The Forecast is Cloudy

The future of computing and how it will
affect you and the economy

You’re probably hearing a lot about cloud computing these days and how it’s
being praised as being the death of the PC. In fact, this week’s eWeek announced
that the era of the PC was officially over. Actually, cloud computing is just a
way for the big companies to freshen up and KEEP their revenue streams. In other
words, where their money comes from and how much they can get. It’s also the
ultimate anti-piracy strategy. But cloud computing represents a much more
profound change, a massive, world-wide paradigm shift:: a shift away from
physical stuff towards non-physical stuff, and that has massive consequences for
all of society.

Why Cloud

Cloud computing is not simply the latest-and-greatest, “Hey, cool, I can
store all my music on Amazon’s cloud” idea. Instead, cloud computing is a major
paradigm shift* in the way humans have done business for thousands of years: by
buying and owning things. Once you bought something, you owned it.
After that, you only bought a new something when yours broke or you lost it or
gave it away. I’ve had my blender for nearly forty years. How’d you like to buy
a new blender every year? Or all your kitchen appliances? Or rent them by the
month? That’s what’s called a paradigm shift. A change in a major way of
thinking so profound that it affects everyone. Like the development of the
scientific method. Or the notion that the earth rotates around the sun, instead
of the other way around. Or, here are some good ones: freedom, equality, and
equal rights. Or, in quantum mechanics, the idea that the laws that apply to
large things are different from the laws that apply to small things.

The first hint of this paradigm shift started decades ago with the advent of
cable television (actually, it really started with the telephone service which
replaced much of written communication, but cable is where we all really started
noticing the difference). Broadcasting wasn’t free anymore; you had to pay by
the month, in short, rent. The same paradigm shift has already expanded to cell
phones and cable/dish television. You rent your cable or satellite connection,
the same way you rent your cell phone service. Now, it’s happening with
computers. The whole idea of owning your own software, to say nothing of being
able to be an independent user not connected to the virus-ridden Internet 24/7,
is going out the window. Nothing will ever be the same again.

Here’s what happened. One day Microsoft and Adobe and IBM and HP and Dell and
all the big software and hardware companies woke up and realized to their horror
that they’d actually SOLD their products to people who (gasp) might not
upgrade to the new version or, even worse, in the case of software, copy and
distribute it. The “cloud” is the ultimate anti-piracy scheme.
(This means you, China.)

How it will

First of all, you will no longer own your own software. What you will own is
a gadget the computer industry has for years been calling “an Internet
appliance” or a “thin Internet client.” Now, when you hear the word
“appliance” you might be thinking of, say, a dishwasher, or a washer or dryer,
maybe a small appliance like a blender or a coffee maker. Wrong. Think “cell
phone.” Because that’s how the Internet Service Providers will be thinking of
it; in fact, they already are. Here at DataStep, we’ve already bought our first
two dirt-cheap Internet appliances: a couple of little notebooks chock full of
RAM and with almost no software. Instead of Microsoft Office, we’re switching to, which is FREE. It’s part of the international
Open Source project and it’s available in nearly all languages and on all
platforms: Mac, Windows, Unix, Linux, whatever. And, unlike the latest grotesque
versions of Microsoft Office, it’s simple, clean, and efficient. To get your
copy, just click here or click the
logo under the menu. Of note: Microsoft is now offering a “reduced
functionality” version of Office. Great. Now can they get rid of the incredibly
ugly menu bar at the top?

Instead of what we now think of as computers, you’ll have something that
looks vaguely like a cross between a tablet and a cell phone, say an Apple iPad
or the Motorola (now Goggle) Xoom. It will be small, flat, and thin. Not small
enough to put in a pocket, at least until the designers start re-designing
pockets, which they will, along with purses and carry-bags, because we’ll all
need somewhere to put the gadget. And note that I’m saying gadget, singular. One
of the problems now is that there are just too many gadgets. A recent industry
survey estimated a current national distribution of about seven gadgets per
person. Cell phones, Blackberries, laptops and tablets, Wii devices and other
gaming controls, iPods or other MP3 players, cable/satellite television
receivers, even remotes for your television or to open or lock your car, the
list goes on and on. Sometime very soon, manufacturers are going to start
combining gadgets. They’ll have to. In fact, they’ve already combined the cell
phone and MP3 player, but that was inevitable. You don’t need too much room for
either one. The next step will to combine the reader and computer. After all,
wouldn’t it be neat to unfold your cell phone or eReader and have a decent sized
screen to play your favorite game?

The gadget itself might have room for a DVD drive (maybe, but we’ll discuss
that later). Current cell phones and eReaders have screens too small to display
very much information, so we’ll probably have some kind of gadget that unfolds
to offer a larger display, for, say, those of us who want to read more than one
paragraph at a time. Amazon’s Kindle is nice for reading, but still too small
for real computer functions like writing, spreadsheets, spiffy game displays, or
Internet surfing. And have you seen the size of the keys on the Kindle DX? Great
for mice-feet, I suppose, but hardly for human fingers. (Who do they test these
things on?) Hence the idea about unfolding. And when you open it up, you’ll have
a not-too-ridiculously small screen that will function as your computer
interface (screen) and e-reader. For a keyboard, the screen will display what
look like keyboard keys. The “keys” might even give you some sort of tactile
response, so you’ll know when you’ve actually hit one. In fact, just the other
night I saw an ad for (I think) Verizon about a nifty little device that
unfolds! Pretty cool, huh? Unfortunately, the keys are still the itsy-bitsy ones
you have on the average cell phone. So you won’t be doing anything practical
there. And, wait a minute, now that everyone has or craves the most gigantic TV
screen they can find, suddenly we’re going back to screens the size of a
whopping 3.5 inches?

As for the software, you won’t own that at all, so you won’t have a choice as
to whether or not you upgrade. Instead, you will have to rent the software from
the various providers, Microsoft, Adobe, Apple, gaming companies, whomever. And
your helpful service provider will upgrade the software for you. (Remember when
I said cloud computing was the ultimate anti-piracy device?) Here’s an example.
I keep my email on the Yahoo server because I’m betting they keep their servers
in better shape than I do my computer. And I’m willing to upload my music
purchases to Amazon’s Cloud, but I’m also going to make damn sure I download
them to my own device. Because here we’re getting into the fine print.

Now, don’t get me wrong. I love Amazon. I have since the day I first heard of
it something like fifteen years ago, and it’s only gotten better in the
meantime. But Amazon is currently making a very big deal about how you
automatically get five gigabytes of music storage for free whenever you buy a
single MP3 download. If you buy an entire MP3 album, you automatically
get upgraded to twenty gigabytes of storage. Pretty keen, huh? Now let’s read
the fine print. If you click the “Learn more” button on Amazon’s main “cloud”
page, you find that the 20 GB upgrade is just for the first year. After that,
it’s $20 per year. Okay, twenty bucks isn’t that much, only about $1.70
a month. For now. But there are two problems here. The first is that you’re
going to be paying rent to the providers of every piece of software you use:
word processing, spreadsheets, desktop publishing, games, and just about
anything you’ve already bought. If you use software from a number of different
providers, those numbers are going to add up. But so what? You’re willing to pay
a few bucks a month, say ten or twenty or even thirty, adding up to, say,
between $120 and $360 a year. Still, not so bad. And here we come to problem the
second: wait until the providers decide to increase their prices. Or you use
more applications or store more data. But, even so, it’s still probably cheaper
or not much more in the long run than laying out $350 for a basic laptop. Which
can keep running for years.

But now we come to the nasty part. Remember all those Microsoft ads about how
you should be running their latest operating system on your computer? Vista?
Windows 7? Or Apple’s ads for OS 10? I’ve been in this business a long, long
time, and I can barely count the number of times some software manufacturer came
out with a new operating system or some new razzle-dazzle upgrade of their
software applications (We’re even starting to trash old versions of Microsoft
Office and operating systems.) And have you noticed how, purely by chance, I’m
sure, the new operating system won’t run on your current computer because you
don’t have a fast enough processor or enough RAM or a large enough hard drive?
Which means that you have to buy a new computer IF (and that’s a very big “if”)
you want or, more importantly, need to run the latest and greatest
operating system and software.

So far, hardware and software purchases, have made up a big part of the
various manufacturers’ revenue. But some people might not want to upgrade. Some
people might think the already bloated-beyond-belief version of Microsoft Word
is just fine and dandy for them. But, as go operating systems, so go the
programs (applications). And soon, not immediately, but soon, the requirements
of the operating systems and the software applications won’t be compatible with
your current Internet appliance. Recently, after two days on the phone with
Adobe trying to figure out why my CS2 version of GoLive (the HTML editor I use
to maintain this web site) wouldn’t install on my new laptop, it turns out that
GoLive isn’t compatible with Windows 7 (which came with the new laptop), and I
should upgrade to Adobe’s Creative Suite 5.5 so I could (LEARN TO) run
Dreamweaver, which is ridiculously expensive for a simple web site. So I went
back and installed it on another laptop running Windows Vista. But it’s not just
Adobe, everyone will be doing the same thing. Get a new application, or even
upgrade an existing one, and suddenly, by golly, by gosh, you have to go buy
yourself a new Internet appliance, or laptop or operating system. And don’t
forget, you can’t run Microsoft’s Internet Explorer 9 unless you have at least 2
GB of RAM. See? A tiny tweak to the operating system or application or even your
Internet browser, and suddenly you’re out in the cold.

Remember when I said, “Think ‘cell phone.’”? So, how often do you buy a new
cell phone? How long a contract do you sign up for? We’re old and poor and cheap
these days, so when our two-year contract runs out, I usually go into the
Verizon store and say, “What new phones can I get with no money out of pocket?”
And, of course, the answer is always, “Nothing you’d want to own.” You
always want to upgrade to the latest and greatest. Now that I’ve retired
and am trying to make that long time dream of writing come true, anything I
write I could do perfectly well with any of the past four or five versions of
Word. In fact, now that we’re poor again, we’ve already converted two machines
to After all, not only is it free, but all the files it creates
are completely compatible with those of Word, Excel, and PowerPoint. But do you
know about Do your friends? Of course not. is an
international, collaborative project developed by volunteers and available
online for free, so they don’t have multi-million-dollar advertising

Security: the ugly

And now we get to the really nasty part. According to a recent study
published in eWeek (a very reputable industry journal), something like
two-thirds of the “cloud” providers don’t consider the security of their
operating systems or applications, or, more importantly, the data you’ve stored
on their servers, to be their responsibility. Which means that you’re paying
them every month for systems and software that may or may not work and for
storing your data on servers that can be breached by any fairly talented

So now you own nothing, really, except a neat little device that you’ll have
to trade up every few years (and I’m being generous here; my real guess would be
more like every one or two years, just like cell phones). But, even worse than
being essentially a slave to the Internet and the storage and applications
providers, forking over your monthly dues, you won’t even have a guarantee about
the safety of your data or your music, your movies, your cherished family
photos, or anything else you store on the provider’s server.

The Anti-piracy

I know this all sounds fairly dire, and I know that everyone in the computer
biz is publicly saying, “Pish tosh, we would never do anything like that. You’re
just being backward, an old stick-in-the-mud. This is a great new idea. Everyone
will have the latest and greatest, and no one will ever, ever again copy and
distribute our software without bloody well paying for it.
that’s how the anti-piracy solution works. Because the software won’t reside on
your cool little Internet appliance; instead, you’ll have to log on to your
Internet provider to do something as simple as writing a letter. (At which
point, of course, Office Assistant will pop up and say, “It looks like you’re
writing a letter. Would you like some help?”)

So, you’re probably thinking, “Well, this stuff isn’t going to affect me.
Clouds are just for big companies.” Guess what facebook is? Yep, it’s a cloud.
Just like Twitter and WordPress and every social networking and blogging site
out there. So if you’re uploading your precious thoughts and photos or even
(Heaven fore fend) writing original stuff there, make sure you keep a copy for
yourself. Offline. On your hard drive. Or, better yet (because Robin’s Rule #2**
is that all drives fail eventually) on some external storage like a CD, DVD, or
flash drive.

The Word is

Remember when I said your Internet appliance might not even have a DVD drive
for watching movies or playing games? That’s because the providers’ goal is to
control the broadcasting of everything. Whatever you currently do on your
computer you will have to do online. Bye-bye, DVDs. Bye-bye user independence.
Now, whenever you consider moving, your first thought will be, “How can I
connect to the Internet?”

And then there’s the money, and this is the perfect time to discuss the
money. Cloud computing is a brave new business model that magically transforms
purchasers into renters/subscribers. The manufacturers are trying to recapture
their revenue stream. Except that, in the future of cloud computing, that
revenue stream has turned from merely a highly lucrative stream into a
Mississippi-500-year-record-level flood, a surging river that will consume
everything in its path. Remember how we all used to be so impressed that the
Mississippi River was a whole mile wide? Well, this year it was three miles
wide. And raging. And headed straight for Baton Rouge and New Orleans. Now think
of that three-mile-wide surging river in terms of the amount of new money that
will start pouring into the silicon companies once cloud computing takes over.
They’ll tweak an operating system or modify a game and, oops, you’ve just lost
your Internet connection because your current “Internet appliance” isn’t
compatible with the new system. Which means you have to buy a new one. Because,
when it comes to connectivity, we’re all addicts. And the hardware and software
companies are the pushers.

Streaming and the

Up to now, software of various kinds has generally been distributed on
physical media. Now, what if the software companies could eliminate the cost of
physical media? Imagine the savings they could achieve. Which I’m sure they’ll
pass on to you, the consumer. NOT. This is another very attractive reason for
the software companies to switch to streaming distribution. Everything is live.
Nothing is fixed. Which also means the elimination of all those jobs associated
with physical media. Think about the people who made the materials for the CDs
and DVDs that have been mailed out for all these years. Think about the people
who make the plastic for the discs themselves, and for the disc cases. Think
about the people who make the paper and the ink, and the people who make the
machines that produce the plastic and the discs and the paper and the ink. And
what about the people who make the mailers the discs go into? And the paper and
ink and adhesive for those mailers.

Sure, you’re saying, but streaming is so green. It eliminates the need for
all those physical materials. But what about the people who make those
materials? You want to go further? Think about the reduced demand on the postal
system, and the clerks, sorters, and mail carriers who deliver those materials.
Then think about how they’ll buy the clothes they wear and those comfy shoes
they have to buy, and the people who make all those clothes and shoes, and the
people who make the cloth and thread and leather and plastic and vinyl and
zippers and buttons, and so on and on and on.

The Ultimate
Paradigm Shift: Welcome to Incorporeality

So, when you think about cloud computing in these terms, suddenly it’s not
just ownership that’s going out the window. Suddenly it’s a shift from the
physical (the corporeal) to the non-physical (the incorporeal) and all that
incorporeality comprises. As it is, even the amount of actual cash we use is
dwindling as everything becomes electronic. So what about the jobs of the people
who make the paper and the ink and the wrappers and the machines that print,
count, sort, store, and package money?

Each shift away from corporeality to incorporeality means a loss of jobs,
especially the loss of jobs involved in the production of stuff. Real, physical
stuff. And the loss of those jobs means a reduction in the overall demand for
stuff that other people produce. It’s not just a vicious circle; it’s a downward
spiral. And with the world’s population still spinning out of control, there
will be more and more people willing to work for less and less money, depressing
wages in every industry. It’s one of the first things you learn in economics
classes: supply-and-demand doesn’t just apply to just prices of stuff, it
applies to labor (read: jobs), as well. The more production, the more jobs. The
less production, the fewer jobs. And, hence, less demand for labor, at which
point, with the supply of labor increasing, but the demand for labor decreasing,
the average wage, which is the intersection of the supply of labor and the
demand for that labor, plummets. This is what economists refer to as the theory
of surplus labor. And that’s the effect of this particular paradigm shift.


Now, please, feel free to disregard everything I’ve said. No one ever
believes me when I predict things. There was once a Trojan princess named
Cassandra to whom Apollo gave the gift of prophecy, with the catch that, while
she could see the future, no one would ever believe her. Way back around 1994, I
asked a Microsoft rep when we’d be able to query databases over the Internet.
His response was, “Why would you want to?” Well, guess what runs Amazon.
Databases. Same as every Internet storefront you shop at. Same as the Internet
Movie (look, it’s even in the name) Database. So call me Cassandra, but don’t
say I didn’t warn you.

* The phrase “paradigm shift” first entered the common language when Thomas
S. Kuhn published his landmark book, The Structure of Scientific
all the way back in 1962.

**Robin’s Rule #1 is: “Never pass a law you can’t enforce.” Just in case you
were wondering.

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Class warfare ahead?

Can you believe what’s happening in Libya? Long after the world had lost interest (we now know the international attention span is about three months), suddenly the rebels are taking Tripoli. Naturally, I’m back, glued to the television, waiting each moment for the announcement that Felafel has been captured or just turned tail and run. Of course, I’m sure it isn’t sudden for the rebels, the ones who kept fighting long after the “greatest democracy in the world” lost interest and went home, taking their ball with them. Long after said “greatest democracy” refused to recognize the TNC, despite recognition by nearly all of Europe. Apart from the rebels, the credit goes to Europe on this one.
So here’s the question: why do we always support the bad guys? It’s a long list, but I think the problem goes back to the Batista fiasco in Cuba. William Walker taking over Nicaragua, backed by United Fruit, is just too weird, so I’m discounting it. I remember back in seventh grade hearing our teacher talk about the brilliant new freedom fighter named Fidel Castro who was going to overthrow the evil dictator and about how America was helping him (I think I’ll check Howard Zinn’s People’s History of the United States and his book on American imperialism on that), and suddenly the shiny new liberator of Cuba is a wicked, evil Communist because he thinks people should work for their money. Wait, I’ve heard that somewhere before. Okay, it’s coming back slowly from grammar school history lessons. Right! There it is! Sir Walter Raleigh in Virginia? Or what became North Carolina (after all, Raleigh is the capitol)? In those hard years with little food, he declared that if you wanted to eat, you had to work. Imagine that.
Of course, Raleigh, the once and future pirate, was no lowly pauper himself, but, still, when did we lose sight of that idea? When the south grew rich on the backs of slaves? When too many rich men, or wanna-be rich men got into government? Certainly by the time of the robber barons who made it blazingly clear to anyone who wanted to look that the American government was for sale to anyone with enough money (which proved to be fairly little, indeed) could buy enough politicians to be able to do anything they wanted? Surely, the final step was the miners’ strike in 1913-1914 in Ludlow, Colorado, when a corporation brought in armed private “detectives” (a.k.a., mercenaries) and turned their guns on their own employees, then burned the miners’ tent city to the ground, knowing that the only people in it were women and children.
When did corporations become governments, with their private armies and their private politicians? When did we lose sight of the time-honored law that the worker was worthy of his hire? Looking back, I’m beginning to think the Weather Underground was right. Maybe we do need a class war, because violence is apparently the only language the rich understand. Certainly the rule of law no longer works, because the corporations have lawyers who can twist the law to their own meaning, and plenty of judges they can bribe to see it their way. The current “corporatization” of the world (see any William Gibson novel), combined with the distribution of information by broadcast, instead of allowing “consumers” (there’s a word that’s lost a lot of its meaning) to purchase and own computers, software, music, movies, etc., is quickly turning free people everywhere into slaves to the corporations, slaves to the rich.
Remember Aldous Huxley’s “soma” drug in Brave New World? Well, he was right. Only our soma is television, video games, and witless tweets on sites like Twitter and facebook. Keep people distracted enough when they’re not out working at low-wage jobs or spending what little money they have on things no one needs, and they won’t have time to look around and put even one and one together. Problems with the economy? Start another war! Give the workers someone else to blame for their problems. Going to the real heart of the problem seems so much easier. Take the money and power away from the rich and powerful. Tossing a few bombs onto expensive golf courses (see any Carl Hiaasen novel, but especially Tourist Season, an amazingly funny book) might actually get the idea into the heads of the rich and powerful that maybe the people have finally had enough. Maybe we could convince them, those who have earned so much money by sending jobs out of their own country, that maybe it’s time to pay to bring the jobs back. It isn’t immigrants, legal or illegal, we should be worried about. Most of them just want to live in a relatively safe country and get decent jobs. It’s the (yes, sorry, but we can’t avoid the phrase anymore) capitalist oppressors we should be worried about. Because if someone doesn’t do something, and damn soon, then we really will have a revolution on our hands. After all, when did we finally get jobs programs? When the rich and powerful thought the Great Depression was bringing the people to the point of actual violence. (See Piven and Cloward, Regulating the Poor.) Suddenly the idea of tossing a few bombs onto some unattended yachts or telling the golf course caddies to stay away from the 13th hole because it’s about to not be there anymore doesn’t seem like such a bad idea.
Note: You can still find the Anarchist Cookbook online, but only if you look really, really hard. Why don’t we try some non-violent techniques first? There’s nothing that works quite so well or so fast as a good old-fashioned boycott. Start by boycotting anything not made in America. Or, here’s an idea: want less, use less. Employ the old Shaker rule: Use it up, wear it out, make it do, or do without. Start protesting wars. And don’t bring just the wars home; bring the jobs home.
Here endeth the lesson.
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Science Fictions: A Scientific Mystery, A Massive Cover-Up, and the Dark Legacy of Robert Gallo

The fundamental question of Science Fictions is, is Dr. Gallo a tragic hero or just a bullying fraud? In his “Poetics,” Aristotle defines a tragic hero as someone as good or better than we, brought low by his own tragic flaw. Certainly Dr. Gallo has plenty of tragic flaws, of which hubris or “overweening pride” must be uppermost. Other flaws include greed, vaingloriousness, bullying, a nearly complete inability to admit being wrong, a callous disregard for the injury he does others, and, most certainly, vanity. But is he any worse than the rest of us, which would make him, in Aristotle’s definition, a comic hero? Probably not by much. He appears to be a weak man thrust into a situation that brought out the worst in him: big science.

There’s big money in big science — big money, big egos, and big living. And, most of all, there’s the Nobel Prize, which Gallo clearly covets desperately. And there’s la vida, the lavish lifestyle of first-class tickets, fine hotels, jetsetting around the world, international prizes, a far cry from the everyday drudgery of the lab. So did Dr. Gallo give in to his lust for la vida and the Nobel Prize and commit scientific fraud? Almost certainly. But the more troubling aspect of Mr. Crewdson’s book is the willing, nearly gleeful, complicity of the U. S. Government in perpetuating the fraud and intimidating any who would expose it.

That the government put people’s lives at risk by insisting on using the Gallo-sponsored AIDS test with its alarmingly high rate of false positives and even more troubling rate of false negatives is bad enough. Were patients infected with AIDS as a result? Absolutely. Like Dr. Gallo, the government too was thrust into a situation guaranteed to exploit its greatest weaknesses. And in the Reagan administration Dr. Gallo found his perfect match: people who were equally prideful, vainglorious, and bullying.

In “Science Fictions,” Mr. Crewdson protrays a government that has sold itself to the big American pharmaceutical companies. And for this portrayal alone the book is well worth its price. But what is even more fascinating is the sheer breadth of the research involved. Mr. Crewdson covers in depth not only the science but also the politics and legal wrangling involved in the US-French dispute of the discovery of the AIDS virus.

One ironic note: Nicholas Wade, one of the science reporters who had hailed Dr. Gallo as a true hero, was at the same time writing his own history of scientific fraud, “Betrayers of the Truth” (now lamentably out of print) which is a fitting companion to “Science Fictions.”

It’s too bad there aren’t more stars. “Science Fictions” is an extraordinary work.

Posted in Books, Epidemiology, Non-Fiction, Science | 3 Comments

The Great Influenza: The Epic Story of the Deadliest Plague in History

In The Great Influenza, John Barry has produced a massive and exhaustively researched description of one of the greatest disasters of human history. At least, from the American point of view. While there are a few glancing references to what was going on in the rest of the world, there is no serious discussion of any attempts to deal with the pandemic in other countries, even in other industrialized countries. On the other hand, Barry has chosen a very specific point of view: the transition of American medicine and medical training from folk wisdom to science. It’s a compelling point on which to balance a long and exhaustive (there’s that word again) study of how America and, specifically, American medicine confronted an epidemic in which people were dying faster than the technology of the time could handle, an epidemic in which society itself was nearly overwhelmed by death.

As other reviewers have noted, the book’s weakness is a tendency towards melodrama, as in the far-too-often repeated tag line “This was influenza. Only influenza.” After a while, you think to yourself, “Yes, we get it. Give it a rest.”

On the other hand, the book has one of those quirky displays of real brilliance in the last two chapters in which Barry deals with how science is done well (in the case of Oswald Avery) or done poorly (in the case of Paul A. Lewis). These two chapters are so strong that they could stand on their own, and what they have to say about the process of scientific thought itself is fascinating. Avery’s story is that of a man who was just relentessly focused, who kept digging deeper and deeper into a single issue until he discovered the source of heredity itself. Lewis’s story, on the other hand, is that of a man who simply lost his way. Distracted by the need to administer an institute, the need constantly to raise money, to deal with the politics of science, the need to socialize and just plain hustle to support the work of others, Lewis lost the focus that Avery had and ending up flailing in a sea of theories and methodologies. In fact, if you don’t read any other part of this book, read these two chapters.

There is no question about The Great Influenza being a monumental work. It’s so good that you just have to overlook the bits of melodrama that pop up from time to time. The research is, well I obviously can’t use “exhaustive” again, so let’s say nearly encyclodedic. In fact, there’s so much research, and so much documentation that Barry has used an odd method of footnoting. Instead of using footnote numbers that refer to the notes section at the end of the book, you have to turn to the notes section and find the specific page and text being referenced. Unfortunately, as a result you don’t know while you’re reading which bits have footnotes and which don’t. I’d prefer actual footnote numbers. Ah, well. I’m sure it seemed like a good idea at the time.

In any case, Barry has produced a massive and important work of epidemiological history which is, at the same time, as readable as a thriller. In writing this review, I kept wavering between giving it four stars or five stars and finally decided on five based on the scope, the thoroughness, and what Aristotle would call the “point of attack,” that is, the point at which the story really begins, which is, in this case, the birth of truly scientific medical education in America. All in all, it’s a truly fascinating and immensely readable piece of history.

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The Medical Detectives

The Medical Detectives 

by Berton Roueche
Edition: Paperback
Price: $10.36

Somewhere in my teens (a long time ago), I picked up one of my mother’s discarded New Yorkers and chanced upon a column called “Annals of Medicine.” Curious, I skimmed through the first few paragraphs and then got comfortable and read the whole thing start to finish. After that, I read the column as soon as my mother would finally give it up. (Another story altogether.) After a couple of months or so, I was hooked. One day, by happy chance, I discovered that the articles had been collected (back then) into two volumes called “Medical Detectives,” volumes 1 and 2. I bought them and devoured them over a weekend. As I remember, I was still in my teens. Ever since, I’ve had a passion for epidemiology, which studies the source and spread of diseases, mostly infectious, but often environmental or acute (like cancer swarms). In fact I’m currently reading another of his books, The Man Who Grew Two Breasts: And Other True Tales of Medical Detection which I stumbled across in reorganizing our personal library and just finished reading, Roueché’s last work, just as good as his other twenty-some books, not listed here.

In his books and articles, Roueché covers everything from a mysteriously sore thigh (ultimately traced to a famous, but useless, exercise device) to the poisoning of an entire family by radioactive lemonade. The process of uncovering the cause of a disease or other medical problem, and its fascinating range, are, I think, the source of my fascination with epidemiology: it’s basically a mystery story. Like police procedurals, but with doctors and other scientists as the detectives, epidemiology involves the sifting of clues, including questioning of victims and witnesses, to discover the source of the problem and what, if any, the treatment should be.

It’s safe to say that Roueché’s books have changed my life (to say nothing of my bookshelves). If you’re interested or think you might be interested in epidemiology, you might also want to consider microbiology, say Clinical Microbiology Made Ridiculously Simple (Edition 4), which provides a very nice overview of the subject and which finally answered the question that had been hounding me all my life: just how does it all work anyhow? In any case, there are dozens of similar books you might enjoy, including And the Band Played On: Politics, People, and the AIDS Epidemic, 20th-Anniversary Edition, about the beginning of the AIDS epidemic in America, The Hot Zone: A Terrifying True Story, about an outbreak of Ebola in an American military lab, and more, such as:

Scourge: The Once and Future Threat of Smallpox

The Barbary Plague: The Black Death in Victorian San Francisco About an outbreak of plague in San Francisco, 1900-1905

Man and Microbes: Disease and Plagues in History and Modern Times

Plagues and Peoples

Guns, Germs, and Steel: The Fates of Human Societies

The Black Death About the societal and economic consequences of the Black Death in England, as the flap says: “Culminating eventually in the Peasants’ Revolt of 1381”

Rats, Lice and History: The classic discussion of the plague through time

Catastrophe: An Investigation into the Origins of Modern Civilization, a fascinating study of the world-wide consequences of what Keys posits was a super-volcano explosion in 535 CE, including the various invasions from the East of an already depopulated Europe. Controversial, but well researched and lots of fun.

And speaking of fun, what could be more fun that the study of scientific scandals? Take a look at:
Betrayers of the Truth: Fraud and Deceit in the Halls of Science, by William Broad. Covers several scientific scandals.

Science Fictions: A Scientific Mystery, a Massive Cover-up and the Dark Legacy of Robert Gallo. A study of the scandal of the Nobel Prize awarded for the discovery of the virus that causes AIDS (and yes, to all you statisticians out there, correlation is not causation, but in this case, it’s pretty damn close)

From epidemiology, you might want to branch out into public health, and read Laurie Garret’s books such as
The Coming Plague: Newly Emerging Diseases in a World Out of Balance and
Betrayal of Trust: The Collapse of Global Public Health.

If you’re interested in health, medicine, science in general, or just whopping good detective stories, you might find epidemiology is your field. Certainly, Roueché’s books are an excellent place to start.

Being that I have recently encountered people who still think people in Africa got AIDS by having sex with monkeys, here’s a clarification. NO ONE IS HAVING SEX WITH MONKEYS. They eat green monkeys. Which means they butcher the monkeys. With very sharp knives called machetés. And these are animals who strongly object to being butchered and can express their objections with long and agile hands, feet, and prehensile tails. In other words, they’re hard to kill and you tend to end up with blood everywhere, including no small amount of it on yourself, where monkeys have most likely scratched you, to say nothing of the damage done to the other wielders of the machetés used to butcher the monkeys. Clear? Thank you. Sorry if that sounds condescending; it’s just frustrating to hear the same superstitions still making the rounds in the cause of persecuting those carrying a tragic disease. AIDS is not a sex disease, it’s a BLOOD and fluids disease. Sometimes these are exchanged during sex.

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The Forgotten Plague

The Forgotten Plague

Certainly the great hallmark of modern civilization is the dramatically increased ease of communication, and it is this ease of communication which has so changed the face of modern science. It is fitting, then, that Dr. Ryan begins his book with a brief history of tuberculosis leading up to Koch’s epic-making lecture on 24 August 1882 announcing his discovery of the cause of tuberculosis. Towards the end of the chapter he quotes the protest of an editor at the New York Times about the delay in receiving the news in America; the editor wrote, “it is safe to say that the little pamphlet which was left to find its way through the slow mails . . . outweighed in importance and interest for the human race all the press dispatches which have been flashed under the Channel since the date of the delivery of the address – March 24.”

As the book proceeds, we see the effect of the growth of the worldwide scientific establishment and the network of scientists and ideas that have led the battle against the “white plague.” As fascinating and compelling as is the subject of the search for the cure for tuberculosis, I think an even more important theme of the book is just exactly how science works. We see Paul Erlich influenced by Koch’s lecture and the coincidental development of the sanatorium movement. We see Selman Waksman working in soil microbiology and taking as an assistant the young René Dubos who, reading an article by Winogradsky, would drastically change his career to focus on what he described as “the biochemical unity of life” and what would come to be known as the ecology of disease and health. We see Oswald Avery (see “The Great Influenza” by John M. Barry) assisted partially by Dubos in discovering “that DNA was the wonder chemical of heredity and life.” And we’re still only about a quarter of the way through the book.

It’s true that the book reads somewhat like a thriller, with one discovery leading to the next, and with the inevitable dead ends and red herrings, but through it all we are impressed with the steady, relentless stream of study, investigation, and discovery. It is certainly one of the best illustrations I have ever read of how science works. It should be required reading for, well, everyone.

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