29 April 2009

signing a cease-fire

*feliz a-cump!*

Hey all! Amazing how much more often I update when there are real updates, eh?

As mentioned last time, I'm cycling between wellness and not-so-wellness, not because I'm a KUB rockstar, but because I have a hi-qual Pseudomonas infection. The plan had been to break out the big guns and treat it with a superpowered intravenous antibiotic. However, we decided that I'm going to skip the antibiotic and tough it out unless I get über-mal.

"What?!", you say, "an infection that serious and you're not even going to treat it?"

Bingo. Commence ridiculous explicative analogy.

For most any bacterial infection, there is at least one "good" antibiotic that takes out the problem bacteria like microscopic machine gun-wielding Rambo. However, there are inevitably strains of the bacteria in question that are slightly genetically different, such that they are resistant to that antibiotic. In this ridiculous example, umm, maybe there are some bacteria with natural bulletproof vests or whatever. Anyway, when someone has this infection, we unleash Rambo to take it out, and he annihilates all of the bad guys but the few that have the bulletproof vest mutation.

To start, this is great - for a while, we just summon the Rambo antibiotic when someone has an infection, it toasts basically all of the bacteria, and the person's immune system either eliminates the few remaining bulletproof bacteria or tolerates them in their tiny numbers.

The more we page Rambo, though, the more un-tiny the population of vested bacteria grows (oh no, the "e" word). With overuse, Rambo eventually eliminates just about all of the non-bulletproof baddies of that particular species. But eek! Now the Rambo antibiotic is powerless and pointless. oops.

With most minor infections, this isn't a big deal; we can just switch to the samurai antibiotics, or antibiotics with grenades, or antibiotics with whatever relatively mild form of violence you prefer. As long as the bacteria we're fighting can't cause that much damage, we're not afraid to attack in a variety of ways, even if we're risking the proliferation of more resistant strains. Also, there are often so many different effective antibiotics that we can pick from them at random and no strain ever has a significant resistant advantage. For example, there are myriad Penicillin-like drugs (a Penizillion, perhaps), and we're free to use them as we please because there is trivial likelihood that a significant population of bacteria will be resistant to all of them.

However, my current infection is superpowered and megaresistant. It can cause pretty severe illness if it wants to, and the bacterial population has already developed bulletproof vests, chain mail, mine detectors, Sherman tanks, missile flak... The bacteria can battle everything short of medicinal nuclear bombs, and a tiny portion of them can even handle nukes, rendering those few indestructible to us.

So, following the Rambo pattern, what's not a good idea for dealing with this bacteria? Well, what will happen if we unleash nuclear warfare the moment we detect their existence, every single time? To start, great, they stand no chance. But slowly, the nuke-resistant strain will grow in number. Eventually the nukeable strain population shrinks until what's left are all essentially invulnerable. Problem! We can tough it out when we do this with the wimpy fever-bacteria infection until our immune systems clear it up, but the superpowered bacteria will likely take us out before our immune systems can deal.

It sure would've been a better idea to use nuclear bombs on the über-bacteria as rarely as possible so that the nuclear-resistant population would remain insignificantly small and non-threatening...

Well, I have a superpowered infection, and the IV antibiotic is its nuclear bomb. I'm not that sick, so taking the one effective antibiotic would mostly just contribute to the proliferation of the indestructible strain. If I become extremely ill, then it's the right situation to use this last remaining weapon.

That was a horrible, holey, unclear, and noneducational example, but oh well. Isn't [quasi-]natural selection great?


  1. Hi John, Your explanation makes perfect sense to me. I've heard it before from my children's doctor too.

    Hope you are feeling better soon!

    Pam in WA state

  2. Here comes the science, in a headband and no shirt.

  3. That was one damn good explanation! You are by far one of the most creative people I know :)