Increasing the Illumination “of Everyday Hardship”

History records much more on the lives of the rich, powerful, and articulate, than on the lives of ordinary citizens. But if we want to deeply understand what happened in the past, and how far we have come, we need to tease out evidence of the lives of ordinary citizens. Gabriel Zucktriegel makes the case that the ruins of Pompeii provide us some evidence. The volcano did not care if you were rich, powerful, articulate or ordinary–it buried everyone who did not escape in time. And more importantly, it buried the artifacts and settings of everyone.

(p. C11) After lying inert beneath volcanic ash for nearly 17 centuries, the Roman city of Pompeii, near Naples, is today a site of continuous change. New discoveries emerge constantly, even as conservators struggle to protect what’s been found from damage by weather, looters and crowds. Articles and books about these findings have steadily appeared as excavations expand into parts of the town that remain buried.

In 2021 Gabriel Zuchtriegel, a German classicist then in his late 30s, was given the enormous task of directing this dynamic site.

. . .

“Pompeii is like a rip in the screen, through which we have the opportunity to take a peek behind the official version of history,” writes Mr. Zuchtriegel. He describes in vivid detail his 2021 discovery of a small room containing the remains of three beds and other quotidian objects. Perhaps it was the dwelling, as well as the workspace, of slaves. A newspaper described the discovery as “the rarity of the everyday,” and Mr. Zuchtriegel takes the phrase as a rallying cry. “The ‘rarity of the everyday’ could also be the title for my personal access to archaeology and Pompeii,” he writes.

“What we found here was different, precisely because it wasn’t a temple, grave or palace,” says Mr. Zuchtriegel, just some 50 square feet “of everyday hardship.” He recounts how he noticed a nail on the wall for hanging an oil lamp and, beneath it, a white painted rectangle designed to reflect the lamplight and increase illumination. Moved by this simple effort to lighten a dark existence, he ponders how the room’s occupants, who no doubt lacked paint and brushes, got that rectangle made. It’s one of many instances where he reimagines the lives of Rome’s downtrodden.

. . .

“The Buried City,” translated from the German by Jamie Bulloch, offers many such glimpses of common Pompeians, some of whom stand before us today in the form of plaster casts made from cavities in the ash where their bodies decayed. Mr. Zuchtriegel is deeply moved by these casts, the phantoms of those who were trying to hide or flee when a searingly hot blast of dust and ash swept in. As he contemplates them, he tells us, “the academic in me switches off.”

For the full review see:

James Romm. “An Ordinary Day in Pompeii.” The Wall Street Journal (Sunday, June 28, 2025): C11.

(Note: ellipses added.)

(Note: the online version of the review has the date June 27, 2025, and has the title “‘The Buried City’: Pompeii on Display.”)

The book under review is:

Zuchtriegel, Gabriel. The Buried City: Unearthing the Real Pompeii. Translated by Jamie Bulloch. Chicago: University of Chicago Press, 2025.

The Democratic Deep State Looked the Other Way as Fraudsters Stole 10 BILLION Healthcare Dollars

When DOGE fired federal workers we saw televised scenes where the fired workers expressed outrage at how taxpayers would be hurt by the loss of devoted civil servants. So where were the devoted civil servants in 2023? Were they doing their jobs to be alert to the Medicare, and personal identity, fraud that cost the public about 10 billion (that is “billion” with a “b”) dollars?

When Elon Musk’s DOGE uncovered myriad examples of major fraud, I saw Democrats on television complain that of course they were against fraud too, but it should be pursued more slowly and systematically, following traditional procedures. The Democrats were running the federal government in 2023. What procedure were the Democrats using, fast or slow, to protect taxpayers from the fraudulent loss of 10 billion (that is “billion” with a “b”) dollars?

Our jerry-rigged government-run-and-regulated health care system is rife with middlemen. In a true free-market healthcare system, patients would directly pay for healthcare, without middlemen. Patients would have the information, and the incentive to act on the information, to detect, report, and pursue fraudsters. Some fraud would exist under any system, but my hypothesis is that much less of it would exist under a free-market system.

(If you are concerned that patients would not have enough funds to pay for healthcare themselves, we could adopt the much better insurance system once proposed by Susan Feigenbaum, combined with deregulation that would reduce healthcare costs–like no longer mandating Phase 3 clinical trials.)

And my secondary hypothesis is that if we have to have a jerry-rigged government-run-and-regulated system, the Republicans, a party full of former bourgeois entrepreneurs and business managers, will usually do a marginally better job of detecting and pursuing fraud.

I wonder if these hypotheses have ever been researched by any of those noble economists studying the field of Public Choice?

(p. A18) When hundreds of thousands of people enrolled in Medicare were billed for expensive medical equipment they never asked for in 2023, it was part of a $10.6 billion fraud, among the largest such schemes in the program’s history, federal prosecutors said this week.

. . .

Those involved in the fraud bought dozens of companies that were accredited to submit claims to Medicare and the program’s supplemental insurers, prosecutors say.

Then, using personal information stolen from more than a million Americans, the defendants filed billions of dollars in claims for equipment that had not been ordered by people enrolled in Medicare and was not delivered to them, according to the indictment.

Of the $10.6 billion that was fraudulently billed, the indictment says, the defendants collected more than $900 million, most of it coming from private “Medigap” insurers and the rest from the Medicare program itself.

Even if the patients themselves did not pay for the phantom supplies, which included urinary catheters, braces and other durable medical equipment, such schemes can affect Medicare recipients by causing premium costs to rise.

. . .

In 2019, the Justice Department uncovered a scheme that it said had defrauded the program of more than $1 billion with phony claims for back and knee braces. In April 2023, prosecutors charged 18 defendants in a nearly $500 million scheme that involved false billing for Covid-19 tests that were never administered.

For the full story see:

Santul Nerkar. “11 Accused of Medicare Fraud In Scheme Based in Russia.” The New York Times (Sat., June 18, 2025): A18.

(Note: ellipses added.)

(Note: the online version of the story has the date June 27, 2025, and has the title “U.S. Charges 11 in Russia-Based Scheme to Bilk Medicare of $10.6 Billion.”)

The better healthcare insurance system proposed by Susan Feigenbaum was proposed in:

Feigenbaum, Susan. “Body Shop’ Economics: What’s Good for Our Cars May Be Good for Our Health.” Regulation 15, no. 4 (Fall 1992): 25-31.

A.I. Hastens Search for Antibiotic Peptides in Extinct Species

In an earlier entry I commented on the use of A.I. to seek antibodies by George Church’s startup Lila. Now it appears that César de la Fuente is employing a similar approach. In both cases A.I. is being used to more efficiently do repetitive well-structured tasks. This is not the highest creative level of human intelligence, but it can free time for humans to exercise the highest level of human intelligence.

(p. A3) Buried in the DNA of the long extinct woolly mammoth is a compound that scientists hope will one day yield a lifesaving antibiotic.

In experiments, mammuthusin, as the compound is called, has eradicated superbugs—bacteria that are resistant to today’s antibiotics and cause infections that are hard to treat—says César de la Fuente, the bioengineer who helped discover the molecule.

. . .

To help combat superbugs, doctors say we need new antibiotics with novel chemical structures or mechanisms of action. But only a handful of such drugs has entered the market over the past several decades.

De la Fuente is banking on artificial intelligence to help end this dry spell. He and his collaborators have built deep-learning algorithms to comb through enormous genetic databases to find peptides, or protein fragments, that have antibacterial properties. They have used this method to analyze animal venoms, the human microbiome and archaea, an underexplored group of microorganisms. They have also mined the genetic codes from fossils of long-extinct animals and humans, including Neanderthals and Denisovans. “This deep-learning model has opened a window into the past,” de la Fuente says.

. . .

When the algorithms identify a new peptide with antibiotic potential, de la Fuente and his team use robots to manufacture the compound in their lab and then test it in mice infected with bacteria. So far, a few hundred peptides made in de la Fuente’s lab have safely and effectively cured sick mice.

One of them was mammuthusin, identified in the genetic code of Mammuthus primigenius, a species of mammoth that last roamed the Earth about 4,000 years ago. The researchers discovered the peptide after mining a National Center for Biotechnology Information database of DNA sequencing data obtained from the fossils of extinct animals. In experiments, mammuthusin was as potent as polymyxin B, an antibiotic often used as a last resort for serious infections, according to a paper published in the journal Nature in June [2024]. The mammoth peptide effectively eradicated a type of bacterium that the World Health Organization has designated a critical pathogen because of its resistance to many common antibiotics.

For the full story, see:

Dominique Mosbergen. “Search for New Antibiotics Turns Back Time.” The Wall Street Journal (Weds., May 28, 2025): A3.

(Note: ellipses, and bracketed year, added.)

(Note: the online version of the story has the date May 24, 2025, and has the title “A Search for New Antibiotics in Ancient DNA.” In the original of both the online and print versions, Mammuthus primigenius appeared in italics.)

The academic article published in Nature Biomedical Engineering in June 2024, and mentioned above, is:

Wan, Fangping, Marcelo D. T. Torres, Jacqueline Peng, and Cesar de la Fuente-Nunez. “Deep-Learning-Enabled Antibiotic Discovery through Molecular De-Extinction.” Nature Biomedical Engineering 8, no. 7 (July 2024): 854-71.

My Email Response to George Church on A.I. and Longevity

On May 17 I ran an entry commenting on George Church’s over-optimism about the use of A.I. to replicate the scientific method, and expressed wistful disappointment that Church’s longevity project had not advanced as quickly as 60 Minutes implied it would in 2019.

On May 20, Church sent me a cordial email disputing some of what I wrote in my entry. I responded to him on May 22, and asked him if he would mind if I ran his email and my response on my blog. He never responded to that request, so I will not reproduce his email here. But I see no harm in my including below the links he sent me. And then I will follow with my email response to him.

Here are the links that Church thought I should ponder:

2024 pmc.ncbi.nlm.nih.gov/articles/PMC10909732 (see Fig 1b)
2022 rejuvenatebio.com/animal-health-pipeline
2022 rejuvenatebio.com/pipeline
2023 biorxiv.org/content/10.1101/2023.11.13.566787v1.full

Here is my email response to Church:

Dear Prof. Church,

Thank you for taking the time to read and respond to my blog post. I appreciate the links you sent. The first link gives us the good news of progress toward increasing the lifespan of mice and in reducing their frailty, which could be interpreted as one part of reversing their aging. The fourth link also gives good news of the proof-of-concept of a new factor at the cell level that may be able to rejuvenate cells without the cancer of the Yamanaka factors.

But on 60 Minutes in 2019 you said age reversal was already “available to mice.” And you said the “veterinary product might be a couple years away and then that takes another 10 years to get through the human clinical trials.” That is not exactly a promise, but it does sound like a hopeful prediction. And I will admit that the timing matters to me. If your 60 Minutes prediction was right there’s a good chance I might live to see it; if it takes twice that long, I almost certainly will not.

In re-reading my post, I see a couple of revisions I would make. I would add that I wish you well in what you are trying to do, and strongly and sincerely hope that you succeed (whether through A.I or by other means). And I would add that I believe Elon Musk said that being overly optimistic is one way that great innovators push themselves toward great goals.

I appreciate your “fact checking” offer. I have a comment apropos that. You say that “The Lohr article doesn’t say “feeding” or “literature”. “ Here is the relevant exact quote from the Lohr article:

Lila has taken a science-focused approach to training its generative A.I., feeding it research papers, documented experiments and data from its fast-growing life science and materials science lab. That, the Lila team believes, will give the technology both depth in science and wide-ranging abilities, mirroring the way chatbots can write poetry and computer code.

So the Lohr article does say “feeding.” It doesn’t say “literature,” but does say “research papers” which I take to be the same thing. I appreciate that Lila also is collecting new data. But is it some generative intelligence in Lila that is identifying the new data to seek or is it George Church and his team?

I agree that A.I. can help crank through possibilities that have already been defined. I am dubious that A.I. can come up with the possibilities as well as George Church and his team can. It may seem harmless that A.I. is being over-hyped. But as an economist it is my job to notice that funding is scarce, so funding spent on A.I. is funding not spent on other inputs to science.

I fear that I may come across as a privileged spectator complaining about the bloodied combatant in the arena. But a big part of my research is aimed at reducing the regulations that burden medical entrepreneurs. For instance, I am working on a paper supporting Milton Friedman’s suggestion that the F.D.A. should just regulate for safety and stop regulating for efficacy. Without Phase 3, more can be tried, more quickly and more cheaply.

If you are willing, I would like to paste your response (or an edited version if you prefer) at the end of my original post. Let me know if that is OK.

Thanks!

Art

Gram and Boudreaux Present Data to Refute Myths About the History of Capitalism

Donald Boudreaux makes the case for economic freedom more clearly, effectively, and persistently than almost anyone. I have not yet read his book with former senator Phil Gram, but I look forward to doing so.

(p. A13) . . . if you control the historical narrative surrounding economic questions, you are more than halfway toward winning the policy battles. This is the insight Phil Gramm and Donald J. Boudreaux bring to “The Triumph of Economic Freedom.”

. . .

In eight chapters, Messrs. Gramm and Boudreaux tackle seven longstanding historical myths about American capitalism that still influence economic discussion today. In each case, they are careful not to caricature the conventional wisdom they challenge.

But having given their opponents’ positions more than a fair shake, Messrs. Gramm and Boudreaux turn to extensive rebuttals. These are supported by detailed attention to data sets. The authors also outline alternative explanations for the path taken by American manufacturing since the 1970s, and for the state of poverty in America today.

For the full review see:

Samuel Gregg. “Bookshelf; A Few Lessons From History.” The Wall Street Journal (Tuesday, June 17, 2025): A13.

(Note: ellipses added.)

(Note: the online version of the review has the date June 16, 2025, and has the title “Bookshelf; ‘The Triumph of Economic Freedom’: A Few Lessons From History.”)

The book under review is:

Gramm, Phil, and Donald J. Boudreaux. The Triumph of Economic Freedom: Debunking the Seven Great Myths of American Capitalism. Lanham, Maryland: Rowman & Littlefield Publishers, 2025.

One Third of Near-Death Multiple Myeloma Patients Are Cured by a New CAR-T Immunotherapy

Many consider immunotherapy to be the most promising current approach to curing cancer. One way to implement immunotherapy is to develop CAR-T cells. But there apparently are many ways to develop a CAR-T cell and which, if any, will work is a matter of trial-and-error.

It seems overly-cautious for regulators to require that the most innovative and promising therapies must first be tried on the patients nearest to death, and so least likely to respond. Why not allow patients at earlier stages to volunteer to try the new therapies earlier? They would be taking a bigger risk, but also would have the possibility of a bigger benefit. They would avoid the suffering from current treatments that are known to have major side-effects, and also are known to only extend life for short periods of time; and they would gain a shot at a real long-term cure.

(p. A18) A group of 97 patients had longstanding multiple myeloma, a common blood cancer that doctors consider incurable, and faced a certain, and extremely painful, death within about a year.

They had gone through a series of treatments, each of which controlled their disease for a while. But then it came back, as it always does. They reached the stage where they had no more options and were facing hospice.

They all got immunotherapy, in a study that was a last-ditch effort.

A third responded so well that they got what seems to be an astonishing reprieve. The immunotherapy developed by Legend Biotech, a company founded in China, seems to have made their cancer disappear. And after five years, it still has not returned in those patients — a result never before seen in this disease.

These results, in patients whose situation had seemed hopeless, has led some battle-worn American oncologists to dare to say the words “potential cure.”

. . .

The new study, reported Tuesday [June 3, 2025] at the annual conference of the American Society of Clinical Oncology and published in The Journal of Clinical Oncology, was funded by Johnson & Johnson, which has an exclusive licensing agreement with Legend Biotech.

. . .

The Legend immunotherapy is a type known as CAR-T. It is delivered as an infusion of the patient’s own white blood cells that have been removed and engineered to attack the cancer. The treatment has revolutionized prospects for patients with other types of blood cancer, like leukemia.

Making CAR-T cells, though, is an art, with so many possible variables that it can be hard to hit on one that works.

. . .

The . . . study took on a . . . challenge — helping patients at the end of the line after years of treatments. Their immune systems were worn down. They were, as oncologists said, “heavily pretreated.” So even though CAR-T is designed to spur their immune systems to fight their cancer, it was not clear their immune systems were up to it.

Oncologists say that even though most patients did not clear their cancer, having a third who did was remarkable.

To see what the expected life span would be for these patients without the immunotherapy, Johnson & Johnson looked at data from patients in a registry who were like the ones in its study — they had failed every treatment. They lived about a year.

. . .

. . ., the hope is that perhaps by giving it earlier in the course of the disease, it could cure patients early on.

Johnson & Johnson is now testing that idea.

Dr. Kenneth Anderson, a myeloma expert at Dana-Farber Cancer Institute who was not involved with the study, said that if the treatment is used as a first-line treatment, “cure is now our realistic expectation.”

For the full story, see:

Gina Kolata. “From No Hope to Potential Cure for Deadly Blood Cancer, Study Shows.” The New York Times (Thurs., June 5, 2025): A18.

(Note: ellipses, and bracketed date, added.)

(Note: the online version of the story was updated June 5, 2025, and has the title “From No Hope to a Potential Cure for a Deadly Blood Cancer.”)

The academic article on the new cure is:

Jagannath, Sundar, Thomas G. Martin, Yi Lin, Adam D. Cohen, Noopur Raje, Myo Htut, Abhinav Deol, Mounzer Agha, Jesus G. Berdeja, Alexander M. Lesokhin, Jessica J. Liegel, Adriana Rossi, Alex Lieberman-Cribbin, Saad Z. Usmani, Binod Dhakal, Samir Parekh, Hui Li, Feng Wang, Rocio Montes de Oca, Vicki Plaks, Huabin Sun, Arnob Banerjee, Jordan M. Schecter, Nikoletta Lendvai, Deepu Madduri, Tamar Lengil, Jieqing Zhu, Mythili Koneru, Muhammad Akram, Nitin Patel, Octavio Costa Filho, Andrzej J. Jakubowiak, and Peter M. Voorhees. “Long-Term (≥5-Year) Remission and Survival after Treatment with Ciltacabtagene Autoleucel in Cartitude-1 Patients with Relapsed/Refractory Multiple Myeloma.” Journal of Clinical Oncology https://doi.org/10.1200/JCO-25-0076.

Public Should Beware of F.D.A.’s Lax Inspections of Drugs Made in India and China

On drug safety, the public puts its trust in the F.D.A. which frequently drops the ball. The public would be better off adopting caveat emptor, and seeking private means of assurance of safety. These would include certification (stamps of approval) from private organizations like the United States Pharmacopeial Convention (USP).

They might also choose to buy well-known name brands, since a well-known brand has more reputation capital to lose if they produce a bad batch, and thus can be expected to invest more in quality control. (Lester Telser made this argument–I need to seek where.)

(p. A10) A highly drug-resistant bacteria that was linked to eyedrops imported from India and that spread from person to person in a Connecticut long-term care center has prompted concerns that the strain could gain a foothold in U.S. health care settings, according to the Centers for Disease Control and Prevention.

. . .

The outbreak has renewed longstanding concerns about the quality and frequency of the F.D.A.’s overseas inspections.

In June 2020, Senator Chuck Grassley, Republican of Iowa, held an oversight hearing on the F.D.A.’s foreign inspection process, noting that the plants were given 12 weeks’ advance notice, “plenty of time to doctor up a facility to make sure that it passes inspection.” The agency has since received budget authority to conduct unannounced overseas inspections.

. . .

The F.D.A. paused overseas inspections during the height of the coronavirus pandemic, and the number of foreign inspections remained low last year, at 684 compared with 3,272 in 2019, according to agency data.

The F.D.A. has 4,000 overseas facilities to inspect, with about 20 percent in India; one of its six inspector positions in that country was vacant in late 2021, according to a report issued last year by the Government Accountability Office.

For over-the-counter drugs, the F.D.A. uses a system that essentially lists a medication recipe. Companies can make the products without express agency approval but are expected to follow agency rules for manufacturing quality products, said John Serio, a lawyer with Withers who has pharmaceutical clients.

“If you’re not out there inspecting facilities,” Mr. Serio said, “these sorts of problems will crop up because there’s no threat that if you’re out of compliance that the inspector will come knocking at your door.”

For the full story see:

Christina Jewett and Andrew Jacobs. “Drug-Resistant Bacteria Linked To Eyedrops Can Easily Spread.” The New York Times (Mon., April 3, 2023 [sic]): A10.

(Note: ellipses added.)

(Note: the online version of the story has the same date as the print version, and has the title “Drug-Resistant Bacteria Tied to Eyedrops Can Spread Person to Person.”)

The F.D.A.’s lax inspections of generic drugs made in India is documented in:

Eban, Katherine. Bottle of Lies: The Inside Story of the Generic Drug Boom. New York: Ecco, 2019.

Electricity May Be a Pellet in the “Magic Buckshot” Against Cancer

In a recent entry I claimed that the cure for many diseases may not be Paul Ehrlich’s one “magic bullet” but may instead be “magic buckshot.” A recent article in The Wall Street Journal suggests that one pellet in the magic buckshot against cancer is electricity. As proof of concept, the article claims that after surgery, radiation, and chemotherapy for a glioblastoma brain cancer, adding electrodes to the skull that deliver low-intensity electricity to the brain, will add a median of 4.9 months to the patient’s lifespan.

The Wall Street Journal article mentioned above is:

Brianna Abbott. “Next Hope in Treating Cancer: Electricity.” The Wall Street Journal (Tues., May 20, 2025): A10.

(Note: the online version of the article has the date May 16, 2025, and has the title “The Next Frontier to Treat Cancer: Electricity.”)

The Wall Street Journal article links to the following article in JAMA:

Stupp, Roger, Sophie Taillibert, Andrew Kanner, William Read, David M. Steinberg, Benoit Lhermitte, Steven Toms, Ahmed Idbaih, Manmeet S. Ahluwalia, Karen Fink, Francesco Di Meco, Frank Lieberman, Jay-Jiguang Zhu, Giuseppe Stragliotto, David D. Tran, Steven Brem, Andreas F. Hottinger, Eilon D. Kirson, Gitit Lavy-Shahaf, Uri Weinberg, Chae-Yong Kim, Sun-Ha Paek, Garth Nicholas, Jordi Bruna, Hal Hirte, Michael Weller, Yoram Palti, Monika E. Hegi, and Zvi Ram. “Effect of Tumor-Treating Fields Plus Maintenance Temozolomide Vs Maintenance Temozolomide Alone on Survival in Patients with Glioblastoma: A Randomized Clinical Trial.” JAMA 318, no. 23 (Dec. 19, 2017): 2306-16.

During Covid-19 “Bureaucratic Authorities Erred in Pretending . . . Certainty”

(p. A13) Adam Kucharski, a professor of epidemiology at the London School of Hygiene & Tropical Medicine, takes the reader on a fascinating tour of the history of what has counted as proof.

. . .

What should we do, . . ., when a mathematical proof of truth is unavailable, but we must nonetheless act?

This leads us to a discussion of probability and statistics, and of pioneers such as William Gosset, a brewer at Guinness who figured out how to quantify random errors in experiments, and Janet Lane-Claypon, an English scientist who first thought to investigate confounding factors while analyzing children’s health. Some innovations, though, have hardened into unhelpful dogma. The scientific notion of “statistical significance” relies, Mr. Kucharski explains, on a wholly arbitrary cutoff, which incentivizes researchers to massage their data. Such issues, he says, can be hard for scientists, let alone the laity, to understand.

Mr. Kucharski speaks from experience, since he was one of the experts first called upon by the British government for advice on the Covid-19 pandemic. He explains brilliantly the fragmentary and confusing nature of the data then available, and the provisional conclusions they led to. As a public face of this effort, Mr. Kucharski was bombarded daily with abusive and threatening messages from angry citizens who simply didn’t believe what they were being told.

The lesson Mr. Kucharski draws isn’t that he and his colleagues were right (though they largely were), but that bureaucratic authorities erred in pretending there was certainty when all that was possible at the time was messy and provisional. Notoriously, in March 2020 the World Health Organization tweeted “FACT: #COVID19 is NOT airbone.” (As it turns out, it was, and it is.) The author regrets, too, that politicians claimed to be “following the science,” because science can never tell you what you should do.

For the full review see:

Steven Poole. “Bookshelf; Finding Truth In Numbers.” The Wall Street Journal (Friday, June 6, 2025): A13.

(Note: ellipses added.)

(Note: the online version of the review has the date June 5, 2025, and has the title “Bookshelf; ‘Proof’: Finding Truth in Numbers.”)

The book under review is:

Kucharski, Adam. Proof: The Art and Science of Certainty. New York: Basic Books, 2025.

Dream of the Magic Buckshot

Paul Ehrlich in the early 1900s sought a “magic bullet” for each disease (including cancer). Given the alternatives at the time, when he found Salvarsan it could be considered a magic bullet against syphilis. Today Dr. Dale Bredesen has replaced “magic” with “silver” and “bullet” with “buckshot.” In his effort to cure Alzheimer’s “Bredesen believed in firing a “silver buckshot” (a reference to the sprayed pellets that come out of shotgun shells) by modifying 36 factors simultaneously” (Gellman, p. 18).

I have not investigated Dr. Bredesen’s “cure” for Alzheimer’s and express no opinion on it. I will express the opinion that I do not like the arrogantly dismissive tone of Lindsay Gellman’sThe New York Times article, bowing to “experts,” but calling Bredesen “Mr.” instead of the “Dr.” he has earned.

And I do like the idea that sometimes what is effective against a disease (including cancer) is not a single drug or therapy, but several taken together. For example, multi-drug cocktails have been effectively used against HIV, childhood leukemia, and Hodgkin’s lymphoma.

Ehrlich’s big dream was to find a magic bullet for each disease. But maybe it is mostly more promising to dream of the magic buckshot.

[N.B., the “Paul Ehrlich” I refer to is not the contemporary environmental alarmist “Paul Ehrlich” who famously lost his bet with the heroic heretic Julian Simon.]

The NYT article quoted above:

Lindsay Gellman. “Lifestyle to Reverse Alzheimer’s Carries High Costs and, Many Say, False Hope.” The New York Times, First Section (Sun., May 25, 2025): 1 & 18.

(Note: the online version of the NYT article was updated May 31, 2025, and has the title “An Expensive Alzheimer’s Lifestyle Plan Offers False Hope, Experts Say.”)

How Did Ed Smylie and His Team Create the Kludge That Saved the Crew of Apollo 13?

Gary Klein in Seeing What Others Don’t analyzed cases of innovation, and sought their sources. One source he came up with was necessity. His compelling example was the firefighter Wag Dodge who, with maybe 60 seconds until he would be engulfed in flame, lit a match to the grass around him, and then laid down in the still-hot embers. The roaring fire bypassed the patch he pre-burned, and his life was saved. The story is well-told in Norman Maclean’s Young Men and Fire.

Pondering more cases of necessity might be useful to help us understand, and encourage, future innovation. One candidate might be the kludge that Ed Smylie and his engineers put together to save the Apollo 13 crew from suffocating after an explosion blew up their command capsule oxygen tank.

Necessity may be part of it, but cannot be the whole story. Humanity needed to fly for thousands of years, but it took Wilbur Wright to make it happen. (This point is made in Kevin Ashton’s fine and fun How to Fly a Horse.)

I have ordered the book co-authored by Lovell, and mentioned in a passage quoted below, in case it contains insight on how the Apollo 13 kludge was devised.

(p. B11) Ed Smylie, the NASA official who led a team of engineers that cobbled together an apparatus made of cardboard, plastic bags and duct tape that saved the Apollo 13 crew in 1970 after an explosion crippled the spacecraft as it sped toward the moon, died on April 21 [2025] in Crossville, Tenn. He was 95.

. . .

Soft-spoken, with an accent that revealed his Mississippi upbringing, Mr. Smylie was relaxing at home in Houston on the evening of April 13 when Mr. Lovell radioed mission control with his famous (and frequently misquoted) line: “Uh, Houston, we’ve had a problem.”

An oxygen tank had exploded, crippling the spacecraft’s command module.

Mr. Smylie, . . ., saw the news on television and called the crew systems office, according to the 1994 book “Lost Moon,” by Mr. Lovell and the journalist Jeffrey Kluger. The desk operator said the astronauts were retreating to the lunar excursion module, which was supposed to shuttle two crew members to the moon.

“I’m coming in,” Mr. Smylie said.

Mr. Smylie knew there was a problem with this plan: The lunar module was equipped to safely handle air flow for only two astronauts. Three humans would generate lethal levels of carbon dioxide.

To survive, the astronauts would somehow need to refresh the canisters of lithium hydroxide that would absorb the poisonous gases in the lunar excursion module. There were extra canisters in the command module, but they were square; the lunar module ones were round.

“You can’t put a square peg in a round hole, and that’s what we had,” Mr. Smylie said in the documentary “XIII” (2021).

He and about 60 other engineers had less than two days to invent a solution using materials already onboard the spacecraft.

. . .

In reality, the engineers printed a supply list of the equipment that was onboard. Their ingenious solution: an adapter made of two lithium hydroxide canisters from the command module, plastic bags used for garments, cardboard from the cover of the flight plan, a spacesuit hose and a roll of gray duct tape.

“If you’re a Southern boy, if it moves and it’s not supposed to, you use duct tape,” Mr. Smylie said in the documentary. “That’s where we were. We had duct tape, and we had to tape it in a way that we could hook the environmental control system hose to the command module canister.”

Mission control commanders provided step-by-step instructions to the astronauts for locating materials and building the adapter.

. . .

The adapter worked. The astronauts were able to breathe safely in the lunar module for two days as they awaited the appropriate trajectory to fly the hobbled command module home.

. . .

Mr. Smylie always played down his ingenuity and his role in saving the Apollo 13 crew.

“It was pretty straightforward, even though we got a lot of publicity for it and Nixon even mentioned our names,” he said in the oral history. “I said a mechanical engineering sophomore in college could have come up with it.”

For the full obituary, see:

Michael S. Rosenwald. “Ed Smylie Dies at 95; His Team of Engineers Saved Apollo 13 Crew.” The New York Times (Tuesday, May 20, 2025): B11.

(Note: ellipses, and bracketed year, added.)

(Note: the online version of the obituary was updated May 18, 2025, and has the title “Ed Smylie, Who Saved the Apollo 13 Crew With Duct Tape, Dies at 95.”)

Klein’s book that I praise in my introductory comments is:

Klein, Gary A. Seeing What Others Don’t: The Remarkable Ways We Gain Insights. Philadelphia, PA: PublicAffairs, 2013.

Maclean’s book that I praise in my introductory comments is:

Maclean, Norman. Young Men and Fire. new ed., Chicago: University of Chicago Press, 2017.

Ashton’s book that I praise in my introductory comments is:

Ashton, Kevin. How to Fly a Horse: The Secret History of Creation, Invention, and Discovery. New York: Doubleday, 2015.

The book co-authored by Lovell and mentioned above is:

Lovell, Jim, and Jeffrey Kluger. Lost Moon: The Perilous Voyage of Apollo 13. Boston, MA: Houghton Mifflin, 1994.