More on this book
Community
Kindle Notes & Highlights
Read between
September 20 - October 5, 2023
After his discovery, Félix had gone on to apply phage therapy to thousands of cases of cholera and bubonic plague in India.
All told, many phage preparations being sold were useless.
It wasn’t until the first electron microscope was developed in 1940 that bacteriophages could finally be visualized, and Félix was vindicated.
After penicillin came to market, phage therapy was relegated to the back burner, at least in North America.
Beria saw to it that Eliava was executed in 1937; he was one of many scientists to suffer a similar fate around that time.
Apart from the logistical issues, another reason why phage therapy didn’t get taken up in the West is because if you supported it, you would be labeled a pinko commie sympathizer.
Just as phage therapy was abandoned in the West, phage biology—the pure science of it—was taking off in other ways.
Phages had been used to show how genes turn on and off. Phage enzymes had launched the fields of molecular biology, genetic engineering, and cancer biology.
But if Tom died despite my efforts, at least I’d know that I’d tried my very best.
To make it perfectly clear what we are up against, our lab has only collected a few A. baumannii phages in the last seven years. But I’ll have them tested against Tom’s bacterial culture as soon as we get his sample, and we will know if we have a match in a day or two.
Iraqibacter has become so virulent and resistant, it stands out, even among superbugs. My guess is that we’d need even more phages to cure a patient like Tom, who is fully colonized.
And I’d like to see some real-world good come from this research and the career I’ve spent on phage biology.”
He eventually won the support of the higher-ups at Texas A&M, and in 2010 they established the Center for Phage Technology (CPT), providing faculty positions and a base research budget.
It became one of the pioneering phage centers in the US.
Ry’s email had been persuasive. Phage researchers in India, Switzerland, and Belgium had all agreed to send A. baumannii phages to Ry for testing.
The military is working on phage research? No wonder I hadn’t turned up any details on these investigators. Do you suppose it’s classified?”
“I spoke to the brass at the Army and Navy who are heading up their phage programs. Both were leery of getting involved in the care of a civilian.”
They dug in their heels until I told them that I was more impressed with the Belgian military because they were offering their phages in a diplomatic pouch.”
“Bottom line—the Army is definitely out,” he said. “But I think I convinced the Navy to at least test their phage collection against Tom’s isolate.
Theron would be putting a lot on the line to do this.
But then, everything the Navy could learn about A. baumannii and how to treat it added to the Navy’s medical arsenal if it struck the troops, and it could prove valuable in a bioterrorist attack.
“He told me he was ordering his lab to work double shifts this weekend, so they’ll test Tom’s isolate against their phages as soon as we can ship them a sample.”
The FDA is so often cast as the bad guy standing in the way of innovation, but in fact, those safeguards are important to protect us all.
Dying patients and their families are vulnerable.
Worse, in today’s world, the profiteers are coopting the language of science and medicine to legitimize their unproven claims and services.
The process took time for good reasons, but it might be time that Tom didn’t have.
All scientific research done on humans needs to be vetted and approved by an ethics committee.
And this was a compassionate use request, which meant the team was asking the ethics committee to grant permission to use a therapeutic agent that had not been FDA approved on a patient who was dying.
“These Pac-Men are going to have a feast!” he exclaimed, rubbing his hands together with anticipation.
In all my fifty years of doing psychic readings, I have never had a more thrilling experience,” he told me earnestly.
Since Tom was already on life support for heart and lungs, dialysis would signal a terminal trifecta of system-wide organ failure—the beginning of the end.
“There’s a rumor you and Chip are planning some sort of experimental treatment involving viruses,” Dr. Fernandes began, his tone cautious but curious.
I explained that Chip and I had only enlisted the help of CPT and the Navy less than a week ago, and we didn’t yet know if they’d find any matching phages, or how long it would take.
“I know it’s a long shot,” I said. “And I know it’s risky. But I don’t see any alternatives being brought to the table.”
you can pull this off, it may benefit a lot of other patients. So, you and Chip have my full support.”
But a few studies had suggested that comatose patients could sometimes hear, and that the sound of their loved ones’ voices aided their recovery.
After agonizing over what to do, I signed the consent authorizing interventional radiology to insert a new G-J-tube in his jejunum the next day, after no amount of hand-squeezing could coax a response from Tom.
He lay quiet, still unresponsive, but when I arrived I was dismayed to see that he was in wrist restraints.
Chris and I looked at each other, read the signs, and came to the same conclusion at the same instant: more septic shock.
Somehow the fungal infection had breached the walls of the pseudocyst and was spreading.
For all the attention paid to time, all the ways the TICU staff sliced and diced and measured it by heart rates and shift changes and scheduling and bowel movements, in a real sense, time stood still.
Depending on my mood, the days felt like either a countdown to blastoff or the last dark minutes of the Doomsday Clock.
Chris always went a step further, making minute adjustments in care to not only keep Tom alive but also keep him comfortable, actively make him better, even in small ways.
He always took the time to explain ICU lingo to me in a way that didn’t feel patronizing.
The hum of the monitors that had been so annoying before had become the only note of reassurance that he was, at least, still alive.
They had to find the phages that would target Tom’s multi-drug-resistant strain of A. baumannii, then grow the phages in quantity, purify them, and get them to the UCSD’s investigational pharmacy to be prepped.
They had to find ways to hurry the process without sacrificing quality—and Tom.
Once you’ve isolated a phage that’s active against the target bacteria, you have to grow lots more of it to obtain enough for a therapeutic supply.
Carl later told me that in several of the early phage therapy experiments in the 1930s, phage concoctions may have killed more people than they cured, because no one knew that they needed to be purified or how to do it.
The more phages found that were active against Tom’s A. baumannii and the more varied their weaponry against it, the better.
