Book – Gut: The inside story of our body’s most under-rated organ
Author: Giulia Enders
Publisher: Speaking Tiger
Pages: 262 pages
Price: Rs 350
At the age of 25, Giulia Enders is a publishing phenomenon in her native Germany, where her book Darm Mit Charme (Guts with Charm) has sold over 1.3 million copies since it was published by Ullstein Verlag in March last year. It now promises to be a global bestseller. It’s inevitable, because the majority of reviewers seem to believe that this is a book about poo, and the majority of the human race is obsessed with bowel movements.
But you know what: this is not a poo book. It is a love song to the gastro-intestinal tract, the human body’s least sung organ system. In popular medical literature, the high notes are reserved for the nervous and cardiovascular systems. The immune system is gaining some profile because droves of American children are developing allergies to nuts, grains and other everyday realities. But all other organ systems are simply taken for granted. Gut is a fine attempt to break this caste system and celebrate the digestive system, which is ignored because it does its work so quietly and unassumingly that its owner may not even be aware of its existence, until they develop that inexplicable bout of gastric reflux or colitis.
The book is the work of a PhD candidate in gastroenterology with an interest in microbiology and comes armed with 13 pages of scholarly references, but Enders has the proselytiser’s infectious enthusiasm which make her account as readable as a Lonely Planet guidebook to the innards. Making complex structures and dynamics accessible to lay readers is the main challenge of good science writing, and Enders does it effortlessly, making the work of the stomach, the liver, the pancreas and the small intestine as they digest a meal sound as exaltingly harmonious as a philharmonic performance.
Gut also discusses issues at the leading edge of gastroenterology and shows how rapidly medical science is evolving. Doctors a generation older than Enders were taught that the vermiform appendix was a vestigial organ, and it routinely became collateral damage in unrelated abdominal surgeries. If you needed your gall bladder out, why wait for the appendix to rot, too? Off it went in one fell swoop. Now, the appendix is regarded as an important part of the immune system, an emergency capsule of flora which repopulates the gut after disease and antibiotics devastate it.
A generation ago, gastric ulcers were attributed to psychosomatic factors, and patients were told to calm down. Now, Helicobacter pylori is known to play a crucial role in exposing the lining of the stomach to its acid contents. And it has become common for gynaecologists to test pregnant women for toxoplasmas, little devils which live in the guts of cats without harming them, but use humans and other animals to leap to other cats. If the transmitter is pregnant, miscarriage frequently results.
Enders recounts the experiment of Joanne P Webster, who demonstrated that rats infected with Toxoplasma gondi lost all fear of cats, literally dying to transmit the organism. The discovery, in the Nineties, immediately drew attention to suicidal behaviour in schizophrenic humans. The book expands on the theme: if a heavy meal makes us stupid, if too much coffee makes us jumpy, can things we eat try to take control of our minds? Then, is there such a thing as free will?
See, this is not a poo book. Even though one reviewer in London went to the extent of meeting Enders in a Victorian loo converted into a bar, imagining it would be an appropriate setting. One of London’s famous offal restaurants would have been even more apt. But criminally expensive, or course.
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