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. The culprit that Dr. Marshall discovered was Helicobacter pylori, an adaptable bacterium that lives within the layer of mucus that protects the stomach from the acid it produces. H. pylori defies the conventional wisdom that says it shouldn’t be able to grow in so inhospitable an environment: By creating a small alkaline bubble that neutralizes the surrounding acid, the bacteria can flourish.
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.
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 at Children’s Hospital in Boston has become a referral center for children with many types of neuropathic pain, but especially limb pain associated with signs of abnormal circulation, which has been variously named reflex sympathetic (or neurovascular) dystrophy (RSD/RND), sympathetically maintained pain (SMP), and complex regional pain syndrome type 1 (CRPS1).
His findings, combined with advances that have greatly reduced the risks from anesthesia during the past 10 to 15 years, have brought about some substantial changes. “Now no newborn is too sick to get pain medication,” Berde says. In general, there seems to be more effort to reduce kids’ pain from all medical procedures, including bone-marrow biopsies, spinal taps and repeated blood drawings. Says Berde: “I think most major children’s hospitals are changing. There is less willingness than there used to be to hold kids down and brutalize them.”
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.
Time article on Johnson
Find out more about Johson’s book
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.
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.
TRAN KHOUNG DAN
Tran Khuong Dan, a Vietnamese construction foreman, made it his life goal to find a cure for opium addiction after his brother and father both died in 1976 and 1977, respectively, from their addictions. In order to find an herbal cure for the drug, Dan traveled across Vietnam searching for the correct remedy. He studied over 100 herbal potions that villagers used to satisfy their opium need when their poppy crops failed in bad seasons, but none of these led him to a solution.
Dan was committed to discovering a remedy to this deadly addiction, so in a last-ditch effort to finding a solution, he made himself addicted to opium so that he could experiment on himself. “I knew from my brother how dangerous this could be,” he says, “but I decided this was the only way.” After spending days smoking opium with tribal leaders, he would return home to test various herbal concoctions on himself. He tried to avoid smoking opium while he tested himself on the potential medicines, but this caused him to suffer violent withdrawal symptoms, and he often returned to his opium pipe for relief.
After six months of self-experiementation, Tran Khuong Dan finally discovered the right concoction of herbs that rid him of his opium addiction. The end-result was a muddy-brown syrup, later named Heantos, made from the leaves, roots, and stems of 13 plants and a dash of alcohol. To further test the curing abilities of this medicine, Dan addicted himself to heroin as well and discovered that this brew cured him of that addiction as well.
Dan announced his breakthrough in 1989 and says he has treated about 4000 patients since then, most of whom have been cured.
By the end of the Spanish-American War in 1900, American troops were dealing with rampant Yellow Fever. Yellow fever is commonly known as a fever virus and is transmitted through mosquitoes. Symptoms range from “hepatitis to hemorrhagic fever”. Jesse William Lazear was the leading scientist to develop a cure for this deadly disease at the cost of his own life. Lazear born in 1866 was an American bacteriologist and army surgeon who was appointed as head of the laboratory of Columbia Barracks at Quemados, Cuba. While in Cuba, Lazear joined the Yellow-Fever Commission run by several scientists including Walter Reed.
There, Lazear joined the Yellow Fever Commission, headed by Major Walter Reed, James Carroll, and Aristides Agramonte. At the time, the scientists did not know of the mosquito transmission of the disease. They proposed that illness was spread from victims’ “bedclothes, blood, or vomit”. However, Lazear was the only scientist to discuss the findings of British scientist Sir Ronald Ross concerning the mosquito vector for malaria. Lazear was, courageously, the only one to willingly offer his body to test out the theory of mosquito transmission for yellow fever. While the other scientists refused to participate in the experiment, Lazear willingly, in an effort to protect American troops, donated his body for the research.
On August 1, 1900, Lazear began cultivating infectious mosquitoes and made a series of eleven experimental inoculations, successfully producing cases of full-blown yellow fever. In September 1900, Lazear allowed himself to be bitten by an Aëdes mosquito, the primary transmitter of yellow fever. Due to Lazear’s courgageous self-experimntation, the scientific community accepted the fact that mosquitoes were indeed the cause of many diseases. Lazear’s memorial plaque at Johns Hopkins Hospital reads, “With more than the courage and devotion of the soldier, he risked and lost his life to show how a fearful pestilence is communicated and how its ravages may be prevented.”
Center for Disease Control http://www.cdc.gov/ncidod/dvbid/YellowFever/index.html
John Hopkins Magazine http://www.jhu.edu/~jhumag/496web/yourself.html
Born on July 16, 1874, Doctor Joseph Goldberger was a Jewish physician and epidemiologist who worked for the United States Public Health Service in order to recognize links between poverty and disease. Because of his work with the disease, pellagra, he was nominated five times for the Nobel Prize
It was in 1912 that Dr. Goldberger begain to study a skin disease that was killing thousands in the South – the disease was later discovered to be pellagra. In order to study mass populations of individuals infected will the illness, Dr. Goldberger traveled to the state of Mississippi where he went on to investigate both the victims of pellagra and their families. Following the investigation, Dr. Goldberger discovered that most of these individuals were poor. Due to this discovery, he assumed the disease has less to do with infection, and more to do with diet.
In order to further investigate this hypothesis, Dr. Goldberger received permission from the state governor to test this idea at a prison. The prisoners that took part in this study were offered pardons. He split the subjects into two groups where one group of prisoners received their usual foods which consisted mostly of corn products. The second group was fed meat, fresh vegetables and milk.
After studying the results, Dr. Goldberger found out members of the first group developed pellagra while the second group did not. He came up with the idea that people who eat mostly corn-based products, food that is considerably cheaper, had more of a chance of developing pellagra. Unfortunately, some medical researchers and doctors refused to accept his belief that poor diet could be associated with pellagra.
In order to further develop this belief, Dr. Goldberger had himself injected with blood from a person with pellagra. Additionally, he consumed liquid from the nostrils and esophagus of a pellagra patient. Assuring that he was subjected to pellagra, he also swallowed pills that contained skin from pellagra patients. Keeping up with a balanced diet, Dr. Goldberger discovered that a small amount of dried brewer’s yeast daily could prevent pellagra.
An audacious individual, Joseph Goldberger died of cancer in 1929. Years later, researchers agreed with Dr. Goldberger’s discovery and found out the exact cause of pellagra – a lack of the B vitamin known as niacin. Therefore, the disease is tied to diet, or more specifically the diet of poor individuals, who do not consume a sufficient amount of Vitamin B.
Contributed by Ubah Dimbil
Dr. Seth has been working in the field of Virology since 1968. From 1970 to 1990, he worked on the role of viruses, particularly herpes simplex virus type 2 and Human papilloma viruses in the aetiopathogenesis of uterine cervical cancer in humans. In 1986, the Government of India identified his laboratory as a National HIV/AIDS Reference Centre. In 1987, he and his co-authors were the first ones in India to isolate HIV-1 from Indian patients infected with HIV. In the decade of 1990 several landmarks were achieved by their Reference Centre: development of indigenous ELISA kit for the detection of HIV-1 and 2 antibodies in infected individuals; identification of HIV-1 subtypes circulating in India. Presently his laboratory has been working on the development of Indian HIV-1 subtype C DNA vaccine. It is under preclinical trials in non-human primates for its efficacy.
Das, M. (2004). How far would you go to advance medical research?. BMJ CAREER FOCUS 329: 142-143 [Full text]
CLAUDE H. BARLOW
In 1929, Dr. Barlow joined the staff of the International Health Division and was sent to Egypt where he conducted hookworm and schistosomiasis campaigns and did basic snail research. Schistosomiasis, also known as bilharzia, is caused by infection with trematode worms belonging to the genus Schistosoma, of which the most important are S. haematobium, S. mansoni, and S. japonicum. The adult worms live in blood vessels associated with the intestine or bladder, and the females produce eggs that are passed out with the feces or urine. Larval stages, miracidia, emerge from the eggs when they reach water and bore into the intermediate host, a snail. After a period of multiplication in the snail, the next larval stages, the cercariae, emerge, and these are the stages that infect humans. The cercariae bore through the skin and transform into schistosomula that migrate through the body until they reach their final position in blood, vessels where they mature.
The pathological effects of the disease are due mainly to immunological reactions to eggs that, instead of passing to the outside world, become deposited in different tissues; the effects depend on the tissues involved (111). In this context, it is interesting that schistosomiasis has been associated with carcinomas of the colon and bladder (111), one of the few examples of parasitic infections causing cancer.
In 1944 he infected himself with schistosomiasis in order to bring viable eggs to Johns Hopkins for further study.
GUADALUPE ARIZPE DE LA VEGA
In 1949, after years of democratic rule, Haiti was placed under the control of General Paul Magloire. Under this dictatorial regime, the rate of malnutrition and infant deaths rapidly increased. In 1980, when Haiti was hit with the HIV/AIDS epidemic, even UN peacekeeping troops were ineffective, as the government was noncompliant.
In 2000, a new president was elected president of Haiti, under threats of US sanctions if democracy was not established. As the new president Aristide grew more totalitarian, many rebellions broke up, which further entrenched the country in poverty.
Since Aristide’s departure, there have been drastic efforts aimed at bringing healthcare, medicine and AIDS treatment to affected Haitians. At the forefront of this social change was Loune Viaud. Born in the coastal town of Port-Salut in the south of Haiti, Viaud was proactive in bringing about the change she believed was necessary in Haiti. She campaigned for governmental responsibility in providing health care for all Haitians. She also opened Clinique Bon Sauveur in Cange, a rural clinic which provides free healthcare to those in need. A self-professed feminist, Viaud also opened Haiti’s first women’s health care center, Proje Sante Fanm. This center has been at the forefront of educating women on safe practices of birth and healthcare.
Viaud’s work to raise awareness about health care has had huge impact on the health systems in Haiti. In addition for helping women understand their right to healthcare, she has been instrumental in helping those with HIV in the country. She currently runs Zanmi Lasanteis, a hospital, clinic and healthcare center that provides healthcare to the poor. Moreover, in cooperation with the Robert F. Kennedy Memorial Center for Human Rights, Loune Viaud been actively advocating UN forces to take human rights based approach in intervening in Haiti. For all of her efforts to make health care a human right in Haiti, in 2002, she won the Robert F. Kennedy award for human rights.
Contributed by Lily Saadat
An epidemiologist, Carlo Urbani was born on October 19, 1956 in Castelplanio Italy. He was the first World Health Organization officer to identify the outbreak of severe acute respiratory syndrome, otherwise known as SARS, a disease that has taken more than a hundred lives since emerging in southern China. Dr. Urbai alerted the world to an outbreak of a disease that causes a form of viral pneumonia. He discovered that it could not be treated with antibiotics.
On February 28, 2003, the Vietnam-France Hospital in Hanoi asked the doctor for support, considering him an expert in communicable diseases. They asked him specifically to identify an unusual infection, which he immediately recognized as the threat he knew as SARS. Dr. Urbani then made sure that the hospital significantly increased the control measures for the infection, and that other hospitals in the area followed suit.
In adamantly researching the disease, Dr. Urbani developed signs of it on March 11th. Four days following this discovery, the World Health Organization recognized SARS as a worldwide health threat.
Because Carlo Urbani was the first doctor to warn the world against this disease and because he died fighting the infection, he is considered an influential researcher in battling and controlling SARS. He died of the infection on March 29, 2003.
Contributed by Ubah Dimbil
“I really wanted to be a part of the study that could someday help somebody else, that could make a difference.”
Ron Artel had been healthy for his entire life, but things changed when he learned that he tested for high PSA levels, a common indication of prostate cancer. After surgery to remove cancerous tumors from his body, Ron Artel learned that his elevated levels of PSA had not changed. Upon further testing by doctors at the Winship Cancer Institute, which runs one of the nation’s leading prostate cancer program by a team of expert doctors and researchers, Ron and his family learned that his cancer was continuing to spread throughout his body. He decided to enroll in a Phase III clinical trial that aimed to see if an experimental vaccine called CG1940 and CG8711 had comparable effects to chemotherapy treatment.
Though patients choose to become involved in clinical trials for a number of reasons, Artel claims that he was in a place in his life where he wasn’t sure of what his future looked like. This inspired him to try a path that would hopefully help people develop a novel, efficient way of getting rid of cancer. Artel’s battle with cancer has given him “a new sense of purpose in life,” causing him to enjoy every minutes’ worth and work his hardest at helping others enjoy their lives as well.
Contributed by Danica Zold and Mahta Baghoolizadeh
Born on November 24 1957, Matthew Lukwiya was a Ugandan physician and he supervised the St. Mary’s Hospital Lacor in the Gulu District of northern Uganda. He was the first doctor to die of the ebola virus and in 2000 was at the forefront battling the disease in the St. Mary’s Hospital, the center of treatment for an outbreak of Ebola. The ebola virus, a cureless disease, results in severe bleeding. Doctors merely hoped to contain the spread of the infection. Dr. Lukwiya acted rapidly in order to contain the outbreak of the Ebola virus by ordering workers in the hospital to wear full protective gear, and by separating patients infected and not-infected with the virus. Other safety measures were also enacted.
One day, Dr. Lukwiya was forced to deal quickly with a frantic patient who was dying of Ebola. The man was unfortunately out of control and because the doctor knew him well, he decided to take control of the case. The patient was bleeding, hemorrhaging, and coughing. In order to provide him with quick aid, Dr. Lukwiya violated his own rule – he did not wear any protection over his eyes. This was enough to infect the doctor with the virus.
In December of 2000, Dr. Matthew Lukwiya died of the ebola virus. A significant number of Ugandans grieved his death because of the important medical influence he had over the region. Many proclaim that the work Dr. Lukwiya completed during his time at the St. Mary Hospital helped to contain the spread of the ebola virus.
Contributed by Ubah Dimbil