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Referral: Maryn McKenna On Regulatory Obstacles To Fecal Transplants

 

 

 

# 5999

 

Maryn has a fascinating article this morning on her Superbug Blog on the regulatory obstacles that are hindering what appears to be a safe, cheap, and extremely effective cure for often intractable and devastating C. diff infections; Fecal Transplants.

 

First a link to Maryn’s article (which goes along with a series she is writing for Scientific American), and then I’ll return with a brief anecdote.

 

 

Fecal Transplants: They Work, the Regulations Don’t

 

 

A little over 40 years ago (1970 to be precise), I read a book that had a profound effect on my future. It was Dr. William Nolen’s The Making of A Surgeon, which recounted his surgical internship at Bellevue Hospital during the 1950s.

 

It is what inspired me to become a paramedic.

 

One of the stories he relates in this book was of a patient in the surgical ward suffering from uncontrollable diarrhea due to what was likely C. diff, who was at genuine risk of dying.

 

Nolen and two other interns were at wit’s end, trying to treat this person, until one of them reasoned that if they could introduce good bacteria from a healthy patient into this patient's gut, they might effect a cure.

 

What followed next essentially involved chocolate milk, a `secret ingredient’, a lot of stirring, and no informed consent.

 

When their resident found out what they’d done, he went ballistic, and for a time all three interns thought their careers were ended.  They waited in fear for days for the patient to die from their ill advised treatment.

 

As it turned out, the `cure’ worked.

 

Although the delivery method (and donor screening) used by Nolen and his cohorts needed substantial upgrades, it is a bit amazing that 60 years later this technique hasn’t become routine.

 

While it is a bit dated, I highly recommend Dr. Nolen’s book to anyone who has an interest in the hectic, and often hilarious, learning curve of medical interns.

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