A Science Odyssey: Matters of Life and Death - Documentary

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IN 1900, THE ERA OF SCIENTIFIC MEDICINE IS ONLY JUST BEGINNING.

THERE ARE FEW FIRST-RATE PHYSICIANS
ALMOSTNES.

IF YOU BECOME SICK OR INJURED
YOU'LL NEED A STRONG CONSTITUTION
OR PLENTY OF LUCK TO SURVIVE
EVEN IF YOU ARE PRESIDENT OF THE UNITED STATES.

IT'S BEEN A FEW DECADES
SINCE THE FRENCH SCIENTIST LOUIS PASTEUR DISCOVERED
THE MICROSCOPIC CREATURES WE CALL BACTERIA
AND DEMONSTRATED
THAT THESE GERMS COULD CAUSE MANY ILLNESSES.

LATER, RESEARCHERS DISCOVER
AN EVEN TINIER INFECTIOUS AGENT-- THE VIRUS.

BUT DESPITE THESE DISCOVERIES
MANY PEOPLE CONTINUE TO BLAME SICKNESS
OF HUMAN TRAITS AND SOCIAL CONDITIONS--RIETY
A POOR CONSTITUTION, A DEGENERATE LIFESTYLE
OR MIASMIC CLOUDS OF FILTH EMANATING FROM THE CITY SLUMS.

THOUGH THE SCIENTIFIC COMMUNITY KNOWS
THAT GERMS CAUSE DISEASE
THEY DON'T COMPLETELY UNDERSTAND HOW THEY'RE SPREAD
AND THEY CERTAINLY DON'T KNOW HOW TO DESTROY THEM.

IN THE EARLY MORNING HOURS OF JUNE 27, 1899
A SHIP SAILS INTO SAN FRANCISCO BAY
ENDING A FATEFUL VOYAGE FROM HONG KONG.

AT THE U.S. QUARANTINE STATION ON ANGEL ISLAND
A DELEGATION OF HEALTH OFFICIALS
ANXIOUSLY AWAITS THE SHIP'S ARRIVAL.

TWO PASSENGERS ABOARD MAY HAVE DIED
FROM THE DREADED BUBONIC PLAGUE.

IF IT'S TRUE, THE SHIP CANNOT BE ALLOWED TO REACH THE MAINLAND.

ANGEL ISLAND IS SAN FRANCISCO'S BASTION OF DEFENSE
AGAINST INFECTIOUS DISEASES.

ALL IMMIGRANTS MUST FIRST PASS THROUGH THESE HALLWAYS
TO BE EXAMINED AND DISINFECTED.

ANYONE WHO SHOWS SIGNS OF ILLNESS COULD BE QUARANTINED
OR SENT BACK HOME.

LATELY, HEALTH INSPECTORS HAVE BEEN ESPECIALLY WORRIED
THAT FOREIGNERS MIGHT BRING IN THE PLAGUE
AN ANCIENT AEADLY BACTERIAL INFECTION
THAT RAPIDLY OVERWHELMS THE BODY'S DEFENSES.

Man: THERE WAS A GREAT DEAL OF FEAR AND ANTICIPATION
IN SAN FRANCISCO
THAT THE PLAGUE WAS GOING TO INVADE THE WEST COAST.

IN FACT, THE PLAGUE HAD ALREADY BEGUN IN CHINA 30 YEARS EARLIER
AND HAD MOVED DOWN THE COAST
TO CITIES LIKE CANTON AND HONG KONG
WITH WHICH WE HAD A GREAT DEAL OF COMMERCIAL TRAFFIC
AS WELL AS IMMIGRATION TRAFFIC.

Osgood: THERE ARE HUNDREDS OF THOUSANDS OF VICTIMS IN CHINA AND INDIA.

JAPAN, THE PHILIPPINES AND HAWAII
HAVEK.

WHEN THE PLAGUE BREAKS OUT IN THE CHINESE QUARTER OF HONOLULU
PANICKED OFFICIALS ACCIDENTALLY
BURN THE NEIGHBORHOOD TO THE GROUND.

500 YEARS AFTER THE PLAGUE WIPED OUT A THIRD OF EUROPE
IN THE MIDDLE AGES
THERE IS STILL NO CURE.

AND NOW THE DISEASE MAY HAVE FINALLY REACHED AMERICA.

AT ANGEL ISLAND, THE SHIP IS QUARANTINED
BY THE U.S. GOVERNMENT'S TOP BACTERIOLOGIST, JOSEPH KINYOUN.

ASSUMING THAT PLAGUE BACTERIA IS SPREAD PERSON TO PERSON
KINYOUN QUARANTINES THE MOSTLY ASIAN PASSENGERS AND CREW.

IKE HIS COLLEAGUES L
HE ALSO BELIEVES PLAGUE BACTERIA THRIVE IN DIRT
AND CAN BE SPREAD TO HUMAN DWELLINGS BY VERMIN.

SO HE ORDERS THE SHIP FUMIGATED
WITH STEAM AND POISONOUS SULFURIC SPRAYS.

AS OFFICERS INSPECT THE CARGO
STOWAWAYS ARE SUDDENLY DISCOVERED.

TWO APPEAR TO HAVE THE PLAGUE.

FEARING IMPRISONMENT
THE ILL STOWAWAYS ESCAPE DURING THE NIGHT
AND TRY TO SWIM TO SAN FRANCISCO.

EARLY THE NEXT MORNING
THEIR CORPSES ARE FOUND FLOATING IN THE HARBOR.

WHEN LOCAL OFFICIALS ANNOUNCE THAT THEY DO HAVE THE PLAGUE
THE CITY FEELS MORE VULNERABLE THAN EVER.

(trolleys dinging, horns honking)
ON MARCH 6, 1900, THE CHINESE YEAR OF THE RAT
THE BODY OF CHIC GIN, A CHINESE MERCHANT
IS FOUND IN THE BASEMENT OF A CHEAP HOTEL.

AN AUTOPSY CONFIRMS EVERYONE'S WORST FEARS--
THE PLAGUE HAS STRUCK IN CHINATOWN.

ACCUSING THE CHINESE OF BEING FOUL SPREADERS OF DISEASE
THE CITY JUMPS INTO ACTION.

POLICEMEN STRING A HEAVY ROPE
AROUND THE 15 SQUARE BLOCKS OF CHINATOWN.

TO THEIR SURPRISE, CHINESE SAN FRANCISCANS DISCOVER
THEY ARE NOW PRISONERS TO THEIR SURPRISE, CHINESIN THEIR OWN HOMES.ISCOVER

GUARDS ARE ASSIGNED
TO KEEP RESIDENTS FROM SPREADING THE DISEASE
TO THE WHITE COMMUNITY.

ARMED WITH CROWBARS AND DISINFECTANTS
POSSES SYSTEMATICALLY RAID AND FUMIGATE EVERY HOUSE
DESTROYING THE WORST OF THE SLUMS.

ANYONE WHO EVEN LOOKS SICK IS WHISKED AWAY TO ANGEL ISLAND.

Man: THE CHINESE RESPONSE TO WHAT WAS HAPPENING WAS TERROR.

WHAT WOULD THEY BE SUBJECTED TO?
ULD THEY BE PUT? WHAT WOULD THEY BE SUBJECTED TO?
WOULD A WALL BE PLACED AROUND CHINATOWN?
WOULD THEY ALL BE EXPELLED FROM THE UNITED STATES?
Risse: AND WHEN THE POSSE OF POLICEMEN WITH A FEW VOLUNTEERS
WERE COMING INTO THE VARIOUS HOUSES WITH CROWBARS AND AXES
AND STARTED TO TEAR DOWN WALLS AND DOORS
THE HOSTILITY AND THE PANIC INCREASED DRAMATICALLY.

Osgood: THE CHINESE SMUGGLED THEIR SICK OUT OF THE CITY
THROUGH A VAST LABYRINTH OF TUNNELS BENEATH CHINATOWN.

MANY EE ON RAFTS FLOATED OUT INTO THE BAY.

AS A RESULT
NO ONE KNOWS HOW MANY PLAGUE VICTIMS THERE REALLY ARE.

BUT WITH FEWER THAN 200 CONFIRMED DEATHS
RELIEVED AUTHORITIES DECLARE THE QUARANTINE A SUCCESS.

(bell ringing)
LIFE RETURNS TO NORMAL.

THE MEMORY OF THE PLAGUE RECEDES WITH THE YEARS.

FEW REALIZE THAT THE CITY IS MORE VULNERABLE THAN EVER.

(low rumbling)
(people screaming, bell tolling)
IN 1906, A DEVASTATING EARTHQUAKE ROCKS SAN FRANCISCO.

AGING FIRES SPREAD IN 1906, A DEVASTATING EARTHQTHROUGHOUT THE CITY.ISCO.R
MORE THAN A THOUSAND PEOPLE DIE.

RATS, DISORIENTED BY THE EARTHQUAKE
SWARM THROUGH THE STREETS
AND THE PLAGUE STRIKES AGAIN.

BUT THIS TIME, THERE IS NO TALK OF QUARANTINING NEIGHBORHOODS.

PUBLIC HEALTH OFFICIALS NOW TARGET RATS INSTEAD OF PEOPLE.

RATS HAD ALWAYS BEEN ASSOCIATED WITH PLAGUE OUTBREAKS
BUT NOW SCIENTISTS UNDERSTAND THEIR ROLE
IN TRANSMITTING THE DISEASE.

RESEARCHERS IN INDIA NOTICED
THAT PLAGUE-RIDDEN RATS AND HUMAN VICTIMS
WERE BOTH COVERED WITH FLEA BITES.

WHEN THEY FOUND PLAGUE BACTERIA IN THE SALIVA OF FLEAS
THE CONNECTION WAS MADE.

FLEAS WERE BITING DISEASED RATS
AND THEN TRANSMITTING THE PLAGUE BACTERIA
WHEN THEY BIT HUMANS.

THE CITY BANDS TOGETHER TO WAGE A WAR ON RATS AND FLEAS.

BUILDINGS ARE RAT-PROOFED AND FUMIGATED.

GARBAGE IS COLLECTED AND REMOVED.

OVER A MILLION RATS ARE TRAPPED AND SLAUGHTERED.

AS A RESULT
A DISEASE THAT COULD HAVE REACHED EPIDEMIC PROPORTIONS
IS STOPPED IN ITS TRACKS.

Kraut: WHEN THE 1907 EPIDEMIC FINALLY PETERED OUT
SAN FRANCISCANS COULD LOOK BACK AND DISCOVER A FEW THINGS.

ONE IS A BETTER UNDERSTANDING OF MEDICINE
OF SCIENTIFIC MEDICINE
HAD LED TO THE EXTERMINATION OF RATS
AND A HUNT FOR RATS RATHER THAN PEOPLE AS COMPARED TO 1900.

BUT CERTAINLY
BACTERIOLOGY WAS BECOMING INCREASINGLY IMPORTANT.

GERM THEORY HAD LED TO A WHOLE NEW SCIENTIFIC U??ERSTANDING
OF WHAT MAKES PEOPLE SICK.

Osgood: EPIDEMIC DISEASES LIKE TYPHOID AND CHOLERA BEGIN TO FADE
AS CITIES START PROVIDING
SAFE DRINKING WATER AND BETTER SEWER SYSTEMS.

REDUCING DISEASES LIKE YELLOW FEVER.

AND EDUCATIONAL CAMPAIGNS TEACH MOTHERS
HOW TO BETTER FEED AND NURTURE THEIR CHILDREN.

AS A RESULT, INFANT MORTALITY BEGINS TO DECLINE.

AND BY THE SECOND DECADE OF THE CENTURY
LIFE EXPECTANCY IN WESTERN COUNTRIES STARTS TO RISE.

NOW PUBLIC HEALTH TRIED TO BE PROACTIVE RATHER THAN REACTIVE.

THEY TRIED TO PREVENT THINGS FROM HAPPENING
RATHER THAN REACTING AFTER THEY HAPPENED.

THIS WAS ALSO THE PROGRESSIVE ERA IN AMERICAN HISTORY
AND THIS WAS A TIME
WHEN THE PROGRESSIVES WERE VERY INTERESTED
IN REFORMS OF ALL KINDS.

THEY HAD A GREAT FAITH IN SCIENCE.

SCIENCE WAS THE NEW RELIGION.

AND THIS REFORMIST SPIRIT ATACTED
A NUMBER OF VERY GOOD, YOUNG PHYSICIANS
WHO WANTED TO MAKE PUBLIC HEALTH A CAREER.

Osgood: ONE OF THE MOST INFLUENTIAL
PUBLIC HEALTH FIGURES OF THE PERIOD IS JOSEPH GOLDBERGER.

IN 1914, HE'S SUMMONED BY THE SURGEON GENERAL TO INVESTIGATE
AN ESPECIALLY BAFFLINGLY DISEASE RAVAGING THE AMERICAN SOUTH.

IT'S CALLED PELLAGRA.

THE VICTIMS DEVELOP REDDISH, ROUGH SKIN THAT OFTEN APPEARS
AS A BUTTERFLY-SHAPED RASH.

AS THE DISEASE PROGRESSES
PATIENTS BECOME CONFUSED, HALLUCINATE
AND FINALLY GO INSANE.

THERE HAVE BEEN TENS OF THOUSANDS OF DEATHS
IN THE RURAL SOUTH
BY THE TIME JOSEPH GOLDBERGER IS ASSIGNED THE CASE.

Woman: AT THE TIME
IT WAS A MYSTERY DISEASE
AND PEY THEORIES ABOUT WHAT CAUSED IT.

THE MOST PROMINENT THEORY
WAS THAT IT WAS CAUSED BY EATING CORN.

AND THERE WERE OTHER PEOPLE WHO THOUGHT
THAT IT MUST BE CARRIED BY AN INSECT.

THIS WAS FAIRLY EARLY ON IN THE BACTERIOLOGICAL REVOLUTION
AND SO SOME PEOPLE THOUGHT THAT IT WAS CARRIED BY A BACTERIA
BUT NO ONE KNEW WHAT CAUSED IT, AND THERE WAS GREAT PANIC.

Osgood: GOLDBERGER JOURNEYS THROUGH THE SOUTH TO OVE FIRSTHAND
THE CONDITIONS WHERE PELLAGRA IS MOST SEVERE.

EVERYWHERE HE TRAVELS, THE PICTURE IS STRIKINGLY SIMILAR--
WORKING IN COTTON FIELDS AND TEXTILE MILLS
SUFFERING FROM THE DISEASE.

GOLDBERGER VISITS INSANE ASYLUMS E INSTITUTIONS
WHERE ALARMING NUMBERS OF NEW CASES ARE BEING REPORTED.

HE KNOWS THE DISEASE CAUSES INSANITY
WHICH MIGHT ACCOUNT FOR THE VICTIMS IN ASYLUMS.

BUT WHY IS IT SO PREVALENT IN ORPHANAGES AND PRISONS?
AND IF IT'S AN INFECTIOUS DISEASE
WHY ISN'T THE STAFF GETTING SICK AS WELL?
Kraut: ONE WOULD THINK THAT IF THIS WERE A GERM DISEASE
THE GERMS CERTAINLY WOULDN'T BE AWARE OF STATUS BOUNDARIES.

WHY WOULD ONLY THE INMATES GET PELLAGRA
AND WHY NEVER A NURSE, A PHYSICIAN OR A TEACHER?
AND HE BEGAN TO LOOK AT WHAT PEOPLE ATE
AND HE WAS HORRIFIED AT WHAT HE SAW
BECAUSE THE DIET WAS SO MISERABLE--
NOT LIKE ANYTHING HE HAD EVER SEEN BEFORE.

IT WAS THE DIET OF THE SOUTHERN FRONTIER
CONSISTING PRIMARILY OF CORNBREAD
AND SO INCREASINGLY
AS HE WENT FROM INSTITUTION TO INSTITUTION, UH, OBSERVING
GOLDBERGER BECAME CONVINCED THAT HE WAS DEALING WITH
SOME SORT OF NUTRITIONAL ISSUE, BUT NOT A GERM DISEASE.

Osgood: GOLDBERGER IS WELL AWARE OF THE RECENT DISCOVERIES
OF CHEMICAL ELEMENTS IN FOOD CALLED "VITAMINS."
HE ALSO KNOWS THAT DISEASES LIKE SCURVY AND BERIBERI
HAVE BEEN LINKED TO VITAMIN DEFICIENCIES
AND HE SUSPECTS PELLAGRA MAY BE THE SAME KIND OF DISEASE.

GOLDBERGER DECIDES TO TEST HIS THEORY
AT TWO ORPHANAGES FULL OF PELLAGRA VICTIMS
IN JACKSON, MISSISSIPPI.

WITH FRESH VEGETABLES, MEAT AND MI
FOODS RICH IN VITAMINS AND PROTEINS.

Kraut: AND LO AND BEHOLD, MUCH TO HIS OWN DELIGHT
THE CHILDREN WHO HAD PELLAGRA
GOT WELL WHEN THEIR DIETS WERE CHANGED
AND THOSE WHO DIDN'T HAVE PELLAGRA
DIDN'T CONTRACT PELLAGRA AFTER THEIR DIETS WERE CHANGED.

WELL, THAT WAS ALL WELL AND GOOD
BUT IT CERTAINLY WASN'T SCIENTIFIC EVIDENCE
AND GOLDBERGER WAS VERY MUCH AWARE OF THAT.

Osgood: GOLDBERGER PUBLISHES HIS DIET THEORY ANYWAY.

IF HE'S RIGHT, LIVES WILL BE SAVED
AND IF HE'S WRONG, BETTER FOOD CERTAINLY WON'T HARM ANYONE.

BUT TO HIS DISMAY, FEW TAKE HIS THEORY SERIOUSLY.

Etheridge: A LOT OF PEOPLE DIDN'T BELIEVE DR. GOLDBERGER'S THEORY
BECAUSE THE MEDICAL PROFESSION
WAS JUST GETTING USED TO THE BACTERIOLOGICAL REVOLUTION
AND THEY COULD NOT BELIEVE
THAT THEY HAD SOMETHING YET THAT THEY...

HING ELSE THAT THEY HAD STHAT THEY HAD TO MASTER..MET
THEY COULD NOT GET USED TO THE FACT
THAT A DISEASE COULD BE CAUSED BY THE LACK OF SOMETHING.

IT'S LIKE PROVING A NEGATIVE
AND THEY JUST COULDN'T H THAT.

SOME OF THEM MAY HAVE TAKEN OFFENSE ALSO
AT THE FACT THAT HIS CRITICISM OF THE DIET
IMPLIED A CRITICISM OF THE SOUTHERN WAY OF LIFE.

Osgood: GOLDBERGER DECIDES TO SHOW SOUTHERNERS
THAT HE CAN ACTUALLY GIVE PEOPLE PELLAGRA
BY SIMPLY CHANGING THEIR DIET.

HE PERSUADES THE GOVERNOR OF MISSISSIPPI
TO PARDON ANY CONVICTS
WHO VOLUNTEER FOR A CONTROLLED DIET EXPERIMENT.

HE CHOOSES THE RANKIN PRISON FARM
BECAUSE THERE RA
AND PLENTY OF ROOM TO ISOLATE THE CONVICTS FROM GERMS.

THE VOLUNTEERS
WHOSE OFFENSES RANGE FROM EMBEZZLEMENT TO MURDER
ARE DUBBED "THE PELLAGRA SQUAD."
Etheridge: THEY WERE MOVED TO A SPECIAL BUILDING
THAT HAD SCREENS ON THE WINDOWS
SO THAT NO INSECTS COULD COME IN.

IT WAS SCRUBBED ONCE A WEEK VERY CAREFULLY.

THEY WORE CLEAN CLOTHES EVERY DAY.

THE ONLY THING THAT WAS DIFFERENT ABOUT THEIR LIVES
OTHER THAN THAT WAS THE FOOD THAT THEY ATE.

INSTEAD OF EATING THE VEGETABLES FROM THE PRISON GARDEN
WHAT THEY'RE NOW GOING TO BE EATING
IS WHAT OTHER IMPOVERISHED SOUTHERNERS EAT--
CORNBREAD, CORNMEAL, CORN MUSH, OCCASIONALLY SOME PORK.

IN SHORT, HE'S GOING TO SWITCH THEIR DIET
IN SUCH A WAY THAT IT WILL BE
THE DIET THAT HE HAS OBSERVED PELLAGRA VICTIMS EATIN
Osgood: AT FIRST, THE MEN TREAT THE EXPERIMENT AS A LARK.

IT ALL SEEMS SO EASY.

BUT THREE WEEKS IN, THEY START COMPLAINING TO GOLDBERGER.

THEY ARE NAUSEATED.

THEY SUFFER PAINS IN THEIR BACKS AND SIDES.

THEY BECOME MOODY, CONFUSED AND EXHAUSTED.

TWO MEN BEG TO BE RELEASED
SAYING THEY WOULD PREFER A LIFETIME OF HARD LABOR
TO ANOTHER WEEK OF THIS "HELLISH EXPERIMENT."
SIX MONTH LATER, SEVEN OF THE 11 PRISONERS BREAK OUT
WITH THE CHARACTERISTIC PELLAGRA RASH.

Kraut: GOLDBERGER IS THRILLED.

HE HAS SUCCEEDED AT WHAT HE WANTS TO DO
AND HE EXPECTS EVERYONE NOT ONLY TO APPLAUD HIS EFFORTS
BUT TO ACCEPT HIS UNDERSTANDING OF PELLAGRA
THAT THIS IS A DIETARY DISORDER AND NOT A GERM DISEASE.

Osgood: GOLDBERGER TELLS THE PARDONED MEN
WHICH FOODS THEY SHOULD EAT TO CURE THEIR PELLAGRA
AND THEN WAITS
FOR PUBLIC ACKNOWLEDGMENT OF HIS BREAKTHROUGH.

BUT ACCEPTANCE DOESN'T COME.

SOME SOUTHERNERS EVEN ACCUSE HIM OF PERPETRATING A HOAX.

WHEN HE LINKS PELLAGRA
TO JOBS THAT DON'T PAY ENOUGH FOR PEOPLE TO EAT WELL
SOUTHERNERS HEAR ONLY HIS SOCIAL CRITICISM
NOT HIS MEDICAL REASONING.

GOLDBERGER, THE SCIENTIST, IS STUNNED
BY WHAT HE SEES AS TOTAL IRRATIONALITY.

Brieger: THE GOLDBERGER STORY SHOWS YOU
THAT SCIENCE BY ITSELF IS NOT ENOUGH
THAT PEOPLE HAVE TO CHANGE THEIR BEHAVIOR
PEOPLE HAVE TO BELIEVE WHAT THE SCIENTISTS ARE TELLING THEM
AND ONLY THEN WILL THEY ACTUALLY ACT UPON
THE KNOWLEDGE THAT SOMEONE LIKE GOLDBERGER PROVIDES.

Osgood: GOLDBERGER RETURNS TO THE LAB
AND DEDICATES THE REST OF HIS LIFE
TO FINDING THE SPECIFIC CAUSE
OF A DISEASE HE ALREADY KNOWS HOW TO PREVENT AND CURE.

HE HASN'T FOUND THE ANSWER
WHEN DEATH COMES ATGE OF 53
FROM ANOTHER MYSTERY DISEASE, CANCER.

HE DIED A DISAPPOINTED MAN
BECAUSE PELLAGRA WAS MORE PREVALENT IN 1929
THAN IT HAD BEEN IN YEARS
AND HE THOUGHT THAT HE WAS A FAILURE.

Osgood: EIGHT YEARS AFTER GOLDBERGER'S DEATH
SCIENTISTS FINALLY DISCOVER THAT NIACIN, A B-COMPLEX VITAMIN
CAN PREVENT THE DISEASE.

IT'S SOON ADDED TO COMMON FOODS.

TODAY THERE ARE NO MORE CASES OF PELLAGRA IN THE UNITED STATES
AND HARDLY ANYONE KNOWS THIS TERRIBLE DISEASE EVER EXISTED.

BY 1920, THERE HAS BEEN A REVOLUTION IN PUBLIC HEALTH.

WE HAVE STRATEGIES THAT CAN HELP TO PREVENT INFECTIOUS DISEASES
AND WE UNDERSTAND
THAT BETTER FOOD, CLEANER WATER AND IMPROVED SANITATION
CAN LEAD TO A LONGER AND HEALTHIER LIFE.

OF COURSE, PEOPLE STILL GET SICK A LOT
AND WHEN THEY DO, THEY HAVE MOSTLY THESE TO TURN TO.

HERE IS COOPER'S NEW DISCOVERY FOR INDIGESTION, RHEUMATISM
FOR BLOOD DISEASE, FEVER AND CHILLS, MALE AND FEMALE PROBLEMS
AND IF THAT ISN'T ENOUGH, IT ALSO REMOVES WORMS.

THE BUSY COOPER MEDICAL COMPANY ALSO OFFERS
COOPER'S QUICK RELIEF
WHICH CLAIMS TO CURE EVERYTHING FROM TOOTHACHE TO CHOLERA.

AND LET'S NOT FORGET GLYCOHEROIN FOR COUGHS--
ONE-HALF GRAIN OF PURE HEROIN IN EVERY FLUID OUNCE.

BUT THERE ARE SIGNS THAT THINGS ARE ABOUT TO CHANGE.

USING X-RAYS AND LABORATORY TESTS
SCIENCE IS CAREFULLY STUDYING THE BODY NOW.

BEGINNING TO UNDERSTAND SCIENCE IS CAREFULLY OUR INTERNAL ORGANS, OUR GLANDSE
SBEGINNING TO UNDERSTAND SCIENCE IS CAREFULLY OUR INTCALLED "HORMONES" GLANDSR
ATE SO MUCHTO UNDERSTAND SCIENCE IS CAREFULLY OUR OF OUR INNER CHEMISTRY.REGUL
BUT HOW WE CAN USE THIS KNOWLEDGE
TO HELP THOSE WHOSE BODIES HAVE BROKEN DOWN
THAT'S ANOTHER MATTER ENTIRELY
AND AS ALWAYS, TIME IS RUNNING SHORT.

Osgood: OF ALL THE WAYS OUR BODIES CAN BETRAY US
FEW ARE AS TERRIFYING AS DIABETES.

THE DISEASE STRIKES SOME WHEN THEY ARE YOUNG
OTHERS WHEN THEY GROW OLD.

ALL WHO SUFFER ARE CONSUMED WITH A TERRIBLE HUNGER AND THIRST
BUT NO AMOUNT OF FOOD OR DRINK WILL HELP.

THE DIABETIC'S BODY CANNOT ABSORB WHAT IT TAKES IN.

SLOWLY, THE VICTIM SLIPS INTO A DEADLY COMA
THAT DOCTORS ARE POWERLESS TO HALT.

NO ONE CAN EXPLAIN
THIS BREAKDOWN OF THE BODY'S INTERNAL CHEMISTRY
BUT IT'S REASONED THAT IF DIABETICS CANNOT TOLERATE FOOD
PERHAPS THEY CAN SURVIVE BY EATING LESS.

THE LEADING PROPONENT OF THIS THEORY IS DR. FREDERICK ALLEN
AN UNCOMPROMISING MAN WHO DEMANDS THAT HIS PATIENTS
LOSE AT LEAST 30% OF THEIR BODY WEIGHT.

Man: DR. ALLEN'S UNDERNUTRITION APPROACH--
PROMPTLY DUBBED "THE STARVATION APPROACH TO DIABETES"--
LED TO A GHASTLY KIND OF THERAPY
IN WHICH PEOPLE WHO WERE ALREADY COMPLAINING
THAT THEY COULDN'T GET ENOUGH FOOD AND DRINK
HAD TO DO WITH LESS
AND, IN FACT, HAD TO GRADUALLY STARVE TO DEATH.

AND THERE ARE TERRIBLE STORIES
OF DIABETIC PATIENTS STEALING HOT FOOD FROM OVENS
BURNING THEIR HANDS TO DO IT
EATING TOOTHPASTE AND BIRDSEED LEFT IN THEIR ROOMS.

BUT IF YOU STARVED YOURSELF CAREFULLY
YOU COULD BUY ANOTHER YEAR OR TWO OF LIFE
BUT IT WAS NOT A VERY SATISFACTORY LIFE.

Osgood: ONLY THE STRONG-WILLED CAN SURVIVE THE ALLEN DIET.

ELIZABETH HUGHES
THE 11-YEAR-OLD DAUGHTER OF A SUPREME COURT JUSTICE
HAS ALREADY LOST 20 POUNDS.

BARELY CLINGING TO LIFE
ELIZABETH AND HER PARENTS CAN ONLY PRAY
FOR A SCIENTIFIC BREAKTHROUGH TO SAVE HER.

A GLIMMER OF HOPE COMES WHEN RESEARCHERS DISCOVER
THAT A GLAND IN THE ABDOMEN, CALLED THE PANCREAS
PLAYS AN IMPORTANT ROLE IN THE DISEASE.

THE GLAND APPEARS TO HAVE TWO MAJOR FUNCTIONS.

IT PRODUCES ENZYMES THAT TRAVEL THROUGH DUCTS
AND INTO THE SMALL INTESTINE TO HELP IN THE DIGESTION OF FOOD
AND IT PRODUCES ANOTHER INTERNAL SECRETION
THAT IS ABSORB INTO THE BLOODSTREAM
TO HELP REGULATE THE METABOLISM OF SUGARS
AND OTHER CARBOHYDRATES.

BECAUSE DIABETICS HAVE A HIGH LEVEL OF SUGAR IN THEIR BLOOD
SCIENTISTS WONDER IF THEIR DISEASE IS BEING TRIGGERED
BY THE GLAND'S FAILURE TO PRODUCE THIS INTERNAL SECRETION.

ALMOST IMMEDIATELY, ATTEMPTS ARE MADE TO ISOLATE THIS SUBSTANCE
IN HOPES OF CURING THE DISEASE
BUT BY 1920, NO ONE HAS SUCCEEDED.

THEN A YOUNG CANADIAN SURGEON NAMED FREDERICK BANTING
STUMBLES ACROSS AN ARTICLE
ABOUT THE RELATIONSHIP BETWEEN DIABETES AND THE PANCREAS
WHICH GIVES HIM AN IDEA.

HE GOES TO TORONTO UNIVERSITY
AND MEETS WITH AN INTERNATIONALLY KNOWN EXPERT
ON THE METABOLISM OF CARBOHYDRATES, J.J. MACLEOD.

ALTHOUGH BANTING HAS NO BACKGROUND
FOR THIS TYPE OF RESEARCH
HE PROPOSES A NEW APPROACH TO THE PROBLEM.

BANTING'S IDEA IS TO TIE OFF
THE PANCREATIC DUCTS LEADING TO THE SMALL INTESTINE
SO THE CELLS MAKING THE DIGESTIVE JUICES
WILL ATROPHY AND DIE.

THEN ONLY THE PANCREAS'S "INTERNAL" SECRETION
WILL BE ACTIVELY PRODUCED, MAKING IT EASIER TO ISOLATE.

INTRIGUED, MACLEOD AGREES
TO GIVE BANTING TEN DOGS TO EXPERIMENT ON
A TINY LAB
THE SERVICES OF A RESEARCH ASSISTANT, CHARLES BEST
AND A FEW MONT ON THE PROBLEM.

THE EAGER YOUNG SCIENTISTS BEGIN OPERATING ON THE DOGS
WITH DISASTROUS RESULTS.

Bliss: YOU HAVE TO IMAGINE
WORKING IN A LABORATORY IN SWELTERING WEATHER
WITHOUT AIR CONDITIONING.

IMAGINE A COUPLE OF ENTHUSIASTIC YOUNG RESEARCHERS
TRYING TO OPERATE ON DOGS
THE SWEAT POURING OFF THEIR BODIES
DRIPPING INTO THE WOUNDS OF THE DOGS...

THE DOGS BECOMING INFECTED AND DYING
AT A FASTER RATE THAN THEY EVER DREAMED OF
THAT THEY WERE KILLING SO MANY DOGS
THAT THEY WENT OUT ON THE STREETS OF TORONTO
AND BOUGHT EXTRA DOGS
AND SLIPPED THEM INTO THE LAB SURREPTITIOUSLY.

ALMOST EVERYTHING THAT COULD GO WRONG DID GO WRONG.

THERE WERE TIMES WHEN THEY WERE READY TO QUIT.

Osgood: FINALLY, AFTER WEEKS OF FUMBLING
BANTING AND BEST MANAGE TO MAKE AN EXTRACT
THEY HOPE WILL CONTAIN THE INTERNAL SECRETION.

THEY INJECT IT INTO THE DOGS
WHOSE PANCREASES HAVE BEEN REMOVED
AND WHO ARE NOW SEVERELY DIABETIC.

IT WILL BE HOURS BEFORE THE RESEARCHERS WILL KNOW
IF THE INJECTION HAS LOWERED THE DOGS' HIGH LEVEL OF BLOOD SUGAR.

WHEN THEY MEASURE THE LEVEL AGAIN
IT'S GONE DOWN DRAMATICALLY
A SIGN THAT THE EXTRACT IS WORKING.

THE PAIR IS CONVINCED IT'S A BREAKTHROUGH.

AN ECSTATIC BANTING AWAITS MACLEOD'S RETURN
FROM HIS SUMMER HOLIDAY
TO SHARE THE RESULTS AND ASK FOR ADDITIONAL SUPPORT.

HE WANTED BETTER FACILITIES.

HE WANTED MORE DOGS, MORE ASSISTANTS.

HE ALSO WANTED SOME MONEY
BECAUSE HE WAS WORKING FOR NOTHING AND WAS BROKE.

UM... WANTED HIS RESEARCH TO HAVE THE HIGHEST PRIORITY
IN J.J.R. MACLEOD'S LAB.

MACLEOD WAS NOT PREPARED TO DO THIS
BECAUSE THE RESULTS WERE NOT YET
AT ANYTHING LIKE THAT LEVEL OF CREDIBILITY.

SO BANTING AND MACLEOD, AT THE END OF THE SUMMER OF 1921
HAD A TERRIBLE CONFRONTATION
WITH BANTING FINALLY SAYING TO MACLEOD:
"DR. MACLEOD, WE WILL SEE
"IF THE UNIVERSITY OF TORONTO APPRECIATES
THE IMPORTANCE OF MY RESEARCH."
MACLEOD SAYING, "DR. BANTING, AS FAR AS YOU ARE CONCERNED
IAM THE UNIVERSITY OF TORONTO."
BEST REMEMBERED BANTING COMING OUT OF THE MEETING
FROTHING BEST REMEMBERED BANTING COMING AT THE MOUTHEETINGLLY
SAYING, "I'LL SHOW THE LITTLE SON OF A BITCH
THAT HE ISNOT THE UNIVERSITY OF TORONTO."
: THAT HE ISNOT THE MACLEOD WANTS TO KNOW."good
HOW LONG A DIABETIC DOG CAN SURVIVE ON BANTING'S EXTRACT--
TO SEE IF IT'S EFFECTIVE OVER TIME.

BUT TO CARRY OUT THE NEW EXPERIMENT
BANTING AND BEST WILL NEED FAR MORE OF THE INTERNAL SECRETION
THAN THEY PRESENTLY HAVE.

IN A DESPERATE MOVE, BANTING GRINDS UP PANCREASES
OBTAINED FROM THE LOCAL SLAUGHTERHOUSE
AND TRIES TO ISOLATE THE INTERNAL SECRETION
BY COOLING AND SEPARATING IT WITH ALCOHOL SOLVENTS.

SURPRISINGLY, THIS SIMPLE METHOD GIVES HIM
THE SUPPLY OF EXTRACTS HE NEEDS.

THE EXHAUSTING MONTHS OF TYING OFF PANCREATIC DUCTS
HAVE BEEN TOTALLY UNNECESSARY.

THE RESEARCHERS ARE NOW READY TO BEGIN THE LONGEVITY EXPERIMENT
WITH DIABETIC DOG 27 AND DOG 33.

BOTH ANIMALS ARE GIVEN TWO DAILY INJECTIONS.

11 DAYS LATER, DOG 27 GOES INTO SHOCK AND DIES.

INSTEAD OF PROLONGING THE DOG'S LIFE
THE EXTRACT HAS MYSTERIOUSLY KILLED IT.

BUT DOG 33 IS ALIVE AND WELL
EVEN AFTER 70 DAYS OF INJECTIONS.

THEORIZING THAT DOG 27 WAS KILLED BY IMPURE EXTRACT
MACLEOD SUGGESTS
BRINGING BIOCHEMIST J.B. COLLIP ONTO THE TEAM.

THE EXPERIENCED COLLIP QUICKLY IMPROVES
THE QUALITY OF THE EXTRACT.

HE WRITES IN HIS DIARY:
"WE HAVE OBTAINED FROM THE PANCREAS OF ANIMALS
STERIOUS SOMETHING "WE HAVE OBTAINED FROM THE PANCREAS OF ANIMALS"A MY
"WHICH WHEN INJECTED INTO TOTALLY DIABETIC DOGS
"COMPLETELY REMOVES ALL THE CARDINAL SYMPTOMS
OF THE DISEASE."
"IF THE SUBSTANCE WORKS ON HUMANS
IT WILL BE A GREAT BOON TO MEDICINE."
COLLIP'S "MYSTERIOUS SOMETHING"
IS THE INTERNAL SECRETION OF THE PANCREAS--
A HORMONE THAT THE TEAM NAMES "INSULIN."
ON JANUARY 11, WITHOUT COLLIP'S KNOWLEDGE
BANTING PREPARES HIS OWN VERSION OF THE EXTRACT.

IT WILL BE GIVEN TO A 14-YEAR-OLD DIABETIC BOY
NAMED LEONAR.

BANTING HOPES THE INJECTION WILL LOWER
THE BOY'S HIGH LEVEL OF BLOOD SUGAR.

BUT WHEN IT FAILS TO WORK AND CAUSES A REACTION
THE EXPERIMENT IS HALTED.

Bliss: WHAT A DISCOURAGEMENT.

WHAT A DISCOURAGEMENT.

THE EXTRACT HAD ALWAYS BEEN LOADED WITH TOXIC CONTAMINANTS
AND EVEN ON THE DOGS, THE EFFECT HAD BEEN VERY ERRATIC.

SOMETIMES YOU HAD GOOD STUFF, SOMETIMES IT DIDN'T WORK.

IT WAS JUST SO FULL OF IMPURITIES
THAT IT WAS REALLY
A KIND OF HIT-AND-MISS, SCATTER-GUN APPROACH--
MAYBE HITTING A FEW MORE TIMES THAN MISSING
BUT IN FACT IT MISSED IN THE FIRST CLINICAL TEST.

Osgood: ON JANUARY 23, LEONARD THOMPSON IS GIVEN
A NEW EXTRACT, PREPARED BY COLLIP.

THIS TIME IT WORKS.

THE BOY BECOMES MORE ALERT, LOOKS BETTER
AND SAYS HE FEELS STRONGER.

IT'S THE FIRST SUCCESSFUL USE OF INSULIN ON A HUMAN DIABETIC.

AMAZINGLY, SADLY
THE GREAT BREAKTHROUGH ON LEONARD THOMPSON
WAS FOLLOWED BY THE UTTER BREAKDOWN
OF RELAT OF THE RESEARCH TEAM
AS COLLIP WENT TO BANTING AND BEST IN THE LAB AND SAID
"I'VE DONE IT, I KNOW HOW TO DO IT."
BANTING SAID, "HOW DID YOU DO IT?"
COLLIP SAID, "I'M NOT GOING TO TELL YOU."
WHEREUPON BANTING GRABBED COLLIP AND TRIED TO THROTTLE HIM.

IT WAS CLOSE TO A FIST FIGHT IN THE LAB.

HOW COULD THIS HAPPEN?
HOW COULD RESEARCHERS
ON THE BRINK OF A GREAT DISCOVERY LIKE THIS--
A DISCOVERY THAT REALLY IS OF GLOBAL IMPORTANCE--
HOW COULD THEY TURN INTO WRESTLING CHILDREN?
SOMEBODY HAD TALKED ABOUT PATENTING THE DISCOVERY
AND AS OFTEN IN SCIENCE
TEAMWORK, CO IS ALL VERY GOOD
UNTIL IMMORTALITY, GLORY AND DOLLARS START TO INTRUDE.

Osgood: AFTER THE BREAKTHROUGH WITH LEONARD THOMPSON
COLLIP IS PUT IN CHARGE
OF MAKING THE EXTRACT IN LARGER QUANTITIES.

BUT THIS TIME, HIS NEW METHODS FAIL.

HE GOES BACK TO HIS OLD LABORATORY PROCEDURES
AND THEY DON'T WORK EITHER.

HE HAD BLENDED AND FILTERED, CONCENTRATED AND DILUTED
DISTILLED AND EVAPORATED
NEVER MAKING THE SAME BATCH OF EXTRACT TWICE
AND NOW HE HAS TROUBLE RECALLING WHAT HE HAS DONE.

AS THE FIRST STORE OF INSULIN RUNS OUT
THE TEAM IS BESIEGED BY DYING PATIENTS.

THEY PUT ASIDE THEIR DIFFERENCES AND WORK TOGETHER IN THE LAB.

THREE MONTHS AND COUNTLESS COMBINATIONS LATER
THEY REGAIN THE ABILITY TO MAKE INSULIN
BUT STILL ONLY IN SMALL QUANTITIES.

DESPERATE FOR HELP, THEY FORGE AN ALLIANCE WITH ELI LILLY
A LARGE AMERICAN PHARMACEUTICAL FIRM.

LILLY'S CHEMISTS SOON SOLVE THE PROBLEMS OF MASS PRODUCTION.

FINALLY THERE IS ENOUGH INSULIN FOR EVERYONE.

THE IMPACT ON DIABETICS IS IMMEDIATE AND EXTRAORDINARY.

ONE DOCTOR, STUNNED BY THE RESURRECTION OF HIS PATIENTS
EVOKES THE BIBLICAL STORY OF EZEKIEL:
"I WILL BRING FLESH UPON YOU, PUT BREATH IN YOU
AND YOU SHALL LIVE."
HE CALLS IT "BANTING'S CHAPTER OF THE BIBLE."
THE FIRST CHILD BANTING BRINGS BACK FROM A DEADLY COMA
IS ELSIE NEEDHAM.

FOUR MONTHS LATER, SHE SEEMS LIKE A HEALTHY, NORMAL GIRL
WITH YEARS OF LIFE AHEAD OF HER.

YET OF ALL BANTING'S GRATEFUL PATIENTS
HIS MOST MEMORABLE IS ELIZABETH HUGHES
WHO HAD BARELY CLUNG TO LIFE.

"YOU'D THINK IT WAS A FAIRY TALE," SHE WRITES HER MOTHER.

"I LOOK ENTIRELY DIFFERENT
"GAINING EVERY HOUR IN STRENGTH AND WEIGHT.

OH, IT IS SIMPLY TOO WONDERFULFOR WORDS!"
IN BOSTON, DR. ELLIOTT JOSLIN
IS ONE OF THE FIRST AMERICAN SPECIALISTS
TO BE SUPPLIED WITH INSULIN.

HE ENDORSES IT
AS ONE OF THE GREATEST DISCOVERIES OF THE CENTURY--
THE BEGINNING OF A NEW EPOCH IN MEDICINE.

BUT EVENTUALLY, HE AND HIS STAFF REALIZE
THAT THE DRUG IS NOT AS MIRACULOUS AS THEY HAD HOPED.

Man: IN THE BEGINNING, AFTER THE DISCOVERY OF INSULIN
ITS USE WAS WIDELY MISUNDERSTOOD.

EVERYONE THOUGHT THIS WAS A CURE, AND WHY NOT?
OF COURSE WHAT WAS NOT KNOWN WAS THAT PEOPLE WERE ALIVE,
BUT NOT NECESSARILY CURED.

IT WAS NOT UNTIL... OH, THE 1940s
THERE WAS A GREAT AGE OF DISILLUSIONMENT
BECAUSE THEY THEN DISCOVERED THAT ALTHOUGH THE PEOPLE LIVED
AND LIVED REALLY NORMAL LIVES
THEY WERE DEVELOPING EYE COMPLICATIONS
KIDNEY COMPLICATIONS, NERVE COMPLICATIONS.

SIMPLY TO GIVE INSULIN WAS NOT GOOD ENOUGH.

IT HAD TO BE PRECISELY THE RIGHT AMOUNT
SUCH AS YOUR BODY DOES IN NORMAL CIRCUMSTANCES.

Osgood: JOSLIN IS AMONG THE FIRST TO REALIZE
THAT INSULIN HAS TRANSFORMED DIABETES
FROM A FATAL DISEASE TO A CHRONIC ONE.

HE WARNS THAT THE ERA OF COMA AND DEATH HAS GIVEN WAY
TO THE ERA OF COMPLICATIONS.

HE TEACHES HIS PATIENTS
THAT THE DISEASE CAN ONLY BE HELD AT BAY
BY STRICT DIET, CONSTANT TESTING
AND A RIGID SCHEDULE OF INJECTIONS.

BUT THERE'S NO MISTAKING THE ELATION
THAT ALTHOUGH DIABETES CANNOT BE CURED
IT CAN AT LEAST BE TAM.

Brieger: THE EFFECT OF INSULIN WAS TO SHOW IN A VERY DRAMATIC WAY
THAT DOCTORS REALLY COULD BE EFFECTIVE
THAT THEY COULD TREAT A DREADFUL DISEASE
IN A RELATIVELY SIMPLE AND INEXPENSIVE WAY
AND THAT SCIENCE NOW REALLY MADE A DIFFERENCE.

AND THIS GAVE NOT JUST DOCTORS MORE CONFIDENCE
IN WHAT THEY WERE DOING
BUT IT GAVE PATIENTS A GREATER CONFIDENCE
IN WHAT MEDICINE COULD DO FOR THEM
AND IT IMMEASURABLY BOOSTED THE IMAGE OF MEDICINE
IN THE EYES OF THE PUBLIC.

BY NOW, WHEN A DOCTOR COMES TO YOUR HOUSE--
YES, THERE ARE SUCH THINGS AS HOUSE CALLS--
HE COMES WITH A FEW REAL REMEDIES IN HIS LEATHER CASE.

BESIDES INSULIN FOR DIABETICS
HE HAS ASPIRIN FOR ACHES, PAINS AND FEVER...

DIGITALIS FOR A BAD HEART...

AND FOR INFECTIOUS DISEASE
HE AT LEAST HAS A VACCINE THAT CAN PREVENT SMALLX.

NOW, A VACCINE DOES NOT CURE YOU OF ANYTHING.

IT ACTUALLY GIVES YOU A WEAKENED DOSE OF THE DISEASE.

BUT YOUR BODY IS NOW ABLE
TO PROTECT YOU AGAINST THE REAL ILLNESS
SHOULD YOU COME IN CONTACT WITH IT LATER ON.

BUT THE ELUSIVE PRIZE FOR MEDICAL SCIENCE
IS TO FIND SOMETHING THAT CAN CURE PEOPLE
AFTER THEY'VE GOTTEN SICK.

SINCE THE DAYS OF PASTEUR, RESEARCHERS HAVE SEARCHED
FOR SUBSTANCES THAT COULD KILL BACTERIA--
THE GERMS THAT CAUSE INFECTIONS
RANGING FROM PNEUMONIA TO BLOOD POISONING
ALL OF WHICH CAN BE LIFE-THREATENING.

BUT NO ONE HAS FOUND TCINE"
EVEN AFTER DECADES OF TRYING.

Osgood: ONE LABORATORY SCIENTIST
SEARCHING FOR WEAPONS AGAINST BACTERIA
IS BRITISH RESEARCHER ALEXANDER FLEMING.

HE'S JUST BEGINNING HIS CAREER
WHEN THE OUTBREAK OF WAR ALLOWS HIM TO OBSERVE FIRSTHAND
SEVERELY INFECTED WOUNDS.

Man: WHEN THE FIRST WORLD WAR BROKE OUT
ALEXANDER FLEMING, LIKE MANY OTHER PHYSICIANS
FOUND HIMSELF OVER IN NORTHERN EUROPE
TREATING BATTLEFIELD CASUALTIES.

THE FIELDS IN NORTHERN EUROPE, IN BELGIUM, FLANDERS--
THESE WERE RICHLY FERTILIZED FIELDS
AND RICHLY FERTILIZED FIELDS ARE RICH IN MICRO-ORGANISMS
WHICH, WHEN THEY COME IN CONTACT WITH EXPOSED WOUNDS
CAUSE DEADLY INFECTIONS.

IT'S SAID THAT PROBABLY MORE SOLDIERS DIED FROM INFECTION
THAN DIED FROM DIRECT BULLET OR SHELL INJURY.

Osgood: ON THE BATTLEFIELD, FLEMING EXPERIMENTS
WITH VARIOUS ANTISEPTICS
AND EVEN MANAGES TO SAVE SEVERA
AFTER THE WAR, HE RETURNS TO ENGLAND
FOR COMPOUNDS THAT CAN KILL BACTERIA.

Sneader: FLEMING WENT OFF
AT THE END OF JULY EVERY YEAR FOR SUMMER HOLIDAYS
IN THE NORTH OF SCOTLAND, AND JULY 1928 WAS NO EXCEPTION.

HE TIDIED UP HIS LABORATORY BEFORE LEAVING, OF COURSE
AND IN DOING SO, HE TOOK ALL THE PLATES
THAT HE'D BEEN GROWING BACTERIA ON
AND HE STACKED THEM IN A BATH OF ANTISEPTIC.

BUT THERE WASN'T ENOUGH ANTISEPTIC IN THAT BATH
TO COVER ALL THE PLATES.

FORTUNATELY, ONE OR TWO REMAINED UNCOVERED.

Osgood: WHAT HAPPENS NEXT IS THE STUFF OF LEGEND
RECREATED IN A FILM BY FLEMING HIMSELF.

Newsreel announcer: HERE AT ST. MARY'S HOSPITALING TON
THROUGH THIS VERY WINDOW 25 YEARS AGO
A SPECK OF MOLD BLEW IN
AND SETTLED ONTO PROFESSOR FLEMING'S CULTURE PLATE.

Sneader: MANY PEOPLE WILL TELL YOU THAT THE MOLD CAME IN FROM THE STREET
THROUGH THE WINDOW OF FLEMING'S LABORATORY.

FLEMING COULDN'T POSSIBLY HAVE OPENED HIS WINDOW
HE HAD A WHOLE BENCH FLEMING COULDN'T POSSIBLY FULL OF LABORATORY GLASSWARESE
AND PETRI DISHES IN FRONT OF HIM
AND HE COULDN'T HAVE STRETCHED OVER TO OPEN THE WINDOW.

NO TRUTH IN THAT STORY.

THE MOLD ALMOST CERTAINLY CAME FROM THE LABORATORY BELOW HIS
WHERE A RESEARCHER WAS WORKING WITH FUNGI
AND THAT MOLD LANDED ON THE DISH
AT THE TOP OF THE STACK, AND STARTED TO GROW.

Osgood: WEEKS LATER, FLEMING DISCOVERS
WHAT LUCK AND A LITTLE SLOPPINESS CAN PRODUCE.

Newsreel announcer: PROFESSOR FLEMING WAS EXAMINING COLONIES OF BACTERIA
WHEN HE CAME UPON ONE WHICH HAD GONE MOLDY.

ROUND THE MOLD, THE JELLY WAS CLEAR
AS IF THE MOLD WERE PREVENTING THE BACTERIA FROM GROWING.

Sneader: NOW, WHEN FLEMING PICKED UP THIS PLATE AND LOOKED AT IT
HIS FIRST REACTION PROBSAY
"HMM, IT'S CONTAMINATED," AND THROW IT AWAY.

BUT HE THOUGHT TWICE
AND HE REALIZED... HE HAD THE SAGACITY
TO UNDERSTAND WHAT WAS HAPPENING.

Osgood: FLEMING IMMEDIATELY SETS OUT TO CONFIRM HIS SUSPICION
THAT A SUBSTANCE IN THE MOLD HAS KILLED THE BACTERIA.

HE CALLS HIS NEW DISCOVERY "PENICILLIN"
AFTER THE MOLD PENICILLIUM.

HE OBSERVES THAT THE MOLD CAN DESTROY THE CELL WALLS
F THE MOST VIRULENT HE OBSERVES THAT THE MOLD CANSTRAINS OF BACTERIA.LLS O
AND WHEN HE MIXES PENICILLIN WITH HIS OWN BLOOD
HE'S DELIGHTED TO SEE THAT WHILE IT'S LETHA BACTERIA
IT'S QUITE HARMLESS TO HUMAN BLOOD CELLS.

BUT FLEMING HAS DIFFICULTY
EXTRACTING PENICILLIN FROM THE MOLD.

HE MANAGES TO RECOVER JUST ENOUGH
TO TEST ON THE KIND OF SURFACE-WOUND INFECTIONS
HE SAW DURING THE WAR.

IN THE BROTH IN THE LABORATORY DIDN'T PRODUCE ENOUGH PENICILLIN
TO CURE INFECTIONS BY APPLYING IT TOPICALLY.

IT WAS FINE TO KILL OFF BACTERIA GROWING ON A PLATE OF AGAR--
YOU DIDN'T NEED MUCH PENICILLIN TO DO THAT--
BUT TO WORK IN AN OPEN WOUND
NEEDED A FAIRLY HIGH CONCENTRATION OF PENICILLIN.

FLEMING WASN'T EVER ABLE TO ACHIEVE THAT.

SO WHEN HE FOUND THAT HIS PENICILLIN WASN'T WORKING
HE LOST INTEREST IN IT.

Osgood: ON MAY 29, 1929, FLEMING PUBLISHES
THE RESULTS OF HIS WORK
IN THEBRITISH JOURNAL OF EXPERIMENTAL PATHOLOGY.

HE MATTER-OF-FACTLY DESCRIBES A SUBSTANCE
THAT DEMONSTRATES SOME ANTIBACTERIAL PROPERTIES.

PERHAPS THINKING HE WOULD RETURN TO PENICILLIN ONE DAY
HE CAREFULLY PRESERVES THE FICKLE MOLD
AND MOVES ON TO OTHER RESEARCH.

IN 1929, ALEXANDER FLEMING DOESN'T REALIZE WHAT HE'S FOUND.

FOUR YEARS LATER, GERMAN CHEMIST GERHARDT DOMAGK
DISCOVERS A SULFA DRUG
THAT PREVENTS BACTERIA FROM MULTIPLYING
GIVING THE BODY'S OWN DEFENSES A CHANCE TO DESTROY THEM.

(explosion)
WHEN WORLD WAR II BREAKS OUT, SOLDIERS ON BOTH SIDES
ARE GIVEN SULFA POWDER TO CARRY INTO BATTLE.

IF INJURED, THEY'RE TOLD TO SPRINKLE IT
DIRECTLY ON THE WOUND TO THWART THE GROWTH OF BACTERIA.

BUT SULFA PROVES INEFFECTIVE AGAINST A NUMBER OF INFECTIONS
AND SOMETIMES CAUSES SEVERE REACTIONS.

THE MAN WHO WILL TAKE UP THE CHALLENGE IS HOWARD FLOREY
CHAIRMAN OF THE PATHOLOGY DEPARTMENT AT OXFORD UNIVERSITY.

FLOREY HIRES A BIOCHEMIST, ERNST CHAIN
WHO HAS RECENTLY FLED FROM NAZI GERMANY.

THEY BEGIN EXPLORING NATURAL SUBSTANCES
THAT CAN KILL BACTERIA
WHEN THEY CHANCE UPON FLEMING'S TEN-YEAR-OLD ARTICLE ON PENICILLIN.

AMAZINGLY, A SAMPLE OF FLEMING'S MOLD HAS BEEN KEPT ALIVE.

WITHIN MONTHS, THEY EXTRACT ENOUGH OF THE CRUDE DRUG
TO CONDUCT A FEW SMALL EXPERIMENTS.

(air-raid sirens blaring)
Osgood: ON MAY 25, 1940, WHILE BRITAIN PREPARES
FOR ANOTHER NIGHT OF AIR RAIDS
THE OXFORD TEAM ATTEMPTS THE EXPERIMENT FLEMING NEVER TRIED.

THEY INJECT A GROUP OF MICE WITH A FATAL DOSE
OF STREPTOCOCCUS BACTERIA.

AN HOUR LATER, FLF THE GROUP W ITH PENICILLIN.

NORMAN HEATLEY IS LEFT TO WATCH OVER THE PROGRESS OF THE MICE.

THE MICE WHO HADN'T HAD PENICILLIN
STARTED LOOKING VERY SICK AFTER ABOUT SIX OR SEVEN HOURS
STARTED LOOKING VERY SICK AFTER ABOUT SIX OR SEVEN HOURS 16 AND A HALF HOURS
THE CONTROL MICE WERE ALL DEAD-- THE ONES THAT HADN'T HAD IT--
BUT THE ONES THATHADHAD PENICILLIN
WERE BEHAVING JUST NORMALLY.

THEY WOULD RUN AROUND FOR A BIT, THEY'D SLEEP FOR A BIT
AND IF YOU CLICKED YOUR FINGERS, THEY'D WAKE UP.

THE RESEARCHERS INVOLVED CERTAINLY HAD A STRONG FEELING
THAT THEY WERE ON THE BRINK OF SOMETHING MAJOR.

THE TEAM ACTUALLY TOOK SOME OF THE SPORES OF THE PENICILLIUM
AND RUBBED IT INTO THEIR CLOTHING
UNDER THE LAPELS OF THEIR JACKET
SO THAT IF BRITAIN WAS INVADED
THEY COULD FLEE PERHAPS TO AMERICA OR SOMEWHERE ELSE
WHERE THEY COULD BEGIN THE RESEARCH ALL OVER AGAIN.

OPLE WORKING WITH THE PENICILLIN AT OXFORD
CERTAINLY HAD TREMENDOUS FAITH IN IT.

Osgood: BUT THE REAL TEST OF THE DRUG'S EFFECTIVENESS
WILL HAVE TO BE MADE ON HUMAN SUBJECTS...

AND THIS WILL REQUIRE 3,000 TIMES THE AMOUNT
OF PENICILLIN GIVEN TO A MOUSE.

DESPERATE FOR HELP, FLOREY TRIES TO PERSUADE
BRITISH PHARMACEUTICAL FIRMS TO TAKE UP THE CHALLENGE...

BUT THE WAR HAS DRAINED THEM OF MANPOWER AND RESOURCES.

AS GERMANY ESCALATES ITS BOMBING RAIDS
FLOREY PUSHES HIS TEAM TO FIND CREATIVE WAYS
TO INCREASE PRODUCTION ON THEIR OWN.

SOON PENICILLIN MOLD IS GROWING
IN CONTAINERS SCROUNGED FROM EVERYWHERE.

FINALLY, THEY HAVE ENOUGH TO TREAT A HUMAN PATIENT.

THEY CHOOSE A 43-YEAR-OLD POLICEMAN
WHO SCRATCHED HIS CHEEK ON A ROSE THORN.

A STAPH INFECTION HAS SPREAD FROM THE TISSUES OF HIS FACE
TO HIS EYES AND LUNGS.

Heatley: NONE OF THE SULFA DRUGS HAD HELPED
AND HE WAS REALLY AT DEATH'S DOOR
AND SO HE WAS GIVEN PENICILLIN
AND WITHIN A COUPLE OF DAYS, THE EFFECT WAS NOTICEABLE
AND HE MADE GREAT PROGRESS FOR FIVE DAYS
AND THEN THE PENICILLIN RAN OUT.

THE URINE OF THE POLICEMAN HAD BEEN COLLECTED
TAKEN BACK TO THE LABORATORY OVER THE PROCEEDING DAYS
AND THEY'D RECOVERED PENICILLIN
WHICH WAS UNCHANGED IN THE URINE
AND PURIFIED IT AS BEST AS THEY COULD IN THOSE DAYS
AND RE-INJECTED IT.

BUT THERE WASN'T ENOUGH, AND HE RELAPSED
ED FOR ABOUT A MONTH, BUT THERE WASN'T ENOUGH, AAND THEN DIED. AND LIV
Osgood: DESPITE THE TRAGEDY, A NEW BATCH OF PENICILLIN
COMPLETELY CURES INFECTIONS IN THE NEXT FIVE PATIENTS...

BUT IT HAS TAKEN 19 RESS WORKING NIGHT AND DAY FOR MONTHS
FLOREY KNOWS THAT IF THE DRUG IS TO SAVE THOUSANDS
HE WILL HAVE TO GET HELP.

HE FINDS IT IN AMERICA
WHERE GOVERNMENT AGENCIES AND PHARMACEUTICAL COMPANIES
FIGURE OUT HOW TO GO FROM TINY QUANTITIES TO MASS PRODUCTION.

ON THE EVE OF D-DAY, 1944
MILLIONS OF UNITS HAVE BEEN PRODUCED AND STOCKPILED.

THE ALLIES NOW HAVE ENOUGH PENICILLIN TO TREAT
ALL THEIR BATTLE CASUALTIES IN THE INVASION OF EUROPE.

THEY CAN TREAT DIFFICULT WOUNDS
THAT ONCE WOULD HAVE LED TO AMPUTATION OR DEATH.

THE MOLD THAT FLEW INTO FLEMING'S LAB
WOULD SAVE THOUSANDS IN THE NEXT FEW MONTHS
AND MILLIONS MORE IN THE YEARS TO COME.

NEVER BEFORE HAS A SINGLE DRUG DONE SO MUCH.

Man: THE IMPACT OF PENICILLIN
IS THAT IT HAS CHANGED
WHO IS LIVING IN THIS WORLD AND WHO ISN'T.

I HAVE OFTEN SAID WHEN I TALK TO A GROUP OF STUDENTS
THAT YOU MAY NOT FEEL THAT ANY SPECIFIC VACCINE OR MEDICINE
HAS ALLOWED YOU TO BE HERE
BUT IF YOU WENT BACK ONLY ONE GENERATION OR TWO GENERATIONS
YOU MIGHT BE SURPRISED
HOW FEW OF YOU WOULD BE IN THIS AUDIENCE.

MYSELF, FOR INSTANCE, IN THE 1940s
I WAS TREATED WITH PENICILLIN FOR SEPTICEMIA
WHERE THE PHYSICIAN SAID
"TWO YEARS AGO, WE COULD NOT HAVE DONE THIS."
SO I FEEL LIKE I OWE MY EXISTENCE TO THIS ONE DRUG.

NOW, MY CHILDREN, UNLESS I TELL THEM
WON'T UNDERSTAND THEY OWE THEIR EXISTENCE
TO THE FACT THAT PENICILLIN WAS AVAILABLE FOR ME IN THE 1940s.

IT'S BEEN A MIRACLE DRUG.

Osgood: PENICILLIN'S WARTIME SUCCESS IS A TRIUMPH FOR ALL OF SCIENCE.

SOON, PUBLIC SUPPORT FOR MEDICAL RESEARCH VASTLY INCREASES
AS EVERYONE WAITS FOR THE NEXT MEDICAL MIRACLE
THAT WILL SURELY COME.

Osgood: BY MID-CENTURY, THE CRIPPLING DISEASE POLIO IS SO FEARED
THAT SOME PARENTS LOCK THEIR CHILDREN AWAY
DURING THE SUMMER MONTHS
WHEN THE RISK OF INFECTION IS GREATEST.

BUT BEFORE LONG, A NEW LIFE-SAVING POLIO VACCINE
JOINS PENICILLIN IN WHAT THE PUBLIC ASSUMES
WILL BE A LONG LINE OF MEDICAL BREAKTHROUGHS.

OUR CONFIDENCE SEEMS TO BE WELL FOUNDED
WHEN POLIO IS VIRTUALLY WIPED OUT IN WESTERN COUNTRIES.

SO CONTINUOUS IS THE STRING OF NEW VACCINES AND ANTIBIOTICS
THAT MANY OBSERVERS PREDICT AN END TO ALL INFECTIOUS DISEASES
IN THE FORESEEABLE FUTURE.

AT THE SAME TIME, THERE IS ALSO THE BELIEF
THAT SURGERY IS ENTERING ITS OWN GOLDEN AGE.

SURGEONS ARE NOW TACKLING PROBLEMS
ONCE THOUGHT IMPOSSIBLE TO SOLVE.

THEIR PRIME TARGET:
AN ORGAN THAT FOR CENTURIES WAS CONSIDERED UNTOUCHABLE--
THE HUMAN HEART.

THE CARNAGE OF WORLD WAR II FORCES SURGEONS TO TRY
RISKY PROCEDURES TO SAVE THE BATTLEFIELD WOUNDED.

ONE OF THE MOST DANGEROUS
INVOLVES SOLDIERS WITH BULLETS AND SHELL FRAGMENTS
LODGED IN THE CHAMBERS OF THEIR HEARTS.

FEW SURGEONS HTO A HEART
OUT OF FEAR IT MIGHT SUDDENLY STOP.

GOING AGAINST CONVENTIONAL WISDOM
A YOUNG ARMY DOCTOR DARES TO TRY.

HE CUTS A SMALL HOLE IN THE WALL OF THE HEART
AND SECURES IT WITH STITCHES.

THEN, BLINDLY BY TOUCH, AS THE HEART STILL BEATS
HE LOCATES AND REMOVES THE METAL FRAGMENTS.

WITHIN DAYS, HIS FIRST GROUP OF SOLDIERS RECOVERS
PROVING THAT THE HUMAN HEART IS NOT TOO FRAGILE FOR SURGERY.

BUOYED BY HARKEN'S SUCCESS
POSTWAR DOCTORS HOPE TO SAVE THOUSANDS OF CHILDREN
BORN WITH DEFECTIVE HEARTS.

BREATHLESS AND BLUE, WITH SWOLLEN FINGERS AND TOES
THEIR HEARTS ARE TOO DAMAGED TO PROPERLY CIRCULATE THEIR BLOOD.

FEW LIVE TO ADULTHOOD.

THEIR PLIGHT ATTRACTS DOCTORS AT THE UNIVERSITY OF MINNESOTA.

AMONG THEM IS SURGEON WALTON LILLEHEI.

Lillehei: THESE CHILDREN WERE DYING
WITH SIMPLE LITTLE HOLES IN THE HEART
THAT ANY SEAMSTRESS COULD SEW UP IN ABOUT 30 SECONDS.

BUT THESE PEOPLE WERE DYING
BECAUSE THESE DEFEC CENTER OF THE HEART.

YOU CANNOT REACH THEM FROM THE OUTSIDE
AND THERE WAS NO WAY OF SEWING
IN A BLOOD-FILLED HEART THAT WAS BEATING
UNTIL YOU EMPTY THE HEART.

Osgood: BUT AN EMPTY HEART CAN NO LONGER PUMP BLOOD TO THE BODY.

WITHOUT BLOOD, ALL THE ORGANS DETERIORATE
AND THE BRAIN SUFFERS IRREVERSIBLE DAMAGE
IN LESS THAN FOUR MINUTES.

IT'S JUST NOT ENOUGH TIME TO OPERATE.

THE OBSTACLE SEEMS INSURMOUNTABLE.

THEN A YOUNG CANADIAN SURGEON NAMED BILL BIGELOW
BEGINS EXPERIMENTING WITH A TECHNIQUE CALLED HYPOTHERMIA.

HE KNOWS THAT THE FIERCE CANADIAN WINTER ACTS
TO SLOW DOWN THE HEARTS OF HIBERNATING ANIMALS
ALLOWING THEM TO SURVIVE MONTHS WITHOUT FOOD.

SO HE TRIES TO GET THE SAME EFFECT BY CHILLING DOGS
AND DISCOVERS THAT HE CAN OPERATE ON THEIR SLOWED HEARTS
FOR MORE THAN FOUR MINUTES.

THIS CONVINCES LILLEHEI AND HIS COLLEAGUES
THAT HYPOTHERMIA MIGHT WORK ON HUMANS AS WELL.

AFTER MONTHS OF PREPARATION
THE MINNESOTA SURGEONS ARE READY TO TRY.

A DYING GIRL IS WRAPPED IN A SPECIAL BLANKET
THAT COOLS HER BODY TEMPERATURE 17 DEGREES BELOW NORMAL.

THE DOCTORS HAVE TEN MINUTES TO EMPTY HER HEART OF BLOOD
LOCATE THE HOLE AND MAKE THE REPAIR.

THEY BEGIN AT 10:10 IN THE MORNING.

Lillehei: WHEN WE HAD CLOSED THE HOLE INSIDE THE HEART
AND THE HEART STARTED BEATING WITH A NORMAL BEAT
AND NORMAL BLOOD PRESSURE, AND I LOOKED UP AT THE CLOCK--
IT WAS ABOUT 10:15 IN THE MORNING--
AND I REMEMBER SAYING, "THIS IS IT, FELLOWS.

THIS IS THE BEGINNING OF OPEN-HEART SURGERY."
Osgood: THE CHILD'S RECOVERY IS COMPLETE
WHEN HER BODY TEMPERATURE IS BROUGHT BACK TO NORMAL
WITH WARM WATER.

LILLEHEI WILL GO ON TO PERFORM
DOZENS OF HYPOTHERMIA OPERATIONS.

BUT THESE ARE EXTREMELY RISKY PROCEDURES
NOT ONLY FOR THE PATIENT, BUT FOR THE SURGEON
WHO HAS NO MARGIN FOR ERROR.

Man: MANY TIMES THE DIAGNOSIS WAS INCORRECT
AND THE SURGEON WOULD BE STANDING THERE
LOOKING AT A VERY COMPLEX CONGENITAL HEART ANOMALY
WITH ONLY TEN MINUTES TO CARRY OUT
SOME KIND OF AN OPERATIVE MANEUVER.

AND IF YOU WENT COLDER WITH THE BODY TO GET MORE TIME
TO PROTECT THE BRAIN, YOU COULD NOT RESTART THE HEART.

WELL, YOU CAN IMAGINE THE DIFFICULTY
AND OF COURSE IT WAS VERY STRESSFUL.

Osgood: IN AN ATTEMPT TO GAIN MORE TIME TO OPERATE
LILLEHEI TRIES AN EVEN MORE AUDACIOUS PROCEDURE
CALLED CROSS-CIRCULATION.

HE CONNECTS THE BLOOD VESSELS OF A DYING CHILD
WITH THOSE OF HIS PARENT.

WHILE THE FATHER'S HEART PUMPS THE CHILD'S BLOOD
LILLEHEI HAS ALL THE TIME HE NEEDS.

BUT THIS IS
A DESPERATE OPERATION FEW SURGEONS DARE TO TRY
BECAUSE OF THE RISK IT POSES TO THE HEALTHY PARENT.

FOR HEART SURGERY TO GO FORWARD, THERE HAD TO BE A BETTER WAY.

(heart beating)
THE HUMAN HEART SOUNDS LIKE THIS.

(heart beating)
WHEN THAT SOUND STOPS, LIFE STOPS.

THE INEXORABLE RULE.

TODAY, EVEN THAT RULE HAS AN EXCEPTION.

MEDICAL SCIENTISTS CAN, IF THEY MUST, STOP A HEART TO REPAIR IT.

BUT THEY MUST HAVE A SUBSTITUTE HEART TO DO ITS WORK
AND THIS THEY NOW HAVE.

IT'S A MACHINE.

Osgood: THIS IS THE BREAKTHROUGH LILLEHEI HAS BEEN WAITING FOR--
THE HEART-LUNG MACHINE
WHICH CAN CIRCULATE AND OXYGENATE A PATIENT'S BLOOD
WHILE THE SURGEON OPERATES.

INVENTED BY SURGEON JOHN GIBBON, IT HAS TAKEN DECADES TO PERFECT.

BY 1956, LILLEHEI IS SO CONFIDENT OF ITS EFFECTIVENESS
HE DARES TO REPAIR THE HEART OF A CHILD
ON.

Surgeon: ALL RIGHT, PUMP ON.

Newscaster: THE MECHANICAL HEART-LUNG TAKES OVER.

DEBBIE'S HEART IS OPENED.

Osgood: THE HOLE IN HER HEART IS TOO LARGE TO SEW UP
SO LILLEHEI REPAIRS IT WITH A SPECIAL PLASTIC PATCH.

THIS OPERATION, ONCE REGARDED AS UNIMAGINABLE
WILL SOON BE ROUTINE.

Newscaster: ANOTHER CHAPTER, ANOTHER JOURNEY.

IN HUMAN TERMS
IT COULD BE MEASURED IN THE SKILL OF MEDICAL SCIENTISTS
WHO TAKE IN THEIR HANDS THE HEART AND THE LIFE OF A CHILD.

BUT THE POINT OF OUR STORY SEEMS CLEAR.

THE AGE OF SCIENTIFIC DISCOVERY IS JUST BEGINNING.

A TIME LIKE OURS THERE HAS NEVER BEEN.

Osgood: HEART-LUNG MACHINES FREE THE SURGEON
TO TRY ALMOST ANYTHING.

IF A VALVE IS DAMAGED BEYOND REPAIR
AN ARTIFICIAL ONE CAN BE PUT IN.

IF ARTERIES ARE BLOCKED, THEY CAN BE BYPASSED OR REPLACED
THUS DIMINISHING THE MAJOR CAUSE OF HEART ATTACKS.

Woman: THERE WAS A WHOLE NEW FEELING
THAT WE COULD REALLY DO VERY EFFECTIVE THINGS ABOUT ILLNESS
AND THE ABILITY TO OPEN UP A PATIENT'S CHEST AND GO IN
AND OPERATE ON HIS OR HER HEART, FOR EXAMPLE.

THAT WAS MIRACULOUS TO SEE.

I MEAN, PEOPLE WHO HAD BEEN PROFOUNDLY INVALIDED
BY THEIR CARDIAC CONDITIONS FOR YEARS--
YOU CAN'T SAY THEY JUST SORT OF WALKED
OFF THE OPERATING TABLE, BUT IT WAS CLOSE TO THAT.

Osgood: AFTER CONQUERING THE HEART
SURGEONS TACKLE ANOTHER MAJOR BARRIER--
THE TRANSPLANTATION OF HUMAN ORGANS.

IN BOSTON, DOCTORS AT THE PETER BENT BRIGHAM HOSPITAL
TAKE THE FIRST TENTATIVE STEPS.

THE HOSPITAL IS ALREADY A PIONEER
IN THE USE OF DIALYSIS MACHINES
THAT CLEANSE THE BLOOD OF PATIENTS WITH KIDNEY DISEASE.

BUT FOR THOSE WHOSE KIDNEYS HAVE PERMANENTLY FAILED
DIALYSIS IS THE LAST STAGE BEFORE DEATH.

IN A FINAL ATTEMPT TO SAVE THESE PATIENTS
THE BRIGHAM DOCTORS TRY TRANSPLANTING KIDNEYS
TAKEN FROM CADAVERS.

ALTHOUGH THE NEW KIDNEYS FUNCTION PERFECTLY
THE PATIENTS SOON DIE.

DR. FRANCIS MOORE WAS THE BRIGHAM'S CHIEF OF SURGERY.

Moore: EARLY IN THIS CENTURY
DR. ALEXIS CARREL DID DO SOME KIDNEY TRANSPLANTATIONS IN CATS
BUT NONE OF THEM LIVED
AND HE DIDN'T REALLY REALIZE WHY THEY DIDN'T LIVE
BUT THEY DIDN'T LIVE BECAUSE OF WHAT WE N
THEY WERE GIVEN SOMETHING NEW, AND THEY SAID
"NO, THAT DOESN'T BELONG TO US; WE'RE GOING TO THROW IT OFF."
Osgood: TRANSPLANTS OF SKIN HAD BEEN TRIED DURING WORLD WAR II
BUT ONLY SKIN FROM THE VICTIM'S OWN BODY WOULD TAKE.

WHEN FOREIGN SKIN WAS TRANSPLANTED
THE BODY'S IMMUNE SYSTEM DESTROYED IT
AS IF IT WERE AN INFECTIOUS INVADER.

THE BRIGHAM TEAM TRIES TO OUTWIT THE IMMUNE SYSTEM
WITH A NUMBER OF TECHNIQUES.

THEY EVEN WRAP THE TRANSPLANTED KIDNEY WITH A PLASTIC BAG.

BUT NOTHING WORKS.

THE BODY WILL NOT ACCEPT THE ONE THING THAT CAN SAVE IT.

THEN IN 1954, RICHARD HERRICK COMES TO THE BRIGHAM
DYING OF KIDNEY FAILURE.

HE'S ACCOMPANIED BY HIS IDENTICAL TWIN, RONALD
WHOSE KIDNEYS ARE A GENETIC MATCH TO HIS BROTHER'S.

THE HOPE IS THAT ONE OF RONALD'S KIDNEYS WILL BE ACCEPTED
BY RICHARD'S IMMUNE SYSTEM.

BUT SURGEON JOSEPH MURRAY KNOWS
THAT EVEN THE IDEA OF REMOVING AN ORGAN FROM A WILLING DONOR
IS HIGHLY CONTROVERSIAL.

WE HAD TO PLAN A MAJOR SURGICAL OPERATION
TO REMOVE ONE KIDNEY
NOT FOR HIS GOOD BUT FOR SOMEBODY ELSE'S.

NOW, THE GOOD LORD HAS GIVEN US TWO KIDNEYS
AND WE KNEW THAT WE COULD LIVE ON ONE KIDNEY.

BUT IT SO BASICALLY AND PROFOUNDLY VIOLATES
WHAT PHYSICIANS ARE TRAINED TO DO-- DO NO HARM.

IN THIS CASE, YOU HARM A HEALTHY PERSON
AND TURN THAT PERSON INTO A PATIENT
BECAUSE YOU HAVE SUBMITTED HIM OR HER
TO A MAJOR SURGICAL PROCEDURE.

Murray: ONE OF MY CLOSEST SENIOR SURGEONS SAID
"JOE, DON'T GET INVOLVED IN THIS-- IT'LL RUIN YOUR CAREER."
BUT WE HAD PATIENTS WHO WERE DYING.

THEY WERE MOSTLY YOUNG
AND IF WE DIDN'T DO IT, WHO WAS GOING TO DO IT?
AND IT WAS THE PLIGHT OF THE PATIENTS, I THINK
THAT REALLY KEPT US GOING.

Osgood: BER 23, 1954
MURRAY GIVES ONE OF RONALD'S HEALTHY KIDNEYS TO HIS BROTHER.

IT'S THE FIRST KIDNEY TRANSPLANT EVER PERFORMED
USING A LIVING DONOR.

RICHARD'S NEW KIDNEY WORKS PERFECTLY
PROVING THAT TRANSPLANTATION IS POSSIBLE FOR IDENTICAL TWINS.

AS NEWS OF THE OPERATION SPREADS
TWINS IN SIMILAR CIRCUMSTANCES RUSH TO THE BRIGHAM.

BUT THEY REPRESENT ONLY A TINY FRACTION
OF PATIENTS WITH KIDNEY FAILURE.

FOR THE REST, THERE IS STILL NO HOPE.

AND WE ENTERED A VERY UNHAPPY PERIOD
THAT I'VE CALLED THE "BLACK PERIOD"
WHEN PATIENTS WERE SENT TO US FROM ALL OVER THE WORLD
WHO NEEDED A KIDNEY BUT WHO'D HAD NO IDENTICAL TWIN.

AND FOR A WHILE WE MOSTLY SENT THEM BACK HOME AGAIN.

OTHERS, WE TRIED RADIATION--
WE GAVE THEM WHOLE-BODY IRRADIATION.

Osgood: RADIATION TEMPORARILY DESTROYS A PATIENT'S IMMUNE CELLS
SO THEY CAN'T ATTACK THE TRANSPLANTED ORGAN.

BUT ALMOST ALL THE PATIENTS DIE FROM RADIATION POISONING
OR FROM INFECTIONS THE BODY IS NOW POWERLESS TO STOP.

Moore: WE WERE ON WHAT I CALLED THE "KNIFE-EDGE OF SURVIVAL"--
TIP ONE WAY, THE KIDNEY WOULD REJECT
TIP ANOTHER WARADIATION.

WAS PROBABLY GOING TO TURN OUT TO BE A DRUG
A CHEMICAL COMPOUND--
IT MIGHT BE A VERY SIMPLE CHEMICAL COMPOUND--
THAT WOULD ALTER THE PATIENT'S IMMUNOLOGY
SO THAT THE PATIENT WOULD BE, YOU MIGHT SAY
FOOLED INTO THINKING THAT THE KIDNEY BELONGED THERE.

Osgood: IN 1959, A REPORT BRINGS SOME HOPE.

IT DESCRIBES A FAMILY OF ANTICANCER DRUGS
THAT UNEXPECTEDLY SUPPRESS THE IMMUNE SYSTEM.

AT THE BRIGHAM
DOCTORS WONDER IF THE DRUGS WILL PREVENT REJECTION
AND BEGIN EXPERIMENTS ON ANIMALS RECOVERING FROM TRANSPLANTS.

WHEN THE DOGS REMAIN ALIVE AFTER A YEAR
THE TEAM FEELS READY TO TEST THE DRUGS ON HUMANS.

WHEN PEOPLE START SURVIVING AS WELL
PATIENTS DYING OF KIDNEY FAILURE
BESIEGE THE BRIGHAM AND OTHER HOSPITALS.

WITH THE STAMPEDE THAT STARTED
ESSENTIALLY AT THE END OR DURING THE SUMMER OF 1963
NOBODY WAS PREPARED FOR WHAT HAD TRANSPIRED.

IT WAS LIKE THE BERLIN WALL GOING DOWN.

CREATED A TIDAL WAVE OF ENT
Osgood: WITH THE NEW DRUGS IN HAND
SURGEONS BEGIN WORKING WITH OTHER ORGANS.

TOM STARZL TRANSPLANTS THE LIVER.

JAMES HARDY TRIES A LUNG.

AND THE WORLD WAITS TO SEE
Announcer: THE WORLD'S FIRST HEART TRANSPLANT HAS BEEN PERFORMED.

MEDICAL HISTORY WAS MADE IN SOUTH AFRICA.

NEWSPAPERS EVERYWHERE CARRY BANNER HEADLINES
FOR THE DRAMATIC BREAKTHROUGH.

Osgood: ON DECEMBER 3, 1967
CHRISTIAN BARNARD, A SOUTH AFRICAN SURGEON
REMOVES A HEART FROM AN ACCIDENT VICTIM
AND PLACES IT INTO THE CHEST OF A DYING MAN.

HE SURVIVES ONLY 18 DAYS...

HIS SPECTACULAR RECOVERY SPURS TRANSPLANTATION TO NEW HEIGHTS.

BY THE END OF 1971
THERE HAVE BEEN 170 HEART TRANSPLANTS IN 17 COUNTRIES...

BUT ONLY 23 PATIENTS ARE STILL ALIVE.

THE AVERAGE SURVIVAL RATE IS JUST 29 DAYS.

EVEN BARNARD'S FIRST TRIUMPH, PHILIP BLAIBERG, IS DEAD.

REJECTION STILL REMAINS THE CENTRAL PROBLEM WITH TRANSPLANTS
DESPITE THE NEW DRUGS.

Starzl: WELL, IN THE 1970s
I THINK THERE WAS A BIG LYING CONTEST THAT WAS GOING ON
PARTICULARLY IN KIDNEY TRANSPLANTATION
WHERE THE RESULTS WITH CADAVER KIDNEY TRANSPLANTATION
WERE REALLY TERRIBLE.

THE NATIONAL AVERAGE SURVIVAL OF KIDNEYS AT ONE YEAR WAS 45%.

THAT MEANS 55 OUT OF EVERY 100 CADAVER KIDNEYS
THAT WERE TRANSPLANTED WERE LOST WITHIN THE FIRST YEAR
AND ALMOST HALF WITHIN THE FIRST SIX MONTHS
AND YET MANY CENTERS WERE CLAIMING HIGH RATES OF SUCCESS.

PERSONALLY, I THOUGHT AT THAT TIME
THAT KIDNEY TRANSPLANTATION WAS MORE LIKE A DISEASE THAN A CURE.

Osgood: THE ONLY TRANSPLANTS THAT SEEM SUCCESSFUL
ARE THOSE THAT USE KIDNEYS FROM LIVING RELATIVES
WHO ARE GENETICALLY SIMILAR.

BUT MANY SURVIVING PATIENTS SUFFER PAINFUL SIDE EFFECTS
AND COUNTLESS INFECTIONS
FROM TAKING IMMUNOSUPPRESSANT DRUGS.

Starzl: BECAUSE THE MARGIN
BETWEEN EFFECTIVE THERAPY AND FATAL COMPLICATIONS
WAS SO NARROW-- RIGHT IN THAT ZONE BETWEEN THE TWO
WERE FOUND A NUMBER OF NEW DISEASES.

AND HERE YOU HAVE EXOTIC NEW INFECTIONS WITH NEW VIRUSES
NEVER PREVIOUSLY SEEN IN HUMANS.

NEW BLOOD DISORDERS, NEW KINDS OF PNEUMONIAS.

IT JUST WAS A PRIMROSE PATH OF SORROW.

Osgood: BUT TRANSPLANT PATIENTS AROUND THE WORLD
ARE ABOUT TO GET A SECOND CHANCE AT LIFE.

FROM A FEW OUNCES OF SOIL
GATHERED IN NORWAY'S REMOTE TUNDRA
COMES A FUNGUS CONTAINING CYCLOSPORIN.

THE NEW COMPOUND WOULD BE VASTLY MORE SUCCESSFUL
AT PREVENTING THE REJECTION OF TRANSPLANTED ORGANS.

Shumway: WELL, THIS IGNITED AN ENTIRE NEW ERA.

PROGRAMS THAT HAD ABANDONED TRANSPLANTS
WERE SPRINGING UP AGAIN
AND EVERYBODY WAS GETTING GOOD RESULTS.

AND IT DID SOMETHING
THAT I HAD ALMOST BEGUN TO DESPAIR WOULD NEVER BE POSSIBLE.

AND IT, OF COURSE... IF IT WASN'T POSSIBLE
EVERYTHING THAT HAD BEEN INVESTED--
THE LIVES OF PATIENTS
AND THE LIVES OF HEALTH CARE PERSONNEL--
WOULD HAVE BEEN IN VAIN.

Osgood: WITH CYCLOSPORIN
LIVER TRANSPLANTS, NEARLY ABANDONED, ARE NOW ROUTINE.

SURGEON NANCY ASCHER HAS SEEN THE FIVE-YEAR SURVIVAL RATE
CLIMB FROM 30% TO OVER 75%.

BUT SUCCESS HAS BROUGHT NEW DILEMMAS.

Ascher: FROM A TECHNICAL AND FROM A MEDICAL STANDPOINT
WE HAVE REACHED TREMENDOUS PINNACLES
IN THE FIELD OF SOLID-ORGAN TRANSPLANT.

THE PROBLEMS IN SOLID-ORGAN TRANSPLANT
ARE NOT THE MEDICAL AND TECHNICAL ONES ANYMORE.

THE PROBLEMS TODAY ARE THAT WE DON'T HAVE ENOUGH ORGANS
FOR THE PEOPLE WHO COULD BENEFIT FROM TRANSPLANTATION.

WHO'S GOING TO PAY FOR ALL THESE EXPENSIVE TRANSPLANTS?
WHAT HAPPENS ONCE THE PATIENTS GET THEIR TRANSPLANTS?
ARE THEY NORMAL?
CAN THEY GET INSURANCE?
CAN THEY GET JOBS?
THESE ARE THE PROBLEMS NOW.

Osgood: WE ONCE THOUGHT IF WE COULD BEAT REJECTION
PLANTATION Osgood: WE ONCE THOUGHT IF WEWOULD BE LIFTED.CTIONANS
BUT THERE ARE TOO FEW ORGANS
TO SAVE ALL THE PEOPLE WHO NEED THEM.

SOME PATIENTS STILL SUFFER SEVERE COMPLICATIONS
AND OTHERS JUST DON'T MAKE IT.

BUT MANY PEOPLE WHO ONCE FACED DEATH
ARE LIVING REASONABLY FULL LIVES NOW
GRATEFUL FOR THE GIFT OF TRANSPLANTATION.

AS SURGEONS PERFORMED EVER MORE MIRACULOUS FEATS
OTHER SCIENTISTS WERE ASKING NEW QUESTIONS
ABOUT THE NATURE OF HUMAN ILLNESS
SEARCHING FOR REASONS WHY OUR BODIES FAIL IN THE FIRST PLACE.

IT'S A QUEST THAT LEADS MEDICAL SCIENCE
TO THE VERY CORE OF OUR BEING.

BY 1953, JAMES WATSON AND FRCIS CRICK
HAD ALREADY UNRAVELED THE STRUCTURE OF DNA--
THE MOLECULE THAT MAKES UP OUR CHROMOSOMES AND GENES.

MANY SCIENTISTS SAW GENES AS A CRITICAL PIECE OF THE PUZZLE
THAT EXPLAINS HOW OUR BODIES FUNCTION
WHAT WE INHERIT FROM OUR PARENTS
WHAT MAKES US INDIVIDUALS
AND PERHAPS WHAT MAKES SOME OF US TERRIBLY SICK.

WHEN MEDICAL RESEARCHERS TURN THEIR ATTENTION TOWARD DISEASES
THAT MYSTERIOUSLY SPRING UP WITHIN US, LIKE CANCER--
WHICH IS RAVAGING MORE AND MORE PEOPLE EACH YEAR--
SOME SUSPECT THAT GENES ARE INVOLVED
BUT NO ONE KNOWS HOW.

WHAT THEY DO KNOW IS THAT THE WORD "CANCER"--
NOT "POLIO" OR "TUBERCULOSIS"--
IS NOW STRIKING THE GREATEST FEAR IN OUR HEARTS.

Doctor: YOU SEE THAT AREA THERE?
THAT'S THE TUMOR THERE.

Man: THAT RED SECTION?
THIS VENTS HERE...

Osgood: THROUGHOUT THE 20th CENTURY
THE NUMBER OF CANCER CASES HAS GROWN STEADILY AND ALARMINGLY.

BUT ONE OF THE MOST BAFFLING TRENDS
IS THE RISE IN LUNG CANCER.

SOME EXPERTS THEORIZE
THAT POLLUTION FROM INDUSTRY OR AUTOMOBILES
MAY HAVE SOMETHING TO DO WITH THE INCREASE.

BUT THERE IS NO PROOF FOR THIS OR ANY OTHER THEORY.

IN 1948, TWO BRITISH RESEARCHERS--
BRADFORD HILL AND RICHARD DOLL--
BEGIN THEIR OWN SEARCH FOR THE CAUSES OF LUNG CANCER.

Man: I PERSONALLY THOUGHT WHEN WE STARTED THIS STUDY
THAT IT WAS PROBABLY SOMETHING TO DO WITH MOTORCARS.

THAT IT WAS PROBABLY SOMETHING TO DO WITH MOTORCARS.INK TH EY WERE...

MOST OBVIOUSLY HAD INCREASED ENORMOUSLY.

ROADS HAD BEEN TARRED
AND WE KNEW THAT FUMES FROM TAR COULD BE CARCINOGENIC
AND IF I'D HAD TO BET
I WOULD HAVE BET IT WAS SOMETHING TO DO
WITH THE TARRING OF ROADS AND WITH MOTORCARS.

Osgood: HILL AND DOLL SURVEY HOSPITAL PATIENTS
WITH AND WITHOUT LUNG CANCER.

THEY ASK WHERE THEY LIVE AND WORK...

WHAT KIND OF JOB THEY HAVE...

THE FOODS THEY EAT AND HOW MUCH THEY DRIVE...

AND IF THEY'VE EVER SMOKED CIGARETTES.

Doll: WHEN WE STARTED LOOKING AT THE RESULTS
IT VERY RAPIDLY BECAME CLEAR
THAT THERE WAS A CRUCIAL DIFFERENCE
BETWEEN PATIENTS WITH LUNG CANCER AND OTHER PATIENTS
AND THAT WAS NOT ONLY DID PEOPLE WITH THE DISEASE
SMOKE CIGARETTES MORE OFTEN, BUT THEY SMOKED MORE HEAVILY
THEY'D BEGUN SMOKING EARLIER IN LIFE
THEY HAD LESS OFTEN GIVEN UP SMOKING.

AND THEN WHEN WE LOOKED AROUND THE WORLD, WE FOUND COUNTRIES
WHERE CIGARETTE SMOKING HAD BEEN COMMON FOR SOME YEARS
LUNG CANCER WAS COMMON.

Announcer: TO ANALYZE WHAT CIGARETTE SMOKE CONTAINS
THIS CIGARETTE-SMOKING MACHINE WAS BUILT BY SCIENTISTS
OF THE SLOAN-KETTERING INSTITUTE FOR CANCER RESEARCH.

IT MECHANICALLY PUFFS EACH CIGARETTE IN TURN...

AND TRAPS THE SMOKE IN GLASS TUBES.

THE SMOKE CONTAINS A TAR.

THE TAR IN THE SMOKE CONDENSES AFTER A TIME
ON THE BOTTOM OF THE TUBES.

THE TAR FROM CIGARETTE SMOKE WAS APPLIED REPEATEDLY
TO THE SKIN OF MICE.

THIS SHOWS THAT IT CAN CAUSE CANCER.

Osgood: THE SURGEON GENERAL OF THE UNITED STATES
LUTHER TERRY, HIMSELF A SMOKER
IS FINALLY SWAYED BY THE SCIENTIFIC EVIDENCE.

IN 1964, HE ISSUES A PUBLIC WARNING AGAINST SMOKING.

THERE IS A DEFINITE, SIGNIFICANT HEALTH HAZARD
ASSOCIATED WITH CIGARETTE SMOKING.

CIGARETTE SMOKING IS THE PRINCIPAL CAUSE RESPONSIBLE...

Foege: AS HE WAS DRIVING TO THE STATE DEPARTMENT
FOR THE PRESS CONFERENCE
HE WAS GOING THROUGH HIS NOTES, SMOKING A CIGARETTE.

ONE OF HIS AIDES SAID
"YOU KNOW, THEY'RE GOING TO ASK YOU ABOUT THAT."
HE SAID, "I KNOW."
HE PRESENTED THE PRESS CONFERENCE
AND THEN ASKED FOR QUESTIONS.

SOMEONE ASKED, "DR. TERRY, DO YOU SMOKE?"
HE SAID, "NO, SIR, I DON'T."
"DR. TERRY, HAVE YOU EVER SMOKED?"
"YES, I USED TO."
"DR. TERRY, WHEN DID YOU QUIT?"
HE SAID, "TEN MINUTES AGO."
Osgood: SOON THERE ARE ALARMING NEW FINDINGS:
EXPOSURE TO ASBESTOS, CERTAIN CHEMICALS
EVEN TOO MUCH SUN CAN CAUSE CANCER.

MEANWHILE, DOCTORS TRY RADIATION IN ADDITION TO SURGERY
IN AN EFFORT TO CURE THE DISEASE.

ALTHOUGH PATIENTS NOW SURVIVE LONGER
THEIR MALIGNANCIES SOORETURN.

THE FIRST CANCER TO SHOW ANY PROMISE
OF YIELDING TO MODERN MEDICINE IS CHILDHOOD LEUKEMIA.

THE DISEASE DEVELOPS
WHEN THE BODY'S BLOOD-PRODUCING CENTER, THE BONE MARROW
CREATES AN EXCESSIVE GROUP OF MALIGNANT WHITE BLOOD CELLS--
HERE, THE LARGE PURPLE ONES.

THEY QUICKLY CROWD OUT
AND DESTROY OTHER CELLS IN THE MARROW
INCLUDING PLATELETS, WHICH HELP THE BLOOD TO CLOT
AND NORMAL WHITE BLOOD CELLS, WHICH HELP PREVENT INFECTION.

VICTIMS SUFFER ANEMIA, COUNTLESS INFECTIONS AND BLEED PROFUSELY.

ONCE DIAGNOSED
THESE CHILDREN HAVE ONLY TWO OR THREE MONTHS TO LIVE.

IN 1949, DR. SYDNEY FARBER OF BOSTON'STAL
BEGINS TO EXPERIMENT WITH A RADICAL NEW APPROACH
TO FIGHT THE DISEASE.

BECAUSE LEUKEMIA IS CHARACTERIZED
BY THE OVERPRODUCTION OF WHITE BLOOD CELLS
FARBER LOOKS FOR ANY SUBSTANCE THAT MIGHT IMPAIR THEIR GROWTH.

HE KNOWS THAT SOLDIERS EXPOSED TO MUSTARD GAS
SUFFERED SUCH SEVERE DAMAGE TO THEIR BONE MARROW
THAT IT DESTROYED THEIR WHITE CELLS.

FARBER EXPERIMENTS WITH MUSTARD COMPOUNDS
LEUKEMIA PATIENTSRIMENTS WITH MUSTARD COMPOUNDS
BUT THE CHEMICALS PROVE TOO POISONOUS TO USE.

HE THEN TRIES A LESS TOXIC SUBSTANCE, A FOLIC ACID BLOCKER
THAT ALSO CURTAILS WHITE CELL FORMATION.

Man: AND LO AND BEHOLD
THE LEUKEMIA SHRUNK IN A MAJOR WAY
IN A SIGNIFICANT NUMBER OF THE PATIENTS.

THE NORMAL MARROW CAME BACK.

THAT IS, THEIR ANEMIA WENT AWAY
THEIR WHITE COUNT CAME UP TO NORMAL
THEY COULD RESIST INFECTIONS, THEY DID NOT HAVE BLEEDING.

AND WHEN THE MARROW WAS LOOKED AT AFTER THREE OR FOUR WEEKS
VERY OFTEN THE MARROW WAS FREE OF LEUKEMIA CELLS
AND THEY ENTERED COMPLETE REMISSION
AND THAT WAS THE GOOD NEWS, THAT WAS SPECTACULAR
THAT WAS, IN FACT, A MIRACLE.

THE BAD NEWS WAS
THAT UNFORTUNATELY ALL OF THE PATIENTS RELAPSED.

BECAUSE THE DRUG THEY RECEIVE DOES NOT DESTROY
ALL THE LEUKEMIA CELLS LEFT IN THEIR BODIES.

Frei: MICROSCOPIC DISEASE PERSISTED.

IT'S LIKE A NEEDLE IN A HAYSTACK.

YOU COULDN'T FIND IT BY FEELING, YOU COULDN'T FIND IT BY X-RAY
YOU COULDN'T FIND IT BY LABORATORY TECHNIQUE
BUT IT WAS THERE IN ENOUGH QUANTITY SO THAT IT GREW BACK
IN A MATTER OF MONTHS, MAYBE SOMETIMES AS MUCH AS A YEAR.

WHEN IT GREW BACK, THE CELLS THAT GREW BACK
WERE THE CELLS THAT SURVIVED THE INITIAL TREATMENT
SO LOGICALLY YOU MIGHT EXPECT THEM TO BE RESISTANT
AND THEY WERE.

Osgood: BY THE MID-1950s
EMIL FREI JOINS A TEAM OF CANCER PHYSICIANS
AT THE NATIONAL INSTITUTES OF HEALTH.

THEY WANT TO EXPAND ON FARBER'S WORK
BY EXPERIMENTING WITH ADDITIONAL DRUGS
AND THEY WANT TO LENGTHEN THE COURSE OF TREATMENT.

BUT TESTING BECOMES IMPOSSIBLE
BECAUSE THE CHILDREN DIE TOO SOON
EITHER FROM INFECTIONS OR EXCESSIVE BLEEDING.

Frei: START WITH THE NOSE
THE EYES, THE THROAT, THE BOWEL, THE LUNGS
AND WITH AN INABILITY TO CONTROL THAT BLEEDING.

UH, IF YOU HAD FIVE PATIENTS LIKE THAT
IN A WARD OF 20 PATIENTS
IT WAS CHAOTIC, IT WAS ENORMOUSLY DIFFICULT.

YOU COULD PACK THE NOSE IN FRONT, PACK IT IN BACK
BUT THAT WAS TRAUMATIC
AND OFTEN WHEN THE PACKS WERE REMOVED
THE BLEEDING STARTED AGAIN
AND PSYCHOLOGICALLY THE... THE MOTHERS, THE FATHERS
THE NURSES, EVERYBODY KNEW THAT ONCE THIS BLEEDING STARTED
IT MIGHT BE INTERMITTENT, BUT IT WAS PROBABLY THE END.

Osgood: THE LEUKEMIA TEAM LEARNS HOW TO STOP THE BLEEDING
BY TRANSFUSING PLATELETS FROM FAMILY MEMBERS.

THEY ALSO ADMINISTER REGULAR DOSES OF ANTIBIOTICS
WHICH HALT THE INFECTIONS.

NOW CHILDREN ARE LIVING LONG ENOUGH
TO TEST THE EXPERIMENTAL DRUGS.

USING FARBER'S COMPOUND AND A NEW DRUG SIMULTANEOUSLY
THE TEAM ANXIOUSLY MONITORS THE EFFECT ON THEIR PATIENTS.

IN 90% OF THE CASES, THE DISEASE IS HALTED.

Frei: NOW, THAT'S AN EXTRAORDINARY ACHIEVEMENT
IF YOU THINK OF IT IN TERMS OF THE CONTEXT OF THE TIME.

THESE WERE KIDS WHO CAME IN DESTINED TO DIE OF THEIR DISEASE
AND TO HAVE 90% OF THEM TURN OVER
AND GO INTO COMPLETE REMISSION
HAVE THE DISEASE COMPLETELY DISAPPEAR IN THREE TO FOUR WEEKS
WAS THE THING THAT I THINK PERSUADED ME
THAT WE WERE GOING TO GET SOMEPLACE IN TERMS OF A CURE
BUT IT STILL WAS TRUE
THAT THE VAST MAJORITY OF PATIENTS RELAPSED.

Osgood: DESPITE THESE SETBACKS
THE TEAM HAS MADE A CRITICAL BREAKTHROUGH
IN THEIR UNDERSTANDING.

USING FOUR POWERFUL DRUGS, THEY ADMINISTER ALL OF THEM
SIMULTANEOUSLY OVER SEVERAL MONTHS.

THE REGIMENT IS DIFFICULT TO TOLERATE
AND PATIENTS SUFFER GREATLY
FROM SO MANY TOXIC CHEMICALS IN THEIR BODIES.

BUT BY THE MID-'60s, THOUGH NO ONE KNOWS IT YET
ABOUT 40% OF THESE PIONEERING CHILDREN
WILL SURVIVE LONG ENOUGH TO BE CALLED CURED.

Woman: NOW WE'LL TAPE IT DOWN.

Osgood: OVER THE NEXT DECADE, FURTHER REFINEMENTS
BRING CURE RATES FOR LEUKEMIA AND SEVERAL OTHER CANCERS
0%. BRING CURE RATES FOR LEUKEMIA AND SEVERAL OTHER CANCERSVE 7
AN OPTIMISTIC PRESIDENT NIXON DECLARES WAR ON CANCER
AND MONEY FLOWS INTO CANCER RESEARCH.

BUT BY THE MID-1970s
FRUSTRATION WITH PROGRESS SETS IN.

THE MAIN REASON IS THAT CHEMOTHERAPY
IS NOT WORKING NEARLY AS WELL ON THE DEADLIEST ADULT CANCERS
LIKE THOSE OF THE LUNG AND BREAST.

IN TRUTH, THE TREATMENT HAS ALWAYS BEEN A BLUNT INSTRUMENT
THAT HAPPENS TO KILL SOMECANCER CELLS.

IT DOES NOT TARGET THE STILL MYSTERIOUS PROCESS
THAT CREATES THE DISEASE IN THE FIRST PLACE.

Man: IT BECAME INCREASINGLY APPARENT
THAT IF WE WERE TO CREATE A NEW GENERATION OF ANTICANCER DRUGS
WE'D HAVE TO FIGURE OUT WHAT MAKES CANCER CELLS GROW
OR RATHER, WHAT MAKES THEM GROW ABNORMALLY
AND AT THAT TIME, VIRTUALLY NOTHING WAS KNOWN
ABOUT THE ORIGINS OF HUMAN CANCER--
THE MOTORS THAT DRIVE
THE UNCEASING PROLIFERATION OF CANCER CELLS.

D DISCOVERY
THE REVOLUTION IN THIS FIELD CAME IN 1975, 1976
WHEN HAROLD VARMUS AND J. MICHAEL BISHOP DISCOVERED
THAT WITHIN NORMAL CELLS THERE LAY GENES
WHICH, WHEN THEY BECAME DAMAGED
WOULD NOW BEGIN TO INSTRUCT A CELL TO GROW UNCEASINGLY;
THAT IS TO SAY, TO BECOME A CANCER CELL.

Osgood: WHAT BISHOP AND VARMUS DISCOVERED IS ONE GENE
FROM A SPECIAL GROUP WE ARE ALL BORN WITH
CALLED PROTO-ONCOGENES.

OVER ONE'S LIFE-SPAN
PROTO-ONCOGENES HELP NORMAL CELLS TO REPRODUCE
LIKE THESE IN THE SKIN.

BUT ONCOGENES ARE SUSCEPTIBLE TO DAMAGE--
IN THIS CASE, BY TOO MUCH SUN--
AND WHEN DAMAGED, THEY CAN FORCE CELLS TO MULTIPLY
WHEN THEY SHOULDN'T.

WE NOW HAVE ONE PIECE OF THE PUZZLE.

THEN IN THE MID-1980s
ROBERT WEINBERG AND HIS COLLEAGUES FIND ANOTHER.

Weinberg: BY THE EARLY '80s
WE BEGAN TO REALIZE THERE WAS A SECOND CLASS OF DAMAGED GENES
WHICH PLAYED AN EQUALLY WEIGHTY ROLE IN CAUSING CANCER
AND THESE CAME TO BE CALLED TUMOR SUPPRESSOR GENES.

E TUMOR SUPPRESSOR GEN ES
IN THEIR NORMAL INCARNATION
WAS TO SUPPRESS THE GROWTH OF NORMAL CELLS--
TO HOLD IT DOWN, TO BREAK THEIR PROLIFERATION
AND WHEN THESE TUMOR SUPPRESSOR GENES BECAME DAMAGED
AS WE NOW REALIZE, THEY BECOME DEFECTIVE BREAKS.

THEY NO LONGER STOP THE PROLIFERATION OF CELLS.

Osgood: WE NOW UNDERSTAND THAT THE SEEDS OF CANCE
IN THE ONCOGENES THAT CAN FORCE UNRELENTING GROWTH
AND THE TUMOR SUPPRESSOR GENES
THAT CAN FAIL TO STOP SUCH GROWTH.

AND WE NOW KNOW HOW WE GET THE DISEASE.

WE ALL HAVE AT LEAST THREE GENERAL KINDS OF WAYS
IN WHICH OUR GENES MAY BE RENDERED ABNORMAL.

WE MAY HAVE INHERITED AN ABNORMAL FORM
FROM OUR MOTHER OR FROM OUR FATHER--
THAT'S A HEREDITARY MUTATION.

WE MAY HAVE A MUTATION RESULT DURING OUR LIFETIMES
BECAUSE WE ENCOUNTER ENVIRONMENTAL FACTORS
THAT CHANGE THE STRUCTURE OF OUR DNA
OR WE MAY SIMPLY SUFFER THE RESULTS
OF THE ERROR-PRONE PROCESS
THAT OUR CELLS MUST UNDERGO TO DIVIDE.

EVERY TIME OUR CTHEY COPY VAST AMOUNTS OF DNA
AND THERE IS A CERTAIN INBORN ERROR RATE.

Man: NOW, YOU MIGHT ASK
AFTER FIVE BILLION YEARS OF EVOLUTION
WHY ISN'T THE COPYING MECHANISM PERFECT?
WHY DOES IT ALLOW THIS TERRIBLE MISTAKE TO OCCUR?
AND THE REASON IS KIND OF INTERESTING.

CELLS HAVE TO MAKE MISTAKES WHEN THEY REPLICATE THEIR DNA.

THAT'S WHAT DRIVES EVOLUTION.

IF WE DIDN'T MAKE MISTAKES WHEN WE COPIED OUR DNA
WE WOULDN'T BE HERE.

WE'D BE AMOEBAE OR SOMETHING, HOWEVER WE STARTED
BECAUSE WE COULDN'T HAVE EVOLVED.

SO VIEWED IN THAT CONTEXT
CANCER IS A SIDE EFFECT OF EVOLUTION.

IT'S MISTAKES THAT ARE MADE DURING DNA REPLICATION
THAT, UNFORTUNATELY, WHEN THEY AFFECT THE SMALL SUBSET OF GENES
CAN START A DISEASE.

Osgood: ALTHOUGH WE NOW KNOW HOW CANCER BEGINS
WE HAVE YET TO FIND NEW CURES.

BUT THROUGHOUT THE CENTURY
ONCE SCIENCE HAS TRULY UNDERSTOOD A DISEASE
IT HAS, MORE OFTEN THAN NOT, FOUND WAYS TO OVERCOME IT.

Weinberg: I REMIND US THAT THE ORIGIN OF BACTERIAL INFECTIONS
WAS IN THE 1880s
AND THE APPLICATION OF THIS TO CURING BACTERIAL INFECTIONS
TOOK UNTIL THE 1930s AND THE 1940s.

IT TOOK TWO FULL GENERATIONS.

GIVEN THE DRAMATIC ADVANCES IN BIOMEDICAL RESEARCH
IT'S NOT GOING TO TAKE TWO GENERATIONS
BEFORE WE CAN CONVERT OUR INSIGHTS
INTO THE ORIGIN OF DISEASE
INTO RADICALLY NEW KINDS OF CURES.

THEY'RE ALREADY SLOWLY COMING ON-LINE
AND IN THE FIRST DECADE OF THE NEXT CENTURY
WE'RE GOING TO BE ABLE TO REAP SOME OF THE FRUITS
OF THIS ENORMOUS AMOUNT OF INFORMATION WE GAINED
THE LAST QUARTER OF THIS ENORMOUS AMOUNT OFOF THE 20th CENTURY.ED IN
ALTHOUGH WE'RE STILL WAITING FOR NEW CANCER REMEDIES
MODERN MS ALREADY GIVEN US THE POTENTIAL
FOR A LIFE THAT'S LONGER AND HEALTHIER THAN EVER BEFORE.

AT THE START OF THE CENTURY, WE COULD CURE ALMOST NOTHING.

NOW WE EXPECT TO BE CURED OF ALMOST EVERYTHING.

OF COURSE, THERE ARE STILL AILMENTS WE'RE POWERLESS TO STOP
AND EVERY SO OFTEN, A NEW DISEASE, LIKE AIDS
EMERGES TO CONFOUND US AND TEST ALL OUR SKILLS.

BUT MEDICAL RESEARCHERS HAVE LEARNED TO FIGHT BACK.

THERE ARE MEDICINES NOW THAT SEEM TO BE HOLDING AT BAY
THE SYMPTOMS OF SOME AIDS PATIENTS.

FOR EVERYONE, THE'S BETTER DIAGNOSTIC EQUIPMENT
THAT CAN DETECT DISEASE EARLY ENOUGH TO CURE IT.

AND WE HAVE CHEMOTHERAPY AND SURGERY
AND HIGH-TECH PROCEDURES THAT SAVE COUNTLESS LIVES EVERY DAY.

WHAT WE DON'T SAVE IS MONEY.

MODERN MEDICINE CAN BE EXTREMELY EXPENSIVE.

MES MODERN MEDICINE CAN BE EXTREMELY EXPENSIVE.W BECO
HOW CAN WE DISTRIBUTE MEDICAL TECHNOLOGY
TO EVERYONE THROUGHOUT THE WORLD
NOT JUST THOSE WHO CAN AFFORD IT?
IN A REGIONAL HOSPITAL IN NORTHERN GHANA
PATIENTS DIE OF LIVER FAILURE JUST AS THEY DO IN THE WEST
BUT NO ONE IN THIS HOSPITAL EXPECTS A TRANSPLANT.

THROUGHOUT THE CENTURY
SCIENTIFIC MEDICINE RARELY REACHED PLACES LIKE WEST AFRICA
AND LIFE EXPECTANCY LAGGED FAR BEHIND THE DEVELOPED NATIONS.

BUT MODERN MEDICINE IS BEGINNING TO MAKE AN IMPACT HERE
EVEN IF ITS BENEFITS ARE SOMETIMES HARD TO SEE.

EVERY MORNING, VILLAGERS OF SAVALAGU
MUST TRAVEL A WELL-WORN PATH TO THE LOCAL POND.

THROUGHOUT THIS REGION
PEOPLE ARE STILL PLAGUED BY INFECTIOUS MICROORGANISMS
AND DANGEROUS PARASITES LONG VANQUISHED IN THE WEST.

AND WATER, SO PRECIOUS TO LIFE, CAN HARBOR GERMS
THAT DISABLE AND EVEN KILL WITH DEPRESSING REGULARITY.

THIS POND IS SAVALAGU'S ONLY SOURCE OF DRINKING WATER
THE WORMS CAN GROW SEVERAL FEET INSIDE A PERSON'S BODY
AND CAUSE A PAINFUL SWELLING WHEN THEY ARE ABOUT TO EMERGE.

VICTIMS CAN SUFFER FOR WEEKS AT A TIME
UNLESS THEY GET RELIEF
BY HAVING THE WHITE THREADLIKE WORMS REMOVED
AT THE LOCAL CLINIC.

TODAY, NORTHERANA IS ONE OF THE LAST REMAINING HOMES
OF GUINEA WORM DISEASE.

BUT THE PARASITE IS ON THE VERGE OF EXTINCTION
MAINLY THROUGH THE EFFORTS OF DONALD HOPKINS.

Hopkins: I MEAN, HERE YOU CAN SEE THE WORM
RIGHT UNDER THE SKIN.

Osgood: HOPKINS WAS INSTRUMENTAL IN THE CAMPAIGN
THAT SUCCESSFULLY ERADICATED SMALLPOX IN 1978.

HE REMEMBERS THE BOOST THIS ACHIEVEMENT GAVE
TO PUBLIC HEALTH THE WORLD OVER
AND HE'S DETERMINED TO WIPE OUT GUINEA WORM AS WELL.

Hopkins: IT'S BEEN 20 YEARS SINCE SMALLPOX WAS ERADICATED
AND THAT WAS A TREMENDOUS ACCOMPLISHMENT IN ITSELF.

THAT WAS A VERY TERRIBLE DISEASE.

IT KILLED MILLIONS OF PEOPLE THROUGH THE CENTURIES.

BUT IN ADDITION TO GETTING RID OF SMALLPOX
IT ALSO CHANGED THE WAY THE WORLD THINKS
ABOUT ERADICATION IN GENERAL
BECAUSE IT PROVED FOR THE FIRST TIME
THAT, INDEED, IT IS POSSIBLE
TO KILL ONE OF THESE DISEASES ALTOGETHER
AND REMOVE IT FROM THE HUMAN EXPERIENCE.

Osgood: DISEASES LIKE MALARIA, WHICH ARE SPREAD BY INSECTS
MAY NEVER BE ELIMINATED ENTIRELY.

BUT ILLNESSES THAT RELY ON PEOPLE TO SPREAD INFECTION
ARE MORE SUSCEPTIBLE TO ERADICATION.

(man instructing villagers in local language)
Osgood: HOPKINS HAS TRAVELED THE WORLD OVER
TEACHING VILLAGERS AND HEALTH WORKERS
HOW TO FILTER GUINEA WORM PARASITES FROM THEIR WATER.

HE ALSO WARNS PEOPLE TO STAY AWAY FROM PONDS
WHEN THEY HAVE EMERGING WORMS.

IF THE WORM IN SOMEONE'S BODY IS KEPT FROM THE WATER
IT CANNOT REPRODUCE AND ITS LIFE CYCLE IS BROKEN.

(villagers responding to instructor's questions)
Osgood: HOPKINS PREDICTS THAT BY THE YEAR 2000
THERE WILL BE NO GUINEA WORM PARASITES LEFT ON EARTH.

THE DECLINE OF GUINEA WORM DISEASE IS JUST ONE INDICATION
OF AN EXTRAORDINARY TRANSFORMATION
IN THE HEALTH OF MANY DEVELOPING NATIONS AROUND THE WORLD.

NOT ONLY IS MEDICAL AID REACHING MORE PEOPLE
BUT BETTER NUTRITION AND A DECLINING BIRTH RATE
ARE ALSO STARTING TO MAKE A DIFFERENCE.

Hopkins: MANY OTHER WESTERNERS WHO COME HERE
MIGHT SEE THE PROBLEMS THAT REMAIN AND FOCUS ONLY ON THOSE.

I'M VERY MUCH HEARTENED
BY THE PROGRESS THAT WE'VE SEEN OVER THE LAST TEN YEARS
OVER THE LAST FIVE YEARS
AND A MUCH LONGER PERSPECTIVE THAN THAT.

I'VE SEEN MANY MORE CHILDREN IMMUNIZED NOW, FOR EXAMPLE
THAN WERE BEING IMMUNIZED FIVE YEARS AGO.

WE'RE ON THE VERGE OF ERADICATING POLIO
WITHIN ABOUT FIVE YEARS OF THAT, WE THINK.

WE HAVE MANY MORE COMMUNITIES
HAVING ACCESS TO SAFE DRINKING WATER.

THERE ARE MANY MARKERS OF PROGRESS.

AND CERTAINLY THE PEOPLE LIVING IN THESE COMMUNITIES
SEE THE PROGRESS
WHETHER OTHER PEOPLE FROM THE WEST CAN SEE IT OR NOT.

THEY ARE WELL AWARE OF THE FACT
THAT LIFE, INDEED, IS GETTING BETTER.

Osgood: IT HAS BEEN THE LESS VISIBLE PRODUCTS OF MEDICAL SCIENCE--
THE VACCINES, PRENATAL CARE AND BASIC HEALTH SERVICES--
THAT HAVE MADE THE BIGGEST IMPACT
ON THE LIVES OF PEOPLE HERE
JUST AS THEY DID IN THE WEST EARLIER IN THE CENTURY.

LACKING MOST OF MEDICINE'S MORE EXPENSIVE TECHNOLOGIES
MANY PEOPLE IN DEVELOPING NATIONS
ARE NOW ROUTINELY LIVING TO THEIR 70s--
QUITE A CHANGE FROM JUST A FEW DECADES AGO.

AS PEOPLE EVERYWHERE GROW OLDER
SOCIETIES WILL BE CHALLENGED TO CARE FOR AN AGING POPULATION.

BUT AT THE START OF THE CENTURY, MANY OF US DIED IN INFANCY
AND FEW OF US EVER REACHED OUR 70s.

Foege: MY GRANDMOTHER HAD TEN CHILDREN.

ONLY FIVE OF THEM Foege: MY GRANSURVIVED INFANCY.HILDREN.

FIVE WENT ON TO BECOME ADULTS, ONE BEING MY FATHER.

FIVE WENT ON TO BECOME ADULTS, HE WAS DESTINED TO DIE IN 1953
GIVEN LIFE EXPECTANCY AT THAT TIME.

BUT HE SAW ALL OF THE 1950s
AND THEN HE SAW ALL OF THE 1960s
AND INCREDIBLY HE SAW ALL OF THE 1970s
AND THEN HE SAW ALL OF THE 1980s
AND THE AMAZING THING IS
HE'S NOW SEEN THE MAJORITY OF THE 1990s.

I THINK ONE OF THE MOST REMARKABLE THINGS
OF THIS CENTURY OF SCIENCE
HAS NOT BEEN WHAT HAPPENS IN AN EMERGENCY ROOM
OR IN AN INTENSIVE CARE UNIT OR IN THE LABORATORY.

IT'S THE INFORMATION NOW AVAILABLE TO THE AVERAGE PERSON.

THE AVERAGE PERSON ACTUALLY KNOWS ABOUT TOBACCO
AND KNOWS ABOUT CHOLESTEROL
AND KNOWS ABOUT THE RISKS OF THE SUN
KNOWS ABOUT USING SEAT BELTS.

SO THE INFORMATION GIVEN TO THE AVERAGE PERSON
TO RUN THEIR AVERAGE DAY
CAN ACTUALLY AFFECT WHAT HAPPENS TO THEM IN THE FUTURE.

AND AT THE BEGINNING OF THE CENTURY
WE WERE STRUGGLING JUST TO GET SCIENTIFIC KNOWLEDGE.

AT THE END OF THE CENTURY
WE'RE STRUGGLING TO ACTUALLY RESPOND TO THAT KNOWLEDGE.

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A Science Odyssey: Matters of Life and Death - Documentary

 

VideoID: YT/I_xIxU7TDHE

License: creativeCommon from channel YT:user:documentaryondemand

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Duration: ISO 8601 PT1H48M59S = 6539.0 seconds

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