Three Non-Fiction Books About Medicine

Pale Rider: The Spanish Flu of 1918 and How It Changed The World by Laura Spinney probably isn’t what most people consider to be cosy festive reading over Christmas but it is somewhat seasonal. Much of what has been written about the Spanish flu tends to focus on the impact it had on Western countries in the aftermath of the First World War but Spinney’s book is a refreshingly global account of how the virus reached all corners of the earth from Alaska to Rio de Janeiro to Samoa to China. Estimates remain vague but the Spanish flu is believed to have killed at least 50 million people worldwide, possibly as many as 100 million, and its rapid spread is likely to have been partly exacerbated by soldiers returning home at the end of the First World War.

Scientists at the time of the outbreak were gaining a better understanding of germ theory but knew very little about viruses. There is still a fair amount of speculation about the true extent of the Spanish flu, with three separate theories about where it originated from (despite its name, Spain is not one of them). Spinney argues that this lack of knowledge goes some way towards explaining why the flu hasn’t been imprinted in the collective memory despite its vast scale. However, the pandemic has shaped the course of history in striking ways. In one example, Spinney notes that a German immigrant to America who died from Spanish flu had taken out a life insurance policy for his widow and son who invested his legacy in property. The son prospered financially and later had a son of his own whose name is Donald Trump.

2018 marks a century since the first wave of Spanish flu spread across the world and I hope Spinney’s accessible and comprehensive account of the historical, cultural and scientific implications of one of the deadliest pandemics will gain more attention this year.

On a similar subject, The Health of Nations: The Campaign to End Polio and Eradicate Epidemic Diseases by Karen Bartlett look at the history of vaccination and disease eradication programmes with a focus on polio. While smallpox was officially declared eradicated nearly four decades ago, polio remains endemic in Nigeria, Pakistan and Afghanistan and Bartlett examines why this is still the case, despite the development of the Salk and Sabin polio vaccines to contributions made by billionaire philanthropists such as Bill Gates towards eradication programmes.

As well as the challenges of funding and developing viable vaccines, the logistics of innoculating people in poor and remote parts of the world are particularly difficult with the remaining unvaccinated populations proving the hardest to reach. Healthcare workers have to engage communities, combat stigma and navigate various security and terrorist threats in order to carry out their work as well as dealing with a frustrating number of bureaucratic obstacles including budgetary constraints and competing priorities. The politics surrounding vaccination also remains controversial and there is a very interesting chapter about the anti-vaccine movement in which Bartlett clearly lays out the pros and cons of each side of the argument.

Some of the detail about global healthcare infrastructure may have less appeal for the general reader compared to ‘Pale Rider’ but overall, ‘The Health of Nations’ provides a great deal of insight into the complex issues surrounding vaccination and disease eradication.

‘Pale Rider’ and ‘The Health of Nations’ are potential nominees for this year’s Wellcome Book Prize longlist due to be announced next month. The Immortal Life of Henrietta Lacks by Rebecca Skloot won the WBP back in 2010 and is a narrative non-fiction account about a poor black woman originally from Virginia named Henrietta Lacks who died in 1951 and how her cancer cells (later known as HeLa) were used for several groundbreaking medical research programmes from the development of IVF to gene mapping. However, while Henrietta’s cells have contributed towards some of the most important scientific discoveries in recent decades, they were taken without her consent and her family never received financial compensation despite pharmaceutical companies making billions in profit from them.

There are three main strands to this book. Firstly, Skloot outlines the background of the HeLa cells themselves and the scientific experiments they were used for. Secondly, she shines a light on medical ethics in the pharmaceutical industry, the treatment of black patients in medical institutions and the legal ramifications of consent. And finally, Skloot paints a portrait of Henrietta and her family, interweaving her life story with that of her “immortal” cells. The Lacks family initially wanted nothing to do with Skloot, who proved to be remarkably persistent in pursuing information about Henrietta, and equally thorough in uncovering the full extent of how her cells have been used in medical research.

Much like The Hare with Amber Eyes by Edmund de Waal and other part-biographical multi-genre non-fiction books, it is the personal angle of Henrietta’s story combined with Skloot’s assured investigative reporting style which makes ‘The Immortal Life of Henrietta Lacks’ such an engaging book with wide appeal. I would recommend it to any general non-fiction reader.