MAY JUNE 2018 | MOTHER JONES 55steffanie strathdee hunched over her
laptop, fretting. She barely noticed the
kittens asleep next to her or the serene
Buddha figure across the living room,
anch ored next to the glass doors that
looked toward the gleaming Pacific. Her
mind was 20 miles away in the intensive
care unit of the University of California-
San Diego’s medical center, where her hus-
band, Tom Patterson, lay in a coma.
Patterson was 68; Strathdee was 49. They
had been married 11 years, after meeting
in a grant review group convened by the
National Institutes of Health. He was a psy-
chologist and she was an infectious-disease
epidemiologist; when they fell in love, they
also formed a powerhouse research team,
studying the effect of the aids virus on vul-
nerable people in Tijuana, Mexico.
But it was a bacterium, not a virus, that
was bedeviling them now. Three months
earlier, on the last night of a Thanks giving
vacation in Egypt, Patterson had suddenly
fallen ill, so severely that he had to be
medevaced to Germany and then to ucsd.
There were several things wrong—a gall-
stone, an abscess in his pancreas—but the
core of the problem was an infection with
a superbug, a bacterium named Acineto-
bacter baumannii that was resistant to every
antibiotic his medical team tried to treat
it with. Patterson had been a burly man,
6-foot-5 and more than 300 pounds, but
now he was wasted, his cheekbones jutting
through his skin. Intravenous lines snaked
into his arms and neck, and tubes to carry
away seepage pierced his abdomen. He was
delirious and his blood pressure was fall-
ing, and the medical staff had sedated him
and intubated him to make sure he got the
oxygen he needed. He was dying.
Strathdee’s friends knew she was des-
perately searching for solutions, and one
told her about an acquaintance with an
intractable infection who had traveled to
Eastern Europe to seek out a century-old
cure. Strathdee spent days reading what-
ever she could find about it, and now she
was composing a last-ditch email to the
hospital’s head of infectious diseases, the
person who would rule on whether they
could use it to help her spouse.
“We are running out of options to save
Tom,” she wrote. “What do you think
about phage therapy?”
Strathdee didn’t realize it at the time,
but her attempt to save her husband’s life
would test the bounds of the American
medical system—and throw its limitations
into stark relief.the treatment Strathdee had fixed on
as a last-ditch hope is almost never used
in the United States. The Food and Drug
Administration has not licensed phage
therapy, keeping it out of pharmacies and
hospitals. Few physicians have used it even
experimentally, and most civilians have
never heard of it. But phages are a natural
phenomenon, frequently deployed in the
former Soviet Union. When used properly,
they can save lives.
To understand how phage therapy
works, it helps to know a little biology,
starting with the distinction between bac-
teria and viruses. Most of the drug-resistant
superbugs that cause medical havoc are
bacteria, microscopic single-celled organ-
isms that do most of the things that other
living things do: seek nutrition, metabolize
it into energy, produce offspring. Viruses,
which are much smaller than bacteria, exist
only to reproduce: They attach to a cell,
hijack its reproductive machinery to make
fresh viruses, and then, in most cases, ex-
plode the cell to let viral copies float free.
Phages are viruses. In the wild, they are
the cleanup crew that keeps bacteria from
taking over the world. Bacteria reproduce
relentlessly, a new generation every 20 min-
utes or so, and phages kill them just as rap-
idly, preventing the burgeoning bacterial
biomass from swamping the planet like a
B-movie slime monster. But phages do not
kill indiscriminately: Though there are tril-
lions in the world, each is tuned evolution-arily to destroy only particular bacteria. In
1917, a self-taught microbiologist named
Félix d’Herelle recognized phages’ talent
for targeted killing. He imagined that if he
could find the correct phages, he could use
them to cure deadly bacterial infections.
That was a gleaming hope, because at
the time, nothing else could. (Sir Alexander
Fleming wouldn’t find the mold that makes
penicillin, the first antibiotic, until 1928.)
Treatments were primitive: aspirin and ice
baths to knock down fever, injections of
crude immunotherapy extracted from the
blood of horses and sheep, and amputa-
tion when a scratch or cut let infection bur-
geon in a limb and threaten the rest of the
body with sepsis. Phages—whose full name,
bacterio phages (or “bacteria eaters”), was
given by d’Herelle in 1916—did something
that medicine had never before been able
to accomplish: They vanquished the in-
fections for which they were administered
without otherwise harming patients. A
medical sensation and a cultural phenom-
enon, they provided the key plot device in
the novel Arrowsmith, about an idealistic
doctor, that won the Pulitzer Prize in 1926,
and they saved the life of the Hollywood
cowboy actor Tom Mix, a 1930s superstar.
D’Herelle was a restless researcher who
seems to have felt undervalued despite
being awarded jobs in Paris and Vietnam
and at Yale. That insecurity made him
vulnerable to an offer he received in 1933
to relocate to Tbilisi in Georgia, home
territory of Soviet dictator Joseph Stalin.
With a protégé, Georgi Eliava, d’Herelle
co-founded the Eliava Institute of Bac-
teriophages, Microbiology and Virol-
ogy. Stalin showered the institute with
attention and money because it offered
something he badly wanted: a scientific
achievement that he could portray as a
pure product of communism. Antibiot-
ics became the basis of infectious-disease
medicine in the West, but behind the Iron
Curtain, phages took their place.
Eliava was murdered in a political purgeAntib
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