Semmelweis, Agency, and Compulsion

I’m interested by the way Ignaz Semmelweis blends his scientific data and the narrative of his life in “The Etiology, Concept and Prophylaxis of Childbed Fever,” particularly in how this commingling shapes the language of resignation, compulsion, and choice that infuses the account. At seems, at first, that when Semmelweis moves from discussing his findings to discussing how he found them he is seeking the readers’ sympathy. The disrespect shown toward the personnel of the first clinic makes him “so miserable that life seemed worthless” (5). This interpersonal problem is quickly linked to a scientific one—everything is doubtful, all he knows is that lots of people die in the obstetrical clinics. But it becomes clear that his reflections on his misery are not a brief aside, when in the next paragraph he describes the changes he elected to make in the first clinic—essentially, testing his hypothesis that a difference in practice in the two clinics must be a cause of the difference—as the act of “a drowning person grasping at a straw” (5). Does he want the readers to realize that this choice was scientifically unsound or does he want us to feel sorry for him in his perplexity? More importantly in my eyes, here Semmelweis characterizes himself as an agent as well as a victim of misery: he takes responsibility for making this change. When he switches back in the next paragraph to talking about his own life events, he continues to figure himself as an agent.

When he returns and hears of his friend’s death, however, his language of agency slips into that of compulsion. Kolletschka’s death agitates him (that is, he is acted on by this event), but now he can (actively) see that his friend died of childbed fever. And here’s where the facts begin to act on him rather than he on them: he “was compelled to ask” about the cause of death and “was forced to answer affirmatively” (6). This is the key to his figuring out the causes of childbed fever, a major turning point in his research, but he represents it with resignation. Rather than lauding his discovery and its ability to, if I may paraphrase Tyndall, better man’s estate, he presents it as forced upon him. And this language continues as he unravels the mystery: a “new tragic experience persuaded” him that air plays a role (8). Rather than taking credit for his discovery, Semmelweis laments his unwitting role in many deaths: “In consequence of my conviction I must affirm that only God knows the number of patients who went prematurely to their graves because of me” (10). Instead of taking on the role of God, as we talked about on Thursday, as a positive sign of his and science’s power, he blames himself for deaths unwittingly caused by his uncleanness. Solving this scientific question, Semmelweis presents himself as a pawn of the facts that force themselves upon him, but he holds himself responsible for the spread of germs.

And here, instead of becoming predictably self-congratulatory, he becomes really quite melancholy. Because the “truth must be made known to everyone concerned,” he must share it, though the recognition is “painful and oppressive” (10). He defends himself for doing so: he says that he does not “undertake these polemics because of pugnaciousness” (11) but rather because of his “right and obligation” to do so, interestingly marrying once again the language of choice and compulsion (12). In light of these discoveries, he can “endure the miseries” to which he has “been subjected” only by thinking of the lives to be saved in the future—but even here, he turns back to sadness when he realizes that he may not be “allowed to see this fortunate time” with his own eyes (12). I think it’s the nature of his discovery that forces him into this elegiac tone; it seems to me that before germ theory, it would have been impossible to imagine causing someone else’s death entirely unwittingly (i.e., without doing anything). The ability to cause death calls into question, for Semmelweis, what his life has really meant, and imagining the balance between lives taken and lives saved does little for him because he does not really imagine himself as the one responsible for saving them. “[T]he number of patients saved by my students and by me is insignificant;” he looks forward to those “to be saved in the future” but does not envision himself as the agent of that salvation (12). In contrast to the laudatory views of what science has to offer the individual we read last week, Semmelweis’s representation of his own agency and lack thereof points to another potential outcome: a sense of being a pawn of scientific fact, forced to recognize what one does not wish to see and a sense that tragedy comes not at the hands of God, but rather at the hands of individuals, no matter how well-intentioned.