It Takes Guts

"Now they might say, “It’s so off-the-wall....Is it true?”

            When Barry Marshall went to medical school, his planned to become a general practitioner, not a Nobel Prize winner. He got B's and C's in high school and felt lucky just to get into med school. After growing up in remote Australian mining boom towns with names like Kalgoorlie, Rum Jungle, and Kaniva, he had set his sights no further than going into practice in Perth, Australia's fourth biggest city.

            Once there, he realized how hard it was to diagnose many patients. Not every patient fit the classic textbook models he learned in school. This made him want to keep an open mind.

            "As a trainee general physician with broader training, I was comfortable with the notion of infectious disease and antibiotic therapies," says Marshall. "I am told by others that I have a lateral thinking broad approach to problems, sometimes to my detriment. In school my grades always suffered because I was continually mucking about with irrelevant side issues which I often found to be more interesting."

            He became troubled by the ulcer patients he saw. Some were in excruciating pain, and many of those who underwent surgery found no relief. In 1981, he partnered with his hospital's pathologist Robin Warren who had discovered that such patients' stomachs were awash with the bacteria Helicobacter pylori. Marshall did his own research and found pylori in the stomachs of patients with stomach cancer.

A Simple Cure

            "We observed that everybody who got stomach cancer developed it on a background of gastritis, an irritation or inflammation of the stomach lining," Marshall said. "Whenever we found a person without Helicobacter, we couldn’t find gastritis either."

            Marshall became convinced that antibiotics represented a simple cure for ulcers and a potential way to wipe out stomach cancer.

            "I had developed my hypothesis that these bacteria were the cause of peptic ulcers and a significant risk for stomach cancer," Marshall said. "If I was right, then treatment for ulcer disease would be revolutionized. It would be simple, cheap and it would be a cure."

            Up until this point, the medical community thought stress and other psychological maladies caused ulcers. After all, so many martini-swilling, two-pack-a-day big-city businessmen had ulcers. Then when researchers found antacids cured ulcers in rats, everyone thought they'd found the way to treat the problem

            This became big business. Drug companies made millions from their antacid preparations. Other physicians routinely prescribed anti-depressants and tranquilizers for ulcers. The Mayo Clinic built its reputation on gastric surgery. In short, many of the biggest players in medicine had no incentive to look for another cure. No one believed that bacteria could thrive in the stomach's acid environment.

            "[At the time], to gastroenterologists, the concept of a germ causing ulcers was like saying that the Earth is flat," Marshall recalls. "I had this discovery that could undermine a $3 billion industry, not just the drugs but the entire field of endoscopy. Every gastroenterologist was doing 20 or 30 patients a week who might have ulcers, and 25 percent of them would. Because it was a recurring disease that you could never cure, the patients kept coming back."

Swigging the Broth

            Marshall needed a guinea pig to test his theory. In 1984, he found one—Himself. He first had an endoscopy to sample his stomach's contents. It found no pylori. He then took the pylori from a petri dish and mixed it with a cup of the standard beef extract solution his laboratory used to grow cultures of bacteria. He let the "cloudy broth" sit overnight swigged it the next morning.

            Three days later, his mother told him he had bad breath. "After five days, I started to have bloating and fullness after the evening meal, and my appetite decreased," he recalls. "I vomited clear watery liquid, without acid, each morning." Soon thereafter he had two more endoscopies. Both now revealed that pylori had invaded his stomach and were thriving there.

            "Rob blabbed the results of my still unreleased work, [saying it had found the cause of ulcers] "….Barry Marshall has just infected himself and damn near died;" a slight exaggeration, but it made for good copy.

            "What he didn't know was that the journalist he was speaking to was from the "Star" newspaper, a tabloid that often features with stories about alien babies being adopted by Nancy Reagan. This was right up their alley. The next day the story appeared, "Guinea-pig doctor discovers new cure for ulcers ... and the cause."    

            "This became one of the serendipitous, life changing events in my life, and I have Rob's temper to thank for it…. I was contacted by a continuous line of patients in the USA who read the story and were desperate for treatment."

            For the next 10 years, he and Warren worked to get physicians to accept their findings. During that time, he secretly treated patients with antibiotics because gastroenterologists would not prescribe them. Finally, in 1993 and 1996 the National Institutes of Health and the FDA announced they would investigate the Australians' findings, and in 2005, Marshall and Warren won the Nobel prize in Physiology for their pioneering work.

MORAL: You've got the stomach for it.

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He Found the Real Treasure

"I preferred risking my life to placing my honor in jeopardy."

            The Spanish slave raiders were speechless. It was April 1536 on the Pacific coast of present day Mexico. Skilled in the dark art of burning Indian villages to kidnap men, women, and children into slavery, the cavalrymen were out seeking new captives.

            Now they saw a group of Indians walking towards them—unafraid. But one of them was black. Another was white. Both were barefoot and wore only animal pelts. The white man's hair had grown to his waist, and his beard hung down to his chest.

            "They remained looking at me for a long time, so astonished that they neither talked to me nor managed to ask me anything," wrote Cabeza de Vaca. He and 300 other men had left Spain in 1527 on a mission to colonize Florida. Now nine years later, only de Vaca, the expedition's Royal Treasurer, and three other men had survived.

Hammered by a Hurricane

            After being hammered by a hurricane in Cuba, the explorers landed on Florida's west coast near present day St. Petersburg. The expedition's leader Narvaez decided to send half his party by ship to Panuco, a distant Spanish outpost on the far side of the Gulf of Mexico.

            He, de Vaca, and others would head inland in search of gold. With misgivings, de Vaca followed orders. "I preferred risking my life to placing my honor in jeopardy," he would write in his account of his odyssey.

            For months, the party fought Indians. "All the Indians we had seen from Florida to here are archers, and as they are of large build and go about naked, from a distance they appear to be giants," de Vaca wrote.

            Finally, the exhausted explorers became lost in swamps, their numbers depleted from skirmishes with Indians. To survive, they had no choice but to starting to eat their horses one by one. To reach Panuco more than 1,000 miles away, they decided to build five 33-foot-long rafts, each able to carry 50 men. They had no tools, so they melted their crossbows, spurs, horseshoes and all other metal and built a forge so they could fashion primitive axes and saws.
            "It seemed impossible," he wrote, "as none of us know how to construct ships. We had no tools, no iron, no smithery, no oakum, no pitch, no tackling: finally, nothing of what was indispensable. Neither was there anybody to instruct us in shipbuilding, and, above all, there was nothing to eat, while the work was going on….

            "Considering this, we agreed to think it over. Our parley ceased for that day, and everyone went off, leaving it to God, Our Lord, to put him on the right road according to His pleasure."

“The Isle of Doom”

            Then they set to sea, hugging the coastline westward. "And so greatly can necessity prevail that it made us risk going in this manner and placing ourselves in a sea so treacherous," wrote de Vaca. "And without any one of us who went having any knowledge of the art of navigation."

            Amazingly, they traveled 400 miles to the mouth of the Mississippi. There the strong current pulled the rafts in different directions, and Narvaez was carried out to sea and never seen again.

            Now only 80 explorers were left alive near Galveston Island on an island they named Malhado, the Isle of Doom. Only 15 would survive the winter. Many died after resorting to cannibalism. "They were people beyond hope and all died that winter of hunger and cold, eating one another," de Vaca wrote.

            Indians captured and enslaved the survivors, putting them to work digging roots to eat and hauling timber. Killed for the slightest misstep or no reason at all, de Vaca and his weary group lived in terror.

            For several years, the explorers lived as slaves, passed from one tribe to another. Finally, only four were left alive, and after escaping, they began a journey west that would take them through present day Texas, New Mexico, Arizona, and northern Mexico.

            Then something miraculous happened. Indians observed the Spanish performing Christian rituals and concluded that they were medicine men. At first, de Vaca would only make the sign of the cross over a sick Indian or blow on his body, fearing that if he did more he might be killed if his 'medicine' failed to work.

“The Children of the Sun”

            Over time, he grew bolder. He used a knife to perform surgery on an Indian's chest, digging out a deeply embedded arrowhead and suturing the incision. When another Indian given up for dead had been prepared for burial, de Vaca made the sign of the cross over him. Hours later, he rose and went about as if he had never been ill.

            Now in awe of the men they called "the children of the sun" (because their appearance and ways were so alien), the Indians revered them. Instead of being sold to other tribes as slaves, the Spaniards led crowds of as many as 3,000 to 4,000 Indians from one tribe to the next, each tribe marveling at the strangers' mighty deeds.

            "In this way Jesus Christ guided us, and his infinite mercy was with us, opening roads where there were none," wrote de Vaca. "And the hearts of men so savage and untamed, God moved to humility and obedience."

            When the slave raiders rescued de Vaca, he had lived in the wilderness and among Indians for so long that he found Spanish ways strange. For days, he could not sleep in bed or wear clothes.

            What's more, his long years with the Indians had given him great sympathy and respect for them. He was appalled by his countrymen's horrific treatment of Indians. He wanted Spain to peacefully partner with them.

            Upon returning home, he made his case to the king and became governor of an area in South America which includes present day Argentina, Uruguay, and Paraguay. His hopes of working together with the natives proved naïve. The men under his command, eager for gold and power, took him prisoner and sent back to Spain where lived out his days in his ancestral village.

            De Vaca was true to what his heart told him was right. He had found his treasure. "For myself I may say that I always had full faith in His mercy and in that He would liberate me from captivity, and always told my companions so."

MORAL: If life hands you a lemon, 
you may be in Florida. 
Do whatever is necessary 
to get to the Pacific Ocean.

Buy the book "Courage 101: True Tales of Grit & Glory" at Amazon!