PHYSICIAN, WASH THYSELF

The 1840s were a big decade for the advancement of washing your hands, particularly if you were a doctor and delivered babies. Back then, Oliver Wendell Holmes Sr. and, independently a couple of years later, Dr. Ign?c Semmelweis of Hungary, both following Dr. Alexander Gordon, concluded that puerperal fever was spread by a contagion of some sort and proposed lack of sanitation as the culprit for the deadly childbed fever.

Reception to this idea was, like Semmelweis’ temperament, uneven, and doctors needed several more decades and Louis Pasteur’s theory of germ disease before accepting it, eventually saving countless lives by no longer ending them prematurely.

We were reminded of this recently by an essay in the New England Journal of Medicine. It was written by Dr. Donald Goldmann, who notes that antibiotic-resistant bacteria are transmitted “primarily by the contaminated hands of health care providers.” Dr. Goldmann, who is senior vice president of the Institute for Healthcare Improvement in Cambridge, Mass., and a professor in the Department of Pediatrics at Harvard Medical School, may have pointed to the core of the problem when he urged that hospital staff “not be so seriously overworked that they do not have time” to wash up or use alcohol-based antiseptics. He advocates that hospitals develop specific programs for hygiene that include assessment and consequences for those who fail to measure up.

How important is this? “If every caregiver would reliably practice simple hand hygiene when leaving the bedside of every patient and before touching the next patient,” Dr. Goldmann writes, “there would be an immediate and profound reduction in the spread of resistant bacteria.”

Doctors conscientiously emphasize simple but difficult paths to better health for their patients to follow – an improved diet and regular exercise, for instance. To hear, some 160 years after Drs. Holmes and Semmelweis, the medical community being reminded that it too has a simple but important habit to more fully adopt, makes a layman’s heart beat a little stronger. We’re all in this together after all.