(Synthetic) Penicillin - (NOT) meeting the Challenge : by Gladys Hobby (co-worker Karl Meyer)

It is a real pity that biochemist Karl Meyer left the writing of a real insider's account of wartime penicillin to his microbiologist co-worker Gladys Hobby.

Because Hobby's book "Penicillin : Meeting the Challenge", one or two gentle digs aside, is decidedly all moral uplift and hands across the water, marking her as "The Pollyanna of Penicillin".

Hobby's book sometimes is more fascinating for what she chooses to leave out than what she puts in it --- and yet she added a great deal of rare, even unique, information.

Meyer only really made one "for publication" comment about his part in wartime penicillin but it was frank and astringent.

It makes a reader wish he had said more : much, much more.

The major reason he didn't was because Meyer knew his role in saving the lives of thousands of SBEs and jumpstarting the fabulous success of native penicillin was all very well, but he was a biochemist damn it and his original goal was to synthesize native penicillin and replace it - not guide it up to the winner's podium.

Meyer had failed, partly because all chemists in the world also failed at this synthesis task --- and partly because he was treated very unfairly by his more powerful scientific competitors - and who wants to research and write a long book about your successful life's one big failure ?

By the time Meyer felt free to make even those few comments, for a book published in 1981, he was over eighty and the key penicillin players had almost all died.

In particular, Ernst Chain had just died a few months earlier.

Inspired by the death of Chain's boss, Howard Florey, in 1968, the first truly multi-continent account of wartime penicillin had come out in 1973, researched and written by Australian journalist and author Leonard Bickel.

Bickel did enough interviewing of minor front line participants still alive to uncover many fascinating, important but unreported/un-Pollyanna aspects of the saga.

His "Rise up to Life" included information from Gladys Hobby that first brought to those interested in the history of penicillin the forgotten efforts of Dr Martin Henry Dawson.

She said Dawson had pushed the North American development of early penicillin in an ultimately successful attempt to cure then invariably fatal SBE , the endocarditis that made Rheumatic Fever the leading killer of school age kids for half a century, a disease she said he had long made his personal crusade.

None of this was true - and she half knew that to be so.

I have found no evidence what so ever that Dawson ever mentioned SBE at any of the many scientific meetings he attended or that he wrote articles on it or did research into it.

And Hobby was his closest co-worker for ten years : she too had said, written and done nothing on SBE.

So Dawson had done nothing on SBE --- least not before October 1940, when the penicillin project at his hospital had already been underway for 5 weeks.

Hobby freely admits that she herself was away on vacation when the project began and she returned after several hectic weeks into the effort - so she could only know of the project's origins from what Meyer, Chaffee and Dawson told her.

The agreed plan, by the time she arrived, was that the native penicillin would be grown mostly by Hobby.

Then after being purified and its chemical structure figured out, it would be synthesized artificially, all this mostly done by Meyer and Chaffee, tasks expected to be completed sometime early in the New Year.

Then, and only then, would clinician Henry Dawson reach centre stage - injecting the synthetic penicillin into patients whose care he controlled as the sole attending physician among the small four person team.

A few days before Draft Registration Day, October 16th 1940, Dawson suddenly decided to put a very little of the very weak and very impure native penicillin into two patients with SBE, a disease whose cure, virtually all doctors agreed, would require lots of medication every day for weeks and weeks on end.

Dawson's tiny injections might raise the dying pair's morale but could have had no direct physical impact on their disease.

And it rather upended the team's agreed upon project protocol.

As that chemically-oriented protocol suggests, Meyer the biochemist had actually started the project.

But he waited a half century, till just after the death of Ernst Chain, to say exactly why he had.

In 1980, Meyer was interviewed by a young endocarditis researcher, Australian born Dr David T Durack, who was writing an article on the early history of the conquest of endocarditis by antibiotics for a book, edited by Allan Bisno, on infective endocarditis.

Meyer told Durack that in the late summer of 1940 he was incensed by the assignment of priority given to Meyer's own pioneering work on lysozyme in articles by Ernst Chain.

(Meyer probably didn't mention it but he was possibly even more incensed by Chain jumping his priority on Meyer's much more exclusive pioneering work on hyaluronan.)

Chain had been a fellow biochemistry student with Meyer in Berlin and even more importantly, both were not-yet-established-German-Jewish-emigre-scientists in the wartime Anglo-American medical research world.

For either, scoring a significant scientific discovery might keep them out of an internment camp, while a rival stealing their credit might mean a hard bed in that same internment camp.

I think most biochemistry experts agree that Karl Meyer was a far, far better biochemist all his life than Chain.

So for whatever reason(s) , Meyer's pioneering work was always closely followed up by Chain.

Only this time, Meyer would turn the tables --- follow up on Chain's pioneering work for once.

Try to beat Chain to the goal of purifying native penicillin to the point when its structure could be determined and then it could made by artificial synthesis.

A great story --- but how true ?

Because Chain didn't even submit his co-authored articles on hyaluronan and lysozyme until late September 1940 and late October 1940 and they weren't even published in the UK till December 1940 and no one in America could have read them before January 1941.

Was Meyer clairvoyant then ?

No - and Professor Ronald Bentley provides the solution.

He got to know Professor Leslie (Epstein) Falk late in both their careers and learned that Epstein had not just done his PhD thesis on lysozyme under Chain's close supervision but had also informally helped Chain in the early Oxford work on penicillin.

The Fall of France had prompted the US & UK governments to agree to return all the American Rhode scholars posthaste, because America was still neutral.

So Epstein couldn't even stay long enough to dot the last "i"s on his thesis, but he was in Oxford when Florey first injected penicillin into mice and cured their fatal disease without harming the mice with side effects.

Epstein felt the sudden uprise of excitement in Florey's entire institute and the move to keep it all hush hush until it had secured a commercial sponsor and had been published.

Epstein was Jewish and a leftist - Florey didn't much like either.

Epstein probably felt he owed Florey no particular loyalty as a result.

So he spilt the beans on the penicillin project, including Chain's expected role, to Meyer while using Meyer's expertise in lysozyme together with Meyer's reagents and lab space to finish his PhD - sometime between June 10th and September 7th 1940.

Like Epstein (and Chain for that matter), Meyer was also Jewish and left-leaning.

I personally feel that Epstein really liked Chain and only inadvertently let slip Chain's 'off the cuff' dismissive comments about Meyer's work.

Probably while recounting some of the endless 'colourful stories' that Chain's very mercurial personality tended to throw up.

Because I see nothing too offensive in either of Chain's relatively cautious articles (on Lysozyme and Hyaluronan) and in any case, they came out months after Meyer began his penicillin project.

No, Meyer, forewarned by Epstein in person what journal would get the Florey,Chain et al penicillin article and what month it might come out, lay in wait for whatever tidbits of new information on penicillin's curative effects the article might have.

He needed that information to be good because he needed microbiologists (Hobby) and clinicians (Dawson) on side, if he was to pull off the synthesis of penicillin.

Because there was no chemical test to tell you that you have actually synthesized penicillin - that could only be established biologically by skilled workers.

Now Durack also interviewed Hobby and Dawson's last co-worker Thomas T Hunter for his article and told them they'd be in it and when and where it would come out.

Hobby read Durack's article when it came out in 1981, that I am sure , including Meyer's bombshell revelation, and went on to publish her own account of wartime penicillin in 1986.

But she choose not to alter in any way her earlier claim to Bickel that their pioneering penicillin effort was led from the start by Dawson and was set up to defeat SBE with penicillin.

Meyer's account rang true, but Hobby wanted nothing in her book to upset its thesis that good will and a lot of hard work among united allies gave us the miracle of wartime penicillin.

If her work sold far less copies than Watson's 1968 "The Double Helix" one need not search hard to find why.

Her account of the 'drama' of wartime penicillin left out all the drama .....

Bickel penicillin book vivid -- at cost in accuracy

Lennard Bickel's 1972 book, "Rise Up To Life", was the first book that covered the wartime saga of penicillin as it occurred around the entire world.

But it was also one of the first written by someone who was not an eyewitness to the actual events.

But Bickel, an Englishman who emigrated to Australia in mid life, was a very good journalist and interviewed all and everyone he could find from the wartime era and got lively quotes from all.

Unfortunately, as a journalist rather than a historian, he sometimes chose to sacrifice all the facts in order to keep things lively and vivid.

I believe that as a result, he chose to detail almost no pioneering penicillin patient -- unless they could be fully named in his account --- regardless how important they actually were in historical terms.

But even back in the more innocent era of the 1940s, peer reviewed medical articles tended to simply describe but not name patients -- or just given them unique numbers or initials.

Revealing full names was simply no indication of relative historic or scientific importance.

How this historical travesty all began :

Bickel, probably in 1971, interviewed American Gladys Hobby, who as a PhD in microbiology had personally witnessed many pioneering wartime penicillin events from late 1940 through to late 1945.

But she recalled them mostly from memory and a few personal papers.

In the early 1970s, she surely knew the birthdate, medical history and the initials (CA) for one patient from wartime's pioneering Patients Zero.

Because she had surely read - many times -  the medical article her friend and co-worker, the late Dr Martin Henry Dawson, had written in late 1944.

The Patients Zero were the first people ever in history to get injections of life saving antibiotics - doing so on October 16th 1940 from Doctor Dawson at New York's famous Columbia Presbyterian hospital.

But she had forgotten what name lay behind those initials CA.

Fatal SBE was their fate

For the first half of the 20th century, Rheumatic Fever was the leading killer of young people.

Most actually died a few years later, when their heart valves earlier damaged due to Rheumatic Fever, failed because of an attack by common and usually harmless mouth bacteria.

The dreaded SBE - then an invariably fatal form of endocarditis - was what was due to shortly kill this historic duo of patients.

Hobby remembered the other Patient Zero well enough.

Aaron Alston, a young black man from Harlem, had received quite extensive penicillin treatment from Hobby's teammates while Hobby was employed at the hospital but had still died in late January 1941, despite all her's and their best personal efforts.

Louise Good to the rescue

It wasn't till the 1980s, while writing her own book on wartime penicillin, that Hobby contacted a Columbia Presbyterian Hospital employee named Louise Good, who did have access to more detailed contemporary records.

Good revealed that CA was Charles Aronson and confirmed that Hobby was correct in believing that the other was Aaron Alston.

Charles Aronson was actually treated far more extensively with penicillin than Alston - but treated in 1944, when Hobby was then employed elsewhere.

Employed at Pfizer, which had earlier worked very closely with her and Dawson.

Still, she stayed in very close touch with Dawson's team and had certainly read the medical article describing CA's extensive second penicillin treatment.

But that wasn't the same as actually being there at his bedside, daily for months, to burn his real name permanently into her memory.

Bickel lays his thumb on the history balance

This was unfortunate, because Bickel - for reasons perhaps not altogether honourable - chose to focus only on Hobby's fully named patient, the one who died.

By not also including the patient with only initials, the one who survived his invariably fatal disease twice thanks to Dawson's penicillin, he tilted his account of Dawson's work to the side of failure.

Failure, rather than the actual facts - which was that five years of life-costing hard work by Dawson - and Dawson alone - had made an once common and then invariably fatal heart disease the most curable heart condition known.

Bickel's brief account of Alston's early death - followed by Dawson's 'early' death, became the gospel on the whole fascinating penicillin story at Columbia-Presbyterian and Pfizer to generations of writers.

I will satisfy the natural curiosity

I fully and truly understand the curiosity that drives people to inquire as to who is the real person behind mysterious initials .

That is why I have worked so hard to recover the lost story of CA - and of Alston and the handful of other patients of Dawson who were given full names names in Hobby's 1985 book, "Penicillin : Meeting the Challenge" ...