SUPERFREAKONOMICS by levitt steven d

Author:levitt,steven d.
Language: eng
Format: mobi
Tags: archivio inglese, cover, english
ISBN: 9780060889579
Publisher: William Morrow
Published: 2012-02-07T10:54:54+00:00

SuperFreakonomics

CHAPTER 4

THE FIX IS IN—AND IT’S CHEAP AND SIMPLE

It is a fact of life that people love to complain, particularly about how terrible the modern world is compared with the past.

They are nearly always wrong. On just about any dimension you can think of—warfare, crime, income, education, transportation, worker safety, health—the twenty-first century is far more hospitable to the average human than any earlier time.

Consider childbirth. In industrialized nations, the current rate of maternal death during childbirth is 9 women per 100,000 births. Just one hundred years ago, the rate was more than fifty times higher.

One of the gravest threats of childbearing was a condition known as puerperal fever, which was often fatal to both mother and child. During the 1840s, some of the best hospitals in Europe—the London General Lying-in Hospital, the Paris Maternité, the Dresden Maternity Hospital—were plagued by it. Women would arrive healthy at the hospital to deliver a baby and then, shortly thereafter, contract a raging fever and die.

Perhaps the finest hospital at the time was the Allgemeine Krankenhaus, or General Hospital, in Vienna. Between 1841 and 1846, doctors there delivered more than 20,000 babies; nearly 2,000 of the mothers, or 1 of every 10, died. In 1847, the situation worsened: 1 of every 6 mothers died from puerperal fever.

That was the year Ignatz Semmelweis, a young Hungarian-born doctor, became assistant to the director of Vienna General’s maternity clinic. Semmelweis was a sensitive man, very much attuned to the suffering of others, and he was so distraught by the rampant loss of life that he became obsessed with stopping it.

Unlike many sensitive people, Semmelweis was able to put aside emotion and focus on the facts, known and unknown.

The first smart thing he did was acknowledge that doctors really had no idea what caused puerperal fever. They might say they knew, but the exorbitant death rate argued otherwise. A look back at the suspected causes of the fever reveals an array of wild guesses:

“[M]isconduct in the early part of pregnancy, such as tight stays and petticoat bindings, which, together with the weight of the uterus, detain the faeces in the intestines, the thin putrid parts of which are taken up into the blood.”“[A]n atmosphere, a miasma, or…by milk metastasis, lochial suppression, cosmo-telluric influences, personal predisposition…”Foul air in the delivery wards.The presence of male doctors, which perhaps “wounded the modesty of parturient mothers, leading to the pathological change.”“Catching a chill, errors in diet, rising in the labor room too soon after delivery in order to walk back to bed.”

It is interesting to note that the women were generally held to blame. This may have had something to do with the fact that all doctors at the time were male. Although nineteenth-century medicine may seem primitive today, doctors were considered nearly godlike in their wisdom and authority. And yet puerperal fever presented a troubling contradiction: when women delivered babies at home with a midwife, as was still common, they were at least sixty times less likely to die of puerperal fever than if they delivered in a hospital.

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