Books to Get You Thinking

The science of medicine has made amazing strides over the last century with a deeply expanded understanding of how the human system works, and the development of drugs and instruments to counter and prevent disease. The result has been a rise in life expectancy and the eradication of diseases like polio and small pox. Yet many challenges remain that include the quest for cures for diseases like cancer as well finding solutions for the looming threat of antibiotic resistant bacteria and mutating viruses. The recent outbreaks of Ebola and Zika are just reminders of all the work that remains to be done. This month’s book selections provide a fascinating look at some of the research and development that has taken place in medicine as well as the race to meet new threats posed by pandemics. Next month’s column will focus on books that examine a different but equally important facet of medicine—the problem of health care access and health care delivery.

Vaccine Race
The Vaccine Race: Science, Politics and the Human Costs of Defeating Disease by Meredith Wadman
Meredith Wadman, a Rhodes Scholar who graduated from medical school at Oxford, writes on biomedical research issues for Science. The author takes readers back to the sixties, a time when diseases like polio and rubella devastated entire communities. Meredith Wadman brilliantly interweaves the history covering the development of the first vaccine with the political and institutional roadblocks that made the process so challenging, explaining the science behind vaccines in layman’s terms. Rubella, coming in waves every six to seven years, was the cause of tens of thousands of children born with birth defects. Anticipating another major outbreak in 1970, there was a push to develop a vaccine that could help contain it. Around this time, Leonard Hayfleck, working at the University of Pennsylvania’s Wistar Institute, discovered a way to extract clean cell cultures from fetal tissue obtained from Sweden. A major breakthrough in cell biology, the clean extracted cells called WI-38s were sold to drug companies by Hayfleck and were key to the development of vaccines that subsequently protected billions of people around the world from polio, measles, chicken pox, hepatitis A and a host of other diseases. Prior to Hayfleck’s method of extracting cells, animal cells had been used to make vaccines, carrying with them the danger of transmitting other viruses present in animals to people. Wadman‘s book abounds in fascinating facts about the science behind vaccines, as well as anecdotes about the characters and organizations involved during the time period when vaccine development was still in its infancy.

Cured
Cured: How the Berlin Patients Defeated HIV and Forever Changed Medical Science by Nathalia Holt
AIDS, a devastating illness afflicting over 35 million people worldwide, is caused by the Human Immunodeficiency Virus's (HIV) attacking and severely compromising the immune system. AIDS patients have to take a combination of multiple medications each day, often facing significant side effects just to stay alive. The author, an HIV researcher with academic training at MIT and Harvard, chronicles a beautiful story about two special AIDS patients, Christian Hahn and Timothy Ray Brown, known in medical literature as the Berlin Patients. Each had a unique medical profile requiring unconventional treatments but surprisingly, after a few years, both were found to be free of the disease and able to go back to leading a normal life without any medications. The author provides insights into the struggles that led to finding treatment regimens for AIDS, the extraordinary complexities of fighting HIV and the exceptional journey of the Berlin Patients and their caregivers in their quest for attaining the improbable goal of being fully cured of the AIDS affliction. The paths of recovery for Christian Hahn and Timothy Ray Brown were very different. Christian received early therapy and an experimental cancer drug, while Timothy received a stem cell transplant of HIV-resistant cells in Berlin. Both therapies inspired numerous clinics and researchers to try and replicate the success on a larger scale and enhanced our understanding of how HIV disrupts the human immune systems and how we can build a robust clinical response to the disease. The author brilliantly highlights both the resilience of researchers who are working relentlessly to find a cure and the courage of patients who go through enormous pain and suffering but still carry the hope that a cure will eventually be found.

Pandemic
Pandemic: Tracking Contagions, from Cholera to Ebola and Beyond by Sonia Shah
The book, a finalist for the 2017 Los Angeles Times Book Prize in Science, provides thoughtful insights into the evolving biological danger posed by a pandemic. Sonia Shah, a leading science journalist, takes a close look at the factors that could drive "deadly pathogens" to rapidly spread across communities, regions and continents, and become a full blown global threat to human life. Shah looks back at the last 200 years of the history and science of major pandemic events including Cholera, SARS, Ebola, and H1N1 to uncover and analyze the underlying reasons that led to the rise and spread of catastrophic outbreaks and our inability to garner a quick response to combat the crises. The author uses a detailed study of the outbreak of cholera in England in the nineteenth century to come up with a host of ways we can ready ourselves to counter future threats of a pandemic. The key to prevention lies in building a strong first response with close collaboration between all nations and the development and stockpiling of adequate vaccines. At a more fundamental level, Shah raises concern over the socioeconomic and political factors that have played a part in the spread of pandemics including overcrowding of cities, lack of adequate sanitation, poor healthcare infrastructure, climate change and increasing intrusion by people into wildlife habitats that allows the transfer of pathogens from animals to people. It is only by tackling some of these problems that we can hope to avert a major pandemic from occurring within the next two generations. Shah has taken a complex topic and voiced it in a simple, interesting language that will speak to all readers.

—Nita Mathur

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