Clinicians Star in Off-Broadway Musical About Antimicrobial Resistance

It’s not every day that scientists and health professionals sing alongside seasoned actors in a show, much less a musical about a pressing public health threat. But “Lifeline,” an off-Broadway show about antimicrobial resistance (AMR), is no ordinary production.

The series weaves together the revolutionary discovery of penicillin by Scottish physician-microbiologist Alexander Fleming in 1928 with the story of Jess, a fictional modern-day doctor in Scotland who attempts to save the life of his childhood sweetheart who is battling an AMR infection after cancer surgery.

The themes overlap across timelines; both Fleming and Jess struggle to care for patients in dire need of care and face resistance as they attempt to change the practice of medicine. When Fleming won a Nobel Prize in 1945, he warned of the dangers of AMR—decades before Jess is shown struggling to care for patients with it.

In recent years, global experts have warned that AMR needs to be tackled now, and that requires adequate funding. One of the key messages of “Lifeline” is that systemic problems like AMR are hard to solve, but that doesn’t mean it’s not worth it. And the people doing the work? Well, they’re part of the show.

In addition to the main cast, each week of the show’s five-week run, a different 12-person Greek choir of real-life medical professionals and scientists sings along and shares vignettes inspired by real-life patient stories. Hundreds of people auditioned for each of the 57 spots in the choir, including medical residents, epidemiologists, doctoral students, CDC and Environmental Protection Agency (EPA) staff, mental health professionals, and Department of Health employees. Many are from New York, but several traveled across the United States to appear on the show.

One of the choir members, Brandon Warren, MPA, associate director of hospital operations at Memorial Sloan Kettering Cancer Center in New York, said being part of a group of health care professionals telling the story of an urgent public health issue was profound.

“We all come from the healthcare industry and brought a greater sense of urgency and a tremendous commitment to the overall quality of the show,” Warren said. “Clearly, AMR is a real concern and is unfortunately underreported, which this show helps shine a light on.”

Despite themes highlighting the systemic nature of AMR, the show ends triumphantly with the choir members each sharing who they are, what they do, and how their work relates to the fight against AMR.

Judy Minkoff, Ph.D. and a virologist in the department of microbiology at New York University Langone Health, said this gives “tremendous credibility to the message that AMR is a public health crisis.”

Overall, Minkoff said, “the science communication aspect of this musical is really unmatched.” Audience members are given a pre- and post-show survey on antibiotic resistance so the team can see if the audience’s understanding of the basic concepts of antibiotic resistance is improving.

Meghan Perry, MD, MBChB, is a Scottish-trained NHS infectious diseases consultant who researches antibiotic resistance. She is also a scientific advisor to the series. The creative team meticulously researched Fleming’s life, even speaking to his family members and visiting his lab, Minkoff said.

Sarah Tupchong, a resident in internal medicine at Montefiore Medical Center in New York, managed to squeeze in a cameo appearance on the show by traveling from session to session. The show is set in Scotland, and Tupchong pointed out that some key medical terms are different across the pond. For example, a “consultant” in the UK is an attending physician in the US, and a “junior physician” – as Jess’s character is – is the equivalent of a resident physician – which Tupchong is.

“I’m the real Jess,” Tupchong joked. But overall, Tupchong said she hopes viewers go home knowing that antibiotics aren’t necessary for everything and that taking them too often or incorrectly contributes to AMR in the long run.

Eva Chebishev, a doctoral student in microbiology at the Icahn School of Medicine at Mount Sinai in New York, said “Lifeline” helps humanize the faces of AMR. She added that the series “is not just about the history and importance of penicillin. It’s about the people who are affected by AMR on a daily basis. These are the people who are moving the story forward and driving change.”

Chebishev knows this firsthand; as she shares on the show, she is resistant to methicillin. Staphylococcus aureus She herself is a survivor of MRSA.

Previously titled “The Mould That Changed the World,” “Lifeline” has already sold out two Edinburgh Festival Fringe runs in 2018 and 2022, and has played in Scotland, England and a few cities on the East Coast. Earlier this summer, the production released a concept album of the show’s Scottish folk-inspired soundtrack, featuring 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 health organizations, plays at the Alice Griffin Jewel Box Theatre at the Pershing Square Signature Center in New York City through September 28. Tickets and more information are available at lifelinemusical.com.