WEBVTT 00:00:00.000 --> 00:00:02.759 Okay, let's unpack this. I want you to imagine 00:00:02.759 --> 00:00:06.679 a scenario. Just put yourself in this room. It's 00:00:06.679 --> 00:00:11.080 1950. All right, 1950. You're a doctor, and you 00:00:11.080 --> 00:00:13.779 are standing in the delivery room. You have a 00:00:13.779 --> 00:00:17.160 patient in labor. And let's say it's a... pretty 00:00:17.160 --> 00:00:20.120 difficult labor. Which was incredibly common, 00:00:20.219 --> 00:00:22.440 obviously. Right. Now, you can measure the mother's 00:00:22.440 --> 00:00:25.379 blood pressure. You can check her pulse. You 00:00:25.379 --> 00:00:27.140 can ask her, you know, where it hurts. You have 00:00:27.140 --> 00:00:29.460 all this data on her. Yeah, that's standard procedure, 00:00:29.600 --> 00:00:31.699 even back then. But then there's the other patient 00:00:31.699 --> 00:00:35.420 in the room, the baby. And regarding that baby, 00:00:35.600 --> 00:00:39.100 you were effectively flying blind. You have absolutely 00:00:39.100 --> 00:00:42.619 no way of knowing what is happening inside that 00:00:42.619 --> 00:00:44.960 womb. None at all. You don't know if the baby's 00:00:44.960 --> 00:00:46.820 getting enough oxygen. You don't know if their 00:00:46.820 --> 00:00:49.000 heart rate is crashing. You were literally just 00:00:49.000 --> 00:00:50.380 waiting for them to come out to see if they're 00:00:50.380 --> 00:00:53.200 alive. It's a terrifying thought, isn't it? But 00:00:53.200 --> 00:00:56.100 that was the reality of obstetrics for centuries. 00:00:56.679 --> 00:01:00.039 The fetus was essentially the black box. A complete 00:01:00.039 --> 00:01:03.079 mystery. Exactly. In fact, historically, the 00:01:03.079 --> 00:01:04.700 fetus wasn't even really viewed as a separate 00:01:04.700 --> 00:01:07.700 patient. Yeah. It was seen as a part of the mother, 00:01:07.819 --> 00:01:10.739 almost like an organ or an appendage. You managed 00:01:10.739 --> 00:01:12.859 the mother and the baby was just. The result. 00:01:13.099 --> 00:01:15.480 Right. The result. An after effect of the pregnancy. 00:01:15.620 --> 00:01:19.060 So it was just a massive wait and see game. Yeah. 00:01:19.140 --> 00:01:21.879 But with the highest stakes imaginable. Completely. 00:01:21.879 --> 00:01:25.400 Well, today we're doing a deep dive into the 00:01:25.400 --> 00:01:29.340 man who smashed that black box wide open. The 00:01:29.340 --> 00:01:32.040 men who decided that hoping for the best just 00:01:32.040 --> 00:01:34.379 wasn't a valid medical strategy. We're talking 00:01:34.379 --> 00:01:36.640 about Eric Saling. A name that really should 00:01:36.640 --> 00:01:39.879 be as famous as Pastor or Lister. Yeah, you really 00:01:39.879 --> 00:01:41.719 don't hear enough outside of medical history 00:01:41.719 --> 00:01:44.239 circles. You don't. But in those circles, he 00:01:44.239 --> 00:01:46.659 is widely recognized as the father of perinatal 00:01:46.659 --> 00:01:49.099 medicine. And looking at the sheer volume of 00:01:49.099 --> 00:01:51.400 sources we're pulling from today, the biographies, 00:01:51.400 --> 00:01:54.219 technical papers, patent records. There's a lot. 00:01:54.280 --> 00:01:57.019 So much. It is not an exaggeration to say that 00:01:57.019 --> 00:01:59.200 he single -handedly dragged obstetrics into the 00:01:59.200 --> 00:02:01.359 modern age. It's incredible. I mean, if you were 00:02:01.359 --> 00:02:04.540 born after, say, 1965, the fact that you were 00:02:04.540 --> 00:02:07.019 sitting here today, healthy, breathing, without 00:02:07.019 --> 00:02:09.990 brain damage from oxygen. deprivation it's highly 00:02:09.990 --> 00:02:12.210 likely because of protocols this man invented 00:02:12.210 --> 00:02:15.370 that is wild it is and the central theme of his 00:02:15.370 --> 00:02:18.250 life the thing that drove him for 70 years was 00:02:18.250 --> 00:02:21.930 this realization that the time around birth is 00:02:21.930 --> 00:02:24.689 and i'm quoting his actual words here the most 00:02:24.689 --> 00:02:27.650 dangerous stage of life that's a heavy statement 00:02:27.650 --> 00:02:30.610 it is but statistically it's absolutely true 00:02:30.610 --> 00:02:33.210 you can live for 80 years drive cars catch the 00:02:33.210 --> 00:02:35.849 flu maybe smoke a cigarette or two sure but the 00:02:35.849 --> 00:02:39.330 few hours of labor and delivery That is statistically 00:02:39.330 --> 00:02:41.650 the moment you are most likely to die or suffer 00:02:41.650 --> 00:02:45.169 a permanent injury. Wow. And Saling made it his 00:02:45.169 --> 00:02:47.990 absolute mission to change those odds. But here's 00:02:47.990 --> 00:02:50.629 where it gets really interesting to me. You would 00:02:50.629 --> 00:02:53.189 expect a medical pioneer like this to come from, 00:02:53.229 --> 00:02:56.150 I don't know, a long line of famous surgeons 00:02:56.150 --> 00:02:58.689 or wealthy academics. Right. The typical pedigree. 00:02:58.750 --> 00:03:01.110 Exactly. Yeah. But Saling's story starts in a 00:03:01.110 --> 00:03:02.569 completely different setting. It starts in a 00:03:02.569 --> 00:03:05.449 forest. It does. Eric Saling was born in 1925 00:03:05.449 --> 00:03:08.120 in Stanislaus. Back then it was Poland. Today 00:03:08.120 --> 00:03:10.960 it's part of Ukraine. And his father, Heinrich, 00:03:11.120 --> 00:03:13.979 was a forestry manager. A forestry manager. I 00:03:13.979 --> 00:03:17.120 just love this detail so much. So he wasn't learning 00:03:17.120 --> 00:03:19.120 anatomy at the dinner table. He was learning 00:03:19.120 --> 00:03:22.039 about trees. He was learning about systems, really. 00:03:22.219 --> 00:03:24.900 And more importantly, he was learning craftsmanship. 00:03:25.340 --> 00:03:27.979 The sources emphasize that young Eric inherited 00:03:27.979 --> 00:03:30.680 a very specific set of hands -on craft skills 00:03:30.680 --> 00:03:33.300 from his dad. He learned how to build things, 00:03:33.520 --> 00:03:36.539 how to fix mechanical issues, how to tinker. 00:03:36.719 --> 00:03:39.080 Which sounds like a great hobby for a kid, but 00:03:39.080 --> 00:03:41.580 how does that translate to saving babies? Well, 00:03:41.599 --> 00:03:44.219 think about the era. In the 1950s, if you had 00:03:44.219 --> 00:03:46.699 a theory about a new medical tool, you couldn't 00:03:46.699 --> 00:03:48.759 just hop on the internet and order a... prototype 00:03:48.759 --> 00:03:51.159 from a manufacturer in China. Right. The tools 00:03:51.159 --> 00:03:53.400 just didn't exist. If you wanted to look inside 00:03:53.400 --> 00:03:55.560 the womb, you had to physically build the window 00:03:55.560 --> 00:03:58.319 yourself. So that tinker mindset was actually 00:03:58.319 --> 00:04:00.639 a prerequisite for the job he was about to do. 00:04:00.800 --> 00:04:03.520 Exactly. He had the medical theory, yes. But 00:04:03.520 --> 00:04:05.560 he also had the engineering grit to go down to 00:04:05.560 --> 00:04:07.620 a workshop and actually construct the devices 00:04:07.620 --> 00:04:09.759 he needed with his bare hands. Before he could 00:04:09.759 --> 00:04:11.780 start building anything, though, he had to get 00:04:11.780 --> 00:04:14.919 through the 1940s. And looking at his timeline, 00:04:15.159 --> 00:04:19.379 it is just chaotic. Chaotic is putting it mildly. 00:04:19.740 --> 00:04:22.199 He finishes his Abitur, his high school exams 00:04:22.199 --> 00:04:26.759 in 1943. He's 18 years old and immediately he 00:04:26.759 --> 00:04:29.180 is conscripted into the military. So he spends 00:04:29.180 --> 00:04:31.699 two years in the Wehrmacht during the absolute 00:04:31.699 --> 00:04:33.779 collapse of the German front in World War Two. 00:04:33.860 --> 00:04:37.310 Right. Just brutal conditions. And then in 1945, 00:04:37.750 --> 00:04:40.470 amidst the rubble and the ruin of post -war Germany, 00:04:40.689 --> 00:04:43.089 he decides to enroll in medical school, first 00:04:43.089 --> 00:04:45.670 in Jena, and then he moves to Berlin. And you 00:04:45.670 --> 00:04:47.750 have to remember, studying in Berlin between 00:04:47.750 --> 00:04:51.709 1945 and 1952 meant navigating a city that was 00:04:51.709 --> 00:04:53.790 literally being ripped in half. Oh, yeah. The 00:04:53.790 --> 00:04:55.769 sources mentioned he was constantly moving between 00:04:55.769 --> 00:04:58.110 the Soviet sector and the Western sectors just 00:04:58.110 --> 00:05:00.610 to attend classes and do his studies. Unbelievable 00:05:00.610 --> 00:05:03.329 stress. Immense instability. But he stuck with 00:05:03.329 --> 00:05:05.360 it. He eventually got his doctorate from the 00:05:05.360 --> 00:05:08.040 Free University of Berlin in 1952. But here is 00:05:08.040 --> 00:05:10.639 the real pivot point. Okay. When he finally qualifies 00:05:10.639 --> 00:05:13.800 as a specialist in 1958, he chooses gynecology 00:05:13.800 --> 00:05:16.319 and midwifery. Which apparently was the unfashionable 00:05:16.319 --> 00:05:18.379 choice at the time. Extremely unfashionable. 00:05:18.439 --> 00:05:20.579 It wasn't the rock star medicine of the era, 00:05:20.720 --> 00:05:23.839 cardiac surgery, neurology, that was where the 00:05:23.839 --> 00:05:26.839 glory was. That's where you went if you wanted 00:05:26.839 --> 00:05:30.199 to be famous. Exactly. Obstatrix was seen as 00:05:30.199 --> 00:05:34.079 messy, unpredictable, and frankly, a bit low 00:05:34.079 --> 00:05:37.639 -tech. It was viewed as women's work by a very 00:05:37.639 --> 00:05:40.279 traditional male -dominated medical establishment. 00:05:40.639 --> 00:05:42.939 But Saling had this trait that keeps coming up 00:05:42.939 --> 00:05:47.100 in the texts. Stubborn persistence. Yeah. He 00:05:47.100 --> 00:05:49.699 didn't care about the prestige. He saw a mechanical 00:05:49.699 --> 00:05:52.300 problem that needed fixing. He saw that black 00:05:52.300 --> 00:05:55.560 box and he decided he was going to build a dashboard 00:05:55.560 --> 00:05:58.720 for it. So let's get into the how then. Because 00:05:58.720 --> 00:06:01.939 almost immediately after he qualifies, the inventions 00:06:01.939 --> 00:06:04.360 just start coming. And the first one is a perfect 00:06:04.360 --> 00:06:06.620 example of that forestry background meeting medicine. 00:06:06.899 --> 00:06:08.680 You're talking about the newborn resuscitation 00:06:08.680 --> 00:06:11.040 machine. Right. What was the situation in the 00:06:11.040 --> 00:06:13.100 delivery room before he built this thing? It 00:06:13.100 --> 00:06:15.500 was primitive. If a baby was born and wasn't 00:06:15.500 --> 00:06:17.639 breathing, doctors would try to manually clear 00:06:17.639 --> 00:06:19.620 the airway with a simple suction ball, maybe 00:06:19.620 --> 00:06:21.699 do a mouth -to -mouth. Just guessing. Basically. 00:06:21.699 --> 00:06:24.600 Very inconsistent. So sailing, realizing he needed 00:06:24.600 --> 00:06:26.779 a better tool, built a double -barreled machine 00:06:26.779 --> 00:06:29.500 with his own hands. How did it actually work? 00:06:29.779 --> 00:06:33.959 Simple physics. It had two tubes. One tube blew 00:06:33.959 --> 00:06:36.600 pure oxygen into the lungs to inflate them and 00:06:36.600 --> 00:06:39.279 deliver oxygen. The other tube simultaneously 00:06:39.279 --> 00:06:42.399 sucked mucus and fluid out of the airway. So 00:06:42.399 --> 00:06:44.860 it's a continuous cycle. Right. It allowed for 00:06:44.860 --> 00:06:47.459 clearing and oxygenating at the exact same time. 00:06:47.519 --> 00:06:49.439 It sounds so logical. Blow the good stuff in, 00:06:49.459 --> 00:06:52.199 suck the bad stuff out. It is logical, but nobody 00:06:52.199 --> 00:06:54.639 else had built it. That is the sailing difference 00:06:54.639 --> 00:06:56.500 right there. He didn't just write a theoretical 00:06:56.500 --> 00:06:58.779 paper about how resuscitation should work. He 00:06:58.779 --> 00:07:00.759 built the machine that made it work. But the 00:07:00.759 --> 00:07:03.360 real game changer, the innovation that completely 00:07:03.360 --> 00:07:06.000 defines his career, happened right around 1960, 00:07:06.519 --> 00:07:10.860 1961. This is fetal blood analysis. Yes. This 00:07:10.860 --> 00:07:14.100 is the moment obstetrics shifts from an art into 00:07:14.100 --> 00:07:16.339 a hard science. OK, let's slow down and really 00:07:16.339 --> 00:07:18.060 explain this one, because to me, this sounds 00:07:18.060 --> 00:07:20.740 like absolute science fiction for 1960. It really 00:07:20.740 --> 00:07:22.699 was. I mean, I know what a blood test is. I go 00:07:22.699 --> 00:07:24.519 to the clinic. I give you my arm. You take blood. 00:07:24.920 --> 00:07:27.000 But we are talking about a baby that is still 00:07:27.000 --> 00:07:30.120 hidden inside the mother. How on earth do you 00:07:30.120 --> 00:07:33.149 get a blood sample? That was the puzzle. Now, 00:07:33.189 --> 00:07:36.589 Saling had been using blood gas analysis on newborns 00:07:36.589 --> 00:07:38.949 after they were delivered, checking their oxygen 00:07:38.949 --> 00:07:42.290 and carbon dioxide levels to see if his resuscitation 00:07:42.290 --> 00:07:44.550 machine was doing its job. Okay, that makes sense. 00:07:44.709 --> 00:07:46.889 And he realized that the chemistry of the blood 00:07:46.889 --> 00:07:49.449 told the absolute truth about the baby's health. 00:07:49.629 --> 00:07:52.290 Because if the baby isn't getting oxygen, the 00:07:52.290 --> 00:07:55.149 blood chemistry actually changes. Exactly. And 00:07:55.149 --> 00:07:57.629 this is the key concept we need to understand 00:07:57.629 --> 00:08:00.990 here. Anaerobic metabolism. Break that down for 00:08:00.990 --> 00:08:03.910 us. Sure. When a human body, whether it's an 00:08:03.910 --> 00:08:06.850 adult or a fetus, runs out of oxygen, it doesn't 00:08:06.850 --> 00:08:09.470 just shut down instantly. It switches to an emergency 00:08:09.470 --> 00:08:12.389 power source. A backup generator. Exactly. It 00:08:12.389 --> 00:08:15.339 starts creating energy without... using oxygen 00:08:15.339 --> 00:08:18.500 but the byproduct of that emergency process is 00:08:18.500 --> 00:08:21.019 lactic acid like when you sprint way too hard 00:08:21.019 --> 00:08:23.399 and your legs start to burn precisely that burn 00:08:23.399 --> 00:08:26.040 you feel is lactic acid building up in your muscles 00:08:26.040 --> 00:08:29.560 now imagine that happening to a tiny fetus if 00:08:29.560 --> 00:08:32.139 the baby is suffocating during a long labor that 00:08:32.139 --> 00:08:34.620 acid builds up in their blood and what does acid 00:08:34.620 --> 00:08:38.559 do it lowers the ph level Exactly. A drop in 00:08:38.559 --> 00:08:42.500 pH is a chemical siren going off. It is scientific, 00:08:42.600 --> 00:08:45.419 undeniable proof that the baby is in distress. 00:08:45.840 --> 00:08:48.700 So Saling knew what he needed to measure. Right. 00:08:48.820 --> 00:08:51.500 The problem was just how to get the blood to 00:08:51.500 --> 00:08:53.179 measure it. And this is where he teams up with 00:08:53.179 --> 00:08:56.240 a chemist, Kay Dimashkin. Yes. Together, they 00:08:56.240 --> 00:08:58.679 developed a high -speed method to test blood 00:08:58.679 --> 00:09:02.299 oxygen and pH levels using only tiny, microscopic 00:09:02.299 --> 00:09:05.100 amounts of blood. Because you can't exactly draw 00:09:05.100 --> 00:09:07.259 a whole vial from a fetus. No, you just need 00:09:07.259 --> 00:09:09.379 a drop. So Saling developed a physical technique 00:09:09.379 --> 00:09:12.159 where once the mother's cervix was dilated enough 00:09:12.159 --> 00:09:14.399 and the water had broken, he could reach in with 00:09:14.399 --> 00:09:17.080 a specially designed tool. And do what? He would 00:09:17.080 --> 00:09:19.500 make a tiny superficial scratch on the baby's 00:09:19.500 --> 00:09:21.960 scalp. Because the head is usually the part presenting 00:09:21.960 --> 00:09:24.000 first in the birth canal, just a small prick. 00:09:24.179 --> 00:09:26.639 Okay. A single drop of blood would form on the 00:09:26.639 --> 00:09:29.039 scalp. He would then collect that drop into a 00:09:29.039 --> 00:09:31.940 long, thin glass capillary tube. While the baby 00:09:31.940 --> 00:09:34.259 is still fully inside. the mother. While the 00:09:34.259 --> 00:09:36.500 baby's still inside, he would take that glass 00:09:36.500 --> 00:09:39.179 tube, run the analysis on his machine, and within 00:09:39.179 --> 00:09:41.860 minutes, he would have a hard pH number. That 00:09:41.860 --> 00:09:44.480 is just wild. So suddenly, the doctor isn't just 00:09:44.480 --> 00:09:46.620 standing there guessing. He's not putting a stethoscope 00:09:46.620 --> 00:09:49.360 to the belly and thinking, hmm, maybe the heartbeat 00:09:49.360 --> 00:09:52.200 sounds a little slow. No more guessing. He has 00:09:52.200 --> 00:09:55.820 a binary decision tool. Wow. If the pH is normal, 00:09:56.039 --> 00:09:59.059 you know the baby is fine. You can wait, let 00:09:59.059 --> 00:10:02.240 labor progress naturally. But if the pH is low, 00:10:02.889 --> 00:10:05.970 If it's acidic, you know for a fact the baby 00:10:05.970 --> 00:10:08.450 is suffocating, and you need to perform an emergency 00:10:08.450 --> 00:10:10.970 C -section right then and there. That is the 00:10:10.970 --> 00:10:13.190 ultimate shift from guessing to knowing. It really 00:10:13.190 --> 00:10:16.149 is. It saved thousands of babies from unnecessary 00:10:16.149 --> 00:10:19.110 surgery, and it saved thousands more from severe 00:10:19.110 --> 00:10:21.529 brain damage caused by waiting just a little 00:10:21.529 --> 00:10:23.889 too long. And he didn't stop there. He was on 00:10:23.889 --> 00:10:27.230 a roll. In 1962, he comes out with another invention. 00:10:29.009 --> 00:10:30.409 Fristfasserspiegel? I hope I said that right. 00:10:30.470 --> 00:10:32.889 Close enough. Or, as we call it in English, the 00:10:32.889 --> 00:10:35.830 amnioscope. The amnioscope. This one sounds more 00:10:35.830 --> 00:10:38.129 visual than chemical. It was. This was all about 00:10:38.129 --> 00:10:40.529 looking before you leap. The device itself was 00:10:40.529 --> 00:10:43.009 incredibly simple. It was basically a conical 00:10:43.009 --> 00:10:45.110 metal tube with a bright light source attached 00:10:45.110 --> 00:10:47.549 to it. Like a specialized flashlight? Sort of. 00:10:48.190 --> 00:10:50.289 Saline would insert it through the cervix to 00:10:50.289 --> 00:10:52.850 press gently against the amniotic sac, the bag 00:10:52.850 --> 00:10:55.610 of waters, before it had even broken. So he's 00:10:55.610 --> 00:10:57.509 looking through the membrane. Yes. He's shining 00:10:57.509 --> 00:10:59.470 a light through to look at the amniotic fluid 00:10:59.470 --> 00:11:02.409 itself because he was looking for one very specific 00:11:02.409 --> 00:11:05.889 warning sign, meconium. Which is? The baby's 00:11:05.889 --> 00:11:09.250 first stool. Ah. See, when a fetus is under severe 00:11:09.250 --> 00:11:12.590 stress, usually from oxygen deprivation, their 00:11:12.590 --> 00:11:16.029 anal sphincter relaxes and they pass stool into 00:11:16.029 --> 00:11:18.809 the amniotic fluid. It turns the normally clear 00:11:18.809 --> 00:11:23.059 water to a murky green or brown. Oh, wow. So 00:11:23.059 --> 00:11:24.759 if sailing looked through his metal tube and 00:11:24.759 --> 00:11:27.500 saw green water. He instantly knew the baby was 00:11:27.500 --> 00:11:29.600 in trouble, even before labor really got going. 00:11:29.720 --> 00:11:31.840 It was just another brilliant way to peer into 00:11:31.840 --> 00:11:33.820 that black box. It's amazing to me because these 00:11:33.820 --> 00:11:36.340 aren't supercomputers. It's a metal tube with 00:11:36.340 --> 00:11:39.259 a light. It's a tiny scratch on the scalp. It's 00:11:39.259 --> 00:11:42.360 relatively low tech, but the impact is astronomical. 00:11:42.500 --> 00:11:44.440 And this leads us to the bigger picture here. 00:11:44.580 --> 00:11:47.419 The technology is fascinating, yes, but the philosophy 00:11:47.419 --> 00:11:49.860 behind it is what truly revolutionized the entire 00:11:49.860 --> 00:11:52.620 field of medicine. The sources refer to this 00:11:52.620 --> 00:11:55.500 as a paradigm shift. Saling wasn't just making 00:11:55.500 --> 00:11:58.220 cool gadgets in his workshop. He was changing 00:11:58.220 --> 00:12:00.919 the very definition of who the patient was. Correct. 00:12:01.120 --> 00:12:03.700 He essentially discovered the fetus as a patient. 00:12:03.919 --> 00:12:06.639 He wrote a groundbreaking book called Das Kind 00:12:06.639 --> 00:12:09.480 im Bereich der Geburtshilfe. Which translates 00:12:09.480 --> 00:12:12.820 to The Child in the Context of Obstetrics. Right. 00:12:12.860 --> 00:12:15.320 And in this book, he argued that the obstetrician 00:12:15.320 --> 00:12:18.100 has two patients in that room, not one. Which, 00:12:18.220 --> 00:12:20.899 again, seems so obvious to us sitting here today. 00:12:21.139 --> 00:12:24.679 It does now. But back then, it was highly controversial. 00:12:25.120 --> 00:12:28.919 Why? Why would anyone in the medical field object 00:12:28.919 --> 00:12:31.399 to treating the baby as a patient? Because it 00:12:31.399 --> 00:12:34.059 drastically increased their responsibility. Think 00:12:34.059 --> 00:12:36.279 about it. If the fetus is an official patient, 00:12:36.559 --> 00:12:39.100 you are now legally and ethically liable for 00:12:39.100 --> 00:12:41.259 its well -being. Ah, I see. You have to monitor 00:12:41.259 --> 00:12:43.600 it. You have to actively intervene. A lot of 00:12:43.600 --> 00:12:45.759 the traditionalists felt that birth was a natural 00:12:45.759 --> 00:12:48.179 process and nature should just take its course. 00:12:48.440 --> 00:12:51.039 And sailing wasn't having that. Not at all. Sailing 00:12:51.039 --> 00:12:53.970 was saying no. Nature is failing these babies 00:12:53.970 --> 00:12:56.129 and we now have the tools to save them. We have 00:12:56.129 --> 00:12:59.470 to use them. It completely disrupted the comfortable 00:12:59.470 --> 00:13:02.029 status quo. He had that famous quote we mentioned 00:13:02.029 --> 00:13:04.870 earlier. The period around an individual's birth 00:13:04.870 --> 00:13:07.350 is the most dangerous stage of life. It became 00:13:07.350 --> 00:13:10.269 his rallying cry. He absolutely refused to accept 00:13:10.269 --> 00:13:13.649 that death at birth was just fate or bad luck. 00:13:14.110 --> 00:13:16.789 So we move into the 70s. Sailing is well established. 00:13:16.850 --> 00:13:19.309 He's the expert in his field. Yeah. But reading 00:13:19.309 --> 00:13:20.909 through these notes, I was genuinely shocked 00:13:20.909 --> 00:13:22.490 by what came next. Oh, I know what you're going 00:13:22.490 --> 00:13:25.110 to say. Because he moves from immediate crisis 00:13:25.110 --> 00:13:28.950 management in the delivery room to... Well, it 00:13:28.950 --> 00:13:31.350 looks exactly like early telemedicine. This is 00:13:31.350 --> 00:13:33.190 hands down one of my favorite parts of his career. 00:13:33.269 --> 00:13:35.990 It just shows his incredible foresight. We tend 00:13:35.990 --> 00:13:38.149 to think of telemedicine as a very modern thing. 00:13:38.350 --> 00:13:41.070 Zoom calls, smartphone apps. Yeah. Saling was 00:13:41.070 --> 00:13:44.370 doing this in 1978. 1978. I mean, people barely 00:13:44.370 --> 00:13:46.610 had touchstone phones in their houses. Right. 00:13:47.110 --> 00:13:49.669 But he was heavily focused on the problem of 00:13:49.669 --> 00:13:52.950 premature birth. He knew that by the time a pregnant 00:13:52.950 --> 00:13:55.070 woman feels strong contractions and physically 00:13:55.070 --> 00:13:57.929 drives to the hospital, it's often too late to 00:13:57.929 --> 00:14:00.210 stop the labor. The baby just comes out too early 00:14:00.210 --> 00:14:02.049 and their lungs aren't ready to breathe air. 00:14:02.210 --> 00:14:04.789 Exactly. So he realized he needed to catch those 00:14:04.789 --> 00:14:06.990 contractions while the woman was still at home. 00:14:07.210 --> 00:14:09.549 Okay, so how did he pull that off in the 70s? 00:14:09.669 --> 00:14:13.149 He and a colleague, Hugh Blucher, invented a 00:14:13.149 --> 00:14:16.080 portable device called a cacademometer. That 00:14:16.080 --> 00:14:18.279 is quite a mouthful. It's just a fancy word for 00:14:18.279 --> 00:14:20.259 a sensor that measures uterine contractions. 00:14:20.440 --> 00:14:23.480 They gave these portable boxes to women who were 00:14:23.480 --> 00:14:26.460 at high risk for premature labor. Okay. The woman 00:14:26.460 --> 00:14:28.419 would strap the sensor to her belly at home. 00:14:28.820 --> 00:14:30.960 The device would pick up the muscle activity 00:14:30.960 --> 00:14:33.360 of her uterus and then convert that data into 00:14:33.360 --> 00:14:36.419 an acoustic signal. Literally beeps and tones. 00:14:36.740 --> 00:14:38.509 Oh, I think I see where this is going. Like an 00:14:38.509 --> 00:14:41.809 old dial -up modem. Exactly like that. The woman 00:14:41.809 --> 00:14:44.070 would pick up her telephone handset, call the 00:14:44.070 --> 00:14:46.110 hospital, and hold the phone up to the speaker 00:14:46.110 --> 00:14:49.259 on this device. The beeps would travel over the 00:14:49.259 --> 00:14:52.059 standard copper phone lines to the clinic, where 00:14:52.059 --> 00:14:55.220 another machine decoded those beeps back into 00:14:55.220 --> 00:14:58.080 a visual graph. He literally wired the human 00:14:58.080 --> 00:15:00.840 womb directly to the public telephone network. 00:15:01.000 --> 00:15:03.659 He did. A doctor could be sitting in his office 00:15:03.659 --> 00:15:06.620 drinking a cup of coffee, looking at a real -time 00:15:06.620 --> 00:15:09.480 graph of a patient's uterus from 10 miles across 00:15:09.480 --> 00:15:12.519 the city. That is just mind -blowing for 1978. 00:15:13.019 --> 00:15:15.870 And the best part is, it worked. It allowed for 00:15:15.870 --> 00:15:18.990 rapid, early intervention. If the doctor saw 00:15:18.990 --> 00:15:21.429 a dangerous contraction activity on the graph, 00:15:21.669 --> 00:15:23.649 they could immediately tell the woman over the 00:15:23.649 --> 00:15:26.549 phone to take specific medication. Stopping the 00:15:26.549 --> 00:15:28.570 labor before it became irreversible. Exactly. 00:15:28.590 --> 00:15:30.690 That connects right back to that theme of prevention. 00:15:31.210 --> 00:15:32.889 Sailing wasn't just interested in saving the 00:15:32.889 --> 00:15:35.009 baby during the crash. He was trying to prevent 00:15:35.009 --> 00:15:36.610 the crash from happening in the first place. 00:15:36.830 --> 00:15:38.889 Which brings us perfectly to his other major 00:15:38.889 --> 00:15:41.970 focus later in his career, infection. Right, 00:15:42.029 --> 00:15:44.779 the ascending infection theory. Yes. Sailing 00:15:44.779 --> 00:15:46.879 realized that a huge percentage of premature 00:15:46.879 --> 00:15:49.899 births were actually caused by bacteria moving 00:15:49.899 --> 00:15:52.659 up or ascending from the vagina into the uterus. 00:15:52.840 --> 00:15:55.720 And that bacteria weakens the amniotic sac. It 00:15:55.720 --> 00:15:58.360 does. It causes the water to break weeks or months 00:15:58.360 --> 00:16:00.659 too early. So how did he tackle the infection 00:16:00.659 --> 00:16:04.059 problem? Well, initially around 1978, he introduced 00:16:04.059 --> 00:16:06.700 very strict vaginal disinfection protocols for 00:16:06.700 --> 00:16:09.720 hospitals. But his most elegant genius solution 00:16:09.720 --> 00:16:13.519 came much later in 1999 and 2000. This is the 00:16:13.519 --> 00:16:16.139 indicator -coated panty liner. Yes. It sounds 00:16:16.139 --> 00:16:18.279 like such a humble everyday product, doesn't 00:16:18.279 --> 00:16:20.659 it? But it's actually brilliant science. How 00:16:20.659 --> 00:16:23.460 does a simple panty liner stop premature birth? 00:16:23.899 --> 00:16:25.919 Walk us through this. It all comes back to pH 00:16:25.919 --> 00:16:28.379 again. Sailing really understood the diagnostic 00:16:28.379 --> 00:16:30.879 power of pH. Right, like the scalp blood test. 00:16:31.080 --> 00:16:33.740 Exactly. Now, a healthy vaginal environment is 00:16:33.740 --> 00:16:36.399 naturally acidic. That acidity kills off bad 00:16:36.399 --> 00:16:38.919 bacteria. But if a dangerous infection is starting 00:16:38.919 --> 00:16:41.600 to brew, the environment becomes more alkaline. 00:16:41.620 --> 00:16:43.940 The pH number goes up. And I'm assuming that 00:16:43.940 --> 00:16:45.820 chemical change happens long before the woman 00:16:45.820 --> 00:16:48.340 actually feels sick or notices symptoms. Long 00:16:48.340 --> 00:16:51.240 before. Days or weeks before. So Sailing developed 00:16:51.240 --> 00:16:54.509 and patented a standard pan... with a built -as 00:16:54.509 --> 00:16:57.090 -litmus test strip. Oh, wow. If the color on 00:16:57.090 --> 00:16:59.309 the strip changed, the woman instantly knew her 00:16:59.309 --> 00:17:01.750 pH was off. She could just go to her doctor, 00:17:01.909 --> 00:17:05.009 get a simple, cheap round of antibiotics, and 00:17:05.009 --> 00:17:07.910 clear the infection entirely before it ever triggered 00:17:07.910 --> 00:17:10.250 premature labor. I love this invention so much 00:17:10.250 --> 00:17:12.710 because it puts the power directly in the patient's 00:17:12.710 --> 00:17:15.289 hands. He didn't build a million -dollar machine 00:17:15.289 --> 00:17:17.769 for the hospital this time. He made a simple 00:17:17.769 --> 00:17:20.470 tool for the bathroom cabinet. It's the ultimate 00:17:20.470 --> 00:17:23.000 democratization of safety. He realized that the 00:17:23.000 --> 00:17:25.539 absolute best person to monitor a pregnancy was 00:17:25.539 --> 00:17:28.319 the pregnant woman herself. Give her the tools 00:17:28.319 --> 00:17:31.000 and she will protect her baby. That is incredible. 00:17:31.180 --> 00:17:33.200 Now, Saling was a professor at the Free University 00:17:33.200 --> 00:17:36.660 of Berlin for a long, long time. But in 1991, 00:17:37.039 --> 00:17:40.759 he turned 65. And in the German university system, 00:17:40.980 --> 00:17:43.980 that means mandatory retirement. Yes. The university 00:17:43.980 --> 00:17:45.940 essentially said, thank you for your service. 00:17:45.980 --> 00:17:48.460 Time to go home. But sailing really wasn't the 00:17:48.460 --> 00:17:50.359 type to just sit on a porch and feed pigeons 00:17:50.359 --> 00:17:52.680 all day. Retirement is for other people. Truly. 00:17:52.759 --> 00:17:55.559 Two years after he, quote unquote, retired in 00:17:55.559 --> 00:17:59.240 1993, he founded the Eric Sailing Institute for 00:17:59.240 --> 00:18:02.200 Perinatal Medicine in Berlin. Just started his 00:18:02.200 --> 00:18:04.619 own place. It was a nonprofit. He basically built 00:18:04.619 --> 00:18:07.789 his own institute from scratch. just so he could 00:18:07.789 --> 00:18:09.930 keep working on these problems. And he kept going 00:18:09.930 --> 00:18:12.490 for a remarkably long time. He did. He worked 00:18:12.490 --> 00:18:15.710 tirelessly on preventing preterm births and improving 00:18:15.710 --> 00:18:18.009 prenatal care worldwide, essentially until the 00:18:18.009 --> 00:18:20.910 very end of his life. He passed away in 2021 00:18:20.910 --> 00:18:24.710 at the age of 96. 96. That is a 70 -year career 00:18:24.710 --> 00:18:28.339 in medicine. And a very... Full, rich life outside 00:18:28.339 --> 00:18:31.059 of the lab, too. The sources mention he was married 00:18:31.059 --> 00:18:33.480 to Hella Wayman, who was a fellow physician for 00:18:33.480 --> 00:18:36.559 nearly 70 years. They got married back in 1952. 00:18:36.759 --> 00:18:39.279 A real medical power couple. They had two sons, 00:18:39.519 --> 00:18:42.380 Peter, who actually became a gynecologist just 00:18:42.380 --> 00:18:44.940 like his father, and Michael, who went into business. 00:18:45.180 --> 00:18:47.920 And by the time sailing passed, he had many grandchildren 00:18:47.920 --> 00:18:50.160 and great -grandchildren. Which feels incredibly 00:18:50.160 --> 00:18:52.880 poetic, doesn't it? A man who spent his entire 00:18:52.880 --> 00:18:55.400 life ensuring that other people got to have healthy 00:18:55.400 --> 00:18:58.119 grandchildren, getting to enjoy a large, thriving 00:18:58.119 --> 00:19:00.420 family of his own. It is a very fitting legacy 00:19:00.420 --> 00:19:02.880 for him. So as we wrap this up, let's zoom out 00:19:02.880 --> 00:19:05.180 a bit. We've gone from the forestry manager's 00:19:05.180 --> 00:19:08.359 son tinkering with metal tubes to the man who 00:19:08.359 --> 00:19:11.240 literally wired up pregnancies to the telephone 00:19:11.240 --> 00:19:14.500 network. When you look at Eric Saling's contribution 00:19:14.500 --> 00:19:17.460 as a whole, what is the big takeaway for you? 00:19:18.039 --> 00:19:21.339 I think the main takeaway is his absolute refusal 00:19:21.339 --> 00:19:24.740 to accept the black docs. He refused to accept 00:19:24.740 --> 00:19:26.380 that we couldn't know what was happening inside 00:19:26.380 --> 00:19:28.880 the womb. He made the invisible visible. Exactly. 00:19:29.119 --> 00:19:32.240 He used every single tool available to him, chemistry, 00:19:32.480 --> 00:19:34.859 optics, mechanics, even the telephone, to turn 00:19:34.859 --> 00:19:37.339 the fetus from an appendage into a patient that 00:19:37.339 --> 00:19:40.039 could be actively treated. He moved us from faith 00:19:40.039 --> 00:19:42.539 to hard science in the delivery room. And it 00:19:42.539 --> 00:19:44.490 really strikes me that... Many people listening 00:19:44.490 --> 00:19:46.589 to us right now, or maybe their children or grandchildren, 00:19:46.849 --> 00:19:49.710 might literally not be here without those innovations. 00:19:50.109 --> 00:19:52.509 It is highly probable. Whether it was the fetal 00:19:52.509 --> 00:19:55.490 heart monitoring, the focus on pH levels, or 00:19:55.490 --> 00:19:57.390 just the general cultural shift in attention 00:19:57.390 --> 00:19:59.990 toward the unborn child, Salink's fingerprints 00:19:59.990 --> 00:20:02.750 are on practically every single birth that happens 00:20:02.750 --> 00:20:05.410 in a modern hospital today. It really puts things 00:20:05.410 --> 00:20:08.220 in perspective. We live in an age right now where 00:20:08.220 --> 00:20:11.279 we are so obsessed with the next high -tech miracle. 00:20:11.500 --> 00:20:14.079 We want AI doctors, we want robotic surgery, 00:20:14.339 --> 00:20:17.440 gene editing. But Saling's story reminds us that 00:20:17.440 --> 00:20:20.099 sometimes the life -saving solution isn't a supercomputer. 00:20:20.619 --> 00:20:24.680 Right. I mean, in 1978, he used a standard rotary 00:20:24.680 --> 00:20:28.140 telephone to save premature babies. In 2000, 00:20:28.359 --> 00:20:30.480 he used a panty liner with a piece of litmus 00:20:30.480 --> 00:20:33.279 paper to prevent major infections. That is the 00:20:33.279 --> 00:20:35.180 provocative thought I'm left with after reading 00:20:35.180 --> 00:20:38.079 all this material. Saling looked at a 100 -year 00:20:38.079 --> 00:20:39.980 -old technology to the telephone, and he saw 00:20:39.980 --> 00:20:43.240 a medical device. He looked at a simple pH strip 00:20:43.240 --> 00:20:45.980 and saw a lifesaver. It makes you ask yourself, 00:20:46.160 --> 00:20:48.619 what other low -tech solutions are we completely 00:20:48.619 --> 00:20:51.420 overlooking today? We're all so busy looking 00:20:51.420 --> 00:20:54.240 for massively complex answers, but maybe the 00:20:54.240 --> 00:20:56.400 solution to our biggest medical problems is sitting 00:20:56.400 --> 00:20:58.539 right there in the hardware store, just waiting 00:20:58.539 --> 00:21:00.339 for someone with a tinkerer's mindset to pick 00:21:00.339 --> 00:21:02.319 it up. Sometimes the most revolutionary tool 00:21:02.319 --> 00:21:04.779 of all is just a fresh perspective and a healthy 00:21:04.779 --> 00:21:07.859 dose of stubborn persistence. A fresh perspective 00:21:07.859 --> 00:21:10.339 and maybe some forestry skills. Hey, it couldn't 00:21:10.339 --> 00:21:12.359 hurt. Thanks for joining us for this deep dive 00:21:12.359 --> 00:21:15.039 into the life of Eric Saling. We'll catch you 00:21:15.039 --> 00:21:15.460 on the next one.