Anne Fulcher Hunter passes -- one of the last adult eyewitnesses to birth of penicillin

Mrs Hunter was born in Wisconsin in 1916 and died in Virginia in 2014, aged 98.

After she had raised her five children she resumed her career as a doctor, now in psychiatry rather than in pediatrics.

She is in my blog today because while a medical resident at Columbia Presbyterian she learned first hand of Drs Dawson, Hobby and Meyer's pioneering work in saving SBE patients with their own hospital-brewed penicillin.

She learned much more about them when she met and married Dr Thomas H Hunter, also a resident there, who from 1943-1946 became Dawson's lead co-worker in this work.

Hunter also became Dawson's personal doctor in Dawson's final months just before VE Day 1945.

Dawson had held off his case of (then almost always fatal) MG (Myasthenia Gravis) for four and a half years, until he had completed his penicillin-for-all project successfully and the Nazis had been defeated.

Mrs Hunter thus had a ringside seat in the most dramatic years of the entire wartime penicillin saga.

But the time I knew more about her, she was in her late nineties and I was not eager to try and get her permission to interview her.

The only other adult eyewitness to wartime penicillin that I know of that who is still alive is Dr H Boyd Woodruff of Watchung NJ, who is 97 and still actively writing scholarly articles !

Perhaps Anne Hunter and her husband told their children a little of those early penicillin days - I sort of hope so.

If not, maybe my book will tell the Hunter grandkids and kids  just what their grand/parents and great/uncle were up to during the war years....

Meet the "GOTHAM SEVEN"

Their leader, Dr Henry Dawson, dying of Myasthenia Gravis (MG) with deadly bulbar nerve involvement.

By the end , his MG crisis were ever more frequent and he was reduced to working out of a wheelchair, with oxygen assist.

WWI poison gas and too much time in damp trenches hadn't helped his lungs now threatened by bulbar nerve failings.

His foot and shoulder had also been severely wounded in the war, resulting in months spent in hospitals recovering.

His wife and helpmate, Marjorie Granger Dawson, had been born with congenital hip problems and no amount of operations had helped - she walked , but with a cane.

His clinical assistant , Thomas H Hunter. Polio had left him with two legs paralyzed so he got about with two crutches.

Former Dawson patient (and Dawson's great behind-the-scenes influence within the powerful WPB ) , financier Floyd Odlum.

The Warren Buffett of his age, he was crippled by rheumatoid arthritis while stressing about American unpreparedness for total war.

He was wracked with pain for the rest of his life and only really comfortable submersed in a warm water swimming pool.

Another former Dawson patient, Dr Dante Colitti

Years spent in hospital while doctors struggled to save his life from TB of the spine left him determined to become a surgeon despite his arthritis of the spine.

A condition which left him a hunchback and required him to use crutches.

The medical establishment rejected his services - partly because he was also catholic and Italian-American.

When he saw his chance he delighted in emulating Dawson , by tweaking the noses of the medically powerfuls by getting scarce penicillin for a dying baby via an appeal to the Hearst newspaper empire.

Miss H : Dawson's first SBE patient in which is can be said for sure that his penicillin alone saved her life.

But SBE casts its net wide and with her , it also damaged her uterus so badly she couldn't have children and left her blind in one eye. But she hung on, despite all the new operations and hospital stays, and thrived.

Her continued survival was crucial to answering the many doubters of Dawson's use of precious penicillin on the useless SBE patients, in the critical period between the Fall of 1942 and the Fall of 1945.

Charlie Aronson, along with Aaron Alston, was the first person to ever get a penicillin shot. Dawson's historical injections couldn't have hurt, because Charlie amazingly survived the then almost invariably fatal SBE.

He got a second bout of SBE and more Dawson penicillin again saved his life - but SBE also gave him a life threatening major stroke that left him permanently paralyzed in speech and body and in a wheelchair.

He survived and thrived - it was but the latest in a life long battle with a half dozen diseases that should have killed him.

As far as we know , he survived SBE - thanks in part to his historic first ever penicillin injection - from October 1940 till at least the end of December 1948.

(My current best guess is that he lived at least until 1955.)

His continued survival again stifled the many doubters to Dawson's SBE efforts.

In the parlance of the day, all seven were 4F --- in fact, the 4F of the 4F , useless, unfit, useless mouths.

But these seven , the Gotham Seven, were the ones who fought off their own Allied government and their own physical weaknesses to rescue natural lifesaving penicillin and set it free for all.

Honour their names : un-super heroes indeed....

Aaron Alston , penicillin's first SBE patient but second to get the historical injection

The known published facts are few

All the contemporary (1945 era) newspaper and book accounts - written by (or coming second hand from) participant eyewitnesses to the events themselves - make it clear that Martin Henry Dawson's first SBE/penicillin patient was a "negro" "man".

And that his name was"Aaron Alston" and that he subsequently "died".

The available record of the amounts and dates that Aaron received Dawson's penicillin - as published by key Dawson team member Dr Gladys L Hobby in her 1985 book on penicillin , Penicillin : Meeting the Challenge , ceases near the end of January 1941.

And that is all the published accounts show.

But now for new research and reasoned suppositions...

We can say that 1940s medical statistics indicate that Alston was a more likely than not a young adult when he entered the hospital with SBE .

It is clear from the census that the names Aaron and Alston is a combination found in a fair number of men in America in the first half century of the 29th century.

However , the censuses generally indicates they are usually negro and that their residences seem centred in the South - from rural Carolina into urban black centres like Washington and Baltimore.

But in the critical 1940 census , there is no Aaron Alston recorded in New York City or in nearby New Jersey and Connecticut.

Now the first SBE patients that Dawson dealt with in the public wards of his upper Manhattan Columbia University Presbyterian Hospital were simply there because they were poor and his hospital happened to be close to where their family lived or close to where they lived when they took ill.

They were not drawn there from great distances because Dawson was then a famous and successful expert in this nearly 100% invariably fatal disease.

Far from it , he hadn't in fact handled any SBE cases up to then as the lead doctor.

Alston almost certainly had to be residing within a three or four miles circle of the Presbyterian hospital, at most , at the time he took ill. But the census does not show this.

He may have moved to New York City after April 1940 and before September 1940 : because southern blacks were still coming north to the unofficial American black capital of Harlem , though there was rarely gold for them at the end of its tattered rainbow.

Harlem is well within the catchment area for the Presbyterian's public wards.

We seemed to have failed to find out anything more about Mr Alston.

But as it happens, the New York City individual death records up to 1948 have been hand indexed on computer by many volunteers and made available via Ancestry.com.

They show an Aaron Alston , born about 1911 , (that is about age 29 on date of his admission to the hospital in September-October 1940) has having died on Jan 25th 1941 in Manhattan.

I am not sure that the original  death record will reveal more more - but perhaps a last address in New York and the name of next of kin and their home town , but I feel 100% certain this is our Mr Alston.

All we have really confirmed so far is that he was indeed a young man at time of his admission , as expected.

Why first patient but second to get the historic penicillin injection

Now while I am certain that Mr Alston was first SBE patient Dawson intended to treat with penicillin, I think he got it moments after Charles Aronson , the other SBE patient to get the historic penicillin injections on October 16th 1940.

Dawson's first major paper on penicillin and SBE was significantly the first penicillin paper not written by him with the help of the very reticent (as he himself was !) Dr Gladys Hobby, his lab chief.

Co-written instead with young Dr Thomas H Hunter, it positively gushes - for Dawson anyway - in giving forth the ages, initials of their name, gender, ethnicity,  dates of treatment, medical condition etc of all the SBE patients that Dawson had treated.

This was a style that Dawson had never shown before in 20 years of writing many, many medical articles.

Some doctors ("clinicians") simply tend to write articles that minutely detail the very 'grain' of  one (person's) case - while others ("researchers") prefer to report on the general conclusions drawn from treating one hundred similar cases.

(Both are valuable to doctors and scientists - but biographers won't be human if they didn't prefer the intimate details of the first type of articles !)

Dawson gets a chance in mid April 1944 to treat Charles Aronson a second time with penicillin for SBE .

This was because the little penicillin Charles had gotten in October 1940 had helped him survive his first bout of SBE.

He thus became that rare successful SBE case (about one in a hundred) that did so , back then.

Dawson indicates  in 1945 , that Charles had first entered the Presbyterian three and a half years earlier - ie mid October 1940 , confirming the common assumption that he was a very late addition to Dawson's Penicillin SBE program.

(Dawson knew he had too little penicillin to even treat Alston adequately, but he kind-heartedly treated both.

He was hoping perhaps that any small sign of a clinical response from either one of them might move Big Pharma to step up to the plate and mass produce the stuff --- for Aaron, Charlie and everyone else.)

Literally : the last shall be first 

But did Dawson really add Charlie at the last minute out of kind-heartedness alone ?

I believe the real reason was because Charlie was such a late addition to his ward's SBE patients.

When a new patient arrived with suspected SBE - a relatively slow killer, first a number of blood tests over a number of days must show the continued and not merely transitory presence of green strep in the blood stream to match all the other classic clinical signs of SBE,.

Then the ethical response is to immediately start treatment with the newest miracle drug , sulfa, and pray.

This is what happened to Aaron, who had been in the ward about a month when he first got his penicillin.

But because Charlie was such a late addition, there hadn't been time to start treatment with sulfa drugs .

So if Charles was treated with penicillin alone and did show a clinical improvement, Dawson's sulfa worshipping naysayers (and their lineup began around the block) could not say it was all due to their established sulfa , not his new penicillin.

(Remember that a lot of middle-aged doctors , the same age as Dawson , had first made their mark as early sulfa drug pioneers - any new miracle drug meant their acclaim was over. )

Behind the polite rancour of academic/scientific 'critiques' is often a lot of half-hidden ego and income concerns.

Dawson recalled, in his 1945 article , that the 1940 Charles was treated with penicillin on October 16 and 17th and then immediately (first) "started" on sulfa on October 22 and that he responded so well that he was released in December and was illness free for three plus years.

Ethically, Dawson would never have wasted half of his tiny amount of penicillin he intended for Aaron on Charles --- if he was already responding well to sulfa.

I think the reason it became so urgent to treat Aaron in mid-October (well in advance of the Dawson team's own original timetable for starting clinical trials) was because he had already been treated with sulfa and it had failed.

And maybe even made him extremely sick  because allergies to sulfa are common and serious.

But treating Aaron alone risked having any penicillin success disputed by the pro-sulfa lobby and this would only forestall drug company involvement - hurting Aaron as well as all others.

Hence Charlie not only getting treatment but getting treated ahead of Aaron , if only by moments.

Ask anyone : nothing starts off a (soon to be citation classic) medical article quite like an opening sentence like this one ---

"The first patient  ever treated with systemic penicillin had (then invariably fatal) SBE , but had not yet had time to start a sulfa treatment, however he responded so well to the penicillin that he has now been home fully recovered for over six months months."

In fact Dawson saw no clinical response at all between cases of endocarditis and penicillin for one and a half long years and he didn't save anyone with the disease purely on penicillin alone until two years later.

But Charles's recovery might have been helped by the morale uplifting affect of simply knowing that he was Patient One of a touted new Miracle drug .

I can only hope that my research efforts eventually help Aaron Alston's relatives to gain some comfort from his short life.

They will learn that he helped bring penicillin into this world and that while it didn't help him personally, it has directly and indirectly helped ten billion of us in the seventy five years since he first received it.....

Dawson long been obsessed with SBE ? Show me ! 'Cause I'm from Missouri ...

Dawson & SBE ?! well I'm from MISSOURI

Even Gladys Hobby says so.

And God Knows, she should know almost better than anyone but Dawson himself.


In her book on penicillin, "Meeting the Challenge", she claims that Dawson had become "especially interested in subacute bacterial endocarditis" (SBE , a heart valve disease).

But no dates when and no specifics. All other writers repeat her claim and again offer no specifics.

I have always been skeptical.

Dawson's day job was running an outpatient clinic in chronic arthritis .

This , at a pre-war large research hospital where discipline borders were heavily policed and where there was a distinct pecking order , from live-saving surgery at the top and outpatient clinics at the bottom.

It still remains true today that dentists don't do open heart surgery and outpatient clinic directors don't handle heart valve diseases.

It is admitably true that in his course of Dawson's job, which consisted in handling the arthritis ( joint inflammation) aspects of every single sort of disease that offers it (and virtually every disease imaginable can offer arthritis pain, if only in a few patients and only transiently) , he would on occasion come across patients with a potential for endocarditis.

But normally a patient who actually had endocarditis in the 1930s was someone with a 99% certainty of a quick death and their arthritis issues were hardly a priority.

In his subsection of his overall department (Internal Medicine) there were people who did work on Rheumatic Fever (RF) and RF frequently ends in SBE, but they specifically tasked not to share RF research with Dawson's clinic.

(They surely exchanged insights and gossips, but only informally.)

During the hospital Grand Rounds, Dawson would definitely come across SBE patients as it was a heart-breakingly common disease to be seen at big hospitals in those days.

But so would every doctor in every big hospital on Earth in 1940 --- so why didn't  hundreds of other doctors  also take up the chance to try the new penicillin on SBE ?

Instead of SBE, Dawson had many other diseases to interest himself in that were closer to the nominal limits of his clinic.

To give but one example of alternate diseases Dawson could have branched into, Dawson did frequently work with patients who had gonorrhea (VD/the clap) because a very common aspect of their disease was arthritis problems.

So, for example, he was one of the first to use the new sulfa diseases on patients with gonorrheal arthritis, starting in March 1937.

But he did not, as a result of this frequent and work-related contact with patients with venereal disease, decide to try Meyer's experimental penicillin on syphilis --- that bold experiment was left to others years later.

So we circle around the issue again : why SBE, a disease so far away from his job definition that him getting involved could only rankle all-powerful senior doctors across the entire hospital?

And if Dawson had a long interest in endocarditis ,where was the proof ?

I am not aware of any published articles by Dawson*, between 1926 -1940,  that even mentioned SBE .

His many recorded comments at conferences in those years also fail to include words involving SBE.

In that same period, Dawson wrote various chapters in medical handbooks (Nelson's Loose Leaf and Cecil's) that involved many aspects of oral strep bacteria , an area where he was considered a world expert, but again nothing on endocarditis, even though SBE originates with the actions of two varieties of oral strep bacteria.

He could have waxed widely here, without raising too many hackles - but again nothing. (By contrast, his young co-worker Thomas H Hunter did write the chapter on SBE in both these textbooks, after Dawson's premature death.)

No specifically medical or scientific explanation for Dawson's sudden and overwhelming interest in SBE

The strong possibility remains - in my studied view - that his sudden and permanent interest in curing SBE with penicillin even at the cost of his own life, has to be set, instead,  against Fall 1940's political and military background in still-neutral America.

We might have to look at why and how Dawson finally got involved in a tremendous effort in WWI , to suggest why and how Dawson choose to get involved in a parallel tremendous effort in WWII.

Substitute WWII Belgium for SBE and Dawson's actions start to become clearer....

* I am unable to find any articles by his three co-workers on the SBE-penicillin project that reference endocarditis, even in passing.

I may be wrong on all this : but show me !

Hobby finally gets her due

Today the best known member, at least among the general public, of the tiny Columbia University team that did the most to bring penicillin to the public as soon as possible (and did so over Columbia's dead body) is Gladys Hobby.

GLADYS LOUNSBURY HOBBY          Nov 19 1910 -July 4 1993

It is a fame she never enjoyed while still active in antibiotics.

The terminally ill Henry Dawson gets most of the credit for providing the moral energy and drive to the Columbia penicillin effort - something that Hobby and Meyer were always forthright in reminding people.

Karl Meyer lived the longest of the main foursome and lived long enough to see his lifelong scientific interest, hyaluronic acid, become a virtual growth industry.

The fourth member ,Eleanor Evelyn Chaffee (aka Mrs Eleanor Hahnel?), will emerge from the shadows, if it is the very last thing I do.

Thomas Hunter first saw fame for finishing Dawson's proof that penicillin could cure the incurable - SBE. Then he became a medical school dean best known for promoting medical education in the third world.

The fairy godfather of the team, Floyd Odlum, is probably best known today for displacing Howard Hughes at RKO.

Miriam Olmstead is today best known as a former girlfriend of the Rocket man, not Elton John, but rather Robert Goddard.

There were a few others, not as invisible as Chaffee ,but rarely connected today to this pioneering penicillin effort.

Hobby after penicillin went on to discover and prove up other big antibiotics and then take leadership roles in science organizations when few women were permitted to do so.

As a result we get many bare bones bios of her - celebrating what she did but not why.

The best - by far - of these is Elizabeth Moot O'Hern's "WOMEN SCIENTISTS" .

It is based on a 1977 interview with Hobby and includes some rare photos of Hobby - most other accounts re-cycle the photograph of Hobby shepherding Fleming about on his tour of South America.

{{What I really want is a photo of Hobby without her pearls - she always wore them - particularly at work in the lab - she was someone that people of my mother's generation would call a 'looker' because of her sharp dress and make-up.

Note the pearls ....

Perhaps this was a survival technique for daring to work above her station  in a very male-dominated world.

But those pearls ----I bet the woman wore them in the bath and to bed !

Perhaps not to church though - a true 'old skool' Presbyterian...}}

But O'Hern's admirable account fails to explain the 'why' in Hobby's four year struggle to bring penicillin to the public, over the opposition of many powerful forces.

I think Professor Jeremy Greene, from Harvard's History of Science Department, does a great job with the 'why' in his brief bio of Hobby in "NOTABLE AMERICAN WOMEN" edited by Susan Ware et al.

He focuses on her very first articles to explain how she came to hold a unique bridge role between the biological and chemical approaches to defeating bacterial infections.

Greene says she defends the validity of studying non-pathogenic bacteria .

(This was a real career-loser between 1870 and 1960 in medical science.)

Dawson's entire career - again opposed to his day job - was also devoted to exploring non- pathogens and pathogens as equally interesting and equally viable ways for commensal bacteria to survive in the human body.

This bonded Hobby to Dawson.

 A deep commitment to seeing new research put to work saving lives, even if it hadn't been all explained in scientific terms, was what bonded Meyer to Hobby.

Meyer was the rarest of 1930s biochemists - he was clinically oriented.... aka he was face to face people-oriented.

Dawson's team was very small and not well supported by his university --- but having two such unusual people to work with him (Hobby and Meyer) helped make up for this....