Category: Book-Blogging

Book-Blogging – Americanah

For all sad words on tongue or pen, the saddest are these, ‘it might have been.’ – John Greenleaf Whittier

The air in Chimamanda Ngozi Adichie’s envy-inducing book, Americanah, is suffused through with saudade.

americanahSaudade is a Portuguese word without a direct English translation, but you probably know it: a sense of wistful nostalgia for something that probably never existed; the what-ifs and maybes that accompany a breakup.

This sense of longing – for a past since relegated to hazy, rose-tinted prologue; for a future perpetually just out of reach – crowds the oxygen from every open space in the book. Many of the characters are caught up in a near-constant fog of saudade, like the minor character Kimberly:

Ifemelu sometimes sensed, underneath the well-oiled sequences of Kimberly’s life, a flash of regret not only for things she longed for in the present but for things she had longed for in the past.

Ifemelu, one of the two main characters, begins her life in Nigeria and emigrates to America in search of a better education and a better life. She finds both, but is drawn back to Nigeria, saudade in tow:

She thanked him, and in the gray of the evening darkness, the air burdened with smells, she ached with an almost unbearable emotion that she could not name. It was nostalgic and melancholy, a beautiful sadness for the things she had missed and the things she would never know.

Ifemelu’s first love, Obinze, could not follow her to America, and ends up in London, where he also sees saudade in others:

It puzzled him that she did not mourn all the things she could have been. Was it a quality inherent in women, or did they just learn to shield their personal regrets, to suspend their lives, subsume themselves in child care?

Adichie is an enviable writer with a powerful and distinct voice; my Kindle is heavy with paragraphs highlighted both for their virtuosity and my edification. She masterfully weaves together the stories of emigrants and those who are left behind, bringing to life the bustle of Lagos and the dark gray winters of the American east coast. This is a book well worth your time.

Book-Blogging – A Problem From Hell, by Samantha Power

A_Problem_from_Hell_(book_cover)Samantha Power’s masterful book, A Problem from Hell: America and the Age of Genocide, will make you want to do one of two things: drop everything and go work with her from the inside, to embolden our institutions and ennoble our leaders; or rage from the outside about the myriad failures of conscience and the fostering of cowardice that have consistently stymied the better angels of America’s nature.* It’s hard to see much middle ground.

In this thoroughly researched and thoughtful book, Power provides a remarkable history of modern-day genocide. She brings the reader to the death marches of Armenians in the gloaming of the Ottoman Empire to the wanton destruction of male Muslims in Bosnia and Kosovo, all the while cataloging the all-too-familiar costs of all-too-familiar inaction on the part of world leaders – saving her sharpest critiques for her adopted homeland, America. This is a book that could profoundly change the way you view the international system, and those at the top of it.

From the mid-17th century, when the Peace of Westphalia ended the Thirty Years’ War to the mid-20th century, nations were assumed sovereign over their land and their citizens (summed up best in Millennial-speak as “you do you”). Certainly, there were land wars and civil wars, insurrection and imperialism, but nations didn’t question how other nations treated their people.

And then in the early 1900s, the Ottoman Empire began massacring its minority Christian Armenian population. This is important for two reasons: it stoked the passions of an American ambassador, Henry Morgenthau, and caused him to speak out against a sovereign nation’s actions towards its people; and it inspired Raphael Lemkin to change the world.

Generally, the Great Man of History theory – the cum hoc ergo propter hoc fallacy that assumes, for example, that everything good or bad that happens during Barack Obama’s presidency is his doing – is just that: a fallacy. But Raphael Lemkin, a passionate Polish lawyer who eschewed decorum and tact in his zeal to codify genocide (his word) as a crime against humanity, was a Great Man of History. He is one of the the but fors of this story; but for Lemkin, it’s hard to see how the United Nations would ever have adopted the Genocide Convention, in December, 1948 or thereafter.**

The other but for of this story is darker and more deeply depressing: but for America’s reticence to enter the fray diplomatically or militarily, again and again, untold lives could have been saved. Power uses the taxonomy of inaction outlined by Albert Hirschman to underline the stated reasoning against action:

“Economist Albert Hirschman observed that those who do not want to act cite the futility, perversity, and jeopardy of proposed measures.”

Each category is pretty self-explanatory. Futility is the sense that nothing could help; perversity that an action could make things worse; and jeopardy a sense that American lives/interests would be harmed by action.

Power is at her best when presenting her unflinching criticism of the cowardice exemplified by America’s leaders each time they invoked the futility, perversity, and jeopardy of action. Facing genocide, or even the prospect of genocide, leaders cowed to interest groups and genocidal leaders, rather than stand up for the ideals they continually cited – nothing more or less than vague platitudes:

U.S. officials spin themselves (as well as the American public) about the nature of the violence in question and the likely impact of an American intervention. They render the bloodshed two-sided and inevitable, not genocidal. They insist that any proposed U.S. response will be futile. Indeed, it may even do more harm than good, bringing perverse consequences to the victims and jeopardizing other precious American moral or strategic interests. They brand as “emotional” those U.S. officials who urge intervention and who make moral arguments in a system that speaks principally in the cold language of interests. They avoid use of the word “genocide.” Thus, they can in good conscience favor stopping genocide in the abstract, while simultaneously opposing American involvement in the moment.

This book won the Pulitzer Prize in 2003, and for good reason; it is thoughtful, unsparing, and scathing. Reading it and thinking about it helped clarify the way I think about America’s role in the world. From the perspectives of morality and pragmatism, we have an obligation to be better; anything less than our best – the officially sanctioned torture in Abu Gharib, the deaths of innocents in misguided drone strikes, the idiocy of using a public health campaign as a front for espionage – invites bad actors to use those same methods. And inaction in the face of injustice and terror is nothing if not a green light for its continuance.

Power, now the United States Ambassador to the United Nations, has walked back some of her more forceful critiques of American action and inaction of the past, saying at her confirmation hearing that “Serving in the executive branch is very different than sounding off from an academic perch.” Activists worry that she has lost her zeal.

This strikes me as unlikely. While it is certainly true that she speaks more carefully now than she wrote before, it seems obvious that she is brilliant, passionate, and willing to do what it takes to effect the change she earnestly argues for in A Problem From Hell and elsewhere – even if that means softening her speech while sharpening her knives.

After reading this book, I’d drop what I’m doing in a heartbreak to work with her from the inside, which should be all that you need to know to go pick it up.

 

*Full disclosure: while I am temperamentally much more comfortable in the latter group – of realists and cynics, agitators and disruptors – in this case I think it’d be really dumb to do anything but side with Power.

**Lemkin is also a good reminder that Great Men of History aren’t always viewed that way during their lifetime: “Lemkin had coined the word ‘genocide.’ He had helped draft a treaty designed to outlaw it. And he had seen the law rejected by the world’s most powerful nation. Seven people attended Lemkin’s funeral.”

Book-Blogging – Scarcity, by Sendhil Mullainathan and Eldar Shafir

Scarcity coverAs I’m writing this, it’s the middle of the holiday season, which means that you’re probably a little dumber right now. A bit more scatterbrained. Likely reaching for that extra holiday cookie or for one more egg nog than you really need.

Upon reflection, you’d probably admit that this is at least partly because you have a lot on your mind; more last-minute gifts to wrap than time; and, after purchasing a plane ticket home, buying gifts, and (over-)indulging with friends, a much thinner wallet. You’re stressed out.

In the parlance of Sendhil Mullainathan and Eldar Shafir, you’re experiencing “scarcity” – you’re “bandwidth-taxed.” In their excellent read, Scarcity, the authors seamlessly weave real-world examples with clarifying experiments to show just how pernicious scarcity can be. I highly recommend picking up the book; it will change the way you look at your finances and your time. And hopefully it will change the way you think about how poorly-aligned our society’s understanding of individuals in poverty is; how a reimagining of anti-poverty policy could make everyone – but especially the poor – better off.

As Mullainathan and Shafir point out, scarcity isn’t all bad; as anyone who has written a last-minute paper or crammed for a test knows, a time constraint provides a useful “focus dividend” – it gets you to get stuff done[1].

But the costs of scarcity often outweigh its benefits. A packed schedule or a bank account near zero (or below) cause tunneling: focusing on the most pressing issue, often at the cost of the long term. You take out a payday loan to pay the late bill, even if it leads to usurious interest rates you’ll have an even harder time paying off next month; all your meetings start 10 minutes late, and none of them are all that productive; you choke on that first date you really wanted to go well.

It’s not just your free time or wallet that are depleted, though; it’s your bandwidth – a wonky way of describing “brainpower.” The correct understanding of bandwidth, Mullainathan and Shafir argue, is akin to a gas tank; you use it up over time, and when you’re working on a thoughtful task, you use it up faster than when you’re doing something mindless[2].

And when your bandwidth is taxed, you are dumber. Literally. In one of Mullainathan’s and Shafir’s studies, mall-goers –some well off, others poorer – were asked about a hypothetical decision to spend either $150 or $1,500 to fix some short-term car trouble, and then were given a test of Raven’s Progressive Matrices to judge fluid intelligence.[3] When given the $150 hypothetical, the rich and poor looked equally intelligent; when given the $1,500 hypothetical, the poor did significantly worse. As the authors note, this was significant both in the statistical sense and in the real-world sense:

 Our study revealed that simply raising monetary concerns for the poor erodes cognitive performance even more than being seriously sleep deprived… our effects correspond to between 13 and 14 IQ points. By most commonly used descriptive classifications of IQ, 13 points can move you from the category of “average” to one labeled “superior” intelligence.

Thinking about money issues temporarily made people less intelligent, by nearly an entire standard deviation. Mullainathan and Shafir found similar effects to executive control:

 The same farmer fared worse on fluid intelligence and executive control when he was poor (preharvest) than when he was rich (postharvest). Much like the subjects at the mall, the same person looked less intelligent and more impulsive when he was poor… The postharvest farmers got about 25 percent more items correct on Raven’s. Put in IQ terms, as in the earlier mall study, this would correspond to about 9 or 10 IQ points

This is why, the authors note, “scarcity creates its own trap.” Tunneling, and the juggling it forces, distorts decision-making:

Scarcity, and tunneling in particular, leads you to put off important but not urgent things—cleaning your office, getting a colonoscopy, writing a will—that are easy to neglect. Their costs are immediate, loom large, and are easy to defer, and their benefits fall outside the tunnel. So they await a time when all urgent things are done. You fail to make these small investments even when the future benefits can be substantial.

You make dumb long-term decisions because you only think about the most immediate and pressing things to do.

A proper understanding of, and reckoning with, these ideas leads to significant individual, social, and political changes.

For individuals, it may mean scheduling high-bandwidth tasks earlier in the day, or at least not scheduling all high-bandwidth tasks back-to-back; perhaps you should put mindless tasks – doing expenses, maybe, or clicking through low-priority emails – after something that requires your full attention.  And it means trying to turn all of the hard, repetitive decisions you have to make into one-time decisions; you can either have to say no to the chocolate bar every time you open the pantry, or just say no to it once at the grocery store. Same deal with habits: if you go on a run or to the gym on a consistent basis, choosing to go today will be, well, less of a choice.

As a society, these ideas should lead us away from viewing the poverty problem as a moral one – thinking that those in poverty are lazy or dumb or what have you – to a practical one. We know – or, more accurately, have a strong factual basis to believe – that a bandwidth-taxed individual is liable to make worse decisions, and that those in poverty are, by definition, bandwidth-taxed individuals. Properly considered, the research should lead to a greater level of empathy; we all know what it feels like to be bandwidth taxed – but most of us are fortunate enough to not feel like that all the time. Many aren’t, though.

If you view poverty through this lens, it’s easy to see how specific policy changes could help increase bandwidth and reduce scarcity. One stark example: payday loans[4]. Mullainathan and Shafir put it better than I can:

Many workers, as we saw in chapter 5, resort to payday loans. Yet it’s worth observing that a payday loan is often simply a loan against work that has already been done. The worker who takes a payday loan halfway through the pay cycle has already earned half her paycheck. The need for a loan is largely due to the fact that payment happens with a delay. Why should an employer have workers taking these loans, potentially falling into scarcity traps, taxing bandwidth, and resulting in lower productivity, especially when the employer can himself give pay advances at low cost? How valuable would it be for employers to improve productivity by offering the right financial products and creating bandwidth?

This is a pretty nonideological solution to a politically-fraught issue. There are costs to it, sure, but as the authors point out, it’s easy to see how they could be outweighed by productivity benefits.

Finally, policymakers and policy wonks need to learn how to craft programs that take the already-limited bandwidth of the poor into account:

We treat education as if it were the least invasive solution, an unadulterated good. But with limited bandwidth, this is just not true. While education is undoubtedly a good thing, we treat it as if it comes with no price tag for the poor. But in fact, bandwidth comes at a high cost: either the person will not focus, and our effort will have been in vain, or he will focus, but then there is a bandwidth tax to pay. When the person actually focuses on the training or the incentives, what is he not focusing on? Is that added class really worth what little quality time he managed to spend reading or with his children? There are hidden costs to taxing bandwidth.[5]

Scarcity is a problem we all face, in one form or another. And we face it together, too, as a society. Read this book and you’ll have a much better understanding of it.



[1] Though, in those cases, neither the paper nor the studying is as good as it would be sans procrastination

[2] You may recognize this idea as “ego depletion,” Roy Baumeister’s model for how willpower is reduced when people are faced with difficult decisions. In this model, willpower is a muscle that can be used, depleted, replenished (with a sugary treat, say), and strengthened over time

[3] You know – and likely loathe – these:

Screen Shot 2014-12-23 at 9.56.48 PM 

 

 

 

 

 

 

 

[4] Speaking of which, the John Oliver segment on payday loans is excellent

[5] As an aside, if you’ve worked in international development in any sector, you recognize how difficult education/”sensitization” (for those in east Africa) is. Add bandwidth to the long list of reasons why.

Book-Blogging: Making of the Atomic Bomb, by Richard Rhodes

The_Making_of_the_Atomic_BombRichard Rhodes’s Making of the Atomic Bomb is not for everyone.

For starters, it’s long – really, really long.  It’s also fantastically dense, serving as not only a history of the atomic bomb but also as a history of nuclear science, anti-Semitism in eastern Europe, and of World War II. And it can be a slog – at times, a hard read and a boring one to boot.

But it is the book to read if you want to learn about, well, the making of the atomic bomb and the Manhattan Project.

For that reason, writing a review of it is pretty much unnecessary: either you’re the type of person to read this book, or you’re not. If you are, I highly recommend it; if not, I don’t think you’ll like it.

Instead, after the jump I’ll list a few of the sections I highlighted while reading on the Kindle, mostly because I thought they were interesting or provided a unique perspective or thought.

Book-Blogging: The Teacher Wars, by Dana Goldstein

teacher-wars-cover picLearning about the past is useful for a lot of reasons, but it’s perhaps best for tamping down hubris – for bringing some needed skepticism to the “Great New Idea” to solve the seemingly-intractable problem of the day. Many Great New Ideas aren’t great or new, and a failure to appreciate the past imperils the future.

American education reformers are perpetually in thrall to this or that Great New Idea, as Dana Goldstein shows in her fantastic new book, The Teacher Wars. From the birth of the modern education system in the 19th century to today’s fights over tenure and value-added pay-for-performance, individuals and organizations have always brought forth teacher-centered reforms meant to improve the quality of American education – and have generally failed to create the change they seek.

As Goldstein puts it, “The history of American education reform shows not only recurring attacks on veteran educators, but also a number of failed ideas about teaching that keep popping up again and again, like a Whac-A-Mole game at the amusement park.”

And in American education, no Great New Idea has failed as many times as rating teacher effectiveness:

“For over a century, school reformers have hoped that tweaking teacher rating systems would lead to more teachers being declared unfit and getting fired, resulting in an influx of better people into the profession. But under almost every evaluation system reformers have tried—rating teachers as good, fair, or poor; A, B, C, or D; Satisfactory or Unsatisfactory; or Highly Effective, Effective, Developing, or Ineffective—principals overburdened by paperwork and high teacher turnover ended up declaring that over 95 percent of their employees were just fine, indeed.”

The current reformers – technocrats like Bill Gates, Arne Duncan, and President Obama – want to use the test scores of students to evaluate teacher effectiveness, employing “value-added measurement” to do so*.

At first pass this sounds reasonable, but Goldstein lays out a few problems with doing so. Perhaps most importantly, American society has always expected way more from teachers than they can reasonably accomplish:

“Effective teachers can narrow, but not close, achievement and employment gaps that reflect broader income, wealth, and racial inequalities in American society. This reality was demonstrated by the most celebrated value-added study ever conducted. Economists Raj Chetty, John Friedman, and Jonah Rockoff tried to figure out if teachers who were good at raising test scores were also good at improving their students’ long-term life outcomes—in other words, if value-added was a good proxy for some of the other goals, aside from raising test scores, that we want teachers to fulfill… One finding was that the current achievement gap is driven much more by out-of-school factors than by in-school factors; differences in teacher quality account for perhaps 7 percent of the gap.”

That critique isn’t limited to value-added measurement, of course, but it’s worth making clear: we spend a disproportionate amount of time and energy worrying about teacher effectiveness when the vast majority of the achievement gap is wholly out of their control. Any reform movement that doesn’t address a variety of socioeconomic factors is bound to fail to have a meaningfully large effect.

More to the point, it’s not clear that reforms centered on value-added measurement will even improve student outcomes:

“Research from the National Center on Performance Incentives at Vanderbilt University found that where teachers had been eligible for bonuses according to value-added ratings, whether $3,000 per teacher in New York City or $15,000 per teacher in Nashville, student outcomes did not seem to improve.”

Another reform championed by many progressives is to end, or at least severely restrict, teacher tenure.  While I’m still sympathetic to this idea, Goldstein’s book convinced me that it is largely a distraction – something that takes up too much space on the reformist agenda and that emits more heat than light. Teacher tenure has outlived its original use (more or less to protect teachers from prejudice and the whims of patronage), but it’s not obvious that ending it would actually improve the academic outcomes of children.

(To be clear: I still think there’s a case for ending teacher tenure – especially the contracts that give tenure after an unusually short amount of time teaching – but it seems to me that the most salient benefit of doing so is that it would simply move the conversation away from tenure and to issues of greater importance)

Whatever the teacher-centric reform du jour, changes based on the assumption that there is a large cohort of bad teachers simply haven’t led to the types of large-scale improvements that reformers seek. There is no question that bad teachers exist – and they should be identified and potentially removed – but there are far more good and teachable teachers that can be made better. Or, put another way: any reform that doesn’t focus on turning good teachers into great teachers is wholly missing the point and – in contrast to the high-minded Helen Lovejoy-like rhetoric and appeals to “think of the children!” – shows that some reformers are more comfortable appealing to equity and fairness in the adult job landscape.

One piece of today’s education reform that Goldstein leaves out of the book is the role that technology and innovation is playing now, and may play in the future, for teachers and students alike. This makes sense, of course – the book is a history book focused on human teachers, and, well, the teaching profession has been a bit slow on the uptake – but it’ll likely be a new front in the “teacher war” that’s worth exploring and understanding now. Some efforts, like the Los Angeles Unified School District’s attempt to bring iPads to all the students in its district, have failed pretty spectacularly. But others won’t.

Goldstein ends the book by offering a number of ideas to improve the education system, including paying teachers more – and sooner; allowing more opportunities for teachers to grow and develop new skills and responsibilities while still being able to teach; focusing on principals, too; using tests and value-added measurement as tools but not the tools; and getting rid of archaic and unnecessary last-in first-out (LIFO) teacher layoff policies. All are common-sense reforms that, though politically difficult, put the focus on promoting an environment that will produce better teachers and, hopefully, better student outcomes.

The Teacher Wars is a great book that I highly recommend. Goldstein synthesizes a wealth of knowledge about the American education system** into a fair, balanced, and nuanced look at today’s education system and its reformers, and shows how history is, as ever, repeating itself. She neither deifies nor vilifies teachers and reformers – judging by most coverage and rhetoric, not an easy thing to do – and instead offers concrete, data-based recommendations for moving the conversation to more productive ends.

 

*To lay out my bias, I would also consider myself a technocrat, though a skeptical one

**Goldstein’s trenchant and useful analyses of the history of teacher unions, Teach for America, urban teacher residencies, and the charter school movement are left out of this review because of length, but are excellent, too

Book-Blogging – Rabid, by Bill Wasik and Monica Murphy

RabidIt’s a disease that crawls in you a centimeter or two every day, slow and steady. Once you feel it – a twitch of your finger, maybe, or a headache – it’s already too late. You are dead. But only after you become viscerally terrified of water (hydrophobic). Before you die, you may bite a caretaker on the way out.

Worst of all? You probably got it from Man’s Best Friend. Your Best (non-human) Friend.

It’s rabies. To be fair, unless you’re one of the 55,000 unlucky people who die from it each year (mostly in low-income countries in Asia and Africa), this isn’t, strictly speaking, you anymore. You’re vaccinated, or at least post-exposure-vaccinated before you show symptoms, just in case.

As Bill Wasik and Monica Murphy, the authors of Rabid: A Cultural History of the World’s Most Diabolical Virus, put it,

“Rabies has always been with us. For as long as there has been writing, we have written about it. For as long, even, as we have kept company with dogs, this menace inside them has sometimes emerged to show its face to us”

Almost unique among diseases, the virus is virtually 100% fatal without pre-exposure or post-exposure-but-pre-symptom vaccination (HIV is another).

Unfortunately, the book is not as fascinating as the disease; while it starts out strong, it flags after the discussion of Pasteur’s vaccine (which is really fascinating), and never really picks back up (though the tale of Jeanna Giese and Dr. Rodney Willoughby, which can also be heard on Radiolab, is great).  It would be better as a 5,000-word magazine feature.

Because of our intimacy with dogs, and their intimacy with rabies, the first half of the book explores how they came about – how the wolf transformed into Man’s Best Friend. It was because of our waste, actually:

“Scientists theorize that the indispensable hearth of domestication was the human garbage pile, with the wolves that scavenged there some fifteen thousand years ago becoming gradually more tame.”

The book delves into man’s relationship with rabies, too: it was a disease of rage, and madness, and one that turned the ever-thoughtful, ever-tame Man into Beast:

“The French word rage is a derivative of rabies, which in Latin served as a rough equivalent of lyssa. As with that Greek term, rage in French begins its life both as a horrible disease and as something more profound, a sort of animalistic fury tinged with madness.”

In medieval times, the medicine practiced was Hippocrates’s and Galen’s; little changed for hundreds of years. It sounds pretty strange to modern ears. We now know that rabies isn’t curable or treatable by any medicine known to man, ever, but at the time medieval medicine men tried just about everything:

“’Other men pull all the feathers from around a live rooster’s anus and, hanging the poor bird by the neck and wings, set the anus on the bite wound, on the theory that said anus would suck forth the poison. If the rooster swells up and dies, then the hound is mad, but the man will be healed; that is, the book avers, “many men say” this is the case, but “thereof I make no affirmation.”

(My favorite part is how the prescriber doesn’t explicitly endorse the  treatment himself. “I’m just saying I heard it from a guy who knows a guy.”)

The authors then touch on how rabies affected literature – werewolves and vampires galore – which is interesting but feels forced

For an anecdote collector, the book holds a few gems, like those cited above, but overall I was a bit disappointed by it.

If you’re really interested in rabies, pick up this book. Otherwise, I’d recommend you read Spillover instead.

Book-Blogging: Spillover, by David Quammen

Spillover 2If you remember one thing from this short review: stay away from bats and try not to eat exotic animals (e.g., apes, monkeys, civets) if you can help it. Both are excellent ways to become the next Patient Zero for a brand-new zoonosis.

You could be forgiven for not knowing the word “zoonosis,” but, without question, you know zoonoses: HIV. Influenza. Ebola (recently back in the news*). Rabies, and dozens of lesser-known diseases – they’re all zoonoses: animal infections transmissible to humans.

And when The Next Big One – a global pandemic that causes untold suffering and remarkable morbidity and mortality – descends upon the earth as one of the Four Horsemen of the Apocalypse, it’ll almost certainly be a zoonosis. This has happened in the past: a simple flu in 1918 killed something like 50 million people. This is happening in the present: HIV’s toll is 25 million and counting. And it will happen again, probably sometime soon; The Next Big One will spill over from an animal population into a human population, and it’ll wreak havoc.

Spillover – as in a moment, an event, a noun – is an evocative word. It brings to mind something vaguely chaotic, worrying, and uni-directional; once it has occurred it can’t un-occur. Spillover is, in other words, an excellent title for David Quammen’s fantastic book on zoonotic diseases.

Quammen is an engaging, lucid, and often very funny writer. He is transparently curious and intelligent-without-trying-to-seem-intelligent, and he has a potent ability to distill complicated scientific jargon to something more palatable for the lay reader.

Spillover is the end result of years of reporting that took Quammen around the world, from the humid jungles of Malaysia to the humid jungles of the Democratic Republic of the Congo to the humidity-controlled laboratories of America’s most precautionary disease research institutes.

What he finds is both deeply distressing and mildly encouraging. The bad news: The Next Big One is coming. Full stop. The good: when it does, the world is more prepared than any other time in history to address it.

And it should be; as Quammen outlines, we’ve had a number of (relatively) dry runs to learn and improve.  Take SARS, the early 21st century disease that traveled from China to the rest of the world on airplanes. A muffled reaction by the Chinese government no doubt led to excess deaths (there were 774 in total around the world, from about 8,000 cases), but the disease was contained and eventually squelched out – for now. As Quammen puts it, SARS was bad but ultimately “an outbreak, not a global pandemic.”

Why? What made SARS The Next One but not The Next Big One? For starters, the outbreak started in China and spread to Singapore, Vietnam, and Canada – not Bangladesh, the Democratic Republic of the Congo, or other infrastructure-poor countries. Quammen writes,

“If the virus had arrived in a different sort of big city—more loosely governed, full of poor people, lacking first-rate medical institutions—it might have escaped containment and burned through a much larger segment of humanity”

As bad as the virus was (is), symptomatically it could have been much, much worse. The mortality rate was about 10% (though in other environs this could have been much higher), and, crucially, with SARS,

“symptoms tend to appear in a person before, rather than after, that person becomes highly infectious. The headache, the fever, and the chills—maybe even the cough—precede the major discharge of virus toward other people.”

A 90% chance that you’ll live isn’t encouraging, but at least with SARS your family and your neighbors know you’re sick before you can infect them.

Imagine a nasty strain of influenza that was as infectious and as lethal as SARS, but that breaks out in Nairobi or Lagos – a dense city with health infrastructure not up to the task of a mass outbreak that also has all kinds of international flights – and has time to infect before it presents symptomatically. That is the Next Big One.

But step back from any individual spillover and ask a larger question: why do spillovers happen at all? Because they’re inevitable, provided humans interact with animals; viruses (especially RNA viruses) mutate – evolve – constantly, and every once in a while they do so in a way that allows a human to become infected.

We’re making it worse, though. Increases in human population and the resultant erosion of natural “walls” between man and beast (so to speak) are putting humans in ever closer contact with animals, and globalization is inexorably accelerating the ability of one human to affect another. This is one of Quammen’s main points: diseases, and outbreaks, have an ecology to them, and in our razing of the rainforests and regular forests we’re building the perfect environment for spillover events.

Read the book.

*If you’re reading this in 2014, the ebola outbreak in West Africa is probably on your mind. Unless you live in West Africa – or, for that matter, East Africa – you simply don’t have anything to worry about. Ebola isn’t contagious in the same way that, say, influenza is contagious – by droplets in the air – and it’s too deadly and quick-to-incubate to cause sustained horror. It burns itself out. What’s happening in West Africa is horrible, but it isn’t The Next Big One.

Book-Blogging: All of Sam Kean’s Books

disappearing spoon

A nagging running injury has kept me elliptical-bound for the better part of six weeks, so lately I’ve been Hoovering books on my Kindle.

You’ve probably never heard of Sam Kean (he doesn’t have a Wikipedia page). If you know the name, it’s probably because you know the voice from Radiolab, where he’s talked about everything from a man who invented technology that has saved and killed a remarkable number of people (that’s Fritz Haber, of the Haber process for producing nitrogen and the “Father of Chemical Warfare” Haber) to the man who survived both atomic bombings, Tsutomu Yamaguchi.

If there’s anything I’m evangelical about, it’s Radiolab, and I liked the way Kean told these stories, so I picked up Kean’s first book, The Disappearing Spoon. And then I read it. Quickly. And then I quickly picked up his next two: The Violinist’s Thumb and The Tale of the Dueling Neurosurgeons.

Each deals with a separate science topic – elements, genetics, and neurology, respectively – and is driven by historical anecdotes followed by in-depth explanation. Each is a delightful read.

And that’s more impressive than it sounds. It’s not easy to make the periodic table (in and of itself) all that interesting; genetics is a difficult topic to truly understand, and so is neurology. Kean combines genuinely fascinating stories (see: Haber and Yamaguchi) with a writing style that’s colloquial without attempting “Talk Hip With the Kids” and lucid without being shallow.  (To wit, from The Disappearing Spoon: “As a metal, polonium is useless. It decays so quickly it might have been a mocking metaphor for Poland itself.” Which, if you know anything about the history of Poland, is both funny and sadly true.)TDN

VTScientists have an undeserved reputation as boring, stodgy, and all-around uninteresting. This could not be further from the truth – it seems like every major invention has a major backstory full of backstabbing, deceit, indifference, and cunning – and it is Kean’s obvious affection for these scientists and their stories that gives otherwise dense material the padding to flourish.

The books are goldmines of interesting tales and facts; I picked a random paragraph in my book notes  of The Disappearing Spoon and this is what came up:

 But the taste buds for sweet and sour are easy to fleece. Beryllium tricks them, as does a special protein in the berries of some species of plants. Aptly named miraculin, this protein strips out the unpleasant sourness in foods without altering the overtones of their taste, so that apple cider vinegar tastes like apple cider, or Tabasco sauce like marinara. Miraculin does this both by muting the taste buds for sour and by bonding to the taste buds for sweet and putting them on hair-trigger alert for the stray hydrogen ions (H+) that acids produce.

Which is pretty interesting. Each of the books is a wealth of factlets like that, without devolving into a book of anecdotes. Not easy to do.

I could go through each book individually, but really they’re all excellent, and you should just start with whichever topic you think you’d find most interesting.

Book-Blogging: The Great Escape, by Angus Deaton

TGE

The past two hundred years have borne awesome changes to the world (in the definitional sense of the word): world population has septupled – septupled! – and, looking at the way lives are lived now, anyone living in 1814 would likely conclude (not wholly incorrectly) that we are Sorcerers Practicing Black Magick. Technologically, socially, and economically, the past 200 years have been vastly different than the preceding 200. Or 1,000, for that matter.

How did a few nations break thousands of years of (relative) constancy and become significantly wealthier and healthier than ever before? Why didn’t, and haven’t, others? What’s happening now, and what can we expect to happen in the future?

Angus Deaton, a professor at Princeton University, wrote a masterclass of a book, The Great Escape, dissecting these questions. I can’t recommend it highly enough to anyone interested in health and wealth; medicine and economics; the past and the future.

The book isn’t actually a book; it’s more like a book and a chapter-length op-ed, and it’s worth reviewing each separately. The book, Chapters 1-6, is the most complete accounting of the recent changes in health and wealth in the world that I’ve read. The op-ed makes the case that foreign aid weakens recipient governments – especially in Sub-Saharan Africa, where in many countries it approaches three-quarters of government expenditures – and as a result harms the people it putatively tries to help (though “tries to help” does a lot of work in that sentence, and Deaton argues it often isn’t about helping them but us).

The first few chapters walk through the truly shocking increases in health many wealthy societies have witnessed during the past few generations. This “aging of death,” as Deaton delightfully calls it, started around the 1850s in Western countries and eventually filtered down to less-developed regions in the 1950s and thereafter; it continues to this day.

As Deaton points out, life expectancy is a confusing metric, and kind of a bad one at that. Take the fictional country of Macronesia: because of a genetic defect, half of its population dies at birth, and half lives to be 100 years old. It’s average life expectancy is, therefore, 50 years – but no one lives to be just 50, and those that make it past their first day have 100 years of life left. 50 is, in this context, a meaningless number. But it’s Macronesia’s life expectancy just the same.

And so it is with many real countries that have intolerably and unconsciously high infant and child mortality rates. Think America at the turn of the 19th century, when life expectancy was something like 40 (a generous, speculative figure that is almost certainly on the high side). But that’s because so many kids died. To pull a few (admittedly non-random) examples of lifespans we would consider long today, George Washington wasn’t 40 when he died; he was 67. Benjamin Franklin, John Adams, and Thomas Jefferson were 84, 83, and 90, respectively.

(Because I just have to: in one of history’s great coincidences, Adams and Jefferson – one-time sworn political enemies who nevertheless developed a long, deep correspondence by pen in the gloaming of their post-presidential lives – died on the same day in 1826 – the Fourth of July. The 50th anniversary of the official signing of the Declaration of Independence. Because of course.)

Another problem with life expectancy: as an American white male, my life expectancy at birth in 1987 was 72.1 years – but that was an outdated figure almost as soon as the ink dried on that year’s actuarial table. Changes in medicine, technology, and policy over my lifetime will almost certainly mean that my (American, white, male) peers and I will live, on average, far longer – even past 100.

Though he (rightfully) questions the use of life expectancy as a metric in and of itself, the massive uptick in it is because far, far fewer children are dying than before, and that this is because of public health measures:

The major credit for the decrease in child mortality and the resultant increase in life expectancy must go to the control of disease through public health measures.

Because of public health measures, when we talk about countries, we no longer talk about neonatal and child deaths per 1,000 live births; we talk about them in numbers greater than that by two orders of magnitude: 100,000.

As a result, in America, life expectancy increased from 47.3 in 1900 to 77.9 in 2006. He puts it more colorfully than I could:

One way in which the transition is sometimes summarized is to say that diseases move out of the bowels and chests of infants into the arteries of the elderly.

The second half of the book describes the unprecedented economic growth that began in the 1800s and continues today. I won’t get into it much (if there’s any story here you already know, it’s this one), and only will make a few points about measurement.

Deaton convincingly argues that defining and measuring poverty across countries is much more difficult than most casual observers realize. A dollar goes further in India than in the states, and even the calculation to account for this – the wonkily-named “Purchasing Power Parity” – is flawed in obvious and predictable ways. Defining poverty is also difficult in America itself; the poverty line was first chosen then rationalized, and has always been politically fraught.

Gross Domestic Product, or GDP, is a problematic measure, too (and a recent one, as Planet Money helpfully discussed on a recent podcast episode). As Robert F. Kennedy pointed out, it measures much of what we don’t necessarily want, and little of the important, ephemeral things in life.

(Deaton doesn’t even dive into the difficulties about figuring out the GDP of a country – especially a poor country – a monster of a problem in itself).

At times during the book part of the book, Deaton is a bit of a broken record – mentioning too many times to count that “escapes leave people behind, and luck favors some and not others”– but this is a minor sin easily overlooked.

The op-ed at the end is, to put it mildly, polarizing. Deaton is an intellectual monster in the field of development economics, so his firmly planting a foot in the “anti” camp made waves. I won’t get into the arguments much – there’s simply too much to cover – but will give a short summary and a note of admiration.

USAID Food Bag

His argument basically rests on the idea that foreign aid – even the 100% benign, apolitical aid, if it exists (though there’s reason to believe it doesn’t) – necessarily distorts the policies and actions of recipient governments. Governments that are strong don’t need the aid, he argues, while governments that aren’t strong (read: corrupt, authoritarian, or both) will be hurt by the aid. In other words, think of it like the Halstedian “radical mastectomy” of aid: it’s used when it either can’t help anyway or isn’t needed in the first place, and causes severe trauma either way.

(For more on radical mastectomies and cancer, read The Emperor of All Maladies, a wonderful book that I reviewed here).

Deaton does mildly argue that aid directed towards the provision of certain types of health care (safe water, sanitation, pest control) can be, on net, a capital-G Good thing. And he voices approval for certain types of indirect aid: funding research into Neglected Tropical Diseases; advocacy for policy changes that promote migration and trade; removing harmful rent-seeking subsidies; et cetera But overall, he’s quite skeptical of direct-to-consumer aid.

Deaton’s op-ed chapter is admirable for its bluntness and for its acceptance of a hard truth: getting rid of aid may be normatively the best for the long-term fate of low-income countries, but in the short-term this is both impossible – does anyone really think USAID and the World Bank are just going to disappear? – and has serious immediate consequences (people will die). But he argues for it anyway, and kudos to him for having the bravery to do so.

This book – and its accompanying op-ed – is fantastic. Full stop. Buy it now.

Book-Blogging: Every Day is For The Thief, by Teju Cole

EVIFTTShort book recommendation: pick up Teju Cole’s Every Day is For The Thief. It’s excellent and, though specific to Nigeria, the anecdotes and sights conjured up in a series of essays about a (fictional character’s) return trip to the country have the whiff of universality, at least in east Africa. The swaggering touts. The relentless, numbing generators.

The book is short and is self-recommending, so I won’t write a full review. Instead, here are a few excerpts I highlighted:

Touting is not a job. It is a way of being in the world, a distillate of pure attitude: the chest puffed out, the body limber, the jaw set to brook no opposition. There is in every tout the same no-nonsense attitude, the quick temper, the willingness to get into a fight over any and all conflicts. There is a strut they do, a swagger. These are the original wiseguys of Lagos; some of them are as young as fourteen. They do not go home in the evening and stop being touts. The thing is bound to their souls.

The informal economy is the livelihood of many Lagosians. But corruption, in the form of piracy or of graft, also means that most people remain on the margins. The systems that could lift the majority out of poverty are undercut at every turn. Precisely because everyone takes a shortcut, nothing works and, for this reason, the only way to get anything done is to take another shortcut. The advantage in these situations goes to the highest bidders, those individuals most willing to pay money or to test the limits of the law.

The energies of Lagos life—creative, malevolent, ambiguous—converge at the bus stops. There is no better place to make an inquiry into what it was I longed for all those times I longed for home.

But also, there is much sorrow, not only of the dramatic kind but also in the way that difficult economic circumstances wear people down, eroding them, preying on their weaknesses, until they do things that they themselves find hateful, until they are shadows of their best selves. The problem used to only be the leadership. But now, when you step out into the city, your oppressor is likely to be your fellow citizen, his ethics eroded by years of suffering and life at the cusp of desperation. There is venality in abundance here, and the general air of surrender, of helplessness, is the most heartbreaking thing about it.