SANDSWA book club recap: The Perfect Predator by Steffanie Strathdee

By Deborah Bright

My husband found out he had cancer for the third time at the age of 25. I didn’t know him then, and I’ll be forever grateful to the team of doctors at the Mayo Clinic for saving his life. But even though he’s been cancer-free for five years now, he still wakes up with debilitating stomach pain most mornings. It’s left him unable to work and constantly searching for a sense of purpose. I often find myself wishing I could cure him. The Perfect Predator by Steffanie Strathdee inspired me to try. 

In this cross between a memoir and a thriller, Strathdee chronicles a 9-month-long battle against a deadly superbug that took up residence inside her husband while the couple was on vacation in Egypt. Strathdee’s vivid storytelling makes the reader feel as if they are descending with the couple into the Red Pyramid, dining with them on the deck of a cruise ship, and then watching in horror as Strathdee’s husband Tom vomits continually for days.  

Doctors abroad attempt to diagnose and treat Tom prior to his medical evacuation home, to the University of California San Diego (UC San Diego) Medical Center where both he and Strathdee work as researchers. There, we come to learn the most likely cause of Tom’s condition: a series of gallstone attacks leading to the formation of a pseudocyst in his abdomen. The pseudocyst had become an apartment for the antibiotic-resistant bacterium Acinetobacter baumannii—an unwanted hitchhiker Tom had inadvertently picked up on their trip.

The medical team at UC San Diego quickly attempts to drain the pseudocyst full of bacteria but the drains keep slipping, sending Tom’s body into septic shock multiple times. With Tom entering multisystem organ failure, Strathdee turns to what she knows best: research. She comes across phage therapy, a practice dating back to the end of the Great War in which doctors treat bacterial infections with viruses that have evolved to destroy bacteria. The practice had fallen out of favor when antibiotics arrived on the scene, but in the case of an antibiotic-resistant bacterium (also called a superbug), phages would be the perfect predator. 

Strathdee swiftly enlists the help of multiple researchers from around the country to identify and isolate phages that will target Tom’s bacteria while she and the UC San Diego medical team jump through hoops to secure permission from the United States Food and Drug Administration (FDA) to administer the phage therapy.

Spoiler alert: It works, and Tom survives.

“Trust your instincts,” she writes in Part II of the book. When I read this, I felt empowered. SANDSWA was fortunate enough to have Dr. Strathdee join us for our book club discussion of The Perfect Predator in January, and I had the opportunity to bring this sentiment up. For a while now, I’ve been wondering if my husband’s stomach pain had something to do with a dysbiosis in his microbiome—the communities of bacteria and other microbes (including phages) that reside in his gastrointestinal tract. But unlike Dr. Strathdee, I’m not a researcher at a world-class institution with access to cutting-edge technology that might help me test my theory. In lieu of it, I’ve started brewing kombucha, a fermented tea drink containing bacteria and yeast cultures that may stick to the wall of my husband’s intestine and provide a protective coating that would mitigate the inflammation likely causing his pain.

Dr. Strathdee encouraged me to keep pursuing this line of thinking and acknowledged my reference to her position, saying that if there’s one thing she wished she would’ve focused on more in the book, it’s that hers is a “story of privilege.” Her advice? Find a provider that will listen and encourage dialogue. 

Another book club member asked Dr. Strathdee about the advances in phage therapy since the book came out in 2019. 

“The innovation was the intravenous phage administration, and the fact that it was applied to a superbug,” said Dr. Strathdee. “Tom’s was the case that brought phage therapy back to the West; there are now phage therapy centers popping up all over the place, in both academia and industry.” One of these is the Center for Innovative Phage Applications and Therapeutics at UC San Diego, which Strathdee helped found. 

She also talked about the decision to “put herself out there”. Early on in the book, Strathdee characterizes herself as “on the [autism] spectrum”. She said that she felt it was important to discuss the topics of neurodiversity and posttraumatic stress disorder (PTSD), but that it was difficult for her to do so.

If you’ve read the acknowledgements section, you know Strathdee had a cowriter. We asked her about the cowriter’s role, and she explained that she had a first draft and an agent who shopped the book proposal around unsuccessfully before they hired a cowriter to rework it. She said she also got a book on getting a book published. “I realized upon reading it that I’d already made a bunch of mistakes. There’s a whole chapter on cowriters. She helped me decide how much of myself to put out there.”

We had some questions for Dr. Strathdee about the COVID-19 pandemic. As an epidemiologist at UC San Diego, she has been heavily involved in the pandemic response by both the university and the county of San Diego. She said that these days, she spends a fair amount of time on Twitter trying to demystify vaccines in the eyes of the public. To read what she says, follow Dr. Strathdee on Twitter @chngin_the_wrld.

Even if you can’t personally relate to the story like I can, The Perfect Predator is a page turner. Strathdee is an engaging writer and an endearing main character. She is also a skilled science communicator and uses her story and platform to drive home an important warning about the dangers of overusing antibiotics. (For more on this topic, see the SANDSWA book club recap of Big Chicken by Maryn McKenna.) 

We asked Dr. Strathdee what’s next. “I finished my first novel a year ago and just submitted the first draft today; it’s a thriller about a pandemic, and I had to rewrite a large chunk of it because it looked like I was plagiarizing real life!” She also mentioned that Hollywood has expressed interest in a potential movie based on The Perfect Predator—stay tuned!

In case you’re wondering what’s next for my kombucha-brewing experiment: Whether or not it works remains to be seen. Regardless, I am now running a full-blown kombucha operation out of my home; feel free to reach out if you’d like to try some!

If you read The Perfect Predator, please leave a review on Amazon.

Our next book club meeting will be March 3 from 6:30–8:30 p.m. We will be discussing Wild Rituals: 10 Lessons Animals Can Teach Us About Connection, Community, and Ourselves by Caitlin O’Connell, and will again be joined by the author.

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