January Book Club - The Mould in Dr Florey's Coat by Eric Lax
Sandemaniac
Shipmate
I realise I'm starting early, but I'm laid up on bed with lurgi railing at all the things I intended to do in my spare time today, and this felt like something productive and achievable. So here goes.
Trigger warning - some of the correspondence quoted between Florey and his wife is jaw-droppingly insensitive.
The story of the discovery of penicillin by Alexander Fleming (quick quiz - can anyone name any other players in the story without reading the book?) after it accidentally blew into his lab is well known.
What's not so well known is that, even though Fleming was among the first to do some research on the activity of mould extracts on bacteria, which was a long-known phenomenon, it took over a decade before penicillin became a life-saver, a war-winning tool in the hands of the Allies that landed with the troops on D-Day.
In that time a myth was made by a newspaper baron that has become known the world over and hides the truth of who made it into the life-saver.
Lax's book covers both the real story and the myth, and weaves them into a compelling narrative of the groundbreaking drug.
I will come up with some questions around the 20th. How many readers/intended readers are there? Please feel free to put your hand up and share your interest in the book, as that may help me set questions.
Trigger warning - some of the correspondence quoted between Florey and his wife is jaw-droppingly insensitive.
The story of the discovery of penicillin by Alexander Fleming (quick quiz - can anyone name any other players in the story without reading the book?) after it accidentally blew into his lab is well known.
What's not so well known is that, even though Fleming was among the first to do some research on the activity of mould extracts on bacteria, which was a long-known phenomenon, it took over a decade before penicillin became a life-saver, a war-winning tool in the hands of the Allies that landed with the troops on D-Day.
In that time a myth was made by a newspaper baron that has become known the world over and hides the truth of who made it into the life-saver.
Lax's book covers both the real story and the myth, and weaves them into a compelling narrative of the groundbreaking drug.
I will come up with some questions around the 20th. How many readers/intended readers are there? Please feel free to put your hand up and share your interest in the book, as that may help me set questions.
Comments
I should probably have mentioned in my intro that there's not a lot of science in the book, which is one of the reasons it was picked. I know how glazed I get by heavy science outside my line, so it's going to be much worse for non-scientists!
Do feel free to post comments queries etc as you go, because I don't think I can keep quiet if no-one posts for a few days (witness this post...), and I'm happy to take on board, attempt to answer, etc.
Sandemaniac, you mention this book is "outside your line". What is your area of science, if you don't mind sharing? Keep in mind I have not taken a science course since 1980.
*I'm particularly thinking of the number of ear infections I had as a wean.
Incidentally, do please join Cheery Gardener in dropping in with your views - if we get onto stuff I was going to ask questions about, I'll write different ones!
There are a couple of jaw-dropping moments, aren't there? I struggle to understand the differences between his relationships - how could he be so crass to one woman, yet adored by another?
Specially as most of the people who knew both women preferred the one he was so awful too.
I was glad to see his wife having success in her own career - it must have been dreadfully boring having to do all the wife stuff with not much intellectual stimulation, until she was able to find her niche.
I didn't know whether to feel sad or happy for their children having such a long separation from their parents. In some ways they would have missed out on the unhappy relationship, but I know how hard it was in our family to reintegrate our daughter after being away from her for months on end when her brother was unwell. She was in the care of really good and caring people, but from her perspective, it wasn't the best and perhaps it's more about the age of the children at the time.
I did know about Florey and some of the rest of the research team before I first read the book, but that's because I live in/near Oxford...
Would you like me to hang on a bit longer for the questions (this a question to everyone), or shall I post, and hope that they don't affect GI's enjoyment?
How does the story as told in this book differ from your understanding before you read it?
Do you feel that the Oxford team have been fairly treated by history? If not, why not?
Should Florey’s personal life have been brought into the story as much as it was?
Any of the key persona that you particularly feel positively or negatively about?
Did anyone spot the comically cut-and-pasted photograph?
How easy or otherwise did you find the sciencey bits to follow?
As a Canuck, the only name I had heard before this was Fleming in relation to Penicillin.
Do you feel that the Oxford team have been fairly treated by history? If not, why not?
I think Fleming was better at self-promotion. Also, I think people tend to want to focus on a hero who "discovered" something rather than those who "developed" it.
Should Florey’s personal life have been brought into the story as much as it was? Given the book title, I was not surprised by the amount of focus on Florey. We also received glimpses into others' personal lives.
Any of the key persona that you particularly feel positively or negatively about? I found both Florey and Chain hard to warmup to and to like.
Did anyone spot the comically cut-and-pasted photograph?
Nope.
How easy or otherwise did you find the sciencey bits to follow?
It got easier as the book progressed. The last science course I took ended in 1980.
The story of Fleming being the discoverer and Florey being the one who developed it further was familiar to me being an Australian just as Florey was. I think my Mum may have explained to me the difference in the contributions of each when I was a teenager. At the time I don’t think I gave it too much thought but as an adult with my child having been sick over many years, I think I have a broad understanding of the collegiate nature of medicine, which is at the same time a competition to be the one to find something new/better or a new application for an old drug. The desire to be the lead author on a scholarly paper and the pressure to publish to maintain one’s prestige in the science community. One of the Fellows on our treating team had a letter published in Nature and they thought they were Christmas at the time!
Do you feel that the Oxford team have been fairly treated by history? If not, why not?
Now that antibiotics have been around for nearly 100 years, I don’t know whether it really matters or not anymore. I can imagine at the time there was a real desire for each of the contributors to think that perhaps they had not received enough acknowledgement for their contributions, but to the lay person now, it’s probably a bit of a a non-question. Time has marched on!
Should Florey’s personal life have been brought into the story as much as it was?
I enjoyed that aspect of the book, otherwise it’s just a flat list, like a timeline without any sense of who the person was, or what drove them. Some people would think that it’s an imposition into a person’s private life, but it’s part of remembering who that person was, warts and all. None of us is perfect and we make judgements about people all the time, of those dead and alive. I had more feelings about the children and their being sent away during the war, I suppose that pushed my own personal buttons.
Any of the key persona that you particularly feel positively or negatively about?
Personally, I didn’t like Florey’s wife much, but of course she cannot answer any questions or defend herself. I did feel sympathy for them both because it seemed to me that they weren’t suited to be together and that if she was enjoying shipboard romances on the way to meet him, that perhaps she was either looking for an out before a commitment was made, or that she didn’t really want a commitment, enjoying the attention and wooing, but not wanting to do the grunt work that most marriages are composed of. Obviously her intelligence and ambition were quite high and I don’t blame her for not enjoying a life of domestic drudgery (who would), and living in a time where women were viewed as subordinate in a relationship would have been very hard to live with and the communication issues resulting from her hearing loss must have really compounded any and all misunderstandings and miscommunications that inevitably occur in a relationship. Perhaps if I met her and saw the story from her perspective, I might like her better.
Did anyone spot the comically cut-and-pasted photograph? I am going back to check this out!
How easy or otherwise did you find the sciencey bits to follow?
I thought the book was well written and interesting to read, it wasn’t dry and I’d honestly never really thought about the wartime aspects of the project and if science people find it hard to get funding now, well it was a lot less well funded then and the need to schmooze different people with perhaps some degree of duplicity was all about getting the money so that the work could be done. Without the war, would the research have advanced so rapidly?
I didn’t find the science hard to follow. Even in high school science we had to use agar plates for experiments and that all made sense to me. I’ve also had the experience of following the son’s treatment roadmap 2 different protocols and 2 transplants and knowing the rules around getting a temperature and the imperative of going straight to the hospital for antibiotics in order to remain fever free for 48 hours before being discharged. Obviously in the early days of leukaemia treatment people died quickly of the disease progression but also from the infections that without antibiotics could not be fought off. I still remember that 2 antibiotics were given together for a few days after blood cultures being drawn and if the response was poor, then after a couple of days bigger gun drugs would be brought in until the infection resolved. It is sobering to me that our kid would not be here at all without antibiotics (or any of the other therapies he received). And of course, the previously shared anecdote about the WWI distant relative.
As a child in England I grew up believing that Fleming had discovered penicillin, and no-one else was mentioned. Since living in Australia, I have been re-educated, so this book was more an elaboration about how the development by Florey’s team happened; certainly I learned more about the process, the politics and the role of the war. But Florey is fairly well-known here. We live in the next suburb to Florey (a suburb of Canberra named after him) and I frequently go shopping there. It also boasts a Colombian café which (according to Tukai) has the best hot chocolate in town, and a Hindu temple. But not much in the way of plaques about Florey the man, though most would connect him to penicillin.
Do you feel that the Oxford team have been fairly treated by history? If not, why not?
I guess it shows that self-promotion matters, and Florey wasn’t much interested in it. Fleming fought for recognition, and got it. It’s hard to tell how much the fact that the Oxford team were outsiders to the British establishment mattered, but it may well have been a factor. It does seem that Florey and his team were highly regarded by most fellow scientists, but the British and American public knew little of them. I thought the book portrayed well the struggles for money and sponsorship (not much has changed!) and the rivalry about who is lead author, order of names on papers etc (no change there either!). Cheery Gardener's comments about their personal encounters with the medical research process are interesting too.
Should Florey’s personal life have been brought into the story as much as it was?
Well it was a popular history, so it added interest. The Floreys’ marriage was clearly a difficult affair, and probably both partners bore some responsibility. But being stuck in an incompatible relationship doesn’t bring out the best in anyone.
Any of the key persona that you particularly feel positively or negatively about? They were a flawed lot, no doubt – but did great good. Heatley comes across as the most appealing figure.
Did anyone spot the comically cut-and-pasted photograph? My (downloaded) copy didn’t have any pictures.
How easy or otherwise did you find the sciencey bits to follow? I understood enough, with O level Chemistry from c60 years ago. But I have been around scientists and academia all my life, so I do understand scientific method, the publication process etc.
I knew nothing about Dr Florey until I read this book, though I remember hearing about penicillin and Alexander Fleming in primary school. I grew up near Paddington, and actually went to secondary school there. I'm sure the teacher framed her lesson about a great important discovery that happened just down the road. I knew nothing about Florey, or all the steps needed to get penicillin actually useable.
Do you feel that the Oxford team have been fairly treated by history? If not, why not?
Having read this book I think there should be more made of what they did, but it isn't such an interesting story. I'm assuming it is something that is well known among scientists, certainly my son who is a scientist but not in the field of biomedical research seemed to know all about when I told him what book I was reading.
Should Florey’s personal life have been brought into the story as much as it was?
I found those bits interesting as they added a human interest aspect to it. As a deaf person I had a lot of sympathy for Ethel Florey. The fact that people thought she was a bit of a liability rather than working out ways to communicate with her made me rather cross. I also thought Lax made some rather sweeping judgements about the characters of some of the people involved, specially the women.
Any of the key persona that you particularly feel positively or negatively about?
I thought Chain got a bit of a raw deal. He was obviously difficult to work with, but I'm not sure the best use was made of his talents. The point they should patent their discovery being one of them. I too liked Heatley, I think he was the only one I would have gone for a drink with.
Did anyone spot the comically cut-and-pasted photograph?
I read this on my Kindle so no photos. I noticed a copy in the charity bookshop where I work last week. If its there tomorrow I'll have a look.
How easy or otherwise did you find the sciencey bits to follow?
I am no scientist so I I could only follow what was happening in the most general terms.
I grew up in Oxford and my History GCSE course included a section on the history of medicine, so I knew the outlines of it being noticed by Fleming, and then developed into something usable by Florey and team. What I didn't know till I read the book was just how many people contributed to that development!
Do you feel that the Oxford team have been fairly treated by history? If not, why not?
Not sure on this one. Everyone hears about Fleming, but Florey is less well-known, and most people would have real trouble naming the rest of the Oxford team. I didn't really know about Heatley till I read this book.
Should Florey’s personal life have been brought into the story as much as it was?
Well, it was a part of the story - some of the USA events only happened because his children had been evacuated to there, and he was talking to the friends they were staying with. I do think that the way he behaved to Ethel was poor, and I really do wish we had copies of her letters, so as to see what she was thinking.
Any of the key persona that you particularly feel positively or negatively about?
Chain just reminds me of several people I've encountered in labs over the years... he was right about patenting though! I've had a soft spot for Heatley ever since I read about him.
Did anyone spot the comically cut-and-pasted photograph?
I'm pretty sure @Sandemaniac pointed it out to me the first time I read the book
How easy or otherwise did you find the sciencey bits to follow?
I grew up with 2 academic parents, one in human biochemistry and human immune systems research, the other having worked in (amongst other things) microbiology, and then become an environmental scientist. The science in this was the sort of stuff I grew up hearing talked about at mealtimes. No problems following it.
I should say that the church in Oxford with the plaque in memory of Florey is the one I learnt to ring at, which I still ring at regularly. The description of its location in the book is a bit misleading, it's actually in the church porch, not on the wall outside! It is entirely possible that I saw Heatley in the church when younger, but since ringers rarely have much to do with the rest of the church, and I never stay for the service (plus I have problems getting a name and a face connected in memory), I can't be sure...
I too would have liked to know how Ethel saw the whole situation and certainly having her letters and not just the response to them, would have been very helpful to round out the people more.
I loved the photos, but didn't spot the pastiche, was it the one with the children and Ethel in the background? Or have I totally misread that??
Confession time. I have skin in this game (Ouch! That’s such an uncomfortable phrase). I worked in Oxford University’s Science Area for 16 years. For 4 of those I worked in the Sir William Dunn School of Pathology. The Dunn School has a tradition of taking photographs of all its postgraduate students, and hanging them in the corridors. Originally this started with members of the department and next to the lab I worked in, so I passed them every day, were photos of (amongst others) Florey, Chain, Heatley, Sanders, Medawar, Jennings, Orr-Ewing, Trueta… the great and good of Oxford bioscience. Between reception and the lab was a photograph of an early 1930s Pathology conference and, with a keen eye, you could pick out Florey and Fleming in the same photo, neither aware of what was to transpire.
Up the stairs were displays, museum pieces themselves, of the early penicillin research, complete with photos of Albert Alexander and Johnny Cox, poor devils.
I wasn’t working there when Norman Heatley died, I first realised he’d still been alive when I saw his obituary, but the more I read the more I liked the man – quiet, unassuming, technical genius, simply got stuck in and did what needed doing. The sort of scientist I wish I was. When I got to the Dunn School, I discovered that many of the longer serving staff had known Norman well – he’d continued to drop in long after he retired, not least to keep an eye on what was retrievable from the departmental skip! He also drove himself to conferences in his camper van to save on hotel bills. Like Sarasa, I would have loved to have gone for a beer with him, I think he'd have been good company, and I have to confess to frustration that @Celtic Knotweed probably encountered my hero and never knew it.
One day I was in stores, when I sensed that something funny was going on – the director came down, which he never normally did. I followed out to the loading bay where, unlike the usual vans, an estate car stood, and a woman and a teenage girl were unloading stuff in bin liners from it. Why the hell did this require the director? Well, it turns out they were Norman’s daughter and granddaughter, and they’d finally got round to clearing out his shed! As you can imagine, there was a lot of stuff that they didn’t know what it was, so they’d brought it to the Dunn School. Probably a good thing as we could safely store things like uranium ore. Yes, you read that right! There wasn’t really a plan to do anything with it, bar work out what was actually dangerous (like the pitchblende and the tin mug with bottles of mercury in…), so I started going through it in my spare time.
A lot of it was junk – there was a box labelled “probably silica gel” (the drying agent in those little packets you get in everything) – and it was, about 5 kilos of the stuff! But there was treasure among the trash. A writing box had all manner of bits and pieces in it – tiny, home-made glass test tubes in profusion that would have held maybe a drop of liquid each, hand-made glass pipettes hardly thicker than a hair – this was a man who could really make stuff! Lots of tiny porcelain cylinders, which turned out to be what he’d had made for assaying penicillin preps (I recreated one of these for the undergraduate medical classroom with some of the original cylinders), and a few vials of yellow-brown powder… genuine Oxford penicillin! Both are illustrated here: https://www.mhs.ox.ac.uk/backfromthedead/exhibition/production/index.html
Most of this was on display in a cabinet in the Dunn School when I left (and was still a year or so later when I was a late sub for a tour of the building when the departmental historian fell ill), but one or two pieces might have finished up elsewhere...
Photos of some of the dramatis personae, for those reading on Kindle, can be seen here, and clicked on to enlarge. I may well expound on the photo of Gordon Sanders later.
https://www.mhs.ox.ac.uk/backfromthedead/exhibition/team-penicillin/index.html
How does the story as told in this book differ from your understanding before you read it?
I wasn't aware of all the people involved in the development of Penicillin or anything about Florey's private life. I also had forgotten how many years it took to develop the first antibiotics.
I also had heard the myth about Fleming discovering penicillin when some mould flew in the window and accidentally ended up in the petri dish. I actually think I heard it in church or Sunday School as there was a religious element in that it was presented as a miracle of God blowing the mould in the window in his timing at the exactly right time and place to help humanity. I think even then I questioned why God didn't inspire the discovery earlier in history, even though I was and am a Christian.
Do you feel that the Oxford team have been fairly treated by history? If not, why not?
They haven't been remembered as much as perhaps they should be, but then lots of people probably don't know about Fleming either. I have asthma and psoriatic arthritis and have good quality of life and well controlled symptoms thanks to modern medicine, but am ashamed to say I have no idea who developed my medicines. I'm guessing it was large teams of scientists making discoveries and connections over time, rather than one genius.
Looks like I have David Jack to thank for some of my asthma medicine https://en.wikipedia.org/wiki/David_Jack_(pharmacologist) . Now I wish I knew in his life time to thank him.
Should Florey’s personal life have been brought into the story as much as it was?
Some of the facts felt a bit intrusive, but I think that is the price of fame. The personal and family stories made the book more interesting.
Any of the key persona that you particularly feel positively or negatively about?
I really liked Norman Heatley. He seemed to get on with everyone, was modest and caring to his family. It is a shame he is not better known. It was amazing reading about all the appliances and techniques he devised and invented from the everyday objects available during World War 2.
Did anyone spot the comically cut-and-pasted photograph?
I read an e-book so didn't see the photographs.
How easy or otherwise did you find the sciencey bits to follow?
I studied biology and chemistry until my final year of high school, so found it easy to follow the science, though I did google what some of the appliances looked like as I am not good at visualising machines and appliances from written descriptions.
I agree with what everyone has said about Norman Heatley, he seemed like a real diplomat to me with a gift of being a team player as well as a scientist and the two in tandem, bingo!
I have now checked out Sandemaniac's photo hint and my goodness, how did I not see this before? Perhaps my brain said to me, oh they had a day where they took a lot of photos, but in reality, I don't think so! I must have been on autopilot!
While we are on photographs, I'll witter a bit regarding the photo of Gordon Sanders and the large-scale apparatus, if you have the book you'll know it, if not it's in the link I posted above - https://www.mhs.ox.ac.uk/backfromthedead/exhibition/team-penicillin/index.html
I love that photo - there's so much story in it. He's so well lit, the light coming through the machine, the white heat of technology shining on him - but with my background growing up in the countryside, going to vintage rallies and visiting farms, I recognise the milk churns, and that the big glass bottles are the receivers from milking machines. A lot of the equipment is brand new, up-to-date - if you were a dairy farmer! And if you look carefully it's all held together with lengths of 4x2 timber. That white heat is relying on bits and pieces (I always used to pause if I used the stairwell they ran the chromatography columns up, trying to imagine the long glass tubes stretching between landings).
It's a pity there's no pics in the Kindle version as there's a diagram of this apparatus in the book, and you can actually see the bathtub bottom left!
On the subject of photos, I found something very interesting a few years ago. I was trying to find the TV programme on David Suchet's grandfather, who was a well-known press photographer, James Jarche. It turns out that he took many photographs of penicillin being produced at St Mary's Hospital - it looks to me as though Beaverbrook actually mounted a considerably more aggresive campaign to get Fleming and St Mary's the credit than the book describes.
A final note, you don't have to like Norman just because he's my favourite! It's nice to know others seem to share my view, though.
How does the story as told in this book differ from your understanding before you read it?
I knew nothing of the history, how long it took in development and all who were involved. In my family, Flemming was the lone hero. Dr. Flemming saved your life as the story went My grandmother died in 1914 from blood poisoning following the birth of my aunt. Only a generation away from when penicillin was available to save me her grandchild. So the start of the book touched me. She also suffered long and hard before her death.
Do you feel that the Oxford team have been fairly treated by history? If not, why not?
It is hard say in hindsight, I do think the book will make them better known now.
.I do hope that the Penicillian Girls found some self-pride in their part.
Should Florey’s personal life have been brought into the story as much as it was?
It made it more interesting and gave some insight into his personality. Were he alive, I would say no, but as all have now passed, it seems fair to include him and the others.
Any of the key persona that you particularly feel positively or negatively about?
I was not all that taken with Flemming as a person. He seemed often unkind.
Did anyone spot the comically cut-and-pasted photograph?
I did not.
How easy or otherwise did you find the sciencey bits to follow?
I was lost a few times but just read on.
Finally, it made me think of my own life being saved by penicillin. I had phunomia, and the old family doctor was treating me, and I was not improving. Against my father's wishes, he was friends with the older doctor my mother sent for a young new doctor who had just opened his practice. He was the one who gave me penicillin it was in the late 40'. I remember he came to check on me several times a day. ( Doctors made house calls back then) I remember getting shots, but not how many. I do remember being very sick and starting to feel better the day after the new doctor gave me the shot. I now wonder if the young doctor knew about penicillin from medical school and it was not yet widely known to older doctors. Word of new things traveled slower back then.