The Race Against Superbugs with Matt McCarthy, MD
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Hi everyone, I'm Emily Silverman and this is The Nocturnous, stories from the world of medicine. We've got a couple special episodes for you as we put together season three of our podcast. And in this first one, I talk with Dr. Matt McCarthy. He's an infectious disease specialist at the New York Presbyterian Hospital who researches drug-resistant bacteria and fungi. In fact, Matt recently wrote a book about these organisms called Superbugs The Race to Stop an Epidemic. His book is many things. It's a memoir, it's deeply scientific, it's a history lesson, but it's also just a gripping story of a race against time and biology. First we have Matt reading an excerpt from his book, where he takes care of a patient with a superbug.
Then he and I talk about the practical, ethical, and emotional aspects of his work and what the future of antibiotics may look like. And before we start There's something we need to clarify. In our conversation, Matt and I talk about the infamous study of syphilis that started in Tuskegee, Alabama in the 1930s. The subjects of the Tuskegee study were all black men, and the study was founded on entrenched racist ideas and attitudes. But in this interview, we didn't say explicitly that the subjects were black. In retrospect, we're clarifying that here, especially for listeners who may not be familiar with Tuskegee and its racist legacy. And with that, here's an excerpt from Superbugs, read by author Matt McCarthy.
It was just after dawn when I felt the buzz on my hip. I broke stride, put down my coffee, and glanced at my pager. I was needed in the emergency room. It was twenty fourteen, an unseasonably warm October day, and the text induced a flurry of anxiety and excitement.
What is the premise of Matt McCarthy’s book “Superbugs” and why is it relevant today?
After eleven years of training, I had accepted a position as a staff physician at New York Presbyterian Hospital, a tertiary. care center on the upper east side of Manhattan. And a patient had just arrived with a perplexing infection, one that had stumped the team in the ER. A moment later I was standing before a group of medical students and residents and my new patient. The young man writhing on the stretcher was an African American mechanic from Queens named Jackson, with dark green eyes and a small Maltese cross tattooed onto his neck. He had been shot. My patient, I discovered, was infected with a nimble and aggressive new bacterium that was resistant to every antibiotic at my disposal, except for one Callista.
I had used the drug only a few times in my career and never with good results because it was so outrageously toxic. Callistin might kill bacteria, but it destroyed kidneys and other internal organs in the process, leaving many of my patients with just two options dialysis or death. I crouched to meet Jackson's eyes and carefully considered my words. You have an infection, I said. A severe infection. The man's gaze darted from me to the men and women standing in a horseshoe behind me. How severe? He took in a small breath of air and held it, waiting for me to say something. It felt like an hourglass had been flipped. Suddenly the tiny room was very hot. I took off my white coat and rolled up my sleeve. Leaves.
Quite severe. His eyebrows raised and I reflexively extended my arm to hold his hand, but caught myself. I wasn't supposed to touch this patient without protection. I pivoted back to my team. Everybody out now. I pointed toward the door. He grasped his thigh inches above where the bullet had entered. Beneath his fingertips bacteria were rapidly multiplying, devouring muscle and bone. Lose it? he asked. The leg? In truth, I wasn't sure. Only Callistin had a chance of destroying the infection, but there were no guarantees. The last person I prescribed it to died twelve hours after she received it. The one before that died while receiving it. I don't think so, I said, as confidently as I could.
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