Prairie Doc® Perspectives for week of October 10, 2021
By Kelly Evans-Hullinger
In the last couple years, I have developed a renewed awe and appreciation of our scientists around the world who work for entire careers to advance science and medicine in their laboratories and beyond. One such scientist is Dr. Barry Marshall.
Marshall is an Australian physician scientist, who in the early 1980’s along with his cohort Dr. Robin Warren, initiated a paradigm shift in the world’s understanding of gastrointestinal disease when they discovered the bacterium Helicobacter pylori. Prior to that, peptic ulcer disease was thought to be due entirely to lifestyle factors and stress. Marshall and Warren were ultimately able to show that H. pylori played a major role in maybe 80 percent of ulcers worldwide at that time.
H. pylori is an unusual bacterium in that it can grow and thrive in a highly acidic environment like the stomach, and for that reason it was difficult to grow in culture. It was found to be widespread around the world, partly due to poor water sanitation systems. The bacteria can invade the surface of the stomach and duodenum, causing inflammation of the stomach or gastritis, ulcers, and rarely, stomach cancer. We now know that if H. pylori is a causative factor in a patient’s stomach ulcers, eradication of the bacteria is an essential part of curing the patient’s disease.
Now here is the greatest piece of this science story. At the time Marshall and Warren made their discovery, the worldwide scientific community was skeptical that H. pylori was an important factor in peptic ulcer disease. H. pylori did not grow in mouse or rat stomachs, so there was not a good way to study it in a traditional lab. Famously, in 1984 Marshall underwent biopsy of his own stomach, proving he did not carry the bacteria nor have any stomach disease. Then, he drank a beaker of H. pylori culture broth. What followed was an acute gastric illness, and after 2 weeks he had another biopsy showing proven H. pylori infection and gastritis. He then cured himself with an antibiotic and bismuth.
After Marshall’s case study was published, much further research ensued. Today, we can detect H. pylori in our patients with several noninvasive testing strategies, and if detected treat them with a combination of antibiotics and acid reducing medication. Surgery to remove a portion of ulcerated stomach, commonplace prior to this discovery, is now incredibly rare in the developed world. In 2005 Marshall and Warren were awarded the Nobel Prize in Physiology for their detective work.
I wonder, had Dr. Marshall not risked his own health for his experiment, would our understanding have shifted so quickly? Maybe, maybe not, but the story sure wouldn’t be as captivating.
Kelly Evans-Hullinger, M.D. is part of The Prairie Doc® team of physicians and currently practices internal medicine in Brookings, South Dakota. Follow The Prairie Doc® at www.prairiedoc.org and on Facebook featuring On Call with the Prairie Doc® a medical Q&A show celebrating its twentieth season of truthful, tested, and timely medical information, broadcast on SDPB and streaming live on Facebook most Thursdays at 7 p.m. central.
Prairie Doc® Perspectives for week of October 3, 2021
By Andrew Ellsworth, M.D.
Imagine yourself in a blizzard so thick and cold and blinding that you could not see your hands right in front of you. Such blizzards were common 150 years ago on the upper great plains. Without much for houses and trees, the wind blew the snow with such force that the little ice crystals were more like little knives making it hard to keep one’s eyes open even if there was something to see. Thus, to get safely from the house to the barn, farmers often hung a rope between the two, to not get lost. It was literally a lifeline. Otherwise, one wrong turn and perhaps nothing would stop you from wandering across the frozen prairie.
As a sixth generation South Dakotan, I cannot imagine some of the hardships my forefathers had to endure to survive. How did they feed themselves when the rains did not come, or when the fires did? How did they heat the house when the wood or coal had run out? How did they fight the boredom of months in a single room, not to mention the isolation?
There are many who still face those questions. Farming still carries great risks with drought, floods, or financial stress. There is the chance of failure, of losing the family farm, of choosing the wrong crops or the wrong time to plant in unpredictable markets with trade wars, changing weather patterns, and other factors. One little mistake may ruin a million-dollar piece of equipment or result in a lifetime disabling accident.
Given these pressures, it may not come as any surprise that farming has one of the highest suicide rates in the nation, which has been rising over the last decade. Of course, you do not have to be a farmer to face financial, physical, or mental pressures that may contribute to feelings of helplessness, failure, loss of hope, and depression. You may be easily irritated and feel like sleeping all day, lack energy, and no longer enjoy what you once did.
If you or someone you know needs help, please reach out. Hotlines available for those in crisis or for those looking to help someone else are the National Suicide Prevention Lifeline 1-800-273-TALK (8255) and the Avera Farm and Rural Stress Hotline at 1-800-691-4336.
Just as that rope was a lifeline from the barn back to the farmhouse years ago, a simple phone call can be a lifeline for those in need of help today. No matter your occupation or stage of life, please reach out if you need help. Even if it feels like you are in a blinding blizzard with nowhere to go, reach out and take hold of that rope, that lifeline, and make that phone call.
Andrew Ellsworth, M.D. is part of The Prairie Doc® team of physicians and currently practices family medicine in Brookings, South Dakota. Follow The Prairie Doc® at www.prairiedoc.org and on Facebook featuring On Call with the Prairie Doc® a medical Q&A show celebrating its twentieth season of truthful, tested, and timely medical information, broadcast on SDPB and streaming live on Facebook most Thursdays at 7 p.m. central.