Tuesday, October 04, 2005

Stomach Ulcers and Barry Marshall

Dr Barry Marshall has just been awarded a Nobel Prize for Medicine for his work (with colleague Robin Warren) in the research of stomach ulcers. Having injected himself with the bacterium Helicobacter pylori, Dr Marshall developed the symptoms of stomach ulcers and then proceeded to treat himself with antibiotics.

I've come across the name Barry Marshall about ten years ago when I saw a documentary featuring his work. I was interested because my selfless mother nearly died from stomach ulcers back in the 1980s. Thankfully her doctor managed to control her condition by drugs, but she was then put on a very expensive drug for years.

Dr Marshall's finding suggested that sufferers of stomach ulcers could have lived in poverty at some point where a combination of poor nutrition and bad hygiene could have allowed the bug to enter the body. The bug could lay dormant for years and manifest itself only years later.

Mum fitted this profile exactly. During the Japanese Occupation, Mum, an uncle and grandmother were moved to a little village in a rural area of Malaysia. She called this place 'Wun lau' in Cantonese. The closest match I could find to this name is 'Endau' somewhere in deepest, most rural Johore, just north of Singapore.

There they eked out a living, growing vegetables and rearing chickens to feed themselves. Mum always loved flowers and had green fingers. I wonder if it was during this period in her young life (about 14 years old) that she found the growing of flowers such a pleasant departure from having to farm for food.

It was here that Mum learned about coping with want and lack. Her parents were fairly well-to-do people. Grandmother told me of the three servants that she had at any one time before she was married. But Mum recycled and reused everything, as I noted in Becoming Mother

One of my enduring pictures of Mum is her sitting at a table counting her Zantac tablets before her regular visits to the consultant at the university hospital. (She was also diabetic, had high blood pressure and eventually died from massive organ failure when her heart couldn't hold out any longer.)

She counted these tablets out very carefully because we had to pay for every single one of those. She needed to know precisely how many to order when she got to the pharmacist. The doctor invariably prescribed more than she needed and she refused to have a stockpile at home. (The excess was due to her intermittent hospital stays which resulted in tablets not being used up at home.)

Singapore, for all its wealth and advances, still does not have a free health service. Mum was a heavily-subsidized elderly patient, but she (and us as family) had to bear much of the cost of her care.

A bit primitive? I hear you say.

Well, contrast this to the picture of a 90+ woman I befriended in the UK. Under her all-purpose table is a huge bucket of unused medicine.

Every time she went to the doctor or called out her GP, which she did very often, she was given new prescriptions which, as you know, she could fill for free being 90-something. She took the medication for a few days and because she still felt a little unwell, would get the GP to call again. More prescriptions, more drugs, and they simply pile up.

You won't see this 90-something great-grandmother counting out her tablets. Not when all these drugs are issued 'free'.

Anyway, back to Dr Marshall. I think he is a most deserving recipient of the Nobel Prize.

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