Okay, let's unpack this. I want you to imagine
a scenario. Just put yourself in this room. It's
1950. All right, 1950. You're a doctor, and you
are standing in the delivery room. You have a
patient in labor. And let's say it's a... pretty
difficult labor. Which was incredibly common,
obviously. Right. Now, you can measure the mother's
blood pressure. You can check her pulse. You
can ask her, you know, where it hurts. You have
all this data on her. Yeah, that's standard procedure,
even back then. But then there's the other patient
in the room, the baby. And regarding that baby,
you were effectively flying blind. You have absolutely
no way of knowing what is happening inside that
womb. None at all. You don't know if the baby's
getting enough oxygen. You don't know if their
heart rate is crashing. You were literally just
waiting for them to come out to see if they're
alive. It's a terrifying thought, isn't it? But
that was the reality of obstetrics for centuries.
The fetus was essentially the black box. A complete
mystery. Exactly. In fact, historically, the
fetus wasn't even really viewed as a separate
patient. Yeah. It was seen as a part of the mother,
almost like an organ or an appendage. You managed
the mother and the baby was just. The result.
Right. The result. An after effect of the pregnancy.
So it was just a massive wait and see game. Yeah.
But with the highest stakes imaginable. Completely.
Well, today we're doing a deep dive into the
man who smashed that black box wide open. The
men who decided that hoping for the best just
wasn't a valid medical strategy. We're talking
about Eric Saling. A name that really should
be as famous as Pastor or Lister. Yeah, you really
don't hear enough outside of medical history
circles. You don't. But in those circles, he
is widely recognized as the father of perinatal
medicine. And looking at the sheer volume of
sources we're pulling from today, the biographies,
technical papers, patent records. There's a lot.
So much. It is not an exaggeration to say that
he single -handedly dragged obstetrics into the
modern age. It's incredible. I mean, if you were
born after, say, 1965, the fact that you were
sitting here today, healthy, breathing, without
brain damage from oxygen. deprivation it's highly
likely because of protocols this man invented
that is wild it is and the central theme of his
life the thing that drove him for 70 years was
this realization that the time around birth is
and i'm quoting his actual words here the most
dangerous stage of life that's a heavy statement
it is but statistically it's absolutely true
you can live for 80 years drive cars catch the
flu maybe smoke a cigarette or two sure but the
few hours of labor and delivery That is statistically
the moment you are most likely to die or suffer
a permanent injury. Wow. And Saling made it his
absolute mission to change those odds. But here's
where it gets really interesting to me. You would
expect a medical pioneer like this to come from,
I don't know, a long line of famous surgeons
or wealthy academics. Right. The typical pedigree.
Exactly. Yeah. But Saling's story starts in a
completely different setting. It starts in a
forest. It does. Eric Saling was born in 1925
in Stanislaus. Back then it was Poland. Today
it's part of Ukraine. And his father, Heinrich,
was a forestry manager. A forestry manager. I
just love this detail so much. So he wasn't learning
anatomy at the dinner table. He was learning
about trees. He was learning about systems, really.
And more importantly, he was learning craftsmanship.
The sources emphasize that young Eric inherited
a very specific set of hands -on craft skills
from his dad. He learned how to build things,
how to fix mechanical issues, how to tinker.
Which sounds like a great hobby for a kid, but
how does that translate to saving babies? Well,
think about the era. In the 1950s, if you had
a theory about a new medical tool, you couldn't
just hop on the internet and order a... prototype
from a manufacturer in China. Right. The tools
just didn't exist. If you wanted to look inside
the womb, you had to physically build the window
yourself. So that tinker mindset was actually
a prerequisite for the job he was about to do.
Exactly. He had the medical theory, yes. But
he also had the engineering grit to go down to
a workshop and actually construct the devices
he needed with his bare hands. Before he could
start building anything, though, he had to get
through the 1940s. And looking at his timeline,
it is just chaotic. Chaotic is putting it mildly.
He finishes his Abitur, his high school exams
in 1943. He's 18 years old and immediately he
is conscripted into the military. So he spends
two years in the Wehrmacht during the absolute
collapse of the German front in World War Two.
Right. Just brutal conditions. And then in 1945,
amidst the rubble and the ruin of post -war Germany,
he decides to enroll in medical school, first
in Jena, and then he moves to Berlin. And you
have to remember, studying in Berlin between
1945 and 1952 meant navigating a city that was
literally being ripped in half. Oh, yeah. The
sources mentioned he was constantly moving between
the Soviet sector and the Western sectors just
to attend classes and do his studies. Unbelievable
stress. Immense instability. But he stuck with
it. He eventually got his doctorate from the
Free University of Berlin in 1952. But here is
the real pivot point. Okay. When he finally qualifies
as a specialist in 1958, he chooses gynecology
and midwifery. Which apparently was the unfashionable
choice at the time. Extremely unfashionable.
It wasn't the rock star medicine of the era,
cardiac surgery, neurology, that was where the
glory was. That's where you went if you wanted
to be famous. Exactly. Obstatrix was seen as
messy, unpredictable, and frankly, a bit low
-tech. It was viewed as women's work by a very
traditional male -dominated medical establishment.
But Saling had this trait that keeps coming up
in the texts. Stubborn persistence. Yeah. He
didn't care about the prestige. He saw a mechanical
problem that needed fixing. He saw that black
box and he decided he was going to build a dashboard
for it. So let's get into the how then. Because
almost immediately after he qualifies, the inventions
just start coming. And the first one is a perfect
example of that forestry background meeting medicine.
You're talking about the newborn resuscitation
machine. Right. What was the situation in the
delivery room before he built this thing? It
was primitive. If a baby was born and wasn't
breathing, doctors would try to manually clear
the airway with a simple suction ball, maybe
do a mouth -to -mouth. Just guessing. Basically.
Very inconsistent. So sailing, realizing he needed
a better tool, built a double -barreled machine
with his own hands. How did it actually work?
Simple physics. It had two tubes. One tube blew
pure oxygen into the lungs to inflate them and
deliver oxygen. The other tube simultaneously
sucked mucus and fluid out of the airway. So
it's a continuous cycle. Right. It allowed for
clearing and oxygenating at the exact same time.
It sounds so logical. Blow the good stuff in,
suck the bad stuff out. It is logical, but nobody
else had built it. That is the sailing difference
right there. He didn't just write a theoretical
paper about how resuscitation should work. He
built the machine that made it work. But the
real game changer, the innovation that completely
defines his career, happened right around 1960,
1961. This is fetal blood analysis. Yes. This
is the moment obstetrics shifts from an art into
a hard science. OK, let's slow down and really
explain this one, because to me, this sounds
like absolute science fiction for 1960. It really
was. I mean, I know what a blood test is. I go
to the clinic. I give you my arm. You take blood.
But we are talking about a baby that is still
hidden inside the mother. How on earth do you
get a blood sample? That was the puzzle. Now,
Saling had been using blood gas analysis on newborns
after they were delivered, checking their oxygen
and carbon dioxide levels to see if his resuscitation
machine was doing its job. Okay, that makes sense.
And he realized that the chemistry of the blood
told the absolute truth about the baby's health.
Because if the baby isn't getting oxygen, the
blood chemistry actually changes. Exactly. And
this is the key concept we need to understand
here. Anaerobic metabolism. Break that down for
us. Sure. When a human body, whether it's an
adult or a fetus, runs out of oxygen, it doesn't
just shut down instantly. It switches to an emergency
power source. A backup generator. Exactly. It
starts creating energy without... using oxygen
but the byproduct of that emergency process is
lactic acid like when you sprint way too hard
and your legs start to burn precisely that burn
you feel is lactic acid building up in your muscles
now imagine that happening to a tiny fetus if
the baby is suffocating during a long labor that
acid builds up in their blood and what does acid
do it lowers the ph level Exactly. A drop in
pH is a chemical siren going off. It is scientific,
undeniable proof that the baby is in distress.
So Saling knew what he needed to measure. Right.
The problem was just how to get the blood to
measure it. And this is where he teams up with
a chemist, Kay Dimashkin. Yes. Together, they
developed a high -speed method to test blood
oxygen and pH levels using only tiny, microscopic
amounts of blood. Because you can't exactly draw
a whole vial from a fetus. No, you just need
a drop. So Saling developed a physical technique
where once the mother's cervix was dilated enough
and the water had broken, he could reach in with
a specially designed tool. And do what? He would
make a tiny superficial scratch on the baby's
scalp. Because the head is usually the part presenting
first in the birth canal, just a small prick.
Okay. A single drop of blood would form on the
scalp. He would then collect that drop into a
long, thin glass capillary tube. While the baby
is still fully inside. the mother. While the
baby's still inside, he would take that glass
tube, run the analysis on his machine, and within
minutes, he would have a hard pH number. That
is just wild. So suddenly, the doctor isn't just
standing there guessing. He's not putting a stethoscope
to the belly and thinking, hmm, maybe the heartbeat
sounds a little slow. No more guessing. He has
a binary decision tool. Wow. If the pH is normal,
you know the baby is fine. You can wait, let
labor progress naturally. But if the pH is low,
If it's acidic, you know for a fact the baby
is suffocating, and you need to perform an emergency
C -section right then and there. That is the
ultimate shift from guessing to knowing. It really
is. It saved thousands of babies from unnecessary
surgery, and it saved thousands more from severe
brain damage caused by waiting just a little
too long. And he didn't stop there. He was on
a roll. In 1962, he comes out with another invention.
Fristfasserspiegel? I hope I said that right.
Close enough. Or, as we call it in English, the
amnioscope. The amnioscope. This one sounds more
visual than chemical. It was. This was all about
looking before you leap. The device itself was
incredibly simple. It was basically a conical
metal tube with a bright light source attached
to it. Like a specialized flashlight? Sort of.
Saline would insert it through the cervix to
press gently against the amniotic sac, the bag
of waters, before it had even broken. So he's
looking through the membrane. Yes. He's shining
a light through to look at the amniotic fluid
itself because he was looking for one very specific
warning sign, meconium. Which is? The baby's
first stool. Ah. See, when a fetus is under severe
stress, usually from oxygen deprivation, their
anal sphincter relaxes and they pass stool into
the amniotic fluid. It turns the normally clear
water to a murky green or brown. Oh, wow. So
if sailing looked through his metal tube and
saw green water. He instantly knew the baby was
in trouble, even before labor really got going.
It was just another brilliant way to peer into
that black box. It's amazing to me because these
aren't supercomputers. It's a metal tube with
a light. It's a tiny scratch on the scalp. It's
relatively low tech, but the impact is astronomical.
And this leads us to the bigger picture here.
The technology is fascinating, yes, but the philosophy
behind it is what truly revolutionized the entire
field of medicine. The sources refer to this
as a paradigm shift. Saling wasn't just making
cool gadgets in his workshop. He was changing
the very definition of who the patient was. Correct.
He essentially discovered the fetus as a patient.
He wrote a groundbreaking book called Das Kind
im Bereich der Geburtshilfe. Which translates
to The Child in the Context of Obstetrics. Right.
And in this book, he argued that the obstetrician
has two patients in that room, not one. Which,
again, seems so obvious to us sitting here today.
It does now. But back then, it was highly controversial.
Why? Why would anyone in the medical field object
to treating the baby as a patient? Because it
drastically increased their responsibility. Think
about it. If the fetus is an official patient,
you are now legally and ethically liable for
its well -being. Ah, I see. You have to monitor
it. You have to actively intervene. A lot of
the traditionalists felt that birth was a natural
process and nature should just take its course.
And sailing wasn't having that. Not at all. Sailing
was saying no. Nature is failing these babies
and we now have the tools to save them. We have
to use them. It completely disrupted the comfortable
status quo. He had that famous quote we mentioned
earlier. The period around an individual's birth
is the most dangerous stage of life. It became
his rallying cry. He absolutely refused to accept
that death at birth was just fate or bad luck.
So we move into the 70s. Sailing is well established.
He's the expert in his field. Yeah. But reading
through these notes, I was genuinely shocked
by what came next. Oh, I know what you're going
to say. Because he moves from immediate crisis
management in the delivery room to... Well, it
looks exactly like early telemedicine. This is
hands down one of my favorite parts of his career.
It just shows his incredible foresight. We tend
to think of telemedicine as a very modern thing.
Zoom calls, smartphone apps. Yeah. Saling was
doing this in 1978. 1978. I mean, people barely
had touchstone phones in their houses. Right.
But he was heavily focused on the problem of
premature birth. He knew that by the time a pregnant
woman feels strong contractions and physically
drives to the hospital, it's often too late to
stop the labor. The baby just comes out too early
and their lungs aren't ready to breathe air.
Exactly. So he realized he needed to catch those
contractions while the woman was still at home.
Okay, so how did he pull that off in the 70s?
He and a colleague, Hugh Blucher, invented a
portable device called a cacademometer. That
is quite a mouthful. It's just a fancy word for
a sensor that measures uterine contractions.
They gave these portable boxes to women who were
at high risk for premature labor. Okay. The woman
would strap the sensor to her belly at home.
The device would pick up the muscle activity
of her uterus and then convert that data into
an acoustic signal. Literally beeps and tones.
Oh, I think I see where this is going. Like an
old dial -up modem. Exactly like that. The woman
would pick up her telephone handset, call the
hospital, and hold the phone up to the speaker
on this device. The beeps would travel over the
standard copper phone lines to the clinic, where
another machine decoded those beeps back into
a visual graph. He literally wired the human
womb directly to the public telephone network.
He did. A doctor could be sitting in his office
drinking a cup of coffee, looking at a real -time
graph of a patient's uterus from 10 miles across
the city. That is just mind -blowing for 1978.
And the best part is, it worked. It allowed for
rapid, early intervention. If the doctor saw
a dangerous contraction activity on the graph,
they could immediately tell the woman over the
phone to take specific medication. Stopping the
labor before it became irreversible. Exactly.
That connects right back to that theme of prevention.
Sailing wasn't just interested in saving the
baby during the crash. He was trying to prevent
the crash from happening in the first place.
Which brings us perfectly to his other major
focus later in his career, infection. Right,
the ascending infection theory. Yes. Sailing
realized that a huge percentage of premature
births were actually caused by bacteria moving
up or ascending from the vagina into the uterus.
And that bacteria weakens the amniotic sac. It
does. It causes the water to break weeks or months
too early. So how did he tackle the infection
problem? Well, initially around 1978, he introduced
very strict vaginal disinfection protocols for
hospitals. But his most elegant genius solution
came much later in 1999 and 2000. This is the
indicator -coated panty liner. Yes. It sounds
like such a humble everyday product, doesn't
it? But it's actually brilliant science. How
does a simple panty liner stop premature birth?
Walk us through this. It all comes back to pH
again. Sailing really understood the diagnostic
power of pH. Right, like the scalp blood test.
Exactly. Now, a healthy vaginal environment is
naturally acidic. That acidity kills off bad
bacteria. But if a dangerous infection is starting
to brew, the environment becomes more alkaline.
The pH number goes up. And I'm assuming that
chemical change happens long before the woman
actually feels sick or notices symptoms. Long
before. Days or weeks before. So Sailing developed
and patented a standard pan... with a built -as
-litmus test strip. Oh, wow. If the color on
the strip changed, the woman instantly knew her
pH was off. She could just go to her doctor,
get a simple, cheap round of antibiotics, and
clear the infection entirely before it ever triggered
premature labor. I love this invention so much
because it puts the power directly in the patient's
hands. He didn't build a million -dollar machine
for the hospital this time. He made a simple
tool for the bathroom cabinet. It's the ultimate
democratization of safety. He realized that the
absolute best person to monitor a pregnancy was
the pregnant woman herself. Give her the tools
and she will protect her baby. That is incredible.
Now, Saling was a professor at the Free University
of Berlin for a long, long time. But in 1991,
he turned 65. And in the German university system,
that means mandatory retirement. Yes. The university
essentially said, thank you for your service.
Time to go home. But sailing really wasn't the
type to just sit on a porch and feed pigeons
all day. Retirement is for other people. Truly.
Two years after he, quote unquote, retired in
1993, he founded the Eric Sailing Institute for
Perinatal Medicine in Berlin. Just started his
own place. It was a nonprofit. He basically built
his own institute from scratch. just so he could
keep working on these problems. And he kept going
for a remarkably long time. He did. He worked
tirelessly on preventing preterm births and improving
prenatal care worldwide, essentially until the
very end of his life. He passed away in 2021
at the age of 96. 96. That is a 70 -year career
in medicine. And a very... Full, rich life outside
of the lab, too. The sources mention he was married
to Hella Wayman, who was a fellow physician for
nearly 70 years. They got married back in 1952.
A real medical power couple. They had two sons,
Peter, who actually became a gynecologist just
like his father, and Michael, who went into business.
And by the time sailing passed, he had many grandchildren
and great -grandchildren. Which feels incredibly
poetic, doesn't it? A man who spent his entire
life ensuring that other people got to have healthy
grandchildren, getting to enjoy a large, thriving
family of his own. It is a very fitting legacy
for him. So as we wrap this up, let's zoom out
a bit. We've gone from the forestry manager's
son tinkering with metal tubes to the man who
literally wired up pregnancies to the telephone
network. When you look at Eric Saling's contribution
as a whole, what is the big takeaway for you?
I think the main takeaway is his absolute refusal
to accept the black docs. He refused to accept
that we couldn't know what was happening inside
the womb. He made the invisible visible. Exactly.
He used every single tool available to him, chemistry,
optics, mechanics, even the telephone, to turn
the fetus from an appendage into a patient that
could be actively treated. He moved us from faith
to hard science in the delivery room. And it
really strikes me that... Many people listening
to us right now, or maybe their children or grandchildren,
might literally not be here without those innovations.
It is highly probable. Whether it was the fetal
heart monitoring, the focus on pH levels, or
just the general cultural shift in attention
toward the unborn child, Salink's fingerprints
are on practically every single birth that happens
in a modern hospital today. It really puts things
in perspective. We live in an age right now where
we are so obsessed with the next high -tech miracle.
We want AI doctors, we want robotic surgery,
gene editing. But Saling's story reminds us that
sometimes the life -saving solution isn't a supercomputer.
Right. I mean, in 1978, he used a standard rotary
telephone to save premature babies. In 2000,
he used a panty liner with a piece of litmus
paper to prevent major infections. That is the
provocative thought I'm left with after reading
all this material. Saling looked at a 100 -year
-old technology to the telephone, and he saw
a medical device. He looked at a simple pH strip
and saw a lifesaver. It makes you ask yourself,
what other low -tech solutions are we completely
overlooking today? We're all so busy looking
for massively complex answers, but maybe the
solution to our biggest medical problems is sitting
right there in the hardware store, just waiting
for someone with a tinkerer's mindset to pick
it up. Sometimes the most revolutionary tool
of all is just a fresh perspective and a healthy
dose of stubborn persistence. A fresh perspective
and maybe some forestry skills. Hey, it couldn't
hurt. Thanks for joining us for this deep dive
into the life of Eric Saling. We'll catch you
on the next one.