The Semmelweis Reflex


Chances are that the reflexes you learned about in school were of the anatomical or physiological variety.  Take the pupillary reflexes to light and accommodation, for example.  Yet the more insidious reflexes that can plague us as well as our patients in practice may be those attributable to the cognitive biases of others.

Ignaz Semmelweis was not a very tactful physician.  He was so convinced that his revolutionary observation about anti-septic hand washing prior to delivery would help keep mothers alive beyond childbirth that he berated people who disagreed with him and made influential enemies ultimately resulting in his death from the very condition he was trying to prevent.

As the review of Infectious Madness in tomorrow’s New York Times Book Review notes, the outright rejection of new paradigms of thought in medicine because they sound preposterous or pose inconveniences to current ways of practice is termed the Semmelweis Reflex, because so many doctors initially dismissed his insights.  As we embark on the year 2016, the Semmelweis Reflex is a reminder that being right about something isn’t sufficient.  How we go about helping others share our insights can be just as crucial.

10 thoughts on “The Semmelweis Reflex

  1. Dear Lenny,

    Thank you for noting Semmelweis’ contribution to medicine. I had noted the irony of his important discovery in my article about Evidence Based Medicine/Evidence Biased Medicine. Despite the fact that he demonstrated a reduction in the incidence of death by demanding that physicians wash their hands, he was ridiculed and scorned by the medical profession. It is similar to most physicians negative response to most alternative methods of intervention including vision therapy. Max Planck had an interesting observation regarding this phenomena

    “A new scientific truth does not triumph by convincing its opponents and making them see the light, but rather because its opponents eventually die, and a new generation grows up that is familiar with it.” It is not simply about research and scientific fact but about one’s perception of the fact(s). As always THANK YOU for your thought provoking insights.

    Richard

  2. Curious about your self edits on this: “being right about something isn’t sufficient. How we go about helping others share our insights can be just as crucial.” What else were you thinking? If, after banging one’s head against the wall to the point of repeated concussion (CTE), there is still mass blindness to truth, where is one to turn? Was Semmelweis’s surly nature innate, or was it a defense mechanism, a shield to protect him in a war where he was right and established men were wrong?

    The nice thing about natural facts is that opinion, in the end, does not matter.

    • There’s a reason Semmelweis was thrown into an asylum, and Lister is credited with being the father of anti-sepsis. My understanding is that Lister had no less of a battle than Semmelweis; he just went about it in a less abrasive manner. Had Semmelweis gone about things as diplomatically as Lister, Lambert pharmaceuticals might have immortalized him with a mouthwash — though Semmelweisine doesn’t roll off the tongue.

      • Thanks for the reply. In the end, Semmelweis was in good company – consider the other great names that were incarcerated or killed for clear sight and long vision. Imprisonment, even in an asylum, is not a mark of failure, but rather a testament to potency and revolutionary thinking. In these cases, that is.

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