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If you like Barry Marshall's story, you might also like:
Elizabeth Blackburn,
Gertrude B. Elion,
David Ho,
Judah Folkman,
Susan Hockfield,
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Bert Vogelstein

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Barry Marshall
Barry Marshall
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Barry Marshall Interview (page: 6 / 8)

Nobel Prize in Medicine

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  Barry Marshall

How did you balance your strong feelings with working in the field professionally, and having to deal with the consequences?

Barry Marshall: Looking back on it, I'm sure I could have been diplomatic and progressed more rapidly. I was probably doing the wrong thing in a number of circumstances, in a number of relationships with my peers, or my senior colleagues. I think it happens to a lot of researchers that are in a new field, or with a new discovery, because you want to keep it for yourself. You love it more than anybody else, and people outside the story who don't understand it all cannot see where you're coming from. You're just in different dimensions all of a sudden. I had connections very early on with people who were the top specialists in the world.

One of the top ulcer specialists in the world was in Amsterdam, and in 1983 I visited him, just a young guy with a few ideas. He had hinted that there were some funny things going on in the ulcer treatment story that didn't add up to the fact it was all caused by acid. There was something else there. So I knew he'd be receptive. I explained it to him and he was very receptive to it. So instead of my bosses in gastroenterology in Australia, it didn't matter what they said, because I knew that the person who wrote the textbook that they were reading actually thought there was some credence to my work. I visited Stanford in 1984, and Dallas, really epicenters, if you like, of the ulcer business. Although they were very skeptical, they did go out and start testing the hypothesis.

What did you do at that point?

Barry Marshall Interview Photo
Barry Marshall: Well, you know, there is a tradition in medicine of medical researchers testing out their own new discovery on themselves. So, I'd heard about this. There was a book called The Brother Surgeons, about John Hunter and his brother. Famous surgeons way back. Lucky I didn't do his experiment. He infected himself with syphilis. He subsequently died by syphilis years later, when he was an old professor, from his own experiment probably. So, this tradition of dangerous experiments exists. I didn't think my experiment was particularly dangerous. I had to get past this hurdle of fulfilling Koch's Postulates. I studied the literature, and there were a few subtle hints that people would have no symptoms when they had this infection. When I spoke to ulcer patients, they couldn't tell me about any illness they had had. They were perfectly fine, and then they developed an ulcer. So I didn't think I would become unwell. I had treated a few patients with antibiotics successfully at that point, so I thought I could probably cure it. I was a bit overconfident in retrospect. I wanted to make sure that it did take, because I didn't know whether I'd have the guts to do this every week.

We mixed up a complete flourishing growth of bacteria from a petri dish -- we calculated out later that it was a thousand million bacteria -- and mixed it up, and I said, "Well, here it goes, down the hatch." And my lab technician, who was fairly conventional, he was horrified. He was waiting for me to drop dead, but I said, "Well, I'm feeling all right. Okay, let's press on." You know, go and do ward rounds. So, off I went and I kind of forgot about the experiment.

[ Key to Success ] Courage

The plan was, a week or so later I was going to have an endoscopy. I already had one at baseline to show I didn't have any bacteria and I was normal, and a week later I planned to have another endoscopy. The subsequent week, I noticed in the evening when I was eating a meal -- like Chinese, which I always love -- it would just sit on my stomach like a lump of lead. I'd be, "Boy, I feel so full!" And I would take little sips of water after dinner, trying to wash it down. I've seen a lot of patients with this symptom.

About the fifth or the sixth day I'd wake up at the crack of dawn and say, "I'm going to be sick." I'd run into the bathroom and I would vomit. But I wouldn't vomit up a meal, I would vomit up just this clear, watery liquid. And I said, "Well gee, that's weird. I don't do that very often." I did it about three mornings in a row and I noticed on the third morning there was no acid in the vomit, and just copious amounts -- maybe a pint -- of just watery stuff would come up. And I went, "Wow, this is weird." And my mother told me that weekend that I had bad breath. Only your mother would tell you such a thing is what I always say. She said, "Barry, are you constipated? How come you've got a bad breath?" I said, "Oh, you silly old nurse, what would you know?" My friends in the lab weeks later told me about this. And I said, "Well, why didn't you tell me I had bad breath?" Because that was interesting in itself. And they said, "Well, we didn't like to say, you know. It's impolite." So the poor fellows, they had to work with me in the lab all this week. I had an endoscopy on the eighth day and I was very, very sick with that endoscopy. Usually I can tolerate the tube pretty easily, with just a little gagging, but it was very uncomfortable. They took several biopsies from my stomach, and the biopsies showed severe damage to the lining, the mucosa. The bacteria all sticking all over the cells, and some of the cells were sloughing off, and the basement membrane was exposed, which is the layer that they sit on. The mucous layer was very, very thin. And so, great experiment!

[ Key to Success ] Courage

I had a publication at that point, and I said, 'Well, this is great. We'll do another endoscopy next week and see what it's like then."

Towards the end of the 14 days, I sort of mentioned to my wife that I'd done this experiment. Because she was saying, "Barry, there's something wrong with you. All night you're hot and cold. You're breaking out in a sweat. You're not eating your meals. You've got dark rings under your eyes. You look terrible." And I said, "Well you know, I took this bacteria and now I've got the infection." She said, "What?" She was, "You'll give it to the children! You get rid of it immediately! Take antibiotics or you're out of the house. You're staying in an apartment," as far as she was concerned. And so, after two weeks I went and had my second endoscopy and started antibiotics that day. So that was the end of the experiment. And subsequently, I've been found that I don't have the bacteria. Everything's back to normal.

Barry Marshall Interview Photo
But I'd identified this syndrome where you catch the bug. A few days later, you start feeling a bit squeamish. Funny things happen. You start vomiting. There's no acid in the vomit. So this was the syndrome. Then I started to do detective work to find out. How come nobody knew about this syndrome?

Would you do something that risky today?

Barry Marshall: I'm not sure that I would. I would definitely study all the different angles of it further before I'd do it on myself. Actually, I do have some future experiments planned along those lines, but not quite as dramatic. We'll be a lot more careful. We know how to get rid of this bacteria now.

Would you tell your spouse before you did it again?

Barry Marshall: Yes. I'll probably have to move out of home for a week. No way does she want to have this thing.

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