Ignaz Semmelweis and the Fools’ Tower

Before the germ theory of medicine, there was a Hungarian doctor, Ignaz Semmelweis, who practiced medicine at the Vienna General Hospital in the 1840s.

Semmelweis noticed, after an anatomy professor who was dissecting a cadaver for his students and cut himself with the scalpel, resulting in a severe infection (sepsis) which eventually claimed his life, that many doctors who practiced surgery on cadavers, were going afterwards to treat women in the hospital’s maternity ward.

After researching and comparing the death rate of women from child bed fever in the maternity ward with the death rate of women who were having their babies at home, he discovered that women giving birth in the hospital were dying at a much higher rate than those delivering at home. Guessing that there must have been some invisible infectious agent, he recommended that doctors wash their hands in chloride of lime. Following this advice and practice, the death rate of women giving birth in the hospital maternity ward went down to almost zero.

Semmelweis did an actual study and published it, but it was not well received at all. Instead of praising him, the international medical community at the time considered him a lunatic, denounced him as deranged, and decided to silence him.

European academia convinced a court in Vienna to declare him mentally insane when he did not stop teaching his medical students to wash their hands in chlorinated lime.

Semmelweis was shocked that eminent doctors, who knew he was right, would rather condemn women to death rather than admit that they were wrong. 

These eminent doctors, with the help of the Vienna court, condemned him to a mental asylum in Vienna, the Narrenturm (Fools tower), where he died years later. In a strange turn of events, a guard at the insane asylum struck him with an object, not sure if it was sharp or blunt, he got an infection and it resulted in his death.

Interestingly, Narrenturm still exists today. It is the oldest building in continental Europe for psychiatric patients. Built in 1784, it is located near the site of the old Vienna General Hospital. The circular building is now the location of the Federal Pathologic-Anatomical Museum of Vienna.

Millions of people since then have been saved because of Dr. Semmelweis’ discovery, a doctor who was humiliated and punished by his colleagues at European universities because he was right and they were wrong; they wanted to save their academic reputation and earnings. They did not care that they destroyed his career and his life. Even his wife left him.

He was eventually vindicated thirty years later with the advent of Robert Koch’s discovery of the TB bacillus, anthrax, and cholera, specific bacteria at the root of those infectious diseases.

Silencing Semmelweis was a sad chapter in the history of medicine, not unlike what happened to some doctors in the U.S. who refused to subject their patients to Covid-19 vaccines and instead treated them with drugs like hydroxychloroquine and ivermectin when they came down with Covid-19. The cure rate for such patients was astonishing, yet the medical profession and the press were laughing at them that they were using “horse paste” to treat the sick. These doctors were vilified, shamed, marginalized, turned into pariahs, their licenses were suspended, lost their hospital privileges, jobs, and professorships for which they had worked hard to achieve.

 

 

 

What Is Amazon?

The ever-growing retail supremacy of Amazon has contributed to the closing of 9300 stores in the U.S. in 2019. Has it or is it just a coincidence of a larger problem? Is this behemoth a monopoly as many have argued and it thus must be broken into smaller entities?

"I think we're just in the middle of a major transition in the retail space. Traditional brick and mortar stores for the most part haven't learned how to compete," stated Nathan. Amazon is a major time saver, delivering stuff to customers door instead of using limited time to go shopping.  

People still use some local businesses for certain things and some avoid the national big box stores in favor of Amazon. They like Amazon's lower prices on many things and free delivery to the front door. Return policies are generous and return shipping is almost always free with convenient pre-printed postage paid label. But other online retailers do the same thing.

"Amazon's customer service is amazing and they've given some customers things for free rather than make them return it. So I reward them with my business and I think that's just fine. I'd be foolish not to do it. I understand the concerns that smaller companies are unable to compete but it's a problem that I don't want to be responsible for solving. I usually prefer to buy clothing at brick and mortar stores however because I like to try things on. And I don't have to fight traffic and weather," added Shannah.

Some have argued that Amazon is not a monopoly at all. 

There are two types of monopolies, pure and natural.

A pure monopoly is an industry in which there is only one supplier of a product for which there are no close substitutes and in which it is very difficult or impossible for another firm to coexist. Sources of maintenance of such a monopoly include legal restrictions (U.S. postal service has a monopoly because Congress has given it one; that is not to say that there are not other mail delivery companies but they are much more expensive), patents (most pharmaceutical companies have patents on their drugs so, until the patent expires, they control a specific drug they develop thus they are a monopolist in that sense), control of scarce resource or input (De Beers control the diamond market), deliberately erected entry barriers into the business (start expensive lawsuits on trumped-up charges or spending outrageous amounts on advertising that rivals cannot match), and large sunk costs (airplane producing companies like Boeing in the U.S. and Airbus in Europe).

A natural monopoly is an industry in which advantages of large-scale production make it possible for a single firm to produce the entire output of the market at lower average cost than a number of smaller firms, each producing a smaller quantity.

Which one of these does Amazon fit into? It supplies and ships goods, connecting suppliers with customers in a novel way that does not require huge personal inventories. But it is still a behemoth company that controls a large swath of the market. So, is it a monopoly? Is it becoming one? Will it eventually put out of business ALL the little guys?

Another interesting issue is that a monopolist engages in price discrimination - charging higher prices for the same goods to customers who are less resistant to price increases, or failing to charge higher prices to customers whom it costs more to serve. (one example is national health care)  
Price discrimination can sometimes be damaging to the public interest, but at other times it can be beneficial. Some firms cannot survive without it, and price discrimination may even reduce prices to ALL customers if there are substantial economies of scale. (Amazon is definitely an economy of scale).

More questions to ponder of other products and service providers:

- Is the software industry a natural monopoly?

- Are Facebook, Google, Twitter, YouTube monopolies?

Some have argued that they are and should be broken up, particularly the social platform ones that drive the information highway.

Last but not least, why do we have Anti-trust laws at the Justice Department and are they doing their job?

What will happen to customer choice for goods and delivery charges once Amazon is the only one left delivering goods and the shipping costs skyrocket? As it is now, Amazon hires the postal service for weekend deliveries.

Not withstanding the wide variety of goods provided, stellar service, free returns and rapid deliveries, does Amazon fall under monopoly, monopolistic competition, oligopoly, or perfect competition?