Crazy Is A Numbers Game

Ignaz Semmelweis was a Hungarian doctor in the 19th century, at the start of the golden age of the physician scientist.

This was a time when doctors were no longer thinking of illness as an imbalance caused by bad air or evil spirits. They looked instead to anatomy. Autopsies became more common, and doctors got interested in numbers and collecting data.

The young Dr. Semmelweis was no exception. He started a new job in the maternity clinic at the General Hospital in Vienna, where he began collecting some data of his own. He wanted to figure out why so many women in maternity wards were dying from a fever commonly known as childbed fever.

To assess this, he studied two maternity wards in the hospital. One was staffed by all male doctors and medical students, and the other was staffed by female midwives.

He began counting the number of deaths on each ward and discovered that women in the clinic staffed by doctors and medical students died at a rate nearly five times higher than women in the midwives’ clinic.

The big question now was why.

Semmelweis went through the differences between the two wards meticulously and started ruling out ideas.

It didn’t take long to spot a huge difference between the two wards. In the midwives’ clinic, women gave birth on their sides, but in the doctors’ clinic, women gave birth on their backs. So he had women in the doctors’ clinic give birth on their sides.

The result had no effect.

Semmelweis then noticed a pattern. Each time a patient died from childbed fever, a priest would solemnly walk through the doctors’ clinic, passing the beds of the women, accompanied by an attendant ringing a bell. Semmelweis hypothesised that the priest and the bell terrified the women so much after delivery that they developed a fever, fell ill and died. (He was really clutching at straws here, in my opinion.) So he had the priest change his route and ditch the bell.

Shock: the result had no effect.

By now, Semmelweis was becoming increasingly frustrated. He took leave from his hospital duties and travelled to Venice, hoping the break would clear his head.

When he got back to the hospital, he was met with sad but important news. One of his colleagues, a pathologist, had fallen ill and died. There was nothing unusual about the way he died. He pricked his finger while doing an autopsy on someone who had died from childbed fever, got very sick himself, and died.

This was a lead for Semmelweis to follow. He studied the pathologist’s symptoms and realised he had died from the same thing as the woman he had autopsied. This was a revelation. Childbed fever wasn’t something only women in childbirth could get. Other people in the hospital could get sick from it too.

But his original question still hadn’t been answered: why were more women dying from childbed fever in the doctors’ clinic than in the midwives’ clinic?

The big difference between the two wards was that the doctors were doing autopsies and the midwives weren’t.

Semmelweis suggested that tiny bits of dead bodies, which he called “cadaverous particles”, lingered on the students’ hands after they worked on the bodies. He believed that when these students helped deliver babies, they passed these particles into the women’s bodies, and this was what made the women sick.

He introduced a new rule for his medical team: they were to clean their hands and instruments not only with soap but also with a chlorine solution. Today, we know chlorine is a powerful disinfectant, but Semmelweis didn’t know about germs. He chose chlorine mainly because he believed it would get rid of the smell of the cadaverous particles he thought were causing the infections.

This time, the result did have an effect.

The rate of childbed fever fell dramatically.

What Semmelweis uncovered is a principle that remains vital in public health today.

You would expect this to have been rolled out as a standard for hospitals everywhere. Yet the response was far from celebratory.

The theory implied that doctors themselves were responsible for spreading childbed fever, a suggestion that provoked outrage among his peers.

Semmelweis was not very tactful about his discovery. He openly criticised those who doubted him and made some influential enemies in the process.

The doctors gave up the chlorine hand-washing and Semmelweis lost his job.

This is more than a chapter in medical history. It’s a stark reminder of the delicate interplay between innovation, acceptance and the human ego. It’s a story of how a simple solution to a complex problem was dismissed, only to be embraced years later as a fundamental truth.

In today’s world, it’s pretty manky to walk out of the bathroom without washing your hands.

Manky (Scottish slang): often used to describe something as dirty, unpleasant, or in a state of disrepair.

Semmelweis wasn’t crazy. He just didn’t have the numbers.

My point is that getting an initial crowd behind you when challenging the status quo is vital to an idea’s success. I see the same thing happening in Bitcoin. Unlike Semmelweis, Bitcoin has the numbers. If enough people believe the same thing, it suddenly isn’t so crazy.

I’m writing this on 2 January 2024, ahead of the expected US spot ETF approval on 10 January, which could be a significant step towards acceptance and dramatically increase the number of people behind it. Whether it happens on that day or not, your guess is as good as mine, but I’m starting to feel a little less crazy as the days go on.

Editor’s note: US regulators approved spot bitcoin ETFs on 10 January 2024, eight days after this piece was written.

This is a guest blog. Views expressed are the author’s own and do not necessarily represent the views of The Bitcoin Collective. This article is for information and entertainment only and is not financial advice. Details of the individuals mentioned are based on publicly available reports at the time of writing and may have changed since. Bitcoin is a volatile asset and its value can go down as well as up. Always do your own research and consider speaking to a qualified financial adviser before making any investment decisions.