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If you like Barry Marshall's story, you might also like:
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Barry Marshall
Barry Marshall
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Barry Marshall Interview (page: 3 / 8)

Nobel Prize in Medicine

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  Barry Marshall

How did you come to specialize in gastroenterology?

Barry Marshall: As I said, when I was doing my training every specialty was interesting to me. I even liked geriatrics. Just the challenge of having older people, who are lovely patients, and very grateful when you're helping them. But many of them have five different diseases, instead of just one, and the interaction of all those diseases and drugs! I needed a rest, because I'd had a busy term in internal medicine.

I did gastroenterology. It was just interesting that there was so much going on in those days, because ulcers were very common and patients were coming in. Every single night we'd have a patient with a major bleed. They'd be getting blood transfusions and going to surgery. It was just an interesting thing to find those little bacteria in the stomach. Actually, I had a colleague, Dr. Warren, who was a pathologist. He's very obsessional, a little eccentric, and it was difficult for him to get any of his colleagues to take this seriously. He sort of gave me a tutorial on them one afternoon, and it was just wonderful to me to see these bacteria that weren't in the medical books. I like to do things a little differently, buck the authority, try something out of the box. Thinking out of the box, as it's been said. And the idea that bacteria could survive in the stomach, when the medical books said they couldn't survive in the stomach, that's what made me so curious about it.

[ Key to Success ] Vision

Could you tell us about Robin Warren and his impact on you, the partnership that you had? Was he a mentor?

Barry Marshall Interview Photo
Barry Marshall: We didn't actually have parallel careers, we just crossed paths when I was doing a gastroenterology fellowship. He had collected about 20 patients with these bacteria, but he didn't have the clinical correlation. He could see the biopsies and the inflammation, but needed somebody else to go and talk to the patients and find out what they felt like, whether there was any relationship between their disease and these little bacteria on the biopsy. He taught me a lot about microbiology and pathology. And then, from what he had told me, I would then go and read the medical books and try and find out what was in the books. And every single pathologist in the whole world who wrote a book described gastritis totally differently. In other words, they didn't understand it.

I'd actually worked this out when I was a student in college, that if I went to a lecture and came out of the lecture thinking, "I don't understand that," it was because it was a bad lecture, and the lecturer didn't know his stuff. Because when I had a good teacher, I would always know exactly what he was talking about and I'd never have to refresh it. I would just understand it. And that's actually something that I've taken into my teaching career, is that if I know the subject and know my stuff, I don't have to get nervous about getting up in front of hundreds of people and giving a lecture, and they'll say it was a good lecture. And so, it's the preparation you put into it, and you have to know your stuff to be able to teach it to others.

[ Key to Success ] Preparation

The fact that all those pathologists had different interpretations of the same material meant to me that they didn't understand it. So I'm thinking, maybe these bacteria play a role in there.

One of the things that happened with me is that I was interested in computers, even in 1980 with e-mail, but it was really teletypes in those days. Our library had just got a line to the National Library of Medicine. So I came in and started doing literature searches, because I was interested in computers and it was fun for me. But I started trying to track these bacteria. And I found various, very widespread, dispersed references to things in the stomach, which seemed to be related to the bacteria, going back nearly 100 years. So that we could then develop a hypothesis that these bacteria were causing some problem in the stomach, and maybe that was leading to ulcers. And then, instead of having to do 20 years of research checking out all those different angles, the research was done, but it was never connected up. And so, with the literature searching, as it became available, we were able to pick out the research that was already there and put together this coherent pattern, which linked bacteria and ulcers. It didn't happen overnight. We actually thought about it for two years before we were reasonably confident. It was really quite a few years before we were absolutely water-tight.

[ Key to Success ] Preparation

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