Speaker:  Cynthia Connolly, PhD, RN, FAAN

Date and Time:  September 19, 2012, 12:00 PM to 1:30 PM in Room 2019, Floor 2U, Claire Fagin Hall

Abstract:    This seminar uses patient records from Baltimore’s Sydenham Hospital to explore the therapeutic revolution “on the ground” as sulfonamides replaced therapeutic sera in the treatment of two infectious diseases in children in the 1930s and 1940s: meningococcal meningitis and pneumococcal pneumonia.  A close reading of patient records tells something very different from an examination of reports in medical journals. The latter focus on the success [or failure] of new treatments; the former reveal the challenges of making them work and the many different clinical decision points involved. The patient records also show the personal responses of clinicians observing children recover from once uniformly deadly infections. The idea that children, and especially newborns and young infants, reacted differently than adults to drugs and required distinctive dosage calculation and medication administration methods, had long vexed clinicians in terms of applying that understanding in practice. The sulfa drugs were no exception. But this paper contends that caring for infants and children receiving the agents made unique demands on nurses that differed from the work of caring for adult patients. The differences arose from age-related responses to the pathogenic organisms and the particular challenges of administering sulfonamides to the pediatric patient and monitoring youngsters for adverse reactions. As a result the nursing protocols developed for infants and children receiving sulfonamides not only laid the groundwork needed a few years later for the adoption of penicillin, they forged the template for postwar pediatric nursing in the United States and the contours of American pediatric nurses’ phenomena of interest going forward. This study is important for multiple reasons. First, both scientific accounts of therapeutic reform and traditional historical narratives of antibiotic development often overlook sulfonamides in favor of penicillin. Second, an appreciation of the “real time” experience of nurses struggling to adapt to a new treatment paradigm within a short window of time is meaningful and the rich data set afforded by the Sydenham records provides a case study to address this issue.  Third, the normative experiences of pediatric patients and the practitioners caring for them must be distinguished from adult patients and their health care providers. This perspective has been underdeveloped in nursing and medical historiography. 

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