DISCOVERING TUBERCULOSIS, by Christian W. McMillen

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Discovering Tuberculosis: A Global History, 1900 to Present
By Christian W. McMillen
Yale University Press – 30th June 2015
ISBN 9780300190298 – 352 Pages – Hardback
Source: NetGalley


For now, just a short posting review of this, as I will be writing a more complete review soon for incorporation into a Small Things Considered piece on the topic of current tuberculosis vaccine research, addressing some of the science behind what this book addresses from a primarily historical perspective.
While the author of this is a historian and the realm of history is the primary focus of this book, it obviously contains some medical and scientific details. But it should be easily accessible for any lay reader. As a microbiologist familiar more with the bacteria than the disease and its treatment history I found a lot in this that I hadn’t been aware of, particularly in the earlier periods when Tb was frequently thought to be more easily contracted by non-white groups of people, such as the American Indians.
The book covers these early views steeped in racism and colonialism through the data that argued against such interpretations. It then covers the development of the Tb vaccine and consistent questions/uncertainties of its effectiveness. Finally the book covers the more modern – but at this point hardly new – threat of Tb infection in the face of HIV. Throughout, McMillen addresses the question of why Tb continues to be a scourge despite a century of global health efforts.
Overall McMillen provides a good historical coverage of the topic. At times I was annoyed at repetitiveness in the text, and I would have appreciated both more coverage of  future prospects for Tb vaccines, and more of a scientific discussion of the issues behind this whole history in general. I would recommend this for a general audience with interest in history, medicine, and/or global humanitarian health efforts. I will post a link to what I write for Small Things Considered after its publication.

Disclaimer: I received a free electronic copy of this from the publisher via NetGalley in exchange for an honest review.

A Constellation of Vital Phenomena, by Anthony Marra

A Constellation of Vital Phenomena, by Anthony Marra
Publisher: Hogarth Books
ASIN: B00A5MS0Z0
402 pages, ebook
Published 1st January 2013
Sources: Blogging for Books & Edelweiss

 Somehow, this notably well-reviewed novel slipped under my radar even past its release. Only upon perusing the Blogging for Books offerings did I discover it, and I am glad I chose to give it a try. If you haven’t heard about A Constellation of Vital Phenomena yet, or if it has been sitting on your to-read or consideration list, I’d recommend getting a copy ASAP. Then clear some nights for engrossed reading.
For those not familiar with the plot of Anthony Marra’s award-winning novel, it is set in the war-ravaged region of Chechnya and traces the intersecting experiences of a small cast of characters as they struggle for life, a combination of survival and purpose.
When Russian soldiers come for her father, eight-year-old Havaa flees into the surrounding Chechen woods, where her father’s friend Akhmed rescues her and takes her to hide at the nearly deserted hospital. There, the sole doctor left in this war-torn wasteland is Sonja, a European-trained physician who has returned through a sense of responsibility both to home and to a sister that has gone missing. Reluctantly, Sonja agrees to help care for Havaa, and – in testament to dire conditions – accepts the inept medical help of Akhmed, who has failed out of medical school and yearns more for artistic expressions.
Thrown together in awful circumstances, these characters share a stubborn commitment to hope for individuals and a future that fights against the despair surrounding them. With recollections of the past years of the Chechen conflict, and the constant threat that present friends may turn on them for personal gain with the Russians, these characters discover their lives intertwined, past, present and future.
The novel’s title comes from a definition for life given by a medical text/dictionary in the novel. The term is remarkably difficult to biologically define in one sentence. Typically, biologists will talk of characteristics of life, rather than settling on a strict definition. But the one here given title is particularly resonant in capturing the essential sum of those characteristics of life. They form an interlocking constellation of phenomena, individual traits that put together form a picture unique and new with a story. Similarly like stars each of the characters in Marra’s novel interact together to form a constellation in this historical space of humanity.
Metaphorically one could speak of a certain balance between the stars in forming a constellation. Similarly, Marra’s novel succeeds so well because of the careful balance he is able to strike in its construction. The shifts in time from chapter to chapter (or even within chapters) is managed without any sense of rupture or confusion. Each of the characters is an interesting balance of strengths and weaknesses and even the villains are shown with traits of sympathy and compassion.
(The novel does appropriately stay focused on the Chechens. The Russians in the novels are an outside force of the plot and setting more so than characters, and the villains, heroes, or mixtures in the story are each Chechen here.)
The emotional weight of A Constellation of Vital Phenomena could quickly take it into a story that feels utterly bleak. Marra nicely finds balance here as well, with the character’s vital hopes and perseverance working to counter the negative, and the young Havaa in particular offers a bright ray of humor and compassion that symbolizes a certain hope for the lives of a future generation.
The events of the novel’s ‘present-day’ plot consist of a mere five days, but A Constellation of Vital Phenomena takes these points to form a picture over decades of conflict, personal and spiritual. The novel will pass similarly fast while reading, but its power and humanity will echo with the reader far longer.
Five Stars out of Five

Disclaimer: I received a free copy of this from the Crown Publishing Group via their Blogging for Books program in exchange for an honest review.

Inheritance: How Our Genes Change Our Lives—and Our Lives Change Our Genes, by Sharon Moalem

Inheritance: How Our Genes Change Our Lives – and Our Lives Change Our Genes, by Sharon Moalem
Publisher: Grand Central Publishing
ISBN: 1455549444
272 pages, hardcover
Published April 2014
Source: Goodreads First-Reads

This popular science book is a broad overview of genetic and epigenetic inheritance, basically exactly what the subtitle says. The introduction oversells the epigenetic focus (how life experience or environment can lead the changes in DNA that are not strictly sequence-based) because the majority of the book does stay within the realms of traditional sequence-based inherited genetic variation. Moreover, given Moalem’s specialty, the focus is not so much on inheritance itself, nor even the specific mechanisms of inheritance.

Instead this book really comes down to these ideas: 1) There are a lot of genetic disorders. 2) Individually these disorders are often rare. 3) It is fairly likely that any given individual though will have some kind of disorder. In other words, everyone is unique; most of us have unique rare disorders of some severity or another. The truth of this may surprise some, as may the implications: namely that any health advisories are tailored for the ‘average population’. But no one is average. So not everyone can take the same amounts of medication. Eating high amounts of fat may be great for some people. Eating any fruits may be really bad for someone else. Running is good exercise for your spouse, it might give you a heart-attack, etc.

“Inheritance” thereby sweeps across a wide realm of human genetic variation, threading topics together under common themes. Moalem avoids getting bogged down into a lot of detail, making this book of greatest interest to the general public with medical interests, or those in particular who find medical anomalies interesting. For those that are really ignorant just how much variation there is to life, and how easily life can go wrong, this book is an excellent primer, and even for those with a background in medicine or biology, many of the specific rare disorders in the book that Moalem discusses may be new to them.

Personally I wish that given the title he had delved a little more in-depth, particularly into the mechanisms of inheritance, and variations across life. The book is squarely human- (or at least mammalian-) centric. Moalem’s style is very light-hearted, at times veering into stories whose connections to the actual topic at hand aren’t apparent, but for its intended audience, I find the style appropriate. Finally, I appreciated him bringing up discussion on how studies of genetic disorders allow us to have a firmer grasp of how ‘normal’ biology occurs.

An episode of the X-Files I adore, “Humbug” addresses several of the issues covered in “Inheritance”, including the speculative ones regarding the increasing genetic technologies available to our society. At what point will we be able to eradicate all genetic disorders? What understanding will we lose in the process? How do we decide what is a serious enough disorder? Though briefly touched upon, the book could have spent more space covering the implications of our increasing knowledge and technological powers.

Four Stars out of Five

John Snow, by Jack Challoner

John Snow, by Jack Challoner
Publisher: A&C Black (Bloomsbury)
ISBN: 1408178400
112 pages, paperback
Published March 2013
Source: Goodreads First-Reads

This short biography covers the work of doctor John Snow in investigating outbreaks of cholera in England, a key event in the development of the science of epidemiology, tracing an illness back to its source and ultimate cause. Although Snow was no microbiologist, and it fell to Koch to eventually clearly identify the bacteria Vibrio cholera as the causative agent of the disease, Snow’s work laid the foundations for establishing a way to control cholera, namely to focus on water supplies rather than the prevailing view of the time, ‘bad air’.

Challoner, an established writer of communicating science to a lay audience, particularly youth, writes this geared for older children and young adults, but for those unfamiliar with Snow’s work and epidemiology, it would be quick, highly readable primer on the topic. Challoner focuses on the cholera-related work of Snow, rather than writing an all-encompassing birth-to-death biography, though he does discuss tangentially Snow’s role as physician and pioneering anesthesiologist.

Despite focusing on this history of science and medicine, Challoner relates the story with descriptive warmth, including small details of everyday life at the time (mid-late 1800s) and conversationally, anecdotally through the thoughts of Snow and those he comes in contact with in his endeavors. Though fabricated in that retelling, the facts behind the story, the history, remain solidly accurate to my eye.

Beyond introducing Snow’s accomplishments, this book in general outlines the scientific process of mystery, curiosity, research, refinement, and ultimate success, but with more work for others to carry on. In this sense it is a good general introduction of children to science in general.

The only drawback to the book relates to who the audience may actually be. With text alone, it tends towards the dry and detail-laden, including some medical/scientific vocabulary, despite being related in a straight-forward way, more relatable perhaps to an adult. Yet, it is written in a short and succinct manner with phrases interspersed in the detail that seem geared towards the young. It thus seems most appropriate for a teen with a keen interest in science or medicine, or as a fine source for some school project or paper.

Four Stars out of Five