Eat Shit and...Ride

I can't count how many times I have said that understanding the mysteries of the microbiome will unlock the secrets to many physiological and pathophysiological process. The latest example of the microbiome's explanatory power regards the athletic prowess of elite cyclists. In a new unpublished study, that is getting a crapload of press, the microbiomes of elite and amateur cyclists were compared and, not surprisingly, differences were found. Particularly intriguing was the presence of the anaerobic bacteria Prevotella in half of the elite cyclists and none of the amateurs. An archae (Methanobrevibacter archaea) -- a disparate branch of life from eukaryotes (us) and prokayrotes (bacteria) was also more likely to be present.

This study is thought provoking and has many implications and it will be important for this to be thoroughly vetted through the peer-review process -- as studies on rugby players have. It will also be essential to untangle this correlation to try and determine causation -- is the microbiome difference related to the enhanced performance of athlete or the result of their diet, their exercise regimen, their genetics, or some other factor. If the microbiome is causative, poop doping could become a real phenomenon for enhancing athletic prowess (it already has promise in weight management and treatment of Clostridium difficile infection).

Though it's not quite time to follow athletes into the port-a-John, the promise of microbiome research is definitely making poop exponentially more appetizing each day.

The Ebola Inferno: A Review of Dr. Hatch's Memoir

I just finished another Ebola memoir by an American doctor who battled the virus during the West African outbreak. Inferno: A Doctor's Ebola Story by UMass's Dr. Steven Hatch is much more than patient vignettes and is really an intimate window into how an academic infectious disease physician fared against a deadly virus. 

Dr. Hatch's book moves from his first pre-Ebola visit to Liberia in which he was tasked with building medical capacity in a country ravaged by a recent civil war to his return to the country in the midst of the Ebola outbreak.

It is now almost cliche to say that the usual measures didn't work in Liberia because of the populace's distrust of the government and that one-size-fits-all solutions don't exist. Dr. Hatch unpacks that statement by weaving into this narrative an important discussion of the origins of Liberia and the civil war. As Dr. Hatch demonstrates, both of these factors distinctly shaped the response to the virus as did the Christianity and animistic beliefs of the population. 

Another aspect of the book that bears highlighting is Dr. Hatch's unfortunate navigation of the myriad details regarding his return to the panic-stricken US and the inanity of bureaucracies that were responsive less to science than to pandering politicians. 

I highly recommend the book.