Penicillin Man: Alexander Fleming and the Antibiotic RevolutionBMJ 2004; 330 doi: https://doi.org/10.1136/bmj.330.7481.50-a (Published 30 December 2004) Cite this as: BMJ 2004;330:50
In the preface to his tale of the discovery and development of penicillin, KevinBrown says, “This is the book I never intended to write.” The story is medical legend: Fleming, a modest man from St Mary's, returned from holiday to find some mould growing in one of his discarded staphylococcus culture plates. It made him stop and say, in classic understatement, “That's funny,” as, around the mould, staphylococci had been killed. He experimented and found a culture of the mould prevented staphylococcus growth. He called the active agent penicillin—an innovation that changed forever the treatment of bacterial infections such as pneumonia, syphilis, diphtheria, scarlet fever, and previously fatal wound and childbirth infections. It made Fleming asmuch a household name as Albert Einstein.
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Brown is trust archivist and curator of the Alexander Fleming Museum at St Mary's NHS Trust. Given Brown's connection with St Mary's, where Fleming spent his entire career, you might expectthis biography to be fawning and sycophantic. It isn't. This fascinating life history of the public and intensely private Fleming is written with honesty, intelligence, and just enough gossip—about subjects like his lifelong commitment to freemasonry—to make it as much a beach book as a bench book.
With scientific precision, Brown presents evidence from Fleming's papers and conversations that he has had with many who knew Fleming. In doing so, he debunks many of the myths surrounding one of the greatest medical discoveries.
Fleming, known as Alec to his family, had a rather idyllic childhood on an Ayrshire farm. His “rags to riches” story is so much a part of medical folklore that readers might have heard that young Alec went to school barefoot as his family was so poor. Brown points out that the family was in fact comfortably off. On rainy days, the Fleming children did indeed go to school with their boots and socks around their necks, apparently to keep them dry in wet weather and because their mother, Grace, thought it would make them hardy. In later life, Fleming is said to have attributed his good health to his barefoot excursions. He remained healthy despite years of hard work, chain smoking, and heavy drinking, before dying suddenly, aged 74, from a coronary thrombosis.
Instead of the humdrum, grainy images proffered in so many scientific biographies, there are some wonderful visual treats in Brown's centre pages. Of course there is the obligatory young Fleming at his microscope, but he is accompanied by classy silhouettes of the 1920s inoculation department, a poster exhorting men to build a penicillin factory to aid the war effort, a snapshot of so-called “penicillin girls” employed to attend to cultures, and a photograph of the original contaminated Petri dish.
Previous biographers have described Fleming as a dour, earnest Scot. Brown's account of Fleming's relationship with Sarah Marion McElroy, who died in 1949, and his second marriage four years later to a colleague at St Mary's, Amalia Koutsouri-Voureka, shows a softer, warmer side. Former BMJ editor Hugh Clegg called Fleming “modest to the point of shyness.” Although Brown contests that he was shy, he was clearly self effacing: when knighted in 1944, he insisted on pouring out drinks for everyone, even the tea lady.
Brown lists 25 honorary degrees, 26 medals, 18 prizes, 13 decorations, and membership of 87 scientific academies and societies awarded to Fleming, and he quips that he was as proud of his 1903 medal from the London Scottish Regiment Swimming Club as he was of the Nobel prize he received in 1945. He suggests that “good luck had made him the best known and most revered doctor in the world.”
Many other historians have supposed that Fleming would have been another obscure bacteriologist if serendipity had not left its calling card in his Petri dish. Given Brown's account of Fleming's scholarly years, from winning the University of London's Gold Medal on graduation, to his days as a fledgling surgeon who caught the bacteriology bug, it seems an odd conclusion. Flemingappeared predestined for greatness: a precise, painstaking man who knew how to look when a sporedrifted into his lab and made sense of what he saw. In this era of antibiotic resistance, thislesson may yet be his greatest legacy.