Thursday, March 10, 2016

Book Review: Pandemic

Pandemic: Tracking Contagions, From Cholera to Ebola and Beyond
Sonia Shah

"But." It's such a powerful, deflating little word. It's like kryptonite for whatever goes before it. "He's a nice guy, but ..." "The food is good, but ..."

Well: Pandemic is a good book, but ... it suffers from narrative tunnel vision. By which I mean that Sonia Shah has a narrative, and by gum she's going to ram every piece of evidence she can find into that narrative, whether it fits or not. The effect is to make Pandemic into a series of Just-So Stories.

Sometimes this takes the form of blinkered research. For example, thirty seconds with Google would have informed Sonia Shah that the fable of "medieval Europeans never took baths!" is, at best, a wild oversimplification. But she has her narrative, and she sticks to it, and her narrative requires this fable in undiluted, un-nuanced form.

In other cases, Shah takes one of several competing scientific theories--the one that fits the narrative--and runs with it. She's careful not to present it as fact, but all the same the reader is left with a strong impression that, yes, this is how the whole overarching epic ought to go. For example, disease resistance is one of several competing explanations for why sexual reproduction evolved out of the boring old asexual variety. From Pandemic, you could be forgiven for thinking it's the consensus. It's not. (Just a few weeks ago I recall reading an article that made a credible alternative case for heat resistance as the driving force, at least in yeasts.)

Finally, this particular tocsin ("bad diseases are coming to destroy us all!") has been sounded before now. I read Laurie Garrett's* The Coming Plague in 1994 and Richard Preston's The Hot Zone in 1995. That doesn't mean that Shah's book is not true. It does mean that a more balanced, less narrative-tunnel-vision presentation might have been in order.

So I had reservations, but ... Pandemic is a great read. Shah has a brilliant structure. She takes cholera, about which a great deal is known, and which is a relatively new disease--the first mass outbreaks date to the early 19th century--as her explanatory device. Every chapter deals first with some known aspect of cholera: where it came from, what it does, how it spreads, etc. It then applies this to the emerging diseases of the 21st century. The result is a superb synthesis: here's what we know, and here's what that tells us about what to expect.

Should you read it? Absolutely, if you're interested. The prose is good, the level of scientific detail is about right, there are some engaging personal touches. Just remember: Sonia Shah has a seamless narrative, but ... it might not be true. Then again, it might.

P.S.: this.

*Incidentally, Garrett wrote a review of Pandemic that is so utterly wrong-headed and sour-grapesish ("Why didn't Sonia Shah write the book I wanted her to write?" seems to be the theme) that it made me think better of the present book.

One of the best books I've ever read on this sort of thing is Steven Johnson's The Ghost Map, on the London cholera epidemic of 1854. Do not miss it if you're at all interested in the subject matter.


  1. Stop recommending interesting books! You have more time than I. Wait no. Keep doing it please. :)

    1. Just take a 45-minute train ride (each way) three days a week as part of your commute. Trust me, you'll have more time.

  2. Library finally got it to me. Agreed on most of your points. I've been following this topic off-and-on for a while. Shah makes some good points about increased travel and trade, high-density farming, and population increases/habitat loss helping diseases to spread. Her comments liking NY's early 19th c. cholera outbreak to Aaron Burr were an amusing factoid.

    By coincidence, I stumbled across an 1883 case talking about a scarlet fever and diphtheria outbreak in Groton, CT as part of research on the powers of health inspectors. “…strenuous efforts were made to discover the cause of the malady. It is a matter of common knowledge that these diseases are supposed to originate in noxious exhalations from decaying animals and vegetable matter, and when once in existence are greatly aggravated by the continuance of the malarious atmosphere.” Raymond v. Fish, 51 Conn. 80, 94 (1883). The law in question was passed in 1849, likely in response to the NYC cholera outbreaks.

    1. Shah never says anything that isn't, at worst, perfectly plausible. It's hard to avoid thinking that this kettle is going to boil over somewhere, somehow.

      "Noxious exhalations" ... I like it.

      One of the things that The Ghost Map details is the infamous Great Stink. Ever since I read it I've been looking for a good, recent bio of Joseph Bazalgette.