Sunday, March 9, 2014

Short Book Review - Gulp: Adventures on the Alimentary Canal

This blog is about Evidence-based IBD, but this post is a bit different – I generally don’t review books, but Mary Roach’s Gulp. (the period is part of the title, but I’ll drop if for the rest of the post to avoid having my grammar checker go crazy) is unique.  Roach has written about several “taboo” subjects in polite conversation before – namely Bonk (sex) and Stiff (dead people).  Gulp takes readers on a trip through the digestive system in a fascinating way and is highly entertaining reading.

The reason Gulp appeals to Evidence-based IBD is that it gets people who don’t have the disease talking about their digestive health.  While those with IBD feel comfortable discussing the difference between “soft” and “loose” bowel movements and can talk about a colonoscopy without blushing, the general public doesn’t have the same tolerance levels.  Staying out of the public eye has some serious downsides:

1.       It alienates those with IBD and keeps them from being able to discuss an important part of their lives.
2.       It keeps those who are undiagnosed from seeking treatment due to the taboos surrounding the issue.
3.       “Popular” diseases receive more funding.  The more public-facing, the more likely that research dollars will be directed to a particular disease.

Gulp tackles digestive issues head-on, while remaining as sensitive as possible given the topic.  Roach looks at the fringes of the alimentary system, starting with the mouth and ending with the rectum (what did you expect from a book with the subtitle Adventures on the Alimentary Canal?)  Instead of dealing directly with disease, Roach paints interesting vignettes about the different parts of the digestive system.  For instance:

·         The possibility (or impossibility) of being eaten alive and surviving.
·         Exploding intestines from colonoscopies.
·         The viability of fecal transplantation.
·         The potential impact of bowel disease on the death of Elvis.

All of Roach’s chapters use the digestive system as a rough roadmap to tell interesting stories about people (and parts of people).  She brings a critical eye to scientific areas, but has a voice that entertains while educating.  The humor (especially the footnotes) that is present is the equal of any current author, and brings a light hearted bent to a heavy subject.

Of particular note (and the one the tale vignette that stuck with me) was the story of Alexis Bidagan St. Martin.  A 20 year old fur trader injured by a musket shot on Mackinac Island, St. Martin ended up with a hole in his stomach.  The treating doctor, William Beaumont, treated the wounds but left an open fistula in the stomach.  Miraculously, St. Martin survived almost 60 more years.  In the decades following his injury, Beaumont experimented on St. Martin by placing food directly into the stomach, measuring how it digested in-situ (this was, of course, before IRBs and perhaps even "medical ethics"). 

There is no Bottom Line to this post – it is simply a recommendation to read Gulp, to enjoy a lighter view on what is usually covered in a more serious tone (at places like Evidence Based IBD), and to think about how we can all socialize IBD in a more effective way.

No comments:

Post a Comment