→ December 19, 2023
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The Ghost Map.

Our current understanding of the ways in which diseases spread goes back to a little-remembered cholera epidemic that devastated a London neighborhood in 1854, when a physician-scientist and a minister began working, first on their own and then together, to trace the outbreak’s origins. In a time of superstition and errant beliefs in “miasmas,” these two men realized through hard work, going door to door at one point to ascertain where each household obtained its water, that the agent causing the disease was spread through human waste that contaminated a particular water supply. In The Ghost Map: The Story of London’s Most Terrifying Epidemic – And How It Changed Science, Cities, and the Modern World, author Steven Johnson tells this story in the fashion of a medical mystery – until a pointless epilogue full of speculation about the future of epidemics and treatments that has aged very poorly in the 16 years since its publication.

Cholera today is a disease of extreme poverty, and even more so of the lack of infrastructure that accompanies it; nearly all cholera outbreaks occur in desperately poor (or desperately corrupt) countries, or in those ravaged by war. Large outbreaks occurred in Syria during the early part of its civil war and Yemen during its endless civil/proxy war. In the third quarter of 2023, the hardest-hit countries, measured by cholera cases per capita, were Syria and Afghanistan, followed by Haiti, Bangladesh, and several countries in sub-Saharan Africa. The disease, caused by the bacterium Vibrio cholerae, first emerged in India in 1817 and then spread around the world, killing over 35 million people, with multiple pandemics affecting Europe and North America, until advances in sanitation and public health helped eliminate the disease in more affluent countries. Those advances, and the lives saved, all came about because of the work of physician and scientist John Snow and Anglian priest Henry Whitehead.

Snow was an avid researcher and experimented with ether and later with chloroform, developing more reliable methods of anesthetizing patients that brought him significant renown, to the point where Queen Victoria called on him to assist her with chloroform during the birth of her eighth child, Prince Leopold. He took a general interest in cholera’s spread during the pandemic that first reached England in 1848, publishing a paper that argued that the prevailing theory that it was spread via polluted air, the “miasma” theory, was wrong. That outbreak eventually petered out, but cholera returned to England in 1854, leading to a horrific outbreak near Broad Street in London’s Soho district. Snow created a dot map to track cholera cases in the neighborhood, gaining help from Whitehead in going door to door to ask families about cases in the house – including houses where the majority of family members had died – and, after Snow’s initial research identified the Broad Street pump as a possible link between nearly all of the cases, where they got their water.

When Johnson tells this history, which takes up about 80% of the book, it’s fantastic. He balances the historical details, the science, and the biographies of the two main characters in the story well enough to maintain the interest level without ignoring the significance of the effort or the context in the history of science. He also has quite a bit of detail on some of the families destroyed by the outbreak, and on the quotidian lives of the inhabitants of this overcrowded part of what was becoming a massively overcrowded city. It’s a great, brisk history of science book.

If he’d stopped there, around page 200, I’d be raving. Unfortunately, there’s a long, tacked-on epilogue that goes well beyond the scope of the book in both its historical and scientific aims. Johnson couldn’t have known that we’d have several epidemics and one global pandemic before 20 years were up, but the larger point is that this book is about history, not predictions, and his don’t hold up particularly well. I read the epilogue wondering if an editor had asked him to add it, because it’s so out of character with the rest of the book.

That’s not a reason to skip The Ghost Map – you can always choose not to read the last bit – and the story it’s telling remains extremely relevant. The work the CDC and the WHO did to track SARS-CoV-2 in 2020, or that they’re doing right now to track current epidemics like chikungunya in Burkina Faso or Mpox in the Democratic Republic of the Congo, is a direct ancestor of the work that Snow and Whitehead did in 1854. If the field of epidemiology has an origin point, it’s their efforts, and we have them to thank for all of the outbreaks of highly infectious diseases that never reach our shores.

Next up: I just finished R.F. Kuang’s Babel and started Tana French’s In the Woods.

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→ October 9, 2022
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Wired for Love.

Dr. Stephanie Cacioppo spent her early career researching the neuroscience of love, even as she privately doubted that she’d ever find it in her personal life. Then she did, in a whirlwind romance with Dr. John Cacioppo, an esteemed researcher on the effects of loneliness who happened to be 20 years her senior. They married inside of a year, and spent almost seven years together before a rare salivary cancer took his life in 2018. Her new book Wired for Love: a Neuroscientist’s Journey Through Romance, Loss and the Essence of Human Connection is part memoir, part popular science tome, a brief but engaging look at the subject of her research, interspersed with the story of her life with John.

The Cacioppos’ story together is bittersweet, wonderful at first until it turns tragic, even more than you might expect from a marriage of two people separated by over twenty years. John even warns her before they marry that they’re not likely to have that many years together, and he worries about ‘leaving’ her too soon, but that can hardly prepare them for what’s about to befall them. It would seem like the plot of a Nicholas Sparks novel if it weren’t someone’s actual life: Their areas of research were already similar, and they met and fell in love despite the huge age gap and the fact that they lived on different continents, after which they published several joint papers in a field that needed more attention, only to have him die of a rare, aggressive cancer before he turned 70.

The real interest in the book is her work on the neuroscience of love, and if anything, I wish there were more of it. Some of the content revolves around how little interest there was in the topic when she began her academic career, with almost no research on the subject, and substantial institutional and individual objections to her attempts to undertake this research. (I’m sure much of it was worse because she was a young woman trying to research this, which I’m sure elicited eyerolls from the men who ran the neurology departments and IRBs who had to support and approve those proposals.)

Eventually, she did get published, and her research came to more public notice, earning her the moniker “Dr. Love,” which I couldn’t read without hearing Paul Stanley’s voice. Her published papers include works on the “toxic effects of perceived social isolation,” an fMRI analysis on the interactions in the brain between sexual desire and love, and multiple papers on the neurology of loneliness that she co-authored with her husband. It’s important work that has helped highlight the large health cost of loneliness, or perceived loneliness, which others, including current Surgeon General Vivek Murthy, have identified as an “epidemic” with large medical and social costs.

Wired for Love only scratches the surface of Cacioppo’s work, to the detriment of the book; it’s not a book about loneliness or the neuroscience of love, per se, but it could have used more in the science half to balance out the tragic romance story of her personal life. It’s even more powerful knowing that her story starts and ends with her being alone, which could have led to some discussion of the neuroscience of grieving, or how to cope with the loneliness after the death of a loved one. The half of the book about her whirlwind romance and too-brief marriage with John Cacioppo was beautiful, but it didn’t educate readers as much as it could have given her body of work as a researcher and the importance of the subject. I was left wanting a good bit more on the science side.

Next up: I’m three books down the road already, but right now I’m reading Hervé Le Tellier’s novel The Anomaly, winner of the prestigious Prix Goncourt, France’s equivalent of the Pulitzer Prize for Fiction, in 2020.

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→ September 29, 2022
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Neurotribes.

Steve Silberman’s 2015 book Neurotribes: The Legacy of Autism and the Future of Neurodiversity is a history of autism, but one told through anecdotes of people with the neurodevelopmental condition or the scientists who studied it. It’s also an education, and an attempt to set the record straight that we are not, in fact, in the middle of an autism “epidemic,” but that the condition has always existed, even if doctors at those times didn’t realize what they were seeing.

Much of the history of autism is one of tragedy, as people with the condition were often treated as insane, or as imbeciles, and stuck in institutions or otherwise abandoned by their families. The condition was seen as incurable – meaning it was seen as something you’d want to try to cure – and that an autistic child was nothing more than an animal. This view persisted, at least in the west (there’s no discussion here of views of autism outside of the U.S. and Europe), until the early 20th century.

That’s when two researchers working independently* had their Newton/Leibniz moment, as both Leo Kanner, working in the U.S., and Hans Asperger, working in Vienna, both published key papers identifying autism as a condition with a specific, and in both cases narrow, set of symptoms. Asperger’s name has lived on beyond Kanner’s, but at the time, Vienna was under Nazi control, and Kanner’s work and views took precedence on the larger stage.

*I got a kind note from Steve Silberman via Twitter, saying: “The biggest historical scoop in NeuroTribes is that Kanner and Asperger were NOT working independently, but shared two assistants, Anni Weiss and Georg Frankl.”

If you know of Asperger, it’s through the now-deprecated “Asperger’s syndrome,” which has been subsumed into the larger diagnostic term autism spectrum disorder. One of the most enlightening parts of Neurotribes is Silberman’s explanation of that entire process, although its roots are horrifying: Because the Nazis were murdering any children held in institutions for health or mental reasons, Asperger’s work focused on the socially awkward prodigies he found. This spurred the still-extant stereotype of the autistic savant, which was further cemented in the public mind by the film Rain Man, the history of which Silberman details at great length and with significant empathy for everyone involved in the film.

Kanner viewed Asperger much as Newton viewed Leibniz, and we’re all quite a bit the worse for it, as the rivalry meant Kanner worked to “own” the definition of autism for some time. He claimed the disorder (a term still in use in the technical literature) only affected young children – if they were older, they had schizophrenia or something else – and that the cause was parental indifference. The idea of the “refrigerator mother” who failed to love her child enough, thus giving the kid autism, persisted for decades, at least into the 1980s. When that finally started to crumble, parents began looking for other explanations, landing on environmental toxins and, with the help of a fraudster named Andrew Wakefield, vaccines.

All the while, parents and researchers were looking for a cure, in no small part because Kanner’s definition of autism excluded all but the most serious cases. Some attempts were well-intentioned, while others were (and still are) quackery, and even dangerous. There’s still an institution in Massachusetts that uses shock therapy on autistic residents, despite no evidence that it works (and ample evidence that it’s torture). The FDA has had to issue warnings about so-called “miracle mineral solution,” which is bleach by another name, and which Youtube for one has banned but refuses to remove instructional videos about. (MMS does not cure autism, or anything else, but it can kill you.) Silberman gets into some of this, although I think the bleach stuff largely postdates his book.

It took some substantial efforts by later researchers and especially by activist parents to bring about changes. Those parents demanded changes in how the medical establishment viewed and treated their autistic children, and lobbied for changes in the definition of autism so that school districts would be forced to provide accommodations for autistic students who were previously left behind or even told that they had to attend school elsewhere. The passage of the Individuals with Disabilities Education Act in 1975 and again in 1990 as well as the Americans with Disabilities Act in 1990 allowed autistic children to stay in public schools and required the districts to provide them with individualized education programs (IEP) to determine what accommodations and modifications the child needs to succeed in school. It shouldn’t have been that hard, but Silberman makes it clear that Kanner’s narrow definition and the stranglehold he had on the definition of autism, helped by a small number of others who seemed to profit from their work with autistic kids, made this process far more difficult.

There’s far more to Neurotribes than just a history, however. Silberman discusses a few notable historical figures who almost certainly were autistic, including chemist and physicist Henry Cavendish, the discoverer of hydrogen; and Nikola Tesla, inventor of an overpriced electric car. (Hold on, I’m getting a note here that that isn’t correct.) Temple Grandin makes several appearances on these pages as well. There’s also a deep dive into the correlation between autistic people and sci-fi fandom, including Claude Degler, a key early figure in spreading the gospel of science fiction (until his views on eugenics caught up with him), and perhaps an autistic person himself. Silberman argues that sci-fi fandom was one of the first safe spaces for autistics, as personality “quirks” were less important than one’s passion for the subject – and perhaps because those quirks were more common among the fan base anyway.

There’s a wealth of information within Neurotribes, even though the book is now seven years old and it seems like the medical community knows even more about autism now than it did then. It’s a well-researched and well-argued work, one that encourages empathy for autistic people but not pity, and if anything gives more respect to Wakefield, the NVIC, and other cranks than they deserve, presenting the views of people who seek to find non-genetic causes for autism fairly before explaining that the evidence says they’re wrong. And Silberman makes it very clear that autism isn’t what history tells us it is, or even what many people probably still think it is, thanks to Rain Man or, worse, Music. It’s a deeply humanistic work of non-fiction, and that alone makes it worth a read.

Next up: Dr. Stephanie Cacioppo’s Wired for Love.

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→ September 19, 2022
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An Immense World.

Ed Yong won the Pulitzer Prize for Explanatory Writing last year for his articles in the Atlantic (not my employer) about the COVID-19 pandemic, which I called way back in May of 2020, over a year before the award announcement. I was already a fan of his work after reading his tremendous first book, I Contain Multitudes, a thoughtful, detailed look at the importance of the microbiome, and how so many of our actions and policies work against our own health because of our fear of bacteria. (He also described the experiment to infect male Aeges aegypti mosquitos with the Wolbachia bacterium, which makes the eggs that result from their mating activity fail to hatch. It has since been used to reduce mosquito populations in areas where dengue fever is endemic.)

Yong’s latest book, An Immense World: How Animal Senses Reveal the Hidden Realms Around Us, is a big departure from anything he’s written before, although he retains both his commitment to scientific accuracy and the sense of wonder that permeated his first book. This time around, he’s exploring an area I would guess most readers have never contemplated: How animals sense the world, often in ways that are beyond the reach of our senses, or even rely on senses that humans don’t have.

Yong begins with some discussion of the erroneous historical view, one that still persists today on a smaller scale, that non-human animals are less cognitively capable than we are, because we have evolved consciousness and they haven’t. It’s a view that fails on its face, as just about everyone who’s been around a dog knows that canines can hear sounds we can’t – hence the dog whistle, at least in its literal sense. It turns out, unsurprisingly, that there are examples across the animal world, and in some cases in other biological kingdoms as well, of senses more powerful than our five senses, and examples beyond those.

One of the best-known colloquial examples, although I would say probably not a well-understood one by laypeople, is echolocation in bats. Bats are nearly blind, but their powers of echolocation, using what we now call sonar to determine not just where objects are around them, but to find food and distinguish, say, something to eat from the leaf on which it’s sitting, involve a mental processing speed that is hard for us to comprehend. And it turns out humans are capable of echolocation as well, although evolution hasn’t advanced our skills in that area to the same extent because we haven’t needed it.

Yong also describes the handful of species that can sense the Earth’s magnetic field, a sense humans do not have at all, to find their way back to the beach where they were born, in the case of some turtles. There are animals and insects that can see parts of the infrared spectrum that we can’t, but there are also substantial portions of the animal kingdom that don’t see the world in the same colors we see – which is why waving a red cape in front of a bull is just a silly tradition, as bulls don’t have the red cones in their eyes to detect that color. Indeed, few animals see the world in the same colors that we do, which comes down to the fact that color isn’t something inherent in nature; it is how our eyes perceive vibrations of molecules in nature, because we have red, green, and blue cones in our retinas that send signals that our brains convert to color. (And some people, almost all women, have a fourth cone, making them “tetrachromats,” which Yong also discusses.) If you don’t have those cones, you see the world completely differently.

Yong ends with what is probably the most important part of An Immense World ­– an examination of how humans are screwing all of this up. You’re probably aware of how climate change and overdevelopment are already threatening habitats around the world. Light pollution threatens many species that rely on natural light sources to find food or shelter, or to migrate; noise pollution interferes with many species’ ability to communicate with each other, to find mates or identify predators. Humanity’s rapid rise in the last 200 years has been an unmitigated disaster for everything else on the planet, and Yong points to even more threats to biodiversity than those we already know about (e.g., those explained in The Sixth Extinction). There are also some examples of species adapting to these changes – birds that have learned to hang out near streetlights to eat the moths attracted to the illumination, for example – but they’re too few to make up for the losses. We have to be the ones to adapt, to live with less light, less noise, less everything, so that we don’t lose any more than we’ve already lost, especially not before we’ve learned more about it.

Also, Ed will be my guest this week on the Keith Law Show. The episode should be up on Tuesday, 9/20.

Next up: Steve Silberman’s Neurotribes: The Legacy of Autism and the Future of Neurodiversity.

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→ January 26, 2022
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This is Your Mind on Plants.

Michael Pollan made a name for himself, or perhaps a bigger name, for his book The Omnivore’s Dilemma, which came off like such an attack on our modern diets that he wrote a brief companion book called In Defense of Food. In defense of Pollan, however, his writing goes well beyond those two books or that subject; he can be a gifted writer on many matters of food and food science, and is not the scold that Omnivore’s Dilemma might lead you to believe that he is. Cooked: A Natural History of Transformation is a history of food and food science, and an explanation of how we used fire and heat to change the way we ate, in turn changing the trajectory of our species. His most recent book, a collection of two previously published essays plus a third, is called This is Your Mind on Plants, and covers three psychoactive compounds or chemicals produced by the plant world: opium, caffeine, and mescaline.

By far, my favorite part of this book was the portion on caffeine, which was originally released as an Audible original and excerpted by The Guardian as part of its longread series a few months ago. Pollan was a caffeine addict, like the overwhelming majority of Americans, and as part of his research into the chemical’s effects on our brains and our lives, chose to give it up completely before gradually reintroducing it into his life. He spoke to Dr. Matthew Walker, author of How We Sleep, who is a scold, at least on this topic, and among other things claims that caffeine’s half-life is around 6 hours, so a quarter of the caffeine you consumed in a cup of joe at 9 am is still in your system at 9 pm. (Estimates of its actual half-life vary, but it may be closer to 5 hours, which would push up that latter time to 7 pm.) Caffeine in the afternoon, which we often consume to combat our bodies’ evolved tendency towards biphasic sleep, is especially harmful; the iced coffee you have at 2 pm would still leave more than a quarter of its caffeine in your system at 11 pm, a typical bedtime for adults who have kids or at least have to work in the morning.

Most people understand on some level that caffeine can harm your sleep quantity and quality, but Pollan also points out how much we depend on caffeine each day for simple alertness, to feel like we think clearly, to clear the fog of sleep – or, of course, the fog of caffeine withdrawal. There is even research showing that caffeine can help certain types of recall and improve our reaction times in certain physical tasks, although viewers of Good Eats know that caffeine may make you work faster, but it doesn’t make you work smarter. Pollan gives a breezy history of caffeine and its two major delivery systems (tea and coffee), including descriptions of their ties to colonialism, exploitation of native peoples, and slavery, before bringing us back to the narrative of his caffeine withdrawal and reintroduction.

The opium essay appeared in slightly redacted form in Harper’s in the late 1990s, and is less about what the drugs derived from opium do than Pollan’s own misadventures in growing poppies in his own garden, only to discover that he may be violating federal law by doing so. Opium is a latex taken from the seed capsules of the Papaver somniferum plant, although Pollan claims that there are other poppies that can produce some of the same compounds, just in smaller quantities. The drugs we associate with poppies are opiates, alkaloids found within the latex, including morphine and codeine; or derivative products, such as heroin (made through acetylation of morphine) or oxycodone (synthesized from thebaine in the latex). You can consume the raw latex, which is supposed to be unspeakably bitter, and will cause nervous system depression. Pollan didn’t end up doing that, although he certainly thought about it, and wrote about thinking about it, and expunged a few pages until releasing the full article here. He describes the conversations from the time around what it was safe to write, while his editor at the time, John R. MacArthur, has disputed Pollan’s version of events. Anyway, Pollan drank some opium tea, and said it tasted awful but felt nice.

Then there’s mescaline, which, of these three drugs, has the unusual characteristic of offering very little downside to the user. Its use is highly restricted, because Drugs Are Bad! even though there’s a small body of evidence that mescaline, derived from a cactus that grows in the American southwest, and psilocybin, produced by several hundred species of fungi mostly in the Psilocybe genus, may help people with severe depression or anxiety. The majority of Pollan’s essay here revolves around mescaline’s somewhat recent history of use in religious ceremonies among certain indigenous American tribes, the ridiculous laws around its use, and environmental and cultural concerns around it. He eventually tries some as well, and has what sounds like a very pleasant experience of heightened awareness with mild hallucinations, not something that might fit the stereotype of a trip. I have never tried either of these psychotropics, and Pollan’s narrative made me slightly more curious about them.

Pollan the anti-scold is an insightful, conversational writer who is unafraid to educate his readers but never loses sight of the need to entertain at the same time. There might be a bit too much of him in the opium section – the idea of DEA agents bashing down his door because he had two poppies in his garden might come across as paranoid – but despite his first-person writing in the remaining two sections, he takes care not to let his persona take over. His thoughtfulness in describing the mescaline ceremony he witnesses, for example, does him credit; he’s just trying to get high, so to speak, not to appropriate anyone’s culture. It’s a short book, compiling some pieces you may have read before, but an enjoyable diversion, and one more tiny brick in the wall for drug decriminalization.

Next up: Helen DeWitt’s The Last Samurai, because Mike Schur told me to read it.

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→ November 19, 2021
→ By

Infinite Powers.

I’m a sucker for a good book about math, but a lot of books about math aren’t that good – either they’re dry, or they don’t do enough to explain why any of this matters. (Sometimes it doesn’t matter, as in Prime Obsession, but the author did such a good job of explaining the problem, and benefited from the fact that it’s still unsolved.) Steven Strogatz’s Infinite Powers: How Calculus Reveals the Secrets of the Universe manages to be entertaining, practical, and also educational, as the author builds up the reader through some essentials of pre-calculus before getting into the good stuff, to the point that I recommended that my daughter check it out before next year when she takes calculus in school.

Calculus underlies everything in the universe; it is the foundation upon which the universe, and everything in it, functions. It is also one of humanity’s most remarkable discoveries, one that required multiple leaps of mathematical faith to uncover hidden truths about the universe. Physicist Richard Feynman quipped that it is “the language that God talks,” although he meant it in a secular sense, while mathematician Felix Klein said that one could not understand “the basis on which the scientific explanation of nature rests” without at least some understanding of differential and integral calculus.

 The story of how both Isaac Newton and Gottfried Wilhelm Leibniz simultaneously discovered calculus in the late 1600s, doing so both with their own remarkable insights and by building on the discoveries of mathematicians before them, going back to the ancient Greeks, would by itself be enough for an entertaining history. Strogatz does start with that, and uses the history as scaffolding to bring the reader up from algebra through geometry and trigonometry to the mathematics of limits, which is the essential precursor to calculus, before getting to the main event.

Or I should say “events,” as differential and integral calculus, while two sides of the same analytical coin, were discovered at separate times, with separate methods, and Strogatz tells their stories separately before bringing them together towards the end of the book. Differential calculus is what we learn first in schools, at least in the United States. It’s the mathematics of the rates of change; the rate at which a function changes is the derivative of that function. Acceleration is the derivative of velocity – that is, the rate at which velocity is changing. Velocity, in turn, is the derivative of position – the rate at which an object’s position changes. That also makes acceleration the second derivative of position, which is why you see a 2 in the formula for the acceleration of an object falling due to Earth’s gravity (9.8 m/s2): a position might be measured in meters, so velocity is measured as the change in position (meters) by time (seconds), and acceleration is the change in velocity (meters per second) by time (seconds, again).

Integral calculus goes the other way – given an object’s acceleration, what is its velocity at a given point in time? Given its velocity, what is its position? But Leibniz and Newton – I expect to hear from Newton’s lawyers for listing him second – conceived of integration as a way to solve an entirely different problem: How to determine the area under a curved function. Those two didn’t think of it that way – the concept of a function came somewhat later – but they understood the need to find out the area underneath a curve, and came up, independently, with the same solution, which broke apart the space into a series of rectangles of known heights and near-zero widths, giving rise to the infinitesimals familiar to any student who’s taken integral calculus. They aren’t real numbers, although they do appear in more arcane number systems like the hyperreals, yet the sum of the areas of this infinitesimally narrow rectangles turns out to be a real number, giving you the area under the curve in question. This insight, which was probably Leibniz’s first, opened the world up for integral calculus, which turns out to have no end of important applications in physics, biology, and beyond.

Strogatz grounds the book in those applications, devoting the last quarter or so of Infinite Powers to discussing the modern ways in which we depend on calculus, even taking its existence for granted. GPS devices are the most obvious way, as the system wouldn’t function without the precision that calculus, which GPS uses for dealing with errors in the measurements of distances, offers – indeed, it’s also used to help planes land accurately. Yet calculus appears in even less-expected places; biologists used it to model the shape of the double helix of strands of DNA, treating a discrete object (DNA is just a series of connected molecules) as a continuous one. If your high school student ever asks why they need to learn this stuff, Infinite Powers has the answers, but also gives the reader the background to understand the author’s explanations even if you haven’t taken math in a few decades.

Next up: David Mitchell’s The Thousand Autumns of Jacob de Zoet.

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→ May 3, 2019
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Bad Blood.

Theranos was one of the hottest tech startups of the last fifteen years, at least in terms of the breathless coverage afforded to the company’s putative blood-testing technology and young founder and CEO, Elizabeth Holmes. As you know by now, the entire thing was a giant fraud: the technology never worked, the company ducked or lied to regulators, and Holmes in particular lied to the press and investors who plowed a few hundred million dollars into the company before it collapsed. That implosion came about thanks to a few whistleblowers from inside the firm and the diligent reporting of Wall Street Journal journalist John Carreyrou, who tells the entire history of the scam in his book Bad Blood. The book is thorough, gripping, and infuriating: how did one inexperienced college dropout manage to con so many ostensibly intelligent people into believing her bullshit?

Theranos’s claim was that they could run over a hundred tests on just a single drop of blood drawn by a fingerstick by using a relatively minuscule device, first one called the Edison and later one called the miniLab, that could live in a doctor’s office, a pharmacy clinic, or even a patient’s home. This included routine tests like those for blood cholesterol levels as well as more complex tests that would ordinarily require a lot more blood, which would have to be drawn from a vein. None of this ever worked, and Theranos hid the fraud by taking blood samples back to its headquarters and running the samples on larger machines made by Siemens, all the while making increasingly grandiose claims about its technology, forging nine-figure partnerships with Walgreens and Safeway, and continuing to solicit investments at valuations that eventually crossed $5 billion, making Holmes a paper billionaire.

The media coverage of Theranos in general and Holmes in particular was willfully credulous, none more so than the Fortune cover story “This CEO’s Out for Blood,” a fawning profile that bought all of Holmes’ lies wholesale with what appears to be no attempt to independently validate any of her claims. (The writer, Roger Parloff, eventually admitted he’d been duped.) Holmes appears to have had a strategy for executing this con by co-opting the reputations of powerful, older men: she managed to pack her board with major political figures, including George Schultz and Gen. James Mattis, who all tended to be old white men with zero scientific or technical background, but whose presence carried a lot of weight with the media. She also hired attorney David Boies, eventually giving him shares in the company and a board seat, to stage scorched-earth attacks on anyone who dared criticize the company, which included intimidating former employees who might reveal that Theranos’ technology didn’t work. She even landed a spot as an Ambassador for Global Entrepreneurship for the Obama Administration, only stepping down months after the fraud was revealed.

Carreyrou didn’t buy it, and he didn’t back down, all of which shows in his WSJ articles that dismantled the company’s house of lies and again shows in Bad Blood, which is meticulous in reconstructing the genesis and perpetuation of the fraud, with information gleaned from over 150 interviews with employees and others close to Theranos. He particularly benefited from information from Tyler Schultz, George Schultz’s grandson and a Theranos employee for about a year, who realized that Theranos’ technology didn’t work and that they weren’t properly verifying their results (but were still making the same claims of accuracy to the public), and who reported the company to regulators despite intense pressure and outright threats from Theranos, its lawyers, and his own family. (Schultz, who will turn 99 later this year, was a true believer in Theranos and in Holmes until well after the fraud was made public.) Bad Blood is full of details of internal interactions from Theranos that depict Holmes and COO Ramesh “Sunny” Balwani as vindictive, paranoid bullies who didn’t care that the technology didn’t work, or simply refused to accept that it didn’t, and thought they could steamroll anyone who tried to get in their way – and for about a decade, it worked.

The overwhelming sense Bad Blood gave me is that so very many of the people involved in the scam belong in jail. Holmes and Balwani, who was also her boyfriend when she hired him, come across as sociopaths who relentlessly bullied employees and the media; both are still facing criminal charges, while Holmes settled SEC fraud charges while Balwani is fighting them. They had many allies in their scheme, from Boies (whose behavior seems unethical, at least) to the various marketing and PR flacks inside and outside Theranos who helped perpetuate the con. Does Chiat Day, the major advertising agency Theranos hired to build its image, bear any responsibility for helping disseminate untruths about the company? What about Theranos’ marketing employees or in-house attorneys, the former repeating the lies Holmes and Balwani told them, the latter using dubious tactics to intimidate former employees into signing agreements against their own interests? If Holmes and Balwani actually serve jail time – I’m skeptical, but there’s still a nonzero chance of that – it may deter some future mountebanks, but the biggest lesson of Bad Blood seems to be how many people happily went along with the scheme because they thought Theranos was going to make them rich, and because there was little direct cost to them. Patients could have died from errant medical directions that came from Theranos’ inaccurate test results, yet just about every person involved in promulgating the swindle walked away with nothing worse than a bad name on their resumes.

Carreyrou raises the most salient point that investors and reporters missed during Theranos’ days as a high-flying simurgh: the venture capital firms backing Theranos focused on high tech, but not on biotech or medical devices. The VCs with expertise in medical investments were absent. Carreyrou argues that that should have set off alarm bells for other investors or for reporters racing to laud the company or its female founder/CEO, who benefited from the media’s desire to find a rare woman among Silicon Valley leaders, from her photogenic looks, and from her overt attempts to channel Steve Jobs (which come off as delusionally creepy in the book). Con artists will never lack for marks, but when the people who would ordinarily be most interested in backing a venture head in the other direction, it should serve as at least a prompt to ask more probing questions before putting the CEO on your magazine’s cover.

Next up: I’m preparing for the upcoming amazon series by reading Terry Pratchett & Neil Gaiman’s novel Good Omens.

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→ April 8, 2019
→ By

Longreads, 4/7/19.

My latest draft post for ESPN+ subscribers looks at the top prospects from last week’s NHSI tournament, including C.J. Abrams, Riley Greene, and Jack Leiter; as well as Saturday’s outing by Elon RHP George Kirby.

Here are some of the leftover longreads I hadn’t gotten through in time for yesterday’s post:

  • The Guardian looks at the evolution of the influencer market, which continues to grow even through scandals and fragmentation. The article also focuses, a bit oddly, on influencers’ drive for “authenticity,” which strikes me as a contradiction in terms.
  • A reader sent this lengthy Current Affairs overview of Pete Buttigeig as seen through his book Shortest Way Home, arguing that he’s not a progressive candidate and that progressive voters shouldn’t want any part of him as a Presidential candidate. I think the article makes many good points, notably when discussing his policies as South Bend mayor and how he seemed to deprioritize issues like poverty reduction or racial inequality, but also makes some dubious inferences and leans too much on the book itself, which is a campaign document. Buttigeig also wrote about his ten favorite books for Vulture and I find it hard to believe that these ten, which read like the list of books you want other people to believe are your favorite books, are actually his favorites.
  • The Indy Star profiles John Franzese, whose testimony sent his father, a Colombo crime family boss, to jail, and his life after leaving witness protection, trying to work with recovering addicts like himself.
  • I’ve read two great books on the Chicxulub impact event, the asteroid collision with the earth that wiped out the dinosaurs and caused the KT mass extinction event, in the last year: The Rise and Fall of the Dinosaurs and T. rex and the Crater of Doom. The New Yorker has a piece right in line with those, looking at the recent discovery of a site that may have a fossil record of the first few hours after the impact.
  • Matthew Komatsu documents his experiences as a Japanese-American in the wake of the 2011 tsunami, and what he found in his 2018 return to the country.

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→ March 8, 2019
→ By

T. rex and the Crater of Doom.

I read and greatly enjoyed Steve Brusatte’s The Rise and Fall of the Dinosaurs back in the fall, and made a note to pick up a book to which he referred many times, Walter Alvarez’s delightfully titled T. rex and the Crater of Dooooooooom (I may have added a few o’s there). Alvarez, an earth sciences professor at Cal Berkeley, developed the hypothesis that a massive impact of a non-terrestrial object wiped out the dinosaurs and ended the Cretaceous period in what is now known as the K-Pg or K-T extinction event. Along with his father, Luis, and numerous other scientists from multiple disciplines, Alvarez worked on the hypothesis and led the search for evidence, eventually finding enough evidence that the hypothesis is considered the correct explanation for the mass extinction. In this quick 150-page book, Alvarez retells the story of the development of the hypothesis and the global hunt for proof as well as the scientific fights over this specific hypothesis and the challenge it posed to the previous orthodoxy of uniformitarianism – the idea that changes to the earth were gradual and not caused by catastrophes like an asteroid or comet impact.

The scientific consensus on the K-T extinction event is well-established now, and Alvarez begins the book with a description of what likely happened the day that a giant rock, around 10 km in diameter, slammed into the northwest portion of what is now the Yucatan peninsula of Mexico, creating the Chicxulub crater on land and beneath the Gulf of Mexico. The impact took place 66 million years ago, so in the interim it had been largely covered by additional layers of sediment and rock on land, and thus its discovery was delayed until someone was actually looking for it in the first place. The Chicxulub impact was catastrophic on a scale unimaginable to us today; a rock that was wider than the height of Mount Everest slammed into the earth, releasing a billion times more energy than that created by the atomic bombs the U.S. dropped on Hiroshima and Nagasaki. This impact was so powerful it vaporized gypsum in the earth, created tektite glass nodules, led to seismic waves in the rock itself, and would have killed anything living within several hundred miles of the impact site through heat or fire. The impact also kicked up enough dust, including the iridium that would settle in a consistent layer around the planet, to lead to a year or more of a de facto winter where sunlight was blocked enough to halt photosynthesis and devastate the global biosphere.

The hypothesis itself was controversial because of that previous orthodoxy that all changes to the earth occurred gradually, which dated back to Charles Lyell in the early 1800s and influenced the work of Charles Darwin. Alvarez’s heresy, that a single, massive, external catastrophe permanently altered the shape of the earth’s surface and the course of life on the planet – wiping out the dinosaurs and creating a massive ecological void that would be filled by large mammals, including us – encountered immediate pushback, some of which persists today even though the evidence in favor of the impact hypothesis is substantial. Alvarez walks through the history of the development of his hypothesis, including why it was never taken seriously before, and the scientific battle that followed it up through the 1990 discoveries that led to the conclusion that the impact that caused the Chicxulub crater was the same one that killed the dinosaurs.

Alvarez’s writing is on the dryer side, unsurprising given his background as scientist, but the story itself carries the book through – this was an earth-shattering (pun very intended) discovery, and it shook the foundations of an entire field of science. It’s a worthy read on its own but also a great reminder of the power of entrenched thinking, and how many earth scientists and geologists continue even to this day to fight against the preponderance of evidence that Alvarez’s hypothesis is correct. (We know the crater exists, so we know something very large hit the earth there, but there are arguments that, for example, the impact didn’t cause the global iridium layer, even though nearly all iridium in the earth’s crust came from extra-terrestrial sources.) He also makes sure to credit many, many other scientists who helped along the way, emphasizing that the search for evidence to support or contradict the hypothesis was a multi-disciplinary effort that spanned the globe and took over a decade, which is a kind gesture but did tend to slow the story down for me. It’s a short enough book that this was never really a problem, although I think Brusatte does a better job of explaining the Alvarez hypothesis for the lay audience than Alvarez himself does here in more academic fashion.

Next up: Still reading Iraj Pezeshkzad’s very funny novel My Uncle Napoleon.

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→ October 5, 2018
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The Rise and Fall of the Dinosaurs.

If it seems like there’s a surfeit of information out there on dinosaurs for readers or viewers of all ages (“Dinosaur Traiiiiiiin…”), then you might share my surprise to see the publication this year of a new book, The Rise and Fall of the Dinosaurs: A New History of a Lost World, that covers similar ground. Providing an overarching history of the reign of the members of the Dinosauria clade from their rise prior to the end-Triassic extinction event, through the Jurassic era, until the Chicxulub meteor caused the K-Pg extinction event and wiped out all non-avian dinosaurs from the planet around 66 million years ago, the book works down from a high-level overview and then dives to the surface to provide more specific example. Author and paleontologist Steve Brusatte, who appears on the BBC program Walking with Dinosaurs, has managed to create a book for the mass market that doesn’t skimp on the science or on the sort of specific details that give texture and relevance to the broader story, while also drawing very specific parallels between the two extinction events that bookend the dinosaurs’ reign and the mass extinction event going on right now due to the actions of mankind.

(Full disclosure: This book was published by the William Morrow imprint of HarperCollins, which also published my book, Smart Baseball, and I received a copy of the book through my relationship with them after Mr. Brusatte reached out to me via Twitter.)

Brusatte provides two main recurring features in the book while telling a fairly linear history of dinosaurs, including why they ended up the dominant species after the Triassic-Jurassic extinction event (one caused by runaway global warming that was exacerbated by the release of methane trapped in glaciers and polar ice caps, which is exactly what anthropogenic climate change is threatening to do right now) and how they died off in rather quick fashion. One is that he profiles several of the best-known dinosaur species or genii, including Tyrannosaurus rex and Triceratops, in disciplined, fact-based fashion to try to counteract many of the myths that have grown up around various sauropods through the magic of fiction. (The demon spawn of Michael Crichton come in for special criticism throughout the book.)

The other feature is a series of concrete examples from the field, as Brusatte goes to dig sites and/or talks to other paleontologists who have done so and gives detailed descriptions of how new species are found, identified, and categorized. China is the hottest spot for new dinosaur finds, and he explains why that is in geological terms, as well as why T. rex was only king of some parts of the world. Understanding what we know directly from Jurassic era fossils and what we can infer from those bones but also where and how they were found helps the reader follow the scientists’ path towards a more accurate taxonomy of sauropods and of their timeline on the planet.

Near the end of the book are two chapters that stood out as fascinating enough to live on their own as excerpts or as something a reader who might not have the interest or the reading level to get through an entire book would enjoy. One, “Dinosaurs Take Flight,” explains that birds are indeed the descendants of dinosaurs – actually, they are dinosaurs, in Brusatte’s telling – and explains how and why they evolved. The idea of something as complex as an avian wing or an eyeball emerging from the process of evolution is often a stumbling block for those who choose to deny the facts of the matter, but Brusatte lays out the story in plain language, with examples, without detracting from the sheer interest level of what he’s describing. The other is the final chapter, “Dinosaurs Die Out,” which has one of the best pop histories I’ve seen of the discovery of the Chicxulub meteor impact and the Alvarez hypothesis, by the father and son team of Luis and Walter Alvarez. The pair did a bit of forensic geology to discover that the iridium layer in the world’s crust at the K-Pg boundary was too dense and too uniform to have originated on the planet, and thus must have come from an external source. They looked for an impact site from a large meteor or comet and eventually found it in the Yucatán peninsula of Mexico, a buried crater now known as Chicxulub, a nearby town. Brusatte leads the chapter with a fictional but probable rendition of what the day of impact looked like; the meteor hit at around 67,000 miles per hour, hitting with the force of over 100 trillion tons of TNT, causing earthquakes near 10 on the Richter scale and winds over 600 mph, killing everything within about 600 miles of the blast site.

Brusatte in turn credits Walter Alvarez’s book T. rex and the Crater of Doom as a source, calling it “one of the best pop-science books on paleontology ever written,” high praise as I think Brusatte himself may have written one too. I knew fairly little about dinosaurs coming into the book, other than what I might have learned 35 years ago (probably inaccurate) or learned more recently sitting alongside my daughter, so this book was right in my wheelhouse – a pop-science book that never talks down to the reader but also remembers to provide some fundamental knowledge before deep dives into the specifics. It’s fun, it’s interesting, and Brusatte also manages to make many of the scientists in the book seem like stars (google Jingmai O’Connor, whom he calls the world’s preeminent authority on avian dinosaurs, to see what a cool scientist is like). I’m glad Steve contacted me as the book would likely have slipped right past my radar otherwise.

Next up: I read Nick Drnaso’s Booker Prize-longlisted graphic novel Sabrina today, and just started Patrick Modiano’s novella Missing Person.

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