Like millions of others worldwide, I’ve been paying close attention to the events happening in Egypt. For the last two and a half years, the country has experienced what can be best described as a sociopolitical roller coaster ride. The 2011 Arab Spring to oust Hosni Mubarak was regarded as one of the most powerful public movements yet paled in comparison to the current unprecedented gatherings to protest the now-deposed President, Mohamed Morsi. Whatever your political view, you cannot argue that what has happened in this small corner of Africa has been historical.
Yet, while this movement on a human scale may seem rare if not unique, the same type of struggle often occurs in the microbial world, particularly in the human gut.
When happy and healthy, the gastrointestinal tract is colonized with a combination of helpful microbes that work together to help digest food, balance the immune system and even send signals to the brain that all is good. Yet, when another type of microbe ventures in, such as norovirus, Salmonella or C. difficile, a struggle ensues. The outcome, much like political strife, can happen in one of three ways.
In the case of norovirus, as anyone who has suffered this infection knows, the result is akin to a pillage, sending the gut and the body politic into turmoil within hours. The virus metaphorically scorches the gut leaving it almost uninhabitable. After the virus has completed its horrific task, usually 48 to 72 hours, it leaves the body in search of its next conquest. The gut, however, cannot heal as quickly and may need weeks if not months to heal, recolonize with good bacteria and eventually return to a content state.
For Salmonella, the battle is like an insurgence that goes back and forth until one side wins. If the pathogen is strong enough and in high enough numbers, the good bacteria are overwhelmed, being killed off or ousted from the body as diarrhea. The gut countryside becomes a Salmonella state ensuring that the microbes are fed well and thrive. Eventually, as the body recognizes the problem and learns to fight the pathogen, a process that usually takes no more than a few weeks, the Salmonella are beaten down by both the immune system and any newly introduced fighters, such as antibiotics and/or probiotics and eventually cast out of the body. The healing process takes some time, perhaps weeks, but because the landscape wasn’t entirely decimated, there can be a rapid return to normal life.
Opportunism is the best way to describe C. difficile. Normally, this bacterium is harmless and cannot establish any kind of presence in the gut, even though we are exposed to it fairly regularly in the community. Yet, when a battle in the gut has taken place, such as an infection followed by antibiotics, there is a chance that there will be no clear winner – the gut will be left relatively bare. C. difficile can take hold of this opportunity and start to form its own colonies. However, much like an opportunistic dictator who takes over after a war, the bacteria makes its own decrees regardless of the state of the country.
The bacterium releases a toxin that can kill anything in its path. Over time, it forms its own castles in the gut, known as pseudomembranes. Also, due to the lack of a proper connection with the body, it renders the entire person in a state of illness. Diarrhea is common, pain can be at times unbearable and eventually, in the weak, the only salvation is death.
What makes C. difficile so problematic is that once it has laid down its foundations, it is very difficult to remove. No matter what kind of fight might ensue, the bacterium fights until the bitter end and will not give up its reign until it has been killed off completely. While possible, it’s not easy on the patient and can lead to even more troubles down the line.
As for Egypt, the situation is different; the changes that have occurred have been for the most part non-violent and mediated by the people. While there have been deaths and other crimes against humanity recorded, for the most part, the process has been peaceful. In a microbial sense, the people of Egypt are akin to probiotic bacteria in the gut.
Individuals want to have a healthy and prosperous country and will do what they can to preserve a beneficial state. In 2011, these probiotic people amassed in Tahrir Square to protest years of unhappiness under Mubarak. In 2012, they allowed another type of bacterium to enter the fold – Morsi – along with his supporters. However, much like what happens in cases of irritable bowel disease (IBD), the presence of these new players was less than beneficial, causing a form of dysbiosis. The body economy suffered, the psychological state worsened and relationships with other bodies became sour.
But as seen in many cases where IBD is managed and resolved, the public version of probiotics once again came to the rescue. A new and even more powerful rise occurred. Through their protest, a signal was sent to the immune system – the military – to do what is right and attempt to restore balance. While there may soon be calm again, much like the medical state, the political state is far from being at peace and the people may once again come out into the streets if displeasure occurs.
The world is a continually dynamic and there are so many ways that our social, political, economic and even interpersonal worlds shift and change over time. But the Earth is in many ways no different than each and every human body. One can take a closer look inside at the microbiome, the immune system, the nervous system, the endocrine system and others to not only identify ways to relate, but also to see how outcomes may turn out.
In the case of Egypt, while resolution may be a long time away, I am sure that as long as the probiotic people are out in force, the entire country will stay in at least some kind of balance – as long as they don’t have to worry about another norovirus, Salmonella, or C. difficile.
As always, I would love to know your thoughts and whether you know of other germy models for sociopolitical events.