If you're fascinated by bacteriophages (thanks, microbiology!) and love history lessons mixed in with your science history, you have to pick up Lina Zeldovich's The Living Medicine. This book weaves the story of phages, how they kill to save lives, the history behind their discovery, and how we almost lost them thanks to powering hungry men and oppressive regimes.

A truly fascinating book -- I think this is an important book, as well. Very well written and highly readable, I learned quite a bit about both the subject and the period. I would recommend this book to others looking for a specialized look at medical research . . . I would also recommend it, as well, to a general audience simply interested in a "good read".

Lina Zeldovich is an award winning journalist and science writer. In this book Zeldovich discusses the use of bacteriophages (phages) - viruses that destroy bacteria - to treat infection and disease.

By now it's well known that 'the miracle of antibiotics' is over. Antibiotics are drugs that destroy bacteria, and antibiotics like penicillin once reliably treated gonorrhea, syphilis, tetanus, anthrax, gangrene, staphylococcus infections, streptococcus infections, meningitis, food-borne intestinal diseases, and so on. As early as 1940, however, scientists were already seeing the emergence of bacteria resistant to penicillin. To address the problem, researchers developed new and stronger antibiotics, one after another, but bacteria ALWAYS develop resistance sooner or later. This is evidenced by infections such as methicillin-resistant Staphylococcus aureus, or MRSA. According to Zeldovich, "This dreaded superbug now lurks in hospitals, sickening 120,000 American per year and killing about 20,000. MRSA currently responds to vancomycin [used for the treatment of serious, life-threatening infections], but they may learn to repel it."

Zeldovich describes an alternative treatment for bacterial illnesses, namely phages. Phages are special kinds of viruses that prey solely on bacteria. Phages look like tiny rockets, a thousand times smaller than their prey, which they pierce with their tails. The phages then reproduce inside the bacteria and burst them open.

The Soviet Union has been using phages to treat diseases for decades, but western countries have been reluctant to embrace this therapy. As Zeldovich notes, "Unfortunately, you can't yet buy a bottle of bacteriophage in your local pharmacy - not over the counter or by prescription. But in the era of skyrocketing antibiotic resistance, these phages might be our best weapons against the next bacterial pandemics."

Zeldovich provides a comprehensive history of medicinal phages, starting with Giorgi Eliava's discovery of bacteria-killing phages in 1917. Eliava was a trained microbiologist in the Georgian city of Tiflis (Tbilisi), studying the city's drinking water for disease-causing microbes. "And sure enough, there they were....Vibrio cholerae [cholera bacteria] that turned people into emaciated blue corpses, literally sucking their life out of them." Eliava was examining a microscope slide containing contaminated drinking water, and saw Vibrio cholerae bacteria wiggling around. Eliava happened to leave the slide for a couple of days, and when he looked again, there were no bacteria on the slide. SOMETHING MUST HAVE KILLED THEM! It took some time, but Eliava discovered the 'something' was bacteriophages.

As often happens in science, another researcher also discovered phages in the early 20th century - Félix d’Hérelle, a scientist at the Pasteur Institute in France. D'Hérelle was studying Shigella dysenteriae, the dysentery-causing germs ravaging soldiers during WWI. A recovering patient had dying Shigella dysenteriae microbes in his stools, and when d’Hérelle seeded stool samples onto petri dishes, empty patches developed where Shigella had been destroyed. Once again, the killers were bacteriophages.

D’Hérelle became convinced the phages, which devoured specific bacteria, could be beneficial to people, to be curative entities and "agents of natural immunity." Other researchers began to experiment with phages, and their healing power was soon proven. Phages are especially good candidates for remedies because they're abundant in water, soil, and especially in sewage. Scientist Alexander “Sandro” Sulakvelidze, a phage expert, observed, "They are the most plentiful biological entities in any habitat, but sewage is particularly good for phage-hunting because it's teeming with various bacteria that become phage food." Zeldovich goes on to discuss the development of phage 'therapies', which became ubiquitous in the Soviet Union and used in other places, such as parts of Africa, India, and the Far East.

The author also provides mini-biographies of scientists who studied phages, and Eliava's life in particular is fascinating. Zeldovich writes, "Gregarious and full of burning energy, Eliava embraced his city to the fullest. He instinctively knew how to dress, how to court, how to charm. He appreciated art and literature. He was a passionate dancer and an enthusiastic boxer. He cherished good food and had a sweet tooth. He rode horses [and was] a prankster always ready to pull a joke on a friend." Eliava married the beautiful opera star Amelia Wohl-Levicka, and at the height of his career - when Eliava was building the Tiflis Bacteriophage Institute (later renamed the George Eliava Institute) - the microbiologist tragically got caught up in Stalin's purges.

Unlike Eliava, Félix d’Hérelle didn't have a degree in microbiology, but had a passionate interest in the subject. A "restless world traveler", d’Hérelle studied microbes wherever he went, and his wife Marie Caire was his lab assistant. At times, D’Hérelle worked with Georgi Eliava in Tiflis, and the two scientists traveled together, attended microbiology conferences, visited major research centers, and exchanged bacterial cultures and phages with other scientists. Unfortunately, d'Hérelle's travels exposed him to exotic germs, and he contracted amoebiasis (dysentery caused by amoebas) two times, and a long-lasting fever of unknown origin. All this led to d'Hérelle's chronic ill health later in life. D’Hérelle's lasting contributions to science include two important books about bacteriophages.

Zeldovich writes about additional scientists as well, and it took a group effort to advance phage therapy. Nevertheless, phage medicines were a hard sell in the west, and "No average American clinician in the United States would try phages for treating bacterial infections." This began to change in the early 1990s, when Glenn Morris at the University of Maryland offered Alexander “Sandro” Sulakvelidze, from the Soviet Union's Eliava Institute, a postdoctoral fellowship. Sandro informed Morris about phage therapy, and they put together a proposal regarding the use of phages to treat MRSA. There was TREMENDOUS pushback/criticism from American scientists and doctors, and the proposal was denied. However, in 2006, phages were approved for use in food safety.

Afterwards, in 2016, phage medicine was approved in the United States, on 'one-off' grounds, for a man called Thomas Patterson in San Diego. While vacationing in Egypt, Patterson had contracted a 'vicious bug' called Acinetobacter baumannii, which infects many organs and systems. Patterson had tried about fifteen antibiotics, been in an out of comas, and was on the brink of death. Luckily for Patterson, his wife Steffanie Strathdee was an infectious disease epidemiologist, and Strathdee reached out to every medical expert she could find. This led to phage therapy being approved for Patterson on a onetime basis with an 'experimental Investigational New Drug' (eIND). It took a global effort to produce the phage medicine, and it worked. Patterson recovered! After that, several other dying patients were treated with phages on an eIND basis.

Finally in 2018, Sandro - who was now President and CEO of the biotech venture Intralytix, Inc. - was approved to do a clinical trial that involved growing phages to treat Crohn's disease, "a chronic inflammation of the gastrointestinal tract that causes pian, diarrhea, fatigue, weight loss, and malnutrition, and has no known cure." Sandro then wrote proposals to test phages against other illnesses, all of which laid the groundwork for possible medical applications in the United States. So widespread phage therapy may be in American's future.

Zeldovich covers much more ground in her book, which I'd recommend to everyone with an interest in health and medicine.

Thanks to Netgalley, Lina Zeldovich, and St. Martin's Press for a copy of the book.

Who knew bacteriophages were so interesting?

THE LIVING MEDICINE is a science-heavy book. We are, after all, discussing microbiology. But it’s well written, in accessible language for those of us without science degrees. Also, it’s truly fascinating.

Lina Zeldovich weaves this story with a combination of biography, history, and science that entertains as well as educates. The cost on our healthcare that politics, power, and pharmaceutical companies’ determination to pursue only that which they can patent is abundantly clear. People are dying every day from “incurable” and antibiotic-resistant diseases. Yet for more than a century, bacteriophages, discovered in the Soviet Union, have been and are known to be a miracle cure.

It’s way past time for us to put people’s health before money and politics. As someone who has lived a life with a debilitating, bacterial-borne chronic illness (Lyme disease), I’m both thankful to Zeldovich for bringing this slice of history to my attention and furious at the medical community for letting people suffer unnecessarily.

*Thanks to St. Martin’s Press for the free copy!*

An interesting look into history with a heavy science theme. I enjoyed the perspective of this author and would recommend this book to others in the healthcare profession but maybe not for others.

Heavy on the scientific history, Zeldovich makes a very convincing case for the widespread use of phages in medical treatment. Antibiotic resistance is a huge problem and we shouldn’t ignore these viruses that have been feeding on bacteria for eons. A worthwhile read.

apparently bacteriophages—or “phages”—are living medicines: viruses that devour bacteria, will be our only hope when Antibiotics Fail. Not if when. This one awe inspiring and terrifying at the same time. This is not only eye opening but informative as well.

Beautifully written and completely fascinating, focusing around the history and lives of the people involved in researching phages. Zeldovich is an excellent science communicator as well. I've already read two books about phages and wasn't sure how much of a new perspective this one could bring but it really delivers. It has resounding implications for the future as well. Excellent read!

In the span of a few days of reading this nonfiction book, I went from knowing nothing about the existence of phages to reading about it AND in a car ride with a fifteen year old who is doing research ABOUT phages. Who knew? Of course, history concludes by Zeldovich's accounts that no one really wanted to know and poo pooed the scientists who discovered this living virus that can kill bacteria.

Well, it's not going anywhere because it is effective. There is one pause for concern, which is brought up but the book is amazingly sensitive to the politics of scientific discovery, research, collaboration, and of course about the money involved. Zeldovich introduces the lifesaving effectiveness of phages and then dives into the lives and history of the discovery and those that discovered it before circling back to the importance of using it to our full capacity since antibiotics are seemingly running their course and are not able to effectively manage issues because there are too many resistant.

It relies on the science, not talking down to readers which means that some of the presented material is out of my league, however I liked being a seat at the table to learning about this. It feels like I got smarter by reading this science story. Not only coming out of the pandemic, is this an important book but also it felt a little like reading a "race to space" type science and politics showdown. I know TWO people I'm going to immediately recommend it to and of course buy a copy for my HS library.

Fascinating description and history of phage research and use in addition to antibiotics. would like more info on current use of phages to combat bacterial diseases that have become resistent to available antibiotics, will reccomend to all my medical colleages.

As a pulmonary pharmacist who has had patients pursue bacteriophage therapy for treatment of resistant infections, either via clinical trials or international procurement, I was excited to read this book. Phage therapy sounds like science fiction, and I admit that I have been skeptical (perhaps cautious is a better term) of embracing its applications. Much of this surrounds the almost secretive nature of how page therapy came to be, not necessarily that it was purposefully kept secret, but that language barriers and publishing biases prevented the widespread dissemination of information to the US. But, there was really so much more at play. This is a prime example of how politicians and governmental leaders have stymied science for the sake of political gain over the years, and particularly during the Cold War. It is also a story of caution. While likely generally safe, it does not mean that regulation which is mean to ensure quality products and safety can be abandoned for expediency for the masses. It is good to see that phage therapy is gaining traction in the US and that creative ways to evaluate these therapies with scientific rigor and manufacturing standards can be accomplished if we put our smart heads and our funding together and think creatively.

This book was well written, extensively researched, and presented in a way that was both interesting and scientifically valid. Reading almost like a true crime novel, you are reminded that these were/are real people discovering something special and doing their best to cure disease amidst political upheaval, wars, fascism, political imprisonment, and economic disaster. Just think where we might have been if WWII had never happened or the Cold War was not so chilly or scientists weren't imprisoned and executed along the way. 100 years into phage therapy, and we are just beginning to imagine its potential in the West. Antimicrobial resistance, superbugs, cystic fibrosis, lung transplantation, immunocompromised hosts, maternal and infant mortality... there is something for everyone in health care within these pages. A definite must read for those with an interest in infectious diseases.

Medical science has convinced us that viruses are dangerous. Between influenza, shingles, COVID-19, hepatitis, HIV, polio, and rabies we fear these diseases that can cause severe illness and even death. However, in The Living Medicine author Lina Zeldovich introduces us to viruses that are our friends.
Miss Zeldovich wrote an engaging history of bacteriophages, viruses that attack bacteria. Bacteriophages live with us in our bodies, and while harmless to us, they protect us from harmful bacteria. Bacteriophages function like natural antibiotics. And they are now being used against bacteria that have become antibiotic-resistant, a significant problem that is increasing in frequency.
But The Living Medicine is not just a story of viruses or bacteria, but of the people who discovered and developed them into clinically useful entities. And the story is not just about their professional work, but their private lives and the political background of the countries where they lived and worked.
Miss Zeldovich begins in Europe with two scientists who first worked with bacteriophages, Felix d’Herelle from France and his friend George Eliava from Georgia. They lived in Europe in the early 20th century before the discovery of antibiotics.
She weaves the story as personal lives intersected with their professional lives amid the turmoil of Europe through the World Wars and their aftermath. Their work was often interrupted and disrupted by professional opposition and government suppression. These scientists risked their fortunes, families, and lives to pursue knowledge.
She continues to introduce us to the subsequent scientists who continued to work with phages, work that continues today. We learn the stories of patients whose lives were saved by phage therapy when their infections proved to be antibiotic resistant.
The casual reader may not appreciate the detailed descriptions of the scientific work involved in developing phage therapy. After reading about Eliava and d’Herelle, I found the stories about the subsequent research less engaging.
I think the author could have written two separate books rather than putting it all into one volume, which made it lengthy at 15 chapters and 320 pages in the print version.
This book prompted me to explore bacteriophages further, a subject I knew medical school but had not read about recently. It is a reminder that there is never a last word in science, but always something new to learn.

One word Lina knew from experience was the Russian word for dysentery, which, years afterward, pointed her to the possibilities of “biological entities…[that] have been feeding on bacteria for eons, so they are better equipped than our pharmaceutical industry to keep up with bacterial evolution.” Yet, as Lina discovers, making phages part of the American pharmacopoeia is easier said than done: In Europe and the United States they’re interdicted, for creating phages means manipulating the stuff that otherwise winds up in sewage treatment plants. Still, it’s fascinating to learn of free-floating bacteria in the Ganges River (which one suspects would be an undesirable place to take a swim) that in untreated water “dissolved cholera vibrions”; just so, it’s sobering to hear that the potentially deadly MRSA bacteria, so common in American hospitals, can be killed by viruses in short order thanks to advances made in the former Soviet republic of Georgia. In a well-written book that ranges widely through scientific history, marked by episodes of suppression on the part of both the Soviet authorities and the American medical and pharmaceutical establishments,Lina makes a convincing case for phages helping us all in the future. It is a microbiological detective story, with the promise of magic bullets to come.

Are you familiar with bacteriophages? I read a fair amount of pop science books, yet I’ve never heard of bacteriophages or phages. This book was a revelation surrounded by some of the best pop science/history writing I’ve encountered recently.

One reviewer on Goodreads points out how this book really buries the lede by first walking through decades of Soviet Georgian medical research. They are absolutely right, but it’s still a fascinating history that connects to politics, some wacky personalities, and more.

I also appreciated the balance. The book, while being enthusiastic about phages, still addresses their faults. They aren’t a solution to everything, but they’re a very compelling part of a solution given increasing antibiotic resistance.

The Living Medicine by Lina Zeldovich is a deeply thought-provoking exploration of traditional healing practices and the ways in which ancient knowledge intersects with modern medicine. Zeldovich weaves together cultural history, personal anecdotes, and scientific inquiry to shed light on the healing wisdom passed down through generations, particularly in Eastern Europe and Russia. Her writing is engaging and thoughtful, highlighting the relevance of these ancient practices in a world increasingly focused on pharmaceutical solutions. The book challenges readers to consider the value of natural, holistic approaches to health and wellness, all while questioning the over-reliance on modern medical systems. The Living Medicine is an eye-opening and enriching read for those interested in alternative medicine, cultural history, and the balance between tradition and modernity in healthcare.

This erred a little more into science history than I was expecting - I thought it would be more focused on the actual science. I ended up pretty bored for the first seven or eight chapters. Once the actual science started being discussed, though, I was all in!

This nonfiction book covers some of the history of the use of bacteriophage to treat infections that antibiotics fail to treat. It also touches on some current day uses of phage, and potential future uses.

While I did learn a lot about the history of bacteriophage from this book, I had some issues trusting the writer. In a couple of spots, information is simplified to a point where it is no longer representative of truth, which forced me to question everything the author presented as fact. I also found the sections dealing with current uses and potential future uses of bacteriophage to be underdeveloped. I was able to follow most of it (I am a microbiologist), but other readers might not be able to.

This was a fascinating look at the history of viruses that attack bacteria, or bacteriophages, and their use in the fight against antibiotic resistant super bugs. There is a well researched book about the history of the scientists and science that discovered and studied phages from 1917 to today. It also talks a lot about the politics and approvals that have caused the US to be slow to adopting this type of remedy which I found fascinating. I recommend this book for those that enjoy history, medicine or medical history.

"Four people die every hour from an antibiotic-resistant bacterial infection in the United States."

I vaguely remember many years ago hearing someone argue that American medicine wasn't really so great and that our former enemy - the Soviet Union - was actually more advanced because they had medicines we didn't. At the time I'd never heard of bacteriophages (I don't even recall if the name was mentioned) but the smugness in the argument was enough to put me off.

Lina Zeldovich, whose parents were courageous enough "to dissent in the dictatorial Soviet state" (from the dedication), tells us the history of research on "phages," which are viruses that naturally prey upon bacteria. The narrative is heavy on the history of Soviet Georgia and especially Giorgi Eliava and Frenchman Felix d'Herelle, two who independently discovered that their samples of bacteria were being destroyed by something they couldn't see. Although most of their colleagues ridiculed their findings, they later collaborated and established an institute in Georgia (in the USSR) to produce phages.

While Zeldovich is an advocate of phages, she's not as blind to history as my friend was. We read of the fickle favor the Soviets had for Eliava and his phages, as both he and his wife were executed in Stalin's purges, and funding for the institute was at the mercy of self-serving Soviet bureaucrats. But in a world where bacterial infections are increasingly becoming antibiotic-resistant, phages have finally found champions in the United States and a few modern companies are trying to develop phages that will satisfy the stringent rules of the FDA. She also discusses the significance of a memoir I read a few years ago, The Perfect Predator, which opened minds and doors to the potential of phages.

This is a very well-researched book on the history of phages. That history might be a bit heavy for some readers, but I felt Zeldovich did a great job while also conveying the challenges faced by researchers trying to produce phages. And hopefully the time will soon come that phages become more common in our medicines. (I received an advance digital copy of the book from the publisher.)

Without trying, I’ve recently come across numerous written and audio media about antibiotic-resistant infections. Nothing that I’ve read/heard has offered a suggestion about what we might turn to as antibiotic resistance grows. Then this book appeared on NetGalley, and I felt compelled to request it.

The Living Medicine is phages. Once a rising star, talk of them all but disappeared with the rise of antibiotic therapy. I found it very interesting that the use of phages was essentially discontinued in America right around the same time that antibiotic resistance became a problem. I can’t imagine that today’s physicians even know much about them.

The author, Lina Zeldovich, has accomplished something that’s tough to do in nonfiction. The writing is engaging and packed full of information. I learned a lot about the FDA and its approval process, bacteria in general, disease, cures/treatments, drugs and research. Perhaps none of that sounds fun on its own, but the writing easily drew me in and kept me interested.

Thanks to NetGalley and St. Martin’s Press for granting access to a digital ARC in response to my request.