Changing the world can make you insane, but it doesn't have to (5 tips)


You can change the world, but it sometimes comes at a steep cost. It did for Ignaz Semmelweis, the first doctor to discover handwashing saved lives, especially mothers in his maternity ward. He made 5 key mistakes that you can avoid. And in doing so, I hope you'll be able to avoid the insane asylum. Everyone who makes something new gets hit back quickly with what is known now as the Semmelweis Reflex— people reject anything that challenges them out of hand. 

You can be prepared to face this. Here's the five ways steps: 
  1. Speak for yourself — 03:05 
  2. Persevere, and don’t ragequit — 04:26 
  3. Speak truth when you know you’re right — 05:34
  4. When they go low, we go high — 06:09
  5. The breakthrough is only half the work — 07:13  

Thanks for watching! I made this video last night in about 3 hours— I'm going for a video a week, and my goal is to just help future founders and people who are making things get to the next stage.



Excerpt from 12 Monkeys (Brad Pitt's character is speaking)—

Germs? Uh-huh. In the 18th century, no such thing. Nada, nothing. No ever imagined such a thing. No sane person, anyway. Along comes this doctor, uh, uh, uh... Semmelweis. Semmelweis. Semmelweis comes along and he's trying to convince people, well, other doctors mainly, that there are these teeny, tiny, invisible bad things called germs that get into your body and make you sick. He's trying to get doctors to wash their hands. What is this guy? Crazy?

I don't know about you, but these days I'm pretty thankful for hand washing. But did you know that one of the first people who tried to bring it to the world suffered a nervous breakdown and died in an insane asylum at the age of 47? His name was Ignaz Semmelweis. 

Today we're going to talk about what it takes to change the world, and how that change doesn't come for free. 

Somebody's got to pay. Let's get into it. 


The discovery

Semmelweis was born the year 1818 in the Kingdom of Hungary. He was a physician and a scientist. He worked at a Viennese hospital that had rates of maternal mortality of up to 18%. That means 18% of mothers who were about to deliver a child died. Women begged not to be admitted, with some women preferring to give birth in the streets. It turned out, the first hospital was used in the service of teaching medical students who had performed autopsies, and that's why so many people died in that first hospital. In response, a 29 year old Semmelweis instituted a policy of washing hands with chlorinated lime between autopsy work and the examination of patients. The effect was immediate. 18.3%. That was the death rate in April of 1847. In that first ward it got down to 2.2% in June, all the way down to zero in August of that year. Semmelweis was 29 at the time of this discovery. Eureka. It saved lives. 

Lesson #1: Speak for yourself

But it wasn't Semmelweis who brought it to everyone. He died before he could make that happen. In fact, his theory was almost completely rejected. By late 1848, just a year later, the students had published in Lancet and elsewhere, yet people still didn't adopt the hand washing technique. Many people in the medical community of the 1800s got confused. They thought Semmelweis was just saying that this type of fever was contagious, and that was widely known. They misunderstood a very specific point: that organic dead tissue could be the actual way these diseases were transmitted. 

It was Semmelweis' students who wrote lectures about this breakthrough. Through this whole time period, Semmelweis never published on his own. He never directly addressed these confusions in the journals himself, it was always the students and others who spoke on his behalf. That's lesson number one, speak for yourself. Don't expect others to speak for you. 

Certainly the data can't speak for itself. In fact, without you, the data is mute. In the 1800s, you had letters, journals, and that was it. Today, things happen overnight. 

If you're watching this, you should practice writing and social media. Get into the habit of being able to communicate with strangers on the internet. At these critical moments later in your career you will have a skill that will help you fundamentally. Lesson one, learn to communicate for yourself. 

Lesson #2: Don't ragequit

Let's put this in perspective. Imagine being that one person who dropped the death rate for expecting mothers from 18% per month to zero. That's exactly what Semmelweis did. Yet the Chief Resident, his boss, Johann Klein, decided to go a different way. Even though Ignaz Semmelweis had a huge breakthrough, he couldn't keep his job. Semmelweis' boss didn't want to keep him around, and it was all because of politics. Now, Ignaz Semmelweis did fight a little bit, but then one day he quit, and he never came back. He basically ragequit. 

That's lesson number two, don't ragequit. And I have to admit that this has happened to me before in my career, it might happen to you. Sometimes things get heated, they don't quite go the way you planned. Promises might not be honored. We are aggrieved. But take a breath, take a moment, think about the people around you and what you want out of this situation. I've yet to meet a person who has ever told me they wish they were more rash when making a hard decision, like where to work. 

You do have to make a decision, but when you do, feel the emotions, but be sure it's the rational part of you doing it. 


Lesson #3: Speak truth when you know you're right

He was only 29 when he made and instituted these discoveries. Heads of maternity hospitals, professors, and many other pivotal figures in the medical community disagreed with him, and because Semmelweis was not yet established, they didn't take him seriously. There were also structural reasons why they were fundamentally wrong. For one, theory. Doctors didn't have a scientific understanding of what was really going on. They believed in the Miasma theory, and that's what everyone believed. That noxious bad air was the cause. Hand washing was physical, so how could it have anything to do with bad airs? Beyond that, doctors felt their status as gentlemen was inconsistent with the idea that their hands could be unclean. That's lesson number three, the establishment is often absolutely wrong. It's an act of courage to continue to say what you know to be right. You have to have the data, you have to have the conviction to back it up, but just because people say things are so does not make it so. 

Lesson #4: When they go low, we go high

Now, by 1861, Semmelweis started writing letters full of bitterness and desperation, and the upshot of this was. It seemed to his contemporaries that he was losing his grip on reality. That's lesson number four: no matter how wrong your haters are, don't stoop to their level. When they go low, we go high. How you address things matter. Nobody will ever deny that this road is long and hard, but if you resort to the bad or worse arguments of your adversary, nobody wins, especially not you.

Michelle Obama: "When they go low, we go high."


Lesson #5: The breakthrough is only half the work

By 1865, he was brought to an asylum to be mentally committed. He tried to escape, and he was forcibly subdued by the guards.

Two weeks later he was dead from a wound on his hand, probably from the struggle, and it wasn't for another 20 years that the germ theory of disease became widely accepted. Louis Pasteur was able to overcome the establishment with data and he engaged in the debate at the right level so he could change minds. 

This is the ultimate lesson, and the tragic lesson Semmelweis learned the hard way. The breakthrough is only half of the work. The other half is spreading it to the rest of the world. Innovations must be spread and communicated effectively if you want them to have an impact on the world. There are so many lessons to be learned. 


Recap: The five lessons of Semmelweis

Here's the five. 
  1. Speak for yourself — 03:05 
  2. Persevere, and don’t ragequit — 04:26 
  3. Speak truth when you know you’re right — 05:34
  4. When they go low, we go high — 06:09
  5. The breakthrough is only half the work — 07:13  
These days, we call the reflex-like rejection of new knowledge the Semmelweis reflex. Anyone who is creating something new that will push forward humanity and break the existing status quo will face incredible pressure. Great change comes at a great cost. And we've got to remember this, it doesn't come for free. And if we don't handle these breakthroughs properly, they have the potential to break us. True change requires perseverance and a fundamental focus, but then communicating that breakthrough. 

That's the big lesson for today. Thank you so much for watching. If you watched all the way to the end, I really, really appreciate it. Please click like, leave a comment. Let me know what kind of things you want to hear on this channel. Take care.