Courageous Profiles in Medicine
At a Glance:
Charles Berde
Charles Berde is co-founder and director of the pain-treatment service at Children's Hospital in Boston. The service, established in 1986, was among the first in the U.S. to specialize in children's pain. It is one of only a few dozen of its kind in the U.S. The department treats children who experience both acute and chronic pain due to injuries, surgery, cancer, AIDS, cystic fibrosis, sickle-cell anemia, hemophilia, migraine headaches, and nerve disorders. Berde is also a leading researcher in pediatric anesthesiology, and has written more than 70 scientific papers and 50 book chapters dealing with ways to improve the prevention and treatment of pain in children. He takes every child seriously, stating, "They're not crazy, they're not faking it, they're not making it up, they're not lying. Pain is real." The pain-treatment service came about because Berde and colleague Navil Sethna, faced with patients who had seemingly intractable problems, devised novel solutions, and because other doctors began to seek them out. Berde is an inspiration not only to his fellow physicians but to his patients who find in him a grown up who finally understands.
Mahlon Johnson
The situations that throw heroes into relief are ones in which surrender is acceptable, when the consensus says it's okay to be passive. True heroes are immune to passivity, no matter how daunting the circumstances. Testing positive for HIV, for example; most people would expect anyone on the receiving end of this diagnosis to need time to adjust to the gravity of such an event. Mahlon Johnson quickly hurdled the initial fear and shock, however, and has since been relentlessly launching daring experimental attacks against the disease. Johnson accidentally cut himself with a scalpel he had used to examine the brain of a deceased AIDS patient, a physically trivial but personally tragic twitch of the fingers. After a tremendously agonizing waiting period, the neuropathologist was informed that he had acquired the virus.
Johnson immediately took inventory of ways he could fight, not simply for his own sake but for all those afflicted with the virus. Broadly speaking, there are two avenues of treatment. One holds that it is best initially to avoid heavy medication and all the peripheral drawbacks that can accompany taking several doses a day of up to 20 prescriptions. Others argue that it is better to medicate early and often, to aid the immune system as the virus silently combats it. Johnson chose this second treatment, which lends itself more readily to a breakthrough, and has been running with it ever since. He has dosed himself with several of the most potent drugs available, many of which render prescription-writing doctors gun-shy for fear of toxicity and side effects, and in doing so he has contributed copiously to HIV/AIDS research. Not only has Johnson boldly acted as guinea pig in these important experiments, he has also documented his experiences and lent an encouraging word to other HIV/AIDS patients in his successful book Working a Miracle. The book has been warmly received by the HIV/AIDS community and highly informative to a widespread public audience.
Sources:
Time article on Johnson
Find out more about Johson's book
Barry Marshall
Wherever Barry Marshall is right now, he's probably smiling. You see, Marshall has earned that savory satisfaction that comes with being able to justifiably say 'I told you so'. And this is no playground squabble; Marshall's (former) opponents are a worldwide audience of medical skeptics who doubted his claim that Helicobacter pylori, a bacterium that is literally a bug, causes gastritis and ulcers in the stomach. That was largely because Marshall's idea ran so contrary to established beliefs (despite the fact that established beliefs never hinted at a cure), which were too deeply rooted for anyone to give his novel suggestion much credibility. Marshall contended that the bug infected and inflamed the stomach, a thought most researchers rejected since they considered the stomach's environment too acidic to accommodate a living host. Staunchly committed to his theory, however, Marshall willingly swallowed a sample of the bacterium that he had extracted from a patient of his. It contained Heliobacter pylori, so if it generated gastritis, a nauseating and often painful inflammation of the stomach, then the pathologist would have evidence of his audaciously proposed link. Marshall waited, feeling no immediate signs of the bug's presence. Then, in the middle of the night, he began throwing up profusely - he had been right.
True, the excitement of his discovery was likely moderated by the fact that it was confirmed only by a fierce bout of retching, but he could endure that with the knowledge that the doubtful medical community would eventually be swallowing his much-assailed hypothesis as proven fact. Marshall began treating patients with his own results in mind; their success rates rose. Other doctors soon followed, and now treatment of ulcers and gastritis has been significantly improved. The risk paid off in dollar signs, too, as Marshall has since been garlanded with numerous international awards and the research money that goes with them. He continues to study H. pylori, refining treatment and searching for applications toward other conditions, such as stomach cancer.
Sources:
http://www.helico.com/index.html
http://www.vianet.net.au/~bjmrshll/features2.html
http://www.time.com/time/reports/heroes/physician4.html
Werner Forssmann
Werner Forssmann (1904-1979) was a physician from Eberswalde, Germany. He was credited as the pioneer of human cardiac catheterization. In 1929, at the age of 25, while doing his surgical residency at Eberswalde, he made an incision into his antecubital vein and fed a 65 centimeter catheter into the right atrium of his own heart. He then climbed the stairs to the radiology department, where he had an x-ray taken showing the catheter in his heart. By doing this experiment, Forssmann hoped to accomplish two objectives: first, to use this technique in emergencies to administer drugs directly into the heart, and second, "to study the heart and for diagnosis."
At the time of Forssmann's self-experimentation, it was believed that any entry into the heart would be fatal. Despite the significance of his discovery, Forssmann was immediately fired and branded as crazy by the medical community. His work was scorned and ignored for over a decade.
Sources:
http://en.wikipedia.org/wiki/Werner_Forssmann
http://nobelprize.org/nobel_prizes/medicine/laureates/1956/forssmann-bio.html
http://www.ptca.org/archive/bios/forssmann.html
Max Joseph von Pettenkofer
Max Joseph von Pettenkofer (1818-1901) was a Bavarian chemist and hygienist. He is considered a founder of epidemiology and is known for his research on the spread of cholera. During the early 1850s, epidemics of cholera and typhoid in Munich compelled Pettenkofer to investigate John Snow's thesis that cholera and typhoid were water-borne. Through his research, he was convinced that the fermentation of organic matter in the subsoil released the cholera germ into the air, which then infected those who were most susceptible.
Determined to prove his (incorrect) belief that cholera spread via the atmosphere rather than directly from person to person, on October 7, 1892, Pettenkofer drank a broth containing cholera bacteria obtained from the excrement of a dying patient. Miraculously, although he fell ill, he survived. He later declared that even if he had died, "I should die in the cause of science, like a soldier on the field of honour."
Forssmann continued to experiment with catheterization in dogs, and it is believed that he catheterized his own heart on six more occasions, using all of his veins with 17 cut downs. In 1956, he was awarded a Nobel Prize in Physiology or Medicine (along with cardiology innovators Cournand and Richards) for his pioneering efforts.
Sources:
http://www.timesonline.co.uk/article/0,,8123-2217159,00.html
http://en.wikipedia.org/wiki/Max_von_Pettenkofer
http://www.lshtm.ac.uk/library/archives/pettenkofer.html