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The Life of Sir Alexander Fleming
Epilogue


Only in extraordinary circumstances does the name of a scientist reach out beyond the borderline of science and take its place in the annals of humanity.

BALZAC

He was buried in the crypt of St Paul's, a high honour conferred on only a few illustrious Englishmen. The ushers were drawn from among the students and nurses of St Mary's. Professor Pannett, his friend and companion since the day when they entered the world of medicine together, delivered the funeral oration:

Fifty-one years ago a small group of young men, most of us in our teens, met at St Mary's Hospital Medical School. We were competitors for a scholarship. It was there that I first met Alexander -Fleming, He was a little older and more mature than the rest of us, a quiet man with alert, blue, penetrating, resolute eyes ... For the first few years we were rivals but afterwards our paths diverged, yet never was this bond of, friendship strained, for Fleming had that steadiness and steadfastness of character that gave the quality of security to a friendship which lasted unsullied until his death. This constancy of his was outstanding and inspired a confidence in his friends and companions which was never misplaced ...

On that early autumn morning how far it was from our thoughts that we were in the presence of one of the greatest men of the century and that, one day, a large crowd would be gathered together in this beautiful cathedral to mourn the death of one acclaimed by the whole world as a scientific genius; and to do homage to his memory.

Tributes to his greatness have poured in from far and wide, for it is generally recognized that by his work he has saved more lives and relieved more suffering than any other living man, perhaps more than any man who has ever lived. This by itself is enough to alter the history of the world. His name will always be cherished as long as this Western culture, so dear to us, exists.

I shall not speak of his hopes, his strivings, his disappointments and frustrations ... Every great scientist knows these and Fleming experienced them in full measure ... but there is a remarkable aspect of Fleming's life which is not so widely known. Looking back on his career, we find woven into the web of his life a number of apparently irrelevant chance events without one of which it would probably not have reached its climax. There were so many of these events, and they were all so purposive that we feel driven to deny their being due to mere chance ...

His choice of a profession, his selection of a medical school, his deviation into bacteriology, his meeting with Almroth Wright, the nature of the work he did with him, the chance drop of a tear, the chance fall of a mould, all these events were surely not due to mere chance. We can almost see the finger of God pointed to the direction his career should take at every turn.

In the crypt of St Paul's, close to the towering tombs of Wellington and Nelson, the letters 'A. F.' upon a flagstone discreetly mark the spot wherein his ashes lie, and on the wall near by is a tablet of Pentelic marble brought from Greece to London. On it are carved the thistle of Scotland and the lily of St Mary's. In this way are united three great loves of his life.

The shock of Fleming's death was felt far beyond England. Not only did official expressions of regret reach his family from the governments of many countries, but deeply moving tributes from people in every walk of life. At Barcelona, the flower-sellers emptied their baskets before the tablet on which his visit to their city is commemorated. Two little girls of Bologna sent flowers which they had bought with money saved for their father's birthday present. Far and wide his name was given to streets and squares, and subscription lists were opened in many cities for the erection of monuments in his honour. In Greece the flags were flown at half-mast. Two motorists driving through that country, and surprised to see these signs of mourning in every village through which they passed, asked an old shepherd near Delphi the reason for this public display of grief. 'Do you not know/ replied the old man, 'that Fleming is dead?'

The following leading article appeared in the British Medical Journal of March 19th:

The Discovery of Penicillin

The discovery of penicillin introduced a new epoch in the treatment of disease. It has been followed by an intense search for other "antibiotics', and a whole range of bacterial infections have now come within the effective control of substances produced, for the most part, by moulds, among which Penicil-lium notatum holds pride of place not only historically but also therapeutically. We stand so close to a bewilderingly rapid sequence of discoveries that as yet we probably fail to understand fully the revolution in medicine that has taken and is taking place as a result of Alexander Fleming's discovery" It is natural that the world will acclaim a medical advance 'great' in proportion to the curative benefits it brings, and on this count alone Sir Alexander Fleming has his place among the immortals. And close beside him will be Sir Howard Florey and Dr Ernst Chain, who in a systematic investigation of antibacterial substances ten years later hit upon the technical ways and means of fulfilling the promise Fleming held out for penicillin in 1929. Fleming had the real naturalist's capacity for observation and the scientific imagination to see the implications of the observed fact — a capacity and an imagination which, it is true, only the prepared mind can compass, and which in the great discovery seem invariably to be joined to a mind that is essentially humble. As there have been some popular misconceptions of the part Fleming played in discovering penicillin it may not be inappropriate at this time of his death to recall in his own words some of the observations he summarized in his historical paper in the British Journal of Experimental Pathology for June 1929:

A certain type of penicillium produces in culture a powerful antibacterial substance ... The active agent is readily filterable and the name 'penicillin' has been given to filtrates of broth cultures of the mould ...

The action is very marked on the pyogenic cocci and the diptheria group of bacilli ...

Penicillin is non-toxic to anirqals in enormous doses and is not irritant. It does not interfere with leucocytic function to a greater degree than does ordinary broth ... It is suggested that it may be an efficient antiseptic for application to, or injection into, areas infected with penicillin-sensitive microbes ...

The discovery recorded in Fleming's paper is a milestone in the history of medical progress, and the 'penicillin' he discovered and named has come nearer than any other remedy to Ehrlich's ideal therapia sterilisans magna.

The discovery of penicillin has indeed opened 'a new epoch in the treatment of disease'. The doctor of today can hardly visualize how helpless his elders felt when confronted by certain infections. He has had no experience of that despair which descended upon them when they had to deal with diseases which were then fatal, but can now be cured and even eliminated. Penicillin, and the whole range of antibiotics which its discovery has initiated, has enabled the surgeon to perform operations which in the old days he would never have dared attempt. The average expectation of life has so enormously increased that the whole structure of society has been shaken to its foundations. No man, except Einstein in another field, and before him Pasteur, has had a more profound influence on the contemporary history of the human race. Statesmen act from hand to mouth, but scientists by their discoveries create the conditions in which action is possible.

How was it that this modest, silent research-worker became the beneficiary of the most remarkable piece of good luck to occur to anyone during his lifetime? Because he had patiently prepared himself to recognize and to accept the truth when the moment of its revelation came. 'In science nothing seems easier than what was discovered yesterday; nothing more difficult than to say what will be discovered tomorrow.'1 Fleming observed much that other men might have observed but did not. The reason for this is that he had a sense of proportion which was all his own.

A flower growing in an unexpected way seemed as important to him as the most spectacular of phenomena. The method employed by ants in the building of their nests was to him a miracle at which he peered with close attention. Everything in nature had aroused his interest since those boyhood days he spent upon the Scottish moors. Had he been sent to one of the public schools, he might have been less shy. He might have learned how to express his ideas and demonstrate his facts in a more dramatic fashion. He might have produced a more vivid impression on others. But would he, in that case, have preserved his astonishing freshness of mind?

Of what benefit to a man of profound intelligence are eloquence, self-confidence and brilliance? They may contribute much to his personal happiness, to his prestige, to his material success. But do they have any marked influence upon the importance of such real results as he may obtain? Let us take, for example, these two men, Wright and Fleming. Both had the same devotion to science. But Fleming, having nothing remotely resembling the gift of rhetoric, lacked the power — which Wright possessed in so high a degree — of striking the public imagination. Wright, it is true, had enemies, but even they, when confronted by that massive personality, could not deny him some element of greatness. Everyone knew that to question the value of his work would draw down upon the greatly daring critic a torrent of brilliant and sarcastic argument. What, on the other hand, more tempting than to think oneself superior to the small, shy stoic who would never do anything to dissipate that illusion? Without danger to oneself one could dispute his findings, since not for a moment would he break his formidable silence for, as he regarded it, so trivial a reason.

'The man of genius', writes Lord Beaverbrook, 'is often an egotist. When, as sometimes happens, he is simple and retiring, the world is inclined to underestimate his gifts. Sir Alexander Fleming was a genius of this rare type. Now, to be sure, his fame is universal ... During his lifetime, and in his own country, his merits were sometimes reluctantly admitted.5 It may be that justice would have been sooner done to him had he been less reticent, if on occasion he had said something. But what? In spite of his silences, it was he who reached the goal.

The best final judgment on Sir Alexander Fleming is that of Professor Haddow, Director of the Cancer Research Institute, who writes of him:

He was a great natural searcher. He knew the importance of work, and he worked hard for the attainment of great ends, but his real superiority is to be found in his tremendous gift of discernment, in the swiftness with which he could pounce upon and grip an unexpected observation the true significance of which would have remained hidden from the ordinary mortal ... in other words, in the power he had to reveal the existence and qualities of fundamental phenomena ... It should never be forgotten that though, for the generality of laymen, it is with penicillin that his name is associated, he contributed other things which, in his eyes, were of no less value, perhaps of even greater value, than penicillin. For this reason alone he would have been a great man, but I think that I would rank higher than anything else in him his tremendous and quiet wisdom, both as regards the world and the nature of research, a wisdom so unruffled and so modest that it escaped most people who knew him only a little. Three things about him struck me most forcibly. This man realized that work mattered, not talk. His real brilliance which consisted in seizing upon the unexpressed and not ignoring it; and, thirdly, his philosophy — hardly expressed and only to be guessed — which amounted to tremendous wisdom about the nature of science and scientific research and, I often think, the world at large and his summing up of other people.

The tribute which would have touched Fleming most deeply was that paid to his memory on October ioth, 1957, in his own county of Ayrshire. On that day a very simple monument was unveiled at the entrance gate to Lochfield farm: a tall block of red granite bearing, as he would have wished, this unemphatic inscription:

SIR ALEXANDER FLEMING

discoverer of penicillin was born here at lochfield

on 6th august 1881

A few cars had climbed the moorland road from Darvel, and a great crowd had trudged the four miles on foot, as he himself had been used to do as a boy on his way to and from school. When the flags, marked with the St Andrew's Cross, had been pulled aside, the Provost spoke of Alec Fleming's childhood. Here, he had received from those sterling parents, Hugh and Grace Fleming, the instruction which guided him through life. In these valleys, and on these hills, he had learned, at work and play, to know nature and to love it. His wife, looking at the lovely autumn sky, at the vast horizons, and at the gentle undulations of the hills, realized that the lofty indifference to all pettiness of life which she had so dearly loved in her husband had been engendered by those mingled feelings of strength and humility which such solitudes evoke.

Nobody, on that 6th August, 1881 [went on the Provost] dreamed that the tiny, weak and puling scrap of humanity then starting on its life, was to be dedicated to the service of mankind. Fleming himself once wrote; cWe like to think that we control our destinies, but Shakespeare, perhaps, showed greater wisdom when he said:

There's a divinity that shapes our ends, Rough-hew them how we will.'

Each one of us, looking back over his past life, may wonder what would have happened had he done something other than he did do, often for no particular reason. At every moment there are two roads open to us. One we must choose. Where the other might have led we cannot know. It may be that we chose the better, but who can say?

Fleming had chosen the good road, and Destiny, all things considered, had been kind to him.


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