FMT: The Future of Medicine…Today?
What in history, if anything, could have prepared us for a future of transplanting poo?
Great strides forward in medicine often feel, to a certain degree, futuristic. Think about modern advancements like 3D-Printed implants, or even not-so-recent breakthroughs like CT scans that can give doctors a baffling amount of insight into the innards of the human body.
But at the same time, without the benefit of hindsight, medicine often seems to move at a snail’s pace. If we’re lucky, these breakthroughs rarely impact us in our day-to-day lives. Or, if they do, it’s unlikely that we take the time to reflect on the legacy of advancements that made these lifesaving measures accessible. If the tech works, we’re grateful, but recipients of a CT scan might not care to ask about the decades of research that contributed to the technology we’re able to use today.
And if you’re ever prescribed a pill made of human poop…well, it might be hard to envision the long road that lead to that noteworthy moment in your life. But it’s coming, trust me. Fecal Matter Transplants are here to stay.
It’s for this exact reason that speculative fiction can be such a valuable tool in offering much-needed perspective on medical advancement. Sci-fi written in the past several decades allows our culture to look backwards in time, and into some truly revolutionary minds, to consider what type of medicine today might at one point have been considered “futuristic,” or even so far-fetched that it bordered on the impossible. With this vantage point, we can look at the 21st Century’s most buzzworthy leaps forward in health research — and yes this includes poop pills — to see whether this technology was the subject of hypotheses and wish-lists in the years, decades, or even centuries of the past. Maybe these forward-thinkers had inadvertently predicted a panacea that we’re finally able to witness come into existence in our lifetimes.
But we’re getting a bit ahead of ourselves. First we need to know why the Fecal Matter Transplant is even worth all the hype.
The praise is well-warranted: studies have shown that in cases of C. diff infection (which impacts half a million in the US and kills over 25k annually), FMTs are 90% effective and come with zero side effects. Now, the practice is being applied to other diseases like Crohn’s and IBS, and starting to be considered as treatment for obesity, Parkinson’s, or even depression.
Yet despite the serious health benefits provided by FMTs, journalists have taken to describing the science with some rather…colorful language. Clearly this comes with the territory when trying to explain that medicine’s new playground involves inserting poop from healthy people into those needing a bacterial boost. Keeping the tone tongue-in-cheek may just help soften the blow. According to reputable sources like NBC News:
As our once-diverse microbiomes continue to go under attack, scientists are considering stranger-than-fiction new ways to repopulate our barren guts. And their search is taking them right to your toilet. *Fart Sound*
“Stranger than fiction,” you say?
NBC isn’t alone in this rhetoric. The New Yorker describes this type of research as having “an air of science fiction,” and TechCrunch seems to look at the field more broadly as “concept from a science fiction movie.” The trend is easy to see: giving sick people pills made of poop seems to dial the science-fiction meter up to eleven. But why?
This returns us to the idea that speculative fiction is a weathervane, so to speak, of scientific advancement. Not only can decades of predictive storytelling help give context to these achievements, but it can also help prepare future generations for larger paradigm shifts in the science climate.
So is the FMT a product of speculative fiction? And, if so, why are we so surprised to see this science finally become a reality?
The Long, Storied History of FMT
For this epic tale, we need to go back far into the archives: Aesop, circa 600 BCE, and the story of the goose that laid golden eggs.
So…right, it’s not a perfect comparison — but there is an important theme at work: an animal excretes something of value. The idea existed with the ancient Aztecs too, calling silver “the white shit of the Gods,” and in ancient Persia where amber was thought to be the dung of a donkey demigod. Even references to “Manna from Heaven” might have been mosquito poop.
That last one is harder to verify, but I’m doing my best.
This theme of “poop is good” seems to pop up again and again in ancient storytelling, which actually makes a lot of sense from a natural perspective. Animal feces like guano has been a valuable source of plant fertilizer for thousands of years. Ambergris, which is practically whale feces, has been harvested as a component in fragrances, cooking, and even medicine.
Egyptian doctors even used a myriad of different animal droppings to seemingly treat any disease they could find. According to the History Channel, which draws it’s source straight from the translations of the translation of scrolls written in 1500 BC:
Donkey, dog, gazelle and fly dung were all celebrated for their healing properties and their ability to ward off bad spirits. While these repugnant remedies may have occasionally led to tetanus and other infections, they probably weren’t entirely ineffective — research shows the microflora found in some types of animal dung contain antibiotic substances.
And not just animals, but human excrement as well. The “poop is good” mythos seems to be a natural response to medicine that may very well predate our historical records.
Now, before we let our speculative fiction evolve past folklore and into the modern era, let’s make sure we’re keeping tabs on the actual science too. Egypt wasn’t alone in their experimentation with fecal medicine: most famously, a Chinese doctor named Ge Hong treated diarrhea in the 4th Century by feeding patients a “soup” brewed from a healthy human stool. Delish.
Things weren’t any cleaner in the West, although they were a few centuries late to the trend. In the 1500s, records show famed chemist Robert Boyle treating cataracts “by drying human poop into powder and blowing it into the eye.” Gosh all around the world doctors were keeping it classy.
Flash forward a few more centuries until 1958 when the science first “reappeared” on the scene in formal literature, albeit much less standardized than the practice we’re beginning to see today. This takes us roughly into an era of modern storytelling and fiction and, as per our ongoing investigation, back to a question of the FMT’s permeance on speculative literature.
And to be frank, the well of pop culture comes up a bit dry.
Most notable is one of the biggest guns in the west: Star Wars. The substance bacta is used to heal a small cohort characters — including Luke in The Empire Strikes Back — and is formed (in part) from the excretions of an insect-like species known as the Vratix. In most lore the substance is synthetic, but in deep history, the compounds were made from organic “bacterial particles.” Not quite an FMT, but still cool to see the universe’s best healing technology derived from a tiny bit of actual science.
Another major touchstone in modern science fiction, Dune, has crossed paths with fecal medicine as well.
We’ve talked about sandworm biology on this blog before, but not specifically their connection to melange (left), the magic spice of the planet Arrakis and one of the largest plot-catalysts in all of fiction.
According to the Dune wiki, which I’m considering 100% accurate, not only does the spice have healing properties but it also originates as the “fungal excretions” of sandtrout, the larval stage of the gigantic worms that plague the planet.
While I was happy to get at least somewhat close to FMTs, I’m also quick to note that neither of these examples touch on the idea of human excretion being used to treat human diseases. It’s certainly not unheard of in science fiction — especially if that umbrella can include blood transfusions that seem to transmit superhuman abilities at the drop of a hat, but never in my research did I come across “fecal transplants” between human subjects. Maybe this one was a bit too bizarre even for great minds like Clarke and Asimov.
So if you’re reading up on FMT research and see exclamations about it being “stranger than science fiction,” well…that’s actually onto something. It’s not a breakthrough with decades of precedent in storytelling — actually quite the opposite. The FMT hasn’t surfaced in modern science fiction simply because it’s been actual science the entire time. The fecal matter transplant has been understood and practiced in the scientific community (in a manner of forms) for centuries.
Early mythology simply reflected a real-world phenomenon that storytellers were able to observe. There is far more that’s practical and tangible about this treatment than anything unreal or unimaginable.
So for a medical practice that’s been around for millennia, why the sudden wave of surprise that’s taking the world by storm? After our retrospective, the evidence seems to show that fecal-transplants have always been an innate part of our understanding of biology — albeit a bit informal. Speculative authors may have never been drawn to the subject for a variety of reasons: perhaps it seemed juvenile or crass, or maybe it seemed primitive, like a step backwards from the shiny, technology-ridden climate of most popular science in the middle of the 20th Century.
However you slice it, describing the FMT as “science fiction” is actually being a bit harsh to the practicers of “science fact” who have understood the health benefits of bacteria for centuries.
There’s one final story I want to leave us with, and although it’s not speculative fiction, it does help add a bit of gloss to our historical puzzle.
In 1961, artist Piero Manzoni produced a famous piece of work known as Merda d’Artista, which translates into English as “Artists’ Shit.” Cans containing the artist’s excrement were sold at values worth their weight in gold.
I’m sure there’s some deep, meta interpretation here about contemporary art…but I’m going to take the literal, scientific approach instead.
Shit has value. That’s an idea that permeates art, popular culture, and modern medicine. In truth, the FMT represents everything great about scientists thinking ahead of their time.
Although, to the science-fiction authors out there…step up your game. The FMT was right under your nose and the closest we got was bacta.
