Antibiotics are something that, today, are taken for granted. This wasn’t always the case. The first patient to get antibiotics shows us how an incredibly minor injury can go bad, and how the road to antibiotic use wasn’t smooth even when scientists knew it worked.

The first person to get penicillin wasn’t the first patient to get penicillin. She was a patient—one afflicted with terminal cancer—but she was beyond the reach of antibiotics. Howard Florey and Ernst Chain, who were developing penicillin, asked her to take it not because it would help her but to check if it was toxic. It was. The woman didn’t die, but she developed a high fever.

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The penicillin wasn’t toxic, but it has been contaminated with something that was. It took time to work out the impurities. They ended up freeze-drying it and reducing it to a powder. Once Florey and Chain got sufficiently pure medicine, they were ready to give it to their first patient. This patient did die. The man was a policeman. His occupation makes it sound like he could have gotten the infection that would eventually kill him any number of exciting ways. Actually, he was pruning roses and got a small scratch on his cheek. A little while later, he was dying of septicemia.

The infusion of penicillin improved the policeman, named Albert Alexander, nearly overnight. Everyone was hopeful, until they ran out of penicillin. Florey did everything he could to stretch the supply, including harvesting leftover penicillin from Alexander’s urine to re-use. It wasn’t enough. Alexander got worse, and eventually died.

Raising a patient’s hopes only to watch him slowly die for lack of enough medicine devastated Florey. He decided not to try the process again until he was sure there was no way to run out of medicine, and converted his research lab to a make-shift manufacturing facility. He would probably be pleased with our manufacturing capacity today. He’d also be the best one to warn us about the consequences of lessening the effectiveness of the antibiotics we have.

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Image: Armin KĂĽbelbeck