The Cry and the Covenant (1949)

This book is OLD. I mean, I'M old, and I read The Cry and the Covenant when I was a teenager, waaay before the era of feminism, women's rights, etc. And it blew me away. I'm sure it's partly responsible for my decision to go to nursing school, work in obstetrics, become a midwife, and write a memoir (Baby Catcher: Chronicles of a Modern Midwife) of my experience doing home births in Berkeley, CA.In a nutshell, it's a meticulously-researched tale of historical fiction about the life and ultimate death of Ignaz Semmelweiss during the era before the discovery of the germ theory. He noticed that women delivered at home by midwives usually lived, while those delivered by doctors in hospitals usually died. Hmmm, he thought (this was a man who lived way before his time, before the concept of scientific thinking had even been expressed), what's different about these two situations? Midwives work only with healthy women who deliver in their own beds. Doctors, wearing bloody aprons and showing off their bloody hands as badges of status and honor, went from the autopsy room to delivery room, where several women often lay on the same sheets before someone had time to change the bed linen. Semmelweiss set up a successful experiment, insisting that the medical students in his hospital ward wash their hands between patients. The women stopped dying.Did the other doctors proclaim him the new hero? What do you think? They did not. They instead castigated him for suggest that they do anything so demeaning as wash their hands - and they self-righteously refused to even consider that perhaps they themselves were the cause of childbed fever (puerperal sepsis) that killed more than half the women who came under their misguided care.Lister got the credit a generation later for proving the efficacy of aseptic technique (it's all about hand washing), but it was upon the foundation of Semmelweiss's pioneering groundwork that he built his edifice. By then, Semmelweiss was dead of madness brought on by utter despair and by his own hand: he exposed himself to the bacteria that caused childbed fever and died of it.God. Read this book. Then read the newest book on this subject, The Doctor's Plague, by Sherwin Nuland. I hope somewhere there's a statue of Semmelweiss or an obstetrical ward that bears his name.

This novelized biography of medical pioneer Dr. Ignaz Semmelweiss, a Hungarian physician, is surprisingly interesting. Semmelweiss lived and practiced medicine in Europe in the 19th Century, predating the groundbreaking work of Louis Pasteur who eventually proved that microbes cause disease and leading medicine to include as an important tenet aseptic and antiseptic technique. Cry and the Covenant paints a compelling picture of a time when doctors took no precaution whatever to make sure that their persons and instruments were clean. Puerperal fever, also known as childbed fever, took the lives of a huge percentage of women who gave birth in hospitals, to the point that intelligent women didn't want to go to the hospital for delivery of their babies for fear of dying. Semmelweiss was a great observer and, although no one had made the connection between the microorganisms (as seen by Leeuwvenhoek through his microscope a century earlier) and diseases, Semmelweiss began to conduct experiments to determine why some large groups of women nearly always contracted puerperal fever and other groups did not. Eventually he demonstrated that personal cleanliness on the part of physicians could prevent the disease, though he did not know precisely why that was so. The data Semmelweiss collected proved beyond a shadow of a doubt that he was correct, but his peers would not listen to him. In an era where infectious and contagious diseases were thought to be caused by a variety of irrelevant things, doctors refused to wash their hands before delivering babies. One would have thought they would have given Semmelweiss's theory and data a try in the interest of saving their patients' lives, but their commitment to their belief systems in place about disease, to blissful ignorance and the status quo meant that what Semmelweiss actually knew was true didn't make the least bit of difference, except to his own patients. Semmelweiss followed scientific method in gathering his data that would be sound even today, but doctors back then didn't know what scientific method was, let alone what it could actually prove or disprove beyond unsubstantiated tradition and belief. This novel is worth reading because, in the end, the reader will have a pretty accurate and compelling picture of just how godawful and relatively useless medicine was before the work of Louis Pasteur and how fortunate we are today. Medicine still can't cure a number of illnesses, but what it can do nowadays is pretty amazing, especially in light of the egregious damage doctors once did. Can anyone today imagine doctors in the process of dissecting cadavers as part of medical education and then going to deliver a baby without even washing their hands, let alone changing clothes or sterilizing their instruments? The story of Dr. Ignaz Semmelweiss is as inspiring as it is frustrating, and though The Cry and the Covenant is a novel, it is written engagingly and the main thread of the story is factual

Ignaz Philipp Semmelweis perhaps did as much to relieve suffering and death as anyone in history. Untold millions are alive today because of the dedication of this tortured man. What he discovered together with the related work of Joseph Lister, changed virtually everything that is done in medicine. The tragedy of the existence of Ignaz Philipp Semmelweis is that his work was never recognized until after his untimely death. Morton Thompson's biography of Semmelweis, The Cry And The Covenant, is a superb literary achievement, almost equal to the man himself. The Cry and the Covenant is a must for everyone in the health care professions, a must for everyone who cares about history, discovery, or medicine. The book is so skillfully crafted that you get inside the man, dreaming his dreams and feeling his despair. Readers will be filled with the exhilaration of the discovery that could save the lives of thousands of women. "A man of sorrows, rejected and aquatinted with grief"appropriately fits this man who, after his death, became a "savior" to so many millions. Even though the story is tragic, knowing that good ultimately triumphs, lifts the spirit and gives hope to those who struggle today. The book was recommended to me by a neurosurgeon whose life has shown that "the more things change,the more they stay the same." Time and technology have wrought infinite changes in the way we live. Great progress has been made but the nature of man has remained the same. "We build the machine wonderful but do we build the man?" We can find in modern medicine today (indeed on the internet) all of the individuals in the book. There are Semmelweises today and there are those who reject them. (Sydney Ross Singer and Soma Grismaijer, who discovered the cause of most breast cancer (book "Dressed to Kill") are modern Semmelweise examples. Another most certainly is John Gofman (book "Preventing Breast Cancer") If you only read two biographies in your lifetime, The Cry And The Covenantshould be one of them.

Recently, when my stepdaughter, just starting her junior year in college, told me of her desire to become a physician, I thought of this book because it was THE BOOK that I read as a teenager that made me want to become a physician. I have never, in 33 years of medical practice, forgotten it's emotional force though it's been perhaps 45 years since I devoured it. I'm sending it as a gift of encouragement to her.

This is one of the best books I've read in my lifetime. I read it first in my early teens and I has haunted and inspired me about what kind of a human and latter a physician to be. It is the story of Ignaz Semmelwiess, a 19th century physician-midwife who discvered the reason for childbed fever in an era when people knew nothing about contagion. But it's also about the influence a person can have if they have integrety to fight for their beliefs, and how much a person can accomplish with sufficient drive and passion. It's a beautifully written compelling book!