class salesman in his thirties from upstate New York - Middletown to be precise ; his name George Milton Conant.
He got at least one course of Dawson's penicillin in late January.
He died on May 31st 1941 -nearly a month after Dawson gave a cautious report May 5th on his treatment of four SBE patients with penicillin , delivered before a huge convention of medical researchers at Atlantic City and given extraordinary wide coverage in the news media.
I (and even the team itself) know nothing of the fourth patient - but Dawson's May 5th report specifically says four were treated ( thus treated between between October 16th 1940 and late April 1941).
(It is is worth remarking, given the canonical status and wide circulation of this newspaper, that The New York Times' science correspondent William L Laurence (who wrote the famous eye-witness account of the first atomic explosion ,"Dawn Over Zero") reported the next day that he had heard Dawson saying that he had treated 4 patients suffering from SBE with his penicillin.)
As of the May 5th date, we know for sure that only one patient had definitely died but Dawson refused to crow about his small successes ---- or give specifics of just when the first injections were given and to how many patients.
Dawson later referred , in his 1944 JAMA article, to treating five SBE patients with early hospital brewed penicillin, of a potency not stated.
This allows us to assume that the fifth patient was probably treated very early in the Fall of 1941.
Because that was before Dawson had been introduced, after a visit from Norman Heatley, to the idea of calibrating the biological activity of penicillin by using Oxford units - as we still do to this day.
(The team seems to have stopped making penicillin during the high summer months because the temperature in the hospital, anywhere than in a bottom basement room, was far too high to successfully grow penicillium that would give off penicillin juice.)
Later he and his fellow team mates bacteriologist Dr Gladys Hobby and chemist Dr Karl Meyer would all give partially accurate and incomplete public accounts of those early (clearly non-dramatic) days - so who could blame the lay press or science historians for repeating their errors and adding some of their own ?
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