The COVID-19 Catastrophe: What’s Gone Wrong and How to Stop It Happening Again, Richard Horton

The COVID-19 Catastrophe was written by the editor-in-chief of The Lancet. Most of the papers I needed to cite in my dissertation on tuberculosis were published in The Lancet, if the name doesn’t mean anything to you; it’s a prestigious medical journal, and Horton himself has a medical degree and a BSc in physiology. He knows whereof he speaks, in other words, and in this book he tears into the failings of governments (mostly the UK, somewhat the US) in coming to grips with the pandemic.

He is very clear in discussing these failings, though he more or less ignores the idea that China had any role to play here. There’s one brief reference to the doctor who tried to raise the alarm and was cautioned by the police, if I remember correctly… but if he does mention it at all, it’s a very bland reference with no further digging into why that occurred, and whether if people had listened at that point, we’d be in this position now. That’s a pretty grave lack.

If you’re curious for his position on matters in the UK, here he doesn’t hold back. I needn’t go over it all again, but suffice it to say that our government was slow to react, loath to give things the weight they deserved, and too quick to lift restrictions. People have died, are dying and will die as a result of the government’s actions; they are massively culpable for a lack of leadership and clarity. And he doesn’t even have to get onto the mess with Dominic Cummings, probably revealed as the book was already going to press.

The final section looks at what we can do to handle future pandemics better: as he rightly points out, this is only the first, and more are inevitable. Other books have done a better job on the whys (Spillover, by David Quammen) and hows (The End of Epidemics, by Jonathan D. Quick), but it’s not a bad high-level summary.

I do worry that one of his final remarks (that COVID marks an end to “sovereignty”) is going to be a massive red button for some people that leads them to just ignore everything he says. I don’t think he’s wrong; I think fragmenting into separate nations with wholly different ways of handling the virus is far from ideal, and I think the WHO has too little power (it has historically received so much of its funding from the US that its policies always have to consider “will this annoy the US?” first and foremost) and funding. We need more unity, not less, if we want to have all this trade and mixing of peoples between different countries… which Britain needs, because we don’t produce everything we need… and that call for unity clashes really badly with current politics.

But them’s the breaks. Pandemics don’t give a fuck about Brexit. If anything, it makes it easier for them as it erodes cooperation, goodwill and information-sharing.

Rating: 4/5

The Science of Monsters, Matt Kaplan

Part of the entertainment factor of this book is the fact that it takes its theories too far. After explaining Chimaera legends as the result of animals wandering into a tar pit and becoming fossilised in a weird tangle, the author goes on:

And Chimera was hardly alone. If a horse went down to a tar pit for a bit of water, got stuck, died, and was subsequently fed upon by a vulture that also got stuck in the tar, that would provide an explanation for the legendary Pegasus. Some art even shows Chimera battling with Pegasus. Was this linked to a find of fossils that people could barely make sense of?

He then goes on to use tar pits to explain sphinxes and Scylla: “Indeed, if there is a monster that stands as evidence that the ancients were looking at fossils of multiple animal skeletons jumbled together, it is Scylla.”

He does nobly admit right after that that “this requires tar pits, and Greece (and the rest of Europe) doesn’t have any”! Yes, that would be a bit of a problem for this theory, but it’s okay — he then posits trade routes as bringing the stories to Greece…

The problem with this book is that there is a lot of truth in it: it discusses gigantism in humans as arising due to tumours in the pituitary gland and suggests that could be the source of some monstrous legends; it points to fossils and tar pits as origins of various monstrous legends and ideas; it points out that giant predators were around in the past. However, it leans on these ifs and maybes — and on a good deal of special pleading — and takes it way too far. Maybe we imagined Cerberus because a giant slavering dog with three heads just seemed scary, you know? No need for three wolves to be swept off to sea together and fossilised as a jumble of bones with three heads.

In the end, I got tired of the exercise for my rolling eyes and put this down, relieved that I never paid for it and instead borrowed it. Whew. If you’re interested in some of the potential scientific seeds of monster stories, there are definitely nuggets of truth here. I learnt that the pituitary tumour thing actually ran in families due to a genetic disposition, producing families of giants! I learnt about some monsters I didn’t know that well! But… I have serious questions about the author’s seriousness here: his Chimera and Pegasus idea really begs for us to ask whether he thinks the fights between King Kong fighting Godzilla were inspired by film-makers finding an enormous ape fighting an enormous reptile in a tar pit? Or does he recognise that while the monstrous can (probably always does) grow from seeds of reality, probably a lot of ancient story-tellers were just thinking up ways to scare the shit out of each other, create amazing spectacles for artwork, or just tell a good story.

Rating: 2/5

How To Invent Everything, Ryan North

I love the idea of books like this: here in one book, we’re going to impart to you the principles behind everything you need to know to rebuild all the comforts of home from nothing. This one has a fun gimmick: it’s been found embedded deep within rocks, and it claims to be the repair manual for a time machine. Since you can’t repair the time machine, instead here’s how to create the comforts of civilisation that you’re used to by accelerating technological progress. To that end, it has some flowcharts for figuring out what time period you’ve ended up in, and technology trees to help you trace out what you need to do to get particular results.

It’s also packed with information, which it delivers in a pretty light style, keeping to the basics. It’s all easy to understand, and the unfortunate thing is that for me the jovial tone got old. Yes, I know, we need XYZ invention to eventually have pizza. I get it. The pizza joke is old now!

The lists for me were kind of… I didn’t like dipping in and out, but it’s also not a great experience to just sit and read it all the way through, either. (For one thing, I think that’s why I got sick of the jokes.)

It’s a really fun gimmick, and there’s a lot of information in here and plenty to pique your curiosity, if a) you know a bit less about science than I do and b) you’re a dip-in-and-out sort of reader. I am just a curmudgeon.

Rating: 3/5

The Atlas of Disease, Sandra Hempel

The Rules of Contagion, Adam Kucharski

The Rules of Contagion is slightly out of my wheelhouse, being less about infectious disease and more about the principles underlying all kinds of contagion. Certainly, there are many examples taken from infectious disease, and it’s a rather on-the-nose choice to read in the current climate (for posterity: I write this review in the midst of the UK’s lockdown to prevent the spread of SARS-CoV-2)… but a good amount of it is discussing other ways of “going viral”: computer viruses, internet memes, and even failure in the financial sector.

I found it reasonably clear and easy to understand, and luckily the math content is pretty light and more theoretical than anything. I did feel sort of like it got stranded in the weeds, though: I wasn’t sure where it was going, and as a consequence, I wasn’t sure whether we got there or not.

In the end, it sort of felt like I was being told a series of cool anecdotes and snippets from research, without them being entirely related to each other. There’s no ur-theory of contagion here, just a ramble connecting some various strands of contagion theory together. That’s not uninteresting, but it feels a little unsatisfying!

Rating: 3/5

Unthinkable, Helen Thomson

Unthinkable is a journey through some non-neurotypical brains. It’s a bit of a mix, actually; some of them have neurological conditions, while others are more psychiatric, and others straddle the border. In part, it illustrates the difficulty in drawing a line between the two. Most of the cases in this book weren’t new to me (or at least, I’d read about similar ones before), although Thomson approaches each person with sympathy and a determination to try and understand them and how they think.

They’re still interesting stories, even though they’re not surprises to me, and there were some details I wasn’t aware of — for instance, the man who believed he was dead was found to have very little brain activity, when scanned, more like someone in a coma than someone alive and walking around.

It’s silly, but I did have to laugh when Thomson mentioned someone “watching manga”. Yikes.

Rating: 3/5

How to Argue with a Racist, Adam Rutherford

I’ve enjoyed Rutherford’s work before; he communicates clearly, and he’s clearly delighted by the intricacies and weirdnesses of DNA and inheritance. In this book, he tries to provide people with the tools to argue back with some key racist talking points about skin colour, intelligence, milk-drinking, ancestry and proficiency at sport. For the most part, he doesn’t argue with a specific study or source of an idea, but offers up general points. It’s actually a very ineffective way to argue with anyone who’s going to ask for evidence, however true his points are; you can explain to a horse how to get to the water, but it’s not going to go and drink no matter how long you talk at it. Or, as my grandmother says, “You can’t educate pork.”

Really, the main problem is that some people are never going to believe you, even if you can talk the hind leg off the proverbial donkey and you can provide the sources. It’s not really clear who benefits from this book — mostly, I guess, people who know people who are sat on the fence, but can listen to reason. If you know any of those, I’ll send you my copy (assuming I haven’t already sent it to someone else) and best of luck to you!

It’s still clear and engaging, but preaching to the choir (by definition, if it’s aimed at people who want to argue with racists) and without a really clear guide to how to use these talking points. Vaguely replying “yes well everyone is related to everyone else if you go back through the family lines to the 16th century” doesn’t cut it for most racists.

If you’re on the fence and you want to understand why Ashkenazi Jews aren’t inherently more intelligent than other people and African runners aren’t inherently better at sprinting than anyone, it might be useful!

Rating: 3/5

The Great Pretender, Susannah Cahalan

I was fascinated by Cahalan’s previous book, Brain on Fire, which documents her hospitalisation for psychosis that turned out to have been caused by encephalitis, prompted by an immune disorder. For a while, Cahalan was lost, but she found her way back, and The Great Pretender is in part prompted by those experiences. Looking at patients with mental health issues, she’s found herself wondering how many might be suffering from brain inflammation in the way she was, and how many could be cured partially or wholly by the same treatment. That’s how she found out about David Rosenhan’s famous study, which was born from a very pertinent question: “How can we tell the sane from the insane?”

Rosenhan’s study sounds simple: he sent nine pseudo-patients, one of them being himself, into a psychiatric ward with a simple description of non-dangerous but troubling symptoms. They all claimed to be hearing voices which said things like “hollow” and “empty”, but they dropped these symptoms as soon as they were actually in the ward. They all emerged from the wards — some after nearly two months — with diagnoses of schizophrenia.

Cahalan found this electrifying: how could psychiatrists not tell the pseudo-patients were perfectly sane? For the same reason as she was originally diagnosed as psychotic, partially: there’s no actual physical diagnostic criteria you can run someone through to prove one way or another whether they are suffering from a mental health disorder. (The DSM, a diagnostic manual, was updated to include a lot more diagnostic criteria as a direct result of this study; the issues are different now, though there are still deep issues with subjectivity and bias.) And also because all kinds of ordinary actions could be interpreted as insanity when seen in the confines of a psychiatric ward. A person taking reams of notes on everything the nurses do might be a pseudo-patient, but your first thought is probably that they’re paranoid and keeping track of the nurses as part of their out of control fear and attempt to control the situation!

In any case, Cahalan found the study fascinating and began to dig in… which is where it all began to fall apart. This isn’t a small study that no one knew about; this shaped mental health policy for years, and despite the protestations of some mental health professionals reading this book, it’s still in people’s minds. (I knew about it as a layperson, and I only had to say “Rosenhan” for my mother, a psychiatrist, to know what I was talking about.) And yet Cahalan’s investigations call it into question. It seems very likely that Rosenhan faked much of the data, as very few of the pseudo-patients could be found. One who was had a markedly different experience in the wards to the one reported, and was allegedly removed from the study… though his data still remained in the published version.

There are all kinds of little inconsistencies that pointed Cahalan to this conclusion, and I think the length of my review shows my enthusiasm and interest for the digging work she’s done here, interviewing the study participants she could find and searching for the others. She calls into question the study’s truthfulness, but not, in the end, its validity. Rosenhan’s observations struck a chord for a reason, after all. Was it bad of him to lie and fake data like this? Of course it was. But maybe psychiatry needed that.

That said, the book also showcases how far the pendulum has swung the other way, with prisons in the US absorbing many of the people originally cared for in specialised wards. And Cahalan keeps putting her finger on the sore place, again and again: we still can’t tell the sane from the insane, not really. We still don’t know the physical causes of much mental ill-health, and diagnosis requires an experienced clinician with a checklist of behaviours — and even they can be fooled by an autoimmune disease.

It’s perhaps not as gripping as Brain on Fire, but I enjoyed it and highly recommend it, and find myself largely in agreement with Cahalan’s conclusions.

Rating: 5/5

When the Dogs Don’t Bark, Professor Angela Gallop

I picked this up on a whim because it looked like it could be my sister’s thing, and I never object to more random information about all kinds of topics. Angela Gallop is a well-known forensic scientist who has worked on several famous murder cases; this is a sort of professional memoir, barely touching on her personal life, but digging into her opinions on forensic science, her part in expanding forensic science services in the UK and eventually worldwide, and her involvement (sometimes tangentially) in various cases.

It’s a little bit of everything, really: she talks about setting up her business, and that butts up against the horrible details of bloody murders and the less than fascinating references to board meetings. It feels rather unfocused, sort of like there’s the kitchen sink at all: there’s certainly plenty of interesting anecdotes, but the wealth of examples sometimes bogs down her theme. Where you expect her to be contrasting two cases, they turn out to be remarkably similar and prove the same point. It’s not terribly written, but I’d tighten it up ruthlessly and make her add in an organising theme.

She does have something she wants to say about forensic science: “it’s more complicated than you think, it needs funding, it needs to be impartial, and it needs to be done in context”. But those cautionary notes for the understanding of and the future of forensic science get a bit lost when suddenly she’s complaining about the perils of borrowing money to start a company and how things could have gone wrong there. The book’s neither fish nor fowl; it’s not just about digging into the story behind investigating specific crimes, but it’s so heavy on those details that it feels like maybe that was the original point.

That said, the details are interesting and her style isn’t bad, just a bit flabby. I mildly enjoyed it, but felt it could’ve been more impactful if it knew what it was.

Rating: 3/5

West Nile Story, Dickson Despommier

I came across this because I was trying out various science podcasts and tried listening to some of the early episodes of This Week in Virology (link goes to the episode about West Nile virus). I was curious to dig in a little more, and lo and behold, this book was on Kindle Unlimited. It discusses the earliest outbreak of West Nile virus in the US, which happened in New York during a hot, dry summer, and was somehow transmitted there from Israel. The podcast actually fleshes out the theory a bit more, while this book focuses on a wider look at the virus, its ecology and implications.

It’s probably a fairly dry read if you’re not interested in emerging infectious diseases, but since I am, I quite enjoyed it; I found it fairly simple, so if you’re just interested in diseases for the sake of it without a professional interest, I think it’s completely understandable for a layperson. It was a little basic for me at times, in fact.

Overall, it was a little scatterbrained somehow; it wandered off into discussing other diseases like malaria, without really tying it into the discussion of West Nile very well. I’d probably recommend the podcast over the book for that reason, but it was still interesting to dig in a bit deeper on some of the points mentioned in the podcast.

Rating: 3/5