Tag: science

Review – Preventable

Posted August 27, 2025 by Nicky in Reviews / 0 Comments

Review – Preventable

Preventable: How A Pandemic Changed the World and How to Stop the Next One

by Devi Sridhar

Genres: Non-fiction, Science
Pages: 432
Rating: three-stars
Synopsis:

The definitive story of COVID-19 and how global politics shape our health - from a world-leading expert and the pandemic's go-to science communicator.

Professor Devi Sridhar has risen to prominence for her vital roles in communicating science to the public and speaking truth to power. In Preventable she highlights lessons learned from outbreaks past and present in a narrative that traces the COVID-19 pandemic - including her personal experience as a scientist - and sets out a vision for how we can better protect ourselves from the inevitable health crises to come.

In gripping and heartfelt prose, Sridhar exposes the varied realities of those affected and puts you in the room with key decision makers at crucial moments. She vibrantly conveys the twists and turns of a plot that saw: deadlier variants emerge (contrary to the predictions of social media pundits who argued it would mutate to a milder form); countries with weak health systems like Senegal and Vietnam fare better than countries like the US and UK (which were consistently ranked as the most prepared); and the quickest development of game-changing vaccines in history (and their unfair distribution).

Combining science, politics, ethics and economics, this definitive book dissects the global structures that determine our fate, and reveals the deep-seated economic and social inequalities at their heart - it will challenge, outrage and inspire.

Devi Sridhar’s Preventable is a discussion of the SARS-CoV-2 pandemic, the global response to it, and how we could’ve handled it better (mostly, how governments could have handled it better). It came out in 2022, so it’s a little out of date now, but I found it an interesting read nonetheless.

Before I go further with the review, a quick note that I studied Infectious Diseases at the London School of Hygiene and Tropical Medicine, starting in 2020 and completing this year, achieving an MSc with merit. So this is a field I know well and am well-qualified to comment on, and I know a fair amount of the cutting-edge stuff about SARS-CoV-2 because I was taught by people who were (and are) researching it. I also volunteered with the WHO managing data about travel restrictions and lockdowns, so I kept fairly abreast of that side of things too. All this to say, you should always take things on the internet with a grain of salt, but that’s where I’m coming from as a reader.

Broadly speaking, I agree with Sridhar’s discussion of how we could’ve prevented the pandemic, or at least the loss of life (and disability-adjusted life years as well). I’d say I remain a little more cautious than she was in 2022, since now in 2025 I still wear a mask in crowded indoor spaces, but things have changed since then (e.g. COVID vaccines are no longer available on the NHS for the majority of people), and I think a bit more is understood about long COVID (or at least about the fact that there isn’t an easy and immediate solution to it just waiting in the scientific wings to fix everything).

I found her tone a bit defensive, but that kinda makes sense: as a scientist and a woman who was saying some pretty unpopular (but generally sensible) things, she faced quite a bit of abuse from the public. Still, I’m a bit iffy about her defenders being people like Piers Morgan, not scientists, and the amount of celebrity name-dropping she does in the book (and which her publisher does on the book cover). I don’t care what Piers Morgan thinks of her!

I was a bit surprised by her degree of support for the idea that SARS-CoV-2 came out of a lab. I do understand the reasons she gives, and the suspicious behaviour of the Chinese government, but… I’m surprised it’s not being treated as a more fringe belief here (though she does emphasise that she’s not seeing any malicious intent, just some kind of lab accident through contact with infected bats).

Her critiques of the British, Swedish and US governments are pretty sound as far as they go, and her praise of the response in other countries likewise tallies pretty well too. I’d just wish for a bit more attention re: long COVID, and maybe a bit more understanding that the vaccine isn’t perfect, and then vaccination wasn’t enough for everyone to go back to normal. She does highlight the problematicness of people with disabilities being told to cut themselves off from society to survive, but she seems to have forgotten that by the conclusion of the book, in her optimistic hope for things to get back to normal.

Rating: 3/5 (“liked it”)

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Review – Most Delicious Poison

Posted August 20, 2025 by Nicky in Reviews / 0 Comments

Review – Most Delicious Poison

Most Delicious Poison: From Spices to Vices - The Story of Nature's Toxins

by Noah Whiteman

Genres: Non-fiction, Science
Pages: 304
Rating: two-stars
Synopsis:

A deadly secret lurks within our kitchens, medicine cabinets and gardens...

Digitalis purpurea. The common foxglove. Vision blurs as blood pressure drops precipitously. The heartbeat slows until, finally, it stops.

Atropa belladonna. Deadly nightshade. Eyes darken as strange shapes flutter across your vision. The heart begins to race and soon the entire body is overcome with convulsions.

Papaver somniferum. The opium poppy. Pupils constrict to a pinprick as the senses dull. Gradually, breathing shudders to a halt.

Scratch the surface of a coffee bean, a chilli flake or an apple seed and find a bevy of strange chemicals - biological weapons in a war raging unseen. Here, beetles, birds, bats and butterflies must navigate a minefield of specialised chemicals and biotoxins, each designed to maim and kill.

And yet these chemicals, evolved to repel marauding insects and animals, have now become an integral part of our everyday lives. Some we use to greet our days (caffeine) and titillate our tongues (capsaicin), others to bend our minds (psilocybin) and take away our pains (opioids).

Inspired by his father's love of the natural world and his eventual spiral into the depths of addiction, evolutionary biologist Noah Whiteman explores how we came to use - and abuse - these chemicals. Delving into the mysterious origins of plant and fungal toxins, and their unique human history, Most Delicious Poison provides a kaleidoscopic tour of nature's most delectable and dangerous poisons.

Noah Whiteman’s Most Delicious Poison: From Spices to Vices – the Story of Nature’s Toxins is primarily focused on the issue of addiction, and includes discussion of his father’s alcoholism and death due to complications thereof. It muses on his own likely propensity toward addiction as well, and generally seems to be part an exorcism of Whiteman’s own demons around addictive plant products.

There is a great deal of discussion of chemistry and biology as well, discussing how exactly the toxins work, and how they interact with receptors — and even how that might have evolved (often coincidentally, but sometimes based on the fact that some things are widespread across the animal kingdom, having evolved early on). It was this that I was interested on, and it largely didn’t disappoint, though I felt the emphasis on addiction meant a bit of a narrowed focus beyond some other plant toxins that would’ve been interesting. Basically everything came down to addiction within a few pages, and I don’t think that emphasis was really clear in the book’s description.

I did also find Whiteman’s style a bit challenging, rather inclined to jump around/link together topics that aren’t closely linked in a very “and another thing!” manner.

Overall, not quite what I hoped for.

Rating: 2/5 (“it was okay”)

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Review – The Future of Dinosaurs

Posted July 1, 2025 by Nicky in Reviews / 2 Comments

Review – The Future of Dinosaurs

The Future of Dinosaurs: What We Don't Know, What We Can, and What We'll Never Know

by David Hone

Genres: Non-fiction, Science
Pages: 272
Rating: four-stars
Synopsis:

Discover the latest frontiers in dinosaur research with Dr David Hone.

Ever since we first started discovering dinosaurs in the early-1800s, our obsession for uncovering everything about these creatures has been insatiable. Each generation has made huge strides in trying to better our understanding of these animals and in the past twenty years, we have made more discoveries than in the previous two hundred.

There have been extraordinary advances in palaeontological methods and ever more dinosaur fossils promise a landslide of new data and huge leaps forward in our understanding of these incredible animals. Over time, we have been bale to look at the sizes and shapes of bones, we have identified patches of fossil skin, we have looked at footprints and bite marks and we've calculated mass estimates and walking speeds.

With surprisingly little data to work from, we can put together a picture of an animal that has been extinct for a million human lifetimes. But for all our technological advances, and two centuries of new data and ideas, there is stull much more we don't know. What parasites and diseases afflicted them? How did they communicate? Did they climb trees? How many species were there?

In The Future of Dinosaurs, palaeontologist Dr David Hone looks at the recent strides in scientific research and the advanced knowledge we've gathered in recent years, as well as what we hope to learn in the future about these most fascinating of extinct creatures.

David Hone’s The Future of Dinosaurs: What We Don’t Know, What We Can Know, and What We’ll Never Know has a very descriptive title that tells you pretty much what’s to come. The seventeen chapters cover various aspects like anatomy, physiology, mechanics and movement, appearance, etc, discussing a little about what we do know, and illuminating where that knowledge can grow, and where we may never know more.

For the enthused dinosaur fan who reads loads of popular science books about dinosaurs, there’s probably not a lot here that’s very surprising — certainly I’m a fairly moderate dinosaur fan, and I wasn’t very surprised by most of it, though I did learn some snippets here and there. For example, about the fact that dinosaurs could and modern birds can isolate infection in one part of the body rather than tending to see systemic spread like humans. I want to do a bit more research into how; more localised immune responses, rather than a lymphatic system…? Or some kind of trigger-happy immune cell policing things harder? I’d like to know.

It’s a pretty dense book, with some black-and-white photos and illustrations; it looks very slim on the shelf, at least in the edition I read, but it has tiny text, so there’s more here than you’d think.

Rating: 4/5

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Review – Cull of the Wild

Posted June 22, 2025 by Nicky in Reviews / 0 Comments

Review – Cull of the Wild

Cull of the Wild: Killing in the Name of Conservation

by Hugh Warwick

Genres: Non-fiction, Science
Pages: 304
Rating: four-stars
Synopsis:

Investigating the ethical and practical challenges of one of the greatest threats to biodiversity: invasive species.

Across the world, invasive species pose a danger to ecosystems. The UN Convention on Biological Diversity ranks them as a major threat to biodiversity on par with habitat loss, climate change and pollution.

Tackling this isn't easy, and no one knows this better than Hugh Warwick, a conservationist who loathes the idea of killing, harming or even eating animals. Yet as an ecologist, he is acutely aware of the need, at times, to kill invasive species whose presence harms the wider environment.

Hugh explores the complex history of species control, revealing the global movement of species and the impacts of their presence. Combining scientific theory with gentle humour in his signature style, he explains the issues conservationists face to control non-native animals and protect native species – including grey and red squirrels on Anglesey, ravens and tortoises in the Mojave Desert, cane toads in Australia and the smooth-billed ani on the Galapagos – and describes cases like Pablo Escobar's cocaine hippos and the Burmese python pet trade.

Taking a balanced and open approach to this emotive subject, Hugh speaks to experts on all sides of the debate. How do we protect endangered native species? Which species do we prioritise? And how do we reckon with the ethics of killing anything in the name of conservation?

Hugh Warwick’s Cull of the Wild is basically a vegan trying to confront the apparent reality that we may have to kill some animals, in great numbers, to protect diversity and preserve populations of endangered animals. Each chapter is a new example, often involving travel and dialogue, and he does his best to write openly about his biases and where he’s coming from.

It was interesting, mostly, but it did kind of drag once the examples started being very similar, because the dilemma is mostly the same in each case. For that reason I found the start of the book best, and by the end the conclusions mostly seemed obvious.

Personally, I’m somewhat ambivalent on the subject: I’d say I basically expect that it’s a case-by-case thing, for me, because some culls seem plausible and likely to both work and help, while others… the species aren’t necessarily surviving even if the predator/competitor pressure is removed, because humans are actually the major problem for many/most species in many/most parts of the world. Sometimes I don’t think killing an invasive species is the solution, because we can’t actually turn back the clock. And sometimes the invasion is new or partial in a way that makes a cull or a killing perimeter or whatever work, but it’s expensive, and then you wonder whether it’s worth it.

I don’t disagree that it’s the fault of humans, to be clear, nor that we bear a responsibility to fix things. These things are true. But killing to save is not going to be a good solution for everything, and I think I come at that answer from a slightly different direction with Warwick, who is largely concerned with a utilitarian weighing-up of suffering against suffering, and finding the greater good. That was maybe a bit frustrating to me, because the “maybe sometimes we should just… leave it alone” viewpoint is rather lacking.

Rating: 4/5

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Review – The Animals Among Us

Posted June 16, 2025 by Nicky in Reviews / 2 Comments

Review – The Animals Among Us

The Animals Among Us: The New Science of Anthrozoology

by John Bradshaw

Genres: Non-fiction, Science
Pages: 371
Rating: two-stars
Synopsis:

The bestselling author of Dog Sense and Cat Sense explains why living with animals has always been a fundamental aspect of being human

Pets have never been more popular. Over half of American households share their home with either a cat or a dog, and many contain both. This is a huge change from only a century ago, when the majority of domestic cats and dogs were working animals, keeping rodents at bay, guarding property, herding sheep. Nowadays, most are valued solely for the companionship they provide. As mankind becomes progressively more urban and detached from nature, we seem to be clinging to the animals that served us well in the past.

In The Animals Among Us, anthrozoologist John Bradshaw argues that pet-keeping is nothing less than an intrinsic part of human nature. An affinity for animals drove our evolution and now, without animals around us, we risk losing an essential part of ourselves.

I found John Bradshaw’s The Animals Among Us initially quite interesting, but ultimately there were a couple of problems: it’s very repetitive, it’s very gender essentialist, and he keeps saying things “cannot be a coincidence” when they can, anything can be a coincidence. Just saying something cannot be a coincidence does not constitute any kind of proof whatsoever that it is not, in fact, coincidence.

He’s also got a pretty cavalier attitude to a number of things, typified by the one I picked up on: he claims that it’s — and I quote — a “fable” that there’s a link between schizophrenia and toxoplasmosis. Not only is it not a fable, but there are also links between Toxoplasma gondii infection and suicide risk, bipolar disease, anxiety, ADHD and OCD. And more! Now I’m not saying all of those are well evidenced, mostly I see stuff like odds ratios and hazard ratios that are suggestive without being conclusive, and we could use more clear-cut explanations of how that’s supposed to be caused and elucidations of stuff like whether it’s infection at any time in your life or infection at a critical period or only if you have both a toxoplasmosis infection and another risk factor… But the point is, it should not be lightly dismissed as a fable.

And sure, it’s a relatively minor point, except he refers to it multiple times and he’s wrong every time. What’s going on here? Has he just decided it’s not a risk and declared that to be the case in spite of the evidence we have? Is he referring to a paper to rule all papers that has disproven all the ones before and after it? Why is he saying this?

This kind of thing always makes me a bit suspicious, and of course, I know my parasitology pretty well (I have an MSc in Infectious Diseases from the London School of Hygiene & Tropical Medicine, one of the top universities for the study of infectious disease in the world — or I will after it’s been officially conferred upon me — and I studied parasitology in the course of that degree) and this jumped out at me. What was there that wasn’t jumping out at me, but is nonetheless equally wrong, dismissive, misguided, etc?

So… read with care, I suppose.

Rating: 2/5 

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Review – Planting Clues

Posted June 9, 2025 by Nicky in Reviews / 0 Comments

Review – Planting Clues

Planting Clues: How Plants Solve Crimes

by David J. Gibson

Genres: Crime, Non-fiction, Science
Pages: 240
Rating: three-stars
Synopsis:

This fascinating book takes the reader on a journey through the role of plants (including algae and fungi) in legal cases. These legal cases range from forensic applications where botanical evidence can link a suspect to a crime scene or a victim to a suspect to cases when plants themselves can be the subject of crime or misadventure. In the latter cases, plants may be poached, illegally traded and trafficked, used as poisons, or illicitly used (i.e., drugs such as cocaine). Botanical evidence has been important in bringing a number of high-profile murderers such as Ted Bundy, Ian Huntley (the 2002 Shoham Murders), and Bruno Hauptman (1932 Baby Lindbergh kidnapping) to trial. These applications of forensic botany capture the public interest; consider, for example, the fascination with Agatha Christie’s murder mysteries involving real plant poisons such as digitalis from foxgloves. The variety and value of botanical evidence including leaf fragments, woody anatomy, pollen and spores, plant toxins, and DNA, is summarized through 8 chapters. This book appeals to general readers interested in the botany underlying true crime.

At times, David J. Gibson’s Planting Clues felt just a bit too random — a string of anecdotes around forensics and botany, loosely connected at best, organised into chapters that do at least fit into coherent themes. There are some fascinating details on both botany and how botanical experts can be involved in legal cases, which at times got a bit too into the weeds for me.

The cases it discusses illustrate the points well and include some fascinating precedents, as well as discussing some big cases (like the deaths of Holly Wells and Jessica Chapman, though now I’m unsure whether the author actually named them or their murderer, which in retrospect feels a bit weird), it just… I don’t know, I found it difficult to keep my attention on it.

If you’re interested in the topic, though, it’s a good pick!

Rating: 3/5

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Review – Fighting Fit

Posted May 22, 2025 by Nicky in Reviews / 6 Comments

Review – Fighting Fit

Fighting Fit: The Wartime Battle for Britain's Health

by Laura Dawes

Genres: History, Non-fiction, Science
Pages: 250
Rating: four-stars
Synopsis:

At the beginning of the Second World War, medical experts predicted epidemics of physical and mental illness on the home front. Rationing would decimate the nation's health, they warned; drugs, blood and medical resources would be in short supply; air raid shelters and evacuation would spread diseases; and the psychological effects of bombing raids would leave mental hospitals overflowing. Yet, astonishingly, Britain ended the war in better health than ever before. Based on original archival research and written with wit and verve, FIGHTING FIT reveals an extraordinary, forgotten story of medical triumph against the odds. Through a combination of meticulous planning and last-minute scrambling, Britain succeeded in averting, in Churchill's phrase, the 'dark curse' on the nation's health. It was thanks to the pioneering efforts of countless individuals - doctors, nurses, social workers, boy scouts, tea ladies, Nobel Prize winners, air raid wardens, housewives, nutritionists and psychologists - who battled to keep the nation fit and well in wartime.

As Laura Dawes shows, these men and women not only helped to win the war, they paved the way for the birth of the NHS and the development of the welfare state.

Laura Dawes’ Fighting Fit: The Wartime Battle for Britain’s Health was a fascinating choice for me, with my interest in infectious diseases, and especially given my electives (which included a module about nutrition and infection). It’s basically the perfect case study for many of my interests, though sadly it doesn’t discuss tuberculosis at much length (and WWI and WWII were times when tuberculosis infection numbers increased after having been in decline).

As a note of caution though, I would point out that it really is about Britain, not the British Empire. It gives no picture of how things went outside of the islands that constitute Great Britain. So it is quite narrow in scope, and I suspect it’d be a less triumphant picture if it discussed the wider picture: there’s some reference to the soldiers fighting, but mostly just to the populace at home, and pretty much nothing to the wider world.

But as I’ve implied, it paints a surprisingly rosy picture of health in the UK during the war, with some bumps here and there (haha) as refugee children passed around childhood diseases rife in the cities they came from to host families in the country, or respiratory infections rippled through bomb shelters. It discusses some fascinating experiments and number crunching that led to conclusions about how to provide people with rations, and the results of rationing. It was an endeavour that seems to me very linked to the formation of the NHS, and that makes it extra interesting reading at this time, when the NHS is being eroded.

One thing I will say… if you have phobias about biting insects, there’s a whole chapter you might want to skip which discusses scabies, lice, etc. It really made me feel itchy — I even had a nightmare about it afterwards, because this is one subject that still makes me feel rather anxious. I suspect the descriptions of some of the scabies experiments would make anyone feel itchy! So, reader beware on that front.

Overall, I found it a surprisingly quick read, and definitely fascinating.

Rating: 4/5

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Review – Black Ops and Beaver Bombing

Posted April 2, 2025 by Nicky in Reviews / 2 Comments

Review – Black Ops and Beaver Bombing

Black Ops & Beaver Bombing

by Fiona Mathews, Tim Kendall

Genres: Non-fiction, Science
Pages: 267
Rating: three-stars
Synopsis:

From seals' frisky behaviour to red squirrels making their last stand in the battle against the greys, here are the mammals of Britain as you’ve never seen them before.

Join Fiona Mathews and Tim Kendall on an overnight stakeout in search of the elusive pine marten. Follow them down mines inhabited by greater horseshoe bats, cavers, ravers and teenagers smoking unusual substances. Meet water voles thriving in the East End of Glasgow – despite the lack of water – and observe the brilliance of wild boar in your back garden.

Lively and light-hearted, Black Ops and Beaver Bombing puts animals at the heart of the story, revelling in their peculiarities, with a few corny jokes along the way. In search of answers to the problems that beset our wildlife, Fiona and Tim reveal the wonder of creatures that are worth fighting for.

Black Ops & Beaver Bombing is by a husband-and-wife pair, Fiona Mathews and Tim Kendall, and it introduces and discusses various of Britain’s wild mammals, scientific engagement with them, and attempts to experience them in the wild. It discusses stuff like rewilding (hence beaver bombing), and the success or not thereof, and also of culling (such as red squirrel culling), and definitely provides some interesting insights.

I think partly the personal touch didn’t work for me a lot; I didn’t care if they managed to see beavers or not, I was here for the science. That’s a failing of a lot of pop-science books, admittedly, and not unique to this. But somehow the chapters really did drag.

All the same, there was a lot of interesting information — I found myself telling my dad various things about voles, since he has an affection for them — and updates on stuff I sort of knew from bits of the news, but had never looked into in detail. The title is probably the snappiest thing about it, though, and much of the content is fairly sobering: we really do fail our wild mammals, here in Britain.

Rating: 3/5

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Review – Close Encounters of the Fungal Kind

Posted March 25, 2025 by Nicky in Reviews / 0 Comments

Review – Close Encounters of the Fungal Kind

Close Encounters of the Fungal Kind

by Richard Fortey

Genres: Non-fiction, Science
Pages: 336
Rating: three-stars
Synopsis:

There are three great kingdoms of life – Animals, Plants and Fungi – but the fungi always come in third place. This may be because fungi seem alien to many their strange forms, their rapid appearance and disappearance, their hidden means of feeding and propagation. In Close Encounters of the Fungal Kind, acclaimed scientist and author Richard Fortey acknowledges this otherworldliness, marvels at their unique charm and boots-up as a guide through this great, mysterious Kingdom of life.

To Fortey, the strangeness of fungi is what makes them so exciting. Many people find them alien and the way so many toadstools appear so quickly and disappear with equal dispatch; their strange forms and colours; their reputation as poisoners. But for Fortey, the extraordinary nature of fungi makes him wonder, think and marvel. In Close Encounters of a Fungal Kind, Fortey leads us on a glorious literary journey, narrated through field trips to real places in search of the strangest, most extraordinary, or even most delicious fungi.

Writing with characteristic warmth, wit and wisdom, Fortey focuses on a selection of the larger fungi, the kind that might be spotted on a country walk, and a handful of microfungi that have particularly caught his attention. His enthusiasm and passion as a life-long ‘mushroom twitcher’ is infectious as he shares his own ‘close encounters’ and brings us along on his treks through this magnificent Kingdom.

The unique charm of the mushrooms themselves is centre stage in this gripping narrative that explains what fungi do in the natural world and rejoices in their profusion and diversity.

Richard Fortey’s Close Encounters of the Fungal Kind is all about obsession with fungi, and often, about collecting them. He’s fascinated by every aspect of them, including identifying them, about how they grow and where they grow, about fungal diversity and whether (as with a lot of other species of all kingdoms) fungi are declining in the modern world.

His interest in eating and collecting fungi is not one I share, but it’s a clear passion, and that’s always fun to read. I think I’d have liked something more focused on the science of fungi — how they work, and even more of their diversity, e.g. delving into fungi like yeast (like baker’s yeast and Candida). But that’s my obsession, not his.

I think I found his writing more engaging about fossils and so on, a thing I think I’ve said before. Maybe that’s because he was younger then and his tone’s evolved, maybe it’s just that that was a topic where he was on surer ground. (It definitely isn’t always my ground, to be clear: I enjoyed his books that discussed lots of geology, which I find dead boring for the most part.)

Fun enough, in any case, and if you’re interested in collecting fungi, it’s not exactly a reference book but it is a fun description and discussion of such a hobby.

Rating: 3/5

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Review – Everything Is Tuberculosis

Posted March 20, 2025 by Nicky in Reviews / 8 Comments

Review – Everything Is Tuberculosis

Everything Is Tuberculosis

by John Green

Genres: History, Non-fiction, Science
Pages: 198
Rating: five-stars
Synopsis:

John Green tells a deeply human story illuminating the fight against the world’s deadliest disease

Tuberculosis has been entwined with humanity for millennia. Once romanticized as a malady of poets, today tuberculosis is a disease of poverty that walks the trails of injustice and inequity we blazed for it.

In 2019, John Green met Henry, a young tuberculosis patient at Lakka Government Hospital in Sierra Leone while traveling with Partners in Health. John became fast friends with Henry, a boy with spindly legs and a big, goofy smile. In the years since that first visit to Lakka, Green has become a vocal and dynamic advocate for increased access to treatment and wider awareness of the healthcare inequities that allow this curable, treatable infectious disease to also be the deadliest, killing 1.5 million people every year.

In Everything is Tuberculosis, John tells Henry’s story, woven through with the scientific and social histories of how tuberculosis has shaped our world and how our choices will shape the future of tuberculosis.

John Green’s Everything Is Tuberculosis is everything I want in a book about tuberculosis that I can hand to laypeople. It’s scientifically up to date, and it’s clear that TB is a curable disease which we’re collectively choosing to inflict on the world’s poorest and most disadvantaged. It’s a disease of inequality and inequity, and Green nails that.

He’s less clear, I think, on how you fix it: he talks about drugs, but the historic example of most of Europe and the USA makes it clear that you don’t even need effective drugs. TB was on the run in Europe before we had streptomycin, as more and more people ate adequately nutritious food and lived in appropriately sized, ventilated buildings, and as work conditions improved. Even without drugs, if we could improve housing and nutrition, we’d gain a lot of ground on TB. But, as with so many of the world’s problems, we choose not to.

Green illustrates his points with the story of Henry, a TB patient in Sierra Leone; at times this felt a bit like inspiration porn, but he does make an excellent point in drawing the comparisons between Henry — an artistic young man who happens, of course, to be black — and the Romantic poets who were feted for being pale and interesting, and the whole tradition that thought TB patients were particularly bright souls full of special creativity. None of that is applied in how people approach Henry, naturally, and that shift occurred as TB became a disease of the poor (instead of all society).

One thing Green covered that I hadn’t known, from this side of the microscope, is that one of the problems with adherence to the courses of drugs that cure TB is hunger. Obviously I knew intellectually that TB patients are often suffering from undernutrition, but I hadn’t actually understood that the process of treatment restores the appetite, prompts roaring hunger, and an empty belly makes all of it feel so much worse.

It fits with one of the key takeaways I have from the tuberculosis course I’m doing right now, though: the major thing we can do to help people adhere to their TB treament is feed them, house them, and give them money. That will help them stick to their treatment and achieve a cure — and that will actually save so much money in treating other TB patients in future.

Finally, I will say that I have a couple of quibbles. First, as I mentioned above, I disagree that streptomycin was key in Europe’s recovery from tuberculosis. Secondly, I feel he conflated DOTS (“Directly Observed Therapy, Short-Course”) and DOT (“directly observed therapy”). As I understand it, it’s important not to confuse the two, because one is a strategy from the 1990s with very specific criteria, and the other is one component of treatment commonly used now which just involves patients being observed while taking their medications. My study materials might be wrong, of course, but I’d be surprised, since I study at the London School of Hygiene and Tropical Medicine, who can usually be trusted to know what’s what as far as infectious disease is concerned.

I’m probably being nitpicky there, though, because for a layperson’s purposes Green explains it — and the problems with it, regardless of whether you mean DOTS or just DOT — very well. Unsurprisingly, we’ve found that trusting TB patients and meeting their needs works better than treating them like children.

If you take one thing away from this book (or indeed from speaking with me), I hope it’s that TB is curable, and that if the will is there, we could do so much more to help people. I think this is something that everyone could use educating themselves about — and this is a very readable, and fairly short, way to do so.

Rating: 5/5

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