Free Radicals - Michael Brooks [55]
It’s what Marshall doesn’t say that is most instructive. He discussed the case with the registrar, and suggested they try an antibiotic, but without any conviction. Here was a man who had reached his limit. His reputation was damaged, and that led him, it seems, to argue only weakly in favour of an antibiotic treatment. Who can blame him? It’s not as though he had convincing medical evidence that he was right. In scientific terms, it was still just a hunch, just a hypothesis. The registrar evidently decided against following Marshall’s advice – and perhaps ignoring it was the proper thing to do – and scheduled surgical removal of the young man’s stomach.
‘I was too upset to go back to see him,’ Marshall says. He still hasn’t.
So far, this is just everyday medical science: messy and difficult. But now events were about to take a more anarchic turn. Like the detective who knows the guilty party but can’t prove it, Marshall decided to take matters into his own hands. He would be the experimental subject. He would put himself in the same position as that unfortunate young man that no one could help. He would do to himself what he had done to the piglets. He would drink a cupful of the bacteria and let nature take her course. And he wouldn’t tell his seniors a thing until it was over.
It was not an easy decision. Every medical research experiment – even a self-experiment – is supposed to be scrutinised by an ethics committee before it can go ahead. And publication of the results in a journal is conditional on the experiment having been approved by the ethics committee as taking place with the full informed consent of everyone involved. The experiment must be useful or necessary, and not ridiculously dangerous. Marshall, considering his standing at the hospital, thought he stood little chance of gaining approval for his self-experiment. Not that the committee’s refusal would have stopped him, Marshall says. But it would have stopped him from publishing the results, and it would most likely have lost him his job and ended his medical career.
Marshall didn’t tell his wife either. Though he suspects she would have been supportive of his goals, she would not have approved. ‘This was one of those occasions when it would be easier to get forgiveness than permission,’ he wrote in his Nobel Prize autobiography. Neither did he discuss it with his immediate colleagues, whose help he required. They suspected what was going through his head, he thinks. The endoscopist who agreed to take samples from Marshall’s healthy stomach, for example, must have had a clue. But a complicit silence reigned.
On 12 June 1984, just before noon, Marshall drank the bacteria, which were in a cloudy, brown, bug-nourishing broth. He didn’t eat anything else all day. Three days later he felt a strange, bloated sensation in his stomach. On the fifth day, he was vomiting as the sun came up.
The morning sickness continued for three days. Adrienne, his wife, told Marshall that his breath was ‘putrid’. Colleagues confirmed this. He was sleeping badly, and felt tired and listless. After ten days, he asked the endoscopist for some more samples of his stomach tissue to be taken. Again, a ‘don’t ask, don’t tell’ policy ruled. Examination under a microscope confirmed that the spiral bacteria were flourishing inside his stomach, which was also coated in pus. The bacteria transferred happily to a culture dish, and continued to thrive. Koch’s postulates were being met.
Marshall was lucky. Saving him a great deal of trouble – domestic, physical and political – his body dealt with the infection all by itself. An endoscopy on 26 June, two weeks after he had ingested the bacteria, revealed that the infection was gone. His blood serum contained no antibodies for the bacteria. The reason for this remains a mystery, and a stroke of good fortune: Marshall now admits that the