How a Deadly Fire Gave Birth to Modern Medicine

How a Deadly Fire Gave Birth to Modern Medicine

The Cocoanut Grove fire in Boston in 1942 tragically claimed 490 lives, but was the catalyst for several important medical advances.

Boston Public Library

On the evening of November 28, 1942, more than 1,000 revelers from the Boston College-Holy Cross football game jammed into the Cocoanut Grove, Boston's oldest nightclub. When a spark from faulty wiring accidently ignited an artificial palm tree, the packed nightspot, which was only designed to accommodate about 500 people, was quickly engulfed in flames. In the ensuing panic, hundreds of people were trapped inside, with most exit doors locked. Bodies piled up by the only open entrance, jamming the exits, and 490 people ultimately died in the worst fire in the country in forty years.

"People couldn't get out," says Dr. Kenneth Marshall, a retired plastic surgeon in Boston and president of the Cocoanut Grove Memorial Committee. "It was a tragedy of mammoth proportions."

Within a half an hour of the start of the blaze, the Red Cross mobilized more than five hundred volunteers in what one newspaper called a "Rehearsal for Possible Blitz." The mayor of Boston imposed martial law. More than 300 victims—many of whom subsequently died--were taken to Boston City Hospital in one hour, averaging one victim every eleven seconds, while Massachusetts General Hospital admitted 114 victims in two hours. In the hospitals, 220 victims clung precariously to life, in agonizing pain from massive burns, their bodies ravaged by infection.


The scene of the fire.

Boston Public Library

Tragic Losses Prompted Revolutionary Leaps

But there is a silver lining: this horrific disaster prompted dramatic changes in safety regulations to prevent another catastrophe of this magnitude and led to the development of medical techniques that eventually saved millions of lives. It transformed burn care treatment and the use of plasma on burn victims, but most importantly, it introduced to the public a new wonder drug that revolutionized medicine, midwifed the birth of the modern pharmaceutical industry, and nearly doubled life expectancy, from 48 years at the turn of the 20th century to 78 years in the post-World War II years.

The devastating grief of the survivors also led to the first published study of post-traumatic stress disorder by pioneering psychiatrist Alexandra Adler, daughter of famed Viennese psychoanalyst Alfred Adler, who was a student of Freud. Dr. Adler studied the anxiety and depression that followed this catastrophe, according to the New York Times, and "later applied her findings to the treatment World War II veterans."

Dr. Ken Marshall is intimately familiar with the lingering psychological trauma of enduring such a disaster. His mother, an Irish immigrant and a nurse in the surgical wards at Boston City Hospital, was on duty that cold Thanksgiving weekend night, and didn't come home for four days. "For years afterward, she'd wake up screaming in the middle of the night," recalls Dr. Marshall, who was four years old at the time. "Seeing all those bodies lined up in neat rows across the City Hospital's parking lot, still in their evening clothes. It was always on her mind and memories of the horrors plagued her for the rest of her life."

The sheer magnitude of casualties prompted overwhelmed physicians to try experimental new procedures that were later successfully used to treat thousands of battlefield casualties. Instead of cutting off blisters and using dyes and tannic acid to treat burned tissues, which can harden the skin, they applied gauze coated with petroleum jelly. Doctors also refined the formula for using plasma--the fluid portion of blood and a medical technology that was just four years old--to replenish bodily liquids that evaporated because of the loss of the protective covering of skin.

"Every war has given us a new medical advance. And penicillin was the great scientific advance of World War II."

"The initial insult with burns is a loss of fluids and patients can die of shock," says Dr. Ken Marshall. "The scientific progress that was made by the two institutions revolutionized fluid management and topical management of burn care forever."

Still, they could not halt the staph infections that kill most burn victims—which prompted the first civilian use of a miracle elixir that was being secretly developed in government-sponsored labs and that ultimately ushered in a new age in therapeutics. Military officials quickly realized this disaster could provide an excellent natural laboratory to test the effectiveness of this drug and see if it could be used to treat the acute traumas of combat in this unfortunate civilian approximation of battlefield conditions. At the time, the very existence of this wondrous medicine—penicillin—was a closely guarded military secret.

From Forgotten Lab Experiment to Wonder Drug

In 1928, Alexander Fleming discovered the curative powers of penicillin, which promised to eradicate infectious pathogens that killed millions every year. But the road to mass producing enough of the highly unstable mold was littered with seemingly unsurmountable obstacles and it remained a forgotten laboratory curiosity for over a decade. But Fleming never gave up and penicillin's eventual rescue from obscurity was a landmark in scientific history.

In 1940, a group at Oxford University, funded in part by the Rockefeller Foundation, isolated enough penicillin to test it on twenty-five mice, which had been infected with lethal doses of streptococci. Its therapeutic effects were miraculous—the untreated mice died within hours, while the treated ones played merrily in their cages, undisturbed. Subsequent tests on a handful of patients, who were brought back from the brink of death, confirmed that penicillin was indeed a wonder drug. But Britain was then being ravaged by the German Luftwaffe during the Blitz, and there were simply no resources to devote to penicillin during the Nazi onslaught.

In June of 1941, two of the Oxford researchers, Howard Florey and Ernst Chain, embarked on a clandestine mission to enlist American aid. Samples of the temperamental mold were stored in their coats. By October, the Roosevelt Administration had recruited four companies—Merck, Squibb, Pfizer and Lederle—to team up in a massive, top-secret development program. Merck, which had more experience with fermentation procedures, swiftly pulled away from the pack and every milligram they produced was zealously hoarded.

After the nightclub fire, the government ordered Merck to dispatch to Boston whatever supplies of penicillin that they could spare and to refine any crude penicillin broth brewing in Merck's fermentation vats. After working in round-the-clock relays over the course of three days, on the evening of December 1st, 1942, a refrigerated truck containing thirty-two liters of injectable penicillin left Merck's Rahway, New Jersey plant. It was accompanied by a convoy of police escorts through four states before arriving in the pre-dawn hours at Massachusetts General Hospital. Dozens of people were rescued from near-certain death in the first public demonstration of the powers of the antibiotic, and the existence of penicillin could no longer be kept secret from inquisitive reporters and an exultant public. The next day, the Boston Globe called it "priceless" and Time magazine dubbed it a "wonder drug."

Within fourteen months, penicillin production escalated exponentially, churning out enough to save the lives of thousands of soldiers, including many from the Normandy invasion. And in October 1945, just weeks after the Japanese surrender ended World War II, Alexander Fleming, Howard Florey and Ernst Chain were awarded the Nobel Prize in medicine. But penicillin didn't just save lives—it helped build some of the most innovative medical and scientific companies in history, including Merck, Pfizer, Glaxo and Sandoz.

"Every war has given us a new medical advance," concludes Marshall. "And penicillin was the great scientific advance of World War II."

Linda Marsa
Linda Marsa is a contributing editor at Discover, a former Los Angeles Times reporter and author of Fevered: Why a Hotter Planet Will Harm Our Health and How We Can Save Ourselves (Rodale, 2013), which the New York Times called “gripping to read.” Her work has been anthologized in The Best American Science Writing, and she has written for numerous publications, including Newsweek, U.S. News & World Report, Nautilus, Men’s Journal, Playboy, Pacific Standard and Aeon.
Scientists Want to Make Robots with Genomes that Help Grow their Minds

Giving robots self-awareness as they move through space - and maybe even providing them with gene-like methods for storing rules of behavior - could be important steps toward creating more intelligent machines.

phonlamaiphoto

One day in recent past, scientists at Columbia University’s Creative Machines Lab set up a robotic arm inside a circle of five streaming video cameras and let the robot watch itself move, turn and twist. For about three hours the robot did exactly that—it looked at itself this way and that, like toddlers exploring themselves in a room full of mirrors. By the time the robot stopped, its internal neural network finished learning the relationship between the robot’s motor actions and the volume it occupied in its environment. In other words, the robot built a spatial self-awareness, just like humans do. “We trained its deep neural network to understand how it moved in space,” says Boyuan Chen, one of the scientists who worked on it.

For decades robots have been doing helpful tasks that are too hard, too dangerous, or physically impossible for humans to carry out themselves. Robots are ultimately superior to humans in complex calculations, following rules to a tee and repeating the same steps perfectly. But even the biggest successes for human-robot collaborations—those in manufacturing and automotive industries—still require separating the two for safety reasons. Hardwired for a limited set of tasks, industrial robots don't have the intelligence to know where their robo-parts are in space, how fast they’re moving and when they can endanger a human.

Over the past decade or so, humans have begun to expect more from robots. Engineers have been building smarter versions that can avoid obstacles, follow voice commands, respond to human speech and make simple decisions. Some of them proved invaluable in many natural and man-made disasters like earthquakes, forest fires, nuclear accidents and chemical spills. These disaster recovery robots helped clean up dangerous chemicals, looked for survivors in crumbled buildings, and ventured into radioactive areas to assess damage.

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Lina Zeldovich

Lina Zeldovich has written about science, medicine and technology for Popular Science, Smithsonian, National Geographic, Scientific American, Reader’s Digest, the New York Times and other major national and international publications. A Columbia J-School alumna, she has won several awards for her stories, including the ASJA Crisis Coverage Award for Covid reporting, and has been a contributing editor at Nautilus Magazine. In 2021, Zeldovich released her first book, The Other Dark Matter, published by the University of Chicago Press, about the science and business of turning waste into wealth and health. You can find her on http://linazeldovich.com/ and @linazeldovich.

Podcast: Wellness chatbots and meditation pods with Deepak Chopra

Leaps.org talked with Deepak Chopra about new technologies he's developing for mental health with Jonathan Marcoschamer, CEO of OpenSeed, and others.

Hannah Cohen

Over the last few decades, perhaps no one has impacted healthy lifestyles more than Deepak Chopra. While several of his theories and recommendations have been criticized by prominent members of the scientific community, he has helped bring meditation, yoga and other practices for well-being into the mainstream in ways that benefit the health of vast numbers of people every day. His work has led many to accept new ways of thinking about alternative medicine, the power of mind over body, and the malleability of the aging process.

His impact is such that it's been observed our culture no longer recognizes him as a human being but as a pervasive symbol of new-agey personal health and spiritual growth. Last week, I had a chance to confirm that Chopra is, in fact, a human being – and deserving of his icon status – when I talked with him for the Leaps.org podcast. He relayed ideas that were wise and ancient, yet highly relevant to our world today, with the fluidity and ease of someone discussing the weather. Showing no signs of slowing down at age 76, he described his prolific work, including the publication of two books in the past year and a range of technologies he’s developing, including a meditation app, meditation pods for the workplace, and a chatbot for mental health called Piwi.

Take a listen and get inspired to do some meditation and deep thinking on the future of health. As Chopra told me, “If you don’t have time to meditate once per day, you probably need to meditate twice per day.”

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Matt Fuchs
Matt Fuchs is the host of the Making Sense of Science podcast and served previously as the editor-in-chief of Leaps.org. He writes as a contributor to the Washington Post, and his articles have also appeared in the New York Times, WIRED, Nautilus Magazine, Fortune Magazine and TIME Magazine. Follow him @fuchswriter.