BOOK REVIEW: Spillover by David Quammen

Spillover: Animal Infections and the Next Human PandemicSpillover: Animal Infections and the Next Human Pandemic by David Quammen
My rating: 5 of 5 stars

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SPILLOVER is a fascinating and in-depth exploration of zoonoses – i.e. diseases that can jump from various animal species into humans. This continues to be a germane topic in the face of our current zoonotic pandemic – COVID-19. The book came out in 2012 / 2013, but has seen a groundswell of interest because it’s the most well-known popular work on this subject. One will read a few sentences in the book that seem prescient, but the author and the many experts he consults would be the first to state that this is no act of mystical precognition. Rather, a zoonotic pandemic seems to be an inevitability given humanity’s huge and growing population and the nature of our interactions with the rest of the animal kingdom. Of course, no one could say precisely when or what pathogen would lead to “the next big one,” of which – it so happens – we are currently amid. Though coronaviruses do come up as potential candidates, but so do others (e.g. certain strains of influenza.)

The book is organized differently than most. It’s cut up into bite sized chunks, with 115 chapters that are usually not more than a few pages each. However, chapters aren’t the relevant unit of interest so much as the book’s nine parts, each of which takes on a particular zoonosis, or class thereof. Because zoonoses are such a huge topic, the author focuses on a few that are of particular interest for varied reasons, including: the challenge of tracking the disease’s origins, the potential to be the next big one, the global influence of some diseases, as well as other reasons a particular zoonosis generates an interesting story.

The first part explores one of the lesser known zoonoses (except for in locales where outbreaks have occurred, e.g. Australia,) Hendra virus. While a common species of bat (the flying fox) is the reservoir for Hendra, what makes the story gripping for humans is that humans contract the disease through the intermediary of horses. While interaction with exotic wildlife is the the mode throughout the book, the fact that, here, transmission occurs from one of humanity’s closest animal friends increases the closeness-to-home effect.

Part two shifts into one of the most dramatic and well-known of the zoonoses, Ebola virus. Ebola is familiar from Richard Preston’s book “Hot Zone,” though Quammen does explain how Preston sensationalized and overstated the physical effects of the disease. [Presumably what Preston did was take the most vicious looking case and describe it through as dramatic of analogies as possible, such that it became unrecognizable from the typical case.] At any rate, it’s a disease that grabs one by the fear center because – while it doesn’t spread readily – it’s highly lethal and is unarguably an unpleasant way to go.

Part three delves into malaria and P. falciparum, the bug that causes it. Malaria has profoundly shaped human existence in the tropics. A vector-borne disease carried and passed by mosquitos, Malaria is widespread throughout much of the world and continues to generate debilitating effects. Many concepts are drilled into one while reading this book, and one worth mentioning here is the differentiation of reservoirs and vectors. A lot of the stories in this book revolve around scientists’ searches for reservoirs – the species where the pathogen resides in waiting. It’s often much more difficult to uncover a reservoir species than it is a vector (vectors invariably coming into direct contact with humans, whereas reservoirs can be far removed from humans.)

Part four investigates Severe Acute Respiratory Syndrome (SARS.) This is one of the most relevant sections because SARS is a corona virus — like COVID-19 — and it served as a harbinger of a corona virus pandemic. SARS is also at least vaguely familiar to most people as it was a relatively recent epidemic.

The next two sections zoom out a bit and, instead of diving down into one zoonosis, they each consider a range of bacterial and viral zoonoses, respectively. Part five discusses Q fever, Lyme disease, Psittacosis, and other bacterial diseases that enter humans by way of other animals. Part six explores a range of viral diseases and – in the process – gives a bit of a lesson as to why viruses present such a risk as well as how different viruses work. This section covers rabies and Nipah virus.

Part seven tells the story of the search for the Marburg virus origin and reservoir. Marburg is similar to Ebola, but the story of the epidemiological search for it makes for intriguing reading. Part eight discusses HIV-AIDS and its simian predecessor, SIDS. What made this fascinating to me was that I learned that HIV has been around (at least) since the first decade of the twentieth century. If you’re like me, you associate the origin of AIDS with the 1980’s. However, with so many people regularly dying from so many different conditions in central Africa, it wasn’t obvious that those killers were getting an added help from a virus that crippled immune systems. It also took scientist a while to realize that SIDS was resulting in the death of chimpanzees. (It’s possible for a reservoir to be unaffected by a disease, and this is what they first thought to be the case.)

The final part is a wrap up that zooms out to look at the nature of episodes of ecological imbalance and “outbreaks” of species. In this case, “outbreak” is used to describe any explosion of population growth of a species. While the section opens with a species of caterpillars [forest tent caterpillars] that would occasionally flare up, killing off trees on a large scale, it discusses human population growth as an outbreak that – like all others – will inevitably end one way or another. This section also discusses influenza (which isn’t a major topic earlier in the book,) presumably because it had been the lead candidate at the time for the “next big one.” And “the next big one” is a related overarching theme in this section.

The book is annotated and has an extensive bibliography. There are few graphics, but there are maps that are helpful for those who aren’t familiar with the areas where many of these disease outbreaks originated (e.g. central Africa.)

I found this book to be intriguing. It teaches the reader some basics of epidemiology as it goes about telling the story of the spread of these diseases. [e.g. It will help one distinguish virulence and transmissibility – terms that are often used by neophytes interchangeably, but which are distinct in important ways.] However, the focus is always on the story and, therefore, it keeps these lessons interesting throughout. I’d highly recommend this book for those who are interested in the pandemic, zoonoses, or the challenges of combating disease.

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BOOK REVIEW: Healing Mushrooms by Richard Bray

Medicinal Mushrooms: Healing Mushrooms for Immune Support - Improve your Memory, Reduce Inflammation, and Fight Cancer (Urban Homesteading Book 7)Medicinal Mushrooms: Healing Mushrooms for Immune Support – Improve your Memory, Reduce Inflammation, and Fight Cancer by Richard Bray
My rating: 4 of 5 stars

Amazon.in page

 

This guide offers a concise overview of the medicinal use of fungi. It’s a soup-to-nuts examination of how to utilize approximately thirty different mushrooms for treatment of a wide variety of ailments.

The book consists of eight chapters. Each of the first three chapters is quite brief and provides simple background information about mushrooms as medicine. The detailed information begins with chapter four, which provides an in-depth overview of fungi and the characteristics by which which some of them derive health and medicinal benefits. Chapters five and six repeat some of the same information, but from opposing angles – making it easier for the reader to find the information they are seeking. Chapter five describes the mushrooms, including a brief mention of the uses of each. Chapter six, on the other hand, introduces a range of ailments and medical conditions, and suggests which of the mushrooms have been studied as remedies. There are endnotes, directing one to the papers in which the scientific results appear. This is also where one finds information on dosages.

Chapter seven shows various approaches to preparing mushrooms for use as medicine. Not all of the mushrooms can be eaten, some require tinctures or other preparations to be made, and this chapter explains how to do that work in a step-by-step fashion. For the mushrooms that can be eaten, it describes the relative merits of different cooking methods. The last chapter discusses where to obtain mushrooms. It offers considerations for foraging mushrooms, but also tips for commercially acquiring them.

The book has many graphics. These include color photos of the various species of mushrooms as well as some drawings and diagrams throughout. The chapter on preparation has graphics interspersed within the textual directions to offer a visual indicator and break up the text. As mentioned, there is a huge set of paper references arranged as endnotes linked to the places (largely in chapter six) where findings are cited.

If one is wondering, the book does not discuss any mushrooms with psychoactive (psychedelic) properties (e.g. psilocybe.) Many of the mushrooms included will be well known to culinary mushroom users (e.g. button, portobello, enoki, lion’s mane, chicken-of-the-woods, shiitake, and oyster mushrooms.) Others were familiar to me [as someone with a minimal knowledge of mushrooms] even though it wasn’t from their culinary use (chaga, reishi, and jelly ear.) And a few of the fungi I was unfamiliar with before reading the book.

I found this to be a useful book. It’s concise and offers attractive and useful graphics. If you are interested in medicinal mushrooms, check it out.

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BOOK REVIEW: Pale Rider by Laura Spinney

Pale Rider: The Spanish Flu of 1918 and How It Changed the WorldPale Rider: The Spanish Flu of 1918 and How It Changed the World by Laura Spinney
My rating: 5 of 5 stars

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Before the present-day COVID-19 pandemic, the Spanish Flu of 1918 seemed to be a largely forgotten historical footnote. It was overshadowed by its more explosive, if less lethal, co-event, World War I – the war that was fallaciously believed to hold the promise of ending all wars. Furthermore, Spanish Flu never achieved the mystique of the Black Death. In fact, among the fascinating questions this book examines is why such a world-changing event isn’t more diligently studied. Of course, these days there is a sort of grim desire to understand what happened in 1918 and what – if any – lessons can be learned.

[Which isn’t to suggest that that Influenza virus pandemic was perfectly analogous to the present Coronavirus pandemic. In 1918, science was still at a state in which there remained debate about whether the disease resulted from a bacterium or a virus, and — in some sense — it didn’t matter because they didn’t have good treatments for either. For COVID, we had accurate tests in short order, and will no doubt have a vaccine at some point in the coming months. That said, I’m not dismissive of COVID-19. As I understand it, COVID’s R-nought (reproductive ratio), and the fact that both pre-symptomatic and asymptomatic transmission occur make the current pandemic serious business. Furthermore, while scientific understanding has increased radically, human psychology is surprisingly similar and some of the same conspiracy theories and wishful thinking that made things worse a hundred years ago may prove to do the same today.]

The strength of Spinney’s book is that it takes global perspective. It doesn’t fixate on the United States (where the 1918 Flu was first understood to its own, new disease) or Europe (where it was inexorably linked to the fighting, and got its fallacious name of “Spanish Flu.”) In addition to these locals, Spinney’s telling visits and revisits China (one of the alternative candidates for ground zero,) India (which suffered tremendous fatalities from the disease,) Brazil, and a number of other countries around the globe.

The book’s twenty-two chapters are arranged into eight parts. While these divisions are topically organized, emphasis is given to the stories being told and so said topics aren’t in one’s face but are, rather, background that is subtly presented in narrative form. Chronological consideration is tertiary. The penultimate part (Part VII) does explore the world in the wake of the Spanish Flu, but discussion of attempts to find the true index patient (a.k.a. patient zero) don’t take place until chapter 11 [Part V.] [To clarify, the acknowledged patient zero was a soldier at a US military base in the middle of America, but there are widely divergent thoughts about how long the disease might have been infecting people before that – masked either by the war or by the lack of data collection and reporting throughout the world. The only thing that is widely agreed upon is that the “Spanish Flu” didn’t originate in Spain.] I’m certainly fine with meandering on chronology in order to serve a more appealing narrative.

A lot of the subjects covered are interesting, but are what one would expect, e.g. what was it like to live in the midst of Spanish Flu. Therefore, I want to focus on a few topics that I found particularly interesting because they were illuminating, but weren’t necessarily what I anticipated. One set of topics addressed sheds light on just how different a time 1918 was. I suppose different people have different ideas about how modern the early 20th century was — relative to today. To me it was interesting to hear about church leaders calling upon people to attend services because there was an idea that the Flu was a result of god finding humanity’s “lack of faith disturbing.” [I quote Darth Vader, not this book’s author.] I’m sure there are priests and preachers saying the same these days, but I also suspect those voices are so far into the lunatic fringe as to not merit much attention, but not so in 1918 (and, thusly, many went to sit in high-density churches only to spread the flu more effectively than any virus could hope for.) Another interesting insight into the level of modernity was Spinney’s explanation of the fact that medicine, as we know it, had not yet risen to a favored spot above approaches like homeopathy and shamanism. Lest it sound like I’m engaging in the outhouse fallacy; I will say that people are falling in many of the same holes despite more advanced understanding of viruses – particularly as regards to people’s desire to impose order and purpose on a natural event.]

The other discussion that I found unexpected and revelatory was about the dearth of art and literature on the subject of the 1918 Flu. Spinney describes the effects of Spanish Flu on many major artists of the time, but goes on to discuss how few of those who survived the flu in 1918 brought it into their works. She does also discuss some of the works that did come about, as well.

I found this book fascinating from cover to cover. The fact that it covered so much ground geographically as well as topically was part of that intrigue. Learning what changes occurred in the wake of the 1918 Flu has certainly helped me consider what to expect in our future. The similarities and differences between then and now also surprised me. Just like today, there were a lot of wildly bizarre conspiracy theories from people who had to make sense of both the randomness of the Flu’s action and the fact that it put such a nasty a crimp in their lifestyle. It’s also interesting to consider some of the more intellectually stimulating theories – e.g. that part of the reason for the lethality of Spanish Flu is that in the theater of war, the virus didn’t benefit from the internal restraint usually shown (because people were dying so rapidly) and so mutations that favored a quick and harsh influence made gains. [For those who aren’t aware, it was the second wave of the Spanish Flu that was really nasty. The first wave was like seasonal flu for almost everyone, and by the third wave the virus didn’t have much of a reservoir of those without acquired immunity and so petered out relatively quickly.]

If you want to learn more about Spanish Flu, I’d highly recommend this book – particularly if you are interested in the global story and the after-effects of the disease.

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POEM: Ode to My Immune System [Day 8 NaPoMo: Ode]

I

Accused of failing to think about you,
I cannot deny that it’s true.
My lymph bristles with white blood cells
that make invading me treacherous hell.
And leucocytes are just a start,
marrow and spleen each play a part.
I can’t thank you all in this strophe,
but if I could I’d give you each a trophy.

 
II

I can’t say I recall each time I’ve been sick,
but my T-cells must surely have a nice trick
cause they’ve got them etched from first to last,
dating back fifty years in my past.
And if my thymus weren’t a taskmaster
I fear my life would end in disaster
for my body would self-cannibalize.
[And if that idea gives me teary eyes,
tears have antimicrobial enzymes.]
If I had to think about all the times
my NK-cells shivved a potential tumor,
I couldn’t maintain such good humor.

 
III

My ode is almost done, and many were left out.
The truth is there’s a lot that I don’t know about.
So, it’s not that I don’t love my antibodies.
Nor that I think their work is shoddy.
I just didn’t do well enough in Chemistry
to describe their heroism with rhymed brevity.
Skin, lung cilia, gut mucus, and macrophage
each deserve more words up on this page…

than have smarts to write.

BOOK REVIEW: The Immune System: A Very Short Introduction by Paul Klenerman

The Immune System: A Very Short IntroductionThe Immune System: A Very Short Introduction by Paul Klenerman
My rating: 5 of 5 stars

Amazon page

 

This is a volume in the “A Very Short Introduction” [AVSI] series put out by Oxford University Press on a wide variety of scholarly subjects. As the series title suggests, the central objective of AVSI books is to pack as much of the fundamentals of a topic into as slim a package as possible. I read quite a few of these to get the gist of a subject without a lot of extraneous information. In short, they are brief and provide a high caliber understanding of the topic, but they aren’t written to be entertaining and they assume a basic scientific literacy. They usually weigh in at between 100 and 200 pages. (In this case, 144 pp.)

I found the seven chapters were optimally arranged. Chapter 1 describes and delineates the immune system, which isn’t as easy as it might seem. Putting the immune system inside neat borders is hard. If you simply describe it as the body’s defensive system, you quickly run into problems at the edges of competing classification. Sure, B cells and T cells are clearly part of the immune system, but what about skin and mucus membranes? Where does the lymphatic system end and the immune system (which uses it extensively) begin?

Chapters two and three explore the two major divisions of the immune system: the innate and the adaptive. These days, with COVID-19 at the center of global attention, the distinction is probably clear to most. The innate system isn’t geared to take on specific invaders. It has the advantage of being able to fight almost any invader, but the disadvantage of not being able to keep up with invaders that grow rapidly, are good at disguise, or both. An adaptive system response is what we all lack for COVID-19 because it only recently jumped to our species (well not “all of us,” those who had it and are recovered have adaptive immunity and that’s why they don’t have to worry about getting it again [those who have properly working immune system, at least.]) The adaptive response recognizes specific invaders and can raise an army against them tremendously quickly. Vaccines train the adaptive system to build such a response (typically by injecting a weakened strain into the body, but more detail is provided in the final chapter.)

Chapter four is entitled “making memories,” and it is an extension of chapter three. It further investigates adaptive immunity by focusing on the question of how the body develops a memory of those invaders it’s crushed in the past (or that it learned to crush by way of vaccination.)

The next two chapters delve into the two opposing ways the immune system can fail. Chapter five is about immunological failure, or how and why the body sometimes isn’t up to defeating invading adversaries. Most famously this is seen in HIV / AIDS patients, but there are other ways that the system fails in its job as the body’s bouncer. Chapter six looks at what happens when the immune system is too aggressive. [It’s important to realize that not only does the immune system check out foreign bodies, it also checks the tags on the body’s own cells, killing those that don’t display a proper “tag.”] The two major categories of over-performance are: autoimmune disorders (when the body wrongly attacks its own cells) and allergies (when the body goes all “This is Sparta!” on relatively benign foreign objects.)

The last chapter looks briefly at what work is being done in medicine these days involving the immune system, including approaches to vaccines, immunotherapy, biological therapies, and work on inflammation and the how the immune system is linked to aging.

If there was one topic I wish was better (more extensively) handled it would be discussion of what is known about how and why lifestyle choices influence immune system operation. There was a mention of how smoking has been linked to a specific immune system deficiency, and a general comment on how diet and exercise appear to be linked to increased effectiveness of autophagy (the body’s process of self-consumption and recycling of cells,) but that’s pretty much it. As there is a lot to cover in a small space, it’s hard to be too critical about this, but it seems like a crucial topic (if not as scientifically sexy as vaccine research, which is discussed relatively extensively.)

I found this book did as advertised, give me the immune system basics in a quick read. It has simple illustrations to support the text, and has a table of abbreviations — which can be beneficial given the hugely abbreviately nature of the immune system physiology. There is also a “further reading” section, but it’s heavily focused on textbooks – versus presenting popular science books that cover the material in a more light and entertaining manner.

I’d highly recommend this book if you have a basic scientific literacy and want just the facts on immunity without a lot of meandering narrative.

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Thoughts of a Traveler Traveling Amid the COVID-19 Pandemic

I just returned from a week of traveling in Rajasthan and Punjab for Holi and Hola Mohalla, respectively. Because my trip involved only domestic travel within India, there were no formal disruptions, but evidence of concern about the virus was widespread.

The first thing one notices is that instead of a few East Asian tourists protecting themselves against the poor air quality of megalopolises, at least a third of those traveling were wearing masks. Some unknown percentage of these travelers presumably have sound, medically-directed reasons for donning the masks (e.g. they have some sort of infection, they have compromised immune systems, etc.) but for many they are merely a security blanket. I suspect the reason that “wear masks” isn’t a part of the advice of public health experts has to do with the two types of masks that one sees:

First, the type that are to keeping out virus as a chain-link fence is to keeping out mosquitos.

Second, the type that will keep out virus (if worn / changed as directed,) but which — because they are expensive and hard to come by — are worn far too long, such that they become a nice warm, moist petri-dish pressed up against one’s face.

I don’t begrudge anyone a security blanket. In fact, a lot of what I’m suggesting herein are ways to maintain a confident and positive attitude so your immune system can be its awesome self — whatever that takes. My worry about the mask phenomena is that some people seem to believe that if one little viral agent makes it inside their body they are doomed. That’s simply not the case. If a viral marauder gets into your body, its chances of being escorted right back out by your body’s mucosal bouncers, swallowed whole by a macrophage, dissolved in your stomach’s acid bath, or otherwise being discovered and destroyed by your body’s sentry force is quite good.

In short, a mask isn’t your last line of defense. It’s a first line of defense that’s followed by an immune response that is swift and deadly to foreign invaders. It should be noted that nose-breathers already have a kind of mask, in the form of the nose and nasal passages. When you breath through your nose, your natural filtration system is at work. If you tend to breath through your mouth (particularly during inhalation) you have a lessened defense.

If you have trouble maintaining nose-breathing under all circumstances, I’d recommend a pranayama (yogic breathing exercises) practice. I don’t know how well it’s established by study, but I’ve found that I breath much more effectively and consistently through my nose since I’ve regularly practiced pranayama. Another helpful yogic tool is kechari mudra, which has helped me to even run without mouth breathing. (Kechari mudra involves curling the tongue so that the bottom of the tongue rests against the soft palate at the back of the roof of one’s mouth. This seems to reduce turbulence that would be created by air swirling in one’s oral cavity, and makes more of a direct line of travel for the breath in and out through the nasal passageways. At a minimum, it focuses one’s attention on the area the breath is passing through, and makes one aware of the breath.)

All this talk about one’s immune system keeping one safe may seem a bit pollyannaish or over-optimistic. Don’t get me wrong, I follow and would recommend others follow all the basic precautions regarding washing one’s hands and minimizing hanging out in high density environments — particularly high density environments with high-risk individuals. (i.e. for the asymptomatic [or alternatively-symptomatic individuals, i.e. those who have something but probably not COVID-19] who think they absolutely must be tested to have peace of mind, realize that you are likely walking into a high-risk environment and increasing your chance of self-fulfilling prophecy. Just sayin’. If you are able to rest comfortably, you might want to consider doing so.)

Back to the issue of being irrationally optimistic or a Pollyanna. My response is: fair enough. But there is an upside to being overly optimistic (if cautious) but none-whatsoever to being a worrier. Again, by being “a worrier” I’m not talking about taking precautions, I’m talking about obsessing or being needlessly pessimistic about the bodily systems (e.g. your immune system, your lymphatic system, your digestive system, etc.) that are keeping you safe all day and everyday.

I’d say if there is an upside to the pandemic, it was in reminding me to practice gratitude toward my body, my immune system, my gut bacteria, etc. — all of which keep me feeling excellent 99.9% percent of the time. Does that mean I think I can’t catch infection? No, it doesn’t, but it does mean that if I catch one my body will be much more effective at defending itself.

So when people ask me why I’m not worried about traveling, it’s because my immune system is awesome and I’m thankful for it every day.

A couple of post-scripts:

– I’ve been seeing the swarm of memes about toilet paper shortage in the US. Having moved to a part of the world that recognizes that wiping one’s backside with dry paper isn’t the height of sanitary practice, all I can say is: “You might want to look into what most of the world does most of the time.”

– I understand that there is a desire to curtail a wider spread of the virus, but this easily tips into a form of xenophobia — “a your COVID-19 is worse than our COVID-19.”  If a person is without symptoms, being Chinese (or from any other country with many cases) doesn’t mean that they are Typhoid Mary.

BOOK REVIEW: Pain: Considering Complementary Approaches by NCCIH

Pain: Considering Complementary ApproachesPain: Considering Complementary Approaches by National Center for Complementary and Alternative Medicine
My rating: 4 of 5 stars

Online here

 

The National Center for Complementary and Integrative Health (NCCIH) has put out a new edition (dated 2019) of its pamphlet (about 50 pages) about how useful various complementary practices are in helping patients reduce, or cope with, pain. The NCCIH is a center in the National Institutes of Health (NIH) that serves as a clearinghouse for information about how alternative and complementary practices perform in treatment of various ailments. While alternative (instead of mainstream medicine) and complementary (in conjunction with mainstream medicine) are quite different, in almost all cases this work herein is reporting on the latter basis. The complementary practices in question include: yoga, taiji, meditation and mindfulness, massage, acupuncture, chiropractic manipulation, relaxation methods, and others.

Complementary approaches to treatment of pain is a particularly salient topic these days as the mainstream medical approach (giving patients pills to gobble down) has resulted in what many have called a “crisis” of opiate addiction. So, if it’s possible to reduce the grip of pain with practices that at best have numerous other health benefits and at worst do no harm, than that’s a pretty good outcome.

Chapters three through eleven form the pamphlet’s core, and all but the last of those look at one complementary practice each, including (in order): acupuncture, massage, meditation, relaxation techniques, spinal manipulation, taiji (a.k.a. tai chi, or tai chi chuan), yoga, and dietary supplements and herbs. Chapter 11 discusses a few additional (less popular) practices. These chapters follow a three-prong approach: 1.) is it safe? 2.) does it help mitigate pain? and 3.) where can I find more information? [Spoiler alert: In almost all cases the answer to #1 is roughly “Yes, for most people, but possibly not for you. Check with your doctor,” and to #2 is usually something like: “there is some preliminary evidence that in certain cases certain people may have benefited.”] The chapters before (ch. 1 & 2) and after (ch. 12 to 14) provide background context and additional information.

On the positive side, it’s great that this information has been gathered together and packaged into a readable format with pictures and easy to read text.

On the down side, this was clearly a document put together by a committee of bureaucrats in consultation with lawyers. It is so laden with qualifiers and spongy speak that it’s impossible to discern how strong the evidence is for the various practices or how one compares to another. I felt that they could have given the same information in a three-column table in which the first column is the practice, the second column is “can’t hurt to try*” [*provided your physician concurs,] and the third column would be “nah, this stuff is fake.” [Spoiler alert: almost everything besides homeopathy would have the first column checked, but the consensus seems to be that homeopathy is pseudo-scientific quackery designed to sell water at medicinal prices.]

This booklet is available on the web for free, so if you’re interested, check it out. But don’t expect to come away with any profound insights. It’s not that kind of booklet.

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BOOK REVIEW: Sound Medicine by Kulreet Chaudhary

Sound Medicine: How to Harness the Power of Sound to Heal the Mind and BodySound Medicine: How to Harness the Power of Sound to Heal the Mind and Body by Kulreet Chaudhary
My rating: 4 of 5 stars

Amazon page

 

The Longfellow poem “There Was a Little Girl” has a line that says, “…When she was good, She was very good indeed, But when she was bad she was horrid.” That’s kind of how I felt about this book. At its best, it reports findings about how practices involving sound (i.e. mantra chanting) effect health and well-being, and lends insight into why sound sooths. At its worst, it tries to sledgehammer the square peg religious / spiritual practices into the round hole of quantum physics and foundational physics, often engaging in leaps that are at best wildly speculative, while presenting them as though they are as likely as not.

My favorite professor from undergraduate studies was a folksy Religious Studies Professor who cautioned against two opposing fallacies. The first he called “the outhouse fallacy.” This is assuming that because people of the past didn’t have indoor plumbing that they were complete idiots. Let me first say that, until recently, yoga (and other complementary health practices) suffered its fair share from this fallacy among doctors and the scientific community who felt that it couldn’t possibly help with health and well-being because it wasn’t rooted in the latest scientific findings. However, there is an opposing fallacy that my teacher called the “firstest-is-bestest” fallacy, which assumes the ancients figured it all out and we are just bumbling around in the dark hoping to stumble back into what they once knew. Scientists are prone to the first fallacy and the second is rife among religious folk. As a medical doctor who turned to siddha yoga (a form that puts a great deal of belief in superpowers and magic), Chaudhary had a rough road to not fall into one of these fallacies and, in my opinion, she falls more into the second — sounding at times like the ancient yogis knew more about the subatomic world and consciousness than science ever will. Most of the time, she words statements so that a careful reader can recognize what is well-supported and what is speculative, but she’s rarely explicit about the degree to which speculations are such, and I don’t remember an instance in which she presented an alternative that would undermine her argument. (i.e. The unstated argument seems to be that mantra is special among practices, that its usefulness is embedded in the fundamental physical laws of the universe, and, therefore, that it works by mechanisms unlike other meditative / complementary health practices [i.e. by engaging the parasympathetic nervous system so the body can make repairs using established biological mechanisms.])

In a nutshell, there is a “god in the gaps” approach to the book that says, look we don’t understand consciousness or all the “whys” of quantum mechanics, ergo there must be supernatural explanations. I don’t think that because we’ve used EEG since the 1920’s and fMRIs since the 1990’s and still haven’t yet unraveled the hard problem of consciousness that we need to say that god / supernatural forces are where we must look for explanation. The gap is ever closing, slowly but surely, and there’s no reason to believe it’s reasonable or useful to cram commentary from Vedas (or any other scriptures) to fill the gap.

It’s not only the science where Chaudhary presents a belief as though it is established truth without alternative explanations. Early on, she states that colonization is the reason for the decline of meditation in India. Don’t get me wrong, I’m as accepting that colonization resulted in a great number of evils as anyone, but it’s a leap to say that – therefore – every negative a society faces is because of its colonizer. I would point to Thailand, a society that was never colonized (except a brief period by the Burmese) and which is primarily made up of Theravadan Buddhists (a system for which meditative practice is considered central,) most of whom also do not meditate regularly today. I suspect a more logical explanation for the fact that most Indians don’t meditate today is that: a.) it’s hard work and time consuming (as a productive endeavor it’s not bread-winning and as a leisure time activity it’s laborious,) and b.) the majority of Indians (like the majority of Thais) probably never mediated. (When we look back in time, we often want to create this wholesome and uniform image that what we have writings about was how everyone lived, and that probably never reflects the truth.)

So now that my rant is over, I should say that I didn’t think this book was horrible, by any means. It has a lot of good information, and some of the speculative bits offer interesting food for thought. As long as one reads it carefully and with a healthy dose of skepticism, it’s a beneficial consideration of sound and vibration in health and well-being. It’s just that when I compare it to, say, Davidson and Goleman’s “The Science of Meditation” (which I reviewed recently) this book is far less careful about presenting the science, eliminating pseudo-science, and letting the reader know what is controversial and speculative versus what is well-supported by sound and rigorous investigation.

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BOOK REVIEW: A Stranger Truth by Ashok Alexander

A Stranger Truth: Lessons in Love, Leadership and Courage from India's Sex WorkersA Stranger Truth: Lessons in Love, Leadership and Courage from India’s Sex Workers by Ashok Alexander
My rating: 5 of 5 stars

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In 2003, Ashok Alexander left a prestigious job at the advisory firm McKinsey and Company to head up the Gates Foundation’s HIV/AIDS prevention program for India. He had no experience in public health and faced an HIV prevention challenge on a scale and of a nature that hadn’t been seen before. This book describes his experiences — and sometimes those of others in Avahan (the Indian HIV Prevention program.) However, the emphasis isn’t on patting himself and his team on the back so much as pointing out the lessons they learned from the high-risk populations they served – mostly sex workers, but also their clientele, as well as intravenous drug users.

The nineteen chapters of this book are arranged into two parts. The first part (Ch. 1 thru 11) explores Alexander’s travels around the country to meet with various high-risk groups and learn about their needs. The second part (Ch. 12 thru 19) takes a deeper dive into the building of Mysore’s program, Ashodaya, which became a global educator on HIV prevention.

Part one offers insight into bits of India that most of us never see. When I mentioned that the problem in India wasn’t just it’s large size, but also the peculiar nature of the environment, that can be seen throughout these chapters. What do I mean by the peculiar nature? In India, not only is prostitution rarely practiced in brothels, but sex workers are largely indistinguishable from the general population. The biggest portion of the group is women in saris who look like much of the female population. Also, the societal stigma is great, which creates all the more incentive to not let your work be known. For these reasons, just finding the at-risk population was challenging, they were dispersed and hid in plain sight. There were also problems of thinking that ranged from politicians who wouldn’t admit there was potential for massive HIV / AIDS in India because they insisted that Indians don’t engage in any of the “immoral” acts seen elsewhere in the world, to johns who honestly believed that drizzling lime juice on one’s manhood would prevent infections.

Among the most intriguing chapters in part one are those that reveal the issues with long-haul truckers (the single biggest demand-side high-risk population), intravenous drug-users in the golden-triangle adjacent states of the Northeast (i.e. Manipur and Nagaland,) and one that explained the unique cultural traditions of the transgender populations in India. There’s also a chapter (Ch. 6) that discusses the leadership traits that were found among the sex workers.

Part II, which dealt with the Mysore program, also had its fascinating elements. Two of the chapters discussed the life stories of two particular sex workers (one female and the other male) who worked in the Ashodaya program. There was also a chapter that dealt with the discussion of violence. That might seem like a diversion, but apparently violence and lack of prophylaxis go hand-in-hand, and had to be dealt with together.

The book has an Appendix of general information on HIV / AIDS and its occurrence in India. Other than that, a few maps and annotations are the extent of the ancillary matter.

I found this book fascinating — if heartbreaking in places. As someone who’s lived in India for over six years, there was a great deal of insight offered into segments of the population of which I had little awareness. Even learning about the trucking industry (divorced from the sex work / HIV angle) was intriguing. I’d highly recommend this book if one is interested in the topics of: leadership, public health, or the unseen side of India. The author uses a narrative approach throughout to great effect.

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BOOK REVIEW: Chloroform by Linda Stratmann

Chloroform: The Quest for OblivionChloroform: The Quest for Oblivion by Linda Stratmann
My rating: 4 of 5 stars

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Stratmann’s book tells the story of the rise, fall, and debauchment of the anesthetic known as chloroform. As such, most of the book — particularly in the first half — is a medical history that offers detailed discussion of the debates that went on between doctors as to whether chloroform was the best form of anesthesia available, or whether an alternative approach was superior. (Contenders include: ether, nitrous oxide, or the old-fashioned approach of no anesthesia whatsoever.) The book also discusses a number of cases in which chloroform was used in the commission of a crime, or was speculated to have been. On the topic of vice, the use of chloroform as a recreational drug is also described. For those who aren’t medical historians, the explorations of chloroform in crime, vice, and licentiousness are where the book gets intriguing, and they tend to take place in the latter half of the book. [That makes sense from a chronological perspective as it took some time before laypeople became aware of the range of uses of this substance.]

The book is well-written and follows the intrigue. That said, it’s definitely a niche work. I came at it from the strange direction of one who is interested in consciousness (and, by extension, how it is lost.) This book could appeal to those interested in the history of medicine, true crime, or recreational drugs, but, regardless, it’s a niche within those niche fields.

The book has graphics, annotations, a bibliography, and even an appendix that describes the chemistry of chloroform. It comes with all the bells-and-whistles one might expect of a scholarly book, but tells a story skillfully. The author is neither a journalist nor a scientist, but she seems to have done an extremely thorough job of research.

If you only read one book on the history of chloroform this year, make it this one. [Disclaimer: As far as I know, this is the only history of chloroform, and it’s certainly the only one that I’ve read to date.]

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