Urban living explored
A personal fight against
a bacterial disease
Ancient Rome’s Monte Testaccio and
modern Tokyo’s Tsukiji fish market
reveal a lot about the nature of cities.
Monte Testaccio is a hill made of broken
pottery in the middle of Rome. Around
2,000 years ago, people tossed empty
wine and olive oil vessels onto what was
then a garbage heap. Tokyo’s vast sea-
food emporium, also known as Toyosu
Market, includes passageways where forklifts deposit and
remove containers of every sea creature imaginable, as chefs
and home cooks bid for the day’s catch.
These metropolitan destinations illustrate how mass
production and consumption of goods — along with public
markets, complex infrastructure and trash — have always
characterized cities, archaeologist Monica Smith writes in
Cities. She argues that cities provide work and leisure opportunities that, once invented around 6,000 years ago, people
couldn’t do without. Trash was part of the deal, along with
poverty and pollution — all of which remain city challenges.
Ancient human traits and behaviors contributed to cit-
ies’ rapid ascendance, even if it took a few hundred thousand
Epidemiologist Steffanie Strathdee and
her husband, Thomas Patterson, went
to Egypt in 2015 expecting to come
home with some photos and souvenirs.
Instead, Patterson was hit with his own
version of the 10 plagues.
At first, doctors in Egypt thought
Patterson had pancreatitis. But his
health worsened after treatment, and he
started hallucinating. Once flown to Germany, he was diag-
nosed with a multidrug-resistant bacterial infection in his
pancreas. He was then airlifted to a hospital at Strathdee’s
home institution, the University of California, San Diego.
There, Patterson suffered several episodes of septic shock
and spent months in a coma.
The Perfect Predator chronicles the couple’s encounter
with a bacterium that was resistant to every available antibiotic, and the rush to find an alternative treatment to save
During the ordeal, Strathdee used her scientific training
to research solutions and stumbled upon phage therapy. The
idea is that even the most resistant bacteria can be defeated
by their natural predators, viruses called bacteriophages. The
Monica L. Smith
The Perfect Predator
and Thomas Patterson
HACHETTE BOOKS, $28
years for agriculture and other cultural developments to spark
that urban transition, Smith writes. As a restless, talkative
species searching for meaning in the world, people eventually started building gathering spots for religious pilgrimages.
One of the earliest such places was Göbekli Tepe in what’s now
Turkey, dating back 10,000 years or more. Public structures
there set the stage for farmers and herders to create the oldest
known city, Tell Brak, about 4,000 years later in Syria.
Cities everywhere have been organized in remarkably similar ways to provide jobs, entertainment and other features, the
author holds. People have always been drawn to those benefits, both for survival and for excitement, she writes.
Smith offers a spirited defense of conspicuous consumption.
Excavations have yielded lots of trash at ancient cities. Changing styles have always fueled a desire to get the latest goods.
Many objects were made to be used and thrown out. Heaps of
cheap ceramic fast food containers, for instance, have been
found at Pompeii and elsewhere. The inventiveness that takes
flight in cities is worth the cost of the trash, Smith concludes.
The urban drawbacks of crime and disease get minimal
mention. And Smith’s arguments seem incomplete without a
comparison of cities to hunter-gatherer societies, the venues
for most of human evolution. But she plausibly concludes
that people will continue to flock to cities, warts and all.
— Bruce Bower
nearly century-old treatment had been all but forgotten in the
United States, in large part because of the invention of antibiotics, but was being used in parts of the former Soviet Union.
Doctors needed the right phage, one capable of parasitizing
the bacteria infecting Patterson. So Strathdee asked a team of
scientists to drop everything and check their phage collections
while also hunting for environmental samples for a virus that
could be turned into an experimental treatment. Within three
weeks, two sets of researchers found phages that were a match.
Patterson was treated successfully, and the first phage therapy
center in the United States opened last year at UC San Diego.
Strathdee, who did most of the book’s writing, provides
clear explanations of the science and weaves historical
vignettes, such as the early days of research on penicillin,
throughout her personal narrative.
The book is a real page-turner, though a few things may
give readers pause. The first is the mention of Strathdee’s
psychic, who appears a few times throughout the book and is
later joined by a holistic healer. Then there are “interludes”
written by Patterson. Over time, it becomes clear that these
snippets are a peek into Patterson’s hallucinations, but the
book would have been stronger if those passages had been
clearly introduced, or left out altogether.
The interludes, and Strathdee’s reliance on some unconventional supports, are distracting, but they don’t take away
from the book’s strong foundation in science and skillful
storytelling. — Allie Wilkinson