PENICILLIN – DON’T we all know the story? Dr Alexander Fleming re-turned to his London laboratory one day to find that some stray mould had killed off all the bacteria in one of his petri dishes and, abracadabra, we had a miracle cure for infection. What more is there left to say?
A lot, as it turns out. Actually, it wasn’t really a case of from-mould-to-medicine-in- three-easy-steps. Fleming was the owner of the remarkable petri dish and he did discover the mould’s antibacterial properties. He even named the substance penicillin (from the source mould Penicillium notatum). Yet he never managed to extract pure penicillin from the mould and he never managed to turn it into a usable therapy. He did manage, in 1929, to write a paper so dull and lacking in any real detail that he killed off any interest in penicillin for the next 10 years.
The Mould in Dr Florey’s Coat is not just gripping from the very first page; it is a surprisingly different take on the well-known story of the discovery of penicillin. Eric Lax conveys all the life-and-death drama of patients being snatched back from the brink of death with a teaspoonful of penicillin. In a book that could easily have become an endless list of “and then they added (insert Latin name of mould) to another petri dish and something happened on the 756 th try”, he evokes the personalities, the struggles and the triumphs of producing penicillin vividly. He gives us an insight into the human side of medical research.
Enter Dr Howard Florey, an Australian Rhodes scholar and somewhat of a maverick when it came to research. Traditionalists hated his new ideas, but despite the fact that he “endeavoured to look like the hardened criminal of the bush everyone expected” at one Oxford tea party, he soon proved himself to be one of the most hard-working, innovative and brilliant scientists of his age. He was also one of the few people who had read Fleming’s paper and realised the potential of penicillin. When he was appointed head of the Dunn School of Pathology at Oxford, he soon made two unconventional, but inspired appointments.
Firstly, he hired Ernst Chain, a Jewish German immigrant, as his biochemist. Chain was a larger than life character, with a highly-strung personality and resembling a dark-haired Albert Einstein physically. As reserved and taciturn as Florey was, so passionate and volatile was Chain. He even called himself the “temperamental continental”.
“Of all the major contributors to the development of penicillin, no one is so little known as Norman Heatley, yet no one was as indispensable”, writes Lax. Heatley was a scientist, but his main talent was that he was good with his hands. Heatley’s manual dexterity would be the key to the extraction of penicillin from mould. His genius at cobbling together sophisticated lab machinery from a couple of quid and some rubbish would be an invaluable skill during the Second World War, when Florey could barely find enough money to pay his staff, never mind buy new equipment. In 1941, Heatley built an extraction apparatus for penicillin from a bookshelf discarded by the Bodleian library and a doorbell: total cost about £5.
The importance of penicillin can hardly be overemphasised. Today we live in a world where antibiotics are commonplace, but as late as the middle of the twentieth century, women routinely died from infections following childbirth; more soldiers died from septicemia and gangrene than on the battlefield itself and even tonsillitis could be fatal. For a seemingly endless catalogue of deadly diseases, including cholera, tuberculosis, typhoid, dysentery and scarlet fever, “the doctor’s best treatment was a soothing bedside manner and a steady dose of optimism” until the patient died.
Never was the need for antibiotics more obvious than during World War Two. Antibiotics were not just needed for the wounded – syphilis and gonorrhea were cutting a swathe through otherwise fighting fit troops. Yet never had it been harder to get funding. Florey spent most of his time scraping together what grants and equipment he could find, but at a time when even food was hard to come by, research money was hardly growing in petri dishes. His team resorted to growing penicillin mould in anything from discarded bedpans to biscuit tins. The threat of German invasion was so real that they rubbed penicillin spores into the fabric of their coats – if they had to destroy their lab to deny the Nazis access to their work, they would carry the germ of a revolution in medicine with them.
Eventually Florey had to turn to the fat cheque books of US pharmaceutical companies in order to get penicillin into large-scale production. The Americans managed to increase the yield of the mould and to purify penicillin further. This led to the price for treating one person with penicillin dropping from $200 to $6 between 1943 and 1945.
Ultimately, this excellent book is a sincere effort to set the record straight. Penicillin was really a transatlantic team effort, but when it came to remembering heroes, Fleming’s was the name writ large in text books. In this case it was not the victor who wrote history, but the person who knew the right people and was there when the press came calling. While Fleming was talking about miracles, Florey and his team were too busy making them happen to grant interviews.
