Ingenious: Jack Gilbert

When I ask Jack Gilbert about the future of medicine, he tells me what he recommends to his graduate students before they head into surgery, “When you go to cut someone open, you don’t just have one patient on the gurney. You have 40 trillion patients, and you have to think of how your actions are going to affect them.”

Those trillions of patients are microorganisms, communities of bacteria, viruses, fungi, and in some unhappy cases—pathogens. But they’re not all free riders. A growing body of research is making the case that the microscopic creatures in our gut, ears, mouth, and on our skin—together called our microbiome—play an essential role in our wellbeing. And Gilbert, faculty director of the Microbiome Center at the University of Chicago, and his team are at the cutting edge of this research.

Gilbert chatted with Nautilus from Chicago about the microbiome revolution, what a future trip to your doctor might look like, how our microbiome can make us fat (or thin), and the advice he presents to parents in his new book Dirt is Good.

You’ve said there is a revolution happening in medicine. What is it?

For the last hundred years, doctors have tried to remove all sources of dangerous pathogens: Making sure that our apron is clean, our hands are clean, the air is clean. Then we pump [the patient] full of antibiotics with the understanding that we’ve then killed off all the bacteria, and therefore there is no chance that