Survival of the Sickest: A Medical Maverick Discovers Why We Need Disease

Survival of the Sickest: A Medical Maverick Discovers Why We Need Disease
by Sharon Moalem, Jonathan Prince

Survival of the Sickest: A Medical Maverick Discovers Why We Need Disease
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Book Summary Information

Author: Jonathan Prince, Sharon Moalem
Edition: Hardcover
Published: 2007-02-01
ISBN: 0060889659
Number of pages: 288
Publisher: William Morrow

Book Reviews of Survival of the Sickest: A Medical Maverick Discovers Why We Need Disease

Book Review: The Power of Evolution
Summary: 5 Stars

The only complaint I have about this book is that the cover refers to Dr. Moalem as a "medical maverick." I don't see the assertions Dr. Moalem makes here as being particularly controversial (at least, for anyone who accepts the basics of the theory of evolution). The fact that diseases are evolutionary pressures on the development of the human species seems very straightforward. Granted, how Dr. Moalem interprets some of these pressures may be subject to debate; however, the basic premise is sound.

In fact, for anyone interested in the contemplation of the development of humans, this is a wonderful book. It's the kind of book that reads so well that, afterwards, you feel like you should have realized what she's been telling you all along. For example, the idea that our bodies have adapted to various diseases seems obvious. What should be obvious but isn't necessarily is the idea that some of these adaptations which served us well for millennia have become liabilities in the twenty-first century.

Take hemochromatosis. It is a surprisingly common genetic disease among people of Western European decent--one in three carry at least one copy of the gene--that causes an abnormally high level of iron in the body. Unchecked, it can lead to severe illness and death. But we also know that hemochromatic macrophages have an advantage in the fight against bacterial invasion. Is it possible that people with hemochromatosis had an advantage in surviving the plague in the 13th century, which is why this gene is common now? Dr. Moalem makes a good case.

And what about diabetes? Most common in cultures that descend from regions of cold climate. Why? Because driving up sugar levels is a natural response to cold. It forces dehydration, and digesting sugar generates heat, both advantages in the cold. It may be a leftover from our ancestors who survived the last ice age, when bodies were forced to use the limited food supplies to best advantage. Now that we live longer and eat more, high sugar levels have become dangerous.

And consider diseases like malaria and the common cold. Why does malaria make us so sick we end up in bed whereas most of us can stay ambulatory with a cold? How about because it gives a transmission advantage to each disease. Malaria wants us still so more mosquitos can get at us. A cold wants us out and about to pass the germs on to others ourselves. Evolution is an amazing thing.

But I think my favorite example Dr. Moalem gives is her speculation against the "savanna hypothesis." This hypothesis says that our ape ancestors moved from all fours to walking on two legs as a response to the new struggles to get food as they moved from the forests to the savannas. The weakness in this theory, however, is that it is very male oriented as males were the primary hunters. Evolution has to impact across gender. Moalem is a supporter of the "aquatic ape" hypothesis, which says that our distant ancestors spent much of their time in and around water. It explains much: why we became bipedal, why we lost fur, why our nostrils face down, why fat is attached to our skin and why babies are born the way they are (leading to much more difficult childbirth for we earth-bound humans).

All in all, I find this to be a very compelling book. Certainly there is room for debate with Dr. Moalem's conclusions but her ideas are interesting and her arguments are strong. It forces one to consider seriously the power of evolution to impact our lives. I, for one, think this is a great book.

Summary of Survival of the Sickest: A Medical Maverick Discovers Why We Need Disease

Dan Ariely on Survival of the Sickest
MIT professor Dan Ariely has become one of the leaders in the growing field of behavioral economics, and his bestselling book debut, Predictably Irrational, has brought his ideas--and his ingenious experiments and charming sense of humor--to a much wider audience. With the simplest of tests (often an auction or a quiz given under a few conditions) he shows again and again not only that we are wired to make irrational decisions in many situations, but that we do so in remarkably predictable ways.

I have always been puzzled by the way in which genetic diseases have managed to survive throughout the ages. How could it be that these diseases were able to withstand the evolutionary process, where only the most fit survive, and continue to be transferred from one generation to the next? Survival of the Sickest provides a thought provoking yet entertaining explanation to this puzzle.

In this insightful book Dr. Sharon Moalem demonstrates how conditions that are considered unhealthy (such as hemochromatosis, diabetes, and high cholesterol), or even deadly in extreme cases, might actually put their carriers at an advantage in combating other life-threatening illnesses. For example, he explains that hemochromatosis, a disease that, if left untreated, will kill you, may have actually been a defense against the deadliest pandemic in history--the bubonic plague during the 14th century. It turns out that this genetic mutation, which continues to be passed down through generations, actually helped spare many lives at one point.

Throughout the book, Dr. Moalem draws many connections between seemingly disparate subjects, such as the accidental invention of ice wine and cold diuresis, in order to illustrate the basic mechanisms of genetics and medicine in charming and intuitive ways. He skillfully interweaves his knowledge of history, genetics, and medicine not only as they relate to specific medical conditions but also in a way that addresses important challenges of modern society and our future evolution.

In the most general terms, Dr. Moalem's description of the human body and its complexity left me in awe of how far we have come in our understanding of biology and medicine, while also being reminded that the road to understanding ourselves is still wide open with much more to learn in the decades, and even centuries, to come. It is a fantastic journey on which he leads us and Dr. Moalem is a kind, knowledgeable, humorous, and helpful guide.


Read it.

You're already living it.

Was diabetes evolution's response to the last Ice Age? Did a deadly genetic disease help our ancestors survive the bubonic plagues of Europe? Will a visit to the tanning salon help lower your cholesterol? Why do we age? Why are some people immune to HIV? Can your genes be turned on -- or off?

Joining the ranks of modern myth busters, Dr. Sharon Moalem turns our current understanding of illness on its head and challenges us to fundamentally change the way we think about our bodies, our health, and our relationship to just about every other living thing on earth, from plants and animals to insects and bacteria.

Through a fresh and engaging examination of our evolutionary history, Dr. Moalem reveals how many of the conditions that are diseases today actually gave our ancestors a leg up in the survival sweepstakes. When the option is a long life with a disease or a short one without it, evolution opts for disease almost every time.

Everything from the climate our ancestors lived in to the crops they planted and ate to their beverage of choice can be seen in our genetic inheritance. But Survival of the Sickest doesn't stop there. It goes on to demonstrate just how little modern medicine really understands about human health, and offers a new way of thinking that can help all of us live longer, healthier lives.

Survival of the Sickest is filled with fascinating insights and cutting-edge research, presented in a way that is both accessible and utterly absorbing. This is a book about the interconnectedness of all life on earth -- and, especially, what that means for us.

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