Interview with Hannah Wunsch

Hannah Wunsch is professor of anaesthesiology and critical care medicine at the University of Toronto, as well as a Canada research chair and intensive care doctor at Toronto’s Sunnybrook Hospital. Her first book, The Autumn Ghost: How the battle against a polio epidemic revolutionised modern medical care, explains how a Copenhagen hospital’s efforts to save patients in 1952 led to the birth of intensive care medicine.

Where and when were you born?
I was born in July 1975 in Boston, and grew up in Cambridge, Massachusetts.

How has this shaped you?
My father was a professor at MIT in physical oceanography and we lived not far from the Harvard campus. I grew up in this academic world where reading books, taking sabbaticals and travelling the world for research were the norm. I saw early on what a remarkable life it was to be an academic.

What kind of undergraduate were you?
I was incredibly diligent, worked hard and lived for school. I knew I wanted to do academic research even if I didn’t know how that career would shape up.

You first read about the Copenhagen polio epidemic of autumn 1952 and Bjørn Ibsen’s novel method to intubate dying polio patients as a student. Why did you come back to the story 20 years later?
I was doing my master’s in London when I read a chapter about it in a book, The Rise and Fall of Modern Medicine by James Le Fanu. I wasn’t sure at that point what specialism I’d take but this story of students heroically hand-ventilating polio patients 24 hours a day, and how this led to the beginnings of mechanical ventilation and the birth of ICUs, stuck with me. It was such a dramatic origin story in medical history.

You profile Ibsen and other trailblazing academic doctors but also delve into the lives of polio patients, describing their lives before and after their illness, and also their deaths. Why did you do this?
The focus on the experience of patients and their families has become really important over the past 20 years and I felt I needed to include this perspective. I went to Denmark to meet the cousins of Vivi Ebert [the 12-year-old girl who was the first patient saved by Ibsen’s intubation method] and heard about her life. It was important to describe not just what doctors were trying to do but how people experienced what was being done to them, and what they went through while being mechanically ventilated. In America, I also discovered the identity of the first child kept alive using an iron lung. Bertha Richard died aged eight in 1928 and has always been referred to as an anonymous child. I felt it was important to say her name and put it in the book.

The spectre of respiratory failure – which haunted the first half of the 20th century because of polio – returned in 2020 with the emergence of Covid. Did the pandemic influence how you wrote the book?
The book shifted in my brain when we started to live through Covid. Previously I’d had to convince people that mechanical ventilation was important enough to write about. Covid helped us all reconnect with an era when we did not have these facilities, and respiratory failure was a death sentence.

In The Autumn Ghost, which refers to the season when polio was thought to arrive, you describe how an outsider scientist with novel ideas helped doctors to move away from using iron lungs to save polio patients. Does this story have any lessons for today?
Ibsen’s story is important for medical innovation. He was an anaesthesiologist who’d never cared for polio patients, so, in some ways, he was absolutely the wrong person for this situation. But he was precisely the right person because he thought differently and could see the issues in a different light. This also highlights why diversity in research groups – race, gender and other minority groups – is so vital; you need people who think in different ways.

Your book also pays tribute to the power of a university community, describing how hundreds of Copenhagen medical students postponed their studies to hand-ventilate polio patients that winter.
It was a privilege to meet some of those students, who are now in their nineties. Many of them lost time from their education and some had to take another year of medical school. But they found it incredibly informative and the sense of mission was huge, with the risk of infection always there for them. The book is, in some sense, a love letter to my specialism, explaining the incredible things that can be achieved through collaboration and hard work.

The Autumn Ghost also describes the rivalries and spectacular fallouts within academic medicine. Ibsen was understandably upset after he was barely mentioned in a Lancet paper written by the hospital’s chief physician, Henry Lassen, about the episode, who later stated: “Soldiers don’t win wars, generals do.”
Lassen is maybe the antihero of this tale, but he is also crucial. He broke down hierarchies and was able to organise the hospital to provide a high level of care to up to 70 patients at a time. That was also an incredible feat.

Should Ibsen have won a Nobel Prize for his innovations?
Maybe not a Nobel, but certainly other prizes. His method of positive pressure ventilation is still a mainstay of critical care medicine and he opened the first modern intensive care unit. His emphasis on supporting breathing and the monitoring of breathing paved the way for intensive care to become a specialism which has helped countless people stay alive through severe illness. It’s something we take for granted but it’s a relatively new phenomenon. China only got its first ICU in the 1980s. For a huge part of the 20th century, if you had a very severe illness, there wasn’t much they could do for you.

jack.grove@timeshighereducation.com

CV

1997 BA biology, Harvard University
2002 MSc epidemiology, London School of Hygiene and Tropical Medicine
2003 MD, Washington University School of Medicine, St Louis
2003-07 internship, residency and fellowship, Columbia University Medical Center
2008-14 instructor, assistant professor and associate professor of anaesthesiology, Columbia University
2014-18 senior scientist in critical care medicine, associate professor, University of Toronto
2018-present professor of anaesthesiology and critical care medicine, Toronto

Appointments 

Larry Kramer, former dean of Stanford University’s Law School, has been appointed vice-chancellor of the London School of Economics. Professor Kramer, currently president of the William and Flora Hewlett Foundation, will take up the post in April 2024, succeeding Baroness Shafik, who is now president of Columbia University. Susan Liautaud, chair of LSE’s council, said Professor Kramer was “an outstanding and visionary leader and scholar”.

Ebrahim Adia will be the next vice-chancellor of the University of Wolverhampton. Currently pro vice-chancellor (academic leadership) at the University of Central Lancashire, he will succeed interim leader John Raftery in the autumn. Professor Raftery said he was “certain Professor Adia will confidently lead the university’s continued growth whilst ensuring the needs of our students and staff remain at the heart of everything we do”.

Chris Peck is joining the National University of Singapore as dean of the Faculty of Dentistry. He spent eight years as dean of dentistry at the University of Sydney.

Nadya Mason has been named dean of the Pritzker School of Molecular Engineering at the University of Chicago. She moves from the University of Illinois at Urbana-Champaign, where she is a professor of physics.

Yang (Lucy) Lu has been appointed provost at Arden University. She was previously provost at the London School of Commerce.

David Newbold has been appointed executive director of national laboratories, science and technologies at the UK’s Science and Technology Facilities Council, where he is currently director of particle physics.

Simon Priestnall, currently professor of veterinary anatomic pathology at the Royal Veterinary College, has been appointed head of its department of pathobiology and population sciences.

Gordon Fletcher has been promoted to be associate dean for research and innovation at the University of Salford Business School. He has been the director of marketing since 2006 and director of business 4.0 since 2019.