BEFORE THE FALL Patterson ( left ) and Strathdee enjoy their vacation in Cairo , just before he developed gallstone pancreatitis and a deadly drugresistant bacterial infection . Photo courtesy Steffanie Strathdee
With much effort , Patterson is medevacked to a Frankfurt hospital where German physicians discover a pancreatic pseudocyst , a collection of fluid around the pancreas . The fluid is drained and cultured . It teems with drug-resistant A . baumannii , which has wreaked havoc in hospitals in the Middle East , Europe and U . S . Doctors prescribe powerful antibiotics , enough to stabilize Patterson so that he can be airlifted back home to the intensive care unit at Thornton Hospital at UC San Diego Health . Extreme precautions are taken ; they do not want A . baumannii to spread there .
It is December 12 , 2015 . At Thornton , now part of Jacobs Medical Center , Patterson begins to recover , but a month later , an internal drain designed to localize his infection slips , spilling bacteria into his abdomen and bloodstream . Patterson immediately suffers septic shock , fever , heart and breathing problems . He is placed on a ventilator and , for most of the next two months , he will drift in and out of a coma .
Strathdee remains at his side . She is no stranger to the terrors of disease . As an infectious disease epidemiologist , she works around the world trying to prevent HIV infection and mortality . At UC San Diego Health , she has access to the best doctors and researchers , the latest technologies and innovative thinking . But nothing is helping Tom . Friends hint that she should prepare for the worst . “ There came a point when he was getting weaker and weaker , and I didn ’ t want to lose him ,” Strathdee recalls . “ I wasn ’ t ready to let him go and so I held his hand and said , ‘ Honey , they ’ re doing everything they can and there ’ s nothing that can kill this bug , so if you want to fight , you need to fight . Do you want me to find some alternative therapies ? We can leave no stone unturned .’”
It is January . Tom is hanging on , barely . Strathdee combs through medical databases , searching through case studies on drug-resistant bacteria , when a colleague of hers relays how a friend underwent successful phage treatment in Tblisi , in the Republic of Georgia . Strathdee grasps at this chance and asks Schooley whether they should try phage therapy . He ’ s intrigued . Phage therapy is not part of mainstream medicine . Current phage research in the U . S . is limited , but interest is rising as the effectiveness of antibiotics diminishes . The problem : phage therapy is largely untested . No one has proven scientifically that it works .
But Tom is dying , and options are dwindling . Phages are the last chance . Strathdee , Schooley and colleagues
THE LONG SHOT
In a last-ditch effort to save his life , Patterson ’ s team turned to a highly experimental treatment using bacteriophages — spidery-looking viruses that reproduce by destroying bacteria .
Through a process a called lysis , the virus commandeers the reproductive machinery of bacteria by injecting genetic material stored in the “ head ” of the phage . This viral DNA uses the bacteria ’ s enzyme equipment to produce new phages , so many that the bacterium ultimately bursts and the new phages are released to continue the cycle .
The process is as old as the origins of life itself , with an estimated ten million trillion trillion ( 10 31 ) bacteriophages in the world . Among them , thousands of phage varieties exist , yet each has evolved to infect only one or a few types of bacteria .
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