Reporter's Notebook: Australian Medicine Men Win the Big One

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Rumors of a Nobel Prize have been swirling around Barry Marshall and J. Robin Warren as far back as 1997—at least in Western Australia, where the two scientists are local heroes, and where I was once a medical writer for the local newspaper in Perth, my hometown. As a joke, Marshall, a gastroenterologist, and Warren, a now-retired pathologist, had even taken to sharing a beer down by the Swan River in Perth every year when the Nobel for medicine was announced.

Guess who’s having the last laugh? The scientists, who together proved that the vast majority of stomach ulcers were caused by bacteria—not stress, spicy food or alcohol—are officially Nobel Laureates. In awarding the prize today, the Nobel committee commented that the pair had fundamentally altered the scientific view of a disease that affects up to five million people in the U.S. each year. Asked how winning the Nobel Prize would affect his future, Warren replied with a West Australian’s typical laconic self-deprecation: "Yeah, we'll have to come to Sweden."

Writing about work like theirs is usually an uphill battle. Nobel-worthy research can be impenetrable to a lay audience, and the men and women doing it tend to be shy and retiring. Not so these two. Warren, known for his absolute loyalty to the bolo tie, wasn’t afraid to go out on a limb for an improbable idea. Back in 1979, Warren, who was then working at Royal Perth Hospital, observed a spiral bacteria growing in the stomachs of people with gastritis, or inflammation of the stomach. He became the butt of jokes among his colleagues, who knew—it was right there in all the textbooks—that nothing could grow in the acid environment of the stomach.

"It was a bit annoying, but I kept on with my work, because I knew I was right," said Warren in a telephone conversation with the Nobel organization Monday.

In 1981, he found someone who would listen in Marshall, a brash young gastroenterology resident born in the bush to a boilermaker and a nurse. Marshall, who reportedly wrote his first scientific paper on a homemade word processor, was looking for a research project to complete his training and found Warren's bacteria intriguing.

Warren and Marshall spent months trying to culture the bug (later named Helicobacter pylori). Once successful, they tried in vain to get the medical establishment to test their theory that H. pylori caused ulcers. Failing that, Marshall, the more daring salesman of the two, tested it on himself in 1984, swallowing the vile brew and infecting himself with an agonizing case of gastritis. He then treated himself with antibiotics and embarked on a campaign to rewrite the medical textbooks. He succeeded. Read any medical textbook today, and you’ll see that H. pylori is acknowledged as the cause of the majority of ulcers. The recommended treatment—an antibiotic triple therapy—permanently cures 90% of patients. Although Marshall knows his discovery has changed millions of lives, he says he and Warren never really thought they would win the Nobel Prize. "There are so many important things in medicine these days," he said. "So many other good discoveries out there."