Vitalism Signs

I had pneumonia once. Here’s the summary: I felt so bad that at first, I was afraid I might die. Then, I was afraid I might not. (Please use your imagination to insert the international sound for bad jokes, the three-beat drum and cymbal “bah, bum, chung,” here.) In the vernacular of which I am so fond, I felt as though I’d been “rode hard and put up wet.” While you’re thinking about what in blue blazes that means (think “horses” and how they should be cared for), I’ll give you the punch line that’s a little surprising in a column about inside-out (not outside-in) health: I believe that an antibiotic most likely saved my life.

There’s no question that antibiotics have saved millions of lives. I think that may be the problem. Because they were so effective in cases that historically would have proven fatal, it wasn’t long before a “just in case” mentality set in and, coupled with the profit motive of drug manufacturers, we entered an era of the promiscuous use of antibiotics.

Their very name—antibiotic, meaning “against life”—should have served as the danger signal, leading instead to an era of extremely cautious and judicious use of them. And, lest you think that we only have to worry about anti-life agents in medical applications, I recently learned that there are a host of other agents known as “biocides” or “life-killers” found in every building material of every structure in which we live and work. Yes, there are life-killers in Sheetrock, paint and carpet.

We already have good evidence that our American/Western hyper-hygienic lifestyle (rampant antimicrobial use and the lack of exposure to the normal, healthy flora and fauna we call “germs”) is causing many of the “normal” symptoms of aging such as arthritis by increasing the number of C-reactive proteins in our bodies. Now come studies from the NYU School of Medicine that suggest antibiotic use in babies may be a contributing factor to the childhood obesity epidemic. Not that we didn’t already have good evidence of that since farmers have been using antibiotics for decades to fatten cattle for market.

And, we have excellent (though indelicate) evidence that common medical practice is so crippling our immune systems that the “poop transplant” has been invented. Yes, you read that correctly. The poop transplant (aka “Faecal microbiota transplantation” or “FMT”) was recently needed to treat a woman caught in the vicious circle of antibiotic treatment. First, she was given antibiotics that so devastated her normal gut bacteria that she developed chronic (one might say “pernicious”) diarrhea that was attributed to a bacterium commonly referred to as “C-diff.” So, to kill the C-diff, the woman was put on another antibiotic. Then, it turned out the C-diff was antibiotic-resistant and the poor woman was possibly in danger of death by diarrhea—all because of her medical treatment.

Eventually, someone started thinking a little more vitalistically and said, “Hey, wait a minute. Maybe the problem wasn’t an over-proliferation of C-diff, which is typically found in the gut without any issues. Maybe the real problem is an antibiotic-induced under-proliferation of all the other typical gut bacteria so that there’s nothing to compete with the C-diff, allowing it to rule the poop roost.” And, thus, the idea of a poop transplant was born. The woman’s husband became the donor, probably because there’s not an unshared microbe between husband and wife, if you know what I mean.

So, once again, we see medicine turning to the inside-out principle that life knows more about running itself than they (or any of us) do, even if they had to get there more circuitously by going inside-out-outside-in. Now, if we could only get them thinking from the inside out somewhere short of the last resort.