Friday, 28 April 2006

The Medical Detective – Sandra Hempel ****

With the terrible disease cholera at its heart, this is anything but a pleasant book to read – but that doesn’t stop it being horribly fascinating.
Sandra Hempel has a gift for taking the reader into the heart of period medicine. Primarily a biography of John Snow, the man who cracked the mechanism for cholera’s spread, The Medical Detective also gives us a good deal of (sometimes graphic) description of the impact of cholera, an in-depth consideration of the UK political reaction to the cholera outbreaks, and a good feeling for the working environment that Snow would be familiar with. Although the US title, The Strange Case of the Broad Street Pump, is more effective in bringing out the medical Sherlock Holmes mystery aspect of the story, the Broad Street incident, of which more later, is very much the climax of the book, not cropping up until over half way through.
Perhaps the most shattering aspect of Hempel’s story is the description of the Tooting child farm. One of the places cholera would break out, this was a location that would make Oliver Twist’s early experiences seem relatively mild. Hundreds of destitute children, crammed into insanitary and disgusting conditions, simply to collect the fee the government paid for looking after them, then to keep them on a fraction of it, making a huge profit. It’s somehow not surprising that Dickens was one of the journalists who wrote about this disgrace after it was discovered.
Back on the case, Snow’s great breakthrough was to uncover the way that cholera spread, thanks to some classic detective work. The mechanism for cholera’s progress had always been something of a mystery. Sometimes it spread gradually in a tight knit community – but would leave pockets untouched. Sometimes it would jump hundreds of miles. It seemed different from something like plague, with its clear person-to-person spread. Although John Snow had made his name as an early exponent of anaesthesia, he had from his early days in medicine had a strongly-felt need to investigate the causes of cholera. Relatively early he developed a theory that it was spread through tainted drinking water. He was able to perform an early piece of epidemiology, getting statistics for the different attack rates for an area before and after conversion to a clean water supply, compared with other boroughs who water was little more than dilute sewage. But the big breakthrough came by studying an outbreak in an area of central London, plotting cases on a map like a modern forensic scientist, Snow would find the epicentre – a water pump in Broad Street. A conclusive argument for the mechanism of cholera’s spreading would follow, though sadly, despite the myth of Snow’s last minute saving of the district, too late to help much in this particularly virulent outbreak, and not widely accept for several years to come.
Broad Street has since been re-christened Broadwick Street, and now houses two of the UK’s biggest magazine companies. Somehow it’s appropriate that the home of Good Housekeeping and House Beautiful should be the very street where it was discovered that inappropriate handling of sewage and water supplies could result in the spread of this terrible disease.
Throughout, Hempel maintains an interesting thread, and though the early chapters on the background of cholera and the ventures into politics aren’t as gripping as those where we get the central character of John Snow involved, she tells a powerful and engaging story of this classic piece of medical detective work. Recommended.
Hardback:  
Review by Brian Clegg

Wednesday, 19 April 2006

Sleepfaring – Jim Horne ****

Sleep is something we’re all familiar with (even if we don’t get as much as we should), but few of us really understand it. Sleeping can seem a waste of time, or a dangerous risk while driving a car, but Jim Horne’s Sleepfaring takes the reader on a journey through the science of sleep that will explain many of sleep’s mysteries and give a better understanding of why it’s so important.
Horne begins with the magnificently titled first chapter “petunias, one-eyed ducks and roly poly mice”, and goes on to explore the nature of sleep and how stimulants effect our sleeping, sleep’s effect on the body, the dangers of sleep deprivation, the different phases of sleep and how the brain operates during them, and the whole range of sleep peculiarities from long and short sleepers to sleepwalkers, insomnia and snoring. There’s a special chapter on children’s sleep for worried parents, and even a little “lark or owl” test to see when your best functional times are.
Horne doesn’t spend too much time on dreams, which is a good thing in the context of the book – it also makes it an ideal companion to J. Allan Hobson’s Dreaming, which though also sporting a “science of sleep” subtitle, turns the emphasis round the other way and concentrates on dreaming, without giving us too much of the detail on sleep itself.
For the first few chapters I was convinced that Sleepfaring was a five star book – it read like a dream (ha), and has an excellent balance of lively, chatty presentation (there’s a real feeling that Horne is talking to you) and remarkable facts. It’s quite a surprise, for instance, to discover that dolphins sleep one side of the brain at a time, while the other side (and its opposing eye) is still active to keep the animal alive. This is wonderful. Unfortunately the book lost that final star by getting a little mired in the middle, particularly when Horne is discussing drivers falling asleep, a chapter that seems to say the same thing over and over again (perhaps because there really isn’t enough to say to make it a chapter, but this is Horne’s speciality). Horne also wildly overuses references to other chapters – “which we’ll find out more about in chapter 18″ and many, many variants of this, becomes a little irritating after a while.
Bear in mind, though, that this still leaves Sleepfaring as a “near best” four star read. It is largely very readable and excellently informative – it’s just a pity when much of it shows signs of being one of the best popular science books of the year that it has moments of inconsistency in interest level. However, if you want to get a better understanding of sleep, and to have an enjoyable read along the way, this is far and away the best book around.
Hardback:  
Review by Jo Reed

Tuesday, 11 April 2006

Lonesome George – Henry Nicholls ****

Pinta Island in the Galapagos has a particularly famous inhabitant – the giant tortoise, Lonesome George, the only known survivor of the Pinta variant of that species. (Technically he isn’t an inhabitant, as he has been moved to a sanctuary on another part of the archipelago, but Pinta is where he came from. PS Also even more technically now George has sadly died.) George inevitably features regularly in the press, thanks to the combination of being a striking animal, a Darwinian icon and a very isolated creature, but does he warrant a whole book?
In a word, yes. Henry Nicholls cleverly makes George a central focus that he keeps returning to, but is able to use the tortoise as a springboard to examine everything from Darwin’s voyages to threats to the Galapagos from incoming, non-native wildlife, eco-tourists and the action of illegal sea cucumber fishers (who have threatened to kidnap George, or worse, in the past).
Some might find the description of the attempt to get George interested in the opposite sex from nearby islands (a lack of interest that seems largely due to lack of practice) a little too detailed, but it too is entertainingly told, bringing in some of the human characters involved along the way. It’s not all about George’s inclinations, though. As well as giving serious consideration to cloning, Nicholls looks at the possibility there might be another Pinta variant out there in the collections of giant tortoises around the world (these are long-lived beasts, and one may have been taken before their scarcity was noted), at various attempts to track down another tortoise on Pinta itself (it’s difficult to be absolutely sure something isn’t there), and at the state of the other sub-species of Galapagos giant tortoise.
There is one aspect of the story that seems underplayed in the book. The only reason George is a celebrity is that he is a one-off – the only representative of the Pinta version of the Galapagos tortoise. But he is quite similar to the tortoises on one of the other islands, and it is known that tortoises have travelled between islands in the past. Could George just be a reptilian island hopper, and not a true Pinta tortoise at all? If this were the case he would just be one of many – no more special than any of the other Galapagos tortoises, rather than the tourist attraction he is today.
There have been two tests, comparing George’s DNA with the skin samples of three tortoises killed on Pinta in 1906. One test found that George didn’t match, one found George did. Nicholls’ conclusion “On balance it looks like Lonesome George fully deserves his hard-earned celebrity status,” sounds more like wishful thinking than a scientific conclusion. When two tests come up with opposite results, you don’t pick the result you want, you do a whole series of tests, reproduced in different labs – this hasn’t been done, so George’s status has to remain in doubt. This doesn’t stop him making a good story, though.
Nicholls gives us a good balance of George himself, the natural and political history of the Galapagos and the inevitable Darwinian connections. It’s a warmly enjoyable book – a pleasure to read.
Paperback:  
Also on Kindle:  
Review by Brian Clegg

Sex, Drugs & DNA – Michael Stebbins ****

“Science’s taboos confronted,” shouts the subtitle, and that’s a fair summary of Michael Stebbins’ thought-provoking and readable book, though perhaps it should be “biological and medical science’s taboos”, because the hard sciences don’t get much coverage, not entirely surprising as Stebbins is a geneticist.
The first section of the book is a fascinating look at the reality of working in science, taking a fictional character through a typical career, and emphasizing how difficult it is to be a working scientist – a useful background to the rest of the book, which is largely about the inability of politicians (and to some extent the general public) to deal with science. Stebbins largely puts this down to ignorance, in part the fault of science education, which we’ll come back to in a moment.
His book is a real indictment of US policy. It reads like a rather more moderate, but still very passionate scientific equivalent of a Michael Moore book. Chances are, if you enjoy reading Moore (whether or not you agree with his manipulative methods), you will want to read this book too. If Moore irritates you intensely, so will Stebbins, though with less reason, because he is less sweeping in his claims.
You will see how badly the US government has handled everything from its approach to GM to global warming, from medical care to science education. For a European reader, the description of the US primary medical service is terrifying, while Stebbins rightly lays into the sort of witless testing that can result in increasingly good test results while at the same time a nation’s children become less and less capable in the sciences.
There are a couple of problems with this book, which is why it got four stars rather than five. I don’t mind the fact that it’s something of a polemic – what’s said needs saying – but I do think in the list of a science publisher that aims to be global in reach, Stebbins should have put some effort into taking a more global view. This is a totally parochial US view, and after a while, for the rest of us, “Senator this said that” becomes a little tedious. The non-global view at its worst when he’s talking about science education. “Next time you crack a joke about the Brits or French, remember: their children are smarter than yours,” he says. The only Brits I crack jokes about are the Brit Awards (the UK’s pop awards, sometimes dire events), and “their” children aren’t smarter than mine, because my children are Brits.
I also found his tendency to throw in excreta related swearing every couple of pages just to show how trendy he is, a little wearing after a while. Generally the book’s style is admirably light and well phrased, and it’s not an objection to the swearing per se, but he could have used more than about two words for a bit of variety. (Having said that, as my mother would have said, it really isn’t clever, Michael. You don’t have to show off this way.)
Don’t be put off by the US content if you aren’t American, though. The US has a huge influence on the rest of the world, and it is vital we all know, US citizens or not, what’s going on there. And Stebbins rightly points out the bizarre inconsistencies and idiocies that science policy throws up. This is, without doubt, a book that anyone who really wants science to succeed should read.
Hardback:  
Review by Brian Clegg