Thomas Goetz Interview, plus links to author biography, book summaries, excerpts and reviews

An interview with Thomas Goetz

Thomas Goetz, author of The Remedy: Robert Koch, Arthur Conan Doyle, and the Quest to Cure Tuberculosis discusses Germ Theory, science, and the impact of technology on society.

What is the Germ Theory, and why was it so important?
The Germ Theory is the hypothesis that many diseases are caused by microbes, not by the body itself or by some other cause such as miasma – bad air. The idea that some diseases were pathogenic or contagious had been around for centuries, but it wasn't until Louis Pasteur in the 1860s and then Robert Koch in the 1870s that enough evidence was marshaled to make the argument convincing. In particular, it was Koch, with his Postulates – a series of conditions that must be met to prove a microbial cause of disease – who produced a method by which science could definitively establish the cause of disease.

Pasteur and Koch's work on the Germ Theory constitutes the birth of modern medicine, when science finally began to explore the true causes of disease – and therefore to determine vaccines or treatments for those diseases. Once the germ theory was established in laboratories, at last hygienists and social reformers could finally attack the causes of infectious disease, which were by far the leading cause of death in the 19th and early 20th centuries. This insight into causes pushed hygiene forward. Within a few decades, infectious disease was no longer the looming threat it had been, and people's lives grew longer and healthier.

Why does it take society so long to believe science?
Any scientific discovery takes about a generation to manifest – to work its way from discovery to publication into practice. That was true in the 1870s and it's true in the 2010s. This lag is vexing, especially for scientists, but it's understandable. It simply takes time for consensus to emerge, and for an academic consensus to actually change practice – how science is applied in the field. The fact that society often needs to be convinced of the new truth only adds to the lag. This sounds old fashioned – the germ theory is entirely common sense now, and it seems absurd to think that anyone would doubt the existence of germs. But we have the same slow process today. Think about something seemingly obvious, like vitamins. The 1980s saw a new wave of research into Vitamin D deficiency and various disease risks – but we are still muddling towards some sort of consensus on what people should actually do 30 years later. Same with the science around sugar and nutrition and obesity. It takes science a long time to establish a proof, and it takes society a long time to believe that proof.

Why should we care about infectious disease today?
There are some scientists would believe we're on the precipice of a new era of infectious disease, due to a few convergent trends. One is the fact that we're exhausting our antibiotics and new superbugs are emerging. Second is the idea that many diseases we have considered chronic – such as heart disease or obesity or auto-immune disorders – may actually have significant microbial components. I think one thing to understand is that our understanding of all microbes as 'germs' may be misplaced. There are many microbes that actually help us more than hurt us – and we need to be aware that purging all germs from our environment can have profoundly negative unintended consequences.

What does Sherlock Holmes have to do with tuberculosis?
Sherlock Holmes is a character of his age – he personifies the late 19th century's appetite for all things scientific and for this new notion that science can actually solve human problems. In creating Sherlock Holmes, Arthur Conan Doyle borrowed not only from his med school mentor Joe Bell, but also from the great scientists of the day, particularly Robert Koch's, who diligent laboratory methods Conan Doyle admired and wrote about. When Koch discovered the bacteria that causes tuberculosis, Conan Doyle was inspired by the rigor and tenacity of Koch's methods, and his single-minded focus on rooting out the cause. The fact that Conan Doyle's own wife would die of the disease decades later – and the fact that tuberculosis was part of the ruse at Reichenbach Falls that allowed Holmes to be "killed" – well, that's the consequence of tuberculosis being such a ubiquitous disease, common to everyday experience at the time.

Why did the last quarter of the 19th century create more technologies that the last quarter of the 20th century?
Those 25 years from 1875 to 1900 were abuzz with discovery, with invention after invention transforming everyday life. Everything from toilet paper to paperclips to electronics were invented in those years. In part, this was a result of the previous decades of industrialization, where factory processes were at last turned toward addressing the toils of daily life. A century later, by 1975, so much of modern life had already been optimized and improved upon. That's not to say there weren't transformative discoveries afoot – the personal computer, the cell phone, and so many other pieces of modern technology emerged in those last 25 years, technologies that we'd consider essential today. But I'd argue that the pace and impact of new technologies was much more profound in the 19th century. For many, the landscape of daily life on either end of those 25 years would be unrecognizable, where life in 2000 wasn't all that different from 1975. Even bell bottoms were making a comeback!

Unless otherwise stated, this interview was conducted at the time the book was first published, and is reproduced with permission of the publisher. This interview may not be reproduced or reprinted without permission in writing from the copyright holder.