Butch Cassidy’s Question

Butch to Sundance: "Who are those guys?"

Butch to Sundance: “Who are those guys?”

In the 1969 Western classic Butch Cassidy and the Sundance Kid, our two outlaws and their Hole in the Wall Gang rob a Union Pacific train on both its eastward and westward runs, thinking that the second robbery would be unexpected and likely reap even more money than the first.

Problem was, the second robbery wasn’t so unexpected: Union Pacific, tired of being robbed, hired a six man Superposse to follow the train. It included renowned Indian tracker Lord Baltimore and relentless lawman Joe Lefors, who tore after Butch and Sundance in hot pursuit, night and day, without pause, “like a machine.” After using every trick in the book to elude the Superposse, and failing to do so, an exhausted Butch peers out from behind mountain rocks at the advancing trackers below and says to Sundance, “Who are those guys?”, a refrain repeated throughout the chase.

Misjudging an opponent is something the medical community is currently reckoning with when it comes to microbes and their increasing resistance to the antibiotics we use on them. Exactly, Who are those guys? — i.e. microbes — is a central question addressed by Brad Spellberg, MD, Chief Medical Officer at the Los Angeles County-University of Southern California Medical Center, in his book Rising Plague: The global threat from deadly bacteria and our dwindling arsenal to fight them. Like Butch & Sundance’s Superposse, Spellberg and other leaders in the field of infectious disease have learned that bacteria and Superbacteria are not what we thought they were either. In essence, we underestimate them, too.

For example, Spellberg points out in his book that:

1. Microbes have existed for a thousand times longer than our species, outnumber us by a factor of 1022, outweigh us by a factor of 108, and represent 60 percent of the mass of life on the planet.

2. They reproduce “almost impossibly quickly.” E. coli bacterium, for instance, can create 69 billion progeny in just twelve hours of growth. “Now that’s an enemy for you,” says Spellberg. “Kill one and as many as 69 billion more can pop up within twelve hours.”

3. About 1.5 million of the 69 billion offspring can have mutations that enhance their ability to survive in hostile environments, such as the presence of antibiotics that would otherwise be lethal to the bacteria.

4. This “astounding replication and mutation rate,” i.e. the evolution in bacteria of resistance to antibiotics, is the method by which bacteria create new weapons and defense mechanisms within generations.

Here’s the neat part: the video below, developed at Harvard Medical School, allows us to watch the evolution of Superbacteria in action. It shows billions of bacteria breaking through ever stronger barriers of antibiotics inside a really big petri dish, or mega-plate. As the bacteria move towards the middle of the plate from both ends they are eating, growing, and multiplying. Along the way, they’re also mutating and evolving. As the bacteria move inwards, mutants evolve that are resistant to increasing doses of antibiotics that would otherwise — but for the mutations — kill the bugs.

Crucially, the evolution of bugs on the mega-plate mirrors real life, says Harvard’s Roy Kishony in an interview with STAT: “Every single antibiotic that we have introduced medically so far, the bacteria found ways to evade it … every single one.”

In other words, just like the Superposse chasing Butch & Sundance, nothing – no amount or kind of antibiotic – can stop the advance of the Superbacteria either.

Check it out:

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