The Yetis’ Reply [Limerick]

A grouchy nitwit wrote a polemic
about how Yetis had caused the Pandemic.
The Yetis protested,
and kindly requested
the man ponder head-in-ass hygienics.

BOOK REVIEW: Introducing Epigenetics by Cath Ennis

Introducing Epigenetics: A Graphic Guide (Introducing...)Introducing Epigenetics: A Graphic Guide by Cath Ennis
My rating: 4 of 5 stars

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I’m old enough to remember when the human gene sequence was first being decoded, and there was a widespread belief that it was going to end genetic diseases in one fell swoop. It didn’t do that, and – in fact – seemed to result in whole new levels of confusion. It’s fascinating to me that now Epigenetics, a subject that grew out of that confusion, is also being seen as the ticket to ending disease. Epigenetics investigates what traits are expressed and why, given that a specific gene sequence has a vast array of potential for various traits to be (or not to be) expressed.

For those familiar with this series (the “A Graphic Guide” series,) this book is more difficult to digest than most titles, certainly than any of the several others that I’ve read. To be fair, the subject matter is more technical than most, leading to it being more jargon- and acronym-intensive. In addition, the subject isn’t cut up into as small of pieces as most of the books. This one has far fewer and longer chapters than the others that I’ve read.

That said, while it reads technically for the general reader, there are a few concepts (methylation, demethylation, and histone modification) that are frequently revisited throughout the book, and so one can get a basic grasp of those concepts. The book also explores some issues that are more readily understood by the lay reader, such as: nature v. nurture in gene expression, the role of twin studies, and how pseudo-scientific individuals and organizations have made fraudulent claims involving Epigenetics.

If you want to learn about the fundamentals of Epigenetics, you may want to look into this book — but keep in mind that it’s not a smooth read.

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BOOK REVIEW: The Exquisite Machine by Sian E. Harding

The Exquisite Machine: The New Science of the HeartThe Exquisite Machine: The New Science of the Heart by Sian E. Harding
My rating: 5 of 5 stars

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Release date: September 20, 2022

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In this book, a renowned heart researcher presents an overview of what we know (and don’t know) about the human heart: i.e. what can go wrong with it and why, how [and to what degree] it fixes itself, and what modern medicine can do to treat or replace a damaged heart. I learned the most from the middle of the book – i.e. chapters five through seven. Chapter five explores plasticity in the heart, plasticity is a concept that most people associate with the brain and its ability to rewire itself to contend with damage or changing needs. The other two chapters look at how the heart can be damaged, specifically as a result of emotional experience. A “broken heart” isn’t necessarily a misnomer.

Chapter four is also intriguing but takes the win for “which one of these things is not like the others.” It deals with big data, though not in a general sense but rather as it applies to gaining a better understanding of the heart. This chapter discusses a common challenge of medical research: that it’s hard to come up with large enough study groups of patients with close enough to the same problem to draw solid conclusions. Four also discusses the potential of the vast amount of data that exists, e.g. Fitbit heart rate figures.

The last couple chapters deal largely with the future of heart repair through genetic / biological means (as opposed to via mechanical hearts and technologies, which are dealt with in Chapter nine.) This is where the book gets to be a challenging read for a readership of non-experts. It gets technical and jargon- / acronym-heavy.

The heart is an astounding entity, relentlessly at work, rarely giving up despite regularly being subjected to intense shocks, an organ tied to our whole being in a way that humans have always felt – if only just begun to understand. If you’re interested in learning more about this magnificent organ, check this book out.

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BOOK REVIEW: Life at the Extremes by Frances Ashcroft

Life at the ExtremesLife at the Extremes by Frances Ashcroft
My rating: 5 of 5 stars

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Anyone interested in the limits of human physiology will find this book fascinating. Technically, its subject matter is broader than that, considering the environmental limits of living creatures, generally. However, all but the last chapter focuses on how humans react to (and adapt to) extreme conditions. Chapters one through six explore the challenges and limitations of humans under extreme conditions of elevation (ch. 1,) of pressure [underwater] (ch. 2,) of heat (ch. 3,) of cold (ch. 4,) of intense physical activity [running-centric, but deals with strength and power as well] (ch. 5,) and in space (ch. 6.) Then, each chapter reflects upon examples of species that are extremely well-adapted to said conditions, and why. (e.g. After learning about how and why humans have to acclimate to survive high elevation treks, one learns about the bar-headed goose, a bird that can go from sea level to flying over Everest – all in the same day.)

The final chapter (ch. 7) is a bit different in that it discusses extremophiles, creatures that can survive in a wide range of conditions (e.g. acidity, temperature, lack of moisture, lack of oxygen, etc.) that would be certain death not only for humans but for any animals. Most of the species discussed are either single-celled creatures or tiny multi-cellular life (e.g. Tardigrades.) With respect to humans, there is a discussion of the limits and present understanding of suspended animation.

This book offers an intriguing look at life at the extremes. While written by a Professor of Physiology, it’s highly readable for a general audience. It mixes narrative examples in with the discussion of physiology to make the material approachable and engaging. I’d highly recommend this book.


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BOOK REVIEW: Madness: A Very Short Introduction by Andrew Scull

Madness: A Very Short IntroductionMadness: A Very Short Introduction by Andrew Scull
My rating: 5 of 5 stars

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This is yet another of the many “Very Short Introduction” books from Oxford University Press that I’ve been pleased to read and review. The series offers concise overviews of a wide range of topics that are presented by scholarly experts. This particular book is a historical examination of the changing approaches to mental illness from the ancient world where such a condition might be attributed to demonic possession to more recent times in which drugs and decarceration / defunding of asylums have become the dominant approaches to mental illness. Along the way the book shines a light on the immense difficulty experts have had in understanding what mental illnesses are and how they can best be dealt with. The book not only looks at the real-world response to mental illness, but also explores how it’s been treated in fiction from “Hamlet” to “One Flew over the Cuckoo’s Nest.”

The book consists of six chapters. As one would expect of a book from a historian’s-eye view, its organization is chronological, but the arrangement of time periods by chapter reflects changing approaches to mental illness. Chapter one focuses on the ancient world, during which we begin to get glimpses of madness in the written record. Chapter two, entitled “Madness in Chains,” focuses on the 16th through 18th century, during which Bethlem [Bedlam] Hospital was the cutting edge. That the institution’s nickname becoming a synonym for chaos and confusion says a lot. It was a time of brutal measures that did little to reduce the trauma of mental illness. The chapter also discusses madness in Elizabethan literature, famously that of Shakespeare.

Chapter three shifts to the 19th century, an era in which incarceration became more widespread as well as coming to be thought of as the best that could be done for the insane. In Chapter four, we learn about the rise of psychoanalysis as well as the increasing employment of treatments that involved the physical body – infamously, the lobotomy.

Chapter five is one of the most intriguing parts of the book. Entitled “Madness Denied” it opens with an exploration of the difficulties that arose from all the war-related cases of mental illness that came about as a result of the two World Wars (and others.) It also discusses a movement to overturn the prevailing approach to insanity, most famously and vociferously argued by the Scottish psychiatrist R.D. Laing, a clinician who had a mix of promising and disastrous results from his experimental approach which used LSD, but few other medicines. What I found most interesting, however, was the discussion of the growing recognition that there was a false front in the idea that psychiatry was beginning to really understand mental illness and its treatment. This was exemplified by the Rosenhan experiments in which sane volunteers checked themselves into asylums and, for the most part, the doctors and staff couldn’t tell that they were sane (though, interestingly, in at least some cases the other patients did call it out.) The troubles in classifying and diagnosing mental illnesses have also seen in the vexed history of the “Diagnostic and Statistical Manual of Mental Illness” [DSM,] a guide meant to get mental health experts on the same page about what’s what. [As opposed to ten psychiatrists offering ten different diagnoses of a given patient.] While a worthy attempt, the DSM has not – thus far – succeeded, though it could probably be argued that progress has been made.

The last chapter brings the reader up to the current period, a period dominated by two trends – first, mental illnesses being treated overwhelmingly pharmaceutically; and second, the closing of asylums and the concurrent ill-effects that have come about, societally speaking.

The book has a few graphics, mostly black and white art and photos used to enhance the reading experience. There are also appendices of references and recommended readings.

If you are interested in the history of psychiatric medicine, I’d highly recommend you check out this brief guide. It may not give you all the information you’re looking for, but it’s a good first stop to organize your thoughts on the subject.

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BOOK REVIEW: Breath Taking by Michael J. Stephen

Breath Taking: What Our Lungs Teach Us about Our Origins, Ourselves, and Our FutureBreath Taking: What Our Lungs Teach Us about Our Origins, Ourselves, and Our Future by Michael J. Stephen
My rating: 5 of 5 stars

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Out: January 19, 2021

 

This book explores the crucial role of breathing in human existence, discussing evidence of how breathing practices can contribute to healing of numerous illnesses, investigating the range of threats — from pollution to smoking to toxic dust — that can threaten our ability to breath, and examining a number of diseases that can disturb a person’s breathing. This book is primarily a popular science look at pulmonary medicine. Unlike other breath-related books that I’ve reviewed, this book is mostly about what can go wrong with our lungs and what medical science is doing to combat these threats. The story of how breathwork and changing breathing patterns can improve health and well-being is addressed, but that’s not the book’s central focus. The book uses plenty of stories (e.g. case studies) and what I call “fun facts” to keep the reading from becoming too dry or clinical for a neophyte reader.

The book consists of fifteen chapters. The first two chapters provide basic background information to help understand how the Earth happens to have the oxygen-laden air necessary for our type of life (Ch. 1) and how the lungs exploit that air in fueling our bodily activities (Ch. 2.) Chapter thee explores how breathing begins in newborn babies, explaining that the lungs are the only major organ that doesn’t start working until we are out in the world, and lung inflation doesn’t always go smoothly. The fourth chapter discusses how breathwork (including — but not limited to — yogic pranayama) has been shown to improve health for those experiencing a range of conditions, including: depression, addiction, PTSD, and pain, as well as how breath and meditational practices contribute to better health, generally.

Chapter five investigates the intersection of the respiratory and immune systems, explaining how autoimmune conditions, allergies, and asthma come to be. In chapter six, the author discusses one of the most common and widespread diseases in the world, tuberculosis (TB,) a disease which not only threatens the lives of many, but also sits dormant in a huge portion of the population.

Chapters seven through nine each deal with hazardous materials that are inhaled into the lungs. The first of these chapters is about smoking, and it focuses on the question of how nicotine acts in the body to create intense addictions – as well as what has and hasn’t worked to help people break said addiction. Chapter eight is about pollution. (As resident of a city of twelve million people, I found this to be a particularly disturbing chapter because air pollution is a hazard that is too easy to be blind to if one doesn’t suffer from respiratory problems.) Chapter nine investigates a range of breathable hazards including smoke, dust, and asbestos, and it does so through the lens of the rescue and cleanup at the World Trade Center after the dual collapse of the twin towers on 9-11, an event which released all sorts of toxic material into the air, hazards for which most responders were ill-equipped.

Chapter ten through twelve are about ailments that may or may not be linked to environmental causes like the ones mentioned in the paragraph above. The first of these is idiopathic pulmonary fibrosis, which, by definition, is a condition that arises from an unknown cause, an ailment which involves a stiffening and thickening of lung tissue (which must be thin and supple to allow gas exchange and the expansion and contraction of the breath cycle.) Chapter eleven focuses on lung cancer, which is often due to an inhaled hazard (most notably, smoking,) but not necessarily. While the other chapters of the book focus on breathing as a process by which we take in oxygen and expel carbon dioxide, chapter twelve turns to a different role played by breath, one that is crucial to the activities of our species, breath as a means to control the voice.

Chapter 13 describes the process and challenges of lung transplant. As mentioned in the discussion of pulmonary fibrosis, lung tissue is rather delicate material, and so it was no easy task to transplant it. Furthermore, because the lungs are a point at which the external world (air) contacts the body’s internal systems the challenges are even greater than for those organs that are hermetically sealed within bodily tissues.

The last two chapters focus on cystic fibrosis (CF.) Chapter fourteen explores the nature of the disease and the slow, but promising, path towards treating it. CF is a genetic condition in which the lack of a single amino acid wreaks havoc on the ability of cells to process minerals. The last chapter tells the story of two cases of CF. The first story – involving a ten-year-old whose family had to struggle against a policy that essentially locked their child out of the lung transplant list – is particularly engrossing.

As someone who practices breathwork, I found this book to be interesting and insightful. While it is heavily focused on pulmonary medicine, it does offer insights that will be beneficial to those who are not afflicted by respiratory ailments. If one wants to know more about medicine as it pertains to respiration, this is definitely an interesting and readable choice. However, even if one is infatuated with breath more generally, I believe you’ll find in this volume a great deal of beneficial food-for-thought.

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BOOK REVIEW: Pandemics: A Very Short Introduction by Christian W. McMillen

Pandemics: A Very Short IntroductionPandemics: A Very Short Introduction by Christian W. McMillen
My rating: 5 of 5 stars

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This book explores disease pandemics through the lens of History. I open with that because this is a topic that can (and has) been addressed through many different disciplines, and a reader expecting biological or epidemiological insights is likely to be disappointed. However, if one is interested in questions of how, where, and with what impacts various diseases spread, this book provides a concise overview for seven select pandemics: The Plague, Smallpox, Malaria, Cholera, Tuberculosis, Influenza, HIV/AIDS.

This book belongs to Oxford University Press’s “A Very Short Introduction” series, a massive collection of brief guides outlining a wide range of scholarly topics. This title complies with general guidelines of the series, presenting the basics of a subject in a manner accessible to a neophyte, citing sources and providing recommendations for further reading, and offering graphics to support the text where beneficial.

As mentioned, the book delves into the seven pandemics listed in the opening paragraph, and does so in the order in which they are listed. Each disease is presented in its own chapter – so the book consists of a prologue, seven chapters, an epilogue, and back matter (i.e. citations, recommendations for additional reading, and the index.)

Obviously, these seven pandemics don’t represent a complete history of disease pandemics. The book was published in 2016, well before the COVID-19 pandemic (though readers will certainly read some prescient-sounding statements — particularly in the epilogue,) but not even all past epidemics classed as pandemics are addressed. [It should be noted that there is no perfectly agreed upon dividing line between epidemic and pandemic.] Still, this book includes the biggest and most globally-widespread pandemics, but it also covers a diverse collection of diseases, including: contagious, vector-borne, and water-borne illnesses, as well as bacteria- and virus-induced diseases. It’s worth noting that The Plague is a worthy first case not only because it’s one of the diseases that has most shaped human history, but also because there’s not a great deal known about disease before then. (During the relatively recent 1918 “Spanish” Flu pandemic, the medical community still didn’t know anything about viruses, and so one can imagine how little ancient people would have understood about these causes of death.)

As the book shares information about the pandemics and their impact on the world, it also teaches one something about how medicine and science progressed as a result of these events. This is famously evident in the case of Cholera, a disease whose unusual characteristics with respect to spread baffled doctors until a clever investigator learned that cases were tied to a common water well. The case of Cholera is a prime example of how changing one’s approach can resolve a stubborn question, looking at the cases spatially offered an immediate insight that other modes of investigation had failed to present.

I found this book to offer interesting insight into pandemics. If you are looking to understand the history of disease pandemics, this is a great book with which to start one’s study.

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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

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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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