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The Living Medicine: How a Lifesaving Cure Was Nearly Lost―and Why It Will Rescue Us When Antibiotics Fail
A remarkable story of the scientists behind a long-forgotten and life-saving the healing viruses that can conquer antibiotic resistant bacterial infections
First discovered in 1917, bacteriophages—or “phages”—are living viruses that devour bacteria. Ubiquitous in the environment, they are found in water, soil, inside plants and animals, and in the human body.
When phages were first recognized as medicines, their promise seemed limitless. Grown by research scientists and physicians in France, the Soviet Union, and elsewhere to target specific bacteria, they cured cholera, dysentery, bubonic plague, and other deadly infectious diseases.
But after Stalin’s brutal purges and the rise of antibiotics, phage therapy declined and nearly was lost to history—until today. In The Living Medicine, acclaimed science journalist Lina Zeldovich reveals the remarkable history of phages, told through the lives of the French, Soviet, and American scientists who discovered, developed, and are reviving this unique cure for seemingly-intractable diseases. Ranging from Paris to Soviet Georgia to Egypt, India, South Africa, remote islands in the Far East, and America, The Living Medicine shows how phages once saved tens of thousands of lives. Today, with our antibiotic shield collapsing, Zeldovich demonstrates how phages are making our food safe and, in cases of dire emergency, rescuing people from the brink of death. They may be humanity’s best defense against the pandemics to come.
Filled with adventure, human ambition, tragedy, technology, irrepressible scientists and the excitement of their innovation, The Living Medicine offers a vision of how our future may be saved by knowledge from the past.
First discovered in 1917, bacteriophages—or “phages”—are living viruses that devour bacteria. Ubiquitous in the environment, they are found in water, soil, inside plants and animals, and in the human body.
When phages were first recognized as medicines, their promise seemed limitless. Grown by research scientists and physicians in France, the Soviet Union, and elsewhere to target specific bacteria, they cured cholera, dysentery, bubonic plague, and other deadly infectious diseases.
But after Stalin’s brutal purges and the rise of antibiotics, phage therapy declined and nearly was lost to history—until today. In The Living Medicine, acclaimed science journalist Lina Zeldovich reveals the remarkable history of phages, told through the lives of the French, Soviet, and American scientists who discovered, developed, and are reviving this unique cure for seemingly-intractable diseases. Ranging from Paris to Soviet Georgia to Egypt, India, South Africa, remote islands in the Far East, and America, The Living Medicine shows how phages once saved tens of thousands of lives. Today, with our antibiotic shield collapsing, Zeldovich demonstrates how phages are making our food safe and, in cases of dire emergency, rescuing people from the brink of death. They may be humanity’s best defense against the pandemics to come.
Filled with adventure, human ambition, tragedy, technology, irrepressible scientists and the excitement of their innovation, The Living Medicine offers a vision of how our future may be saved by knowledge from the past.
320 pages, Hardcover
Published October 22, 2024
44 people are currently reading
6386 people want to read
About the author
Lina Zeldovich
13 books43 followersLINA ZELDOVICH grew up in a dissident family of Soviet scientists and learned English as a second language in her twenties. Now an award-winning author, speaker, and Columbia Journalism School alumna, she has published stories in Popular Science, The New York Times, Scientific American, National Geographic, and more. Zeldovich is the author of The Other Dark Matter: The Science and Business of Turning Waste into Wealth and Health. She lives in New York City.
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December 9, 2024
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."
Staphylococcus aureus
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.
Phages attacking a bacteria
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.
Georgi Eliava
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."
Vibrio cholerae
Patient with cholera
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.
Félix d’Hérelle
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.
Shigella dysenteriae
Patient with dysentery
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.
Researchers developed phage therapies
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.
Amelia Wohl-Levicka
George Eliava Institute for phage therapy
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.
Entamoeba histolytica (an amoeba that causes amoebic dysentery)
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 and 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.
Acinetobacter baumannii
Thomas Patterson and his wife Steffanie Strathdee
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."
Alexander “Sandro” Sulakvelidze
Crohn's Disease
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 America'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.
You can follow my reviews at https://reviewsbybarbsaffer.blogspot.com
June 6, 2024
Bury the lead? Bury the lede? Whichever one you choose, that’s what’s happening in this book.
Presumably, the editors chose the title and subtitle for this book. They got it right. They knew the most interesting thing in this book for the average 21st-century reader would be the prospect that phages (viruses that attack bacteria) will be the new generation of remedies available as antibiotics become less and less effective.
However, a lot of this book (especially near the beginning) is taken up with some less interesting score-settling in which the author takes a victory lap along with a group of long-ignored and -belittled phage scientists (mostly from the former Soviet region of Georgia). There's no argument, I think, that scientists who studied phages were, for most of the twentieth century, ignored (at best) or ridiculed (at worst) for their contention that phages could be an effective part of a healer's toolkit. Cold War mentality in the West and murderous paranoia in the Soviet space allowed phages to remain more or less a medical secret tucked away in Soviet Georgia during the long period when antibiotics reigned supreme.
Chapters two through seven, inclusive, take up 32% of the book (so says my Kindle) and are mostly devoted to the history of phage research in Soviet Georgia, with an emphasis on the personal lives of the scientists. This is only of interest, I think, if you are a science historian. I read it, of course, because (although I am not a science historian) I was fortunate enough to get a free copy of this book to review. However, if you are not a science historian, but instead are a person with the average amount of work, family obligations, cooking, cleaning, ironing, exercising, etc., but still likes to read edifying books, you could skim these chapters and start reading more carefully from chapter eight through the book's conclusion if you'd like to know more about how phages work, how they were used in the past, and how they may become more frequently administered to sick people in the future.
Returning to the theme of burying the lead/lede, I think that phages are now ready for their close-up in part due to other, more ballyhooed advancements in medical science, specifically, our new-found ability to see and edit the genetic structure of living things, including phages, so that people can spend longer and healthier lives. Phages will have to be closely monitored and edited frequently.
If I'm understanding correctly, up until recently, the use of phages in the treatment of sick people was a bit of a crap shoot, since phages come in two varieties: lytic and lysogenic. Lytic phages are the heroes – these are the ones that are used in the many, many cases in this book where gravely ill patients who resisted all other manner of more traditional therapy were suddenly, almost miraculously, cured. On the other hand, “[l]ysogenic phages are unreliable and dangerous – if not as much for a specific patient but on a global scale because they can turn relatively mild bugs into brutal killers” (Kindle location 3206). Up until recently, it was impossible to have a high degree of confidence that you are completely separating the helpful phages from the nasty ones – making the 20th-century Western medical establishment's reluctance to deal with them seem less unreasonable.
Phages aren't a miracle cure. The author, while enthusiastic about their potential, makes this clear. A traditional antibiotic could (at least in the 20th century) be introduced and remain effective for decades, giving profit-making companies the incentive to make the enormous investments of time and energy necessary to get them to market. Phages are narrower and more specialized: new ones would have to be developed constantly, and perhaps will not fit well into the time-consuming process currently in place which has (effectively) ensured that supplies of prescription medicines are uniform, uncontaminated, and consistently safe to use.
Since the medical information space on the internet is routinely full of misinformation and hysteria, this book might be an interesting one to read to get the full background on a “new” technology that may play a bigger role in our lives.
I received a free advance electronic copy of this book from the publisher via Netgalley.
Presumably, the editors chose the title and subtitle for this book. They got it right. They knew the most interesting thing in this book for the average 21st-century reader would be the prospect that phages (viruses that attack bacteria) will be the new generation of remedies available as antibiotics become less and less effective.
However, a lot of this book (especially near the beginning) is taken up with some less interesting score-settling in which the author takes a victory lap along with a group of long-ignored and -belittled phage scientists (mostly from the former Soviet region of Georgia). There's no argument, I think, that scientists who studied phages were, for most of the twentieth century, ignored (at best) or ridiculed (at worst) for their contention that phages could be an effective part of a healer's toolkit. Cold War mentality in the West and murderous paranoia in the Soviet space allowed phages to remain more or less a medical secret tucked away in Soviet Georgia during the long period when antibiotics reigned supreme.
Chapters two through seven, inclusive, take up 32% of the book (so says my Kindle) and are mostly devoted to the history of phage research in Soviet Georgia, with an emphasis on the personal lives of the scientists. This is only of interest, I think, if you are a science historian. I read it, of course, because (although I am not a science historian) I was fortunate enough to get a free copy of this book to review. However, if you are not a science historian, but instead are a person with the average amount of work, family obligations, cooking, cleaning, ironing, exercising, etc., but still likes to read edifying books, you could skim these chapters and start reading more carefully from chapter eight through the book's conclusion if you'd like to know more about how phages work, how they were used in the past, and how they may become more frequently administered to sick people in the future.
Returning to the theme of burying the lead/lede, I think that phages are now ready for their close-up in part due to other, more ballyhooed advancements in medical science, specifically, our new-found ability to see and edit the genetic structure of living things, including phages, so that people can spend longer and healthier lives. Phages will have to be closely monitored and edited frequently.
If I'm understanding correctly, up until recently, the use of phages in the treatment of sick people was a bit of a crap shoot, since phages come in two varieties: lytic and lysogenic. Lytic phages are the heroes – these are the ones that are used in the many, many cases in this book where gravely ill patients who resisted all other manner of more traditional therapy were suddenly, almost miraculously, cured. On the other hand, “[l]ysogenic phages are unreliable and dangerous – if not as much for a specific patient but on a global scale because they can turn relatively mild bugs into brutal killers” (Kindle location 3206). Up until recently, it was impossible to have a high degree of confidence that you are completely separating the helpful phages from the nasty ones – making the 20th-century Western medical establishment's reluctance to deal with them seem less unreasonable.
Phages aren't a miracle cure. The author, while enthusiastic about their potential, makes this clear. A traditional antibiotic could (at least in the 20th century) be introduced and remain effective for decades, giving profit-making companies the incentive to make the enormous investments of time and energy necessary to get them to market. Phages are narrower and more specialized: new ones would have to be developed constantly, and perhaps will not fit well into the time-consuming process currently in place which has (effectively) ensured that supplies of prescription medicines are uniform, uncontaminated, and consistently safe to use.
Since the medical information space on the internet is routinely full of misinformation and hysteria, this book might be an interesting one to read to get the full background on a “new” technology that may play a bigger role in our lives.
I received a free advance electronic copy of this book from the publisher via Netgalley.
October 27, 2024
Special thanks to NetGalley and the publisher for a free, electronic ARC of this novel received in exchange for an honest review.
Expected publication date: Oct. 22, 2024
Lina Zeldovich is a science writer who grew up in Russia and relocated to New York City later in life. Her newest story, “The Living Medicine: How a Lifesaving Cure Was Nearly Lost―and Why It Will Rescue Us When Antibiotics Fail” is a unique investigation of “bacteriophages”, or “phages”, which are natural organisms that can be found in just about anything, including the human body, and work to treat infection.
Zeldovich introduces phages to us in the first few chapters, talking about how they were a popular health treatment in her native Russia. She does use some scientific language, but it is nothing overpowering. “Living Medicine” provides a unique and fascinating glimpse at how the world around us can be used to treat some of the most dangerous infections known to us.
After we learn about phages (where they come from, what they are and how they work), Zeldovich talks about the men and women who played an important role in their discovery and their implementation to treat infection. Then, of course, the latter portion of the story talks about the challenges of bringing such a treatment to North America, the United States in particular. I learned a lot about how the FDA approves (and refuses) new medications and the important, but lengthy, processes this entails.
“Living Medicine” focuses, too, on the antibiotics race, and how infections are mutating in such a way that antibiotics need to continue to become bigger and stronger to fight them. This is nothing new to anyone in today’s society, but it opens a bigger conversation about pharmaceutical companies and the approval processes. “Living Medicine” is an honest depiction of a divisive concept, and it was as educational as it was engaging.
Generally, books on science can overwhelm me. I wish I was better at science, but it’s never been my forte, although I understand its importance and influence in every field. That being said, I found “Living Medicine” to be a scientific story, yes, but also a story on the modern condition and nature’s fight to survive.
Phages have been used in Russia and other Eastern European countries for decades now, and Western physicians have been reluctant to use a treatment from such an unstable, untrustworthy part of the world. However, Zeldovich has no doubt introduced the world at large to a unique treatment that will, hopefully, serve as a more natural solution to some of our biggest bacterial foes.
Expected publication date: Oct. 22, 2024
Lina Zeldovich is a science writer who grew up in Russia and relocated to New York City later in life. Her newest story, “The Living Medicine: How a Lifesaving Cure Was Nearly Lost―and Why It Will Rescue Us When Antibiotics Fail” is a unique investigation of “bacteriophages”, or “phages”, which are natural organisms that can be found in just about anything, including the human body, and work to treat infection.
Zeldovich introduces phages to us in the first few chapters, talking about how they were a popular health treatment in her native Russia. She does use some scientific language, but it is nothing overpowering. “Living Medicine” provides a unique and fascinating glimpse at how the world around us can be used to treat some of the most dangerous infections known to us.
After we learn about phages (where they come from, what they are and how they work), Zeldovich talks about the men and women who played an important role in their discovery and their implementation to treat infection. Then, of course, the latter portion of the story talks about the challenges of bringing such a treatment to North America, the United States in particular. I learned a lot about how the FDA approves (and refuses) new medications and the important, but lengthy, processes this entails.
“Living Medicine” focuses, too, on the antibiotics race, and how infections are mutating in such a way that antibiotics need to continue to become bigger and stronger to fight them. This is nothing new to anyone in today’s society, but it opens a bigger conversation about pharmaceutical companies and the approval processes. “Living Medicine” is an honest depiction of a divisive concept, and it was as educational as it was engaging.
Generally, books on science can overwhelm me. I wish I was better at science, but it’s never been my forte, although I understand its importance and influence in every field. That being said, I found “Living Medicine” to be a scientific story, yes, but also a story on the modern condition and nature’s fight to survive.
Phages have been used in Russia and other Eastern European countries for decades now, and Western physicians have been reluctant to use a treatment from such an unstable, untrustworthy part of the world. However, Zeldovich has no doubt introduced the world at large to a unique treatment that will, hopefully, serve as a more natural solution to some of our biggest bacterial foes.
July 14, 2024
This book was eye opening in the different infections that are out their and are reliance on antibiotics. This was an informative read.
October 30, 2024
"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.)
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.)
June 4, 2024
Thank you, NetGalley and St Martin's Press for this advanced reader's copy. This book was an awesome and informative read as an Infection Prevention RN. I currently see so many multidrug resistant organisms in my patients unfortunately, and so it is inspiring to see there is something other than MORE antibiotics to be able to treat these organisms and help these patients as many of these have no options left. I love that bacteriophages can be used in this way and are a great and unlimited resource.
June 8, 2025
Lina Zeldovich is a journalist who came from a family of Soviet scientists; her 2024 nonfiction science book The Living Medicine interweaves the story of how bacteriophages (a type of virus that infects and kills bacterial/prokaryotic cells, as opposed to eukaryotic cells) were historically used to treat various bacterial-caused diseases in Eurasia, how those efforts were studied but also thwarted under Soviet control, and how phage treatment is being explored in Western medicine today (mostly in the biotech sector and academic research laboratories) to treat antibiotic-resistant bacterial infections. This is an interesting, albeit lengthy read; I did take issue with the title of "the living medicine" as phages, like other viruses, are generally not believed to be alive (as they can't independently reproduce outside of host cells). Zeldovich portrays phages very glowingly here, yet as of 2025 they would still be considered an experimental treatment in the West; time will tell if they have the rigor, reproducibility, and efficacy needed to go mainstream like mRNA vaccines have.
Further reading:
Wasteland: The Secret World of Waste and the Urgent Search for a Cleaner Future by Oliver Franklin-Wallis - particularly the discussion of wastewater treatment, in contrast to the methods used by some scientists here to isolate phages from sewage facilities
The Demon Under the Microscope: From Battlefield Hospitals to Nazi Labs, One Doctor's Heroic Search for the World's First Miracle Drug by Thomas Hager
My statistics:
Book 170 for 2025
Book 2096 cumulatively
Further reading:
Wasteland: The Secret World of Waste and the Urgent Search for a Cleaner Future by Oliver Franklin-Wallis - particularly the discussion of wastewater treatment, in contrast to the methods used by some scientists here to isolate phages from sewage facilities
The Demon Under the Microscope: From Battlefield Hospitals to Nazi Labs, One Doctor's Heroic Search for the World's First Miracle Drug by Thomas Hager
My statistics:
Book 170 for 2025
Book 2096 cumulatively
August 7, 2024
An intense amount of research went into this book. It comes with a word that is about to become more familiar: phages, short for bacteriophage. It’s the beneficial viruses that protect us from harmful bacteria.
When I first started reading this, I was overwhelmed with the terminology that was new to me. Apparently, America has been slow to adapt this scientific method of curing infectious diseases which was used to save Russia’s soldiers during WWI. Meanwhile, U.S. doctors have prescribed all sorts of antibiotics, the “wonder drugs” for years. And yet, it’s not as effective that it once was with evolving bacterial diseases. It was noted by the United Nations that there’s a possibility that by 2050, an estimated 10 million people could die from deadly forms of bacteria. That alone was shocking to me.
Lina Zeldovich takes readers back to the days when phage therapy was first used. She makes it fascinating by providing a historical account of how scientists worked diligently in their labs with the goal of finding a cure for those who were dying. And she makes it personal so readers can visualize more about the good and difficult parts of their lives.
Giorgi “Gogi” Eliava studied infectious diseases in Georgia and phage therapy in the early 1900s. The book gives you a solid view how he was inspired in his youth, continued his studies of microbiology in college, worked on the front lines in WWI, and finally established the Eliava Institute in Tbilisi, Georgia with government support in 1937. There’s more about his personal life with a stunning opera star. Sadly, it didn’t end well when Stalin was a dictator.
During his life, Eliava became friends with the French microbiologist, Félix d’Hérelle, who had already documented the first antibacterial therapy in 1917 which was named Bacteriophage. They had a vision of the future and d’Hérelle came on board to make the Eliava Institute a world-class, state-of-the-art lab with a hospital for 500, an apartment building for staff and a manufacturing plant. They had big dreams that were destroyed by greed and power of the politicians. What happened was unimaginable!
Yet, there was one scientist who continued to believe and work with phage therapy. Alexander “Sandro” Sulakvelidze from Georgia is credited in the book for his years of research and the start of the company, Intralytix in Baltimore, 1998. Other significant supporters were noted as well for helping with medical cases that were on the edge needing immediate attention.
It’s heart-wrenching and exciting to learn about the possibilities that have been made by researchers, developers, medical professionals and investors with advancements of phage therapy. The timing is right for this book. If antibiotics are no longer as effective, this may be our best bet.
My thanks to St. Martin’s Press and NetGalley for allowing me to read an advanced copy of this book with an expected release date of October 22, 2024.
When I first started reading this, I was overwhelmed with the terminology that was new to me. Apparently, America has been slow to adapt this scientific method of curing infectious diseases which was used to save Russia’s soldiers during WWI. Meanwhile, U.S. doctors have prescribed all sorts of antibiotics, the “wonder drugs” for years. And yet, it’s not as effective that it once was with evolving bacterial diseases. It was noted by the United Nations that there’s a possibility that by 2050, an estimated 10 million people could die from deadly forms of bacteria. That alone was shocking to me.
Lina Zeldovich takes readers back to the days when phage therapy was first used. She makes it fascinating by providing a historical account of how scientists worked diligently in their labs with the goal of finding a cure for those who were dying. And she makes it personal so readers can visualize more about the good and difficult parts of their lives.
Giorgi “Gogi” Eliava studied infectious diseases in Georgia and phage therapy in the early 1900s. The book gives you a solid view how he was inspired in his youth, continued his studies of microbiology in college, worked on the front lines in WWI, and finally established the Eliava Institute in Tbilisi, Georgia with government support in 1937. There’s more about his personal life with a stunning opera star. Sadly, it didn’t end well when Stalin was a dictator.
During his life, Eliava became friends with the French microbiologist, Félix d’Hérelle, who had already documented the first antibacterial therapy in 1917 which was named Bacteriophage. They had a vision of the future and d’Hérelle came on board to make the Eliava Institute a world-class, state-of-the-art lab with a hospital for 500, an apartment building for staff and a manufacturing plant. They had big dreams that were destroyed by greed and power of the politicians. What happened was unimaginable!
Yet, there was one scientist who continued to believe and work with phage therapy. Alexander “Sandro” Sulakvelidze from Georgia is credited in the book for his years of research and the start of the company, Intralytix in Baltimore, 1998. Other significant supporters were noted as well for helping with medical cases that were on the edge needing immediate attention.
It’s heart-wrenching and exciting to learn about the possibilities that have been made by researchers, developers, medical professionals and investors with advancements of phage therapy. The timing is right for this book. If antibiotics are no longer as effective, this may be our best bet.
My thanks to St. Martin’s Press and NetGalley for allowing me to read an advanced copy of this book with an expected release date of October 22, 2024.
May 24, 2024
The Living Medicine by Lina Zeldovich is a captivating exploration of the world of bacteriophages, what they are, how they have been used, and possible uses for human health in the future. The author, a science journalist with the capacity for explaining scientific ideas so they can be understood by a general audience, takes readers on a journey through the fascinating realm of bacteriophages, shedding light on how they may very well rescue us.
Bacteriophages, often referred to simply as phages, are viruses that specifically infect bacteria. Discovered in the early 20th century, bacteriophages have been recognized as important players in various ecosystems, particularly in the context of human health and disease. Phages typically consist of a protein coat surrounding their genetic material, which can be either DNA or RNA. They come in various shapes and sizes, ranging from simple structures to more complex ones. Phages are abundant in natural environments, including soil, water, and the human body. They play a crucial role in regulating bacterial populations and shaping microbial communities. They are key players in horizontal gene transfer among bacteria, influencing bacterial evolution and diversity.
They have been used to target and kill specific pathogenic bacteria that cause infections, including cholera and dysentery, beginning in 1919. Phages can be selected or engineered to specifically target particular bacterial strains while leaving beneficial bacteria unharmed. This targeted approach is particularly valuable in the era of antibiotic resistance when traditional antibiotics may be ineffective against certain bacterial infections. They have also proved useful in treating chronic infections by methicillin-resistant Staph aureus (MRSA) which is notoriously resistant to antibiotics and they may serve as possible treatments in the future for chronic conditions.
Much of the bacteriophage research was done at the George Eliava Institute in Soviet Georgia, but it was largely destroyed in 1991 in the Georgian Civil War. Scientists worked to save whatever phage cultures they could and about 50 people still work at the Institute on phage production. There is still much research that needs to be done into specificity, resistance, immunogenicity, safety, and regulatory hurdles, but Zeldovich's book serves to remind us that bacteriophages helped in the past and may have even more uses in the future.
Thank you to NetGalley and St. Martin's Press for providing me with a copy of this book. It will be published on October 22, 2024.
Bacteriophages, often referred to simply as phages, are viruses that specifically infect bacteria. Discovered in the early 20th century, bacteriophages have been recognized as important players in various ecosystems, particularly in the context of human health and disease. Phages typically consist of a protein coat surrounding their genetic material, which can be either DNA or RNA. They come in various shapes and sizes, ranging from simple structures to more complex ones. Phages are abundant in natural environments, including soil, water, and the human body. They play a crucial role in regulating bacterial populations and shaping microbial communities. They are key players in horizontal gene transfer among bacteria, influencing bacterial evolution and diversity.
They have been used to target and kill specific pathogenic bacteria that cause infections, including cholera and dysentery, beginning in 1919. Phages can be selected or engineered to specifically target particular bacterial strains while leaving beneficial bacteria unharmed. This targeted approach is particularly valuable in the era of antibiotic resistance when traditional antibiotics may be ineffective against certain bacterial infections. They have also proved useful in treating chronic infections by methicillin-resistant Staph aureus (MRSA) which is notoriously resistant to antibiotics and they may serve as possible treatments in the future for chronic conditions.
Much of the bacteriophage research was done at the George Eliava Institute in Soviet Georgia, but it was largely destroyed in 1991 in the Georgian Civil War. Scientists worked to save whatever phage cultures they could and about 50 people still work at the Institute on phage production. There is still much research that needs to be done into specificity, resistance, immunogenicity, safety, and regulatory hurdles, but Zeldovich's book serves to remind us that bacteriophages helped in the past and may have even more uses in the future.
Thank you to NetGalley and St. Martin's Press for providing me with a copy of this book. It will be published on October 22, 2024.
October 21, 2024
Thank you to NetGalley and St Martin's Press for the eARC for review.
I went into this book without any knowledge on the topic of biophages and came out at the end with (what I think is) a good understanding and a hope for the future against antibiotic resistant bacteria.
This is one of my favourite types of nonfiction: a mix of science, biography, and history. All the science was very well researched and explained: I went in with no medical or biology knowledge and still feel like this was an amazing read. The history aspects felt very personal, probably from the author interviewing the scientists or their direct relatives. And the author did a fantastic job tying the history from the early 1900s all the way up to the present.
I've already recommended this book to my father and I think you should read it if you're interested in medical or science nonfiction.
I went into this book without any knowledge on the topic of biophages and came out at the end with (what I think is) a good understanding and a hope for the future against antibiotic resistant bacteria.
This is one of my favourite types of nonfiction: a mix of science, biography, and history. All the science was very well researched and explained: I went in with no medical or biology knowledge and still feel like this was an amazing read. The history aspects felt very personal, probably from the author interviewing the scientists or their direct relatives. And the author did a fantastic job tying the history from the early 1900s all the way up to the present.
I've already recommended this book to my father and I think you should read it if you're interested in medical or science nonfiction.
August 14, 2024
I received a free copy of, The Living Medicine, by Lina Zeldovich. from the publisher and Netgalley in exchange for an honest review. Bacteriophages or "Phages" are viruses that devour bacteria, first developed in 1917, they have been forgotten about and not used as often as antibiotics. I never knew about phages before I read this book. it is a very interesting subject.
December 23, 2024
This focuses more on the history of phage use and development and the biographies of some of the major figures involved. Which is really interesting, to be fair, but I think if it was the first book I'd read about phages I would've been more lost about how they actually work. Tom Ireland's The Good Virus: The Amazing Story and Forgotten Promise of the Phage and Steffanie Strathdee's The Perfect Predator: A Scientist's Race to Save Her Husband from a Deadly Superbug: A Memoir are much better for understanding learning about this.
June 4, 2024
Excellent textbook relating the history of feces borne diseases and the differing approaches to treatment and eradication. While the US focused on developing more and more antibiotics (and all the problems incipient in that approach), Russia remained focused on a more biologic treatment which enriched no pharmaceutical companies. There is extensive treatment of the history of the results of the kinds of diseases caused by overcrowding as well as wars. Excellent!
I requested and received a free temporary EARC from St. Martin's Press via NetGalley. Thank you!
I requested and received a free temporary EARC from St. Martin's Press via NetGalley. Thank you!
August 8, 2025
Science, history, and modern medicine, what is there not to love? From the Soviet Union, to Maryland today, phage therapy tells the story of international rivalries, jealousy, hatred, compassion, and the ultimate pursuit of healthcare.
This book is beautifully written with a tasteful balance of history, personal stories, and medical education.
This book is beautifully written with a tasteful balance of history, personal stories, and medical education.
October 13, 2024
Wow! This book is not at all what I expected. The first 40% is a history of the discovery of bacteriophages in the early 20th century involving mostly a Georgian doctor and a french doctor. The next part is about postwar antibiotic uses and then back to the Russian phages postwar history. ( We can only hope that the people who advised adding antibiotics to almost everything were just ignorant of the consequences and not only looking to make money without care of the negative outcomes.)
Then comes the exciting part - current day research. It almost reads like a thriller with a race against time. I so can’t wait to see bacteriophages being used as part of everyday health care!
I did find it slow in the beginning but stick with it! It’s totally worth it!
Then comes the exciting part - current day research. It almost reads like a thriller with a race against time. I so can’t wait to see bacteriophages being used as part of everyday health care!
I did find it slow in the beginning but stick with it! It’s totally worth it!
November 12, 2025
This book is about the history of viruses that attack bacteria. Bacterial infections that once killed people left and right, they found a cure in days. I enjoyed this book, and it was okay to read. I liked how it talked about nursing-related things (obviously). I didn't like how it was super informational instead of more booky. The overall motif of this book is that bacteriophages are an alternative, but they are becoming less effective against antibiotic-resistant bacteria. I would not read this book again, but I would recommend it to someone interested in the medical field.
September 4, 2024
I struggled with the first eight chapters because there was a focus on the personal lives of the scientists. The book had so much potential but the author missed the mark because she focused a lot on the scientists personal life.
November 12, 2024
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.
"When my son has a sore throat, he gargles with Pyophage," Pavlenishvili says. "He really likes the ttaste. Actually, I don't know why, but it seems that all kids like how phages taste." Adults don't necessarily agree, he adds. "It's not a bad taste, just a different taste, and for some reason, kids like it. After he gargles, he can spit it out, but he likes to swallow it."
"The Iraqibacter: The Iraq War was a very different type of combat for the US military. Never before had so many American soldiers fought in desert conditions. And that meant very different types of injuries. In most prior wars, the majority of injuries came from bullet wounds, which usually have small entry points and relatively small contamination from bacterial organisms... During the Iraq War however, the vast majority of injuries were caused by explosions, so these wounds were not only large but often covered in soil and sand. Many soldiers also had burn wounds, with dead tissue that served as food for the incoming organisms. The sand blasts caused by improvised explosive devices seeded broken, bleeding, and burnt tissues with massive amounts of nasty soil bacter, letting them spread wide and penetrate deep... Nicknamed "Iraqibacter" and impervious to many antibiotics, A. baumannii was the worst of them all. It cost some American soldiers an arm or a leg. "Some would eventually die or have a very miserable life because of the infection that no one can get rid of," Young says."
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.
"When my son has a sore throat, he gargles with Pyophage," Pavlenishvili says. "He really likes the ttaste. Actually, I don't know why, but it seems that all kids like how phages taste." Adults don't necessarily agree, he adds. "It's not a bad taste, just a different taste, and for some reason, kids like it. After he gargles, he can spit it out, but he likes to swallow it."
"The Iraqibacter: The Iraq War was a very different type of combat for the US military. Never before had so many American soldiers fought in desert conditions. And that meant very different types of injuries. In most prior wars, the majority of injuries came from bullet wounds, which usually have small entry points and relatively small contamination from bacterial organisms... During the Iraq War however, the vast majority of injuries were caused by explosions, so these wounds were not only large but often covered in soil and sand. Many soldiers also had burn wounds, with dead tissue that served as food for the incoming organisms. The sand blasts caused by improvised explosive devices seeded broken, bleeding, and burnt tissues with massive amounts of nasty soil bacter, letting them spread wide and penetrate deep... Nicknamed "Iraqibacter" and impervious to many antibiotics, A. baumannii was the worst of them all. It cost some American soldiers an arm or a leg. "Some would eventually die or have a very miserable life because of the infection that no one can get rid of," Young says."
October 27, 2024
So what is a living medicine? And why would you want to take it? In this title, it is a phage or more properly a bacteriophage which is a virus that attacks specific bacteria. They are found anywhere there is bacteria and they "eat" that bacteria and leave other bacteria alone. Plus they can work when antibiotics fail. That is part of the point Lina Zeldovich is making in The Living Medicine, part medical discovery, part historical account and part biography.
Lina Zeldovich opens the book with a description of the present day and the problem with antibiotic resistant bacteria. She then jumps back to World War I and the search for cures to infectious diseases such as dysentery, cholera, and typhus. They had vaccines, but those took time to prepare. Giorgi Eliava was a doctor in Georgia (the country) who was working on cholera in Tbilisi when he accidentily discovered phages that were eating cholera bacteria in the samples he was testing, not that his microscope was powerful enough to see them, but he could see the results. Around the same time Felix d'Herelle at the Pasteur Institute in Paris encountered similar action in regard to dysentery. After the war Eliaya and d'Herelle got together in Paris and worked on refining the process of manufacturing phages that would kill various infectious diseases. In the 1920's and 1930's they worked on creating institutes in Tbilisi (Soviet Republic of Georgia) and Paris. Other folks started their own businesses doing the same in other parts of the world. But capitalism killed phages in the US since there was no governmental regulation and the public did not trust the manufactures. In the Soviet Union, phage research continued under government scrutiny and sort of thrived. Phages played a part in saving Stalingrad from the German invasion by preventing a cholera outbreak. But then there came the end of the Soviet Union and disintegration of many institutions which included the library of phages collected from all over the Soviet Union. But with the rise of antibiotic resistant bacteria, scientists and the FDA in the United States are more willing to try other means. So do not be surprised if you get treated with phages in the near future.
If you are looking for an engaging book dealing with history, science, and medicine, pick up Lina Zeldovich's The Living Medicine! Your time will be rewarded!
Thanks Netgaelly and St. Martin's Press for the chance to read this title!
Lina Zeldovich opens the book with a description of the present day and the problem with antibiotic resistant bacteria. She then jumps back to World War I and the search for cures to infectious diseases such as dysentery, cholera, and typhus. They had vaccines, but those took time to prepare. Giorgi Eliava was a doctor in Georgia (the country) who was working on cholera in Tbilisi when he accidentily discovered phages that were eating cholera bacteria in the samples he was testing, not that his microscope was powerful enough to see them, but he could see the results. Around the same time Felix d'Herelle at the Pasteur Institute in Paris encountered similar action in regard to dysentery. After the war Eliaya and d'Herelle got together in Paris and worked on refining the process of manufacturing phages that would kill various infectious diseases. In the 1920's and 1930's they worked on creating institutes in Tbilisi (Soviet Republic of Georgia) and Paris. Other folks started their own businesses doing the same in other parts of the world. But capitalism killed phages in the US since there was no governmental regulation and the public did not trust the manufactures. In the Soviet Union, phage research continued under government scrutiny and sort of thrived. Phages played a part in saving Stalingrad from the German invasion by preventing a cholera outbreak. But then there came the end of the Soviet Union and disintegration of many institutions which included the library of phages collected from all over the Soviet Union. But with the rise of antibiotic resistant bacteria, scientists and the FDA in the United States are more willing to try other means. So do not be surprised if you get treated with phages in the near future.
If you are looking for an engaging book dealing with history, science, and medicine, pick up Lina Zeldovich's The Living Medicine! Your time will be rewarded!
Thanks Netgaelly and St. Martin's Press for the chance to read this title!
January 19, 2025
If you know anything about me, it's that I would love to have a complete career change and become a medical historian or an epidemiologist. I'm constantly on the lookout for books discussing viruses, bacteria, and the history of medicine. So much so, that it's one of my kiddo's favorite topics and by age 4 he knew more about viruses and bacteria than most high school biology students. The Living Medicine by Lina Zeldovich was a fantastic overview of the history of the discovery of bacteriophages and their "reintroduction" to medicine today.
The Living Medicine examines how even before electron microscopes, scientists were finding that some kind of small unseeable force was destroying bacteria. Much of the novel is devoted to the lives and discoveries of the two primary driving forces of the research into phages, Félix d’Hérelle and Georgi Eliava. The book also is a cautionary tale of how politics can play an unwelcome role in science. From the not uncommon dismissal of new ideas that are vastly different from the status quo (I mean, look at how washing hands was dismissed), to the politics of the state where the research was being conducted, to the multi-national politics that all contributed to this research not being worldwide.
The writing by Zeldovich is extremely accessible to the most non-science minded individuals and extremely engaging. In my opinion, that is sometimes one of the most important things in this category of novel. One of my takeaways from the book is to wonder how much other research has been lost or not as fleshed out as it should be due to the chilling effect of the politics of the state. Eliava's story was absolutely heartbreaking in its conclusion. It's also incredible that even today, a medicine that's been in long use in the Eastern bloc still has difficulty getting off the ground due to funding and other constraints in a time when antibiotic resistance is only rising. The way the author has it laid out, while more challenging to keep up with the maintenance of phages, if done right, it seems like the applications of the science of phages is almost limitless. I truly hope we see more about phages and their curative powers in the news, and that credit is given to the men and women who pursued their application decades ago.
Please be advised that I received an Advance Reader Copy (ARC) from NetGalley in exchange for an honest review.
The Living Medicine examines how even before electron microscopes, scientists were finding that some kind of small unseeable force was destroying bacteria. Much of the novel is devoted to the lives and discoveries of the two primary driving forces of the research into phages, Félix d’Hérelle and Georgi Eliava. The book also is a cautionary tale of how politics can play an unwelcome role in science. From the not uncommon dismissal of new ideas that are vastly different from the status quo (I mean, look at how washing hands was dismissed), to the politics of the state where the research was being conducted, to the multi-national politics that all contributed to this research not being worldwide.
The writing by Zeldovich is extremely accessible to the most non-science minded individuals and extremely engaging. In my opinion, that is sometimes one of the most important things in this category of novel. One of my takeaways from the book is to wonder how much other research has been lost or not as fleshed out as it should be due to the chilling effect of the politics of the state. Eliava's story was absolutely heartbreaking in its conclusion. It's also incredible that even today, a medicine that's been in long use in the Eastern bloc still has difficulty getting off the ground due to funding and other constraints in a time when antibiotic resistance is only rising. The way the author has it laid out, while more challenging to keep up with the maintenance of phages, if done right, it seems like the applications of the science of phages is almost limitless. I truly hope we see more about phages and their curative powers in the news, and that credit is given to the men and women who pursued their application decades ago.
Please be advised that I received an Advance Reader Copy (ARC) from NetGalley in exchange for an honest review.
September 13, 2024
I still don't really want to go out and slurp down some untreated river water after reading Lina Zeldovich's The Living Medicine, but a little part kind of does. This book is fascinating, and explores a way of treating bacterial infections in a way that's been dismissed for so many years in western medicine. With the increasing resistance to antibiotics, we likely will have no choice but to learn how to welcome the mighty phage into our bodies, a type of virus that Soviet bloc countries have been using successfully for years to prevent and cure infections. Admittedly, the opportunities for something to go wrong are there, because unlike antibiotics, it will be something very difficult for the FDA to police. Which means there will be plenty of people out there that will crop up with their batches of miracle phages - which may not be anything more than sewage water in the worst cases, and phages that haven't been properly filtered and purified to serve the right purpose in the less worse cases - but the promise of what it can do is mind-boggling. And the thought that it can be done not just for highly industrialized countries but for low and mid-income countries makes it seem somewhat miraculous. The book is a combination of both what phages can do and how they treat bacterial infections as well as a history of how phages were discovered and the often fraught path the researchers that worked with them had to be taken seriously, face communist politics and the dismissal of them as a treatment option in modern Western medicine. Unsurprisingly, many of the medical doctors and researchers that made phages their life work were more interested in improving their efficacy and making them widely available than they were in making money off their discoveries. They were willing to fight to bring them to the people that needed them, willing to die for them, and willing to continue to push for their use when other people dismissed the idea of willingly taking a virus into their body. The very beginning and very end of the book feels a little bit like a selling pitch for the US company that currently manufactures phages, but beyond that I thought the book was fascinating and well-written. A complimentary copy of this book was provided by the publisher. All thoughts and opinions are my own.
November 11, 2024
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.
Thank you to NetGalley and St. Martin's Press for the opportunity to read and review this ARC.
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.
Thank you to NetGalley and St. Martin's Press for the opportunity to read and review this ARC.
November 2, 2024
"The Living Medicine" by Lina Zeldovich is an exploration of the history, near-oblivion, and reemergence of phages, the “living medicine” that offers a promising solution to antibiotic-resistant infections. Phages—viruses that target and destroy bacteria—were discovered over a century ago and showed early promise in treating diseases like cholera and dysentery. However, political tensions, notably during Stalin’s reign and the rise of antibiotics in the West, led to their relegation to the fringes of medical science. Zeldovich chronicles the history of phage research, particularly the work done in Soviet Georgia, shedding light on the tenacity and isolation of the scientists who believed in phages’ potential when the world seemed to have turned its back.
While the historical sections detail the lives and struggles of phage researchers, much of this background may feel overly detailed for general readers, especially those eager to get to the modern implications. And, I'll be honest, I was rolling my eyes when she recounted how she supposedly took the initiative to learn about phages on her own at age 5, and other similar instances of mythologizing the genius of intrepid phage scientists. But however rose-colored the glasses, the narrative serves as a reminder of how scientific progress can be shaped by cultural and political forces—and sometimes at great human cost.
For today’s reader, Zeldovich provides an accessible understanding of how phages operate, with lytic phages acting as the real warriors against bacteria. Given the rise of antibiotic resistance, phages present a unique hope for modern medicine. However, they are not a straightforward solution: unlike antibiotics, phages require customization for each infection, making them more challenging to commercialize. "The Living Medicine" is both a historical account and a call to consider alternative approaches in the ongoing battle against superbugs—a timely read as we look toward new-old solutions for global health challenges.
Thank you to the publishers and NetGalley for the opportunity to review a temporary digital ARC in exchange for an unbiased review.
While the historical sections detail the lives and struggles of phage researchers, much of this background may feel overly detailed for general readers, especially those eager to get to the modern implications. And, I'll be honest, I was rolling my eyes when she recounted how she supposedly took the initiative to learn about phages on her own at age 5, and other similar instances of mythologizing the genius of intrepid phage scientists. But however rose-colored the glasses, the narrative serves as a reminder of how scientific progress can be shaped by cultural and political forces—and sometimes at great human cost.
For today’s reader, Zeldovich provides an accessible understanding of how phages operate, with lytic phages acting as the real warriors against bacteria. Given the rise of antibiotic resistance, phages present a unique hope for modern medicine. However, they are not a straightforward solution: unlike antibiotics, phages require customization for each infection, making them more challenging to commercialize. "The Living Medicine" is both a historical account and a call to consider alternative approaches in the ongoing battle against superbugs—a timely read as we look toward new-old solutions for global health challenges.
Thank you to the publishers and NetGalley for the opportunity to review a temporary digital ARC in exchange for an unbiased review.
December 16, 2024
Bacteriophages are viruses that, for decades, have been used to combat cholera, dysentery, and bubonic plague, among other potentially lethal illnesses. The researchers who discovered and developed this treatment worked largely in Russia, France, and Georgia, formerly part of the U. S. S. R. In "The Living Medicine," Lina Zeldovich makes her fascinating subject come alive by delving into the often dramatic private and professional lives of the scientists who devoted many years to studying the curative properties of bacteriophages. Giorgi Eliava, in particular, was a charismatic and brilliant microbiologist who was unlucky enough to live during the era of Josef Stalin.
Because the developed world has overused antibiotics, doctors can no longer reliably wipe out bacteria that have become drug-resistant. Some may find it surprising that, starting in the early twentieth century, medical practitioners used phages to tackle disease outbreaks among civilian populations and soldiers. There are documented cases of people on the brink of death who ingested or were injected with phages and recovered fully. Not only can properly prepared and carefully administered phages destroy harmful bacteria, but they do not damage healthy cells, nor do they interfere with the human microbiome that is essential to our health.
The author, who drew on such sources as journals, newspapers, memoirs, and oral histories, clearly and informatively explains how phages are harvested from wastewater, rivers, soil, and sewage, and are then filtered, purified, and matched with the particular microorganisms that they are able to neutralize. For years, the Food and Drug Administration has, except in rare cases, refused to approve the use of phages to attack superbugs in patients. In this enlightening and well-researched book, Zeldovich sheds light on why we should be more open-minded about the power of bacteriophages to eradicate treacherous bacterial infections.
Because the developed world has overused antibiotics, doctors can no longer reliably wipe out bacteria that have become drug-resistant. Some may find it surprising that, starting in the early twentieth century, medical practitioners used phages to tackle disease outbreaks among civilian populations and soldiers. There are documented cases of people on the brink of death who ingested or were injected with phages and recovered fully. Not only can properly prepared and carefully administered phages destroy harmful bacteria, but they do not damage healthy cells, nor do they interfere with the human microbiome that is essential to our health.
The author, who drew on such sources as journals, newspapers, memoirs, and oral histories, clearly and informatively explains how phages are harvested from wastewater, rivers, soil, and sewage, and are then filtered, purified, and matched with the particular microorganisms that they are able to neutralize. For years, the Food and Drug Administration has, except in rare cases, refused to approve the use of phages to attack superbugs in patients. In this enlightening and well-researched book, Zeldovich sheds light on why we should be more open-minded about the power of bacteriophages to eradicate treacherous bacterial infections.
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August 26, 2025As heard on This Podcast Will Kill You (Special Episode: Lina Zeldovich & The Living Medicine)
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The development of antibiotics was one of the greatest turning points in the history of medicine. Bacterial infections that were once death sentences were cured within a matter of days after administration of these lifesaving compounds. But the honeymoon didn’t last long, as resistant bacterial strains emerged and spread. Now, antimicrobial resistance poses one of the greatest threats to global health; frankly, we can’t invent new antibiotics faster than resistance develops. Fortunately, there may be a solution, one that has existed even before antibiotics came on the scene: phage therapy, the use of bacteriophages to treat bacterial infections. In The Living Medicine: How a Lifesaving Cure Was Nearly Lost—and Why It Will Rescue Us When Antibiotics Fail, author Lina Zeldovich takes readers through the incredible and long-forgotten story of phage therapy and the doctors who developed it. Tune in to learn how phage therapy, after almost being relegated to a footnote in the history of medicine, is reemerging as a possible solution to the deadly problem of antimicrobial resistance.
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October 9, 2025
I’m very conflicted writing about this. It was a great bit of history and well told, all about the persons and personalities that led to the discovery and ultimate re-discovery of the bacteriophage. These are viruses that prey on bacteria; when carefully cultured, purified, and tested, they can be used therapeutically to great effect.
To sum up the mystery of “Nearly Lost”, I’ll briefly explain what the book is all about. They were discovered independently in several places, and used therapeutically to great effect in Eastern Europe. She spends much time writing about their champions and how the research proceeded. But in Western medicine, they were mostly discredited and ignored—antibiotics worked as well and were a lot easier to create. Until, of course, antibiotics stopped working.
It's a fascinating story and I only have a few complaints to share. (None of which should interfere with your enjoyment of this book) One, she tends to spend a lot of words on the love stories and female companions of the scientists who are the subjects of the book. I found that boring and mostly pointless. Two, there are an awful lot of episodes described that follow the same pattern: person gets an infection; person is at death’s door and nothing will help; patient’s family/doctor/lover insists on getting a bacteriophage treatment; patient experiences miraculous recovery.
Okay, once or twice is enough! It seems to repeat this over and over.
And third complain, the book seems to consistently downplay (and at first, ignore) the issue that bacteriophages, like any living thing, can mutate. And so can bacteria. So a treatment that once worked can stopped working, and also, even the most careful of scientific process can have unintended consequences. Toward the end of the book, these issues are mentioned. But then she’s back on her endless applause for the miracles of bacteriophages.
To sum up the mystery of “Nearly Lost”, I’ll briefly explain what the book is all about. They were discovered independently in several places, and used therapeutically to great effect in Eastern Europe. She spends much time writing about their champions and how the research proceeded. But in Western medicine, they were mostly discredited and ignored—antibiotics worked as well and were a lot easier to create. Until, of course, antibiotics stopped working.
It's a fascinating story and I only have a few complaints to share. (None of which should interfere with your enjoyment of this book) One, she tends to spend a lot of words on the love stories and female companions of the scientists who are the subjects of the book. I found that boring and mostly pointless. Two, there are an awful lot of episodes described that follow the same pattern: person gets an infection; person is at death’s door and nothing will help; patient’s family/doctor/lover insists on getting a bacteriophage treatment; patient experiences miraculous recovery.
Okay, once or twice is enough! It seems to repeat this over and over.
And third complain, the book seems to consistently downplay (and at first, ignore) the issue that bacteriophages, like any living thing, can mutate. And so can bacteria. So a treatment that once worked can stopped working, and also, even the most careful of scientific process can have unintended consequences. Toward the end of the book, these issues are mentioned. But then she’s back on her endless applause for the miracles of bacteriophages.
July 5, 2024
"The Living Medicine" is a fascinating story. I had heard of bacteriophages (phages) but had never thought about the medical benefits of phage therapy. It was interesting to learn that there had been more than a century of research into phages and their benefits for fighting infections and that use of phages was common in the country of Georgia, but relatively unknown in western Europe and the US. I was surprised at how many missed opportunities there have been to utilize phage therapy over the decades. However, I was not surprised by the various reasons that the opportunities were missed -- western prejudice against Soviet-associated innovations; scientific skepticism; capitalism (antibiotics were easier to mass produce and monetize); interpersonal jealousy and politics; and rigid thinking. I am thankful for the men and women who were persistent in their belief that phages existed and were beneficial and were willing to deal with all the frustrations, setbacks, and opposition in order to keep the science alive and advancing.
It is amazing how many lives have been saved in the past due to phage therapy, as detailed in the book. But also disturbing to think how many lives that could have been saved were instead lost because of closemindedness and prejudice.
This book should resonate with a large audience, not only because of the lifesaving potential it discusses, but because it is written a manner that makes the reader feel invested in the people featured in the book. The scientific aspects of the story are also presented in a manner that makes it accessible to the layperson. The author strikes a good balance between not getting caught up in technical jargon but also not dumbing down the science.
It is amazing how many lives have been saved in the past due to phage therapy, as detailed in the book. But also disturbing to think how many lives that could have been saved were instead lost because of closemindedness and prejudice.
This book should resonate with a large audience, not only because of the lifesaving potential it discusses, but because it is written a manner that makes the reader feel invested in the people featured in the book. The scientific aspects of the story are also presented in a manner that makes it accessible to the layperson. The author strikes a good balance between not getting caught up in technical jargon but also not dumbing down the science.
November 7, 2024
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.
Disclaimer: I received an arc of this book from the author/publisher from Netgalley. I wasn’t obligated to write a favorable review. The opinions expressed are strictly my own.
July 6, 2024
What a compelling history! The subtitle summarizes it well: "How A Miraculous Healing Therapy Was Nearly Lost-- And Why It Will Save Humanity When Antibiotics Fail."
"The Living Medicine" reads like a thriller and tells the often-agonizing history of phages. The author began reading about them--in her native Russian-- when she was five years old.
I am not spoiling the story when I say that medical use of phages was common in the Soviet countries and not in North America, where some of the later experiments and studies were performed.
While much of the microbiological study of phages took place in (the former Soviet) Georgia, the first medicinal use occurred in Paris in 1917. Because disease-producing organisms mutate, antibiotics that once worked may no longer do so. Phages only dissolve the cell walls of specific bacteria. The "trick" is to find which phage should be tasked with killing which bacterium.
I thoroughly enjoyed this book. I think that people with biological science backgrounds would find it fascinating, as well as people who have taken antibiotics that didn't work for them and have wondered why not. As I read, I wondered what future phages might have in American medicine.
The story of phages was a complex one to tell. Lina Zeldovich did a wonderful job. The book was such a pleasure to read and I learned so much. I highly recommend it.
Thank you to NetGalley for an advance reader's copy. This is my honest review.
"The Living Medicine" reads like a thriller and tells the often-agonizing history of phages. The author began reading about them--in her native Russian-- when she was five years old.
I am not spoiling the story when I say that medical use of phages was common in the Soviet countries and not in North America, where some of the later experiments and studies were performed.
While much of the microbiological study of phages took place in (the former Soviet) Georgia, the first medicinal use occurred in Paris in 1917. Because disease-producing organisms mutate, antibiotics that once worked may no longer do so. Phages only dissolve the cell walls of specific bacteria. The "trick" is to find which phage should be tasked with killing which bacterium.
I thoroughly enjoyed this book. I think that people with biological science backgrounds would find it fascinating, as well as people who have taken antibiotics that didn't work for them and have wondered why not. As I read, I wondered what future phages might have in American medicine.
The story of phages was a complex one to tell. Lina Zeldovich did a wonderful job. The book was such a pleasure to read and I learned so much. I highly recommend it.
Thank you to NetGalley for an advance reader's copy. This is my honest review.
September 28, 2024
A fascinating volume of popular science.
I am interested in microbiology, so I had heard about bacteriophages - viruses that hunt and kill bacteria - but I had no idea how much therapeutic potential they have, nor that they have been used in medicine for a century.
The author tells this astonishing story, colorfully recounting first the discovery of phages, then how this painfully acquired knowledge was almost lost to science, but was miraculously preserved in Georgia - not the southern state, but a post-Soviet country in the Caucasus, where you can buy these benevolent viruses in a pharmacy. It also describes how the West is finally beginning to accept these unorthodox therapies as a last resort in cases of - increasingly common - antibiotic resistance.
It is not only very well written, it is also of the utmost importance for all of us - this "living medicine" can save so many lives. And it is a rare example of a scientific story that gives some hope and reason for optimism - we could achieve so much if we just accepted that instead of trying to outsmart nature, we should work with it. After all, as the author observes, „phages have been feeding on bacteria for eons, so they are better equipped than our pharmaceutical industry to keep up with bacterial evolution”.
Highly recommended to anyone interested in science or medicine.
Thanks to the publisher, St. Martin's Press, and NetGalley for an advanced copy of this book.
I am interested in microbiology, so I had heard about bacteriophages - viruses that hunt and kill bacteria - but I had no idea how much therapeutic potential they have, nor that they have been used in medicine for a century.
The author tells this astonishing story, colorfully recounting first the discovery of phages, then how this painfully acquired knowledge was almost lost to science, but was miraculously preserved in Georgia - not the southern state, but a post-Soviet country in the Caucasus, where you can buy these benevolent viruses in a pharmacy. It also describes how the West is finally beginning to accept these unorthodox therapies as a last resort in cases of - increasingly common - antibiotic resistance.
It is not only very well written, it is also of the utmost importance for all of us - this "living medicine" can save so many lives. And it is a rare example of a scientific story that gives some hope and reason for optimism - we could achieve so much if we just accepted that instead of trying to outsmart nature, we should work with it. After all, as the author observes, „phages have been feeding on bacteria for eons, so they are better equipped than our pharmaceutical industry to keep up with bacterial evolution”.
Highly recommended to anyone interested in science or medicine.
Thanks to the publisher, St. Martin's Press, and NetGalley for an advanced copy of this book.
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