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Clinicians Star in Off-Broadway Musical About Antimicrobial Resistance

— Past and present collide in a show with an important public health message

MedpageToday
A photo of an advertisement for the Lifeline play outside the Signature Theater in New York City.

It's not every day that working scientists and healthcare professionals sing alongside seasoned actors in a show, let alone in a musical about a pressing public health threat. But "Lifeline," an off-Broadway show about antimicrobial resistance (AMR), is not your average production.

The show intertwines Scottish physician-microbiologist Alexander Fleming's 1928 groundbreaking discovery of penicillin with the story of Jess, a fictional modern doctor in Scotland trying to save the life of her childhood sweetheart who is fighting an AMR infection after cancer surgery.

Themes cross over between the timelines; both Fleming and Jess struggle to treat patients in urgent need of care and experience pushback while trying to change the practice of medicine. When Fleming won a Nobel Prize in 1945, he warned of the danger of AMR -- decades before Jess is shown struggling to treat patients affected by it.

In recent years, global experts have warned that AMR must be addressed now, which requires adequate funding. One of the core messages in "Lifeline" is that systemic issues like AMR are difficult to tackle, but that doesn't mean it's not worth the effort. And the people who are doing that work? Well, they're part of the show.

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Image credit: Andrew Patino

In addition to the principal cast, each week of the show's 5-week run features a different 12-person Greek chorus of real-life healthcare professionals and scientists who sing backup vocals and share vignettes inspired by actual patient stories. Hundreds auditioned for each of the 57 slots in the chorus, including medical residents, epidemiologists, PhD students, members of the CDC and Environmental Protection Agency (EPA), mental health professionals, and health department workers. Many are local to New York but several traveled across the U.S. to be in the show.

One of the chorus members, Brandon Warren, MPA, associate director of hospital operations at Memorial Sloan Kettering Cancer Center in New York City, said being in a cast of healthcare workers telling the story of a pressing public health problem was profound.

"All of us hailing from healthcare backgrounds added a greater sense of urgency and a prodigious commitment to the overall quality of the show," Warren said. "Obviously, AMR is a real concern and is unfortunately underreported, which this show helps to spotlight."

Despite themes highlighting the systemic nature of AMR, the show ends triumphantly with members of the chorus each sharing who they are, what they do, and how their work ties into tackling AMR.

Chorus member Judy Minkoff, PhD, a virologist in the department of microbiology at New York University Langone Health in New York City, said that this lends "huge credibility to this message that AMR is a public health crisis."

In general, Minkoff said that the "science communication aspect of this musical is really unmatched." Audience members are sent a pre- and post-show survey about AMR so the team can see if audience's understanding of core AMR concepts improves.

Meghan Perry, MBChB, PhD, a Scottish-trained infectious diseases NHS consultant physician who researches AMR, also serves as the scientific advisor to the show. The creative team meticulously researched the life of Fleming and even spoke to his family members and visited his lab, Minkoff said.

Sarah Tupchong, MD, an internal medicine resident physician at Montefiore Medical Center in New York City, squeezed in her appearance in the show by moving around clinic sessions. The show takes place in Scotland, and Tupchong pointed out some key medical terminology is different across the pond. For instance, a "consultant" in the U.K. is an attending physician in the U.S. and a "junior doctor" -- as the character Jess is -- is the equivalent of a resident physician -- what Tupchong is.

"I'm the real-life Jess," Tupchong joked. But in the big picture, Tupchong said she hopes audience members go home knowing that antibiotics aren't needed for everything and that taking them too often or incorrectly contributes to AMR in the long term.

Eva Chebishev, a microbiology PhD student at the Icahn School of Medicine at Mount Sinai in New York City, said that "Lifeline" helps humanize the faces of AMR. She added that the show "is not just about the history and importance of penicillin. It's about the people affected by AMR everyday. It's people who drive the story and who conduct change."

Chebishev knows this firsthand; as she shares in the show, she's a methicillin-resistant Staphylococcus aureus (MRSA) survivor herself.

Previously called "The Mold That Changed the World," "Lifeline" already sold out twice at the Edinburgh Festival Fringe in 2018 and 2022, and has played in Scotland, England, and in a few east coast hubs. Earlier this summer, the production released of the show's Scottish folk music-inspired soundtrack, with song titles like "Tip the Odds in Our Favour" and "I've Done All That I Can."

"Lifeline" -- which has received support from GSK, Merck, and other healthcare organizations -- is playing at the Alice Griffin Jewel Box Theatre at The Pershing Square Signature Center in New York City through September 28th. Tickets and more information at .

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    Rachael Robertson is a writer on the 鶹ý enterprise and investigative team, also covering OB/GYN news. Her print, data, and audio stories have appeared in Everyday Health, Gizmodo, the Bronx Times, and multiple podcasts.