The Imperfectionists

Chapter 6Show and Tell

Barry Marshall's Big Gambit

In 1984 Barry Marshall was a researcher at the University of Western Australia in Perth, geographically the most remote city in the world. It certainly felt that way to the young scientist; he had come up with what he thought was a breakthrough idea about the causes of stomach ulcers … but he just couldn't convince the global scientific community to take it seriously. Desperate to get his voice heard, he was about to try something crazy to motivate his colleagues to think again about the established science.

Peptic ulcers cost an estimated $6 billion a year at that time, with 6,500 deaths attributed to them annually and nearly 10% of the population afflicted at some point in their lives.¹ Two blockbuster drugs, Tagamet and Zantac, were the accepted treatments, but the limitation of those drugs was that ulcers returned when the patient stopped taking them. The problem for Professor Marshall was that the medical establishment believed that they already knew the causes of peptic ulcers—lifestyle factors, including stress and alcohol—and weren't open to new science.

Marshall's story starts a few years before when his colleague and collaborator, Robin Warren, identified a new bacterium, Helicobacter pylori, usually known as H. pylori. Marshall says he had no idea what diseases might be associated with the new bacterium, but he nevertheless included a test for it in a study of 100 endoscopy patients. The study results were dramatic—18 ...