THE PERFECT PREDATOR: A Scientist's Race to Save Her Husband from a Deadly Superbug by Steffanie Strathdee and Thomas Patterson. New York: Hachette Books, 2019. 311 pages, plus reference and index. ...Hardcover; $29.00. ISBN: 9780316418089. *I have never been a fan of nonfiction, and although I love biology, I do not have much experience reading about it outside of textbooks. If you had asked me a few months ago, I would have said a book at the intersection of these genres sounded likely to be lethargically paced, overly detailed, and boring. However, Steffanie Strathdee and Tom Patterson's memoir/medical thriller The Perfect Predator changed my mind. The married coauthors share the story of the nine months when Patterson was near death from a formidable antibiotic-resistant bacterial infection. When his situation appeared hopeless, Strathdee enlisted a team of scientists to resurrect a treatment long forgotten by modern medicine: phage therapy. Christians will find much to admire in the selflessness and community displayed by the country-wide team that put together this novel treatment, and any reader will be inspired by the story of compassion and risk-taking to beat the odds. The story is both emotionally engaging and readable, despite all the science, and it draws much-needed attention to the antibiotic resistance crisis and the life-saving potential of phage therapy. *Strathdee, the primary narrator, sets our scene in Egypt, where the couple was on vacation in November of 2015. After a long day of sight-seeing, Patterson came down with what they assumed was a stomach bug. But by the time he had been taken to an Egyptian clinic, medevacked to Germany, and finally transferred back home to a US San Diego hospital, it turned out to be an infection with one of the most dangerous antibiotic-resistant bacteria in the world. Luckily for Patterson, though, Strathdee is a determined epidemiologist as well as a devoted wife. As the doctors' list of options dwindled, she started to do her own research. *She stumbled upon the mostly forgotten technique of phage therapy--using bacteriophages to kill the bacteria that were causing an infection. Viruses and their hosts are precisely matched, so the right virus could be the "perfect predator" to kill even the deadliest bacteria. With the rise of antibiotics in the mid-twentieth century, phage therapy disappeared into the background of medical research. However, antibiotics were proving useless against Patterson's infection. Desperate, Strathdee decided to take a chance on phage therapy, untested as it might be. She enlisted phage researchers from across the country in a race against time to save her husband's life. *Even though the main attraction of the book, phage therapy, does not come into play until halfway through, it never feels like a slog to get to "the interesting part." Strathdee makes those nine long months eventful, and the vulnerability in her writing ensures that we are with her through all the hope and heartache along the way. Readers who enjoy memoirs will feel at home with this book. The science might sound formidable, but the authors ensure that their audience does not need a background in medicine or microbiology. Their readable descriptions provide everything necessary to understand what is going on, whether it is a quick definition of sepsis or a crash course on the history of penicillin. *Strathdee writes with humility; her narrative intentionally and thoroughly highlights all the help she received. Doctors and phage researchers from across the world contributed to Patterson's care. She notes the remarkable collaboration as a picture of global medicine, but I think Christians will also recognize it as a picture of selfless community. So many people dropped what they were doing to save a total stranger, from the researchers who worked overtime to isolate phages, to the FDA officials who fast-tracked the approval paperwork through the system. They demonstrate a lot of the virtues that the body of Christ should exemplify, including compassion, unity, and selflessness. *It is no wonder there were so many people involved, because the path to the phage cocktail that saved Patterson's life was long and convoluted. It took almost half the book before the idea of phages even comes into the picture. Once the idea was introduced, I expected every chapter to be the chapter that they finally start treating Patterson. But Strathdee is too thorough a writer for everything to be over so simply. Her narrative walks the reader through the many, many steps of getting the phages from a culture plate to Patterson. Deciding which phages to use, transporting the phages, getting the necessary paperwork and approval, preparing them at the pharmacy, determining dosages, choosing a method and location of administration--the list goes on. I was getting impatient that the book was so slow, until it occurred to me how agonizing it would be to endure all this waiting in real life, like Patterson's family and care team did. After all, I know what they did not: Tom survives. *That occasional feeling of slowness is this book's only flaw. One thing that contributes to it is the lack of increasing stakes. If this were a novel, the stakes would have to get higher as the plot progressed, but Patterson's life had been on the line since they were in Frankfurt. It has been life-or-death since the beginning, so there is nowhere to go. Of course, this is not the authors' fault. Strathdee does her best to create a sense of urgency by the way she describes her emotional experience. We can feel her becoming more desperate the longer Patterson spends in the hospital. *Another authorial choice that helps the stakes was the inclusion of the "interludes." These short anecdotes are told from Patterson's perspective. While his wife and care team searched for a cure, he wandered in a surreal world of threatening, acid-trip imagery. Even unconsciousness did not protect him from suffering. These interludes remind us of the stakes from his perspective as well as from Strathdee's. Not only could Strathdee lose her husband, but Patterson could die alone and hopeless in the agonizing wilderness of his hallucinations. *However, the authors are aware that the stakes are high for more than the two of them. They do not stop the story after reporting that the phages were successful, and Patterson survived. In the last chapter, they present a larger perspective on the significance of his landmark case. First of all, it is an excellent example of global collaboration and medicine. But more than that, Patterson's case brings much-needed attention to phage therapy's potential. It is a promising and personalizable treatment that has been too long overlooked. Research is needed to explore its efficacy and, if the studies are favorable, to regulate it so that it can save lives on a large scale. *This will not happen, however, until there is more awareness of the antibiotic resistance crisis that demands solutions such as phage therapy. Strathdee is an epidemiologist, and even she did not realize the magnitude of the problem until it nearly killed her husband. Precedent suggests that crises are often what push medicine forward. As the authors point out, WWII and the AIDS epidemic both stimulated advances in medicine and access to treatments. Now is the time, with the resistance crisis causing antibiotics to become less and less effective, to pursue new approaches and to bring phage therapy back out of the shadows. *All in all, I found The Perfect Predator to be a fascinating combination of science and storytelling. Strathdee and Patterson are considerate, compassionate writers, and they do an excellent job of avoiding the traps that could make this book dull. I would recommend it especially to those who work in health care, but it is also relevant and accessible to laypeople. Christians in particular might connect to the kind of selfless community displayed by the phage researchers. This book combines the best of the genres it spans. It is a lucid description of a remarkable achievement in medical science, but it is also the very human story of a woman fighting to save her husband. Whether phage therapy turns out to be the future or not, The Perfect Predator definitely made a medical memoir convert out of me. *Reviewed by Karsten Garwood with Sara Sybesma Tolsma, Department of Biology, Northwestern College, Orange City, IA 51041.
