Lifestyle

How swapping poop has helped one doctor cure disease

Think Like a Freak: The Authors of Freakonomics Offer to Retrain Your Brain
by Steven D. Levitt and Stephen J. Dubner

What if the source of your illness were in your bowels and the cure was in healthy gut microbes? Then the cure, naturally, would be a fecal transplant. That’s right. A healthy stool, from someone else, injected where the sun does not shine via reverse enema. Doctors are doing the procedure right now: They call it a s— swap.

What goes on in your gut is largely a mystery, as opaque as the ocean floor, and yet this “microbial cloud” is, by some measures, the largest organ in the human body. Researchers are starting to think that the root of many diseases, even ones like cancer and diabetes and multiple sclerosis that seemingly have nothing to do with the digestive tract, may be what’s living in your gut. An Australian doctor, Thomas Borody, says he has been using this approach — and those s— swaps — to cure people of ulcerative colitis, which is considered incurable.

Borody says the kind of free-thinking that inspired him — and the “Freakonomics” sequel “Think Like a Freak,” in which his story is told — comes from the work of another doctor, Barry Marshall, who questioned the conventional wisdom on ulcers.

Within the last 30 years, if you had an ulcer, your doctor told you it was your own fault, for being too stressed out and eating too much spicy food. If you protested that you ate nothing but tapioca, Wonder Bread and bananas all day long, he’d tell you it must be worry that was gnawing away at your innards. And if you told him, “Doc, I wouldn’t be so stressed if I didn’t have a frickin’ HOLE IN MY STOMACH,” that would just prove his point.

Marshall noticed something other doctors ignored: that cells taken from ulcer patients were covered with bacteria. The other doctors didn’t see it because they were told it was impossible: Bacteria, the legend went, couldn’t survive in the acidic whirlpool of the stomach. So, to get a look at the stomach cells, they’d just brush off the bacteria that they learned were not there.

What if the bacteria were the cause of the ulcer, wondered Marshall? To prove he was right, he drank a beaker full of the suspect microbe — H. pylori. Then he went on with his work, figuring it would take some years to get an ulcer.

Instead, five days later came the vomiting, and a biopsy revealed that H. pylori was swarming his stomach like New York women at a Louis Vuitton sample sale. Ever wonder why you never hear anybody complaining about an ulcer anymore? Thank Barry Marshall. He won the Nobel Prize in 2005.

“Think Like a Freak,” though barely 200 widely spaced pages of jaunty and simply written prose, is dense with such stories. Authors Steven Levitt and Stephen Dubner hope these parables will entice you to question underlying assumptions, look to the basics and think scientifically. Every few pages, as though repeating an advertising slogan, they cajole you to think more like a Freak.

The self-help exhortations aren’t necessary, because the stories about counterintuitive thinking are so compelling and fun.

Take hiring practices, for instance: If you are, say, a fast-food chain and need to hire a lot of people (in part because so many of your workers keep quitting), should you cast a wide net or a narrow one?

These companies typically have breezy, easy applications, often available online. Result: Employee turnover of roughly 100%. A year. That means lots of training costs as you keep bringing in new workers.

Zappos, on the other hand, does its hiring the Freaky way: They offer people a bonus not to work for them.

In order to weed out the less-motivated, after the introductory training period the online retailer tempts new hires with “the Offer.” It’s a check for $2,000 — a month’s pay — to walk away and never apply to the company again. Anyone who can resist that, the company figures, really wants to work for us.

Zappos saves money, too: It costs roughly $4,000 to replace an employee, and a survey declared that a single bad hire can cost a company in excess of $25,000 in lost productivity and other problems.

Levitt and Dubner may not succeed in teaching you to think smarter. But their book is liberating. Free yourself, they say, from the need to go along with the majority. Or from your biases. Or from the fear of saying, “I don’t know.” Thinking like a Freak means, in some ways, thinking like a child: Never underestimate the value of asking, “Why?”