Category: Books

Is Apple’s Lack of New Breakthroughs Due to Lack of Opportunity or Lack of Steve Jobs?

(p. 15) Steve Jobs, Apple’s co-founder and animating spirit, died in 2011, leaving the firm in the hands of Jony Ive, the British-born designer-savant, and Tim Cook, a child of Alabama who’d become a master of supply chains and production costs. “After Steve,” by the New York Times reporter Tripp Mickle, covers Ive’s and Cook’s careers, and how they and the company changed after they took over.

. . .

In the epilogue, Mickle drops his reporter’s detachment to apportion responsibility for the firm’s failure to launch another transformative product. Cook is blamed for being aloof and unknowable, a bad partner for Ive, “an artist who wanted to bring empathy to every product.” Ive is also dinged for taking on “responsibility for software design and the management burdens that he soon came to disdain.” By the end, the sense that the two missed a chance to create a worthy successor to the iPhone is palpable.

It’s also hooey, and the best evidence for that is the previous 400 pages. It’s true that after Jobs died, Apple didn’t produce another device as important as the iPhone, but Apple didn’t produce another device that important before he died either. It’s also true that Cook did not play the role of C.E.O. as Jobs had, but no one ever thought he could, including Jobs, who on his deathbed advised Cook never to ask what Steve would do: “Just do what’s right.”

Ive and Cook wanted another iPhone, but, as Mickle’s exhaustive reporting makes clear, there was not another such device to be made. Self-driving cars were too hard, health devices too regulated, television protected in ways music had not been, and even the earbuds and watch, devices they actually shipped, were peripheral, technically and conceptually, to Apple’s greatest product.

Epilogue aside, the book is an amazingly detailed portrait of the permanent tension between strategy and luck: Companies make their own history, but they do not make it as they please. What happened after Steve was that Cook’s greatest opportunities were in Apple’s future, Ive’s in its past.

For the full review, see:

Clay Shirky. “The Watchmen.” The New York Times Book Review (Sunday, May 29, 2022): 15.

(Note: ellipsis added; italics in original.)

(Note: the online version of the review was updated May 2, 2022, and has the title “Apple Inc., ‘After Steve’.”)

The book under review is:

Mickle, Tripp. After Steve: How Apple Became a Trillion-Dollar Company and Lost Its Soul. New York: William Morrow, 2022.

“For the Foreseeable Future We Cannot Feed the World Without Relying on Fossil Fuels”

(p. 16) The title’s pleonastic fourth word is the giveaway. It announces the tone of Vaclav Smil’s 49th book: vinegary scorn for the irresponsible declarations of self-proclaimed experts, particularly those guilty of innumeracy, ahistoricism and other forms of wishful thinking that Vaclav Smil would never, ever fall for. You’ve heard a lot of prognostications about the state of the world. They’re bunk. Here, at last, is how the world really works.

. . .

. . . every fundamental aspect of modern civilization rests overwhelmingly on fossil fuel combustion. Take our food system. Readers of Michael Pollan or Amanda Little understand that it’s morally indefensible to purchase Chilean blueberries or, God forbid, New Zealand lamb. But even a humble loaf of sourdough requires the equivalent of about 5.5 tablespoons of diesel fuel, and a supermarket tomato, which Smil describes as no more than “an appealingly shaped container of water” (apologies to Marcella Hazan), is the product of about six tablespoons of diesel. “How many vegans enjoying the salad,” he writes, “are aware of its substantial fossil fuel pedigree?”

It is best to eat local, but we do not have enough arable land to support our population, even in our vast continent, at least not without the application of obscene quantities of natural-gas-derived fertilizer. One must further account for the more than three billion people in the developing world who will need to double or triple their food production to approach a dignified standard of living. Then add the additional two billion who will soon join us. “For the foreseeable future,” writes Smil, “we cannot feed the world without relying on fossil fuels.” He performs similar calculations for the world’s production of energy, cement, ammonia, steel and plastic, always reaching the same result: “A mass-scale, rapid retreat from the current state is impossible.”

Smil’s impartial scientist persona slips with each sneer at the “proponents of a new green world” or “those who prefer mantras of green solutions to understanding how we have come to this point.” Still, his broader point holds: We are slaves to fossil fuels.

. . .

Smil’s book is at its essence a plea for agnosticism, and, believe it or not, humility — the rarest earth metal of all. His most valuable declarations concern the impossibility of acting with perfect foresight. Living with uncertainty, after all, “remains the essence of the human condition.” Even under the most optimistic scenario, the future will not resemble the past. We will have to navigate seemingly impossible conditions, relying on instinct and imperfect assumptions and our old familiar flaws (chiefly “our never-failing propensity to discount the future”). This may not be a particularly galvanizing conclusion, but it is, yes, how the world works.

For the full review, see:

Nathaniel Rich. “The Theory of Nothing.” The New York Times Book Review (Sunday, May 29, 2022): 16.

(Note: ellipses added; italics in original.)

(Note: the online version of the review has the date May 11, 2022, and has the title “Everything You Thought You Knew, and Why You’re Wrong.”)

The book under review is:

Smil, Vaclav. How the World Really Works: The Science Behind How We Got Here and Where We’re Going. New York: Viking, 2022.

Gillies Created Reconstructive Surgery “Through Trial and Error”

(p. C6) During World War I, a handful of soldiers who had suffered catastrophic facial wounds traveled to Paris on a journey of last resort.

. . .

Trench warfare produced a huge number of facial injuries, and bespoke masks could never keep up with the demand.

. . .

But masks were of limited value, because they could conceal, but never heal, grievous wounds. Disfigured men needed a medical breakthrough to help them. Ms. Fitzharris, the author of “The Butchering Art” (2017), a history of Victorian medicine, chronicles the life of the British plastic surgeon Harold Delf Gillies, whose innovations and operating-room magic saved thousands of warriors from their fates and allowed them to walk in the world again. Both heartbreaking and inspiring, “The Facemaker” tells a profound story of survival, resurrection and redemption.

Born in New Zealand and educated in England, Gillies entered the Royal Army Medical Corps early in the war, at age 32. A champion amateur golfer, he began his soldiering as a novice military doctor. The second Battle of Ypres, in May 1915, was his baptism by fire. It was there, Ms. Fitzharris says, that he “first stepped into a field hospital’s makeshift operating theater,” where he labored around the clock, standing on a floor awash with blood. A month later, he was assigned to the Allied Forces base hospital in Étaples, France. The dental surgeon Auguste Charles Valadier showed him how to use bone grafts to reconstruct faces without distorting the features and to restore a patient’s ability to speak and eat.

That summer, Gillies sought out Hippolyte Morestin, an eccentric French surgeon devoted to achieving high-quality aesthetic results. Gillies watched Morestin remove a large cancerous growth from a patient’s face and close the wound with a flap of skin from the patient’s neck. It was a turning point for Gillies, who would describe the moment as “the most thrilling thing I had ever seen. I fell in love with the work on the spot.”

. . .

[Gillies’s] . . . key insight was that a multidisciplinary approach was needed: the combined work of plastic surgeons, dental surgeons, nurses, radiologists, artists, sculptors and photographers.

Gillies conceded it was “a strange new art,” without textbooks, precedent, or experience to guide its practice. Through trial and error, he re-created missing mouths and noses, filled in gaping voids of bone and flesh, restored obliterated jaws, treated horrific burns, and performed skin grafts. Until then, most surgeons had stitched together the edges of a gaping wound, a process that could cause necrosis and cellular destruction as well as further disfigurement. Among other things, Gillies learned that, to achieve the best results, he needed to perform surgery incrementally and space operations out over time, to allow patients to recover from one surgery to the next. Some men required 15 or 20 operations, occasionally as many as 40. “Never do today what can be put off till tomorrow” became his motto.

And Gillies mastered the use of the flaps, which are made to cover a wound and which have, as Ms. Fitzharris tells us, their “own blood supply in the form of a single large artery or multiple smaller blood vessels.” Gillies’s greatest invention was the tubed pedicle—a flap of skin attached to a “protective, infection-resistant cylinder,” which was itself attached to the injury site. It “dramatically reduced the chance for infection,” Ms. Fitzharris writes.

For the full review, see:

James L. Swanson. “Repairing the Wounds of War.” The Wall Street Journal (Saturday, May 28, 2022): C6.

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

(Note: the online version of the review has the date May 27, 2022, and has the title “‘The Facemaker’ Review: Repairing the Wounds of War.”)

The book under review is:

Fitzharris, Lindsey. The Facemaker: A Visionary Surgeon’s Battle to Mend the Disfigured Soldiers of World War. New York: Farrar, Straus and Giroux, 2022.

Lacking Government Approval During Pandemic, “State-of-the-Art Testing Machines . . . Weren’t Turned On”

(p. 12) The ethics manual of the American College of Physicians states that “the ethical imperative for physicians to provide care” overrides “the risk to the treating physician, even during epidemics.” Nevertheless, for most of human history, doctors often ran away in the face of widespread contagious disease.

. . .

When health workers stick around to treat patients, even at risk to their own lives, it is something to be celebrated, and the journalist Marie Brenner does just that in “The Desperate Hours,” an account of how workers at New York-Presbyterian, an academic health system, coped with the Covid surge in New York City beginning in the spring of 2020. The book details both medical heroism and corporate cowardice, prescient decisions and howling missteps, all against the backdrop of a swirling and mysterious pandemic that claimed the lives of more than 30,000 residents, not to mention 35 New York-Presbyterian employees.

Along the way we encounter some eye-opening anecdotes. Early on, New York City hospitals were faced with an alarming dearth of masks and a near rebellion by workers on the front lines. In response, New York-Presbyterian’s chief operating officer, Dr. Laura Forese, a pediatric orthopedic surgeon, assured staff members that “masks would not be necessary” unless workers were in direct contact with infected patients. Though she was working off mistaken C.D.C. guidelines, it was “advice and regulation that countermanded every bit of common sense understood by public health officials since the Black Plague,” Brenner writes.

. . .

Yet state-of-the-art testing machines at New York-Presbyterian weren’t turned on because the leadership was waiting for the government to approve their use. When doctors and nurses complained, the communications office attempted to throttle them and even threatened them with demotions or dismissal. It is part of what Dr. Steve Corwin, New York-Presbyterian’s chief executive, calls “a failure of imagination on our part.”

The book has its share of heroes who buck the strictures of the system to speak the truth about what was coming (or had already arrived). No one was more heroic than Dr. Nathaniel Hupert, an infectious-disease modeler at New York-Presbyterian who raised the alarm about the pandemic in February 2020 but was largely ignored.

“This is going to be historically bad, rivaling the medical consequences of 1918, but far exceeding it in terms of global financial impact,” he warned his colleagues. “If we get through this, it will be the sort of thing that we will tell our grandchildren about.” Yet when Hupert showed his projections at a planning meeting, the medical school dean told him, “I think we will be all right.”

. . .

Compounding the disaster was that little guidance was coming from executives on how to navigate the crisis, including how to potentially ration beds and ventilators (which fortunately did not come to pass). “The amount of moral damage they did to a lot of people while they get paid millions of dollars is disgusting,” a critical-care physician says bitterly.

For the full review, see:

Sandeep Jauhar. “Plagued.” The New York Times Book Review (Sunday, July 3, 2022): 12.

(Note: ellipses added.)

(Note: the online version of the review has the date June 19, 2022, and has the title “Facing Death During the Pandemic.”)

The book under review is:

Brenner, Marie. The Desperate Hours: One Hospital’s Fight to Save a City on the Pandemic’s Front Lines. New York: Flatiron Books, 2022.

Spreading Smallpox Inoculation to Impress Voltaire

(p. A15) Dimsdale had been summoned by Catherine the Great to inoculate not only the empress herself but also her 13-year-old heir, the Grand Duke Paul.

. . .

As Lucy Ward dramatically relates in “The Empress and the English Doctor: How Catherine the Great Defied a Deadly Virus,” Catherine’s invitation was a high-stakes affair, a testament to Dimsdale’s writings on the methodology of smallpox inoculation and his reputation for solicitous care. His Quaker upbringing had encouraged a brand of outcome- rather than ego-led practice.

. . .

As devastating as smallpox was, for the empress herself and the grand duke who would succeed her to personally undergo inoculation was a risk to both patient and doctor. On the success side stood immunity from the disease, an almost holy example for Catherine’s people, and as-yet-untold riches for her nervous doctor. On the other side, not only the fact that all Russia would refuse the treatment if their “Little Mother” died, but also a disaster for Dimsdale and the son who had accompanied him. Geopolitics came into play too—if things went wrong, some would interpret it as a foreign assassination.

. . .

With a happy result for her and her less-robust son, Catherine sets about publicizing the success. Dimsdale receives the equivalent of more than $20 million and a barony. Bronze medals are cast of Catherine’s profile, reading “She herself set an example.” It helps that Catherine was competitive beyond reason: “we have inoculated more people in a month than were inoculated in Vienna in eight,” she wrote to Voltaire, determined to beat Empress Maria Theresa’s efforts.

For the full review, see:

Catherine Ostler. “BOOKSHELF; Inoculate Conception.” The Wall Street Journal (Thursday, June 23, 2022): A15.

(Note: ellipses added.)

(Note: the online version of the review was updated June 22, 2022, and has the title “BOOKSHELF; ‘The Empress and the English Doctor’ Review: Inoculate Conception.”)

The book under review is:

Ward, Lucy. The Empress and the English Doctor: How Catherine the Great Defied a Deadly Virus. London, UK: Oneworld Publications, 2022.

“More a Great Reshuffling Than a Great Resignation”

In the passages quoted below, Nobel laureate, and often-strident leftist Paul Krugman, modifies his views on the state of the U.S. labor market in an interesting and plausible way. I believe another part of the story, as Newt Gingrich has suggested, is that some workers may be following the advice of Ayn Rand’s Atlas Shrugged, by in effect going on strike. So the Great Resignation may not entirely be a “myth.” More remains to be learned.

(p. 3) Have large numbers of Americans dropped out of the labor force — that is, they are neither working nor actively seeking work? To answer this question, you need to look at age-adjusted data; falling labor force participation because a growing number of Americans are over 65 isn’t meaningful in this context. So economists often look at the labor force participation of Americans in their prime working years: 25 to 54. And guess what? This participation rate has surged recently. It’s still slightly below its level on the eve of the pandemic, but it’s back to 2019 levels, which hardly looks like a Great Resignation.

What about early retirement? If a lot of that was happening, we’d expect to see reduced labor force participation among older workers, 55 to 64. But they’ve come rapidly back into the labor force.

A few months ago, it still seemed reasonable to talk about a Great Resignation. At this point, however, there’s basically nothing there. It’s true that an unusually high number of workers have been quitting their jobs, but they have been leaving for other, presumably better jobs, rather than leaving the work force. As the labor economist Arindrajit Dube says, it’s more a Great Reshuffling than a Great Resignation.

. . .

How can labor markets be so tight when payroll employment is still well below the prepandemic trend?

. . .

First, as the economist Dean Baker has been pointing out, the most commonly cited measures of employment don’t count the self-employed, and self-employment is up by a lot, around 600,000 more workers than the average in 2019. Some of this self-employment may be fictitious — gig workers who are employees in all but name but work for companies that classify them as independent contractors to avoid regulation. But it also does seem as if part of the Great Reshuffling has involved Americans concluding that they could improve their lives by starting their own businesses.

Second, a point that receives far less attention than it should is the decline of immigration since Donald Trump came to office, which turned into a plunge with the coming of the pandemic.

For the full commentary, see:

Paul Krugman. “The Myth of the Great Resignation.” The New York Times, SundayReview Section (Sunday, April 10, 2022): 3.

(Note: ellipses added.)

(Note: the online version of the commentary has the date April 5, 2022, and has the title “What Ever Happened to the Great Resignation?”)

Ayn Rand’s magnum opus, mentioned above, is:

Rand, Ayn. Atlas Shrugged. New York: Random House, 1957.

“Quiet, Unassuming” Dr. Zelenko Got Twitter Suspension and Death Threats for Speaking on Hydroxychloroquine

Dr. Zelenko was stricken with a rare form of lung cancer in 2018, shortly before the Covid-19 pandemic. I wonder if that increased his personal sense of urgency to find a cure for Covid-19?

(p. A21) Vladimir Zelenko, a self-described “simple country doctor” from upstate New York who rocketed to prominence in the early days of the Covid-19 pandemic when his controversial treatment for the coronavirus gained White House support, died on Thursday in Dallas. He was 48.

. . .

Like many health care providers, he scrambled when the coronavirus began to appear in his community. Within weeks he had landed on what he insisted was an effective cure: a three-drug cocktail of the antimalarial drug hydroxychloroquine, the antibiotic azithromycin and zinc sulfate.

. . .

“At the time, it was a brand-new finding, and I viewed it like a commander in the battlefield,” Dr. Zelenko told The New York Times. “I realized I needed to speak to the five-star general.”

On March 28, [2020] the Food and Drug Administration granted emergency authorization to doctors to prescribe hydroxychloroquine and another antimalarial drug, chloroquine, to treat Covid. Mr. Trump called the treatment “very effective” and possibly “the biggest game changer in the history of medicine.”

But, as fellow medical professionals began to point out, Dr. Zelenko had only his own anecdotal evidence to support his case, and what little research had been done painted a mixed picture.

Still, he became something of a folk hero on the right, someone who offered not just hope amid the pandemic but also an alternative to the medical establishment and Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, who insisted that months of research would be needed to find an effective treatment.

. . .

A quiet, unassuming man, Dr. Zelenko seemed unprepared for the attention he received, which included harassing phone calls and even death threats. In May 2020, a federal prosecutor opened an investigation into whether he had falsely claimed F.D.A. approval for his research.

. . .

After the F.D.A. rescinded its approval of hydroxychloroquine as a Covid treatment, he founded a company, Zelenko Labs, to promote other nonconventional treatments for the disease, including vitamins and quercetin, an anti-inflammatory drug.

And while he claimed to be apolitical, he embraced the image of a victim of the establishment. He founded a nonprofit, the Zelenko Freedom Foundation, to press his case. In December 2020, Twitter suspended his account, stating that it had violated standards prohibiting “platform manipulation and spam.”

. . .

In a memoir, “Metamorphosis” (2018), Dr. Zelenko wrote that he grew up nonreligious and entered Hofstra University as an avowed atheist.

“I enjoyed debating with people and proving to them that G-d did not exist,” he wrote. “I studied philosophy and was drawn to nihilistic thinkers such as Sartre and Nietzsche.”

But after a trip to Israel, he began to change his mind. He gravitated toward Orthodox Judaism, and in particular the Chabad-Lubavitch movement.

He graduated from Hofstra in 1995 with a degree in chemistry, and he received his medical degree from the State University of New York at Buffalo in 2000.

. . .

In 2018, doctors found a rare form of cancer in his chest and, in hopes of treating it, removed his right lung.

For the full obituary see:

Clay Risen. “Vladimir Zelenko, 48, ‘Country Doctor’ Who Pushed Unfounded Covid Remedy.” The New York Times (Saturday, July 2, 2022): A21.

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

(Note: the online version of the obituary has the date July 1, 2022 and has the title “Vladimir Zelenko, 48, Dies; Promoted an Unfounded Covid Treatment.”)

Dr. Zelenko’s pre-Covid-19 memoir is:

Zelenko, Vladmir. Metamorphosis. Lakewood, NJ: Israel Bookshop Publications, 2019.

A highly credentialed Yale academic presented evidence of the promise of hydroxychloroquine for early outpatient treatment in:

Risch, Harvey A. “Early Outpatient Treatment of Symptomatic, High-Risk Covid-19 Patients That Should Be Ramped-up Immediately as Key to the Pandemic Crisis.” American Journal of Epidemiology 189, no. 11 (Nov. 2020): 1218–26.

California Should Go Nuclear

(p. C1) A recent study sponsored by the Environmental Defense Fund and the Clean Air Task Force concluded that to meet its net-zero pledge by 2045, the state of California will need power that is not only “clean” but “firm”—that is, “electricity sources that don’t depend on the weather.” The same is true around the world, and nuclear offers a relatively stable source of power.

Nuclear plants don’t depend on a steady supply of coal or gas, where disruptions in commodity markets can lead to spikes in electricity prices, as has happened this winter in Europe. Nor do nuclear plants depend on the weather. Solar and wind have a great deal of potential, but to be reliable energy sources on their own, they require advanced batteries and high-tech grid management to balance varying levels of power generation with anticipated spikes in demand. That balancing act is easier and cheaper with the kind of firm power that nuclear can provide.

. . .

(p. C2) In France, as part of a massive push to “reindustrialize,” the government will spend $1.13 billion on nuclear power R&D by 2030. The focus is on developing a new generation of small modular reactors (SMRs) to replace parts of the existing fleet that supplies around 70% of the country’s electricity.

. . .

. . . it’s , , , important to recognize that regulatory oversight and safety provisions are usually effective. Even the Fukushima accident, or the Three Mile Island accident in Pennsylvania in 1979, could be considered a success on the safety front: Some safety features failed but others worked, containing the fallout.

. . .

SMRs and other new technologies are the nuclear industry’s big hope. One focus of research is using new fissile materials such as thorium, which is more abundant, produces less waste and has no direct military applications. Other technologies look to using existing nuclear waste as a fuel source. Turning away from massive reactors toward SMRs might, at first, increase costs per unit of energy produced. But it would open financing models unavailable to large reactors, allowing costs to come down, with reactors following a uniform design instead of being designed one by one. Building many small reactors also allows for learning-by-doing, a model actively pursued by China at home and as part of its Belt and Road Initiative abroad.

None of these new technologies is sure to be economically competitive. Some of the more experimental technologies, like China’s thorium reactors, might yet pay off. TerraPower, a venture founded by Bill Gates, has been working on natrium reactors for over a decade and recently added a molten-salt design to the mix, which could make a real difference if it works out. The point is to try. Like solar and wind, nuclear energy could climb the learning curve and slide down the cost curve with the right financial backing.

For the full commentary, see:

Gernot Wagner. “Is Nuclear Power Part of the Climate Solution?” The Wall Street Journal (Saturday, Jan. 8, 2022): C1-C2.

(Note: ellipses added.)

(Note: the online version of the commentary has the date January 7, 2022, and has the same title as the print version.)

The commentary quoted above is related to the author’s book:

Wagner, Gernot. Geoengineering: The Gamble. Cambridge, UK: Polity, 2021.

Which Country’s National Anthem Ends by Questioning Its Citizens’ Bravery and Freedom?

(p. 9) Mark Clague knows everything about “The Star-Spangled Banner,” . . . .

. . .

The lyrics were composed by the lawyer, politician and amateur poet Francis Scott Key while held prisoner by the British in Baltimore Harbor during the War of 1812.

. . .

Clague even creates a detailed military map of the engagement to demonstrate how “perilous” that fight really was. The first verse, the only one now sung, ends, as every child knows, with a question:

“Oh, say does that star-spangled banner yet wave/O’er the land of the free, and the home of the brave?”

In the complete version, Key details his relief at finally seeing the flag, and rejoices in the promise of future victories. But those three verses are rarely sung, and leaving the question unanswered might be the secret to the song’s hold on the American public. It is not an anthem that, like “La Marseillaise,” calls for our enemy’s “impure blood to water our fields.” Rather, it’s a song for a country that is still in the fight, for its existence and its ideals, and it offers an invitation to any and all — the “you” of the first line — . . .

. . .

. . ., Clague has no patience for anyone who demands . . . reverence from others, . . . . But he reveres the anthem itself, and he makes the strongest case for the song in his detailed analysis of what he calls its most successful modern rendition, Whitney Houston’s performance at the 1991 Super Bowl.

Houston’s version, though, is transformed by artistry and personality and musical genius. She has changed the time signature to 4/4, and imbues the melody with the ornamentation of jazz, blues and, most important, gospel. By the time she gets that highest “FREEEE” she not only reaches but goes above it, expressing ownership of the word and the gesture. While the lyrics may remain as written, the meaning of a crucial word in the first line — “you” — has been wrenched from past to present to be addressed, at last, to all of us.

So: Does that star-spangled banner yet wave o’er the land of the free and home of the brave? Not yet, perhaps. But listening to a descendant of the enslaved claiming the song of a slaver, you want to believe it someday might.

For the full review, see:

Peter Sagal. “High Notes.” The New York Times Book Review (Sunday, July 3, 2022): 9.

(Note: ellipses added.)

(Note: the online version of the review was updated June 22, 2022, and has the title “Our Flag Was Still There.”)

The book under review is:

Clague, Mark. O Say Can You Hear?: A Cultural Biography of “the Star-Spangled Banner”. New York: W. W. Norton & Company, 2022.

The “Perceptually Divergent” Are Open to How Species Differ in Their Sensory Trade-Offs

(p. C1) That I found myself surprised at so many moments while reading “An Immense World,” Ed Yong’s new book about animal senses, speaks to his exceptional gifts as a storyteller — . . .

. . .

(p. C4) Yong’s book is funny and elegantly written, mercifully restrained when it comes to jargon, though he does introduce a helpful German word that he uses throughout: Umwelt. It means “environment,” but a little more than a century ago the Baltic German zoologist Jakob von Uexküll used it to refer more specifically to that sensory bubble — an animal’s perceptual world.

. . .

The human Umwelt will necessarily shape how we apprehend other Umwelten. “An Immense World” inevitably refers to the philosopher Thomas Nagel’s foundational essay on this struggle, “What Is It Like to Be a Bat?”

But some humans might be more open-minded than others. A number of the sensory biologists Yong meets are perceptually divergent, seeing color differently or having difficulty remembering familiar faces: “Perhaps people who experience the world in ways that are considered atypical,” he writes, “have an intuitive feeling for the limits of typicality.”

When it comes to sight, there’s a trade-off between sensitivity and resolution; humans tend to have extraordinary visual acuity during the day but have a much harder time seeing at night, while animals with better night vision don’t register the crisp images at a distance that we do. “Senses always come at a cost,” Yong writes. “No animal can sense everything well.” The world inundates us with stimuli. Registering some of it is taxing enough; fully processing the continuous deluge of it would be overwhelming.

For the full review, see:

Jennifer Szalai. “An Enthralling Tour Of Nonhuman Reality.” The New York Times (Thursday, June 23, 2022): C1 & C4.

(Note: ellipses added.)

(Note: the online version of the review has the date June 22, 2022, and has the title “‘An Immense World’ Is a Thrilling Tour of Nonhuman Perception.”)

The book under review is:

Yong, Ed. An Immense World: How Animal Senses Reveal the Hidden Realms around Us. New York: Random House, 2022.

Key Healthcare Issue Is Not How to Divvy Up a Fixed Pie, But How to Grow the Pie Through New Cures

(p. A23) . . . in the second phase of my illness, once I knew roughly what was wrong with me and the problem was how to treat it, I very quickly entered a world where the official medical consensus had little to offer me. It was only outside that consensus, among Lyme disease doctors whose approach to treatment lacked any C.D.C. or F.D.A. imprimatur, that I found real help and real hope.

And this experience made me more libertarian in various ways, more skeptical not just of our own medical bureaucracy, but of any centralized approach to health care policy and medical treatment.

This was true even though the help I found was often expensive and it generally wasn’t covered by insurance; like many patients with chronic Lyme, I had to pay in cash. But if I couldn’t trust the C.D.C. to recognize the effectiveness of these treatments, why would I trust a more socialized system to cover them? After all, in socialized systems cost control often depends on some centralized authority — like Britain’s National Institute for Health and Care Excellence or the controversial, stillborn Independent Payment Advisory Board envisioned by Obamacare — setting rules or guidelines for the system as a whole. And if you’re seeking a treatment that official expertise does not endorse, I wouldn’t expect such an authority to be particularly flexible and open-minded about paying for it.

Quite the reverse, in fact, given the trade-off that often shows up in health policy, where more free-market systems yield more inequalities but also more experiments, while more socialist systems tend to achieve their egalitarian advantages at some cost to innovation. Thus many European countries have cheaper prescription drugs than we do, but at a meaningful cost to drug development. Americans spend obscene, unnecessary-seeming amounts of money on our system; America also produces an outsize share of medical innovations.

And if being mysteriously sick made me more appreciative of the value of an equalizing floor of health-insurance coverage, it also made me aware of the incredible value of those breakthroughs and discoveries, the importance of having incentives that lead researchers down unexpected paths, even the value of the unusual personality types that become doctors in the first place. (Are American doctors overpaid relative to their developed-world peers? Maybe. Am I glad that American medicine is remunerative enough to attract weird Type A egomaniacs who like to buck consensus? Definitely.)

Whatever everyday health insurance coverage is worth to the sick person, a cure for a heretofore-incurable disease is worth more. The cancer patient has more to gain from a single drug that sends the disease into remission than a single-payer plan that covers a hundred drugs that don’t.

. . .

. . ., the weakness of the liberal focus on equalizing cost and coverage is the implicit sense that medical care is a fixed pie in need of careful divvying, rather than a zone where vast benefits await outside the realm of what’s already available.

. . .

. . . once you’ve become part of the American pattern of trying anything, absolutely anything in order to feel better — and found that spirit essential to your own recovery — the idea of medical cost control as a primary policy goal inevitably loses some of its allure, and the American way of medical spending looks a little more defensible. To just try things without counting the cost can absolutely run to excess. But sometimes what seems like waste on the technocrat’s ledger is the lifeline that a desperate patient needs.

For the full commentary, see:

Ross Douthat. “Being Sick Changed My Views on Health Care.” The New York Times (Thursday, January 20, 2022): A23.

(Note: ellipses added.)

(Note: the online version of the commentary has the date January 19, 2022, and has the title “How Being Sick Changed My Health Care Views.”)

The commentary quoted above is related to the author’s book:

Douthat, Ross. The Deep Places: A Memoir of Illness and Discovery. New York: Convergent Books, 2021.