Staphylococcus Aureus and the Non-Denial Denial
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Hello and welcome to The Anthropocene Reviewed, a podcast where we review different facets of the human-centered planet on a five-star scale. I’m John Green, and today I’ll be reviewing a micro-organism, staphylococcus aureus, and a rhetorical device called the non-denial denial.
Years ago, I acquired an infection in my left eye socket caused by the bacteria staphylococcus aureus. My vision clouded, and then my eye socket swelled shut, and I ended up hospitalized for over a week.
Had I experienced the same infection anytime in history before 1940, I would’ve likely lost not just my eye but my life. Then again, I wouldn’t have ever lived to acquire orbital cellulitis, because I would’ve died of the staph infections I had in childhood. Staphylococcus aureus is not a normal part of the human microbiome, but many people--perhaps around a third--are like me nonetheless hosts to colonies of it on our skin or in our nasal passages or in our digestive systems. These colonies are usually harmless, but while anyone can get sick with staph, those of us who live amid it every day are more likely to suffer infections.
When I was in the hospital, the infectious disease doctors made me feel very special. One told me, “You are colonized by some fascinatingly aggressive staph.” He told me I wouldn’t believe the petri dishes if I saw them, and went on to call my continued existence a real testament to modern medicine.
Which I suppose it is. For people like myself colonized by fascinatingly aggressive bacteria, there can be no hearkening back wistfully to past golden ages, because in all those pasts I would be dead.
In 1941, Boston City Hospital reported an 82% fatality rate for staph infections. I remember as a child hearing phrases like, “Only the strong survive” and “survival of the fittest,” and feeling terrified by them, because I knew I was not fit or strong. I didn’t yet know that when humanity protects the frail among us, and works to ensure their survival, the human project as a whole gets stronger. Failing to understand that has held our species back for millennia, and in fact still does.
Because staph often infects open wounds, it has been especially deadly during war. Near the beginning of World War I, the English poet Rupert Brooke famously wrote, “If I should die, think only this of me: that there’s some corner of a foreign / field / That is forever England.” Brooke would indeed die in the war, in the winter of 1915, but not in some corner of a foreign field, but instead on a hospital ship, of a bacterial infection.
By then, there were of course thousands of doctors treating the war’s wounded and ill. Among them was a 71-year-old Scottish surgeon, Alexander Ogston, who decades earlier had discovered and named Staphylococcus.
Ogston, who sported a magnificent mustache throughout his adult life, was a huge fan of Joseph Lister, whose observations about post-surgical infection led to the use of carbolic acid and other sterilization techniques. These dramatically increased surgical survival rates--in fact, after visiting Lister and learning from him, Ogston returned to his hospital in Aberdeen and tore down the sign above the operating room that read, “Prepare to meet thy God.” No longer would surgery be a desperate, last-ditch effort. It could be safe, and clean, and survivable.
Ogston was so obsessed with Lister’s carbolic acid spray that his students wrote a poem about it:
The spray, the spray, the antiseptic spray
A.O. would shower it morning, night and day
For every sort of scratch
Where others would attach
A sticking plaster patch
He gave the spray.
It’s alright, but it’s no Rupert Brooke.
At any rate, Ogston had good reason to give the spray. His first wife, Mary Jane, had died after childbirth a few years earlier, at the age of 25. There’s no record of her cause of death, but most maternal deaths at the time were caused by postpartum infection, often due to staphylococcus aureus. And Ogston had seen hundreds of his patients die of post-surgical infection, so no wonder he was obsessed with antiseptic protocols. Still, he wanted to understand not just how to prevent infection, but also what precisely was causing it. By the late 1870s, many discoveries were being made by surgeons and researchers about various bacteria and their role in infection, but staphylococcus was not identified until Ogston lanced a pus-filled, abscessed leg wound belonging to one James Davidson.
Under the microscope, Davidson’s abscess was brimming with life. Ogston wrote, “My delight may be conceived when there were revealed to me beautiful tangles, tufts and chains of round organisms in great numbers.”
Ogston named these tufts and chains staphylococcus, from the Greek word for bunches of grapes. And they do often look like grape bunches--plump and just a little bit oblong, and also quite yellowish-green. A few years later, a German scientist noted that there were in fact several species of staphylococcus, and named the one Ogston had found staphylococcus aureus, or the golden staph.
But Ogston wasn’t content with just seeing the bacteria. “Obviously,” he wrote, “the first step to be taken was to make sure the organisms found in Mr. Davidson’s pus were not there by chance.” So he set up a laboratory in the shed behind his house and began trying to grow colonies of staph, eventually succeeding by growing them in the medium of a chicken egg. He then injected the bacteria into guinea pigs and wild mice, which became violently ill. Ogston also noted that staphylococcus seemed to be “harmless on the surface” despite being “so deleterious when injected.” I have also observed this--insofar as I am not much bothered by having my skin colonized by staphylococcus aureus but find it deleterious indeed when it starts replicating inside my eye socket.
James Davidson, by the way, went on to live another forty years after his staph infection, thanks to a thorough debriding and Ogston’s liberal use of the spray, the spray, the antiseptic spray. But staphylococcus aureus remained an exceptionally dangerous infection until another Scottish scientist, Alexander Fleming, discovered penicillin by accident, actually. One Monday morning in 1928, Fleming noticed that one of his cultures of staphylococcus aureus had been contaminated by a fungus, penicillium, which seemed to have killed all the staph bacteria. He remarked aloud, “That’s funny.”
Fleming then used what he called his “mold juice”--I wish I were making that up--to treat a couple patients, including curing his assistant’s sinus infection, but mass production of the antibiotic substance secreted by penicillium proved very challenging.
It wasn’t until the late 1930s, a group of scientists at Oxford began testing their penicillin stocks, first on mice, and then in 1941 on a human subject, a policeman named Albert Alexander, who’d been cut by shrapnel during a German bombing raid, and who was dying of bacterial infections--in his case, both staphylococcus aureus and streptococcus. The penicillin caused a dramatic improvement in Alexander’s condition, but the researchers didn’t have enough of the drug to save him. The infections returned, and Alexander died in April of 1941. His seven-year-old daughter Sheila ended up in a local orphanage.
Scientists began to seek out more productive strains of the mold, and eventually found one on a cantaloupe in a Peoria, Illinois grocery store. That strain eventually became even more productive after being exposed to X-rays and ultraviolet radiation, but essentially all penicillin in the world descends from that mold on that one cantaloupe in Peoria. That’s not the astonishing thing about the story, though. The astonishing thing is that after scraping off the mold that became the world’s supply of penicillin, the scientists in question ate the rest of the cantaloupe.
Even as penicillin stocks increased--from not enough to save a single human being in 1941 to 21 billion units in 1943 to 6.8 trillion units in 1945--there was growing awareness that the bacteria killed by penicillin were evolving resistance to it, especially staphylococcus aureus. A 1946 Saturday Evening Post article worried that antibiotic use would “unwittingly aid and speed up the subtle evolution forces which arrange for the survival of the fittest microbes.” And so it was to be. By 1950, 40% of staphylococcus aureus samples in hospitals were resistant to penicillin; by 1960, 80%. Today, only around 2% of staph a. infections are sensitive to penicillin.
This all happened so, so quickly. 64 years elapsed between Alexander Ogston’s discovery of staphylococcus and the mass production of penicillin, and 64 years elapsed between the mass production of penicillin and my 2007 bout with orbital cellulitis. In the end, my infection did not respond to penicillin, or to the next two lines of antibiotics, but did fortunately respond to the fourth. But antibiotic resistance is not only a problem for the future--some 50,000 people in the United States die of staphylococcus aureus infections every year.
How recent is penicillin? That police officer’s daughter, Sheila, who ended up in the orphanage--she’s still alive. She married an American soldier and moved to California. She’s a painter. One of her recent paintings depicts a block of homes in an English village. Ivy grows up along one wall, creeping over the rough stone.
To me, the great mystery of life is why life wants to be. Staphylococcus doesn’t want to harm people. It doesn’t know about people. It just wants to be, like that ivy wants to spread across the wall, occupying more and more of it. How much? As much as it can. So it’s not staph’s fault that it wishes to be. Wishing to be is the mark of life, and the glory of it.
Still, I can only give staphylococcus aureus one and a half stars.
After the break, we’ll turn our attention to the non-denial denial, but first . . .
Sometimes, when I am exceptionally despondent about the condition of contemporary political life in the United States, I will turn to history, especially to the politicking of ancient Rome.
There’s a famous document called The Little Handbook on Electioneering, purportedly written by Quintus Tullius Cicero, to his older brother, Marcus. Marcus is the famous Cicero, the Roman lawyer and orator who served as Roman consul in 63 BCE. Scholars dispute whether Quintus actually wrote the Little Handbook--it may have been a later creation--but regardless, despite being a couple thousand years old, it is in some ways a very contemporary document. It argues, for instance, that “Men are more taken by look and words than by actual services.” It also points out that when someone asks of you something you cannot do, you can either promise to do it anyway or politely refuse. “The latter is the conduct of a good man,” the Handbook tells us, “the former of a good candidate.”
But what really gets me about The Little Handbook on Electioneering is a paragraph on pointing out the flaws in other candidates, in this case Roman senator Cataline. The Handbook reads, “Why should I speak of him as a candidate for the consulship, who caused Marius, a man most beloved by the Roman people, to be beaten with vine-rods in the sight of that Roman people from one end of the city to the other, forced him to the tomb, rent his frame with every kind of torture, and while he was still alive and breathing, cut off his head?” The Little Handbook goes on to describe Cataline not only as a murderer but worse still as “a man who afterwards lived with actors and gladiators on such terms that the former ministered to his lust and the latter to his crimes.” It’s one thing to decapitate your brother-in-law. But living with actors who minister to your lust--that’s properly disqualifying.
The Handbook also says that people “would rather you told them a civil lie than give them a point-blank refusal.” It’s a coincidence, but a wonderful one, that civil lies sounds so much like civilize.
I first heard the term “non-denial denial” while reading Bob Woodward and Carl Bernstein’s book All the President’s Men about the Watergate cover-up that led to President Richard Nixon’s resignation back in 1974. Nixon’s press secretary Ronald Ziegler regularly released denials that did not actually deny the accusations in question. Ziegler once said, for instance, “Stories are being run based on hearsay, innuendo, guilt by association,” which is a criticism of the press but not a denial of the story.
In the decades since, the non-denial denial has become almost beautiful in its linguistic sophistication. Like after the National Enquirer published reports of 2008 Democratic presidential hopeful John Edwards having a child outside of his marriage, Edwards said "That's tabloid trash. They're full of lies." But that comment is carefully worded to say that tabloids often spread misinformation without saying that they were in this case spreading misinformation. Edwards did eventually say, "The story's just false," but false is a word that pops up in many non-denial denials. It’s useful because it’s vague--like maybe the story is false because you didn’t actually have a child with your mistress whom you supported with funds from campaign donations, or maybe the story is false because it claimed you boarded an airplane at noon when in fact you boarded it at 12:06 PM.
The best non-denial denials sound like broad statements but secretly aren’t. Former U.S. President Bill Clinton issued what seemed to be a blanket denial, when he said of an affair, “I did not have sexual relations with that woman,” but it turned out that he had an extremely specific definition of “sexual relations” in mind when uttering those now-famous words.
But there are many other varieties of non-denial denials. You can answer a question different from the one you were asked, as when Chris Christie responded to allegations he’d closed a bridge for politically motivated reasons by saying, “I am not a bully.” Or you might use certain words to describe an accusation that seem like denials but really aren’t. My favorite is “outrageous,” as when U.S. Senator Marco Rubio described as “outrageous” a report that he mischaracterized his family history. Many things are outrageous but still true, especially in politics.
Ultimately, I think language exists to facilitate communication, to make my thoughts transparent to you and yours transparent to me. But language can also be used to make the past and the present confusing, and even opaque. And in those senses, the non-denial denial is a failure of language. Still, in the end, I think I prefer non-denials denials to the pure lies that some politicians are happy to tell. The current U.S. President seems not to be very interested in linguistic acrobatics, and instead is content simply to lie--both when it comes to big matters, like claiming that China pays for U.S. tariffs on Chinese goods, and also when it comes to ridiculously small matters, like the fact that he used to serve as his own spokesperson under the pseudonym John Barron.
Of course, the President isn’t the only politician to take stretching the truth to the level of breaking it, but he is currently the most prominent. I suppose one could argue that it’s better to live with provably false statements than the intentional obfuscation of non-denial denials. And I realize that no American politician has, as of yet anyway, decapitated a political rival and paraded around town with a disembodied head. Still, I’ll confess that the times in which I find myself have left me a little nostalgic for the days of civil lies.
I give non-denial denials two stars.
Thanks for listening to The Anthropocene Reviewed, which was written by me, edited by Stan Muller, and produced by Rosianna Halse Rojas and Tony Phillips. Joe Plourde is our technical director. Hannis Brown makes the music. The pairing of today’s episode was inspired by a quote apparently misattributed to Cicero: “Politicans are not born. They are excreted.” Penicillin really is excreted, though. Thanks to Megan, Austin, and Deepti for suggestions reviews of penicillin. I want to leave you today with my favorite fact that didn’t make it in to today’s reviews: Alexander Ogston, the Scottish surgeon who discovered staphyloccocus, raised some wondrously radical children, including his daughter Helen, who was a famous British Suffragette. In 1908, Helen attempted to give a speech at London’s Royal Albert Hall arguing that women should have the right to vote. Male stewards tried to pull her off the stage violently; one pressed the lit end of a cigar to her wrist. Helen Ogston responded by pulling out a dog whip and whipping the men. It would be another 20 years before women in Britain had the same voting rights as men. Just as the daughter of that policeman treated with penicillin is still alive, there are British women still alive who were born in a country where women could not vote. History is new, my friends, and we are all of us making it all the time together.