"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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