Be Mindful of Your Metaphors about Microbes

Abstract

Metaphors are ubiquitous in science and have important implications for how we frame our research objectives as well as how we communicate to the public. This piece focuses on the power of metaphors to shape our attitude and actions toward antimicrobial-resistant bacteria. It begins by emphasizing the pervasiveness of war metaphors to describe bacteria. Then it highlights that, with this type of framing, the solutions follow a similar suit. Ultimately, this metaphorical framing can imply dangerously incorrect solutions to the problem of antibiotic resistance. I propose that we need metaphors that represent the problem of antimicrobial resistance as an ecological and evolutionary issue rather than a single bacterial enemy. I end by offering a new metaphor that does not downplay the healthy fear we should have for antimicrobial-resistant bacteria but acknowledges that living things evolve and self-preserve. This piece is a call to action to use metaphors that express microbes' exceptional resilience rather than our brute strength in combat against them.

Full text

Be Mindful of Your Metaphors about Microbes
Jessica Maccaro
a
a
Department of Entomology, University of California Riverside, Riverside, California, USA
ABSTRACT Metaphors are ubiquitous in science and have important implications
for how we frame our research objectives as well as how we communicate to the
public. This piece focuses on the power of metaphors to shape our attitude and
actions toward antimicrobial-resistant bacteria. It begins by emphasizing the per-
vasiveness of war metaphors to describe bacteria. Then it highlights that, with this
type of framing, the solutions follow a similar suit. Ultimately, this metaphorical
framing can imply dangerously incorrect solutions to the problem of antibiotic re-
sistance. I propose that we need metaphors that represent the problem of antimi-
crobial resistance as an ecological and evolutionary issue rather than a single bac-
terial enemy. I end by offering a new metaphor that does not downplay the
healthy fear we should have for antimicrobial-resistant bacteria but acknowledges
that living things evolve and self-preserve. This piece is a call to action to use
metaphors that express microbes’exceptional resilience rather than our brute
strength in combat against them.
KEYWORDS Darwinian medicine, antibiotic resistance, drug resistance evolution,
ecology, martial metaphors, science communication
Look at some of the phrases used to describe antibiotic-resistant bacteria in this
2009 review paper by Nerlich and James (1): “A new killer in our midst,”“powerful
adversaries,”and “the battle against bacteria.”
Notice how they all describe resistant bacteria as an enemy to be feared and
fought. As a result, the solutions to combat this “dangerous adversary”are framed as
weapons: “Scientists show no mercy”with a “silver bullet”antibiotic designed to “give
bacteria a sledgehammer blow”(1). Still, we might be “fighting a losing battle”and
“running out of ammunition”(1). Such martial metaphors are ubiquitous in science
and popular articles on antibiotic resistance.
But, why should it matter what metaphors we choose?
Metaphors are powerful, because they not only guide how to think about an idea
but how to feel about an idea. This is important, because the way you feel about an
idea often determines the action you take next. Let’s explore how these war metaphors
can imply misleading solutions to the problem of antibiotic resistance and how we
should seek to improve them.
First, by personifying antimicrobial-resistant bacteria as the enemy, it becomes easy
to gloss over the fact that antibiotic resistance results from a bigger evolutionary pro-
cess that will not disappear by killing any single enemy. Our metaphors around antibi-
otic resistance should more accurately reflect the evolutionary process so the actions
we take are directed at the process rather than an individual “microbial foe.”
Furthermore, presenting bacteria as adversaries can imply that they are strategic
agents planning their next maneuver, when in reality they are just adapting to the cur-
rent selective pressures (2). This language furthers the misconception that evolution
has foresight if we think about bacterial evolution as a strategizing opponent.
Moreover, the war metaphor is misleading because killing any number of the enemy
seems like a victory in the context of war. So, any amount of antibiotic should weaken
Citation Maccaro J. 2021. Be mindful of your
metaphors about microbes. mSphere 6:
e00431-21. https://doi.org/10.1128/mSphere
.00431-21.
Copyright © 2021 Maccaro. This is an open-
access article distributed under the terms of
the Creative Commons Attribution 4.0
International license.
Address correspondence to
jmacc003@ucr.edu.
"Be Mindful of Your Metaphors About
Microbes" warns @JessicaMaccaro in this
commentary about the danger of martial
metaphors. Let's think up metaphors that
express microbes' exceptional resilience rather
than our brute strength in combat against
them!
The views expressed in this article do not
necessarily reflect the views of the journal or of
ASM.
Published 28 May 2021
May/June 2021 Volume 6 Issue 3 e00431-21 msphere.asm.org 1
COMMENTARY

the enemy according to a war metaphor—but in reality, it can strengthen them.
Without considering this subtlety, people might take antibiotics when they do not
need them or not take the full round when they do. My father just the other day had a
stomachache and popped a penicillin right away. This action made him feel as though
he was getting the upper hand on the enemy. But instead, he might have selected for
stronger pathogenic microbes and disturbed the ecological balance that kept them in
check.
Which brings us to the second point: antibiotic resistance is an ecological prob-
lem—there is no bad microbe in a vacuum, but rather, they exist in a system of other
microbes and their physical surroundings. Fortunately, the language around the
human microbiome is becoming accurately ecological. For instance, a doctor would
not describe irritable bowel syndrome as “abadmicrobe”but rather as a “dysbiotic
condition,”thus reflecting an ecological imbalance instead of a single enemy spe-
cies. The term “dysbiosis”implies that the solution involves restoring a happy eco-
system. We need a metaphor that represents this mentality and encourages people
to pursue a more ecological solution.
I will offer a starting point using the metaphor of the Hydra in Greek mythology.
The Hydra is a snake-like creature with many heads. When anyone would attempt to
cut off one of these heads, two would grow back in its place. The lone fighters that
attempted to slay the Hydra slashed it over and over no matter how many more heads
grew. Trying to destroy the Hydra with brute force only made it stronger. This is what
can happen when we misuse antibiotics: in our efforts to “behead”disease, we provide
an advantage to antibiotic-resistant microbes.
It was not until Hercules sought to understand the strange ways of the Hydra
that he was able to slay it once and for all. He had to first chop off the heads and
cauterize the fresh wounds immediately after. Because Hercules understood that
slashing off each head as they cropped up would only make the problem worse,
he targeted the process of exponential head regeneration rather than the heads
themselves.
This metaphor highlights that we should guide our efforts toward the root of the
problem. Although it still frames our relationship to antimicrobial-resistant bacteria as
afight, it directs our attention to the process that makes the Hydra dangerous. More
specifically, this metaphor highlights that our aggressive interventions to destroy the
Hydra (if indiscriminate and unthoughtful) actually drive the process that makes the
Hydra even more dangerous. In the same sense, when we do not consider the evolu-
tionary and ecological process that makes microbes so resilient, we escalate the very
problem we are trying to eliminate—antibiotic-resistant bacteria. Addressing this prob-
lem is possible only when we deeply understand the nature of the microbes around us
and the processes that underlie their success.
This metaphor does not diminish the healthy fear that we should have for antibi-
otic-resistant bacteria, but it suggests a more strategic path forward. While antibiotics
are still often the best course of action, it is important to recognize the evolutionary
process of resistance that they can escalate. Darwinian or evolutionary medicine is a
huge step forward (3). This approach incorporates concepts from evolutionary biology
to redefine and reframe disease and the questions and solutions surrounding it. Many
have begun to embrace Darwinian medicine, because they acknowledge that living
things evolve and self-preserve. Bacteria are masters of rapid evolution, so we should
embrace metaphors that express their exceptional resilience rather than our brute
strength in combat.
ACKNOWLEDGMENTS
I thank the other microbiologists who looked this piece over and gave valuable
feedback: Quinn McFrederick (my advisor), Michael Baym, and Evelyn Valdez-Ward. I am
very grateful for the eyes of other (nonmicrobiology) scientists who have provided
valuable comments, including Shawn Tan, Krystal Vasquez, and Isabelle Rosenthal at
Commentary
May/June 2021 Volume 6 Issue 3 e00431-21 msphere.asm.org 2

ComSciConLA. Most importantly, I want to thank my partner Dimitri Chesne for his
editing and creativity, as he was the one who came up with the Hydra metaphor.
REFERENCES
1. Nerlich B, James R. 2009. “The post-antibiotic apocalypse”and the “war on super-
bugs”: catastrophe discourse in microbiology, its rhetorical form and political func-
tion. Public Underst Sci 18:574–590. https://doi.org/10.1177/0963662507087974.
2. Collins J, Brown E, Baym M, Wright G, Dantas G, Burrows L, Liu G, Fowler P,
Whitchurch C, Skelly A, Honda K, Strathdee S, Patterson T. 2019. Overcoming
antibiotic resistance. Cell Host Microbe 26:8–11. https://doi.org/10.1016/j
.chom.2019.06.007.
3. Alcock J. 2012. Emergence of evolutionary medicine: publication
trends from 1991–2010. J Evol Med 1:1–12. https://doi.org/10.4303/
jem/235572.
Commentary
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