Swimming upstream

My friend made it pretty clear beforehand what he was going to tell me about, and said that we had better finish our dinner before he started. He had just come out of hospital. We had been talking about bacteria, intestinal problems, smelly diseases. I saw that whatever he was going to talk about could hardly be worse, and told him so. He smiled.

Have you heard about the shit implant? The term sounded horrendous. No, I hadn't heard about the shit implant. Then my friend said the thing has other names because science makes it its business to search out euphemisms, clinical terms, to dissimulate unsavory things. Transplant of fecal microbiota is the term in most general use. And, not long ago, it was discovered to be the most effective therapy against the effects of clostridium difficile , a bacteria that causes an array of stubborn infections and diarrheas that won't go away. Clostridium, which under the microscope looks like one of those breakfast cereals that consist of little batons, is another product of modern times: quiet, minding its own business, causing a minimum of trouble, until the tsunami of antibiotics that every human body in the developed world nowadays receives from time to time turns it into a dangerous beast. This is another alteration in the ecosystem, climate change on a micro-scale: the antibiotics kill off other bacteria that served to keep clostridium in its place and allow it to multiply indefinitely and become a killer.

In the US alone, clostridium attacks about a thousand people a day, and kills about 40. Thus the intense search for effective therapies. As you might expect, antibiotics themselves do not function well against it. Their rate of cure is less than 35 percent. The shit transplant, on the other hand, cures more than 90 percent of the patients who undergo it.

The procedure is rapid and not particularly invasive, as such things go. It consists of receiving through the rectum or the nose by means of the usual sort of tubes some 50 grams of fecal matter from a healthy donor diluted in milk, water or saline solution, so that the healthy and strong bacteria can reestablish the balance of intestinal flora and put clostridium back in its place.

My doctor told me that the patients suffer so much that when this is proposed to them, they usually accept immediately. My friend said he had been suffering from a rare intestinal infection. I was afraid they would want to do that to me.

Would you have let them?

My friend looked at me oddly. There is something out of the ordinary in shaking off one of the ancestral ancient taboos and allowing them to put somebody else's shit in your body. There is something extraordinary in abandoning yourself to science to that extent: when the urge to believe makes you do what you never believed you would do. I don't know. When disease makes you desperate, everything changes, doesn't it? But I thought and thought, and couldn't do it...

The fecal transplant has no generally recognized inventor. They say that the Chinese used it before the time of Christ but not in recent times. And they say that it was an institute in Australia - the Centre for Digestive Diseases in Sydney - that has been in the forefront of its use during the last 20 years, and has popularized it elsewhere. The inventor was a genius, in any case, whoever he is.

My friend says this, and calls for two coffees. A genius, he says, with so few curbs on the activity of his mind, as to have it occur to him that the waste material par excellence, the quintessence of what is repugnant to all of us, might be a remedy. Well, in terms of thought processes swimming against the stream, you can't do much better than that.

He tells me this in a tone so emphatic that I try not to answer with a bad joke.