Erik Visits a (Non) American Grave, Part 2,054

This is the grave of Alexander Fleming.

Born in 1881 in Darvel, Ayrshire, Scotland, Fleming came from an upwardly mobile family. He barely knew his father, who was 59 when his son was born and who died in 1888. Fleming was a really smart kid, gaining scholarships to get an education far beyond most people of his rank. At first, he was just working like any other young man. He labored in a shipping office. But in 1901, his uncle died and left him some money. His older brother had managed to become a doctor and suggested to his younger brother than he do the same and put himself through medical school with that money. He agreed and, well, it was a good idea for humanity. In all the myths around Fleming, it’s worth debunking one. There’s one that says Fleming’s father had saved young Winston Churchill from death and that Churchill Sr. paid for young Alexander’s education. A complete fabrication, in part because Fleming’s father was a farmer.

Fleming graduated from medical school in 1906. Now, how he became interested in vaccines is one of those stupid quirks of fate that is very, very British. In short, Fleming was an expert marksman due to service in the London Scottish Regiment of the Volunteer Force. The medical school had a rifle team. Fleming allowed them to win. So the team’s captain wanted to keep the chap and got the bacteriologist to take Fleming under his win as an assistant. So Fleming became an expert in the field and stayed at St. Mary’s, his school, until 1914. At that point, he joined the British military forces for World War I and worked as a doctor for the rest of the war. During the war, Fleming was critical in researching wounds, discovering that antiseptics killed more wounded soldiers than the wounds they were supposed to treat due to removing bacteria that protected patients from deeper infection.

Fleming continued this research after the war. Now, the thing about Fleming is that he was sloppy. He was bad at cleaning things. This normally was not good for a doctor. However, in his case, it would turn out to be pretty fortunate. This meant that weird things started happening to his samples. But he didn’t see them as mistakes. He saw them as new research opportunities. Interested in bacteria anyway, he wanted to check out what was going on. This is how he discovered lysozyme in 1922, one of the first discovered antimicrobial enzymes, which significantly expanded understanding of the immune system.

It would not be the last discovery Fleming would stumble upon. Fleming was working on staph in 1928. He went on vacation with his family. He left some samples around to see what would happen. One got contaminated with a fungus. That fungus killed the staphylococci around it, but left the staph farther away alone. This is basically how he discovered lysozyme and now he had discovered penicillin, arguably the most important medical advance in history. Of course, it wasn’t total accident. Fleming already had the reputation of a great researcher because he was always trying things out and searching for answers and hoping for things to happen and then recognizing what was happening when they happened. So it takes no credit away from Fleming to note that this was a complete accident because it was accidents he hoped for. Might not be a research method that works for everyone, but it sure worked for him.

Interestingly, it wasn’t until during World War II that the scientific community really took the penicillin discovery that seriously. As late as 1941, scientific journals were largely dismissing it, despite Fleming’s best efforts. It wasn’t until 1943, when Fleming published a follow-up paper after curing a guy using it that its revolutionary potential was fully realized. He also quickly realized that penicillin resistance would be a problem and immediately started publishing about this. Of course, it was all too easy for doctors to overprescribe and the predicted antibiotic resistance has resulted, but it’s also hard to blame doctors at the time for doing what they thought best. I am sure many commenters are more knowledgable about this situation than I am though, so I look forward to reading what people have to say on the issue.

Of course, the realization of what penicillin could do was a genuine medical revolution, among the greatest of all time. This was the first major antibiotic and of course would not be the last, but it does remain the most important. Incidentally, about 10% of Americans claim to have penicillin allergies, but it seems that the actual real negative reaction to it is about 1% and the other 9% are mostly slightly sensitive.

In 1945, Fleming received the Nobel Prize in Medicine for his discovery. No one is retroactively questioning that one. But lest we think that scientists are singular heroes, as it is for most scientific discoveries, there were multiple people involved and in fact that 45 Nobel was shared by three people. The second was Howard Florey, who did the work to make penicillin an effective medicine. Fleming hadn’t fully followed up on it and done the work. It was Florey and his team who did the clinical trials and figured out the manufacturing side of it. The third was Ernst Chain, a German Jewish refugee who was alongside Florey in this work.

For the record, Fleming was very cool with giving Fleming and Chain most of the credit. He actively pushed back against the idea that he was the only one involved. It’s worth noting as well that Norman Heatley was another figure who played a critical role here, who did a lot of the clinical work, even though he didn’t get the Nobel. Each of these four people were absolutely necessary to the development of penicillin. I guess it’s fine that Fleming gets the bulk of the public credit–the public loves a simplified myth, which is how we focus so much of the civil rights movement on Rosa Parks and Martin Luther King, mythologizing while also simplifying and misunderstanding both for often pat, depoliticized narratives that serve whatever we think our interests are in the present at any given time. I guess such is the way of the world, as much as it makes a historian grind their teeth.

Fleming was more or less retired after World War II, though also a big celebrity. He died in 1955 of a heart attack, at the age of 73.

Alexander Fleming is buried in St. Paul’s Cathedral, London, England.

If you would like this series to visit American winners of the Nobel Prize for Medicine, you can donate to cover the required expenses here. Philip Hench and Edward Kendall, who both won in 1950, are both in Rochester, Minnesota. Herman Gasser, who won in 1944, is in Platteville, Wisconsin. Previous posts in this series are archived here and here.