Greetings, Fellow Snowflake

There was a plaque hanging in the kitchen of my childhood home. It read, “No snowflake in an avalanche ever feels responsible.” [Note: I was easily able to locate this quote on the World Wide Web but unable to verify who actually said it.] I knew what that meant as a kid, but I‘d venture to say that it means a great deal more to me in 2021, as an adult. Certain problems can only be created and sustained by the actions—or inaction—of a large number of people. Each of those people has played an essential role, albeit a tiny one, in bringing about the disaster. We face multiple avalanches nowadays: climate change, social inequality, and political apathy, among others, and the subject of our piece today, drug-resistant infections.

When antibiotics were first discovered, they were nothing short of a miracle. Bacterial illness, once a headliner, had to step back, allowing heart disease, cancer, and stroke to take the stage. Apart from COVID-19 prancing into the limelight early last year, infectious disease has really become kind of outdated and amateurish. Antibiotics played an important role in pushing U.S. life expectancy figures from 47 years up to almost 79 years of age.

We loved the power antibiotics gave us and started working our new weapon overtime. These drugs were doled out for every ear infection, upset stomach, sore throat, and slow-growing calf in the country. We administered them during every surgery. Every time we took those antibiotics down off the shelf, the germs learned something new, gradually piecing together what they needed to outwit us and our medicines. We’ve started seeing elderly people, cancer survivors, and organ transplant recipients with serious illness from bacteria that we didn’t perceive as a threat. Treatment regimens have had to be adjusted, requiring more expensive or more toxic pharmaceuticals. Sometimes we fail completely; around 35,000 Americans perish each year from antibiotic-resistant infections.

These days, MRSA, MDR, VRE, and other “superbugs” are a sad fact of life. They are old bacteria that learned to outsmart our antimicrobial drugs because we weren’t judicious enough in how we used them. We all played a little part, snowflake. We requested and expected them from our pediatricians, physicians and vets. We didn’t take our prescriptions properly, squirreling them away to be used at another time of our own choosing. We mixed and matched what we had lying around in the medicine cabinet, because we didn’t want to consult a doctor. We allowed farming operations to use antibiotics in huge quantities on our meat, eggs, milk, and fish because these drugs increase efficiency, thus lowering the purchase price of our groceries. We’ve flushed pills down the toilet and thrown them in the trash. These compounds show up in sewers, waterways, and soil, and back on our dinner plate. They’ve affected our fish and other wildlife, even in uninhabited parts of the earth. They’ve left their footprints in our nursing homes, NICUs, chemo units, and cemeteries.

Is it too late? Can an avalanche be stopped, if the snowflakes refuse to participate?

Dr. M.S. Regan