Category: Books

Public Health “Experts” Rebuffed Renegades Who Saw Covid Spread in Aerosols

Steven Johnson’s The Ghost Map shows how rigid adherence to the miasma theory of disease shut out alternatives. And an alternative was indeed needed to explain the spread of cholera. But the defeat of the miasma theory for cholera may have been too complete, prejudicing scientists to oppose theories of disease-spread through the air, which turn out to be important for some diseases, such as Covid-19.

(p. C9) In early 2020, as word spread of a frightening new respiratory outbreak in China, the World Health Organization and the Centers for Disease Control and Prevention were pressed for advice. Both initially counseled social distancing, guided by the assumption that the disease was spread by large, boggy droplets that fell rapidly to the ground after being expelled by coughing or sneezing.

By avoiding such projectiles and keeping surfaces clean, the reasoning went, infection could be avoided. Yet this advice ignored—with tragic consequences—nearly a century of science suggesting that many respiratory diseases can spread via microdrops that are exhaled during normal breathing and can remain suspended in the air for hours.

In “Air-Borne,” the New York Times science writer Carl Zimmer seeks to explain how public-health officials could have overlooked such an important mechanism of the Covid-19 contagion. He begins his meticulous history with the ancient Greek physician Hippocrates, who taught that illness could be caused by “an invisible corruption of the air,” which he termed a “miasma.”

. . .

While the field of aerobiology may have entered the new millennium stuck on a “stagnant plateau,” as one journal article lamented, hope was starting to emerge. Advances in technology led to a more complete characterization of the aerobiome. A range of scientists from around the world, meanwhile, re-examined the possibility of airborne transmission and discovered the evidence against it wanting.

Following the emergence of Covid-19, many of these researchers were appalled by the seemingly reflexive—“mind-boggling,” in the words of one scientist—rejection of airborne transmission by public-health agencies. At first, these renegades individually struggled to have their work published but were largely rebuffed.

After an early Covid-19 outbreak among a choir in Washington state was initially attributed to large-droplet spread, a more detailed analysis by a unified group of skeptical researchers suggested that airborne transmission was far more likely. On Dec. 23, 2021—nearly 21 months after tweeting “FACT: #COVID19 is NOT airborne”—the WHO “finally issued a clear public statement that the virus was airborne,” Mr. Zimmer writes. A triumph for persistent scientists, perhaps, but also a pointed reminder of the complexity, fragility and deeply human dependencies of evolving science.

For the full review see:

David A. Shaywitz. “Microbes in the Mist.” The Wall Street Journal (Saturday, March 15, 2025): C9.

(Note: ellipsis added.)

(Note: the online version of the review has the date March 14, 2025, and has the title “‘Air-Borne’: The Microbes in the Mist.”)

The book under review is:

Zimmer, Carl. Air-Borne: The Hidden History of the Life We Breathe. New York: Dutton, 2025.

Global Warming Allows German Wine Entrepreneurs to Grow a “Superb” Chardonnay

In my Openness book, I argue that the costs of global warming have been exaggerated, partly because environmentalists forget that entrepreneurs can adapt, either lessening the costs, or sometimes even creating benefits. A case of creating benefits is apparently now the growing of “superb” chardonnay wine in Germany:

(p. D4) What accounts for the arrival of . . . German chardonnays? Certain wine regions like Rheinhessen, the Pfalz and the Obermosel have limestone soils, which chardonnay has a special affinity for, but the warming climate has made it possible to ripen chardonnay sufficiently to make superb wines.

Climate change influenced decisions to plant chardonnay in other ways as well.

“Climate change for us does not just mean it’s getting warmer and warmer, it means everything is getting more extreme — frost risk, weeks without rain, hailstorms,” said Klaus Peter Keller, . . . . “Therefore, we must spread the risk a bit more than we would 30 or 40 years ago. Rather than 100 percent riesling we have now 70 percent riesling, 15 percent pinot noir, 10 percent chardonnay and 4 percent others, and we think that will be the structure for the coming 30 or 40 years.”

Mr. Keller said he had wanted to plant pinot blanc rather than chardonnay but that their son Felix had pushed for chardonnay.

“Felix was right,” he said. “Chardonnay is much better adapted to climate change, with thicker skins, and it transmits the soil much better than pinot blanc.”

Felix Keller said by email that his grandfather had tried planting chardonnay in 1988, but that the timing had been wrong.

“Back then, it didn’t ripen every year,” he said. “It took us until 2018 to try again. We believe chardonnay has a bright future in Germany because we now have the climate that used to be in Burgundy in the early ’90s.”

For the full commentary see:

Eric Asimov. “The Pour; A Surprise From Germany: Chardonnay.” The New York Times (Weds., March 5, 2025): D1 & D4.

(Note: ellipses added.)

(Note: the online version of the commentary was updated March 4, 2025, and has the same title as the print version.)

My book mentioned in my initial comments is:

Diamond, Arthur M., Jr. Openness to Creative Destruction: Sustaining Innovative Dynamism. New York: Oxford University Press, 2019.

Innovative Entrepreneur Bill Gates Believes He Is “on the Autism Spectrum”

In my “Openness” book I argue and present some evidence that toleration for those who think different, including those on the Autism spectrum, will allow more innovative entrepreneurs to flourish, bringing benefits to us all. In the first volume of his autobiography, innovative entrepreneur Bill Gates speculates that he is on the Autism spectrum.

(p. A17) Mr. Gates was, he says, a “happy boy,” according to family lore. He had a wide grin, excess energy and a tendency to rock his body when he was deep in thought. Mr. Gates speculates that today he “probably would be diagnosed on the autism spectrum.”

For the full review see:

David A. Shaywitz. “Bookshelf; A Life of DOS And Don’ts.” The Wall Street Journal (Tuesday, Feb. 4, 2025): A17.

(Note: the online version of the review has the date February 3, 2025, and has the title “Bookshelf; ‘Source Code’: A Life of DOS and Don’ts.”)

The first volume of Bill Gates’s autobiography is:

Gates, Bill. Source Code: My Beginnings. New York: Alfred A. Knopf, 2025.

My book, that I mention in my opening comments, is:

Diamond, Arthur M., Jr. Openness to Creative Destruction: Sustaining Innovative Dynamism. New York: Oxford University Press, 2019.

Songbirds Adapt to Global Warming by Shrinking in Size

In my Openness book I argue that global warming is not as much of a threat as many claim. One part of my argument is that humans, and non-human life too, is much more adaptable than the environmentalists realize. Songbirds discussed below exemplify the point.

(p. A3) North American songbirds have been shrinking steadily in size over the past 40 years, according to scientists who measured tens of thousands of the feathered creatures from dozens of different species and attributed the changes to rising temperatures.

As the birds’ bodies got smaller, their wings gradually got longer, the scientists said in a paper published Wednesday [Dec. 4, 2019] in the journal Ecology Letters. The longer wings, the researchers said, may help offset the loss of body mass so the birds can fly efficiently on their long migrations.

. . .

Warm-blooded animals are generally larger in cold climates and smaller in warm climates because more compact creatures usually release heat more quickly, according to biologists and ecologists.

Given the well-established link, many scientists had predicted in recent years that global warming would affect the size of many animals. Yet until recently, there wasn’t much evidence of the effect at work during modern warming trends.

The new findings are the latest in a series of technical reports this year that link changes in body size among birds to warmer temperatures around the world.

Last month, researchers in Australia who studied physical changes in 82 songbird species, including honeyeaters, fairy-wrens and thornbills, reported in the Royal Society B journal that birds there have grown smaller due to warming over the last half-century, as the annual mean temperature increased regionally by about 0.012 degrees Celsius. They based their conclusions on an analysis of 12,000 museum specimens.

In March [2019], researchers at the University of Cape Town in South Africa who tracked the weight of a long-tailed songbird common across Africa called the mountain wagtail found the species gradually became lighter between 1976 and 1999, as regional temperatures increased by 0.18 degrees Celsius. They published their findings in the journal Oecologia.

For the full story see:

Robert Lee Hotz. “Songbirds Shrink in Size, Study Finds.” The Wall Street Journal (Thursday, December 5, 2019 [sic]): A3.

(Note: bracketed date and year added.)

(Note: the online version of the story has the date December 4, 2019 [sic], and has the title “Songbirds Are Shrinking in Size, Study Finds.”)

My book mentioned above is:

Diamond, Arthur M., Jr. Openness to Creative Destruction: Sustaining Innovative Dynamism. New York: Oxford University Press, 2019.

The academic paper in Ecology Letters, mentioned above, is:

Weeks, Brian C., David E. Willard, Marketa Zimova, Aspen A. Ellis, Max L. Witynski, Mary Hennen, and Benjamin M. Winger. “Shared Morphological Consequences of Global Warming in North American Migratory Birds.” Ecology Letters (2019).

The academic paper in the Royal Society B journal, mentioned above, is:

Gardner, Janet L., Tatsuya Amano, Anne Peters, William J. Sutherland, Brendan Mackey, Leo Joseph, John Stein, Karen Ikin, Roellen Little, Jesse Smith, and Matthew R. E. Symonds. “Australian Songbird Body Size Tracks Climate Variation.” Proceedings of the Royal Society B 286, no. 1916 (2019).

The academic paper in the Oecologia journal, mentioned above, is:

Prokosch, Jorinde, Zephne Bernitz, Herman Bernitz, Birgit Erni, and Res Altwegg. “Are Animals Shrinking Due to Climate Change? Temperature-Mediated Selection on Body Mass in Mountain Wagtails.” Oecologia 189, no. 3 (2019): 841-49.

Nvidia Entrepreneur’s Work-Life Imbalance: Ferocious Hard Work

(p. A15) Mr. Kim’s book is nothing like Walter Isaacson’s portraits of tech geniuses Steve Jobs or Elon Musk. It is more prosaic, focusing on the technical and human ground war of building a company. Even so, there is drama in Nvidia’s remarkable rise, and Mr. Kim’s reporting offers plenty of incident and portraiture.

. . .

As a teenager, we are told, Mr. Huang was a formidable table-tennis player and earned money by cleaning tables and bathrooms at a local Denny’s, a toughening experience that prepared him for life as a tech CEO. As a business sage, Mr. Huang says that work is simply perseverance in the face of difficult odds and that character is the source of greatness. Asked how to be successful, he will respond: “I wish upon you ample doses of pain and suffering.”

. . .

By . . . -the late 1990s—Mr. Huang had figured out a particular way of building and managing his company. The bedrock precept was ferociously hard work. New employees were told that the culture was “ultra-aggressive.” Mr. Huang demanded that they work at the “speed of light,” constrained (as Mr. Kim puts it) “only by the laws of physics—not by internal politics or financial concerns.”

. . .

Does all of this success make Mr. Huang happy? Apparently not. After one especially successful quarter, he began a review meeting by saying: “I look in the mirror every morning and say, ‘you suck.’ ” He still enjoys publicly dressing down employees, saying that humiliation is a small price to pay for group learning. He believes that he can “torture” his people “into greatness.” When employees begin to ramble in his presence, he will start to murmur “LUA,” a warning to the speaker. The abbreviation means: “Listen to the question. Understand the question. Answer the Question.”

For the full review see:

Philip Delves Broughton. “Bookshelf; The Hard Work Of Tech Mastery.” The Wall Street Journal (Monday, Dec. 16, 2024): A15.

(Note: ellipses added.)

(Note: the online version of the review has the date December 15, 2024, and has the title “Bookshelf; The Nvidia Way’: The Hard Work of Tech Mastery.”)

The book under review is:

Kim, Tae. The Nvidia Way: Jensen Huang and the Making of a Tech Giant. New York: W. W. Norton & Company, 2024.

Idaho Cut or Simplified 95% of Regulations by a “Sunset” Review

In my Openness book, I argue that government regulations bind entrepreneurs and reduce innovation. As part of an antidote, I suggest that “sunset laws,” where regulations automatically expire, if not renewed. Later, at a small conference on Adam Thierer’s latest book, I was discouraged to hear a couple of participants grant the plausibility of the “antidote,” but report that in actual practice it does not work because almost all old regulations get renewed. Some hope returned when I read a report from James Broughel of a successful sunset review process:

Idaho has proved deregulation is possible. The state repealed and revised its administrative rules code through a sunset review process in 2019. The results were dramatic. Since then, 95% of state regulations have been eliminated or simplified. The sky didn’t fall. Most regulations, when subject to genuine scrutiny, fail to justify their existence.

I will keep my eyes open on this issue, looking for more evidence.

James Broughel’s commentary is:

James Broughel. “Recipe for a Regulatory Spring Cleaning.” The Wall Street Journal (Tues., Nov. 26, 2024): A13.

(Note: the online version of the commentary has the date November 25, 2024, and has the same title as the print version.)

My book mentioned above is:

Diamond, Arthur M., Jr. Openness to Creative Destruction: Sustaining Innovative Dynamism. New York: Oxford University Press, 2019.

Adam Thierer’s book mentioned above is:

Thierer, Adam. Evasive Entrepreneurs and the Future of Governance: How Innovation Improves Economies and Governments. Washington, D.C.: Cato Institute, 2020.

Off-Label Drug Use Shows F.D.A. Phase 3 Trials Could Be Dropped, Adding New Cures and Lowering Costs

The F.D.A. allows physicians to prescribe drugs for “off-label” use. These drugs were originally approved for a different “on-label” use. For that approval the drugs had to pass through Phase 1 and Phase 2 clinical trials, mainly to show safety, and massively expensive Phase 3 clinical trials to show efficacy for the on-label use.

When off-label use is allowed, that shows that the F.D.A. is accepting drugs for a use where efficacy has NOT been shown.

This is a proof of concept for my suggestion (that I originally heard from Nobel-Prize-winner Milton Friedman) that F.D.A. regulation should be pared back to just Phase 1 and Phase 2, for safety. Since the Phase 3 trials are usually far more expensive than the Phase 1 and Phase 2 combined, this would allow far more new drugs to be developed.

If the development of new drugs was cheaper, Fajgenbaum and others would not need to spend N.I.H.’s 48 millions of taxpayer dollars to comb through already-approved drugs to see if one can be jury-rigged as a therapy for a different disease.

(p. A6) [Dr. David Fajgenbaum, an immunologist at the University of Pennsylvania and . . . Castleman patient who studies the disease] . . . has matched rare-disease patients with drugs that are already in pharmacies for other conditions for over 10 years, starting with himself.

. . .

Every Cure, a nonprofit Fajgenbaum helped found in 2022, received funding on Wednesday [Feb. 28, 2024] that could surpass $48 million from the federal Advanced Research Projects Agency for Health. Fajgenbaum and his team will spend the money to build a drug-repurposing database and algorithms that patients, doctors and researchers can use to find drugs for untreated diseases.

There are over 10,000 known rare diseases and most don’t have a drug approved to treat them. The FDA said it has approved over 19,000 prescription drugs.

The notion of finding new uses for existing drugs has been around for a long time. Once the FDA approves a drug, doctors can prescribe it off-label to patients with other conditions they think it will help. Ozempic, originally approved for people with Type 2 diabetes, is now used by millions of people without the disease for weight loss.

The National Institutes of Health and research institutions have invested over the years in drug repurposing, hoping it would be faster and less costly to find new uses for drugs that have already made it to market, a process that can take more than a decade and cost $2 billion. But systematically matching approved treatments to unmet needs has been hard.

. . .

“Our end goal is not FDA approval. Our end goal is giving patients maximum access to medications,” said Tracey Sikora, co-founder of Every Cure.

For the full story see:

Amy Dockser Marcus. “Repurposed Drugs Give People With Rare Diseases New Hope.” The Wall Street Journal (Thursday, Feb. 29, 2024 [sic]): A6.

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

(Note: the online version of the story has the date February 28, 2024 [sic], and has the title “This Doctor Found His Own Miracle Drug. Now He Wants to Do It for Others.”)

For more on Fajgenbaum’s story, read his autobiographical account:

Fajgenbaum, David. Chasing My Cure: A Doctor’s Race to Turn Hope into Action; a Memoir. New York: Ballantine Books, 2019.

Covid Citizen Scientists Provided Quick and Useful Knowledge

The essay quoted below claims that patients can provide useful knowledge about the symptoms of the diseases that afflict them. I agree, but would go even further. One source of knowledge that all humans have, and even non-humans to some extent, is the observation of patterns. Patients can observe which behaviors, medicines, circumstances make their disease better and which make their disease worse. Of course sometimes patients can be biased, can fool themselves. That can be a reason that patients disagree about what works. But another reason that patients can disagree is that patients have different bodies so that what works for one patient may not work for another. Researchers and clinicians are increasingly recognizing this when they advocate and practice “personalized” (aka “precision”) medicine.

And the academic and popular literatures have exaggerated the extent to which biases undermine our observation of patterns. The exaggeration is partly because bias is bad news, and bad news sells. The usual reliability of observed patterns has been persuasively defended in Gary Klein’s The Sources of Power.

Note another point in the passages quoted below. Patients have a sense of “urgency” that scientists often lack. Sometimes quick imperfect conclusions are actionable, while slow peer-reviewed conclusions are too late to be actionable. And sometimes peer-reviewed conclusions give us conclusions that are both slow and imperfect. Ioannides argues that “most published research findings are false” (2005). I am currently reading Piller’s Doctored that discusses highly-cited papers from the Alzheimer’s literature that illustrate Ioannides’s claim.

(p. C3) A month after her Covid-19 diagnosis last March [2020], Lisa McCorkell wanted to know why she was still struggling with a cough, shortness of breath and other debilitating symptoms. Her doctors didn’t have answers, so she and a group of other Covid patients took matters into their own hands. They formed a research group on a Slack channel and launched their own study.

“I was looking for validation, that my experience was reflected in the others,” said Ms. McCorkell, 28, of Oakland, Calif., who was finishing her graduate studies in public policy when she was diagnosed.

. . .

Covid citizen scientists generated information about symptoms, such as neurological issues, that didn’t garner a lot of attention at the start of the pandemic. They highlighted the overlooked challenges faced by people whose symptoms last longer than 28 days. The studies were limited by drawing largely from patients who joined online support groups, but they gained the kind of recognition by professional scientists that citizen science doesn’t always get.  . . .

The pandemic has created an opening for citizen scientists, because even now clinicians don’t fully understand the virus. Early clinical trial data comes mainly from studies involving hospitalized patients, whose experiences may not apply to those who are suffering but don’t end up in the emergency room.

. . .

Patients who want to lead Covid research projects often must navigate tension between their sense of urgency and the traditional scientific process, which typically requires a long peer review process before publication in a journal, said Emily Sirotich, a Ph.D. student at McMaster University in Canada. On March 12, the day the WHO declared Covid a pandemic, Ms. Sirotich joined a Twitter conversation between rheumatology patients and doctors, who were on equal footing when it came to Covid: No one understood the disease. “Everyone was worried,” she said.

. . .

Patients wanted to share the survey data right away, but the researchers argued that the scientific community wouldn’t use the information to inform patient care without the validation of going through peer review. “It has to be accurate,” said Ms. Sirotich.

The two groups tried to strike a balance, Ms. Sirotich said. Patients created overview summaries of the raw data that they immediately disseminated to support groups for use in personal decision making. The physicians and patients also co-wrote and submitted articles with more detailed data analysis to peer-reviewed journals and conferences.

“Covid gave us the opportunity to show that patients can produce valid data and reliable information about what they are experiencing,” Ms. Sirotich said.

In December [2020], the Patient-Led Research for Covid-19 group posted a paper based on analyzing data from over 3,700 patients to the MedRxiv public server, which professional scientists have used throughout the pandemic to quickly make results available to the wider community before peer review. The group also plans to submit the paper to a scientific journal.

Eric Topol, director of the Scripps Research Translational Institute in La Jolla, Calif., and a proponent of patients tracking their own health, tweeted the results. “There is a dearth of information about Covid,” Dr. Topol later said. As a professional scientist, he added, “The paper provided invaluable new insights to me.”

For the full essay see:

Amy Dockser Marcus. “Patients Are Doing Their Own Covid-19 Research.” The Wall Street Journal (Saturday, Jan. 30, 2021 [sic]): C3.

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

(Note: the online version of the essay has the same date as the print version, and has the title “Covid-19 Patients Are Doing Their Own Research.”)

Marcus’s essay is consistent with the theme of her book:

Marcus, Amy Dockser. We the Scientists: How a Daring Team of Parents and Doctors Forged a New Path for Medicine. New York: Riverhead Books, 2023.

The Gary Klein book I praise in my comments is:

Klein, Gary A. Sources of Power: How People Make Decisions. 20th Anniversary ed. Cambridge, MA: The MIT Press, 2017.

The Ioannidis paper that I quote above is:

Ioannidis, John P. A. “Why Most Published Research Findings Are False.” PLoS Medicine 2, no. 8 (Aug. 2005): 696-701.

The Piller book that I praise in my comments is:

Piller, Charles. Doctored: Fraud, Arrogance, and Tragedy in the Quest to Cure Alzheimer’s. New York: Atria/One Signal Publishers, 2025.

F.D.A.’s Project Optimus Adds to Complexity and Length of Mandated Clinical Trials, Further Burdening Innovative Startups

One of Joseph Schumpeter’s profound subtle points in the key chapter 7 of Capitalism, Socialism and Democracy is that the kind of thinking and rules that aim for optimization, restrict the kind of creative, inspired thinking or improvisational pivoting that results in the greatest and fastest progress and flourishing. (My interpretation of Schumpeter.)

Great leaps forward have tended to originate from small startups. But increasing the size, length, and costs of mandated clinical trials, as the F.D.A. is doing with “Project Optimus,” will make it harder for small startups to survive, let alone flourish.

(p. B2) For years, Food and Drug Administration officials have expressed concern that cancer drug doses are often too high, leading to unnecessary side effects. An FDA program launched in 2021, Project Optimus, requires companies to re-examine how they set doses of cancer treatments.

This typically involves larger clinical trials to test doses to find those that optimally balance safety and efficacy. Entrepreneurs support the aim, but some fear the initiative will add time and cost to drug development, putting startups at a further disadvantage to larger competitors.

“I don’t think anybody disagrees with the idea that we’re trying to find the best thing for the patient,” said David Bearss, chief executive of biotechnology startup Halia Therapeutics. “I hope it doesn’t have unintended consequences of actually suppressing innovation.”

. . .

Because Project Optimus is still relatively new it will take a while for its full impact to be known. But it will likely add six to 12 months to the drug-development process, said Tara Raghavan, a pharmaceutical patent lawyer and partner with law firm Benesch Friedlander Coplan & Aronoff.

For the full story, see:

Brian Gormley. “FDA Drug Initiative Vexes Startups.” The Wall Street Journal (Friday, Aug 30, 2024): B2.

(Note: ellipsis added.)

(Note: the online version of the story has the date August 29, 2024, and has the title “FDA Wants Safer Cancer Drugs, but Some Startups Fear Unintended Consequences.”)

In my comments I mention Schumpeter’s chapter 7 on creative destruction that can be found in his messy, inspired masterpiece:

Schumpeter, Joseph A. Capitalism, Socialism and Democracy. 3rd ed. New York: Harper and Row, 1950.

Harold Ridley’s Innovative Project Was to Replace a Cataract with a Plexiglass Lens

I am currently working on a book on medical entrepreneurship. Harold Ridley deserves inclusion.

Innovative entrepreneurs often observe anomalies and realize how the anomalies can be put to good use, where others would not notice the anomalies, or would notice them, shrug, and forget. (In Ridley’s case the anomalie was that the plastic fragments in Cleaver’s eyes “weren’t causing any inflammation or infection.”)

Pasteur famously said that ‘chance favors a prepared mind.’ If he had read Kirzner, he might have added ‘chance also favors an alert mind.’ (Kirzner’s account of entrepreneurship emphasizes the importance of entrepreneurial alertness.)

(p. A17) On Aug. 15, 1940, Royal Air Force pilot Gordon Cleaver scrambled into the cockpit of his Hawker Hurricane and lifted into the sky.  . . .  He was shot down over Winchester. Enemy bullets shattered his canopy, showering debris into his eyes. Flying blind and in excruciating pain, Cleaver managed to escape his doomed plane and parachute to the ground.

. . .

Cleaver’s damaged eyes were examined by a 34-year-old ophthalmologist, Harold Ridley. Shards of Plexiglas from his shattered canopy remained in the pilot’s eyes. This was a disaster. Foreign bodies in the eye such as lead or shrapnel usually caused inflammation or infection so severe that the eyes often had to be removed. But Ridley noticed something peculiar: The fragments of clear plastic weren’t causing any inflammation or infection. They sat quietly inside Cleaver’s eyes, glistening in the light of the ophthalmoscope. This was a shocking discovery.

Ridley examined Cleaver multiple times. The pilot’s sight was severely damaged, but the Plexiglas remained inert in his eyes, causing no inflammation. In 1948, while Ridley was removing a cataract—a clouding of the eye’s lens—for another patient, the memory of Cleaver’s case sparked an epiphany. A medical student observing the operation said, “It’s a pity you can’t replace the cataract with a clear lens.” Ridley recalled the well-tolerated Plexiglas in Cleaver’s eyes and realized that he could use the material to make an intraocular lens that the body wouldn’t reject.

. . .

His invention has saved the sight of millions. But instead of stirring professional acclaim, Ridley’s invention was a disaster for his career. The ophthalmology establishment labeled him a heretic.

Leaders in the field accused him of malpractice, ridiculed him at science conferences and poisoned colleagues against his ideas. They argued that the procedure was a “time bomb” and that “manufacturers should be prosecuted for supplying implants.” Ridley worked for decades to improve his operation and gain converts, but fell into a deep depression. When he retired in 1971, he considered his career a failure.

For the full commentary see:

Andrew Lam. “The Doctor and the Pilot Who Saved the Eyesight of Million.” The Wall Street Journal (Monday, Feb. 8, 2025): A17.

(Note: ellipses added.)

(Note: the online version of the commentary has the date February 7, 2025, and has the same title as the print version.)

Lam’s commentary is related to his book:

Lam, Andrew. Saving Sight. Bokeelia, FL: Irie Books, 2013.

For Kirzner on entrepreneurial alertness see:

Kirzner, Israel M. Competition and Entrepreneurship. Chicago: University of Chicago Press, 1973.

Rickets Is Now Rare Because Vitamin D Is Easy to Get

(p. A15) Rickets is one of those diseases that seem incredibly old-fashioned. It’s difficult to comprehend, now, how widespread this bone ailment once was: In some cities less than a century ago, 90% of children showed symptoms of rickets during wintertime. But ubiquity has its benefits. In “Starved for Light,” Christian Warren convincingly argues that modern medicine would be unrecognizable without the many advances in treatment that trace their roots to this once-widespread disease.

Rickets results from a lack of vitamin D, which we need to help shuttle calcium and phosphorus into our bones. Our bodies manufacture vitamin D whenever ultraviolet sunlight hits our skin; we can also get it through food. A deficiency in vitamin D causes the softening and bending of bones characteristic of rickets; victims are often left bowlegged or knock-kneed, or with curved spines or misshapen pelvises. The worst cases leave babies unable to crawl or even sit up straight.

. . .

Given how disgusting cod-liver oil tastes, some countries began combating rickets by adding vitamin D to milk in the 1930s—an odd choice, since milk contains no vitamin D naturally. (Amusingly, Mr. Warren calls the practice an “in uddero” health intervention.) The choice seems even odder, the author wryly notes, when there’s a much simpler solution to preventing rickets: going outside for a few minutes. Instead, we’ve effectively turned “a dairy product into a drug-delivery device,” severing the ancient interplay between “sun, skin, and bone.”

For the full review see:

Sam Kean. “Bookshelf; A Disease Of Deficiency.” The Wall Street Journal (Monday, Dec. 9, 2024): A15.

(Note: ellipsis added.)

(Note: the online version of the review has the date December 8, 2024, and has the title “Bookshelf; ‘Starved for Light’: A Disease of Deficiency.”)

The book under review is:

Warren, Christian. Starved for Light: The Long Shadow of Rickets and Vitamin D Deficiency. Chicago: University of Chicago Press, 2024.