Quarantine, the climate crisis, genetics and mysterious illnesses come under the microscope in this year’s highlights
Early in the pandemic it was the blunt tools of past centuries that saved the most lives. Until Proven Safe, by Geoff Manaugh and Nicola Twilley (Picador), dives into the crudely effective and widely abused strategy of quarantine, the separation of those feared to be sick from those deemed healthy. The authors trace formal quarantine back to 14th-century Dubrovnik where, in response to the Black Death, visitors were ordered to spend a month in a nearby town or on an islet before entering the city. The strategy caught on elsewhere but, despite keeping disease at bay, discrimination, inconvenience and miserable conditions hardly encouraged compliance. In one spectacular failure, a plague-infested ship evaded Sicilian quarantine and left 16,000 dead on the island. Examples range from the Apollo astronauts (quarantined in case they carried lunar germs) and the Covid pandemic to efforts to prevent a “chocpocalypse” by protecting the cacao plant. With emerging diseases on the rise, quarantine is back for good, the authors warn, and it must be radically overhauled.
From the moment coronavirus took hold in China, the race was on to make a vaccine. That researchers designed, manufactured, trialled and received approval for jabs in a record 12 months is extraordinary. In Vaxxers (Hodder & Stoughton), two key members of the Oxford Vaccine Group, Prof Sarah Gilbert and Dr Catherine Green, describe the gruelling effort behind that feat. The science is clear, as is the intense pressure the team was under, undoubtedly exacerbated by media scrutiny This is not the only Covid vaccine story: the tale of how mRNA shots came to be is arguably more compelling. But Oxford set out to make a “vaccine for the world” and put profit aside to achieve the goal. In an episode of history short on heroes, there is no need to look further.and controversies over the vaccine’s effectiveness, rare serious adverse events and how it would be distributed.
If the advent of Covid vaccines marked a high point for modern medicine, the story of OxyContin, a powerful and highly addictive painkiller, marks an unforgivable low. In Empire of Pain (Picador), Patrick Radden Keefe, a staff writer on the New Yorker, chronicles the Sackler dynasty, two branches of the family who came together to get behind Purdue Pharma’s blockbuster drug. The pills helped fuel a deadly wave of drug use across the US in an opioid epidemic that has killed more than half a million people. The Sacklers who took over Purdue knew their drug was more potent than morphine, but exploited the fact that physicians thought otherwise. The book reeks with wrongdoing, shameful behaviour and corruption that runs deep into the US healthcare system. Profits from OxyContin helped bankroll Sackler philanthropy, helpfully linking the family name with high culture and scientific advancement. Hence the Sackler library at the University of Oxford and the Sackler Institute at King’s College London. At one Sackler hearing, Jim Cooper, a congressman from Tennessee, said: “Watching you testify makes my blood boil. I’m not sure that I’m aware of any family in America that’s more evil than yours.”
It might be considered a red flag when a scientist wakes with a racing heart after a pig-faced Hitler enters their dream wanting a primer on the “uses” of their discovery. The nightmare struck Prof Jennifer Doudna, a Berkeley biochemist, in 2014 amid a patent row over Crispr, the gene-editing technology she helped develop. In The Code Breaker (Simon & Schuster), Walter Isaacson tells Doudna’s story. Isaacson is an accomplished biographer and the result is clear, insightful and even funny. Doudna and her collaborators, notably Prof Emmanuelle Charpentier, with whom she shared the 2020 Nobel prize, believe Crispr will save lives by curing genetic disease. But as Doudna mulled her nightmare, she also realised the near-countless ways it could be abused.
Our clever attempts to bend nature to our will have an uncanny knack of backfiring. In Under a White Sky (Bodley Head), Elizabeth Kolbert, the Pulitzer prize-winning author of The Sixth Extinction, provides a tour of such calamities. She starts on the Chicago River, once so thick with human excrement and other delights that it was said a chicken could cross without getting its feet wet. The river drained into Lake Michigan, the city’s source of drinking water, so engineers reversed the flow, sending the waste towards St Louis. The move “upended the hydrology of roughly two-thirds of the United States”, Kolbert finds. Later, Asian carp were introduced to feast on weeds that snagged boat propellers, but the invasive species are a threat to the ecosystem and must now be contained by electrifying the river. The book’s title comes from proposals to combat global heating by spraying hundreds of thousands of tonnes of particles into the atmosphere. What could possibly go wrong? For one, if the spraying stopped, the world would suffer rapid heating called “termination shock”. Most disturbing of all is Kolbert’s conclusion that, despite the risks, technological fixes could become our only hope.
One of the most intriguing and provocative books of the year is The Sleeping Beauties: And Other Stories of Mystery Illness by Dr Suzanne O’Sullivan (Picador). In Sweden, hundreds of children from refugee families fall into coma-like states for months or years at a time. In New York state, seizures become contagious among schoolchildren. Meanwhile Nicaraguan communities report tremors, convulsions and disturbing hallucinations of a figure in a hat who comes to take them away. O’Sullivan, a neurologist, delves into the cases and describes how “biopsychosocial” and “functional neurological” disorders may not appear on MRI scans but are no less real or serious for their absence. She finds that social narratives often play a crucial role in the spread of such illnesses – and in their treatment, too.
Efforts to understand consciousness face a daunting question. Appropriately named “the hard problem”, it asks why we should have a rich inner life – why is there something it feels like to be you? It is not clear that science has the answer, but in Being You: A New Science of Consciousness (Faber), Prof Anil Seth, director of the University of Sussex Sackler Centre for Consciousness Science (see above) offers an approach that may get us most of the way there. By focusing on what he calls “the real problem”, modern science can unravel why patterns of brain activity produce particular experiences and not others. It is a brilliant and profound book that explains how our perception of the world, ourselves included, is a “controlled hallucination”: the brain’s best guess of what’s out there, constructed as much from the inside out as the outside in.
Carlo Rovelli, a professor of quantum gravity, takes on another kind of mystery in Helgoland (Allen Lane). The book is named after the North Sea rock where in 1925 the young Werner Heisenberg inched open the door to the quantum realm with calculations that left him reeling. This is not the story of Heisenberg, however. It is Rovelli’s take on how physicists have strayed off course in thinking about the quantum world. He is no fan, for example, of the many worlds theory, where reality cleaves to accommodate all possible futures. He pushes instead his “relational interpretation”, where objects are defined by whatever they interact with. This conjures a bewildering world. “We must abandon something that seemed most natural to us,” he writes: “the simple idea of a world made of things.”
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