Nobel

Congratulations to Barry Marshall and Robin Warren, winners of the 2005 Nobel Prize for Medicine for the discovery that stomach ulcers are caused, not by stress as was formerly believed, but by a bacterium Helicobacter pylori. This is a classic Nobel-type discovery beginning with Warren’s acute observation, and continuing with Marshall’s work in culturing and identifying the bacterium.

It’s a striking observation that, thirty years ago, nearly everybody “knew” two things about stress: it was the primary cause of ulcers and it was particularly common among people men in executive jobs. Although widely held, these beliefs had never been properly tested by research and both turned out to be false. Surprising as it may seem, it’s more stressful to be ordered about than to order other people about. More precisely, the prevalence of stress-related diseases increases as you go down hierarchies of authority, status and so on.

The Nobel Prize for Economics[1] must be coming up soon. I have some ideas as to who should win, but as I’m very peripherally involved in the selection process, I’ll keep them to myself.

fn1. Strictly speaking, the Bank of Sweden Prize in Economic Sciences in Memory of Alfred Nobel

18 thoughts on “Nobel

  1. I would like to add my congratulations as well. Its great to see Austrlalian researchers doing so well.

  2. Why is medicine the only discipline where Australians get Nobel prizes?

    Or to put the same question a different way, why don’t we have any Nobel-class physicists, chemists and economists?

    (These were not sarcastic questions.)

  3. I meant scientific discipline, so White doesn’t count, and neither will Gareth Evans if he ever gets the Nobel peace prize he so craves.

    Didn’t know about the Braggs, but that was a long time ago.

    This is the fourth occasion where Australians have won the Nobel medicine prize. For a small country, this is a very respectable batting average.

  4. “It’s a striking observation that, thirty years ago, nearly everybody “knewâ€? two things about stress: it was the primary cause of ulcers and it was particularly common among people men in executive jobs . . . Surprising as it may seem, it’s more stressful to be ordered about than to order other people about.”

    From personal experience, I’m not at all surprised that working in a Taylorised workplace (e.g. a call-centre) is more stressful than working in a non-Taylorised one.

    The bacterial cause of ulcers is one thing, but ulcers’ seeming prevalence among executives about thirty years ago is another matter. Assuming that there was some scientific basis to this (the prevalence, that is, not the now doubly-discredited cause), it still begs the question: why were executives disproportionately affected by the bacteria?

  5. Dave,

    The lack of a physics/chemisty one is a bit disappointing. I certainly have the impression that we don’t do enough of the really fundamental research that gets the prizes. I think if an Aus physicist gets one it will probably be in some sort of Astrophysical area, where we do have strong research. That being said you can win them as an ex-pat working at one of the overseas schools and we don’t seem to get them either.

    Good researchers get the best research students typically, and its been observed that the nobel prizes typically run in the family, very often going to the students of prior winners. It can take years to graft a really strong research tradition/school into the country.

  6. Why one or the other? Why not consider the possibility of stress and HP interacting?

    Everyone knows how the fight-or-flight stress response created uncomfortable feelings in the gut – and really serious stress can lead to either overeating or loss of appetite, both of which could have a negative physical impact.

    Because HP is incredibly common and many people aren’t even aware of it, it could be the case that overstressed people more readily go on to more serious symptoms, as for many other conditons.

    As for the prevalence of ulcers among executives, perhaps it was the blokey culture of workingclass males which led them to put up with their symptoms without going to the doctor – which any long suffering spouse will tell you they hate to do – while the “executives� or professionals might have had less resistance to doing so and therefore were diagnosed, while their nonexecutive counterparts were not.

  7. Australia, like the USA, spends a disproportionate amount on medical research. I don’t have today’s figures but some years ago, we spent, all up, more on medical research than on all other forms of research put together. While I don’t think this is nationally sensible (at all) it does mean that we have produced many more competent people in medical research than in physics or chemistry. We are not into big instrument physics , space exploration or superpower military things, so we don’t actually produce a lot of physicists. We don’t have a chemical industry (most of what we have is foreign-owned and does R&D back home)…

  8. I suppose it’s plausible that through sheer weight of money we can produce good medical researchers, but I don’t see why the absence of industrial applications hinders research into quantum mechanics or other basic science.

  9. I love this prize for Marshall & Warren. Often, Nobels in the sciences are for wonderful things which lesser mortals can’t quite comprehend. This one we did – a widespread disease cured in a way that we could understand. Added to this the serendipity – the romance of a discovery as an lm would think of it – of a petrie dish left with a culture over a long weekend and then the self-sacrifice of a researcher deliberately giving himself the disease. And two boyz from Oz did this! Just beaut!
    PS: For Dave Ricardo, I think Gareth could only get a Nobel for foot in mouth disease and I don’t think the Academy has a field for that.

  10. Sir John Cornforth, an expatriate Australian living in the UK, shared the Nobel Chemistry prize in 1975. Perhaps the exception that proves the rule?

  11. “why don’t we have any Nobel-class physicists, chemists and economists?”

    Apologies to John Cornforth

  12. Dave said:

    I suppose it’s plausible that through sheer weight of money we can produce good medical researchers, but I don’t see why the absence of industrial applications hinders research into quantum mechanics or other basic science.

    Resources. Why would a Nobel quality researcher stick around in Australia when they have to fight tooth and nail for funding. Take a look at this from the, admittedly self-interested, “Group of Eight”.

    The funding for basic research in Australia is pitiful. The ARC doles out about A$400m a year. The roughly comparable figure I found for the United States is US$105b.

    You don’t have to be a Nobel Prize winner …

  13. Nobels in the sciences are for wonderful things which lesser mortals can’t quite comprehend. This one we did – a widespread disease cured in a way that we could understand.

    I know exactly what you mean, but I think the significance of Marshall and Warren’s work has been misunderstood, or at least misrepresented, as I mentioned on CT.

    As Helen points out, H pylori infection is very common – much commoner than peptic ulcer disease. It seems to be a (somewhat, but not completely) necessary, but not sufficient condition for ulcer formation. None of Marshall and Warren’s work invalidates the epidemiologically-derived risk factors for peptic ulcer disease which we’ve known about for some time: alcohol, smoking, type O blood group and stressful life conditions. So to say, as some do, that “we used to think it was stress, but now we know it’s an infection” is a misrepresentation of the state of knowledge about peptic ulcer disease.

    So, why is the Warren and Marshall work important? For two reasons.

    First, by uncovering an unexpected role for infection in peptic ulcer disease, it raised the possibility that infectious agents might play a part in other disease processes, such as acute cardiac ischaemic events.

    Second, if in most cases of peptic ulcer disease, H pylori is the final common pathway, then eradication of infection might prevent relapse. And it seems to work.

  14. Antirealist —

    The discovery of H. pylori’s role in peptic ulcers has had another impact on medical practice in addition to what you say: It makes it harder, perhaps impossible, for the medical profession to blame the patient of ulcers for his/her disease. This was the common practice when the cause was thought to be stress, and is still the common practice for other conditions and diseases — heart conditions, obesity, addictions to nicotine and alcohol, etc. Whether that blame is justified for these other conditions is contestable. But it certainly follows the historical pattern of western medicine — when ignorant of the true causes of an illness or condition, doctors blame the patient or his/her lifestyle. (Witness: infertility, gender of offspring, cholera, etc.)

  15. Peter, lifestyle factors are involved in the production of peptic ulcers. You need the bug too, but most people are infected.

    The reinfection rate after eradication therapy in adults seems quite low though, so you could say the real benefit of the M&W work is that, after treatment, people can continue to smoke and booze without risking getting their ulcers back.

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