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Pandemic restrictions have mostly lifted now, making it much easier to get books out of my local library. The pandemic has had some influence over which books I read this past year. Are you looking for some good summertime reads? It’s time once again for my annual roundup of some of the best books I read this year. As usual, my focus is mostly on nonfiction tales from the world of science, medicine, and technology. A master list of all books that I recommend can be found here.
First up is Jason Dearen’s Kill Shot: A Shadow Industry, A Deadly Disease (2022). This book, which I strongly recommend, reads like a thriller as it recounts the sickening saga of how the New England Compounding Center got into the drug manufacturing business with horrific results. Compounding pharmacies are supposed to make drugs on demand for individual patients, but this one started making thousands of doses of certain drugs and then selling them all around the country. Preparing these drugs require a great deal of technical expertise as well as a strong focus on cleanliness and sterility as the drugs are mixed and packaged. Unfortunately, their techniques were careless and done by those with insufficient training for the task. This became evident after they had generated and distributed a large batch of a steroid, methylprednisolone acetate, which is injected near the spine for pain relief. The steroid turned out to be contaminated with a rare and deadly mold, Exoserohilum rosratum, which grows very well inside the body, actually eats human tissues, and causes fungal meningitis. Even worse: there are no effective anti-fungal drugs that work against it. The net result was that there were nearly 800 cases of people sickened by the mold, and more than 100 of them died. The management group was eventually brought to trial on a variety of charges that are recounted at the end of the book, but I won’t spoil the ending by telling you what happened. This book deeply explores a very sad chapter of pharmaceutical history and illustrates the need for greater government oversight over this small segment of the industry.
I’ll also recommend Michael Lewis’s The Premonition: A Pandemic Story (2021), a book about the COVID-19 pandemic that takes a different approach than others that present a calendar based look at how things went terribly wrong in the US response. The focus of The Premonition is on a small group of people who largely worked behind the scenes to focus efforts on combatting the pandemic while not being technically charged with doing so. The book details a number of screw-ups of government agencies, particularly the CDC, and how many of the insights into fighting the pandemic actually arose from outside of this politically charged organization. Certain public health officials go missing in action at a critical time, and others step up to provide valuable leadership. The individuals profiled here were certainly not household names before the pandemic, and most of them remain that way today. Also clearly recounted in the book is how the US public health system has been starved for funding for decades, and how that made it much more difficult to combat the pandemic. The bottom line is that if you are smart, highly motivated, and can actually get those in a position of power to pay attention to you, you can actually change the world.
I really enjoyed Mary Roach’s latest book Fuzz: When Nature Breaks the Law (2021). Mary Roach is not only a fine science writer; she finds a way to make even the most arcane subjects both interesting and funny. This book focuses on different types of “interactions” between humans and animals that are not to the benefit of humans. For example, there are lots of good stories from around the world about people who are attacked by bears. And wolves. And leopards. And elephants. Giving that humans keep expanding their footprint into wilderness areas, these types of encounters occur at an ever-increasing rate. Despite warnings, humans often do a poor job of preventing these encounters, such as failing to lock up their food when in bear country. It’s not just that animals can harm humans; they also impact us by attacking our food supply. Scarecrows are interesting looking, but they do little to prevent birds from ravaging crop fields. Fake owls don’t work well either. What does work? How about dead carcasses of marauding birds that are hung upside down for all to see? That works well, at least for a short while. Animals also negatively impact us by simply getting in our way, as anyone who has run into a deer with their car can attest to. The book includes a discussion of ways that deer might be persuaded to not hang out on our highways. Overall, a pretty wide ranging look at how humans need to be more attuned making sure their encounters with animals are good ones.
The failings of the Trump administration to combat the COVID-19 pandemic are well documented in Nightmare Scenario: Inside the Trump Administration's Response to the Pandemic That Changed History (2021) by Washington Post reporters Yasmeen Abutaleb and Damian Paletta. The long book (478 pages) tracks the history of the administrations response to the pandemic in a chronological fashion. Chapters start with the current-at-the-time numbers of cases and deaths. If you followed the pandemic closely in real time, there are not a lot of surprising revelations in the book. Having said that, it nicely summarizes what happened in various quarters as the disease took an increasingly deadly toll on the U.S. Dysfunctional and chaotic would be the best descriptors of the government’s response. Health and Human Services Secretary Alex Azar comes off quite badly in this accounting. One area of particular focus that I enjoyed reading was the interactions of the scientists involved (e.g. Drs. Birx, Fauci, and Redfield) with the politicians in the administration. Some of them did a much better job at handling themselves at this difficult-to-navigate intersection than others did. The primary driver of the administration’s response appears not to have been keeping Americans safe, but in convincing them that all was going well despite mountains of easily seen data that clearly indicated that this was not the case. Example: keeping cruise ship passengers sickened by the coronavirus stuck onboard because taking them off of the ships would inflate the number of recorded cases. Few within the administration come off well in this book, which isn’t surprising considering how badly it all went.
Recommended with reservations is The Memory Thief and the Secrets Behind How We Remember by Lauren Aguirre (2021). This story fits in with a long line of non-fiction books exploring medical mysteries. In this case, the medical mystery is quite an interesting one. People are showing up in emergency rooms with a serious problem: they can’t remember things. Their problem isn’t that they can’t remember their names, or where they went to school, or stuff that happened in the past. Instead, they’ve lost their short term memories. If you tell them your name, ask them questions about themselves, and show them photos, then return an hour later, they won’t remember any of what had just happened. If they parked their car outside, they won’t remember where they parked it. Or what they had for breakfast. They can’t easily watch movies because they forget who the characters, and what they have done, midway through the film. It’s a very interesting look at the many problems these people have navigating through life without the ability to form new memories. They need elaborate strategies to do simple things that all of us take for granted. The doctors figure out that the problem results from significant damage to the hippocampus, that part of the brain where memories are formed. But what caused the damage? Doctors strongly suspect it’s from an overdose of narcotics, and specifically the drug fentanyl. Getting proof for this hypothesis, however, proves very difficult, and that is the weakest point of the book, and why I recommend it with reservations. When we read medical mysteries, we want to have the mystery neatly solved by the end of the book, and that simply doesn’t happen here.
I really enjoyed Mine: How the Hidden Rules of Ownership Control Our Lives by Michael Heller and James Salzman (2021). This might seem an odd topic for a book, but I found the discussions riveting precisely because these are things we don’t often think about. Ownership goes far beyond going to the store and buying a new shirt. Some of the old sayings, such as possession is nine tenths of the law, are not close to being true. Among the subjects looked at: property (are you sure where the boundaries of your property are?); downloadable books and movies (that can be taken away from you at any time); your body (no, you can’t legally sell a kidney), copyrighted materials (can you make copies of this, or not), time (yes, you can pay someone to stand in line for you), and parking spaces dug out from northeastern snow storms (can you reserve the space you freed with your labor?). Sometimes rules of ownership are deliberately left vague (can you lean your seat back on an airplane, thereby encroaching on the space behind you), leaving the person behind you who claim that same space in constant tension. It will come as a surprise to no one that the rules favor the wealthy. In the end, rules of ownership are set by a series of only six rules. The book challenges assumptions and reveals ownership sometimes depends on the local customs where you live.
Another good book is Sickening: How Big Pharma Broke America’s Healthcare And How We Can Repair It by John Abramson (2022). The author has covered similar territory in his previous book Overdosed America. The focus is on explaining how Big Pharma’s practices have created a number of continuing problems in our healthcare system. Examples covered include the withdrawal of Celebrex from the market for safety reasons; why insulin prices have increased so rapidly without evidence that the newer versions enable better disease management; how statins came to be so widely prescribed; and why the industry has profited greatly from the off-label promotion of Neurontin and other drugs.
The primary focus of the book is in explaining how little access outside reviewers have in seeing the raw patient data from pharma sponsored clinical trials, and why that is highly problematic. The book concludes by outlining strategies to combat Big Pharma’s excesses, with large roles for both healthcare providers and patients in addition to regulatory agencies. Given the overwhelming demands on doctors times these days, the fact that consumers are largely cost-focused on drugs (instead of worrying about if they actually work), and that we are currently facing other huge problems in our country, I think it will be very difficult for either of the latter two groups to be highly engaged.
Recommended with reservations: Phil Jaekl’s Out Cold: A Chilling Descent Into the Macabre, Controversial, Lifesaving History of Hypothermia (2021). The basic idea behind the book is solid, examining the history of hypothermia against a background of what science was saying at that particular time about heat was conceptually thought of, and how temperature was measured. The subjects in the book are not so evenly divided, with a much greater emphasis on how cold was thought of before the dawn of the scientific revolution. Deliberately making people hypothermic has a long history, mostly as punishment, torture (much of it done buy the Nazis in concentration camps), and as supposed “cures” for mental illness. The most interesting stories were, for me, those related to commercial efforts to freeze people’s heads or bodies with an eye towards reviving them at some point in the very distant future. Early attempts to do the freezing were incredibly amateurish and only resulted in the destruction of tissues that were meant to be preserved. Making people really cold did develop a legitimate place in medicine as the technique is often used to prevent organ damage during certain surgeries that interfere with oxygen getting to the brain and other tissues.
Happy reading!