Chapter 1Lochfield

Foreword

In November 1930, at the Sheffield Royal Infirmary, a doctor named Cecil George Paine cured gonococcal eye infections in newborn babies using crude penicillin filtrate.

He had been Alexander Fleming's student. He did not publish. He let it drop.

That is the fact this book is organised around, because it makes the usual argument impossible.

The usual argument is that Fleming stumbled onto penicillin in 1928, failed to see what he had, and then spent his later years taking credit for what Howard Florey, Ernst Chain and Norman Heatley did in Oxford a decade afterwards.

That indictment is half right and it is aimed at the wrong target.

He did stumble. Nobody disputes it and he never claimed otherwise. But the eleven years the mould sat unused were not a personal failure of imagination, because a man in Sheffield had already cured babies with it and nothing happened either.

The question this book asks is not why one man missed it. It is why a country did.

The answer is a building.

Sir Almroth Wright's Inoculation Department at St Mary's, Paddington, was not a place where a chemical cure could be developed, and it was not one by design. Wright's doctrine was that the body's own defences were the answer — stimulate the phagocytes, in the phrase Bernard Shaw put on the stage in 1906. The department was hostile to chemotherapy, contemptuous of statistics, paid its own wages by selling vaccines, and employed no biochemist.

Penicillin needed a biochemist. There was not one in the building, and the two young men who tried, Stuart Craddock and Frederick Ridley, ended up boiling ether in a corridor and getting nowhere.

Seven of these twenty-one chapters pass before the plate appears in 1928, and three more sit in the decade after it, because the institution is the argument.

There is a second reason Fleming was slow and it is the most creditable thing in his career.

In 1917, in a converted casino at Boulogne, he proved that the antiseptics being poured into wounds on the Western Front reached the top of a jagged wound and never the bottom, and killed the white cells on the way. He built a glass tube with serrated sides to demonstrate it and published in The Lancet in September 1917, against the entire weight of army surgery.

That is the truest thing he ever proved, and it taught him that chemicals put into a human being do more harm than the germ. He was right, and it is exactly the lesson that made him hesitant about the substance in Chapter 9.

Chapter 9 is the 1929 paper, and both of the things it says are set out here.

The paper proposes penicillin chiefly as a selective culture medium — a way of isolating Pfeiffer's bacillus by killing everything else on the plate. And in one sentence it suggests that it might be injected.

Both are in the document. Every argument about Alexander Fleming's foresight has been conducted for eighty years by people quoting one of those sentences and not the other, and this book gives both, each at the length the paper itself gives it, in substance rather than in Fleming's wording, and prints the pages the wording sits on, because the paper is short and freely available and nobody reads it.

The credit itself can be dated to a single week, and Chapter 16 does.

In August 1942 a man named Harry Lambert was dying of streptococcal meningitis at St Mary's. Fleming asked Florey for the drug, went to Oxford to collect it himself, and injected it into the patient's spine. Lambert lived.

A leader appeared in The Times. On 31 August, Almroth Wright wrote to the paper asking that the laurel wreath be given to Fleming and to St Mary's. Oxford's reply came late and through an intermediary, and Howard Florey would not speak to reporters at all — not then, and not for the rest of his life.

That is the week. One institution had a publicity operation and the other had a principle, and the principle lost, and it is not obvious that anybody did anything wrong.

Three more things.

Norman Heatley built the extraction apparatus out of bedpans, biscuit tins and a doorbell, invented the assay, and made the morning of 25 May 1940 physically possible. Eight mice, four of them treated, and Heatley sitting up until a quarter to four to see how it came out. All four untreated mice dead; all four treated alive.

The Nobel Prize permits three names. Chapter 19 is about what a prize can measure and what it structurally cannot.

The Churchill stories are false. Fleming's father did not pull a drowning boy out of a bog, and penicillin did not save Churchill at Carthage. Both are labelled false at first mention in this book rather than corrected in a note, because a correction that arrives after the story has been told is not a correction.

And Chapter 18 is Stockholm, on 11 December 1945, where Alexander Fleming stood up and described, precisely and in advance, the thing that has since happened: penicillin sold over a counter, a man taking too little of it, educating the microbe rather than killing it, and passing on an organism that kills somebody else.

He was not guessing. Edward Abraham and Ernst Chain had published the bacterial enzyme that destroys penicillin in Nature in 1940, five years before he spoke.

It is the most accurate judgement of his life and he made it at the moment he had the least reason to.

He was born on eight hundred acres of Ayrshire moor above Darvel, a mile from the nearest neighbour, and walked four miles to school. His father died when he was seven. He spent four years as a shipping clerk copying bills of lading, and a legacy from an uncle in 1901 bought him a medical education. He went into research because the captain of the hospital rifle team wanted to keep a good shot at St Mary's.

A career decided by marksmanship. This book is about accident, and about what a country does with one.

Chapter 1 · Lochfield

The ground rises out of Darvel and keeps rising until the fields give out. Above the last of the dykes there is moor: peat and heather, rushes standing in water with nowhere to drain, bracken on the drier shoulders, burns cutting channels down the slope too deep for the amount of water in them. Lochfield sat up in that country. Eight hundred acres of it, and the first thing to understand about the figure is that in Ayrshire it did not mean money. Eight hundred acres of arable ground in the eastern counties would have been an estate. Eight hundred acres of moor is a different unit of measurement altogether. It is grazing. It is valued not by what it grows but by how many animals it will carry through a winter and how many hands it takes to bring them through, and a hill farm of that kind is a business conducted in weather and hours rather than in cash.

The nearest neighbour was a mile away. That is a short sentence with a great deal of childhood inside it. A mile in that landscape is not a mile of pavement; it is a mile of wet ground, and it means that the ordinary traffic of a village childhood — the other family's kitchen, the errand that turns into an afternoon, the argument overheard through a wall — did not happen. The company available at Lochfield was the company already in the house, plus whatever was outside it. Both were plentiful, and neither was various.

The year on such a farm has a fixed shape and very little in it is optional. Stock has to be gathered off the hill and put back on to it. Lambs come whether the weather is fit for them or not. Hay and peat both have to be won in whatever dry spells the west of Scotland allows and got under cover before the rain returns, and the rain always returns. Nothing on that list can be postponed by argument, and nothing on it is improved by discussion. A farm of that kind runs to a calendar written by the ground, and the people on it are simply the ones who turn up. It is a childhood of obligations that arrive without announcement and are met without comment, and it is a fair guess — offered as a guess and nothing more — that a boy raised inside it acquires a certain flatness in the face of urgency. In the years of his fame Fleming would be told repeatedly, by governments and newspapers and crowds, that a thing was urgent and enormous, and would meet nearly all of it with the same unraised voice.

Alexander Fleming was born in that farmhouse on 6 August 1881, to Hugh Fleming and Grace Morton. Grace was not Hugh's first wife, and the household was accordingly a compound one: children of an earlier marriage growing up alongside children of this one, spread across an age range wide enough that the eldest and the youngest were effectively living different lives under the same roof. This is worth pausing on, because the arithmetic of such a family is not merely domestic. On a hill farm, children are labour. The older ones work; the younger ones are watched by the older ones and then, soon enough, work as well. A family on that ground is not a crowd. It is a workforce, and it is barely sufficient.

What that arrangement produces is a particular kind of quiet. Not silence — a working farm is not silent — but a low volume of talk. There is nobody new to tell anything to. The tasks are known, they recur, they are done in the same order by the same people, and the instructions for them do not need issuing again. The shape of Fleming's later manner has often been traced back to this house, and the tracing is easy enough to be suspicious of, but the raw condition is documented and it is unusual: he grew up in a place where very little was said, because there was very little occasion to say it, and where the alternative to conversation was looking at things.

He looked at things on the way to school, at any rate, because the school was four miles off. It was Loudoun Moor, a small moorland school of the kind that gathered in the children of scattered farms at whatever point they could all reach, and the sources behind this book fix its name and the distance and very little else. It was not the whole of the schooling, though it is the part this chapter is about: the standard accounts take him on from Loudoun Moor to the school at Darvel, and then to Kilmarnock Academy on a two-year scholarship, and none of them attaches a distance to either of those. The distance is the part that matters. Four miles out across open ground, and then the same road home at the end of the day, is a substantial portion of a boy's waking life spent alone or nearly alone in the open. In an Ayrshire winter the outward walk is made in the dark and the return in something close to it. In summer it is made through midges and standing water. Whether the other children of the house walked it with him, and which of them, the record behind this book does not say.

What a walk like that gives a child is not, whatever the biographies of scientists like to suggest, an early education in natural history. It gives him time and it gives him weather, and it establishes as a daily fact that the world outside the door is a thing that happens whether or not anybody is attending to it. Burns come up after rain and go down again. The moor changes colour through the year in a fixed order. Frost lifts the ground and lets it down. None of this is instruction. It is exposure, over years, to a set of processes that do not announce themselves and do not care whether they are noticed, and it rewards a particular temperament: the one that notices anyway, and does not immediately say so.

It is worth being exact about what that is worth, because the claim is easy to inflate. Observation of the kind a moor teaches is not a scientific method and does not produce a discovery. What it produces, at most, is a low threshold for finding something interesting — a habit of looking at the thing that is not behaving as expected instead of clearing it away and starting again. The most consequential act of Fleming's professional life was of precisely that kind. It was not an experiment. It was a decision not to throw out a plate that had been spoiled, and to look instead at what had spoiled it. Whether a childhood on the moor above Darvel had anything to do with that is not a question the record can answer, and this book will not pretend that it can. What can be said is that the disposition and the childhood are consistent with one another — which is a far weaker statement than the legend prefers, and the only one that is honest.

In 1888 Hugh Fleming died. Alexander was seven.

The event is one of the few things in this chapter that the record holds securely, and it is the hinge of the childhood. It left Grace Morton on eight hundred acres of moor with four stepchildren and four of her own — eight children and no husband — and it left the farm to be worked by a widow and whichever of them were old enough to be useful. Precisely how that was arranged — who took what, what was decided in the weeks afterwards, what it cost — is not something this book can document. A widow and the older children is the shape of it, and the shape is all the record gives. What can be said without inference is that from the age of seven Alexander Fleming lived in a household that was short of an adult and could not afford to be, and that the ordinary economic slack of a family — the ability to keep a boy at his books past the point where his hands are wanted — was gone from the house before he was old enough to notice it going.

A death on a hill farm is not only a bereavement. It is the removal of a unit of labour from an operation that has no spare, and it raises at once a question that has nothing to do with grief: whether the family can hold the ground. At Lochfield the answer was that they could, or at least that they did. Fleming's Ayrshire years run on past his father's death and do not close until 1895. But the terms on which they ran are not recoverable. The record behind this book does not establish whether the farm was owned or rented, what it earned in a good year or a bad one, what Hugh Fleming died of, or which of the older children took over which part of his work. These are not trivia. They are the entire material condition of the childhood, and a biography that intends to explain a man by his early hardship or his early security ought to be able to say which of the two he had. This one cannot, and would rather say so than choose.

Nothing in the sources behind this book preserves what he thought about his father's death. There is no letter from Lochfield, no boyhood diary, no recollection set down close enough to the event to be worth more than the memory of the man setting it down. This is not a gap that can be closed by looking harder in the right archive. It is a gap of the kind that most childhoods are, and the honest position is to state it and move on rather than to fill it with the emotions the scene appears to require. He was seven; his father died; he went on walking to Loudoun Moor.

It is necessary at this point to be plain about where the rest of this chapter comes from, because it bears on everything that follows.

Almost the whole of what is known about Lochfield reaches us through a single authorised biography written by a novelist. André Maurois published The Life of Sir Alexander Fleming, Discoverer of Penicillin in 1959, at the instigation of Fleming's widow, Amalia, and with the family's cooperation. Maurois was a writer of great fluency and no scientific training, and his book is the largest single manufacturer of the Fleming legend — the version in which the boy on the moor is already, visibly, the man who will find penicillin. It is also, unavoidably, the source for the farm. Nobody else was there, nobody else gathered the family's recollections, and the domestic texture of the Ayrshire years exists in print because Maurois went and collected it. The correct posture towards such a book is not to discard it, which would leave nothing, but to take its facts and decline its judgements: to keep the geography, the dates and the household arithmetic, and to leave the anecdotes where they lie.

There is a further problem, and it is one of distance. The Ayrshire childhood ended in 1895. Maurois wrote in 1959, sixty-four years later, in a house of people who by then knew exactly what the boy had grown into. Every family recollection gathered in those conditions has passed through the knowledge of the ending. The child who stared at things becomes, in the retelling, the child who was always going to notice a plate of mould; the quiet boy becomes the modest great man in embryo. This is not dishonesty on anybody's part. It is what memory does when it is asked, decades on, to explain an outcome that everybody in the room already knows. It means that the anecdotes of Fleming's boyhood — and there are the usual ones, of the sort attached to every scientific life — cannot be tested, and that a book which prints them as evidence is printing the ending twice.

So this chapter declines the temptation, which is a strong one and which the shape of a first chapter almost demands. The temptation is to make the moor explain the microscope. It is available in several flavours. The solitary boy learns to observe; the fatherless boy learns self-sufficiency; the Scot on the hill learns thrift, and thrift becomes the man who will not throw away a contaminated plate. Each of these is plausible. Each is the sort of thing that would be said about any careful adult who happened to be raised in the country, and none of them can be checked. Worse, they all perform the same trick, which is to make the later life inevitable — and inevitability is precisely the wrong instrument for this particular subject, whose career turns on a sequence of accidents so pronounced that the book will spend chapters establishing them. A man whose profession was settled by a rifle club and whose fame was settled by an exchange of letters in a newspaper is not well served by a childhood that predicted him.

There is a further reason to be strict about it here, and it is that the same operation will have to be performed later in the book on far more important material. Gwyn Macfarlane, an Oxford haematologist who had worked at the Sir William Dunn School under Howard Florey, published Alexander Fleming: The Man and the Myth in 1984. Its central charge is that Fleming did not understand what he had, did not pursue it, and afterwards produced a more prescient version of his own story than the contemporary documents will bear. It is the most forensic book anyone has written on the subject, and it is also an Oxford man's account of a quarrel Oxford was a party to, which the reader is entitled to know and which this book will go on saying. But the technique Macfarlane describes — a man reorganising his past around an outcome he could not have known — is not a technique confined to the man. Families do it. Hospitals do it. Authorised biographers do it, at length and with charm. If the method is going to be applied to Fleming's later account of what happened on that plate, it has to be applied first to the account of a boy on a hill above Darvel, and the answer has to be arrived at the same way in both places: by asking what was written down at the time, and by saying so plainly when the answer is that nothing was.

What the record will support is narrower and more useful. It supports a boy raised in a house where very little was said, in country where almost nothing happened quickly, at a distance from other people that made watching a more available activity than talking. It supports the fact that this manner never left him. He was, by every account that survives, a man who did not say — not evasive, not secretive in any way anyone could point to, simply a man who declined to supply the sentence a situation was calling for. Colleagues found it disconcerting. Journalists, much later, found it charming.

That last transformation is the one to hold on to, because it is where this chapter connects to the argument of the book. Kevin Brown, the archivist at St Mary's who has spent a career with the Fleming collections and who published his account in 2004, makes the case that the fame was manufactured by an institution rather than by the man, and that a large part of the mechanism was a simple misreading: Fleming's Scottish taciturnity was taken for modesty, and then rewarded for it. The manner formed on the moor above Darvel would eventually be worth more to him than any of his science. He did not build it for that purpose. He appears never to have used it for that purpose. It worked all the same.

The same manner reads two ways, which is why the argument about Fleming has never settled. Set beside a microphone, silence looks like modesty and is rewarded as such. Set beside a discovery that needed somebody to bang on doors for it, the same silence looks like passivity, and it is the exhibit for the prosecution. Both readings are available from the identical evidence, and both have distinguished books behind them. A reader who wants to know which is right will not get the answer from Ayrshire, because a boy who does not talk much is not yet either of those men. He is a boy who does not talk much.

None of which explains what this book is actually about. In 1928 Alexander Fleming would look at a plate of staphylococci that a mould had got into, notice that the colonies nearest the mould had dissolved, and write it down. And then, for eleven years, essentially nothing would happen — years in which the substance he had named sat in a laboratory in Paddington while the infections it acted on went on killing people. The standard explanation for those eleven years is a failure of imagination in the man, and the standard supporting evidence is his character: the quiet Scot, unassertive, incurious beyond the bench, temperamentally unequipped to push. It is an explanation that runs straight back to Lochfield, and it is very nearly the only thing the childhood is ever used for.

This book does not think the moor is the answer. The eleven years have an address, and it is not in Ayrshire; it is a building on Praed Street where the founding doctrine held that chemicals could not cure infection, where the wages were paid by selling vaccines, and where there was no biochemist on the staff to hand a filtrate to. That argument takes several chapters to make, and it cannot be made until the building has been described.

What can be said here is that the boy left. The Ayrshire years close in 1895, and the moor and the farmhouse and the school four miles off close with them. He was never afterwards a farmer, and he did not, in the manner of men who become famous, spend his later life talking about the hill. He kept the manner and dropped the place.

Eight hundred acres of it, and a mile to the nearest door.