What I've Been Reading (March 2024)
Ten Drugs: How Plants, Powders, and Pills Have Shaped the History of Medicine by Thomas Hager
I read this as part of my goal to read more about “the future of medicine.” While this book was more about the recent past of medicine as opposed to the future, it was still a fun and interesting read. Key takeaways:
We have it really good now. 300 years ago, smallpox was a fact of life. Highly infectious, it would rip through communities, resulting in death 25% of the time. Those lucky enough to survive would often be disfigured; women would often wear veils to cover their pockmarked faces. Even 100 years ago, w knew about germs but there were no antibiotics and no way to help a patient fight off bacterial infections. Hundreds of thousands of soldiers died from post-surgery wound infections
I hadn’t appreciated how much of drug discovery is accidental. There are the famous examples of the smallpox vaccine (milkmaids in England didn’t get smallpox as they had been exposed to the milder “cowpox” in their work) and penicillin (where Alexander Fleming saw there was no bacteria on a petri dish that had a specific mold). But I hadn’t known that the first antipsychotics to treat schizophrenia were repurposed antihistamines (given the side effects of drowsiness and sedation) or that Viagra was originally developed for high blood pressure but re-positioned when its side effects became clear.
We’ve been searching for the holy grain of pain control - no pain with no addiction - for over a hundred years but haven’t found it yet. Everything that makes us feel really good ends up being addictive. It reminded me of Dopamine Nation’s discussion about “feeling good being bad and feeling bad being good.” The biggest step we’ve made has been methadone, which essentially allows people to function with an opioid addiction (it prevents withdrawal without knocking them out the way heroin etc would)
The book was written in 2019 and it’s amazing what’s even come out since then: the covid RNA vaccine, multiple vaccines for malaria, newer GLP-1 drugs for obesity and diabetes.
Pests: How Humans Create Animal Villains by Bethany Berkshire
Book about different animal “pests” and their relationship with people. Book was a good reminder on how different values can make people view the same issue in different ways. Take the “cat wars”: apparently wild cats are a big ecological issue as they eat lots of other species. Animal lover want to to just spay these wild cats. But other conservationists see this as an inadequate solution as it takes too long to fully control a population - and even a few untreated cats can make a large dent in other animal populations. There is not a “right” answer, it just depends what (and who) you care more about
Another interesting example are elephants: people in Western countries generally see them as cute benevolent creatures that should be protected at all costs. But people in countries who actually live with elephants consider them pests: they break through fences to eat farm crops and kill people: over 100 a year in India, for example. And the governments in these countries are in a bind: they need to be responsive to their citizens, but also rely on these animals for tourism. There are solutions - like putting up beehives to repel elephants - but these can be expensive and don’t scale. We want animals to live, but somewhere else.
I enjoyed this. I think “pests” bother us in part due to our inability to control them or completely control our environment. Most of us live in air-conditioned and heated environments where everything around us is mechanical and sterile. It can be a bit humbling and unnerving to be faced with something out of our control that is living.