February 19, 2026 • 39 mins
After bacteria were discovered, it took scientists 200 years to figure out that they cause disease. If scientists had made the link sooner, hundreds of millions of lives could have been saved.
In his recent book So Very Small, Tom Levenson, a professor of science writing at MIT, tells the amazing story of germ theory, and argues that our worldview can prevent us from seeing what is right in front of us – even when lives are at stake.
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Speaker 1 (00:15):
Pushkin. Hey, it's Jacob. Before we start the show today,
I just want to say thank you for listening. I
really appreciate it, We all really appreciate it. And if
there's any way we can make the show better, make
a show that you like better, please tell us how
(00:35):
to do that. You can email us at problem at
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at Jacob Goldstein or on LinkedIn and I read all
the emails we get. So please let us know what
we can do to make the show better. And mostly
thanks for listening. Here is the show. I'm Jacob Goldstein,
(01:01):
and this is What's Your Problem. My guest today is
Tom Levinson. He's a professor of science writing at MIT
and the author of a book called So Very Small.
It's a book that tells the story of one of
the most important breakthroughs in the history of human knowledge.
I don't think I'm overstating it. It's the discovery that
germs caused disease. Before we figured that out, most people
(01:24):
who ever lived died from infections. After we figured it out,
scientists very quickly came up with new vaccines to prevent
infections and new drugs that could treat infections after they happened.
Realizing that germs caused disease and building on that insight
has saved billions of lives. And there's something really interesting
(01:44):
at the center of this story. Bacteria were first discovered
in the late sixteen hundreds, but people didn't realize that
they caused disease until the late eighteen hundreds. So Tom's
book asked this big question, why did it take so
long to figure it out? Which for me points to
an interesting question for today. What does that tell us
(02:05):
about the way humans understand the world. What does it
tell us about our willingness or unwillingness to change our views.
We started our conversation by talking about the first person
ever to see bacteria. He was a Dutch cloth merchant
and his name was Anthony van Lavenhook. In the late
sixteen hundreds. He gets into building microscopes, which was like
(02:27):
a popular hobby at the time, and he gets really
good at it, which allows him to make this extraordinary discovery.
Speaker 2 (02:34):
Lavan, you know, the great breakthrough is he saw this
entirely new domain of life. You know what I call
in the book the microcosmos, This this utterly invisible to
the naked eye, yet enormously rich and teeming with life
and varieties of life and all kinds of things going
on in you know, the gunk between your teeth and
(02:55):
a drop of pond water, and you know, and so on.
Speaker 1 (02:57):
Well, you're doing this list, but he really did, right.
He took the tartar from his teeth and put it
on a microscopic slide. He did exactly and saw and
saw what what did he see? When he looked at
his own tooth gung?
Speaker 2 (03:10):
He saw what he referred to as well in English,
animacules little tiny animals, right, and we now know they
were bacterian in some cases, you know, protozoa and other
forms of microscopic life, but definitely bacteria that had different shapes.
(03:30):
He saw the little cilia the bacteria have to help
them move. He saw corkskew shapes like that of the
family of bacteria that includes the syphilis Bacterium, and little
round ones so called cocy like Streptococcus, and many many
others that are completely benign. He saw all these things,
(03:51):
and you know what was impressive about that is he
recognized that these were similar forms of life, and that
they were all very very tiny they were all on
a similar scale, but there was enormously you know, rich
differences between them. There was a whole bunch of this stuff.
And you know, we would call it now an ecosystem,
(04:13):
a microbial ecosystem, a microbiome as the current term. But
he saw enough to recognize that this was at least
there in, you know, without the apparatus, without the ideas
that could you bring it into our modern understanding.
Speaker 1 (04:27):
So he sees this, he doesn't keep it to himself.
He actually publishes all these papers with detailed drawings of
the bacteria. He sees other people basically confirm the findings
and they see that they're bacteria everywhere. But then you
ask this question in the book, because so this is
late sixteen hundreds. He sees germs. They are germs. He
(04:48):
doesn't use that word, but he knows what they are.
They're little creatures that are living inside our body. And
yet it's going to take two hundred years to figure
out that germs cause disease, and so kind of an
interesting animating question of your book is why did it
take so long? Why did it take so long for
people to make that connection? So what is your answer?
(05:10):
Why do you think it did take so long.
Speaker 2 (05:15):
You know, I've spent a lot of time in thinking
about and writing different things to sort of try and
understand what makes you know, scientific knowledge happen. And in
this case, I think you see very clearly that it's
very hard to replace an underlying theory without both a
(05:42):
compelling need to do so there's something you can't explain
that you really want explain, and with a coherent alternative
theory that can explain what you need to have explained,
and you know, advance advanced state of knowledge. And one
of the reasons that's so hard to do is because
(06:04):
you know, what we think at any given time is
wrongly constrained by I guess you could call it a worldview.
And the big thing that was going on in the
seventeenth and eighteenth and into the nineteenth centuries was you know,
the sort of the over the overarching question that made
(06:26):
it hard to think about. The idea that these that
these microbes could could actually, you know, meaningfully impinge on
human life, actually do something to us. Was a notion
of human beings outside of and sort of in command
of nature. And at the start of the story that's
(06:49):
expressed very much in religious terms, and you know that
gets articulated into a very explicit hierarchy God at the top,
than the angels, than humankind, and then sort of all
the rest of nature. So when you observe when when
you first see microbes, the idea that they may be
consequential is very, very hard to get your head around.
(07:13):
We're in command of nature. These are tiny, diminutive things.
The idea that they could meaningfully you know, matter to
us requires them to sort of climb up that great
chain of being and develop an agency that you know,
biblically and emotionally, is we really reserve for ourselves.
Speaker 1 (07:34):
The first part of what you said is interesting, right, Like,
they thought they knew what caused disease, right, they thought
it was humor's a bad air, and so they didn't
think they had a problem. They didn't think they had
a gap in their knowledge, which which has to have
been part of it.
Speaker 2 (07:51):
You need to have a reason to change your ideas.
And one of the things about you know, sort of
pre germ theory ideas about disease is they were pretty effective. Right.
Speaker 1 (08:01):
Oh, the plague comes to town and there's a miasma
in the air. Better get out of town. And if
you get out of town and get away from the miasma,
you want get the plague. Like it's not I mean,
it's it's sort of wrong, but like, yeah, it's in miasthma,
but what's really in the miasthma is bacteria. Like that's
a better articulation.
Speaker 2 (08:18):
But that's right, I mean, you know, and the miasma
explains why a bunch of people in the same place
get the disease. You don't need to have the idea
that there's something jumping between bodies that do that, or
or you can even you know, like modify it a
little bit and say, well, you know you get sick
because of bad air, then you the sickness produces bad
air in your own body and you exhale, and that.
Speaker 1 (08:41):
Not so far off right, not so far.
Speaker 2 (08:43):
You know, that's one of the issues. And and you
know you have to to replace it. You have to
be able to see that you could have you know
that you have to be able to see an alternat explanation.
And what happened and you know this is this is
not conjecture. What really happened is people lost interest in microscopy.
There was this you know, with Hook's book Micrographia, and
(09:06):
then Levin Hook's you know, endless stream of letters going
the Royal Society. There was a sort of burst of
interest among you know, if you think it, sort of
well off gentlemen, amateurs buying themselves microscopes, often buying sort
of sets of slides. This is in the sixteen eighties
and nineties. It's happening very very early on.
Speaker 1 (09:25):
So you're saying microscopy is a fad, exactly, And by
the sixty nineties Hook is lamenting that the fad has
already passed and no one's really interested.
Speaker 2 (09:36):
If you don't see microbes as anything other than curiosities
confined to their own domain, it's very hard to imagine
that they are, you know, the agents of the single
most potent cause of death in human beings, I mean,
infectious disease through history is what has generally killed us, right,
(09:58):
And you know, that's a really big thing to explain,
and it was a great leap, a very difficult leap,
to say, these funny, little wriggling things you can see
under a microscope might be the the agents of that
enormously potent and terrifying force.
Speaker 1 (10:14):
So okay, so the microscope fad goes away, people stop
caring about and immaculate these tiny creatures, and we get
to this point in the eighteen hundreds where we're not
to germ theory at people aren't actually figuring it out,
but they're getting better at understanding how infectious disease works. Right,
(10:40):
And you talk about a few different people here. I mean,
there's Florence Nightingale, you know, making sanitation at hospitals a
thing and reducing the spread of disease that way. There's
John Snow, the guy who figured out that everybody who
drank from this one pump in London basically got cholera
or you know, and they took the head off the
pump and people stopped getting klera. And nobody knows that
(11:02):
it's germs, but they're getting that there's a mechanism. But
there's one person in this kind of middle period who
I want to talk about at some greater length, who
you're right about. And that's tell me if I'm saying
it wrong, ignots Themovis.
Speaker 2 (11:16):
All right, Your German is undoubtedly better than.
Speaker 1 (11:20):
Mine, is better than nobody's. Who is he? Who were
you gonna call him? Smovis that's what we're gonna say.
Speaker 2 (11:27):
Yeah, so or device. I think they probably both work.
Simis was a a doctor and uh started his sort
of professional career in Vienna at the at the the
great hospital there, and he was working in in obstetrics
(11:51):
and you know, handling childbirth. And he was hired was
the junior assistant to the boss of the obstetrics service.
And it was at a time when two things were
going on. One did there was this critical vital really
you know, sort of overall extremely important and useful development,
(12:14):
an attempt to make medicine more scientific, and the way
to do it was to do pathology basically, to cut
open your mistakes and find out what's wrong. So when
somebody died, you would dissect them, you perform an autopsy,
and you would try and both study the sort of
body as a whole, but really look for the mechanism,
you know, what whatever had killed them did inside the body.
(12:36):
And this was you know, absolutely vital to the development medicine.
Led to all kinds of important ideas about the disease
process and diagnostics and stuff like that, and it created
in this case a repeated sequence of mechanism by which
the doctors of Vienna were killing hundreds and you know,
(13:00):
and then thousands of women in childbirth. So what happened
was that as the use of autopsies to understand what
happened to women who died in childbirth expanded, people would
do the autopsies, wash their hands, you know, the way
(13:21):
you and I might, you know, sort of after we've
been cooking, so as what somebody put social handwashing, not
you know, enough for medicine, and then go off and
deliver a baby. Right, so whatever they had picked up
from the corpse would be carried. You know, it's like
it's you can't imagine a better disease vector. And so
(13:42):
there was a fairly high death rate from this infection.
What we now know is an infection with actually one
of a few bacteria that was called child bed fever
or prayer pool fever. And up until a critical change
was made, it wasn't clear that this was done, that
this was there was a specific singular mechanism that was
doing this. Initially there you know, the hospital just accepts
(14:06):
women into the you know, they come in and they
go into one of two wards, but both of the
wards are served by a mixed staff of doctors and
midwives and then sort of you know, shortly before some
of the ice gets there, that changes, the system changes.
And this is you know, one of the interestings about it,
this is, you know, this is a social change. There's
(14:27):
nothing medical about this. They just decide that there's a hierarchy,
and the doctors and medical students work on ward number
one and midwives deliver babies in ward number two. And
they would you know, you'd get admitted, you know, on
Monday you'd go to ward one, and Tuesday you'd go
to Ward two, and so on. You know, they just
alternated day by day, and very rapidly it became clear
(14:50):
that it was a deadly risk to end up in
the hands of the doctors that they had, you know,
many many times the rate of suffering from purple fever
and dying of it in the doctor's ward then in
the midwives ward. The question was why, And you know,
before some of us got there, they did all kinds
of investigations. Could they be ventilated differently? Was the laundry
(15:13):
being done differently? They don't look for all these different things, notice,
not looking at the personnel, just looking at possible external causes.
So the idea that doctors might be killing their patients
was something that the doctors investigating this issue would find
very hard to accept. And we see this over and
over again in the story of child bed fever, So
(15:36):
you know that happens. Semmelviz comes along and he is
now tasked with trying to figure out what drives the difference,
and he similarly is confused until he goes away for
a little vacation to Italy, comes back and he finds that,
you know, his mentor and somebody who greatly values has
died with symptoms that are very very similar to the
(15:58):
symptoms that are killing the mothers who've just given birth,
this purple fever. And it turns out that this guy
had been doing an autopsy with students of a woman
who died of this disease, and one of the students
had cut him with one of the scalpels, and some
ofvice recognized that had to be important, and that something
(16:20):
passed from the body of the of the cadaver, the
person who the woman who died, into the body of
his mentor, and he said, aha, you know, the something
happens in the autopsy room that takes the poison that
kills these women and carries it on to the next woman,
and that something has to be the hands of the
(16:41):
people doing the autopsy, the doctors and medical students who
are trying to learn from these women what happened. And
it turns out that what happened is they became you know,
those those those professional men became disease vectors. And he
proved this case. You know, again, he had no idea
what it was. His writings make it very clear there's
(17:01):
no specific identification with a bacterium or what have you.
He just knows that there's something real in the world
that's making this journey, and he knows how the journey
is being made. So it says, great, I'm going to
put a chlorine solution sync between the autopsy room and
(17:21):
the delivery wards and everybody who does an autopsy has
to go and wash their hands with this chlorine you know, painful,
really chlorine solution.
Speaker 1 (17:31):
What does he know about chlorine? Like, why does he
do that?
Speaker 2 (17:35):
He knows it's caustic, and he knows it's used for
deep cleaning, and that's basically it. And he says, you know,
you have to scrub your hands until the cadaver's smell
is off you and that turns out to be long
enough to kill the bacteria and very rapidly the doctors
(17:56):
and medical students. Ward approaches the same you know, complication
and death rate from purple fever as the midwives, and
you know, while there's a solution. And to me, one
of the greatest tragedies this book documents is the fact
that this solution was not picked up. It was rejected
again in part because of this notion that doctor, you know,
(18:17):
the the implication is clear, up until that point doctors
had been killing their patients. Didn't mean to, didn't.
Speaker 1 (18:23):
Want to, I mean, including samulvisis right, like, how does
he react to figuring this out?
Speaker 2 (18:31):
He's horrified, he says, he is. He recognizes himself as
somebody who's who's you know, practice Up to that point
he killed, killed women, and he becomes, you know, incredibly
passionate about not doing that anymore, and so much so
that he alienates his colleagues. He accuses them of murder,
which was you know, true but impolitic, and he is
(18:55):
driven out of Vienna. He goes back to his home
in Budapest. He sets up the same regimen in the
hospital he works in Budapest, continues to sort of have
these controversies with colleagues, and finally, you know, he may
have gone, you know, gotten sort of almost you know,
clinically paranoid, but his former professional acquaintances and perhaps his
(19:17):
family sort of conspire to get him locked into an
insane asylum essentially where early in his stay, very early
in his state, he's beaten so badly that he develops
open wounds, and I you know, with this horrible irony
of history, catches an infection and dies of it. It's
one of the great sort of you know, the deaths
(19:39):
of thousands of women who need not have died, maybe
tens of thousands of women across Europe and the world
more broadly, who need not have died if people had
just followed Somelevice's procedure, these deaths would continue from you know,
well past the eighteen forties when Civilis figured it out,
up until you know, near the end of the century.
Speaker 1 (20:03):
Will be back in just a minute. So now we
get into the second half of the eighteen hundred, second
half of the nineteenth century, and we're finally going to
crack it right. Pastor comes along he's going to be important.
(20:26):
We're going to talk about him more in a minute.
But the tea guy, it seems, is a country doctor
basically whose name is Robert Koch. You have a nice
sentence to start your chapter about him. I'm going to
read it. There's very little known about the identity of
one of the most important bodies in the history of medicine.
(20:49):
What was it?
Speaker 2 (20:51):
It was an animal, possibly a horse, but it's not
even that's not known. Almost certainly a domesticated animal that
has died of a then well known but still not
figured out disease called anthrax. And so a local police
(21:13):
constable finds this animal sort of dead in a hedgerow.
Speaker 1 (21:17):
And where was he, by the way, he.
Speaker 2 (21:20):
Was in a you know what was then still part
of East Prussia but is now Poland there was an
antrak's outbreak going on in the area at the time.
Cattle herds were affected by it.
Speaker 1 (21:33):
And people understood that there were outbreaks and that people
could get this disease, and that animals could get it.
And then some fashion it moved back and forth.
Speaker 2 (21:41):
Yes, human beings could get it, especially those who worked
intimately with animals sheep shearers, for example, were at risk
of it, this kind of thing. And so this was
a couple three days before Christmas. But Cooke took the
skin or the body, we don't know, and took samples
(22:02):
from it, including presumably samples in his bloodstream, put them
under a microscope. Saw a characteristic rod like bacterium, and
his bacterium had been noticed already. It seemed to be
associated with anthrax. But people hadn't made the last I mean,
(22:23):
it was like it wasn't clear if they showed up
because some other disease process made the animals susceptible to them.
It wasn't clear what those bacteria were doing. And Cook
then did the critical experiment. He identified the bacteria, He
found a medium he could grow it, and it turned
out to be the fluid inside catalyzed basically. And he
(22:49):
had his family kept rabbits for food. So what he
did is he purified a sample of these bacteria and
he injected it into one of his rabbits, and it
was clear the rabbit got sick. He was able to
harvest more of the bacteria from its bloodstream, isolate the bacteria,
(23:11):
grow it in culture, injected into another rabbit, and the
rabbit got sick with the same disease anthrax visibly. And
after you do that a few times, you keep this
chain going, you realize that what's causing the disease is
the bacteria.
Speaker 1 (23:26):
So he's just done it. It just happened in this
little town in mind I pull and some random country
doctor did the thing that nobody did for almost exactly
two hundred years. Right, this is December eighteen seventy five,
one hundred and ninety nine years after Anthony even leaven
Hook right like, why him? Why then?
Speaker 2 (23:52):
Well, I think, I mean we talked a little bit
about prayerble fever. There was a period of you know,
forty years or so that I called sort of germ
theory without germs. Yeah, when people start to realize that, yes,
there is something that you know, some physical objects, some
material little piece of the world that has to be
(24:14):
involved in these process and they find this out through
a number of different mechanisms, Partly you know Florence Nightingale's
you know, emphasis on hygiene, you just keep filth away
from people. Well, that implies there's something in the filth
that does does the damage.
Speaker 1 (24:28):
We haven't talked about pasteur yet, right, but clearly here
and again, you know, the big demonstration of this you
mentioned John Snow who recognized that there.
Speaker 2 (24:38):
Was something in you know, some specific thing in contaminated
water that reliably produced color and those who consumed it.
And he demonstrated this not just with the pump. He did,
you know, a whole bunch of different kinds of work.
He showed it on on sort of citywide epidemiological scales.
He proved it more than once with sort of individual
locations where that had clearly been the source of a
(24:59):
local outbreak. Again, he had no idea what the thing was,
but he knew there was a thing, and you could
interrupt its journey, you could stop it, and then people
wouldn't get sick. So the ground was finally being prepared.
You know, remember at the beginning of this conversation we said,
you need both the worldview that allows you to recognize
(25:21):
that something might be possible, like it's possible bacteria could
harm us, but you also need a problem that the
existing theory can't explain. And that's what this germ theory
without germs sort of period was all about coming up with.
You know, Okay, if cholor is caused by a material thing,
what is it. You know, a carepool disease, child bed fever,
(25:44):
travels from patient to patient, you know, as some guck
on a doctor's hands. What's in the guck? You know,
these kinds of things set up the final step that
Coke took brilliantly. You know, well that thing is this
micro and you know, the critical thing that really cemented
germ theory was not just Coke's experiment, but the quite
(26:07):
rapid recovery of other bacteria that cause their own specific
diseases of both animals and people. But if you have
disease after disease after disease in rapid succession shown to
be driven by these very specific living pathogens, then all
of a sudden you have not just an example, you
have a theory. You have a broadly explanatory idea.
Speaker 1 (26:31):
So now now that the world has this theory and
everybody believes him, unlike with zemmolweis right, good things start
happening right for human health. And I feel like here
we should talk about Pastor. So let's talk tell me
about Pastor.
Speaker 2 (26:50):
Well, past here is one of the people who really
gets sort of the modern germ theory h era going.
Once Coke shows that Anthrax is a bacterial disease. Pasture
basically sees Coke as having jumped in on his field.
In some ways, there's a real rivalry the development gene
the two men, but he recognizes the power of the idea,
(27:13):
and he has two things. He tries to identify other
disease agents as coc had done, But most importantly, he
really kicks off the modern age of vaccination. He works
on and achieves amazingly a vaccine for anthrax. Within a
very short order, Pastor's lab is churning out anthrax vaccines
(27:34):
enough to, you know, within months, inoculate tens of thousands
of animals. And he does the same for other diseases.
Speaker 1 (27:41):
Right, So, until this point, there was one vaccine, right
famously for smallpox, which was kind of a lucky break, right, Like, yeah, exactly,
Kantor noticed that people who worked with cows didn't get
smallpox and sort of put together that you could give
somebody cow pox basically and they wouldn't get small pox.
But it was a one off and that was all
we had, right, And now we have germ theory, and
(28:02):
Pastor has created like a vaccine factory basically, right, he's
making one after another because of the power of this
theory now because of right inside.
Speaker 2 (28:10):
It, and people recognize that pasture has invented not just
a singular vaccine, but a method. You know. There's an
article in The New York Times basically said, you know,
the expectation is that every infectious disease, every disease organism
will have a vaccine associated with it, will be able
to control infectious disease basically, you know, for the first
(28:33):
time ever, and human beings won't have to die of
these terrible things. Yes, and they were not entirely right,
but there are vaccines for you know, measles and tetanus
and theory and whooping cough protests. And this is a
direct result of germ theory and of you know, past
year's early work and.
Speaker 1 (28:51):
Coax and and as is like not that long after that,
it forty years after that or something fifty years after
that that we get antibiotics. Right, the last big great
tool that is comes to us because of right term theory,
I mean, and it's I mean, that's obviously not a
magic bullet. Nothing as a magic bullet, never call anything
a magic bullet. But it's a very good bullet, like antibiotics,
(29:13):
it's still antibotic because it's whatever. They are incredible bullets.
Speaker 2 (29:17):
Oh, it's it's utterly transformative.
Speaker 1 (29:19):
Yeah, I mean vaccines.
Speaker 2 (29:21):
You put vaccines and antibiotics together, and it's really true.
You know, in nineteen hundred, the top several leading causes
of death were all one form of infectious disease, disease
or another. The you know, by the latter half of
the twentieth century and certainly by the end of twentieth century,
(29:43):
you know, infectious diseases don't make a dent. It's heart
disease and cancer and auto accidents.
Speaker 1 (29:49):
I mean, I feel like a lot of the to
the extent people talk about this stuff now, they talk
about antibiotic resistance and vaccine hesitancy or anti vaccines whatever,
and like those seem like very valid causes of concern.
And yet when you zoom out to the historical kind
of dimensions we've been talking about, like we're still doing
(30:11):
great by historical standards with respect to infectious disease. We are.
Speaker 2 (30:16):
And the question is, I mean the question I think
that keeps me up at night. Is that condition going
to remain in place or are the fact that it's
you know that as a matter of the way we
have used and developed antibiotics sort of running out of
steam and leaving us in a position where they will
be less and less effective. That already seems to be happening.
(30:40):
And of course, if you have a pandemic disease, the
idea that one of our chief weapons against it might
not be as effective is really kind of scary. And
that's even more true of vaccines. It wasn't that long ago.
We've only had the sort of vaccines for the childhood's
you know, the common suite of childhood diseases since beginning
(31:03):
in the nineties, really beginning of the nineteen fifties and
then accelerating in the nineteen sixties. And you know, you know,
the measles vaccine, for example, comes in and is licensed
in the US nineteen sixty three. There are plenty of doctors,
you know, pediatricians who trained in the intervening decades, who
have never seen a case of measles. We've forgotten how
(31:25):
miserable a disease it is, even if it doesn't kill you,
and it could kill you, and resquandering this enormous life
saving Promethean gift that that germ theory has given us
in for reasons, don't I deplore and don't fully understand.
Speaker 1 (31:43):
Let's abstract one level, right, There is this question at
the center of your book, which is why did it
take so long, hundreds of years from the time humanity
recognized that bacteria exists till we realize that they cause disease?
Do you think humanity has gotten better at changing our minds?
Speaker 2 (32:07):
I see no evidence at all that human nature has
fundamentally changed.
Speaker 1 (32:13):
Well, that's the when you say human nature has fundamentally changed,
you're loading the diet.
Speaker 2 (32:18):
That's true.
Speaker 1 (32:20):
I mean, certainly the rate of discovery has increased the
amount of just even just to go back to the
tools idea, like the sharing information idea, like we're sharing
information way better, way faster, with way more people.
Speaker 2 (32:36):
I mean, I think we have a better infrastructure of
knowledge than we used to. But I think because science
is so complicated and because it matters so much in
so many of the ways we live, the fact is
that science has become this kind of political football where
(32:59):
people you know, use beliefs about certain scientific questions as
markers of political tribal identity. That doesn't lead you to truth,
but it's really powerful. And that's where I see a
lot of our problems being right now. Whether that will last,
whether we'll be able to grow out of that in
the next decade or so, I very much hope so.
(33:21):
But we could be going into a sort of know
nothing age where we will lose the advantages of germ
theory and other ideas that have been established painfully by
decades or centuries of work.
Speaker 1 (33:37):
We'll be back in a minute with the lake round.
Let's finish with the lightning round. What's your favorite humor?
Black bile, yellow bile, phlegm or blood?
Speaker 2 (33:58):
Oh I'm all in on blood.
Speaker 1 (34:01):
Oh interesting, I like the hot.
Speaker 2 (34:03):
I like the hot.
Speaker 1 (34:04):
What's one lesson we should learn from the south Sea Bubble?
Speaker 2 (34:09):
The most important lesson we can learn from the south
Sea Bubble is that be wary of the trojan horse
of financial innovation. That is too complicated to explain. So,
you know, we got hammered in the early two thousands
(34:33):
by the subprime mortgage catastrophe, and what was really what
really drove that was a series of you know, newly
invented financial instruments that radically increased the amount of leverage
and hence the the size of the catastrophe that would
follow when, you know, should it all come crashing down.
(34:54):
And almost everyone dealing in those instruments didn't know what
they were dealing with. And when that's happening, there will
be some people who figure it out and they'll get rich,
and the rest of us will pay the price. So
you know what you're talking about before you put the
rent money into your financial gamble.
Speaker 1 (35:15):
You've written about a very large number of very eminent
famous scientists, and I'm curious, are there any non obvious
traits they seem to share.
Speaker 2 (35:29):
I think one of them is what Einstein was famous for,
which you know, it's a kind of stubbornness. I once
spoke with with a physicist to knew Einstein well, and
he said, the difference between him and the rest of
us wasn't you know, he wasn't better than and in fact,
(35:51):
it was worse than an awful lot of physicists At mathematics.
He was really really good at framing a problem, and
that's actually a common that's a trait that I think,
you know, great scientists share. But the most important thing
that this guy who knew Einstein said was the fact
that he was willing to sit with a problem if
(36:13):
he thought it was important, he would sit with a
problem as long as it took so. And most scientists,
if they can't figure something out after two or three
years or whatever, say Okay, that one's you know, that
one's not for me. I'll go find something else to
think about. Einstein, you know, worked on special relativity, you know,
for eight or nine years from the first time he
thought about the question. General relativity was another decade. He
(36:38):
wrestled with quantum mechanics or quantum theory basically all his life.
Speaker 1 (36:43):
I mean, is there a kind of hindsight bias there? Like,
are there lots of scientists who are super stubborn and
wrestle with things for a long time. We just don't
know who they are because they'd ever been to break
it through.
Speaker 2 (36:54):
Because I mean, I don't think it's the only thing
you need, But you asked for a characteristic they share.
Speaker 1 (37:00):
Yeah, fair enough, it's necessary, but not sufficient, not sufficient.
Speaker 2 (37:04):
I mean, I once had the good fortune to run
into Jonah Saulk at an airport, right and we ended
up I recognized him, and I somehow.
Speaker 1 (37:13):
Made the polio vaccine, made.
Speaker 2 (37:15):
The polio vaccine. Yes, and I went up and talked
to him, and this was you know, in the in
the eighties, so you know, he did the polio vaccine
in the fifties. And what was really interesting is the
same issues, the same questions. I mean, he was really
interested in the question was, you know, just how do
(37:35):
you develop vaccines for intractable diseases? And what I met
him he was working on did not succeed, but working
on trying to come up with an HIV vaccine. You know,
this was a man who had, you know, a view
of the world and a view of his sort of
corner of the world that led him to focus on
big issues and stay with him as long as it took,
(37:56):
or as long as he had And that turns out
to be something that really really I think, yes, you
can end up with a with a career that does
not produce anything because you stayed on the wrong problems
too long or you know, as Einstein did. You know,
he was working for the last couple decades of his life,
three decades of his life on a problem for which
the tools were not yet there to really address seriously,
(38:19):
mathematical tools and the observational tools that would have helped
him to try and generalize from the existing theories. You
know he was premature on that's all right. He got
a bunch of other things.
Speaker 1 (38:31):
Right, Thank you for your time.
Speaker 2 (38:33):
Well, it's a pleasure. I really enjoyed this conversation. Thank you.
Speaker 1 (38:43):
Tom Levinson is the author of the book So Very Small,
and he's also a professor of science writing at MIT.
Please email us at problem at pushkin dot fm. We
are always looking for new guests for the show. Today's
show was produced by Trinomanino and Gabriel Hunter Chang, who
was edited by Alexander Garretton and engineered by Sarah Brugeret.
(39:06):
I'm Jacob Goldstein, and we'll be back next week with
another episode of Mine, What's Your Mother?
Pushkin. Hey, it's Jacob. Before we start the show today,
I just want to say thank you for listening. I
really appreciate it, We all really appreciate it. And if
there's any way we can make the show better, make
a show that you like better, please tell us how
(00:35):
to do that. You can email us at problem at
pushkin dot fm. You can also find me on x
at Jacob Goldstein or on LinkedIn and I read all
the emails we get. So please let us know what
we can do to make the show better. And mostly
thanks for listening. Here is the show. I'm Jacob Goldstein,
(01:01):
and this is What's Your Problem. My guest today is
Tom Levinson. He's a professor of science writing at MIT
and the author of a book called So Very Small.
It's a book that tells the story of one of
the most important breakthroughs in the history of human knowledge.
I don't think I'm overstating it. It's the discovery that
germs caused disease. Before we figured that out, most people
(01:24):
who ever lived died from infections. After we figured it out,
scientists very quickly came up with new vaccines to prevent
infections and new drugs that could treat infections after they happened.
Realizing that germs caused disease and building on that insight
has saved billions of lives. And there's something really interesting
(01:44):
at the center of this story. Bacteria were first discovered
in the late sixteen hundreds, but people didn't realize that
they caused disease until the late eighteen hundreds. So Tom's
book asked this big question, why did it take so
long to figure it out? Which for me points to
an interesting question for today. What does that tell us
(02:05):
about the way humans understand the world. What does it
tell us about our willingness or unwillingness to change our views.
We started our conversation by talking about the first person
ever to see bacteria. He was a Dutch cloth merchant
and his name was Anthony van Lavenhook. In the late
sixteen hundreds. He gets into building microscopes, which was like
(02:27):
a popular hobby at the time, and he gets really
good at it, which allows him to make this extraordinary discovery.
Speaker 2 (02:34):
Lavan, you know, the great breakthrough is he saw this
entirely new domain of life. You know what I call
in the book the microcosmos, This this utterly invisible to
the naked eye, yet enormously rich and teeming with life
and varieties of life and all kinds of things going
on in you know, the gunk between your teeth and
(02:55):
a drop of pond water, and you know, and so on.
Speaker 1 (02:57):
Well, you're doing this list, but he really did, right.
He took the tartar from his teeth and put it
on a microscopic slide. He did exactly and saw and
saw what what did he see? When he looked at
his own tooth gung?
Speaker 2 (03:10):
He saw what he referred to as well in English,
animacules little tiny animals, right, and we now know they
were bacterian in some cases, you know, protozoa and other
forms of microscopic life, but definitely bacteria that had different shapes.
(03:30):
He saw the little cilia the bacteria have to help
them move. He saw corkskew shapes like that of the
family of bacteria that includes the syphilis Bacterium, and little
round ones so called cocy like Streptococcus, and many many
others that are completely benign. He saw all these things,
(03:51):
and you know what was impressive about that is he
recognized that these were similar forms of life, and that
they were all very very tiny they were all on
a similar scale, but there was enormously you know, rich
differences between them. There was a whole bunch of this stuff.
And you know, we would call it now an ecosystem,
(04:13):
a microbial ecosystem, a microbiome as the current term. But
he saw enough to recognize that this was at least
there in, you know, without the apparatus, without the ideas
that could you bring it into our modern understanding.
Speaker 1 (04:27):
So he sees this, he doesn't keep it to himself.
He actually publishes all these papers with detailed drawings of
the bacteria. He sees other people basically confirm the findings
and they see that they're bacteria everywhere. But then you
ask this question in the book, because so this is
late sixteen hundreds. He sees germs. They are germs. He
(04:48):
doesn't use that word, but he knows what they are.
They're little creatures that are living inside our body. And
yet it's going to take two hundred years to figure
out that germs cause disease, and so kind of an
interesting animating question of your book is why did it
take so long? Why did it take so long for
people to make that connection? So what is your answer?
(05:10):
Why do you think it did take so long.
Speaker 2 (05:15):
You know, I've spent a lot of time in thinking
about and writing different things to sort of try and
understand what makes you know, scientific knowledge happen. And in
this case, I think you see very clearly that it's
very hard to replace an underlying theory without both a
(05:42):
compelling need to do so there's something you can't explain
that you really want explain, and with a coherent alternative
theory that can explain what you need to have explained,
and you know, advance advanced state of knowledge. And one
of the reasons that's so hard to do is because
(06:04):
you know, what we think at any given time is
wrongly constrained by I guess you could call it a worldview.
And the big thing that was going on in the
seventeenth and eighteenth and into the nineteenth centuries was you know,
the sort of the over the overarching question that made
(06:26):
it hard to think about. The idea that these that
these microbes could could actually, you know, meaningfully impinge on
human life, actually do something to us. Was a notion
of human beings outside of and sort of in command
of nature. And at the start of the story that's
(06:49):
expressed very much in religious terms, and you know that
gets articulated into a very explicit hierarchy God at the top,
than the angels, than humankind, and then sort of all
the rest of nature. So when you observe when when
you first see microbes, the idea that they may be
consequential is very, very hard to get your head around.
(07:13):
We're in command of nature. These are tiny, diminutive things.
The idea that they could meaningfully you know, matter to
us requires them to sort of climb up that great
chain of being and develop an agency that you know,
biblically and emotionally, is we really reserve for ourselves.
Speaker 1 (07:34):
The first part of what you said is interesting, right, Like,
they thought they knew what caused disease, right, they thought
it was humor's a bad air, and so they didn't
think they had a problem. They didn't think they had
a gap in their knowledge, which which has to have
been part of it.
Speaker 2 (07:51):
You need to have a reason to change your ideas.
And one of the things about you know, sort of
pre germ theory ideas about disease is they were pretty effective. Right.
Speaker 1 (08:01):
Oh, the plague comes to town and there's a miasma
in the air. Better get out of town. And if
you get out of town and get away from the miasma,
you want get the plague. Like it's not I mean,
it's it's sort of wrong, but like, yeah, it's in miasthma,
but what's really in the miasthma is bacteria. Like that's
a better articulation.
Speaker 2 (08:18):
But that's right, I mean, you know, and the miasma
explains why a bunch of people in the same place
get the disease. You don't need to have the idea
that there's something jumping between bodies that do that, or
or you can even you know, like modify it a
little bit and say, well, you know you get sick
because of bad air, then you the sickness produces bad
air in your own body and you exhale, and that.
Speaker 1 (08:41):
Not so far off right, not so far.
Speaker 2 (08:43):
You know, that's one of the issues. And and you
know you have to to replace it. You have to
be able to see that you could have you know
that you have to be able to see an alternat explanation.
And what happened and you know this is this is
not conjecture. What really happened is people lost interest in microscopy.
There was this you know, with Hook's book Micrographia, and
(09:06):
then Levin Hook's you know, endless stream of letters going
the Royal Society. There was a sort of burst of
interest among you know, if you think it, sort of
well off gentlemen, amateurs buying themselves microscopes, often buying sort
of sets of slides. This is in the sixteen eighties
and nineties. It's happening very very early on.
Speaker 1 (09:25):
So you're saying microscopy is a fad, exactly, And by
the sixty nineties Hook is lamenting that the fad has
already passed and no one's really interested.
Speaker 2 (09:36):
If you don't see microbes as anything other than curiosities
confined to their own domain, it's very hard to imagine
that they are, you know, the agents of the single
most potent cause of death in human beings, I mean,
infectious disease through history is what has generally killed us, right,
(09:58):
And you know, that's a really big thing to explain,
and it was a great leap, a very difficult leap,
to say, these funny, little wriggling things you can see
under a microscope might be the the agents of that
enormously potent and terrifying force.
Speaker 1 (10:14):
So okay, so the microscope fad goes away, people stop
caring about and immaculate these tiny creatures, and we get
to this point in the eighteen hundreds where we're not
to germ theory at people aren't actually figuring it out,
but they're getting better at understanding how infectious disease works. Right,
(10:40):
And you talk about a few different people here. I mean,
there's Florence Nightingale, you know, making sanitation at hospitals a
thing and reducing the spread of disease that way. There's
John Snow, the guy who figured out that everybody who
drank from this one pump in London basically got cholera
or you know, and they took the head off the
pump and people stopped getting klera. And nobody knows that
(11:02):
it's germs, but they're getting that there's a mechanism. But
there's one person in this kind of middle period who
I want to talk about at some greater length, who
you're right about. And that's tell me if I'm saying
it wrong, ignots Themovis.
Speaker 2 (11:16):
All right, Your German is undoubtedly better than.
Speaker 1 (11:20):
Mine, is better than nobody's. Who is he? Who were
you gonna call him? Smovis that's what we're gonna say.
Speaker 2 (11:27):
Yeah, so or device. I think they probably both work.
Simis was a a doctor and uh started his sort
of professional career in Vienna at the at the the
great hospital there, and he was working in in obstetrics
(11:51):
and you know, handling childbirth. And he was hired was
the junior assistant to the boss of the obstetrics service.
And it was at a time when two things were
going on. One did there was this critical vital really
you know, sort of overall extremely important and useful development,
(12:14):
an attempt to make medicine more scientific, and the way
to do it was to do pathology basically, to cut
open your mistakes and find out what's wrong. So when
somebody died, you would dissect them, you perform an autopsy,
and you would try and both study the sort of
body as a whole, but really look for the mechanism,
you know, what whatever had killed them did inside the body.
(12:36):
And this was you know, absolutely vital to the development medicine.
Led to all kinds of important ideas about the disease
process and diagnostics and stuff like that, and it created
in this case a repeated sequence of mechanism by which
the doctors of Vienna were killing hundreds and you know,
(13:00):
and then thousands of women in childbirth. So what happened
was that as the use of autopsies to understand what
happened to women who died in childbirth expanded, people would
do the autopsies, wash their hands, you know, the way
(13:21):
you and I might, you know, sort of after we've
been cooking, so as what somebody put social handwashing, not
you know, enough for medicine, and then go off and
deliver a baby. Right, so whatever they had picked up
from the corpse would be carried. You know, it's like
it's you can't imagine a better disease vector. And so
(13:42):
there was a fairly high death rate from this infection.
What we now know is an infection with actually one
of a few bacteria that was called child bed fever
or prayer pool fever. And up until a critical change
was made, it wasn't clear that this was done, that
this was there was a specific singular mechanism that was
doing this. Initially there you know, the hospital just accepts
(14:06):
women into the you know, they come in and they
go into one of two wards, but both of the
wards are served by a mixed staff of doctors and
midwives and then sort of you know, shortly before some
of the ice gets there, that changes, the system changes.
And this is you know, one of the interestings about it,
this is, you know, this is a social change. There's
(14:27):
nothing medical about this. They just decide that there's a hierarchy,
and the doctors and medical students work on ward number
one and midwives deliver babies in ward number two. And
they would you know, you'd get admitted, you know, on
Monday you'd go to ward one, and Tuesday you'd go
to Ward two, and so on. You know, they just
alternated day by day, and very rapidly it became clear
(14:50):
that it was a deadly risk to end up in
the hands of the doctors that they had, you know,
many many times the rate of suffering from purple fever
and dying of it in the doctor's ward then in
the midwives ward. The question was why, And you know,
before some of us got there, they did all kinds
of investigations. Could they be ventilated differently? Was the laundry
(15:13):
being done differently? They don't look for all these different things, notice,
not looking at the personnel, just looking at possible external causes.
So the idea that doctors might be killing their patients
was something that the doctors investigating this issue would find
very hard to accept. And we see this over and
over again in the story of child bed fever, So
(15:36):
you know that happens. Semmelviz comes along and he is
now tasked with trying to figure out what drives the difference,
and he similarly is confused until he goes away for
a little vacation to Italy, comes back and he finds that,
you know, his mentor and somebody who greatly values has
died with symptoms that are very very similar to the
(15:58):
symptoms that are killing the mothers who've just given birth,
this purple fever. And it turns out that this guy
had been doing an autopsy with students of a woman
who died of this disease, and one of the students
had cut him with one of the scalpels, and some
ofvice recognized that had to be important, and that something
(16:20):
passed from the body of the of the cadaver, the
person who the woman who died, into the body of
his mentor, and he said, aha, you know, the something
happens in the autopsy room that takes the poison that
kills these women and carries it on to the next woman,
and that something has to be the hands of the
(16:41):
people doing the autopsy, the doctors and medical students who
are trying to learn from these women what happened. And
it turns out that what happened is they became you know,
those those those professional men became disease vectors. And he
proved this case. You know, again, he had no idea
what it was. His writings make it very clear there's
(17:01):
no specific identification with a bacterium or what have you.
He just knows that there's something real in the world
that's making this journey, and he knows how the journey
is being made. So it says, great, I'm going to
put a chlorine solution sync between the autopsy room and
(17:21):
the delivery wards and everybody who does an autopsy has
to go and wash their hands with this chlorine you know, painful,
really chlorine solution.
Speaker 1 (17:31):
What does he know about chlorine? Like, why does he
do that?
Speaker 2 (17:35):
He knows it's caustic, and he knows it's used for
deep cleaning, and that's basically it. And he says, you know,
you have to scrub your hands until the cadaver's smell
is off you and that turns out to be long
enough to kill the bacteria and very rapidly the doctors
(17:56):
and medical students. Ward approaches the same you know, complication
and death rate from purple fever as the midwives, and
you know, while there's a solution. And to me, one
of the greatest tragedies this book documents is the fact
that this solution was not picked up. It was rejected
again in part because of this notion that doctor, you know,
(18:17):
the the implication is clear, up until that point doctors
had been killing their patients. Didn't mean to, didn't.
Speaker 1 (18:23):
Want to, I mean, including samulvisis right, like, how does
he react to figuring this out?
Speaker 2 (18:31):
He's horrified, he says, he is. He recognizes himself as
somebody who's who's you know, practice Up to that point
he killed, killed women, and he becomes, you know, incredibly
passionate about not doing that anymore, and so much so
that he alienates his colleagues. He accuses them of murder,
which was you know, true but impolitic, and he is
(18:55):
driven out of Vienna. He goes back to his home
in Budapest. He sets up the same regimen in the
hospital he works in Budapest, continues to sort of have
these controversies with colleagues, and finally, you know, he may
have gone, you know, gotten sort of almost you know,
clinically paranoid, but his former professional acquaintances and perhaps his
(19:17):
family sort of conspire to get him locked into an
insane asylum essentially where early in his stay, very early
in his state, he's beaten so badly that he develops
open wounds, and I you know, with this horrible irony
of history, catches an infection and dies of it. It's
one of the great sort of you know, the deaths
(19:39):
of thousands of women who need not have died, maybe
tens of thousands of women across Europe and the world
more broadly, who need not have died if people had
just followed Somelevice's procedure, these deaths would continue from you know,
well past the eighteen forties when Civilis figured it out,
up until you know, near the end of the century.
Speaker 1 (20:03):
Will be back in just a minute. So now we
get into the second half of the eighteen hundred, second
half of the nineteenth century, and we're finally going to
crack it right. Pastor comes along he's going to be important.
(20:26):
We're going to talk about him more in a minute.
But the tea guy, it seems, is a country doctor
basically whose name is Robert Koch. You have a nice
sentence to start your chapter about him. I'm going to
read it. There's very little known about the identity of
one of the most important bodies in the history of medicine.
(20:49):
What was it?
Speaker 2 (20:51):
It was an animal, possibly a horse, but it's not
even that's not known. Almost certainly a domesticated animal that
has died of a then well known but still not
figured out disease called anthrax. And so a local police
(21:13):
constable finds this animal sort of dead in a hedgerow.
Speaker 1 (21:17):
And where was he, by the way, he.
Speaker 2 (21:20):
Was in a you know what was then still part
of East Prussia but is now Poland there was an
antrak's outbreak going on in the area at the time.
Cattle herds were affected by it.
Speaker 1 (21:33):
And people understood that there were outbreaks and that people
could get this disease, and that animals could get it.
And then some fashion it moved back and forth.
Speaker 2 (21:41):
Yes, human beings could get it, especially those who worked
intimately with animals sheep shearers, for example, were at risk
of it, this kind of thing. And so this was
a couple three days before Christmas. But Cooke took the
skin or the body, we don't know, and took samples
(22:02):
from it, including presumably samples in his bloodstream, put them
under a microscope. Saw a characteristic rod like bacterium, and
his bacterium had been noticed already. It seemed to be
associated with anthrax. But people hadn't made the last I mean,
(22:23):
it was like it wasn't clear if they showed up
because some other disease process made the animals susceptible to them.
It wasn't clear what those bacteria were doing. And Cook
then did the critical experiment. He identified the bacteria, He
found a medium he could grow it, and it turned
out to be the fluid inside catalyzed basically. And he
(22:49):
had his family kept rabbits for food. So what he
did is he purified a sample of these bacteria and
he injected it into one of his rabbits, and it
was clear the rabbit got sick. He was able to
harvest more of the bacteria from its bloodstream, isolate the bacteria,
(23:11):
grow it in culture, injected into another rabbit, and the
rabbit got sick with the same disease anthrax visibly. And
after you do that a few times, you keep this
chain going, you realize that what's causing the disease is
the bacteria.
Speaker 1 (23:26):
So he's just done it. It just happened in this
little town in mind I pull and some random country
doctor did the thing that nobody did for almost exactly
two hundred years. Right, this is December eighteen seventy five,
one hundred and ninety nine years after Anthony even leaven
Hook right like, why him? Why then?
Speaker 2 (23:52):
Well, I think, I mean we talked a little bit
about prayerble fever. There was a period of you know,
forty years or so that I called sort of germ
theory without germs. Yeah, when people start to realize that, yes,
there is something that you know, some physical objects, some
material little piece of the world that has to be
(24:14):
involved in these process and they find this out through
a number of different mechanisms, Partly you know Florence Nightingale's
you know, emphasis on hygiene, you just keep filth away
from people. Well, that implies there's something in the filth
that does does the damage.
Speaker 1 (24:28):
We haven't talked about pasteur yet, right, but clearly here
and again, you know, the big demonstration of this you
mentioned John Snow who recognized that there.
Speaker 2 (24:38):
Was something in you know, some specific thing in contaminated
water that reliably produced color and those who consumed it.
And he demonstrated this not just with the pump. He did,
you know, a whole bunch of different kinds of work.
He showed it on on sort of citywide epidemiological scales.
He proved it more than once with sort of individual
locations where that had clearly been the source of a
(24:59):
local outbreak. Again, he had no idea what the thing was,
but he knew there was a thing, and you could
interrupt its journey, you could stop it, and then people
wouldn't get sick. So the ground was finally being prepared.
You know, remember at the beginning of this conversation we said,
you need both the worldview that allows you to recognize
(25:21):
that something might be possible, like it's possible bacteria could
harm us, but you also need a problem that the
existing theory can't explain. And that's what this germ theory
without germs sort of period was all about coming up with.
You know, Okay, if cholor is caused by a material thing,
what is it. You know, a carepool disease, child bed fever,
(25:44):
travels from patient to patient, you know, as some guck
on a doctor's hands. What's in the guck? You know,
these kinds of things set up the final step that
Coke took brilliantly. You know, well that thing is this
micro and you know, the critical thing that really cemented
germ theory was not just Coke's experiment, but the quite
(26:07):
rapid recovery of other bacteria that cause their own specific
diseases of both animals and people. But if you have
disease after disease after disease in rapid succession shown to
be driven by these very specific living pathogens, then all
of a sudden you have not just an example, you
have a theory. You have a broadly explanatory idea.
Speaker 1 (26:31):
So now now that the world has this theory and
everybody believes him, unlike with zemmolweis right, good things start
happening right for human health. And I feel like here
we should talk about Pastor. So let's talk tell me
about Pastor.
Speaker 2 (26:50):
Well, past here is one of the people who really
gets sort of the modern germ theory h era going.
Once Coke shows that Anthrax is a bacterial disease. Pasture
basically sees Coke as having jumped in on his field.
In some ways, there's a real rivalry the development gene
the two men, but he recognizes the power of the idea,
(27:13):
and he has two things. He tries to identify other
disease agents as coc had done, But most importantly, he
really kicks off the modern age of vaccination. He works
on and achieves amazingly a vaccine for anthrax. Within a
very short order, Pastor's lab is churning out anthrax vaccines
(27:34):
enough to, you know, within months, inoculate tens of thousands
of animals. And he does the same for other diseases.
Speaker 1 (27:41):
Right, So, until this point, there was one vaccine, right
famously for smallpox, which was kind of a lucky break, right, Like, yeah, exactly,
Kantor noticed that people who worked with cows didn't get
smallpox and sort of put together that you could give
somebody cow pox basically and they wouldn't get small pox.
But it was a one off and that was all
we had, right, And now we have germ theory, and
(28:02):
Pastor has created like a vaccine factory basically, right, he's
making one after another because of the power of this
theory now because of right inside.
Speaker 2 (28:10):
It, and people recognize that pasture has invented not just
a singular vaccine, but a method. You know. There's an
article in The New York Times basically said, you know,
the expectation is that every infectious disease, every disease organism
will have a vaccine associated with it, will be able
to control infectious disease basically, you know, for the first
(28:33):
time ever, and human beings won't have to die of
these terrible things. Yes, and they were not entirely right,
but there are vaccines for you know, measles and tetanus
and theory and whooping cough protests. And this is a
direct result of germ theory and of you know, past
year's early work and.
Speaker 1 (28:51):
Coax and and as is like not that long after that,
it forty years after that or something fifty years after
that that we get antibiotics. Right, the last big great
tool that is comes to us because of right term theory,
I mean, and it's I mean, that's obviously not a
magic bullet. Nothing as a magic bullet, never call anything
a magic bullet. But it's a very good bullet, like antibiotics,
(29:13):
it's still antibotic because it's whatever. They are incredible bullets.
Speaker 2 (29:17):
Oh, it's it's utterly transformative.
Speaker 1 (29:19):
Yeah, I mean vaccines.
Speaker 2 (29:21):
You put vaccines and antibiotics together, and it's really true.
You know, in nineteen hundred, the top several leading causes
of death were all one form of infectious disease, disease
or another. The you know, by the latter half of
the twentieth century and certainly by the end of twentieth century,
(29:43):
you know, infectious diseases don't make a dent. It's heart
disease and cancer and auto accidents.
Speaker 1 (29:49):
I mean, I feel like a lot of the to
the extent people talk about this stuff now, they talk
about antibiotic resistance and vaccine hesitancy or anti vaccines whatever,
and like those seem like very valid causes of concern.
And yet when you zoom out to the historical kind
of dimensions we've been talking about, like we're still doing
(30:11):
great by historical standards with respect to infectious disease. We are.
Speaker 2 (30:16):
And the question is, I mean the question I think
that keeps me up at night. Is that condition going
to remain in place or are the fact that it's
you know that as a matter of the way we
have used and developed antibiotics sort of running out of
steam and leaving us in a position where they will
be less and less effective. That already seems to be happening.
(30:40):
And of course, if you have a pandemic disease, the
idea that one of our chief weapons against it might
not be as effective is really kind of scary. And
that's even more true of vaccines. It wasn't that long ago.
We've only had the sort of vaccines for the childhood's
you know, the common suite of childhood diseases since beginning
(31:03):
in the nineties, really beginning of the nineteen fifties and
then accelerating in the nineteen sixties. And you know, you know,
the measles vaccine, for example, comes in and is licensed
in the US nineteen sixty three. There are plenty of doctors,
you know, pediatricians who trained in the intervening decades, who
have never seen a case of measles. We've forgotten how
(31:25):
miserable a disease it is, even if it doesn't kill you,
and it could kill you, and resquandering this enormous life
saving Promethean gift that that germ theory has given us
in for reasons, don't I deplore and don't fully understand.
Speaker 1 (31:43):
Let's abstract one level, right, There is this question at
the center of your book, which is why did it
take so long, hundreds of years from the time humanity
recognized that bacteria exists till we realize that they cause disease?
Do you think humanity has gotten better at changing our minds?
Speaker 2 (32:07):
I see no evidence at all that human nature has
fundamentally changed.
Speaker 1 (32:13):
Well, that's the when you say human nature has fundamentally changed,
you're loading the diet.
Speaker 2 (32:18):
That's true.
Speaker 1 (32:20):
I mean, certainly the rate of discovery has increased the
amount of just even just to go back to the
tools idea, like the sharing information idea, like we're sharing
information way better, way faster, with way more people.
Speaker 2 (32:36):
I mean, I think we have a better infrastructure of
knowledge than we used to. But I think because science
is so complicated and because it matters so much in
so many of the ways we live, the fact is
that science has become this kind of political football where
(32:59):
people you know, use beliefs about certain scientific questions as
markers of political tribal identity. That doesn't lead you to truth,
but it's really powerful. And that's where I see a
lot of our problems being right now. Whether that will last,
whether we'll be able to grow out of that in
the next decade or so, I very much hope so.
(33:21):
But we could be going into a sort of know
nothing age where we will lose the advantages of germ
theory and other ideas that have been established painfully by
decades or centuries of work.
Speaker 1 (33:37):
We'll be back in a minute with the lake round.
Let's finish with the lightning round. What's your favorite humor?
Black bile, yellow bile, phlegm or blood?
Speaker 2 (33:58):
Oh I'm all in on blood.
Speaker 1 (34:01):
Oh interesting, I like the hot.
Speaker 2 (34:03):
I like the hot.
Speaker 1 (34:04):
What's one lesson we should learn from the south Sea Bubble?
Speaker 2 (34:09):
The most important lesson we can learn from the south
Sea Bubble is that be wary of the trojan horse
of financial innovation. That is too complicated to explain. So,
you know, we got hammered in the early two thousands
(34:33):
by the subprime mortgage catastrophe, and what was really what
really drove that was a series of you know, newly
invented financial instruments that radically increased the amount of leverage
and hence the the size of the catastrophe that would
follow when, you know, should it all come crashing down.
(34:54):
And almost everyone dealing in those instruments didn't know what
they were dealing with. And when that's happening, there will
be some people who figure it out and they'll get rich,
and the rest of us will pay the price. So
you know what you're talking about before you put the
rent money into your financial gamble.
Speaker 1 (35:15):
You've written about a very large number of very eminent
famous scientists, and I'm curious, are there any non obvious
traits they seem to share.
Speaker 2 (35:29):
I think one of them is what Einstein was famous for,
which you know, it's a kind of stubbornness. I once
spoke with with a physicist to knew Einstein well, and
he said, the difference between him and the rest of
us wasn't you know, he wasn't better than and in fact,
(35:51):
it was worse than an awful lot of physicists At mathematics.
He was really really good at framing a problem, and
that's actually a common that's a trait that I think,
you know, great scientists share. But the most important thing
that this guy who knew Einstein said was the fact
that he was willing to sit with a problem if
(36:13):
he thought it was important, he would sit with a
problem as long as it took so. And most scientists,
if they can't figure something out after two or three
years or whatever, say Okay, that one's you know, that
one's not for me. I'll go find something else to
think about. Einstein, you know, worked on special relativity, you know,
for eight or nine years from the first time he
thought about the question. General relativity was another decade. He
(36:38):
wrestled with quantum mechanics or quantum theory basically all his life.
Speaker 1 (36:43):
I mean, is there a kind of hindsight bias there? Like,
are there lots of scientists who are super stubborn and
wrestle with things for a long time. We just don't
know who they are because they'd ever been to break
it through.
Speaker 2 (36:54):
Because I mean, I don't think it's the only thing
you need, But you asked for a characteristic they share.
Speaker 1 (37:00):
Yeah, fair enough, it's necessary, but not sufficient, not sufficient.
Speaker 2 (37:04):
I mean, I once had the good fortune to run
into Jonah Saulk at an airport, right and we ended
up I recognized him, and I somehow.
Speaker 1 (37:13):
Made the polio vaccine, made.
Speaker 2 (37:15):
The polio vaccine. Yes, and I went up and talked
to him, and this was you know, in the in
the eighties, so you know, he did the polio vaccine
in the fifties. And what was really interesting is the
same issues, the same questions. I mean, he was really
interested in the question was, you know, just how do
(37:35):
you develop vaccines for intractable diseases? And what I met
him he was working on did not succeed, but working
on trying to come up with an HIV vaccine. You know,
this was a man who had, you know, a view
of the world and a view of his sort of
corner of the world that led him to focus on
big issues and stay with him as long as it took,
(37:56):
or as long as he had And that turns out
to be something that really really I think, yes, you
can end up with a with a career that does
not produce anything because you stayed on the wrong problems
too long or you know, as Einstein did. You know,
he was working for the last couple decades of his life,
three decades of his life on a problem for which
the tools were not yet there to really address seriously,
(38:19):
mathematical tools and the observational tools that would have helped
him to try and generalize from the existing theories. You
know he was premature on that's all right. He got
a bunch of other things.
Speaker 1 (38:31):
Right, Thank you for your time.
Speaker 2 (38:33):
Well, it's a pleasure. I really enjoyed this conversation. Thank you.
Speaker 1 (38:43):
Tom Levinson is the author of the book So Very Small,
and he's also a professor of science writing at MIT.
Please email us at problem at pushkin dot fm. We
are always looking for new guests for the show. Today's
show was produced by Trinomanino and Gabriel Hunter Chang, who
was edited by Alexander Garretton and engineered by Sarah Brugeret.
(39:06):
I'm Jacob Goldstein, and we'll be back next week with
another episode of Mine, What's Your Mother?
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