Sunday, August 10, 2014

Barry Marshall

When I was on blog hiatus, I still continued with my Australian learning by making flashcards online about various Australian subjects. I did this to increase my knowledge of Australia and to help with my brain...specifically my memory.

One flashcard set I made was about Australian medical researchers. I learned fun things, but didn't often dig deep. So now that I'm back to blogging, I thought maybe I can learn more. Go more into depth.

Well, actually with the person I'm writing about today, I did go more into depth. Barry Marshall interested me.  I think the reason is that while I was researching him I was having suspected gastro problems and that's his area of study.  Well, specifically he studies the bacteria that's responsible for most ulcers. Maybe not all all ulcers, but a specific type?  I'll look into that later.

The thing is, it used to be believed that ulcers are caused by stress. Barry Marshall found this wasn't the case. There's a bacteria. H. pylori. And H. pylori is what's to blame for a lot of ulcers.

What I love about Marshall is he's like a mad scientist hero. He used his own self as the guinea pig in his experiment. He made a broth with this H Pylori and drank it. I don't remember the exact details. But as I do research for this post, I'll hopefully find them.

I'm going to start with Lord Wiki. What does he have to say about Barry Marshall?

First of all, Marshall was born on September 30, 1951. He's a little younger than my parents. And he was born in Kalgoorlie, Western Australia. I think that's west of Perth. How far west?

Google Maps says it's 6.5 hours west, if you drive. If you walk, it's 118 hours.

Lord Wiki says Marshall is a Nobel Prize Laureate in medicine. Does that mean he actually won?

I looked at Lord Wiki''s list of winners. Marshall is on there for 2005, and he wasn't working alone. There's another guy listed with him. J Robin Warren. The two are a science superhero team. I don't know why I knew about Marshall and not Warren. Maybe it's because Marshall's the crazy one who drank the concoction.

Marshall is a professor of Clinical Microbiology at the University of Western Australia. That's another thing that happened to me while on hiatus. I became sort of fascinated by microbiology and tried to learn about that with the flashcards as well. I'm not sure if anything actually stuck in my brain, though.

Here's Barry Marshall's University of Western Australia page. He's published a lot of work.

As for the ulcer stuff, Lord Wiki says it's the peptic ulcer that's caused by H.pylori, and previously people believed stress and spicy food were too blame.

Okay. Now we move onto Marshall's childhood. He moved to Perth when he was eight. His mother was a nurse. He had four younger siblings.

Then in the 1980's, Marshall began his relationship with H.pylori. They started believing in their ulcer stuff years before they won the Nobel Prize. Lord Wiki says that, in the beginning, their ideas were ridiculed. This is good inspiration for people who have ideas today that are ridiculed. Maybe one day their  ideas will finally be accepted, and then they'll be respected.

What the other medical scientists thought was that the stomach was too acidic for H. pylori to survive.

It turns out they were wrong.

Now onto the crazy drinking thing.

Lord Wiki says Marshall tried to infect piglets at first. That failed for some reason. So then he drank a solution made up of H. pylori. I wonder what that tastes like.

Marshall figured he'd have to wait some years to get the results he expected—an ulcer. But he ended up getting sick a few days later. He had nausea and bad breath at first; then vomiting.  He did an endoscopy which showed his digestive bits had major inflammation. Oh. I forgot to mention. He did a baseline endoscopy before he drank the wicked solution. Of course. Otherwise he wouldn't know if the H. pylori is what caused the inflammation.

I really am not sure how what happened to Marshall shows H. pylori leads to ulcers. Well, maybe inflammation leads to ulcers. That makes sense. It's just Lord Wiki doesn't say what happens years later. He says Marshall took antibiotics. So I guess he cured himself before an ulcer began.

Or maybe I'm confused about terminology. I'm thinking inflammation is what leads up to an ulcer,  but maybe inflammation IS an ulcer.

No. According to WedMD, ulcers are sores inside the digestive system. The other name for inflammation is gastritis. I would have expected the gastritis page to say gastritis leads to ulcers; but it doesn't.

I'm all confused now.

Well, this medical website says both gastritis and ulcers can be caused by H. pylori.

Lord Wiki says Barry Marshall was mentioned in the movie Contagion. That's cool. I liked that movie, though it was terrifying. I don't really remember the Barry Marshall scene. Lord Wiki says he's mentioned when the scientist infects herself with the serum to speed up the vaccine-creating process.

Here we go....This movie quote website has the scene. Dr. Ally Hextall says, Do you remember Dr. Barry Marshall? He thought that bacteria caused ulcers not stress. Gave himself the bug and then cured himself. You taught me about him. I'm testing my vaccine.

That was very brave of her.

I was curious who played Dr. Ally Hextall. It's Jennifer Ehle, who also appeared in The King's Speech as Lionel Logue's wife. So in one movie, she played an Australian; and in another she talked about an Australian.

She's not Australian, though. She's from North Carolina.

Discover Magazine has an interview with Marshall. I'll read that.

I'm being reminded that H. pylori causes not only ulcers and inflammation, but stomach cancer as well. So Marshall chose a good enemy to fight. Though most of his colleagues thought he was wrong. It's kind of like when Harry Potter announced that Voldemort was back and people didn't believe him.

This interview says it was mice he tried to infect, not piglets. And the reason the animal experimentation failed is that H. pylori effects only primates. Instead of infecting some chimpanzees, Marshall infected himself.

This interview says that gastritis IS a precursor to ulcers.

The interview says that stomach cancer used to be one of the most common cancers, and now it's almost gone. Really? I didn't know that.

The American Cancer website doesn't really portray Barry Marshall as the one gets the credit for reducing stomach cancer. First of all, they said it stopped being a big killer after the 1930's. Marshall didn't start his stuff until the 1980's. Their website says, Some doctors think the decline may also be linked to the frequent use of antibiotics to treat infections. Antibiotics can kill the bacteria called Helicobacter pylori (H pylori), which is thought to be a major cause of stomach cancer.

It doesn't seem like they're strong believers in Marshall's work. They're quite wishy-washy. But maybe it's not about the ulcers and gastritis. Maybe there's less evidence about the cancer?

Back to the interview.

Marshall's father managed chicken factories in Perth. Yikes. That sounds kind of gross. And sad. I don't like the whole thing of animals and factories.

Marshall was a B and C student, not A. That's inspiring too. There might be some kid who gets mediocre grades and wants to be a doctor and/or scientist. They might imagine it's not possible. But Marshall's story shows that it is. I like that.

Oh! I think I love Marshall. He talks about how doctors have the mindset that everyone can be diagnosed unless they have a fake disease. But he believes you have to have an open-mind. Sometimes the problem can't be found. It remains a mystery. It doesn't mean there isn't a real physical problem there.

I had a medical mystery last summer. I lost my appetite and ended up losing about twenty pounds within a few weeks. That's weird for me, because I'm the type of person who almost always wants to eat. I mean I did have an eating disorder a few years back. But then I wanted to eat and was obsessed with food. I was just depriving myself...purposely.

There was a lot of question of whether or not I was depressed. I wasn't. But the loss of appetite DID begin at a time when I was upset. The thing is I have gotten equally upset many other times without a long term loss of appetite.

I'm thinking, though, that it's possible I lost my appetite from the initial upsetting stuff; then scared myself with the loss of appetite. Because I knew that could be the sign of something serious, I became a bit of a hypochondriac about the whole thing. And being nervous about being ill could have made me ill.

Even if you're a hypochondriac, though, it doesn't mean there isn't something physically wrong with you.

I had blood tests and they found I had low platelets and a high level of Vitamin B12 (which I read is a sign of cancer). I ended up doing the endoscopies and all they found was erosion. Mild...I'm guessing. They didn't tell me to worry about it. Oh, and I was tested for the H. pylori. That came out negative.

There could have been something beyond my emotions causing my problems. I don't know. There came a point where I stopped taking tests. Well, the main reason is my appetite came back. If medical tests were free, I'd go on pursuing the exciting mystery. But they're not. So I decided to leave the story with a question mark.

Though I do like Barry Marshall's attitude—his belief that people can have an undiagnosed medical problem, I also do believe in fake illnesses. Well, maybe fake is the wrong word. What I believe is that sometimes people can have medical problems that are caused by emotional problems rather than cancer, a bacteria, a virus, fungus, etc. It doesn't really make the problems any less real or important. Well, it sort of does maybe. I think there's a big difference between having cancer and losing your appetite because you're in emotional turmoil. There's also a big difference between having cancer and stubbing your toe. But I'd still give some sympathy to the person with the injured toe.

I feel like I'm talking in circles here. I guess what I'm trying to say is that if someone isn't diagnosed with something, it doesn't mean they don't have a real problem. It could be a hidden medical thing, and it could be a psychological thing. And in some pathetic cases...there are fakers. But that's a whole other story.

I should get back to the interview.

Marshall talks about a woman who had chronic stomach pain. They gave her some tests. I think other doctors, not Marshall. Those tests came out negative, so she was sent to a psychiatrist who put her on anti-depressants.

I don't think the outcome of that story is here. I'm guessing later they found out she had H. pylori.

Anyway, Marshall talks of another patient. It was an elderly man with severe pain. For some reason, they put him on tetracycline. Then he was feeling great after that. Marshall says, There was no treatment for an 80-year-old man in those days, so we put him on tetracycline and sent him home. 

So was this one of those cases where people are given antibiotics because the doctors feel obligated to provide some type of treatment...even if it's not likely to help?

I'm reading the rest of the interview. It's kind of complicated—hard to explain. If you're interested, maybe it's easier to just read it yourself. Here's the link again.  Basically, he's explaining how it wasn't easy to get people onboard with the whole bacteria-causes-ulcers idea. If I'm reading it right, they had problems getting research money at first.

Marshall says when his wife found out he drank the bacteria brew, she became paranoid that the whole family would become sick. She's the one who pushed him to take antibiotics.

I'd probably be paranoid too. Well, and I'd be freaked out because I have a vomit phobia. And the H. pylori was causing Marshall to vomit.

I'm proud of the guy—very impressed with his courage. But I'm glad he's not MY husband.

Marshall says that a lot of us get the H. pylori infection when we're very young.

In the interview, Marshall talks about something kind of amazing. They're trying to use modified H. pylori to make vaccines. He says it would be something you drink. It would be cheap and it wouldn't need refrigeration. Amen to all that!

Marshall talks about how we have various infections. They come and go quickly. Or so we think. We pay them little attention. Then later we  might have major medical issues, not realizing they're the result of the microorganisms that invaded our bodies years ago.  It's fascinating, though, also scary and a bit depressing.

Slate Magazine also has an interview. I'm going to read this one too. I'll see if it adds any new information to my brain.

What's puzzling to me is both articles were published in 2010. Why were people suddenly interested in him then? He won the Nobel Prize in 2005.

Maybe it's the vaccine work?

Oh. Wow. This article says that Marshall and his wife Adrienne went to a conference in America in 1986. Adrienne went on a sightseeing thing and was sitting by other gastro-wives on a bus. She overheard them badmouthing her husband and his ideas. Bitches!

I like what Marshall says here about stress and how you can't really prove it's the cause of something. Why? Because you can ask everyone if they've had stress lately, and the answer is yes. Who's not stressed? It's kind of like when I lost my appetite and one of the doctors kept asking me questions about my emotional state.  Yes. I have problems. Who doesn't? Right now, a summer later, I have things in my life that are causing me emotional stress. But my appetite is quite strong, thank you very much.

Marshall talks about how people were told to relax, AND told to take acid blockers. This is the advice I got from the first doctor I visited. She told me to take some acid medicine—pretty much insisted on it. Then I read about side effects it caused, and...well, now I forgot what I read. But it bothered me that she pushed the medicine on me without knowing if I even had an acid problem.

This article agrees with Lord Wiki. It was piglets, not mice. Or maybe there were piglets AND mice. Maybe Barry Marshall is really smart when it comes to infectious disease and gastroenterology, but not so great when it comes to animal identification.

But no. I think they were really pigs. Marshall seems pretty clear about that. He talks about how the baby pigs soon turned into big pigs, and it was chaotic having them around.

Marshall says when he first wrote about the experiment, he talked about himself in third person because he thought self-experimentation wouldn't be respected.

I think what he did is very worthy of respect...and also crazy.

It's awesome.

His wife is asked about the experiment. She says she expected his colleagues to think he was a lunatic and wrong for doing it. But they had the same attitude as me. They were impressed.

There's talk of the evils of pharmaceutical companies. The Discover article also talked about this, but I wasn't as clear on what they were trying to say. I think here it's more clear. I think Marshall is accusing the companies of research-hesitation because they were making tons of money from antacids. It's that whole scary idea. Why cure something when we can make more money if it's not cured?

Marshall says he wasn't bothered too much about people thinking he was wrong; but he was bothered by how hard it was to get money for research.

What probably helped...at least emotionally is that some people felt he was right. Not everyone was against him. It's easier to be the one walking against the crowd, if you know there are others on your side. It's really bad if you're completely alone. What's even worse is if you're completely alone; and unlike Marshall you're never vindicated. Then you eventually die with everyone against you. That really sucks.

I totally love this quote by Marshall.

People used to say to me afterward, "Barry, do you feel vindicated?" And I'd say, "I felt vindicated 10 years ago, because I knew what the result was going to be." There's a saying, "Science is not a democracy." It doesn't matter how many millions of people there are on the other side. There's one right, and it's perfectly possible for all the rest to be wrong.

Yep!

Marshall talks about how people still believe ulcers are caused by stress.

I did! I had no idea about this H. pylori until very recently.

Now this is awesome. The interviewer turns the tables on Marshall and asks for a time that he's been wrong.  He says he used to believe H. Pylori always caused symptoms; but now he realizes it's not true. He says about 75% of people have the bacteria, but it doesn't make them feel ill.

Ah...but he admits he's stubborn about all this. He says he believes maybe people think they're not sick, but they are. You give them the antibiotics; then they feel better even though they didn't know they had felt bad.

Maybe. Though it could be some kind of self-fulfilling prophesy.

I'm seeing a storyline like that on The Secret Life of Us. Kelly is selling bottles of pills for $70. She's also taking them herself, and is insisting that they're making her feel better.

I think most of us do it at some point in our lives. We take something out of our diet; then suddenly we feel better. Sometimes certain foods can cause problems for people...like if they have Celiac disease. But in other cases, it can all be in our head.

The mind is a powerful thing. Bacteria and Viruses are powerful too. If you put them all in a stadium with the Guardians of the Galaxy, the Avengers, and the X-Men....who would win?

I was going to do more research...watch videos. But this post is already so long.

Maybe I'll stop here.

For now.

This story's very interesting to me. I might want to come back to it someday.





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