Way more to learn here. The Soviets were really big on phage research also, wonder if they still have any interesting learnings: https://pmc.ncbi.nlm.nih.gov/articles/PMC7653335/
https://www.economist.com/science-and-technology/2023/05/03/...
It's not money for nothing and it's a bigger choice than people credit.
It's because from my experience doctors usually give me antibiotics even BEFORE they find out what bacteria I have. "Oh you have pneumonia, better give you clavulanic acid". Next time they provide me with something else. When I asked "should we make a bacterial culture" - they say "it will take so much time, better take the antibiotics now".
For a sick person after antibiotics therapy and after culture test results, those days/weeks to raise another culture of phages might be deadly.
My eustachian tubes plugged up while I was flying home from my honeymoon. Three days later, my ears were still stopped up. I was in medical school at the time, so I went to the student health clinic (run by senior residents). I said that I had ear infections commonly as a child, that this ear had been plugged for three days, and could I have antibiotics? He said, let’s look first. He did. He then said, “no pain, just dulled hearing? No fevers?” Correct. “That’s the worst-looking eardrum I have ever seen in an adult. Here’s some amoxicillin-clavulanate.”
Antibiotics are broadly classified as bacteriostatic (prevents multiplication) or bacteriocidal (kills living bacteria). Amoxicillin (like all beta-lactam antibiotics) is bacteriocidal. Thirty minutes after I took my first dose, I vividly experienced this. Chills, fever, shivering, sweating that lasted for almost two hours as millions or billions of bacteria died and their dead cells entered my bloodstream. The second dose was not as bad but still unpleasant. By the third dose, I just felt a few minutes of unpleasantness. And after three days, my ear finally unplugged.
What if the bacteria become resistant to the phages too?
Well, that can happen easily – probably even easier than with antibiotics. Cells have been duking it out with viruses since the beginning of life. (Did you know CRISPR-Cas9, now used for gene editing, evolved in nature as a way for bacteria to recognize and cut up phage DNA?)
But the difference is that whereas new antibiotics are very hard to find, there is a nigh-inexhaustible evolutionary font of phages constantly pulling ahead in the arms race. So in short: once a bacteria becomes resistant to your special phage, just find a new phage.> For a sick person after antibiotics therapy and after culture test results, those days/weeks to raise another culture of phages might be deadly
The hope is that you'd have a bunch of phages ready to go from a variety of patients. So you wouldn't need to make a new culture. However, right now they often do personalized phage therapy because they can only get it approved as a last-hope kinda deal. But then it makes the scientists only target chronic infections, because it does take a couple months to get another cocktail of phages ready to go.
If you like David Foster Wallace his other two novels "Broom of the system" and "The Pale King" are also great. The Pale King was left unfinished when he died and was completed (from various drafts and notes) as a labour of love and respect from his notes by his editor. It's genuinely extraordinary and could possibly even have been his greatest work if he had been able to fully complete it. As is there are certain minor things in it that I'm sure he would have revised (eg I noticed some sentences are repeated etc).
If you're not sure about David Foster Wallace I can really recommend his essays and literary criticism as consistently insightful and extraordinary and also his journalism. From his essays for a starting point I would recommend "De Unibus Pluram" and also "Fictional futures and the conspicuously young", and also "Roger Federer as Religious Experience"[1]. Of his journalism I would strongly recommend "Getting away from already being pretty much away from it all" which is an amazing write up of the experience of visiting a rural state fair and "A supposedly fun thing I'll never do again" which is the same sort of thing about going on a cruise ship. Both are very funny and perceptive.
If you like those you know what you're getting into with this novels.
[1] Especially if you like tennis. He also wrote an amazing essay about a tennis player who is very good but not quite good enough to make the top level and is struggling to break through. THat one is amazing but the title escapes me.
The one upside is that dysentery is common enough in India that it was promptly recognized and treated, with a single giant horse pill targeting both bacillary & amoebic dysentery that basically cured her in 24 hours.
I made the mistake of trying to read Sometimes a Great Notion by Ken Kesey when I had covid last. I never finished it, and when I try to read it now it reminds too much of how awful I felt.
Okay fine. Fuck.