Septicemia Books

I discovered this book three years ago, quite by accident, and it explained--in readable language and comfortable style--EXACTLY what had happened to my body when I came within moments of death in late '04 and early '05. Mine weren't burn wounds like Janice's, but treated the same--the result of a tiny (less than 1/2 inch), single dog bite that injected a bacteria into my bloodstream. My lungs "failed" (Acute Respiratory Distress Syndrome--ARDS)and began a process that led to a near-fatal clotting disorder, multi-organ failure, gangrene and amputation of four fingers and the front halves of both feet; skin and fat necrosis (blackening, rotting) from my waist down (eventually excised--carved off--almost to bone, from knees to ankles of both legs); extensive skin grafts (taken from my back), dramatic scarring, and limited ability to stand or walk. In a burn ward, like Janice in the book, there were brief moments of lucidity over a period of almost three months, during which I repeatedly asked, "What happened to me?" Thanks to Kevin Tracy's "Fatal Sequence," I now thoroughly understand the "domino effect" of severe sepsis and its all-too-common, tragic ending. Readers might accurately conclude, after reading this book, that in obituaries such terms as "pneumonia" or "brief illness" are euphamisms for SEPSIS that leads so quickly to demise. "Fatal Sequence" explores and reveals body functions and self-contained back-up systems of which few people are aware . . . until they fail. I cherish my two copies and highly recommend this book for folks still asking, "What happened?" and for any medical professional who has lost a patient to "infection," despite the best knowledge, resources, technology, treatment, and care. It is a simple, yet technically sound play-by-play account of the body's own dying process. Remarkable.

This is wonderful book for the general public and requires little knowledge of medicine. It is written as a journal followed by a discussion and relates how a physician's compassion for a dying child leads to an important discovery in neuroimmunology. The book also describes in relatively simple terms the process of science and the steps involved in this discovery. At the end, Dr. Tracey introduces a medical theory called "the cytokine theory of disease," to explain many therapeutic effects observed in conventional and alternative medicine. Overall, this is a formidable book that anyone interested in a becoming a healthcare provider should read.

About two thirds of this book is the story of Janice, an eleven months old girl who was admitted to the hospital with burns over 75% of her body. Her life expectancy with this much burn was about 25%, unlikely to survive the first night. But she did. She was recovering until her body began destroying itself. The name of her condition is severe sepsis.

Anyone with a child will shed tears as they read the struggles Janice's little body made against the infection and her own out of control immune system. But with Dr. Tracey this was a life changing experience as his experience with Janice's fight made him choose a life of scientific research into severe sepsis.

The remaining third of the book talks about the research Dr. Tracey and his associates have conducted in the subsequent years and serves as a preliminary finding as to what they have discovered, the status of the research, and the hope for the future.

This book, Fatal Sequence, is highly recommended reading for everyone. The information about sepsis is so pertinent that anyone who reads this book would benefit from the knowledge you receive. Dr.Kevin J. Tracey is world reknowned. He is a neurosurgeon, an immnnologist and a highly regarded scientist. Dr. Tracey's genuis is the ability to write about why sepsis happens in an understandable way. Sepsis is so common that it happens to someone in everyone's family. Many with non fatal illness or injury die of sepsis so often that it is the thrid most common cause of death in our hospitals. It is a must for understanding what happens to us when we get sick. This is a suspensful story that is so well written that you will savor each page. I believe,"Fatal Sequence the killer within", should be a must for all best seller list. Please read this book and write your own review.
Thank you, Dr. Tracey for making a difference
Sincerely,
Alice E. Oliva
580 Horizons West
Boynton Beach, Fl 33435
561-374-8957



Thank you, Dr. Tracey for making a difference.
Please read this book and write your own review.


I urge you to please read this book and write your own review.

Dr. Tracey,
Thanks for writing this book, and making the subject of sepsis into a reading experience that I couldn't put down. Its rare for a professional to be able to write about such a complex subject and make it both interesting and understandable to the non-scientist.

This is a book that I am passing on to my high school and college aged children, in hopes that it sheds some light on the human side of chosing research medicine as a career path.

I'm hoping that you keep publishing!

A great read about a monumental moment in the history of medicine. Originally entitled "Houses of Death," the book is more a historical record of the diagnosis of childbed fever than a biography of Semmelweis. Well written and intended for a general audience, the Carters unfortunately found the wrong publisher for the book. If you have any interest in the history of medicine at all, this is a must read book.

This book, first of all, consists of a brief introduction (2 pages), a brief Preface (2 pages), and six chapters in the order of which three are devoted to initial medical and scientific background, two are focused on Ignaz Semmelweis himself as well as his discovery, while the final two involve a discussion of Mayrhofer's discovery (Mayrhofer was Semmelweis's progeny, so to speak) and a contemporary look at the growing threat of virulent forms of streptococci, the bacteria now known to be the cause for the so-called childbed fever or, more accurately, puerperal fever.

As a scientific biography of the life and work of Ignaz Semmelweis, the heart of the book belongs to Chapters 3 and 4 where the authors discuss Semmelweis's struggles to prevent childbed fever and to know its cause while also giving attention to his theory of causation. For reasons the authors make tragically clear, Ignaz Semmelweis failed to have his work and discovery be immediately accepted, and he died ignobly, having been used, as a political pawn by those in power who believed in his discovery and work, and, simultaneously abused, by yet others in power who did not believe in his discovery and could, and, in fact, did refuse him work as well as respect.

By and large, this book is intended for a popular audience and is charmingly, engagingly, and dramatically written, making "clear exactly" why Ignaz Semmelweis, a once-head resident of obstetrics in 1846 Vienna, was and remains an important figure in medical science - not just to pregnant women and neonates then and now and not just to the now widely accepted practice of antiseptics, but as well to the theoretical development of modern medicine in the early 19th and 20th centuries for the authors show distinctively how Semmelweis, as an innovator, was among the most important mid-19th century scientific figures for defining diseases in such a way that each disease has only one specific cause, a way of thinking that we take for granted today but was completely revolutionary in the mid-1800s.

The charm of this lucidly written work comes from a pleasant knack for accurate historical detail of the time-period, as if observed from a fresh, eye-witness account: "In the nineteenth century, Vaci uta was an important shopping street . . . The building [in which Semmelweis lived] encloses a quiet courtyard from which an ancient well-worn circular marble stairway ascends to the third floor . . ." or "The General Hospital occupies a system of buildings that surrounds a dozen large rectangular courtyards arranged like an irregular checkerboard. The courtyards contain gardens, shady trees, walks, and occasional statutes of prominent persons who have been associated with Viennese medicine."

What is touching and essentially dramatic about this work comes from the well-organized narrative sweep of events the authors orchestrate in keeping with a near-mythic story-line of a young and enterprising man who, as a living protagonist, heroically emerges from a miserable hospital setting, really a house of death (the real and intended name for this book, according to the authors' Introduction, was "House of Death"), to become someone who pits himself against a dreadful antagonist, the killer disease then known as "childbed fever", and, remarkably, in the end, defeats it (or, at least, renders it significantly impotent), while, simultaneously, giving the world a universal, necessary gift, much like Prometheus is said to have given mankind fire.

What is unique about this particular biography, the facts of which nearly every student of medical history apparently already knows, is that, as a popular primer, it satisfies the reader's intellectual curiosity (for "Why?") without ruining the narrative pace for those readers who simply might just want "a good read." It also invents no detail where historical facts are unavailable just merely to keep progress with a strong narrative. The authors stay unflinchingly true to the historical record and yet create no bar to the flow of the story.

The last chapter (Chapter 6) is a bit disconcerting but provocative overall. While this chapter might feasibly have been reduced to an extended footnote after Chapter 5, "Mayrhofer's Discovery," on the one hand, or might have been labeled as an Appendix, on the other, thus transforming the chapter in such a way as to make it more consistent in tone as a popular primer, it contains noteworthy contemporary analyses of streptococci today, first as they relate to puerperal fever, but secondly, and perhaps more importantly, to the threat of the virulent growth of streptococci in the near-future, scarily yet prophetically hinting at events (not known in 2005 when the book was published, but which) we now know in 2007 as "the Superbug" (MRSA) for which there is abundant horrific evidence presently in Baltimore, Maryland.

This last chapter calls out for even greater understanding of streptococci and caution in dealing with it, and, in its own understated but emphatically philosophical way, it ultimately illustrates the idea that the philosophy of science is not a mere Ivory Tower enterprise; it is a highly practical project, one with life-or-death or real consequences.

This is a wonderful book and highly recommended to everyone. A couple of minor quibbles are appropriate at this point, and the first has to do with the price. It ought to be more affordable for its intended target audience. $24 (plus tax) for a paperback is steep. Secondly, since this work is largely a republication of an earlier 1995 hardback but with an Introduction newly added, the early error of repeating Semmelweis's age at death as being "forty-two" (as it was printed in the original Preface) ought to have been fixed before republishing. That having been said, to find the footnotes arranged at the end of each chapter rather than at the end of the book was itself a real joy as it made reading each chapter easy and eliminated the drudgery of flipping back and forth between pages to points of distraction. Reading this short book was an emotional as well as intellectual delight. May it find a broad audience (and perhaps a less technical publisher).

I read the The Cry and the Covenant when I was around 14 years old and it is one of the most affecting books I've ever read. This new book on Ignac Semmelweis is well-researched and it adds greater detail to the sad story of politics, conservatism, and pride which caused countless unnecessary and tragic deaths of young women and children. Given that medical mistakes are all too common, this should be required reading for anyone in the medical field!

"The Doctors' Plague: Germs, Childbed Fever, and the Strange Story of Ignac Semmelweis" by Sherwin Nuland is a nonfiction account of the life, death, and important medical discoveries of Ignac Semmelweis, a doctor who discovered in the nineteenth century that the simple act of washing your hands could save the lives of thousands of patients.

Unfortunately, Semmelweis was so ahead of his time that no one believed him. He studied and worked in Vienna (the Harvard of medicine in its time) and, later, Hungary during a time of political unrest and discrimination that made him and his discoveries more outcast and radical than groundbreaking or believable to his colleagues. He also suffered from his own bellicose nature to the point where his book (which should have justified his discoveries) ended up being an attack upon his enemies and further discredited him.

"The Doctor's Plague" is written by a doctor himself who is personally fascinated by Semmelweis to the point that he traveled to Vienna to see Semmelweis' old stomping grounds in Vienna's maternity ward, as well as researched Semmelweis' own medical records to determine what really caused Semmelweis to go insane and die in a mental facility in the prime of his life.

"The Doctor's Plague" begins with a fascinating (and readable) account of a young pregnant woman who goes to Vienna's maternity ward, gives birth, and then dies from a most horrible and painful death that, at the time, the doctors could not explain. The author, Nuland, goes into gruesome detail about how the infection enters, then destroys, her body, making you shudder and feel grateful for the fact that we live in a world with antibiotics.

The rest of the work is devoted to Semmelweis, with much emphasis on the conflicts he had with medical leaders of his time (as well as his book). The text does get a bit dry at this point, but it is readable, and you are left shaking your head in wonder (and dismay) at the people who were considered geniuses of their time.

I read this book before reading the fictional version of Semmelweis' life (called "The Cry and the Covenant" by Morton Thompson). I believe reading "The Doctor's Plague" helped me a lot in understanding the complex political, social, and medical issues brought up in the fiction version, and am pleased that I read it first.

In a short, readable volume, Sherwin B. Nuland, M.D. has succeeded in telling the story of a brilliant man whose findings changed medical science completely, and might have helped those changes take place much earlier but for his inability to get along with his peers and elders.

True, the blame for childbed fever continuing at the Allgemeine Krankenhaus in Vienna where he worked and studied should not fall solely on Ignác Semmelweis' shoulders. Arrogance on the part of others, as well as politics and simple entrenched institutionalism put up barrier after barrier, ensuring that medical students would for years after continue delivering babies after handling cadavers (the practice which was the primary problem at that hospital, and probably countless others worldwide). Dr. Nuland explains this in a style friendly to lay readers but which pulls together interesting facts from history, the culture in which Semmelweis worked (including its attitude toward women and children), as well as the world of medicine. He also writes sensitively about a man who had the knowledge to save others nearly a half century before it is put to use, whose personal quirks and lack of respect for others played a part in the disregard of that knowledge.

Fascinating, enlightening, and highly recommended.

This is the story of a doctor who realized that birthing women might not die of infections if doctors and other attendants washed their hands before treating them - simple as that.

I think Dr. Semmelweis would have cracked up (for want of a better term) anyway, but his ridicule by colleagues expedited the inevitable.

I first became aware of Dr Ignac Semmelweis through reading `The Cry and the Covenant' back in the early 1970s. Microbiology, theories of germ transfer and other sciences of medicine became more familiar to me later, but I'd not critically revisited the role of Dr Semmelweis until recently.

Dr Nuland's book is valuable on two fronts. Firstly, it provides background and insight into Dr Semmelweis himself which goes some way to explaining why his theory was not universally embraced even though it appeared to be proven in practice. Secondly, it is a reminder that scientific understanding of causation does not always accompany insight.

Dr Semmelweis proved that taking precautions to prevent cadaveric contamination of recently delivered women led to a reduction in puerperal sepsis, but not `why' or `how'. Unfortunately, Dr Semmelweis's abrupt and abrasive personality alienated many of the medical establishment including some of his earlier supporters. This, combined with the fact that it took him 14 years to publish his findings made it easy for many to ignore his conclusions.

At various times Dr Semmelweis has been ignored or condemned, or subjected to hero worship and hagiography. Surely, the truth rests between the extremes. Dr Nuland has written a book which, while it will be accessible to interested non-medical readers also provides an historic insight into the life and times of Dr Semmelweis. It should also provide a timely reminder, too, that some of the best solutions to iatrogenic illness are the simplest ones: effective handwashing remains a front line defence.

Jennifer Cameron-Smith

This is a reprint and translation of a groundbreaking work by an eminent scientist. Every hospital, university, and medical school library should have a copy of this work. At this price, they should have at least two copies. In addition to its importance for the medical profession, this book has a great deal of potential interest for historians and feminist scholars. Semmelweis was the father of modern antiseptic theory, the first to recognize a connection between medical students' visits to the dissecting lab and the deaths following their subsequent visits to the maternity hospital, with no washing of hands in between. His fellow physicians refused to listen to him, unwilling to believe that they themselves were carriers of disease. Semmelweis lost his reputation and his job, dying in disgrace, for his refusal to deny the truth. Only after his death, and the deaths of millions more women from childbed fever, were his theories finally recognized and accepted. For a fascinating look at Semmelweis the man, see Jens Bjorneboe's moving play, Semmelweis, published by Sun & Moon Press.