Let us now praise spin-doctors

It’s bad enough having to fight, in these pages, with Fergus Finlay, but being forced to take on Noel Whelan, as well, is really tough.

Not least because Noel Whelan is twice as big as anybody in the world and a lawyer to boot. Not that I would ever criticize him for being a lawyer. It's a free country.

He, on the other hand, does criticise spin-doctors. On this page, about ten days ago, he mentioned scripted speeches delivered by politicians but written by 'well-heeled spin-doctors.'

That 'well-heeled' crack rankles. He is pointing out that spin-doctors get well paid. Omigod. The filthy image-confectors should at least have the decency to spin their disgusting manipulative webs for free.

Contempt for spin-doctors got an extra nudge from the Hutton report. Alistair Campbell was unashamedly triumphalist about Hutton's findings and used the opportunity to smite lazy journalists, which caused media to unite once again - around the proposition that spin-doctors in general, and Campbell in particular, are the anti-Christ.

Let us now nail the easy media consensus that spin-doctors are an evil irrelevant truth-hating excrescence on the body politic. The very phrase 'spin-doctor' calls to mind leak-peddling publicists who are undoubtedly a regrettable fact of political life. But the notion that raw, unassisted, untrained 'naturalness' is the ideal for politicians or other people in public life, is undiluted horse manure. None of us want to have our hearts transplanted by a 'natural.' None of us want to be flown by a pilot who can't be bothered listening to the control tower or co-pilot.

Absence of communications skills or an expert to develop them can be a matter of life and death. In one non-political case study, it WAS a matter of life and death. Mostly death.

Sherwin Nuland, Professor of Surgery at Yale University, has just published a slim history, The Doctors' Plague, dealing with this case study. His account begins in Vienna in 1847, when a heavily pregnant woman arrives at the city's big hospital to deliver her baby. She is directed to the ward run by the expert surgeons. Her response is terrified protest. No, no, she begs, please can she go to the other ward. The one run by midwives. If she goes to the surgeons' ward, she will die there.

She is dragged, screaming, into the surgeons' ward, where she delivers her baby. And dies. As do most of her fellow-patients. Because, at that time, mothers delivered by surgeons fully trained in anatomy tended to die in huge numbers. Their death, caused by 'childbed' or 'puerperal fever' was characterized by raging septicemia, agonizing pain, ferocious temperatures and delirium.

On the other hand, women who delivered their babies under the care of an illiterate midwife had a much better chance of survival. Division One of the Vienna Hospital, where the surgeons worked, had an horrific death rate. Division Two, where the midwives worked, was reasonably safe.

The same pattern obtained all over Europe. Between 1831 and 1843, only 10 London mothers per 10,000 died of puerperal fever when delivered at home, (by a midwife) compared to 600 per 10,000 in the city's General Lying-in Hospital, where consultants did the job. It was a mystery.

But in the hospital in Vienna was a raw young doctor named Ignac Simmelweis who observed what was going on with a fresh eye. He spotted that the key difference between the two wards was that midwives didn't dissect dead bodies, whereas surgeons did. Having dissected a dead body, they went straight to the maternity ward to examine pregnant women. No rubber gloves, no handwashing intervened. Nobody at the time knew about germs, so Semmelweis, when he figured out that surgeons were carrying killer organisms on their hands, called those organisms 'cadaver particles.'

Semmelweis installed basins of a cleaner chloride of lime together with nail brushes, at the entrance to the killer maternity ward and got surgeons to clean their hands with it before approaching patients. Within weeks, the mortality rate dropped. Brilliant. No need for a communications consultant there, you may say.

Unless you wanted Simmelweis's discovery applied forever more in that particular hospital and introduced all over the world so it could save millions of lives. If you wanted both of those outcomes, then someone needed to grasp Semmelweis warmly by the throat and say "Sunshine, this is not going to catch on unless scholarly papers are published about it in the medical journals. You can't write, you say? You're half-fluent in two languages and incapable of a coherent written sentence? No problem. Sit down there while I get out my quill. Talk, I'll transcribe and write up a paper for you."

That didn't happen. Nothing was written. Nor was Semmelweis interrogated the way he would have been, had he retained a spin-doctor with his interests at heart.

"Ignac, my pet, what about the situation where child-bed fever runs along a line of beds, killing twelve women in a row?" a half-decent communications consultant would have asked. "How do they get it from each other? Is it just cadaver particles or can a doctor pick up something from one woman and transmit it to the next? We don't want the story of corpses as sole source of infection to become popular if the truth is more complicated."

But, in the absence of good communications management, that's precisely what happened. The wrong version of Semmelweis's theory got around. The wrong version was easy to dismiss and dismissing it was a very welcome option for surgeons who did not want to admit that their hands had killed hundreds of their female patients.

If a communications consultant had got to this genius, the histories of gynaecology and of antisepsis would have been very different. (As might be the public perception of the spin-doctor.) Because the communications consultant, in addition to putting Semmelweis's discovery into the written word and getting it widely published, would have had to address the personal communications difficulties of the genius. According to Professor Nuland, Semmelweis's speech "was devoid of smalltalk, superfluous pleasantries, and flowery adjectivesworst of all, his hackles were raised by every challenge to his increasingly self-righteous certainty."

He was, in short, a pain in the ass and a bore to such an extent that, long before he died in a lunatic asylum, his communications failures had utterly subverted his wonderful discovery. Surgeons were coming to their patients with hands awash in bacteria from recently dissected corpses, or transporting germs from one patient to another by failing to handwash in between. Thousands, if not millions of women died, many of them infecting their new babies, when prevention was as easy as a bowl of disinfectant.

For Semmelweis, the truth was so inescapably obvious that anyone who failed to apprehend and live by it was evil. He never understood that failing to communicate your truth means you might as well not have discovered it in the first place.

The old city cemeteries of Europe are filled with the bodies of women and of babies who died because the man who knew how to save them couldn't communicate his discovery in a persuasive way and lived before it was possible to hire someone who could.