The Forgotten Polio Epidemic with Hannah Wunsch, MD
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What was the 1950s Copenhagen polio epidemic and why is it important?
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You're listening to the Nocturnous Conversations. I'm Emily Silverman. If you've ever been to an ICU, you've probably seen a ventilator. It's a machine that helps someone breathe through a tube that goes through their mouth and into their trachea or windpipe. These days, ventilators are really advanced. They can operate on closed feedback loops, adjusting the amount of air and frequency of breaths based on what the patient's body needs. Working in the background, these devices are easy to take for granted. But how did ventilators come to be? Or further, how did intensive care units come to be with their hour-by-hour monitoring of patients and their tight nursing ratios? Today's guest, Dr. Hannah Wunsch, whisks us into 1950s Copenhagen so that we can learn about the origins of ventilators and the ICU.
It was a time and place when the city was fighting a devastating polio epidemic, which she explores in her book, The Autumn Ghost. I found this piece of history to be gripping and love how Hannah guides us through the experiences of doctors, nurses, medical students, patients, and families who are navigating this public health crisis and taking big risks with innovation. Hannah is a critical care physician and researcher at Sunnybrook Health Sciences Center. She's a professor of anesthesiology and critical care medicine at the University of Toronto, as well as a Canada research chair. Before we dive in, let's hear Hannah reading an excerpt from her book, The Autumn Ghost.
August nineteen fifty two, Copenhagen. Very Vivi Ebert was just twelve years old. She was going to die, but Near the end of August, Vivi came home from school, saying she had a headache and went to bed. The next day she complained that she couldn't move her arms and legs well. On Tuesday, august twenty sixth, she had a fever, headache, stiff neck, and some paralysis. The telltale signs of polio. Her mother called an ambulance and Vivi was brought to the hospital. She already had weakness in one arm, but much more concerning she also had difficulty breathing. Since early July, the hospital admitted many patients just like Vivi, and almost all of them had died. As her symptoms worsened, the doctors and nurses knew she likely had only a few more hours or days at most to live.
The polio epidemic that year in Copenhagen had begun with a trickle of cases in July. By the end of the summer, the disease was roaring through Drenmark's capital and outlying regions. It was far worse than in previous years, with more cases of paralysis and difficulty breathing than anyone had ever seen. There were daily news bulletins on the radio announcing the latest areas with outbreaks. Ambulances kept pulling up at the hospital hour after hour, day after day. By late August, there were fifty admissions a day, all with severe polio. The doctors and nurses would have focused on one key question. Could the patient take a breath? For someone who was struggling to breathe, there was little that could be done except to try to keep them comfortable.
Henry Kai, Alexander Lassen, the chief of the Bly Dam, the only infectious disease hospital in the city, was a physician and an expert on polio. He had cared for hundreds of patients with the illness, but this strain of the virus seemed to be causing more cases than usual and was viciously deadly. By the time Vivi showed up, he and his team had already lost dozens of patients, many of them infants and children. Vivi was about to be next. The previous decades had been full of major medical advances, antibiotics allowed for treatments of bacterial infections, the discovery of insulin meant that a diagnosis of diabetes was no longer a death sentence, and x rays provided a way to see inside the body.
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Chapters
7 chapters
1
What was the 1950s Copenhagen polio epidemic and why is it important?
0:00–6:43
2
How did the lack of effective polio treatments spark the search for new ventilation methods?
6:43–14:31
3
Who were the key doctors (Lassen, Ibsen, etc.) and what roles did they play in the crisis?
14:31–22:47
4
How did the first iron lung and negative‑pressure ventilation emerge?
22:47–30:42
5
Why did positive‑pressure ventilation become the breakthrough for polio patients?
30:42–38:44
6
How did medical students become the “army of hands” to manually ventilate patients?
38:44–47:36
7
What ethical dilemmas arose from life‑support technology and how did Ibsen confront them?
47:36–53:56