[Mb-civic] A triumph for scientific freedom - Madeline Drexler - Boston Globe

[William Swiggard]

A triumph for scientific freedom

By Madeline Drexler  |  October 6, 2005

THIS WEEK'S Nobel Prize winners in medicine -- Australians Barry J. 
Marshall and J. Robin Warren -- toppled the conventional wisdom in more 
ways than one. They proved that most ulcers were caused by a lowly 
bacterium, which was an outrageous idea at the time. But they also 
showed that if science is to advance, scientists need the freedom and 
the funding to let their imaginations roam.

Let's start with the Nobel pair's gut instincts. In the late 1970s, the 
accepted medical theory was that ulcers were caused by stress, smoking, 
and alcohol. But when pathologist Warren cranked up his microscope to a 
higher-than-usual magnification, he was surprised to find S-shaped 
bacteria in specimens taken from patients with gastritis. By 1982, 
Marshall, only 30 years old and still in training at Australia's Royal 
Perth Hospital, and Warren, the more seasoned physician to whom he was 
assigned, were convinced that the bacteria were living brazenly in a 
sterile, acidic zone -- the stomach -- that medical texts had declared 
uninhabitable.

Marshall and Warren's attempts to culture the bacteria repeatedly 
failed. But then they caught a lucky break -- or rather, outbreak. 
Drug-resistant staph was sweeping through the hospital. Preoccupied with 
the infections, lab techs left Marshall's and Warren's petri dishes to 
languish in a dark, humid incubator over the long Easter holiday. Those 
five days were enough time to grow a crop of strange, translucent microbes.

Marshall later demonstrated that ulcer-afflicted patients harbored the 
same strain of bacteria. In 1983, he began successfully treating these 
sufferers with antibiotics and bismuth (the active ingredient in 
Pepto-Bismol). That same year, at an infectious disease conference in 
Belgium, a questioner in the audience asked Marshall if he thought 
bacteria caused at least some stomach ulcers. Marshall shot back that he 
believed bacteria caused all stomach ulcers.

Those were fighting words. The young physician from Perth was telling 
the field's academically pedigreed experts that they had it all wrong. 
''It was impossible to displace the dogma," Marshall explained to me in 
a jaunty, wide-ranging conversation several years ago. ''Their agenda 
was to shut me up and get me out of gastroenterology and into general 
practice in the outback."

At first, Marshall couldn't produce the crowning scientific proof of his 
claim: inducing ulcers in animals by feeding them the bacterium. So in 
1984, as he later reported in the Medical Journal of Australia, ''a 
32-year-old man, a light smoker and social drinker who had no known 
gastrointestinal disease or family history of peptic ulceration" -- a 
superb test subject, in other words -- ''swallowed the growth from a 
flourishing three-day culture of the isolate."

The volunteer was Marshall himself. Five days later, and for seven 
mornings in a row, he experienced the classic and unpretty symptoms of 
severe gastritis.

http://www.boston.com/news/globe/editorial_opinion/oped/articles/2005/10/06/a_triumph_for_scientific_freedom/
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