Allies and Enemies: How the World Depends on Bacteria (16 page)
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Authors: Anne Maczulak
Tags: #Science, #Reference, #Non-Fiction
The immune system’s fruitless attempt to fight TB contributes to
the disease’s severity. Most bacteria would be destroyed by a healthy
person’s immune response, but
M. tuberculosis
gathers the immune cells around it until a mass, a tubercle, forms in the lung. Each small 86
allies and enemies
cluster of
M. tuberculosis
cells builds numerous tubercles throughout the lungs. Lymph fluids begin to accumulate in the organ, and the inflammation creates lesions in the tissue. The infected person develops TB’s telltale chronic cough.
A slow decline of an afflicted character helped create storylines for
La Traviata
and
La Bohème
. Departures of hefty opera divas to a disease that actually leaves its victims weak and emaciated never got in the way of the production. Earlier in the 18th century, English physician Benjamin Marten had made an astute observation and proposed that
“wonderfully minute living creatures” might be the cause of consumption. In his writings, Marten discussed the potential risk of healthy individuals living in close contact with the infected. These ideas were ahead of their time. A few doctors advised that the infected refrain from close contact with others, but families often rejected this idea as cruel punishment rather than a preventative. Into the 1940s, medicine still had no reliable treatments or accepted preventions for TB.
For two decades, the health community promoted sanatoria for
the seclusion of TB patients and recovery without transmitting it to
others. Patients spent several months to a year away from their families. (Doctors prescribed complete rest, even limiting patients’ bathroom breaks to one per day.) Imagine the fertile ground dramatists mined by sending a character far from family, lovers, or creditors! In
1945, screenwriter Dudley Nichols banished Sister Mary Benedict
played by Ingrid Bergman to a TB sanatorium in the melodramatic
ending of
The Bells of St. Mary’s
.
In the overall assessment of how diseases move through populations, TB behaves in complete contrast to bubonic plague. The highly
virulent plague bacteria kill victims swiftly. The worst of history’s plague epidemics have wiped out populations nearly en masse, forcing the pathogen to retreat to its rodent reservoir for a while. TB’s slow progression through a population and long course enables it to remain in a population longer than acute diseases. TB does not always
kill but merely incapacitates the host, which further helps it infiltrate entire communities.
The sanatoria depicted as unjust segregation of the sick was in truth the best way to stop the transmission of infectious disease and
remains so today. TB is a social disease. Close interaction between
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people, crowded living and workspaces, and frequent movement of
the infected to new areas help TB persist in society. Society preferred, not for the first time, to equate social disease with destitution, lack of education, and low social standing. The public had a hard time shaking the belief that TB was somehow a person’s fault. This philosophy continues today with other bacterial diseases and viruses.
Despite all of the technological advances microbiology has made, many still view infection in a spiritual sense rather than as a biological reality.
Aside from retreating to a TB sanatorium, many natives of cold,
crowded cities in the east sought a warm place to recuperate for a year or more from a debilitating disease. California’s movie industry
grew in part due to an increased population lured by “a climate that
makes the sick well and the strong more vigorous,” as Chamber of Commerce brochures claimed early in the 1900s. Families that had
been affected by TB or wished to avoid it made cross-continent moves to sun-baked southern California.
TB took lives from the arts as it had from every other faction of
society. Most of the famous who succumbed to TB, shown in
Table 4.1, died young, and this list illustrates the pervasiveness of TB
into the 20th century.
Table 4.1 Famous TB victims
Name
Date Contribution
Alexander Pope
1744 British poet and satirist (age 56)
John Keats
1821 British Romantic poet, wrote “Ode to a Nightingale”
(1819) (age 26)
Percy Bysshe Shelley 1822 British Romantic poet, wrote “Prometheus
Unbound” (1820) (age 30)
Johann Wolfang von 1832 German author of
Faust
(1808) (age 83) Goethe
Emily Brontë
1848 British author of
Wuthering Heights
(1847) (age 30)
Frédéric Chopin
1849 Polish pianist and composer (age 39)
Edgar Allan Poe
1849 American poet and short-story writer, wrote
“Murders in the Rue Morgue” (1841) (age 40)
Charlotte Brontë
1855 British author of
Jane Eyre
(1847) (age 39)
Elizabeth Barrett
1861 British Victorian poet, wrote “Sonnets from the
Browning
Portuguese” (1850) (age 55)
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allies and enemies
Table 4.1 Famous TB victims
Name
Date Contribution
Henry David Thoreau 1862 American writer and philosopher, author of
Walden (1854) (age 45)
Stephen Foster
1864 American composer of “My Old Kentucky Home”
(1853) (age 38)
Fyodor Dostoyevsky 1881 Russian author of The Brothers Karamazov (1880) (age 60)
Robert Louis
1894 Scottish author of Strange Case of Dr. Jekyll and
Stevenson
Mr. Hyde (1886) (age 44)
Anton Chekhov
1904 Russian playwright and short-story writer, wrote
The Seagull (1896) (age 44)
Franz Kafka
1924 Austria-Hungarian author of The Metamorphosis
(1915) (age 41)
D. H. Lawrence
1930 British author of Lady Chatterley’s Lover (1928)
(age 45)
Thomas Wolfe
1938 American author of Look Homeward, Angel (1929)
(age 38)
George Orwell
1950 British author of Nineteen Eighty-Four (1949)
(age 47)
Vivien Leigh
1967 British actress played Scarlett O’Hara in “Gone with
the Wind” (1939) (age 54)
Igor Stravinsky
1971 Russian pianist and composer (age 89)
Outside the arts, King Edward VI (age 16), Doc Holliday (age
36), and Eleanor Roosevelt (age 78) succumbed to the disease as did
Rene Laennec (age 45), the inventor of the stethoscope. Some historians have implied that George Washington died of TB—the disease
had claimed his brother Lawrence—but definite proof has never
been found. The Father of Our Country had been sickly most of his
life and may have suffered two bouts of TB. On December 14, 1799,
Washington died of what his doctor called a case of “inflammatory quinsy” in the respiratory tract. Generations of medical researchers have puzzled over the cause of Washington’s death. No argument exists on the death of Henry Livingston Trudeau, the proponent of
sanatoria in the United States. Trudeau’s repeated exposure to the people he tried to save likely caused his infection and death at age 67.
Modern poet Dylan Thomas did not die of TB but, according to
medical historian H. D. Chalke, he became so obsessed with TB he
chapter 4 · bacteria in popular culture
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might as well have contracted it. Thomas’s repeated references to looming death are thought to provide evidence of the poet’s fear of the disease.
Friends and enemies
Authors have used bacterial diseases as metaphors for various states
of the human spirit and body. The Brontës, Jane Austen, and Charles
Dickens alluded to TB in their novels, especially when guiding a character into imminent suffering, as did John Steinbeck in the somber plots of The Grapes of Wrath in 1939 and its 1938 prelude Their Blood Is Story.
In the 1800s and 1900s, the waterborne disease cholera ranked
second only to TB among infectious diseases in causing death. In the
1912 novella Death in Venice, Thomas Mann killed off his protagonist, the aging artist Gustav von Aschenbach, with cholera to save him from the agony of a sexual obsession. W. Somerset Maugham’s The Painted
Veil (1925) and Gabriel García Márquez’s Love in the Time of Cholera
(1985) also used the swift and deadly disease as a vehicle for advancing their stories. Cholera, TB, or any of the diseases for which cure is elusive have contributed to metaphors on the inevitability of death, infirmity, loss, and the emotions that will always drive literature, music, and the visual arts.
In 1938, a radio drama broadcast from New York City’s Mercury
Theatre created a rare hero’s role for bacteria. At eight o’clock on Halloween Eve, actor Orson Welles stepped to the microphone. For the next hour he reported to an increasingly frantic radio audience the takeover by Martians of the world’s major cities. Scientists, the military, and negotiators failed to stop the invasion. Humans, it seemed, were about to be wiped from the Earth. Near the final minute of the broadcast the protagonist found that the Martians had fallen “stark and silent” with vultures picking at the remains. Microbiologists listening in that night knew that the probable hero to save humanity would be “the putrefactive and disease bacteria against which [the Martians’] systems were unprepared...slain, after all man’s defenses had failed, by the humblest thing that God in His wisdom
put upon this earth.” Welles’s description of bacteria as putrefactive
and disease-causing may have been a bit ungrateful considering they
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allies and enemies
had just saved the planet, but “The War of the Worlds” taught the basic truths of bacteria: Any bacterium can turn deadly in hosts with weakened immune systems.
Since the 1938 broadcast, microbiologists have learned much
more about the resiliency of Earth’s collective population of bacteria.
Bacteria that withstand, heat, cold, radioactivity, intense pressure, desert-dry conditions, ultraviolet light, chemicals, and lack of oxygen have been isolated, studied, and put to productive use. With antibiotic-resistance having spread to the majority of humanity’s worst pathogens, bacteria may someday depopulate the planet in the same way they eliminated Orson Welles’s Martians.
I have always appreciated that the bacteria in “The War of the Worlds” saved the day. I’m doubly happy that Welles did not commit
the frequent error of confusing bacteria with viruses.
In 1987, novelist Michael Crichton returned bacteria to their
more standard role as indestructible enemies of man. With the time—
honored gimmick of a mutant organism arriving from space to
destroy humanity, The Andromeda Strain gave a detailed and mostly
correct view into microbiology few people know about: the techniques used in cultivating life’s deadliest pathogens.
Crichton accurately described the intensive precautions microbiologists take when working with the world’s most virulent pathogens.
These labs are called Biosafety Level 4, or BSL-4 laboratories. BSL-4
labs contain special air circulation and filtration systems, multiple air-locks to prevent the escape of airborne microbes, the use of protective clothing, and decontamination measures before anyone can enter or exit the lab. The author suggested that “disinfectants” such as ultraviolet or infrared light, ultrasonic waves, or flash-heating would sterilize the fictional characters’ bodies. In fact, these methods harm a person more than they hurt bacteria; the human body cannot be sterilized. Disinfectants work only on inanimate objects. Antiseptics, not disinfectants, remove some but not all bacteria from the skin.
Despite the book’s minor mistakes, The Andromeda Strain conveyed many excellent points about the lifestyle of bacteria. Crichton
accurately described extremophiles and bacterial spores. He included
an example of Koch’s postulates in which a microbe can be proven to
cause specific disease by taking it from a sick organism, injecting into a healthy individual, and re-creating the disease.
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Crichton’s fictional strain grew only on carbon dioxide, oxygen, and sunlight, and required a very narrow pH range, meaning the relative amounts of acid and base in its environment. The Andromeda Strain also derived nutrients by eating the rubber gaskets of enclosures the novel’s scientists had hoped would confine the pathogen. Crichton had described what microbiologists call a photoautotroph, which is a