Barry Marshall did not give himself an ulcer

If somebody on the street knew who Barry Marshall was, they’d probably tell you he got his share of a 2005 Nobel Prize for drinking some bacteria (Helicobacter pylori) and getting a stomach ulcer from it. They’d be wrong. Marshall in fact did not develop an ulcer. What he got was a case of gastritis – inflammation of the stomach lining – that largely resolved itself in a couple of weeks, according to original 1985 paper.

Maybe it’s partly because gastritis isn’t a common term. And maybe Marshall hammed it up a tiny bit. It’s hard to tell. In his Nobel autobiography, he implies he sought treatment for the gastritis after he had made his point.

Either way, the gastritis was extremely suggestive but not enough to rigorously prove a link between H. pylori and ulcers. It would take until about the mid-90s for researchers to fill in enough pieces of the puzzle to believe the link and endorse prescribing an antibiotic for ulcers as a rule, which was a separate question, according to anesthesiologist Kimball Atwood in this 2004 Skeptical Inquirer article.

Atwood argued an urban legend of sorts has grown up around Marshall’s self-experiment, citing claims that the gradual acceptance of Marshall and Warren’s hypothesis provides evidence of the medical-industrial complex dragging its feet.

Whether anyone dragged their feet in a socially significant way is subjective but you can’t argue with the illness Marshall actually reported, which was not an ulcer. This is interesting because it shows how quickly even a Nobel moment can get lost down the memory hole.

H. pylori is an ongoing public health story. Sci Am published a feature in 2005, the same year Marshall and his buddy Robin Warren won their Nobel, arguing that people in rich countries could be at greater risk of esophageal cancer because the bug actually protects against it. (See also my story on nitrate’s bad rap.)

Seth Roberts goes so far as to say the bacterium is not even the cause of stomach ulcers:

Marshall and Warren did not consider that lifestyle factors might cause immune efficiency to go down, leading to increased growth of the bacterium.

I guess it depends on what you consider normal. Where’s Aristotle when you need him?

Why Steven Pinker pisses me off

I made the mistake of clicking on some links last night related to whether we are mostly born who we are, and more specifically whether parents “matter that much” for who we turn out to be. Let me tell you why the discourse around this subject, and specifically Harvard University psychologist Steven Pinker’s contribution to it, gets me riled up.

I spent eight years surrounded by people who took it as a given I’m supposed to be a good liberal Democrat, with no sympathy for conservative arguments of any kind. Which was good for me, really. I came to enjoy WNYC, New York’s NPR affiliate. But I’m also a science writer living in the aftermath of Steven Pinker’s 2002 book The Blank Slate, which I’m only now digging through and which is beating me over the head with this argument that our behavioral tendencies are to a good extent heritable (“innate” or genetically derived).

The idea is that although the home environments we find ourselves in may have an indirect effect on how we turn out, on which more below, we come out of the womb largely equipped with our particular cognitive skill-set. Pinker even has this great line in Curious Minds: “Rather than childhood experiences causing us to be who we are, who we are causes our childhood experiences.”

That’s beautiful, actually. I like that it treats a person as a sniffing, seeking agent, and not this bundle of conditioned reactions. Because embracing agency – choice – seems to separate those who flame out, which frightens and intrigues us, from those who hold down a job, a family and an otherwise Normal Life. There’s even supposedly some (lots of?) evidence that as we get older the heritable aspect of our identities comes more to the fore. To poke around for brain-imaging studies that are supposed to bear that out, use “Giedd” as a search term on PubMed.

And I bet Pinker is basically right. But I part ways with the statement that our parents “don’t matter that much” to who we are – that it’s mostly peers, genetics and schools, as in this interview with Pinker’s fellow traveler Judith Rich Harris. I mean, how can anyone who had parents say that with a straight face? Less stridently, were they an only child or did they have siblings close in age?

To be fair, I have no argument with Judith Rich Harris, for reasons that should become obvious. And I know I’m conflating meanings, which is what discourse is all about anyway. I am completely willing to believe the influence I think my parents had on my identity was some combination of the following: a) genetic complement (I refuse to say “genes”) and its accompanying innate tendencies; b) birth order (my brother is five years younger, which makes me a quasi-only child, and I know this because I asked Frank Sulloway about it); c) site of upbringing – until age 15 I lived in Midland, MI, where members of my school-selected peer group (including this guy) had siblings going to college so I never even questioned whether I would go, even as my parents were struggling to break in to the managerial class.

Still, it’s hard for me to shake the idea that my parents had some influence on how I turned out beyond the tendencies I inherited form them. What’s missing for me is a sophisticated notion of imprinting. My anecdotal evidence is simple: My dad was an alcoholic. It’s not fun having an alcoholic parent. Pinker would presumably say it’s a disease – the term “alcoholism” doesn’t appear in his index so it’s hard for me to confirm – and he’d be right. To me, though, it was like being caged up with a monster. Like Mitch Hedberg said, alcoholism is the only disease you can be yelled at for having.

Of course my reaction to my dad’s alcoholism – being freaked the fuck out – was mediated by my own innate behavioral tendencies, inherited from him and my mom. So, am I innately who I am? Yes. And did my peer group influence my SES-related values? Sure. But did the attitudes and behaviors of my parents, or what you would call their environmental contribution, influence my *subjective experience of being who I am* for the past 30 years? Hell yes.

I guess I should thank Steven Pinker. What he’s really offering is some long-term framing to normalize the idea that we are all individual agents. And when we’ve fully normalized that idea, we may even end up talking about giving kids the vote. But we don’t live in a culture that treats kids as agents. We live in a culture where my dad can read Pinker’s book, as he did – into the night, smoking and drinking at the kitchen table – and then tell me and anyone else who’ll listen that parents have no effect on how their kids turn out.

At the time I took it as a cop-out. I’ve come to see it as more like a sick joke. Gee, thanks, Dad. So I was *born* feeling like a freak in a cage? That’s super. When I’m really stoned I can see his bluster about metaphysical impotence as a message from his inner agent, trapped like mine, to the me that would eventually come to understand the way of the world. A smoke signal of sorts, courtesy of Marlboro.

Pinker was born in 1954. Maybe what you learn by the time you get to his age is that everybody goes through a sorting out period, where they come to reconcile the identities of their parents with their own. I’m even willing to buy there’s some kind of physio-genetically determined stage of development in which the self is suddenly able to shake all that dust off its wings.

But if that’s what Pinker is trying to tell us, I wish he’d frame his argument differently; and maybe open up a little about his subjective experience of being who he is. Then all this discourse about the biological construction of our identities might go down easier.