September 23, 2022 • 33 mins
Inventor Franz Reichelt wants to test his novel "parachute suit" from as tall a structure as possible - and the Eiffel Tower seems ideal. Previous trial runs used a mannequin strapped to the chute and have not ended well. Despite this, his plan is to make the Eiffel Tower jump himself. Can he be persuaded to see sense?
Self-experimentation - particularly in the field of medicine - has a long and checkered history. Can we learn anything useful from such unorthodox experiments, or are they reckless acts of egotism and hubris?
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Speaker 1 (00:15):
Pushkin the first floor of the Eiffel Tower, almost two
hundred feet above the ground. Next to the railings a table.
On top of the table a wooden chair, and standing
on the wooden chair a man, Franz Reichelt. He places
(00:39):
a foot on the railing, he leans forward and peers
over the edge. The year is nineteen twelve and Franz
Reichelt is a tailor, thirty three years old. Born in Austria,
he moved to Paris as a teenager and built a
modestly successful business in ladies fashion. But ladies fashion is
(01:03):
not what excites Franz Reichelt. He's fascinated by flight, and
Reichelt has invented a parachute suit. Rychelt looks briefly up
to the heavens early in the morning on the first
Sunday in February. His breath forms in the air. By
nineteen twelve, parachutes are hardly a new idea Leonardo da
(01:27):
Vinci drew on centuries earlier. What is new is the
fast growing market for them. Airplanes have only just been
invented and not yet very reliable. Ryechelt is convinced that
his wearable parachute can save aviators lives with his tailoring skills.
He's made well. I'll let a journalist describe it. This
(01:50):
all silk garment, very well designed, was provided with a
kind of very wide hood which by means of zippers,
would automatically expand when called upon and form above the
head a vast umbrella. Down on the ground nearly two
hundred feet below. A few dozen people have got up
(02:13):
early to watch the demonstration. There are aviation enthusiasts, curious
members of the public, and journalists from all the Paris newspapers.
Reichelt has even drawn a film crew from the path,
a journal cinema newsreel. One camera is on the ground
pointed upwards at him, waiting. Another camera is with Reichelt
(02:36):
on the first floor filming him. He's still standing there,
one foot on the railing, one on the wooden chair.
But is he really going to jump himself? He's told
the Paris authorities that he's going to put the parachute
suit on a tailor's dummy and throw that off the
Eiffel Tower. They would never have given him permission to
(02:57):
jump off the Eiffel Tower himself. And yet there he stands.
Reichelt cautiously shifts his weight onto the foot on the railing.
Then he shifted back. Is he having second thoughts? It
is very windy. He sways gently forward and backward. He
(03:18):
looks over the edge again. Twenty seconds go by, thirty forty.
It's not too late to use the dummy. I'm Tim
Harford and you're listening to cautionary tales. In nineteen fifty one,
(04:01):
in a gold mining town in Western Australia, a nineteen
year old apprentice engineer and an eighteen year old training
nurse had a baby. They called him Barry. Barry Marshall
would grow up to be tempted to test a pet
theory on himself, much like the flying tailor Franz Reichelt
was tempted all those years ago. Growing up in Australia's
(04:24):
Back of Beyond, young Barry Marshall liked to read his
mum's medical textbooks and muck around with his dad's tools.
He made firecrackers and guns, and a device for pressurizing
domestic cooking gas to make balloons that were light of
an air. Do you want to be careful with those balloons?
Son said? Barry's dad might be dangerous if they meet
(04:47):
an open flame. Let's see, shall we. He drew on
his cigarette and touched the lighted end against the balloon.
Marshall recalls he was enveloped in a ball of flame
and his eyebrows were singed off. This didn't worry us
very much because we had seen him in this state before.
(05:07):
In the gold mining town, there was money to be made,
but not much choice of career path. Boys left school
and they mined for gold. The Marshals wanted their kids
to have options, so they moved their growing family three
hundred miles to Perth, the nearest city. Barry went to
medical school and became a doctor. Every six months, he
(05:30):
trained in a different speciality. When he moved to gastro enterology,
Marshall quickly realized that stomach problems could be hard to treat.
One woman on Marshall's ward was in terrible pain from
gastritis inflammation of the stomach. Nothing helped. In desperation, they
sent her away with antidepressants. It wasn't uncommon to link
(05:54):
gastric problems to mental health. Stomach ulcers were widely assumed
to be caused by stress. Ulcer medicines worked sometimes, but
often not for long. After a couple of years, many
patients would be back with another old sir. When medicines
didn't work, patients would often have part of their stomach
surgically removed. But was the medical community missing something. One
(06:20):
of Marshall's colleagues, Robin Warren, had a half formed theory.
People who came into hospital with a stomach complaint sometimes
had a biopsy taken, and Warren had been looking at
these biopsies. When the sample was from a patient with
an inflamed stomach, he could see under the microscope that
it was rife with a kind of spiral shaped bacteria.
(06:41):
It looked like tiny corkscrews. Those bacteria weren't there with
the healthy stomachs. Warren had observed this spiral bacteria many times,
including on the biopsy of the woman Marshall had seen,
the one who got antidepressants. Marshall was intrigued. He felt
bad that they had failed that patient. Perhaps there was
(07:04):
something more they could have done. He volunteered to investigate
warren idea. The medical textbooks weren't much help, but in
a way that Marshall found paradoxically encouraging. Every single pathologist
in the whole world who wrote a book described gastritis
totally differently. That meant to me that they didn't understand it.
(07:27):
So I'm thinking maybe these bacteria play a role in there.
Marshall went to his hospital's library and played around with
the computer. This was nineteen eighty one, their internet yet,
but the library had just got a direct link to
Australia's National Library of Medicine, and Marshall liked tinkering with technology.
He spent months trawling through obscure literature. Had found suggestive
(07:51):
references to bacteria and stomach complaints that went back nearly
a hundred years. It seemed that the evidence of a
link was there that nobody had yet connected the dots.
Marshall wrote up his findings and sent them to the
organizers of a big gastroenterology conference in Australia. They weren't
(08:11):
as excited as he was. They said, dear doctor Marshall,
we're so sorry that we couldn't accept your abstract. It
was such a high standard. This year, we had sixty
seven applications and we could only accept sixty four. Marshall
tried to grow the bacteria to study it better. Every
time he got a specimen, he'd send it down to
the hospital lab to see if they could culture it in.
(08:34):
Every time he visited the lab to ask how it
was going, he got the same answer. Had the bacteria grown. No.
Until one day, the day after the Easter holidays, Marshall
received a phone call. Come down to the lab. The
technician said, we think we've cultured your bacteria. It turned
(08:55):
out that Marshall's bacteria helico back to pylori, or just H. Pylor,
require three or four days to start showing up. The
lab was used to culturing bacteria that grow more quickly,
such as he whole eye. When nothing had appeared in
the petri dish after a couple of days, the technicians
were throwing the samples out. They had succeeded this time
(09:18):
only because Marshall had happened to send the last sample
just before the four day easter break. Now that Marshall
knew how to grow H. Pylorie, his next step was
to prove that the bacteria was causing the stomach illness.
It could, after all, be a coincidence, or maybe causality
could run the other way. Perhaps the illness was enabling
(09:41):
the bacteria to colonize the stomach. Marshall fed his bacteria
to mice and rats to see if they developed stomach problems.
They didn't. He tried it on piglets. Every week he'd
feed them a portion of H. Pylori and do an endoscopy,
sticking a tube down their throat to look for stomach problems.
(10:01):
Weeks went by and nothing happened to the little pigs,
except they grew into bigger pigs. After three of this experiment,
I had seventy pound pigs that I was wrestling with
each week trying to do an edoscopy on and it
was a big mess and the bacteria didn't take. Marshall
was exasperated. Mice and rats and pigs, after all, aren't people,
(10:26):
and he was convinced that H. Pylori was giving people ulcers.
Some gastroenterologists were intrigued by the idea, but many others
were dismissive. To get their attention, Marshall decided he needed
to show that if a healthy person got infected with H. Pylori,
they'd develop a stomach ulcer. But which healthy person could
(10:49):
he ask to do that? There was one obvious answer himself,
like his dad poking a gas filled balloon with a
lit cigarette. Barry was about to satisfy his curiosity in
a rather reckless way, though he didn't think it was
too much of a risk. When I spoke to ulcer patients,
(11:12):
they couldn't tell me about any illness they had had.
They were perfectly fine, and then they developed an ulcer,
So I didn't think I'd become unwell. Marshall had been
feeding his pigs a small dose of bacteria every week,
but would he really be able to persevere with consuming H.
Pylori himself on a weekly basis. He wasn't sure he
(11:34):
could stomach it. Better to summon up his courage once,
he thought, and take one huge dose. Marshall and his
lab technician brewed up a beaker of the potion, a
couple of ounces of cloudy brown liquid. He hadn't told
the lab technician what he was about to do with it.
(11:54):
He hadn't told his bosses either, as he feared they'd
try to stop him. He raised the beaker in his hand. Well,
here he goes down the hatch. The lab technician was horrified.
We'll find out what happened after the break. Barry Marshall
(12:28):
didn't expect to get a stomach ulcer right away. Many people,
it seemed, can carry an H. Pylori infection without developing
any gastric complaints. If he's going to get an ulcer,
he thinks it might take years. He reassures his appalled
lab technician that he feels perfectly fine and goes off
to do his rounds on the ward as usual. It
(12:51):
takes just a few days before Marshall realizes that something
isn't right. He's having one of his favorite meals, Chinese noodles,
but the food is sitting on his stomach like a
lump of lead. Boy, I feel so full. In the morning,
he wakes up at the crack of dawn, I'm going
to be sick. He runs into the bathroom and throws up.
(13:13):
But it's not the Chinese food that comes back up again,
just a clear, slimy liquid about a pint of it. Well, gee,
that's weird. I don't do that very often. The next
morning he wakes up and vomits again, and the next
he visits his mother. He hasn't told her about swallowing
(13:33):
the bacteria. Barry, are you constipated? How come you've got
bad breath. Barry's work colleagues have also noticed his terrible breath,
but they don't want to be impolite enough to tell him.
Ten days after swallowing the h pylorie, he gets them
to give him an endoscopy. Usually I can tolerate the
(13:54):
tube pretty easily with just a little gagging, but it
was very uncomfortable. The endoscopy shows that the lining of
Marshall's stomach is severely inflamed. This is great, says Marshall.
Let's give it another few days and see how it develops.
Marshall hasn't told his wife what he's done either, Barry,
(14:17):
there's something wrong with you. All night, You're hot and cold.
You're breaking out in a sweat. You're not eating your meals.
You've got dark rings under your eyes. You look terrible. Well,
you know, I took this bacteria and now I've got
the infection. You did what? It's not like. Marshall hadn't
done any thinking ahead. He tested the bacteria he had
(14:40):
cultured to make sure that an antibiotic metro nidazole would
kill it. It did in the petri dish at least,
so he was fairly confident that he could cure himself
by taking metro nidazole if his illness got to worrying.
Barry Marshall was the latest in a long tradition of
doctors experimenting on themselves. Alas that long tradition is not
(15:05):
wholly reassuring. John Hunter was eighteenth century English surgeon, royal
doctor to King George the Third. He was also the
leading authority of his time on venereal disease, so much
so that, according to some accounts, he gave himself gonorrhea
to study it better. He extracted us from an infected
(15:27):
patient and injected it into his own penis. This turned
out to be a doubly bad idea. First of all,
none of Hunter's cures for gonorrhea actually worked were still
The patient also happened to have syphilis, and Hunter got
that too, setting up a lifetime of worsening health. Or
(15:49):
take the nineteenth century German chemist Max von Pettenkoffer. Like
Barry Marshall, he downed a potion teeming with bacteria, in
this case the bacteria that caused cholera. He was trying
to prove his theory that the bacteria didn't cause cholera.
He was wrong. They do, and cholera can kill you.
(16:12):
But von Pettenkoffer was lucky. He just got a mild
case of diarrhea. In the nineteen twenties, medical student Werna
Forceman learned from his physiology textbook about an experiment someone
had done on a horse. They inserted a tube in
a vein in the horse's neck, pushed the tube into
the horse's heart, and inflated a rubber balloon to measure
(16:35):
the changes in pressure as the horse's heart beat. The
horse survived. Forceman wandered if a human would too. If
you could insert a tube into a vein in a
patient's arm, he thought, and push it into the heart,
that might have some medical uses. Forceman went to the
boss at his hospital and said, can I try this
(16:58):
on myself? Absolutely not, said his boss. Imagine the scandal
for the hospital if you kill yourself. Forceman decided to
ignore him and do it anyway. He'd need a tube.
To get the tube, he'd need to sweet talk the
nurse who held the keys to the supply covered. The
nurse was forty five year old girder Ditson. The young
(17:22):
doctor took her out to dinner and tried to persuade
her of the importance of what he wanted to do.
Nurse Ditson was completely won over. Do it to me,
she said. They arranged a clandestine meeting. In the lunch break,
Nurse Ditson got out of thirty inch tube, a scalpel,
and a hollow needle. She lay down on the surgical
(17:45):
table and doctor Forceman tied down her arms and legs
to hold her still. Forceman then turned his back on
her as if to arrange the instruments, but instead he
performed the surgery on himself. He dabbed iodine on his
left elbow, injected himself with a local anesthetic, and used
the needle to feed the tube into his vein. He
(18:08):
went back to strap Nurse Ditson and tell her what
he had done. She was furious, but she agreed to
help Forceman do what he needed to do next, get
proof that he'd pushed the tube all the way into
his heart. Together, they went to the X ray department
and asked the technician to let them use the fluoroscope.
(18:31):
On the screen, they could see where the tube was. Gently,
Forceman pushed it further and further towards his heart. The
technician slipped out of the room to alert another doctor
to what was going on. That other doctor now burst in.
What are you doing? He yelled at Forceman, You're crazy.
(18:51):
He tried to pull the catheter out of Forceman's arm,
but Forceman fought him off, kicking his shins. Nine nine,
I must push it forward. At last, the tip of
the catheter entered his heart. Take up picture. He told
the technician had his proof. He wrote up his self
(19:11):
experiment and submitted it to a medical journal. It caused
a huge fuss Enforceman was fired. He struggled to find
a new job. Nobody wanted a heart surgeon who was
known as a risk taker but a rule breaker. He
retrained as a urologist, got a job in a small
town where nobody had heard of him, and joined the
(19:34):
Nazi Party. Meanwhile, two American cardiologists read his old journal
article and decided he was onto something. They turned cardiac
catheterization into a practical technique to investigate heart disease and
to treat it by widening blocked arteries. They received a
(19:58):
Nobel Prize for their efforts, and they shared that Nobel
prize with an obscure ex Nazi small town German neurologist.
Nearly three dec aides after he had tied up Nurse
ditson Verna, Forceman had been vindicated. Just how big is
this tradition of medical self experimentation. A doctor and researcher
(20:22):
called Alan Weiss set out to document every example he
could find from the nineteenth and twentieth centuries. He found
four hundred and sixty five. Then he looked at what
had happened to them. In seven cases, including Forceman, it
won them a Nobel prize. In eight it killed them.
(20:44):
The odds of death and glory were roughly equal. Barry
Marshall's wife was not happy. She was worried about his
health and worried that he might pass on the bacteria
to her and their children. Start taking antibiotics. She tells
(21:05):
him give me till the end of the week. Marshall pleads,
I want to have another endoscopy to see what's happening.
By this point, Marshall has stopped vomiting up colorless, slimy liquid.
To his surprise, the next endoscopy shows that the inflammation
is healing. He takes the antibiotics to be on the
safe side, but he seems to have fought off the
(21:27):
bacteria on his own. Marshall has dinner with Robin Warren,
the colleague Hauld first suggested that he looked into the
spiral shaped bacteria on stomach biopsies. He tells Warren all
about his self experiment The next morning, Warren is woken
up at five am by a call from an American journalist.
They've scheduled a routine interview to discuss Warren's ulcer theory,
(21:51):
but the journalist has got muddled about the time zone
in Perth because he's half asleep. Warren blurts out the
exciting news, Barry Marshall just infected himself and damn near died.
Marshall hasn't yet published his work in a medical journal,
so the first report about it in an American tabloid newspaper,
(22:12):
a sensational story about the Australian guinea pig doctor and
his cure for ulcers. That's not going to help my credibility,
Marshall thinks, But unlike some of his self experimenting predecessors,
at least he was still alive. The tailor Franz Reichelt
(22:34):
had kept his self experimentation plans to himself. The workers
he employed in his tailoring business thought he was planning
to put his parachute suit on a tailor's dummy and
throw the dummy off the Eiffel Tower. That's also what
he told the Paris authorities he wanted to do when
he asked for permission to use the Eiffel Tower for
(22:55):
his test. The wait for that permission was agonizing as
Reichelt tried to improve his designs. Bureaucrats waited a full
year before giving him the nod. By then, Reichelt's workers
were used to him throwing dummies off the fifth floor
balcony of the building where he worked. The first prototype
of his parachute suit had a canopy of just six
(23:17):
square yards. The dummy did not land softly enough. Reichelt
redesigned the suit, this time with a twelve square yard canopy.
He threw the dummy off his balcony and the results
were a little better. Reichelt made the canopies bigger and
bigger in the end over thirty square yards, and it
(23:40):
seemed to him that the falls got chentler. He found
a quiet spot in a village to try the suit himself,
jumping from thirty feet onto a bed of straw. But
he also thought he saw the problem. He wasn't jumping
from high enough. The parachute needed more time to slow
the speed of his descent. On the evening before his
(24:05):
date with the Eiffel Tower Saturday, February fourth, nineteen twelve,
Riichelt wanted to make sure the media would turn up.
He paid a visit to a journalist at a Paris newspaper.
I've told the authorities I'm going to use a dummy,
he says. Actually, I'm going to jump myself. You won't
(24:26):
take any precautions, not in the least. I want to
prove the value of my invention. Word got round, and
when morning came, the journalists were out in force, and
the path a film crew. One writer describes the inventor's
absolute calm and apparent good humor. Another says he's cheerful,
(24:49):
brimming with confidence. He had put on a sort of
brown jumpsuit, a little bulkier than ordinary clothing. The appearance
was elegant, and the inventor rightly pointed out to everyone
that his clothing did not hinder movement. Some people made
a last ditch attempt to dissuade Raichelt from making the
jump himself. It's not too late to use a mannequin,
(25:12):
they point out. Will you at least think about postponing
until the wind calms down. Reichelt is having none of it.
You will see how my seventy two kilos and my
parachute will give to your arguments. The most decisive of denials.
There are three hundred and forty seven steps up to
(25:35):
the first floor of the Eiffel Tower. Reichelt starts to
climb them, with one of the film crews in tow.
He turns to look back at the crowd. Abiento. He says,
see you soon. Franz Reichelt wasn't included in the research
that counted four hundred and sixty five cases of self experimentation.
(25:59):
That research looked at doctors, not tailors. That research found
the pace of self experimentation was slowing towards the end
of the twentieth century. The Golden Age passed a hundred
years ago. Another researcher, Brian Hanley, doubts that he thinks
those figures are just the tip of the iceberg. Hanley
(26:23):
has experimented on himself in gene therapy. He knows lots
of other academics who've done the same but kept it quiet.
They worry that their institutions won't support them. They might
be fired. Like Werner Forceman all those years ago. Hanley
decided to investigate why self experimenting has such a bad reputation.
(26:46):
He and his colleagues contacted the ethics departments of universities
to see if they had a policy on it. There
was no consistency, but they heard a common concern that
self experiments prove nothing. It's called the n of one problem.
If your research has only one subject, you can't learn
anything useful. You need bigger studies to draw wider conclude.
(27:09):
That's just not true, said Hanley. An n of one
experiment can show that something is possible and more research
is worthwhile. That's what happened with Werna Forceman and Barry Marshall.
The sensational tabloid story might not have helped Marshall's credibility,
but it got attention and led to bigger studies. We
(27:30):
now know that roughly half the world's population is infected
with H. Pylori, generally in childhood. For most people it
never becomes a problem, but for some it causes stomach
cultures later in life, and we now know how to
treat them. Barry Marshall joined the list of self experimenters
who won a Nobel prize. The tailor, Franz Reichelt, as
(27:54):
you might have guessed, was not so lucky the path.
A newsreel footage of Franz Reichelt's jump from the Eiffel
Tower is riveting and awful. The parachute never looks like unfurling.
Reichelt drops like a stone. The autopsy will later reveal
(28:15):
that as he falls, he's suffering a massive cardiac arrest.
He fell with a dull thud onto the ground, his
forehead bleeding, his eyes open, dilated with terror, his limbs broken.
The reckless inventor was dead. Reichelt had looked like a
(28:37):
mad genius equipped one journalist, but proved himself worthy of
only half the epithet. It's easy to snicker, but is
it fair? Wearable parachutes are not an intrinsically stupid idea
reichelt design failed, But today we have designs that work,
(28:57):
wingsuits that let you skydive like a flying squirrel. And
when a self experiment goes well, it's easy to forget
how much uncertainty it involved. Barry Marshall didn't expect to
get symptoms so quickly, and he didn't expect the symptoms
to self resolve. I was a bit overconfident in retrospect,
(29:18):
he later admitted. If we can't tell how big a
risk is, how can we tell whether to take it.
I think all we can do is examine our motives.
Are we thirsting for useful knowledge that there's no other
way to obtain, or trying to show off? Barry Marshall
(29:39):
admits with hindsight that he was a brash young man,
impatient to prove his older colleagues wrong. Asked if he'd
do the same again, he says, I'd definitely study all
the different angles of it further before I'd do it
on myself. Franz Reichelt looks like a classic case of hubris.
(29:59):
There was, after all, a risk free way to test
his idea. Use a Taylor's dummy to jump himself suggests
he was delusionally overconfident in his own idea. That seems
to be what most Parisian journalists assumed, but not all.
Joe took the trouble to track down one of Reichelt's
(30:20):
friends and ask what the inventor had been thinking. The
explanation is simple, said the friend. Intellectual property laws. Reichelt
had managed to secure a patent for his parachute suit idea,
but the legal fees had stretched his finances, and patents
lasted for only fifteen years. If he was going to
(30:42):
make money from his invention, he had to commercialize it quickly.
That meant he needed a wealthy sponsor, and his only
hope of getting a sponsor was a spectacular, attention grabbing success.
He'd waited a whole year for bureaucrats to give him
permission to use the Eiffel Tower. He might never get
(31:04):
another chance to make an impact death all glory. As
he hesitated with his foot on the railing for forty
long seconds, perhaps he'd already guessed the answer. Cautionary Tales
(31:41):
is written by me Tim Harford with Andrew Wright. It's
produced by Ryan Dilley with support from Courtney Guarino and
Emily Vaughan. The sound design and original music is the
work of Pascal Wise. It features the voice talents of
Ben Crow, Melanie Gutridge, Stella Harford, and Rufus Wright. The
show also wouldn't have been possible without the work of
(32:03):
Mia LaBelle, Jacob Weisberg, Heather Fane, John Schnars, Julia Barton,
Carlie mc or, Eric Sandler, Royston Basserve, Maggie Taylor, Nicole Mrano,
Danielle Lakhan, and Maya Kanig. Cautionary Tales is a production
of Pushkin Industries. If you like the show, please remember
to share, rate and review, tell a friend, tell two friends,
(32:26):
and if you want to hear the show, adds free
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Podcasts or at pushkin dot fm, slash plus
Pushkin the first floor of the Eiffel Tower, almost two
hundred feet above the ground. Next to the railings a table.
On top of the table a wooden chair, and standing
on the wooden chair a man, Franz Reichelt. He places
(00:39):
a foot on the railing, he leans forward and peers
over the edge. The year is nineteen twelve and Franz
Reichelt is a tailor, thirty three years old. Born in Austria,
he moved to Paris as a teenager and built a
modestly successful business in ladies fashion. But ladies fashion is
(01:03):
not what excites Franz Reichelt. He's fascinated by flight, and
Reichelt has invented a parachute suit. Rychelt looks briefly up
to the heavens early in the morning on the first
Sunday in February. His breath forms in the air. By
nineteen twelve, parachutes are hardly a new idea Leonardo da
(01:27):
Vinci drew on centuries earlier. What is new is the
fast growing market for them. Airplanes have only just been
invented and not yet very reliable. Ryechelt is convinced that
his wearable parachute can save aviators lives with his tailoring skills.
He's made well. I'll let a journalist describe it. This
(01:50):
all silk garment, very well designed, was provided with a
kind of very wide hood which by means of zippers,
would automatically expand when called upon and form above the
head a vast umbrella. Down on the ground nearly two
hundred feet below. A few dozen people have got up
(02:13):
early to watch the demonstration. There are aviation enthusiasts, curious
members of the public, and journalists from all the Paris newspapers.
Reichelt has even drawn a film crew from the path,
a journal cinema newsreel. One camera is on the ground
pointed upwards at him, waiting. Another camera is with Reichelt
(02:36):
on the first floor filming him. He's still standing there,
one foot on the railing, one on the wooden chair.
But is he really going to jump himself? He's told
the Paris authorities that he's going to put the parachute
suit on a tailor's dummy and throw that off the
Eiffel Tower. They would never have given him permission to
(02:57):
jump off the Eiffel Tower himself. And yet there he stands.
Reichelt cautiously shifts his weight onto the foot on the railing.
Then he shifted back. Is he having second thoughts? It
is very windy. He sways gently forward and backward. He
(03:18):
looks over the edge again. Twenty seconds go by, thirty forty.
It's not too late to use the dummy. I'm Tim
Harford and you're listening to cautionary tales. In nineteen fifty one,
(04:01):
in a gold mining town in Western Australia, a nineteen
year old apprentice engineer and an eighteen year old training
nurse had a baby. They called him Barry. Barry Marshall
would grow up to be tempted to test a pet
theory on himself, much like the flying tailor Franz Reichelt
was tempted all those years ago. Growing up in Australia's
(04:24):
Back of Beyond, young Barry Marshall liked to read his
mum's medical textbooks and muck around with his dad's tools.
He made firecrackers and guns, and a device for pressurizing
domestic cooking gas to make balloons that were light of
an air. Do you want to be careful with those balloons?
Son said? Barry's dad might be dangerous if they meet
(04:47):
an open flame. Let's see, shall we. He drew on
his cigarette and touched the lighted end against the balloon.
Marshall recalls he was enveloped in a ball of flame
and his eyebrows were singed off. This didn't worry us
very much because we had seen him in this state before.
(05:07):
In the gold mining town, there was money to be made,
but not much choice of career path. Boys left school
and they mined for gold. The Marshals wanted their kids
to have options, so they moved their growing family three
hundred miles to Perth, the nearest city. Barry went to
medical school and became a doctor. Every six months, he
(05:30):
trained in a different speciality. When he moved to gastro enterology,
Marshall quickly realized that stomach problems could be hard to treat.
One woman on Marshall's ward was in terrible pain from
gastritis inflammation of the stomach. Nothing helped. In desperation, they
sent her away with antidepressants. It wasn't uncommon to link
(05:54):
gastric problems to mental health. Stomach ulcers were widely assumed
to be caused by stress. Ulcer medicines worked sometimes, but
often not for long. After a couple of years, many
patients would be back with another old sir. When medicines
didn't work, patients would often have part of their stomach
surgically removed. But was the medical community missing something. One
(06:20):
of Marshall's colleagues, Robin Warren, had a half formed theory.
People who came into hospital with a stomach complaint sometimes
had a biopsy taken, and Warren had been looking at
these biopsies. When the sample was from a patient with
an inflamed stomach, he could see under the microscope that
it was rife with a kind of spiral shaped bacteria.
(06:41):
It looked like tiny corkscrews. Those bacteria weren't there with
the healthy stomachs. Warren had observed this spiral bacteria many times,
including on the biopsy of the woman Marshall had seen,
the one who got antidepressants. Marshall was intrigued. He felt
bad that they had failed that patient. Perhaps there was
(07:04):
something more they could have done. He volunteered to investigate
warren idea. The medical textbooks weren't much help, but in
a way that Marshall found paradoxically encouraging. Every single pathologist
in the whole world who wrote a book described gastritis
totally differently. That meant to me that they didn't understand it.
(07:27):
So I'm thinking maybe these bacteria play a role in there.
Marshall went to his hospital's library and played around with
the computer. This was nineteen eighty one, their internet yet,
but the library had just got a direct link to
Australia's National Library of Medicine, and Marshall liked tinkering with technology.
He spent months trawling through obscure literature. Had found suggestive
(07:51):
references to bacteria and stomach complaints that went back nearly
a hundred years. It seemed that the evidence of a
link was there that nobody had yet connected the dots.
Marshall wrote up his findings and sent them to the
organizers of a big gastroenterology conference in Australia. They weren't
(08:11):
as excited as he was. They said, dear doctor Marshall,
we're so sorry that we couldn't accept your abstract. It
was such a high standard. This year, we had sixty
seven applications and we could only accept sixty four. Marshall
tried to grow the bacteria to study it better. Every
time he got a specimen, he'd send it down to
the hospital lab to see if they could culture it in.
(08:34):
Every time he visited the lab to ask how it
was going, he got the same answer. Had the bacteria grown. No.
Until one day, the day after the Easter holidays, Marshall
received a phone call. Come down to the lab. The
technician said, we think we've cultured your bacteria. It turned
(08:55):
out that Marshall's bacteria helico back to pylori, or just H. Pylor,
require three or four days to start showing up. The
lab was used to culturing bacteria that grow more quickly,
such as he whole eye. When nothing had appeared in
the petri dish after a couple of days, the technicians
were throwing the samples out. They had succeeded this time
(09:18):
only because Marshall had happened to send the last sample
just before the four day easter break. Now that Marshall
knew how to grow H. Pylorie, his next step was
to prove that the bacteria was causing the stomach illness.
It could, after all, be a coincidence, or maybe causality
could run the other way. Perhaps the illness was enabling
(09:41):
the bacteria to colonize the stomach. Marshall fed his bacteria
to mice and rats to see if they developed stomach problems.
They didn't. He tried it on piglets. Every week he'd
feed them a portion of H. Pylori and do an endoscopy,
sticking a tube down their throat to look for stomach problems.
(10:01):
Weeks went by and nothing happened to the little pigs,
except they grew into bigger pigs. After three of this experiment,
I had seventy pound pigs that I was wrestling with
each week trying to do an edoscopy on and it
was a big mess and the bacteria didn't take. Marshall
was exasperated. Mice and rats and pigs, after all, aren't people,
(10:26):
and he was convinced that H. Pylori was giving people ulcers.
Some gastroenterologists were intrigued by the idea, but many others
were dismissive. To get their attention, Marshall decided he needed
to show that if a healthy person got infected with H. Pylori,
they'd develop a stomach ulcer. But which healthy person could
(10:49):
he ask to do that? There was one obvious answer himself,
like his dad poking a gas filled balloon with a
lit cigarette. Barry was about to satisfy his curiosity in
a rather reckless way, though he didn't think it was
too much of a risk. When I spoke to ulcer patients,
(11:12):
they couldn't tell me about any illness they had had.
They were perfectly fine, and then they developed an ulcer,
So I didn't think I'd become unwell. Marshall had been
feeding his pigs a small dose of bacteria every week,
but would he really be able to persevere with consuming H.
Pylori himself on a weekly basis. He wasn't sure he
(11:34):
could stomach it. Better to summon up his courage once,
he thought, and take one huge dose. Marshall and his
lab technician brewed up a beaker of the potion, a
couple of ounces of cloudy brown liquid. He hadn't told
the lab technician what he was about to do with it.
(11:54):
He hadn't told his bosses either, as he feared they'd
try to stop him. He raised the beaker in his hand. Well,
here he goes down the hatch. The lab technician was horrified.
We'll find out what happened after the break. Barry Marshall
(12:28):
didn't expect to get a stomach ulcer right away. Many people,
it seemed, can carry an H. Pylori infection without developing
any gastric complaints. If he's going to get an ulcer,
he thinks it might take years. He reassures his appalled
lab technician that he feels perfectly fine and goes off
to do his rounds on the ward as usual. It
(12:51):
takes just a few days before Marshall realizes that something
isn't right. He's having one of his favorite meals, Chinese noodles,
but the food is sitting on his stomach like a
lump of lead. Boy, I feel so full. In the morning,
he wakes up at the crack of dawn, I'm going
to be sick. He runs into the bathroom and throws up.
(13:13):
But it's not the Chinese food that comes back up again,
just a clear, slimy liquid about a pint of it. Well, gee,
that's weird. I don't do that very often. The next
morning he wakes up and vomits again, and the next
he visits his mother. He hasn't told her about swallowing
(13:33):
the bacteria. Barry, are you constipated? How come you've got
bad breath. Barry's work colleagues have also noticed his terrible breath,
but they don't want to be impolite enough to tell him.
Ten days after swallowing the h pylorie, he gets them
to give him an endoscopy. Usually I can tolerate the
(13:54):
tube pretty easily with just a little gagging, but it
was very uncomfortable. The endoscopy shows that the lining of
Marshall's stomach is severely inflamed. This is great, says Marshall.
Let's give it another few days and see how it develops.
Marshall hasn't told his wife what he's done either, Barry,
(14:17):
there's something wrong with you. All night, You're hot and cold.
You're breaking out in a sweat. You're not eating your meals.
You've got dark rings under your eyes. You look terrible. Well,
you know, I took this bacteria and now I've got
the infection. You did what? It's not like. Marshall hadn't
done any thinking ahead. He tested the bacteria he had
(14:40):
cultured to make sure that an antibiotic metro nidazole would
kill it. It did in the petri dish at least,
so he was fairly confident that he could cure himself
by taking metro nidazole if his illness got to worrying.
Barry Marshall was the latest in a long tradition of
doctors experimenting on themselves. Alas that long tradition is not
(15:05):
wholly reassuring. John Hunter was eighteenth century English surgeon, royal
doctor to King George the Third. He was also the
leading authority of his time on venereal disease, so much
so that, according to some accounts, he gave himself gonorrhea
to study it better. He extracted us from an infected
(15:27):
patient and injected it into his own penis. This turned
out to be a doubly bad idea. First of all,
none of Hunter's cures for gonorrhea actually worked were still
The patient also happened to have syphilis, and Hunter got
that too, setting up a lifetime of worsening health. Or
(15:49):
take the nineteenth century German chemist Max von Pettenkoffer. Like
Barry Marshall, he downed a potion teeming with bacteria, in
this case the bacteria that caused cholera. He was trying
to prove his theory that the bacteria didn't cause cholera.
He was wrong. They do, and cholera can kill you.
(16:12):
But von Pettenkoffer was lucky. He just got a mild
case of diarrhea. In the nineteen twenties, medical student Werna
Forceman learned from his physiology textbook about an experiment someone
had done on a horse. They inserted a tube in
a vein in the horse's neck, pushed the tube into
the horse's heart, and inflated a rubber balloon to measure
(16:35):
the changes in pressure as the horse's heart beat. The
horse survived. Forceman wandered if a human would too. If
you could insert a tube into a vein in a
patient's arm, he thought, and push it into the heart,
that might have some medical uses. Forceman went to the
boss at his hospital and said, can I try this
(16:58):
on myself? Absolutely not, said his boss. Imagine the scandal
for the hospital if you kill yourself. Forceman decided to
ignore him and do it anyway. He'd need a tube.
To get the tube, he'd need to sweet talk the
nurse who held the keys to the supply covered. The
nurse was forty five year old girder Ditson. The young
(17:22):
doctor took her out to dinner and tried to persuade
her of the importance of what he wanted to do.
Nurse Ditson was completely won over. Do it to me,
she said. They arranged a clandestine meeting. In the lunch break,
Nurse Ditson got out of thirty inch tube, a scalpel,
and a hollow needle. She lay down on the surgical
(17:45):
table and doctor Forceman tied down her arms and legs
to hold her still. Forceman then turned his back on
her as if to arrange the instruments, but instead he
performed the surgery on himself. He dabbed iodine on his
left elbow, injected himself with a local anesthetic, and used
the needle to feed the tube into his vein. He
(18:08):
went back to strap Nurse Ditson and tell her what
he had done. She was furious, but she agreed to
help Forceman do what he needed to do next, get
proof that he'd pushed the tube all the way into
his heart. Together, they went to the X ray department
and asked the technician to let them use the fluoroscope.
(18:31):
On the screen, they could see where the tube was. Gently,
Forceman pushed it further and further towards his heart. The
technician slipped out of the room to alert another doctor
to what was going on. That other doctor now burst in.
What are you doing? He yelled at Forceman, You're crazy.
(18:51):
He tried to pull the catheter out of Forceman's arm,
but Forceman fought him off, kicking his shins. Nine nine,
I must push it forward. At last, the tip of
the catheter entered his heart. Take up picture. He told
the technician had his proof. He wrote up his self
(19:11):
experiment and submitted it to a medical journal. It caused
a huge fuss Enforceman was fired. He struggled to find
a new job. Nobody wanted a heart surgeon who was
known as a risk taker but a rule breaker. He
retrained as a urologist, got a job in a small
town where nobody had heard of him, and joined the
(19:34):
Nazi Party. Meanwhile, two American cardiologists read his old journal
article and decided he was onto something. They turned cardiac
catheterization into a practical technique to investigate heart disease and
to treat it by widening blocked arteries. They received a
(19:58):
Nobel Prize for their efforts, and they shared that Nobel
prize with an obscure ex Nazi small town German neurologist.
Nearly three dec aides after he had tied up Nurse
ditson Verna, Forceman had been vindicated. Just how big is
this tradition of medical self experimentation. A doctor and researcher
(20:22):
called Alan Weiss set out to document every example he
could find from the nineteenth and twentieth centuries. He found
four hundred and sixty five. Then he looked at what
had happened to them. In seven cases, including Forceman, it
won them a Nobel prize. In eight it killed them.
(20:44):
The odds of death and glory were roughly equal. Barry
Marshall's wife was not happy. She was worried about his
health and worried that he might pass on the bacteria
to her and their children. Start taking antibiotics. She tells
(21:05):
him give me till the end of the week. Marshall pleads,
I want to have another endoscopy to see what's happening.
By this point, Marshall has stopped vomiting up colorless, slimy liquid.
To his surprise, the next endoscopy shows that the inflammation
is healing. He takes the antibiotics to be on the
safe side, but he seems to have fought off the
(21:27):
bacteria on his own. Marshall has dinner with Robin Warren,
the colleague Hauld first suggested that he looked into the
spiral shaped bacteria on stomach biopsies. He tells Warren all
about his self experiment The next morning, Warren is woken
up at five am by a call from an American journalist.
They've scheduled a routine interview to discuss Warren's ulcer theory,
(21:51):
but the journalist has got muddled about the time zone
in Perth because he's half asleep. Warren blurts out the
exciting news, Barry Marshall just infected himself and damn near died.
Marshall hasn't yet published his work in a medical journal,
so the first report about it in an American tabloid newspaper,
(22:12):
a sensational story about the Australian guinea pig doctor and
his cure for ulcers. That's not going to help my credibility,
Marshall thinks, But unlike some of his self experimenting predecessors,
at least he was still alive. The tailor Franz Reichelt
(22:34):
had kept his self experimentation plans to himself. The workers
he employed in his tailoring business thought he was planning
to put his parachute suit on a tailor's dummy and
throw the dummy off the Eiffel Tower. That's also what
he told the Paris authorities he wanted to do when
he asked for permission to use the Eiffel Tower for
(22:55):
his test. The wait for that permission was agonizing as
Reichelt tried to improve his designs. Bureaucrats waited a full
year before giving him the nod. By then, Reichelt's workers
were used to him throwing dummies off the fifth floor
balcony of the building where he worked. The first prototype
of his parachute suit had a canopy of just six
(23:17):
square yards. The dummy did not land softly enough. Reichelt
redesigned the suit, this time with a twelve square yard canopy.
He threw the dummy off his balcony and the results
were a little better. Reichelt made the canopies bigger and
bigger in the end over thirty square yards, and it
(23:40):
seemed to him that the falls got chentler. He found
a quiet spot in a village to try the suit himself,
jumping from thirty feet onto a bed of straw. But
he also thought he saw the problem. He wasn't jumping
from high enough. The parachute needed more time to slow
the speed of his descent. On the evening before his
(24:05):
date with the Eiffel Tower Saturday, February fourth, nineteen twelve,
Riichelt wanted to make sure the media would turn up.
He paid a visit to a journalist at a Paris newspaper.
I've told the authorities I'm going to use a dummy,
he says. Actually, I'm going to jump myself. You won't
(24:26):
take any precautions, not in the least. I want to
prove the value of my invention. Word got round, and
when morning came, the journalists were out in force, and
the path a film crew. One writer describes the inventor's
absolute calm and apparent good humor. Another says he's cheerful,
(24:49):
brimming with confidence. He had put on a sort of
brown jumpsuit, a little bulkier than ordinary clothing. The appearance
was elegant, and the inventor rightly pointed out to everyone
that his clothing did not hinder movement. Some people made
a last ditch attempt to dissuade Raichelt from making the
jump himself. It's not too late to use a mannequin,
(25:12):
they point out. Will you at least think about postponing
until the wind calms down. Reichelt is having none of it.
You will see how my seventy two kilos and my
parachute will give to your arguments. The most decisive of denials.
There are three hundred and forty seven steps up to
(25:35):
the first floor of the Eiffel Tower. Reichelt starts to
climb them, with one of the film crews in tow.
He turns to look back at the crowd. Abiento. He says,
see you soon. Franz Reichelt wasn't included in the research
that counted four hundred and sixty five cases of self experimentation.
(25:59):
That research looked at doctors, not tailors. That research found
the pace of self experimentation was slowing towards the end
of the twentieth century. The Golden Age passed a hundred
years ago. Another researcher, Brian Hanley, doubts that he thinks
those figures are just the tip of the iceberg. Hanley
(26:23):
has experimented on himself in gene therapy. He knows lots
of other academics who've done the same but kept it quiet.
They worry that their institutions won't support them. They might
be fired. Like Werner Forceman all those years ago. Hanley
decided to investigate why self experimenting has such a bad reputation.
(26:46):
He and his colleagues contacted the ethics departments of universities
to see if they had a policy on it. There
was no consistency, but they heard a common concern that
self experiments prove nothing. It's called the n of one problem.
If your research has only one subject, you can't learn
anything useful. You need bigger studies to draw wider conclude.
(27:09):
That's just not true, said Hanley. An n of one
experiment can show that something is possible and more research
is worthwhile. That's what happened with Werna Forceman and Barry Marshall.
The sensational tabloid story might not have helped Marshall's credibility,
but it got attention and led to bigger studies. We
(27:30):
now know that roughly half the world's population is infected
with H. Pylori, generally in childhood. For most people it
never becomes a problem, but for some it causes stomach
cultures later in life, and we now know how to
treat them. Barry Marshall joined the list of self experimenters
who won a Nobel prize. The tailor, Franz Reichelt, as
(27:54):
you might have guessed, was not so lucky the path.
A newsreel footage of Franz Reichelt's jump from the Eiffel
Tower is riveting and awful. The parachute never looks like unfurling.
Reichelt drops like a stone. The autopsy will later reveal
(28:15):
that as he falls, he's suffering a massive cardiac arrest.
He fell with a dull thud onto the ground, his
forehead bleeding, his eyes open, dilated with terror, his limbs broken.
The reckless inventor was dead. Reichelt had looked like a
(28:37):
mad genius equipped one journalist, but proved himself worthy of
only half the epithet. It's easy to snicker, but is
it fair? Wearable parachutes are not an intrinsically stupid idea
reichelt design failed, But today we have designs that work,
(28:57):
wingsuits that let you skydive like a flying squirrel. And
when a self experiment goes well, it's easy to forget
how much uncertainty it involved. Barry Marshall didn't expect to
get symptoms so quickly, and he didn't expect the symptoms
to self resolve. I was a bit overconfident in retrospect,
(29:18):
he later admitted. If we can't tell how big a
risk is, how can we tell whether to take it.
I think all we can do is examine our motives.
Are we thirsting for useful knowledge that there's no other
way to obtain, or trying to show off? Barry Marshall
(29:39):
admits with hindsight that he was a brash young man,
impatient to prove his older colleagues wrong. Asked if he'd
do the same again, he says, I'd definitely study all
the different angles of it further before I'd do it
on myself. Franz Reichelt looks like a classic case of hubris.
(29:59):
There was, after all, a risk free way to test
his idea. Use a Taylor's dummy to jump himself suggests
he was delusionally overconfident in his own idea. That seems
to be what most Parisian journalists assumed, but not all.
Joe took the trouble to track down one of Reichelt's
(30:20):
friends and ask what the inventor had been thinking. The
explanation is simple, said the friend. Intellectual property laws. Reichelt
had managed to secure a patent for his parachute suit idea,
but the legal fees had stretched his finances, and patents
lasted for only fifteen years. If he was going to
(30:42):
make money from his invention, he had to commercialize it quickly.
That meant he needed a wealthy sponsor, and his only
hope of getting a sponsor was a spectacular, attention grabbing success.
He'd waited a whole year for bureaucrats to give him
permission to use the Eiffel Tower. He might never get
(31:04):
another chance to make an impact death all glory. As
he hesitated with his foot on the railing for forty
long seconds, perhaps he'd already guessed the answer. Cautionary Tales
(31:41):
is written by me Tim Harford with Andrew Wright. It's
produced by Ryan Dilley with support from Courtney Guarino and
Emily Vaughan. The sound design and original music is the
work of Pascal Wise. It features the voice talents of
Ben Crow, Melanie Gutridge, Stella Harford, and Rufus Wright. The
show also wouldn't have been possible without the work of
(32:03):
Mia LaBelle, Jacob Weisberg, Heather Fane, John Schnars, Julia Barton,
Carlie mc or, Eric Sandler, Royston Basserve, Maggie Taylor, Nicole Mrano,
Danielle Lakhan, and Maya Kanig. Cautionary Tales is a production
of Pushkin Industries. If you like the show, please remember
to share, rate and review, tell a friend, tell two friends,
(32:26):
and if you want to hear the show, adds free
and listen to four exclusive Cautionary Tales shorts. Then sign
up for Pushkin Plus on the show page in Apple
Podcasts or at pushkin dot fm, slash plus
Host
Tim Harford
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