Some Troubling Comments on Covid-19 by Some Conservative Acquaintances

First, full disclosure. My wife is an ICU nurse, and she is thus on the front lines of this pandemic. I would be lying if I said I wasn’t worried for her safety, and for the wellbeing of my family. I don’t think those outside of the medical profession understand what a major pandemic means for people like us. For the most part, the people I will be quoting in this post are white, privileged, and not at risk. So I find it particularly disturbing when they spread both misinformation and - as I will note - veiled threats. 

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While most of my friend list these days are rational people who accept science, seek the common good, and so on, there has been an increasingly troubling trend among my right-leaning acquaintances to take, um, interesting positions on things, particularly those in which the actions of a certain president (or party) might be seen in a bad light. This week, I saw a few posts which I left alone because I had no interest in getting into a fight, but that have really made me think and consider exactly what is going on here. I decided to write a bit about them, and why I think they are seriously problematic. Let’s start with one which is a 100% partisan issue. 

“We need to be honest and call it the Chinese/Wuhan Virus.”

This one comes directly from The Toupee Who Shall Not Be Named and his white nationalist advisers, but the GOP in general seems to be pushing this. There are several problems with this, so let me work through them one at a time. 

#1: It openly encourages racism and xenophobia

Il Toupee, pretty obviously, has a worldview which says that bad things come from “those people,” meaning non-Americans in general, but particularly people with darker skin. This has been obvious throughout his life, but on full display from the beginning of his campaign. In the most recent speech, he pushed (AGAIN!) for his wall, and blamed other countries. So, at minimum, this is part of a calculated play to rile up Trump’s xenophobic base - and stir up xenophobia and support for xenophobic policies. 

But it’s more than that in practice. Chinese (and other Asian) restaurants have seen business dry up. Incidents of hate and hate crimes against Asian Americans has increased. (I have a few friends who have experienced this first hand.) So this isn’t just of academic interest. It is an obstacle to seeing a pandemic virus as something we all have to come together and solve. If we are focusing on blaming the “other,” we miss an opportunity to collaborate. 

This has been obvious in the US response to the pandemic: refusing WHO tests, excluding foreign nationals while failing to screen citizens, and insisting until recently that the whole thing was a Chinese and Democrat hoax. 

#2: It misses that the virus could have originated anywhere

Throughout recorded history, viruses have jumped from animal species to humans. This is well documented. But even more than that, our very DNA shows strong evidence of cross-species transfer dating back to the rise of mammals. This is something that we humans have dealt with and will continue to deal with because it is fundamental to how life on earth works. Anywhere there is human/animal contact, viruses will jump. 

Not only that, but our modern situation makes this even more likely. As habitat destruction occurs, animals are forced into contact with humans. Likewise, as humans push into former wilderness, contact occurs. Climate change will also stir things up by changing ranges for various species, bringing them into contact with each other - and us. 

#3: It obfuscates the frightening parallels between China’s mistakes and ours

Trump fans - and Republicans in general - seem unwilling to see or admit the similarities between China and the United States. The whole “China is Communist, we are Capitalist, so we never make the same mistakes” is a strong ideology. Although beyond the scope of this post, China is far more capitalist than the American Right realizes. It is just unusual in that it is both totalitarian AND capitalist, which is a combination we are not used to. But it also makes the grave error to think that it is China’s Communist traits which were at fault. Rather, it was more broadly human failings - and the failings of a certain kind of politician specifically - that were at fault. 

Let’s look at the factors here that led to this:

Lack of regulations for food safety and animal contact

We need to be honest about this. Not too long ago, the US was every bit as vulnerable. (Read things like Upton Sinclair’s The Jungle for more on this.) 

But how much better are we? As a nation, our methods of raising meat are pretty lax compared to, say, Japan, or most of Europe. We have tens of thousands of animals crammed into tiny cages and kept in unsanitary conditions. We are an accident waiting to happen ourselves. 

Historically speaking, the most common nexus between humans and animals for disease has been poultry and pigs. And guess what? Which animals are raised in the factory farm way here in the US? That’s right: poultry and pigs. So it was really just chance (and the fact that China is a huge place with a lot of people) that led to this coming from China. It could easily have started here. 

And let’s also be honest about this: The GOP and Trump have been working to roll back regulations - including food safety regulations. So they are actually making it more likely that the next pandemic will originate here.

Political suppression of information

It is absolutely true that China suppressed information about the outbreak. It is also true that this was done for political purposes - to keep the Dear Leader from bad news. It is also true that China punished a whistleblower. 

It is also absolutely true that Trump did the same thing. That’s the problem with autocratic narcissists in power. Regardless of the economic or political system, they act in a predictable manner. When pandemics are involved, this causes problems. 

Republicans need to stop with this “blame China” thing and take a hard introspective look at how their policies, and their own Dear Leader are problematic and counterproductive in dealing with a pandemic.

#3: It misses a lesson of history

Have you heard of the “Spanish Flu”? Yeah, probably. That was our last deadly global pandemic, about 100 years ago. But did you know that the Spanish Flu did NOT originate in Spain?

That’s right:

The Spanish Flu did not originate in Spain.

The reason it is associated with Spain is that during World War One, Spain was a neutral country. Because of that, it had no incentive to suppress information about the flu, but openly reported infections and deaths. Unlike countries like the United States, Britain, France, Germany, and so on. They suppressed information because if they reported deaths, it might encourage the enemy. 

There are several hypotheses as to where the Spanish Flu originated. Some have proposed a British military base in France during the war. Others think Chinese laborers may have brought it. But there is also the possibility that it came from...wait for it...Kansas. A military base in Kansas. There is no definitive evidence, in part because we didn’t have tests, and much evidence wasn’t public at the time. 

In any event, the important thing here isn’t exactly where it originated as the fact that it could plausibly have originated anywhere - but the country that first went public got the blame. 

So, in summary, insistence on blaming China for the pandemic is counterproductive. It encourages racism and xenophobia, it ignores the common risk factors that the US shares, discourages collaboration, and misses the lessons of history. 

“The CDC is lying: the death rate is actually really low.”

There are some variants on this one, but the common thread seems to be the idea that the REAL problem is that this is being blown out of proportion, is not really a big deal, and that we should just go on with business as usual. Related to this is conspiratorial thinking that some combination of China/Democrats/the Media want to hurt Trump, and thus manufactured a crisis to tank the economy. 

Frankly, this is troubling. 

Let me tackle a few of the claims to show what is going on here. 

Because we haven’t tested that many people, the death rate is artificially high

It is true that we have tested very few people here in the US. This is actually really troubling to medical professionals and scientists, because it means that we likely have a ticking time bomb of infected people out there. 

Here is why the experts believe the death rate is actually a lot higher than the flu: there are countries who HAVE tested extensively, and have a pretty good idea about the rates. 

It is one thing to say China is still lying. (It’s plausible, although not certain.) It is another to say that ALL of the following countries are lying:

South Korea: has tested far more people by percentage of population than any other. It has also been successful at containing the outbreak by testing, tracing contact, and quarantines. Because of this, it has a huge body of evidence of the rates of serious complications and fatalities. South Korea is also a free country, and has no incentive to fabricate a pandemic. Also, because the US is a big trade partner, why would it try to destroy the US economy?

Taiwan: also has mostly contained things through testing, quarantine, and tracing. Also no friend of China, and depends on the US. 

Iran: has credibility problems, but it seems unlikely that it would fabricate a deadly pandemic in its own country. Also, we have satellite photos of mass graves. It seems like a stretch. 

Italy: In order to believe this is a hoax, you MUST believe that Italy is lying. That it doesn’t in fact have a healthcare infrastructure stretched past the breaking point, with some patients going without care, an overwhelmed funeral industry, and a high death rate. Why would Italy do that? It has no particular hate for the US, it is a free country, and no big friend of China. 

Spain: is in much the same place as Italy, with a disturbingly high death rate, and a higher testing rate than the US. Why would Spain be lying?

Great Britain: is arguably our closest ally, has a similarly incompetent and racist goofus as a leader, and is certainly not Communist. And yet, Britain too is showing a troubling infection and death rate, and is prepared for worse. Why would Britain be lying about that? 

So, to believe that this is somehow just an overblown media panic, you have to believe that ALL of these countries are in on the conspiracy. Really? 

And now, the most troubling of all:

“If this turns out to be overblown, people need to be held accountable.”

This one was shocking to me to hear, particularly from a legal colleague who should know better. 

I mean, WHO is he saying should be “held accountable” and how? 

Are we talking about suing the scientists who warned us? That’s the sort of thing that happens in totalitarian countries, not free democracies with free speech rights. Scientists should be free to give warning where they believe it is appropriate. And, in fact, this has been an ongoing issue with the Right, which is determined to discount any science that gets in the way of profit. From environmental regulation to climate change. I am concerned that the Right would prefer us to be more like China, where everything - including science - is expected to serve the regime and corporate interests. 

Also, let’s say that our drastic action actually works, and we shut down this pandemic. Do we punish the scientists because their advice worked? I mean, it’s hard to tell the difference between successful action and unnecessary action. (Although, you could look at the difference between South Korea and Italy in the actions and their results…) 

Okay, so maybe we don’t sue or prosecute scientists for this. Do we sue the media?

Again, this is what totalitarian regimes do. Not free democracies. But, again, note that Trump thinks (like totalitarians throughout history) that the press is “the enemy of the people.” That isn’t surprising. But to hear so-called conservatives argue for “holding the press accountable” is chilling. 

Again, let’s be honest about what this means in practice. We would be punishing the press for truthfully reporting what other countries are saying. (See above.) We would be punishing the press for reporting what scientists are saying. We would be punishing the press for failing to suppress information that is economically inconvenient. Think about that for a moment. 

Okay, so maybe we don’t punish the press. Maybe we just punish the elected officials who shut down schools and restaurants. 

This is at least not as politically chilling. We can vote out anyone we don’t like, and that is fine in the political sense. 

But think of this too: if a governor (or county government) makes a decision based on the scientific and medical information he or she has, why does that warrant punishment? Would we really prefer that all decisions be made based on the economy and the stock market? This is a lose-lose for elected officials and other decision makers. A pandemic doesn’t have a good result possible - either you leave everything open and let the disease spread or you shut things down and cause hardship. If given the choice, I would prefer that our leaders defer to science in areas in which science has the necessary information. I would certainly trust medical and epidemiological experts to have better advice than investment bankers when it comes to pandemics. And certainly more than a willfully ignorant narcissist who has a “gut feeling.” 

So, summary: it is unlikely that a dozen other countries are just making stuff up. This shit is real, and should be treated accordingly. And let’s stop already with talk of punishing the whistleblowers. That’s crazy, totalitarian talk, and is inappropriate in a democracy. 

We have a rough road ahead of us (particularly my wife and others on the front lines.) Let’s not make it worse with denialism, xenophobia, and calls to punish those trying to limit the damage. 

The Island of the Colorblind by Oliver Sacks

Source of book: Borrowed from the library

It has been a couple of years since I read an Oliver Sacks book, and I needed a beach read (yes, we go to the beach in the winter here in California…), so I picked this one up. I previously read and reviewed Musicophilia. 

  

Sacks was a neurologist, writer, researcher, teacher, and (in his spare time), a pianist. His books cover a fairly wide range of neurological topics, and reveal Sacks to have an astonishingly wide range of knowledge. He seems to know a little about everything, to observe everything, and relish knowledge for its own beauty. There are a lot of examples in this book and the other, where he realizes he has an interesting tidbit that doesn’t fit neatly in the narrative, so he puts it in a long endnote. (There are over sixty pages of endnotes in this book, most of which follow interesting “rabbit trails” related to details in the main body of the book. Definitely read these!) Sacks is also such a music fan, he can’t help working musical references in. In the introduction, he mentions that his soundtrack for writing the book was Tobias Picker’s The Encantadas, a work for orchestra and narrator - with words from Herman Melville’s account of his visit to the Galapagos. 

Rather than write a treatise about a topic, Sacks tells stories. Stories about his patients, stories about his research, stories about friends and family, and so on. This is a big reason why Sacks’ books are so much fun. He really cares about and enjoys people, and his empathy really shows. 

The Island of the Colorblind is about two different trips Sacks took to Micronesia. In each case, he was learning about and researching a particular disease which was endemic to a particular area. 

The title of the book is drawn from the first trip, which constitutes the first half of the book. The island of Pingelap is home to a concentration of people who have a type of colorblindness called congenital achromatopsia. This is a genetic condition that is total colorblindness. Unlike the more common form, where reds and greens get confused, this condition is characterized by a total inability to see color at all. The condition has other, rather unpleasant, symptoms, such as an inability to see clearly in bright light, involuntary eye movements, and poor visual acuity. Unlike the more common red/green colorblindness, achromatopsia is not a sex-linked genetic defect - it is equally common in men and women. 

Achromatopsia is quite rare in most places in the world - Sacks finds two individuals with it who assist him in his research, neither of which had actually met anyone else with the condition until later in life. However, on Pingelap, it affects about a third of the residents. Why is this so? Well, islands are somewhat isolated. In the case of Pingelap, about 200 years ago, the island was nearly destroyed by a hurricane, and there were only a few dozen survivors. With this limited of a gene pool, the recessive gene for achromatopsia spread throughout the population. How it got there is unknown, but it seems plausible that one of the explorers/colonizers from the past had the mutation, and left it behind in the gene pool sometime before the hurricane. 

Sacks travels to Pingelap (and a few nearby islands) with Knut Nordby, a Norweigian scientist with achromatopsia. Knut is able to greatly add to the expedition’s success because of his own experience (which aids in knowing how and what to test) and the natural bond that develops between him and others with the condition - they literally can recognize each other at a distance. 

While the research is the main theme, there are plenty of other incidents and details which are fascinating. Sacks seems to make friends wherever he goes, and gets as much out of the experience as possible. From the local food to the plant life, Sacks makes the islands come alive. Perhaps this is because, as the first few pages indicate, Sacks is fascinated with islands. 

The trip wasn’t all business, either. Sacks and Knut are taken by boat to the far side of Pohnpei to see the ruins of Nan Madol. I admit, I had never heard of the place before reading this book, so I had to look it up. Apparently, it is one of the wonders of the world, and thoroughly mysterious. The only ancient city built on coral reefs, it is believed to have been the capital of an extensive empire. It was constructed largely of giant basalt columns, similar to those found at Devil’s Postpile. Somehow or other, these gigantic rock columns - which weigh many tons - were transported from the other side of the island - which is about the size of New York City. They were then assembled log-cabin style into massive structures which have survived mostly intact for hundreds of years. All food and water had to be brought in by boat, which implies an extensive supply network. And then, about 350 years ago, it was abandoned. Anyway, if you want to read more about it, this Smithsonian article is interesting. 

The second half of the book concerns a trip to Guam, to research lytico-bodig disease - a form of ALS with other complications (parkinsons, dementia, other neurological symptoms) - that occurred with great frequency on the island of Guam. “Occurred” in the past tense is the best way to describe it, because, as of the mid 1990s, when Sacks visited, the condition appeared to only occur in people born before 1952. 

The cause of this disease has been a longstanding mystery, although there is now a promising theory. When Sacks wrote the book, he had to concede that efforts to discover the cause and mechanism had failed - and that it might never be found, because new cases in younger people were not occurring. 

The theories were many, but they had all, after extensive research, failed to prove true. The most likely seemed to be a connection to the consumption of cycad seeds. These were known to be toxic, but could have the toxin leached out. Also, the cycad connection failed to explain why younger people were apparently immune from the disease, despite eating cycad. Was it an increased consumption during World War Two? Was there a genetic component? That theory didn’t pan out, as there was no statistically significant genetic pattern. If anything, the pattern followed families, not genetics, which implied some environmental toxin or pathogen. 

Sacks didn’t end his research with the book, however, but continued to look into the issue. In 2002, he published a paper along with Paul Alan Cox on their theory that the cause was a toxic amino acid which was indeed connected with cycads. However, it was actually from a cyanobacteria that lives symbiotically with cycads. This bacteria was then ingested by a flying fox, and then concentrated in the nerve and brain cells of that creature. These were then eaten by humans, allowing a dose far greater than that of eating cycad seeds. I can’t find a free version of that 2002 paper, but you can read more recent detail on that in this paper by Cox and others in 2003, and this paper from 2012 which looks more broadly at cyanobacteria toxicity. It is fascinating stuff.

In the course of the discussion, Sacks goes off on a tangent about the history of cycads - one of the most ancient plants. His fascination with them goes back to his childhood. (He’s like this about everything - he loves it all and wants to tell you all about it!) 

One thing that stood out to me that Sacks observed in Guam was that the more family-oriented culture adapted far better to progressive neurological disease than our own Western cultures have. Caretaking is both normal and a community endeavor. Nobody complains about caring for family or neighbors. It just gets done, and is accepted as part of life. It is a far cry from our own tendency to go all “every man for himself” whenever something uncomfortable or unpleasant happens to someone else. It is a reminder that there is nothing inherently superior about our own culture. Like every culture, it has its strengths and weaknesses. And there is nothing magical about a particular moment in the past either. Circumstances change, cultures change, and our best bet is to try to make what we have the best and kindest it can be. 

I selected this book (out of the many Sacks books) by the fact that it happened to be checked in at the time - I needed a book for the next day. But, I have come to believe that there is no such thing as a disappointing Oliver Sacks book. No matter the topic, his vast knowledge, his ear for a compelling story, and his compassionate and empathetic approach to life combine to make a thoroughly enjoyable experience. 

An American Plague by Jim Murphy

Source of book: Audiobook from the library.

This book is part of our not-particularly-systematic exploration of Newbery award winners and runners up. This book was an honor selection back in 2004. 

This is the fairly rare award winning children’s book which is non-fiction. It tells of what has to be one of the most obscure events of the early United States - and one which remains relevant today.

It is all too easy to think of history as a series of major events involving (mostly) male characters doing serious stuff like war and government and things like that. It is less easy to imagine how real, ordinary life happened, and how seemingly mundane events could be so terrifying as to cause a constitutional crisis and threaten to bring down the government itself.

But that is what happened in 1793.

Most likely, a merchant ship entered Philadelphia (then the capital of the US and the most populous US city), bringing a few mosquitoes infected with a little virus. The unsanitary conditions combined with perfect weather to cause a serious epidemic of yellow fever, killing thousands, and paralyzing the government. This book tells that story.

First, let me mention that this is technically a book for children - late elementary to junior high. In an odd way, it is therefore less terrifying to kids of that age than it is to adults. While Murphy doesn’t pull punches - the horror and pain of the disease and the tragic deaths are in plain view - it is we adults who truly feel the helplessness of seeing spouses, children, and friends struck down to the grave in a few days. Man, I am glad we don’t live in those days.

I must say, I loved pretty much everything about this book. First, it is scientifically accurate - something you can’t take for granted in these days of partisan denialism. Murphy even gives an extended epilogue explaining the existence of a vaccine - and the limited supplies we have - and the risks of a future outbreak. Thus, the book is both comforting (we know how to prevent yellow fever) and terrifying (we are grossly unprepared should a future outbreak - perhaps aided by climate change - occur in the temperate zone.)

One other thing that was superb about this book was that the author spent a good bit of time on the role of the free blacks in this epidemic. To summarize: in the early days of the outbreak, it was (erroneously) believed that blacks were immune to yellow fever. (Some recent arrivals from Africa were.) Thus, free African Americans volunteered to serve as nurses for the ill. It was a pre-existing society of “free blacks” who stepped up to help, and indeed, did the overwhelming majority of nursing care during the epidemic.

Sadly, they were thrown under the bus afterward, being blamed for price gouging (in reality caused by rich whites competing for scarce services) and theft - which was actually more common by white nurses. To his credit, Murphy spent a full chapter on this issue, quoting extensively the primary sources. While this part of the book might not be the most riveting for kids, it is rather fascinating for us adults, who tend to understand the role of systemic racism in the lies spread afterward to discredit the African American nurses, who were the true heroes of the epidemic.

I should mention some historical figures here, which are particularly fascinating. First is Dr. Benjamin Rush, one of the signers of the Declaration of Independence, and a major figure of the times. On the negative side, he was rather completely wrong about yellow fever, and his “treatment” probably killed more than it cured. On the other hand, he was thoroughly admirable in that he selflessly treated and cared for the sick throughout the epidemic, despite suffering from the fever himself - including a relapse that nearly killed him. So, as a scientist, he failed. But as a human being, he was a badass. And, in retrospect, his extensive documentation of the plague assisted others in eventually coming to the correct scientific conclusions about yellow fever.

I also need to mention Matthew Clarkson, the mayor of Philadelphia, who stayed even after most of the government abandoned the city. He had to make some hard decisions, and essentially take control of a system for the common good, even though his powers were questionable. He didn’t have much obvious power, but after those who did fled for their cushy rural estates, there wasn’t any other option for doing the necessary things: cleaning up the filth, draining mosquito breeding areas, burying the dead, and so on. The thing is, even though he (arguably) seized powers he didn’t have, as soon as the others came back and did their job, he willingly ceded power. That is the sign of a true statesman, not a despot. He took on personal risk, yet declined the reward. One of the true heroes of the time.

Just a few others to mention: over a century later, it would be Josiah Nott, Carlos Finlay, and Walter Reed and others who worked tirelessly to prove that yellow fever was transmitted by mosquitoes (the second deadliest animal - behind humans) which transmitted the disease.

This book is well researched, well written, and a great resource on the history of a nasty, deadly disease, which had serious implications, political as well as epidemiological, for centuries.

Oh, and about those politics: in response to some, um, shenanigans in English history, our constitution didn’t really provide for the assembly of Congress outside of the national capitol. So, what would happen if Congress fled from the capitol (then Philadelphia)? President George Washington was in a bind: he wanted to call Congress together to address the epidemic (and other national issues), but the members had fled the plague and could not easily be brought to session. Could the president order assembly elsewhere? (The answer turned out to be “no.”) What was to be done?

Eventually, laws were passed as a result, which specified what would happen when Congress abandoned the capitol because of a natural disaster or other catastrophe. While this law hasn’t been used much since, it will likely come into play should a terrorist attack render Washington DC unavailable for a session of Congress. As a lawyer, I find this fascinating. And, perhaps (although I hope not) relevant in the future.

This is a good book to read with the kids - history is so very important to our understanding of the present. I think the reality of the way in which human decency (on the part of the free blacks) runs up against hatred and white supremacy (as it sure as hell does today) is crucial to understanding our current toxic right wing politics. Furthermore, disease will always be with us, and it is helpful to understand the factors which combined to make an epidemic.

Scurvy by Stephen Bown

Source of book: Borrowed from the Library

Scurvy: How a Surgeon, a Mariner, and a Gentleman Solved the Greatest Medical Mystery of the Age of Sail is exactly what it sounds like: a tale of the discovery and implementation of the cure for a baffling and deadly disease.

From our 21st Century perspective, it is easy to think of scurvy as a really easy disease to cure. Why didn’t people figure out how to cure it sooner? Well, lots of reasons, as this book points out. 

First, let’s look at the carnage. The Age of Sale lasted roughly from time that transoceanic voyages became practical and common through the invention of steam-powered watercraft. During that time - 400ish years - the death toll from scurvy is believed to have been in excess of two million sailors. That’s a lot. In fact, it is more than the deaths from combat, shipwreck, storms, and all other diseases. Combined. In fact, that is more than all of the combat deaths in the history of the United States - including both sides of the Civil War. That’s a lot of bodies.

As this book makes clear, there are a number of reasons why it took hundreds of years to finally understand the disease, and significant impediments to gaining definitive knowledge.

As we now know, scurvy is a disease caused by deficiency of Vitamin C - ascorbic acid. (The name itself is a contraction of “antiscorbutic” - anti-scurvy.) Most animals can create their own ascorbic acid - but humans cannot. Neither can guinea pigs, which is one reason that they became popular for animal testing. On long sea voyages, without fresh food, this deficiency would cause the breakdown of the connective tissue of the body. Basically, people fall to pieces, crumble to sludge, without this necessary nutrient.

One of the most interesting things about the history of scurvy is that the cure was actually discovered multiple times...then “forgotten” by those who came afterward. The most crazy example of this is that back in 1601, Sir James Lancaster proved that lemon juice prevented scurvy - and the British Merchant Marine believed him and adopted his recommendations. For a while. Likewise, the Dutch merchants used lemon juice as well. But the navies, which at the time tended to say near port, thought themselves above the lowly merchants. And anyway, while merchant vessels could carry a lot of supplies and stop in to port along the way, the navy had few similar options.

Eventually, the cure was forgotten, and not rediscovered until right before the Napoleonic Wars.

There were several inherent obstacles to the discovery and adoption of a cure. Some of these were problematic because of the specifics of the disease. Scurvy can mimic a lot of other diseases that were common at the time, and thus, it took a while before it was recognized as a single disease, rather than a constellation of symptoms which might have been other illnesses. Likewise, because of the generally poor nutrition of the lower classes, scurvy tended to afflict the common sailors before the officers. This meant that other factors were naturally suspected, such as the overcrowded conditions below decks, the generally poor food supplies, infectious diseases (which would come aboard the same way gaol fevers would), and other class-based causes.

There were also scientific reasons scurvy was difficult to pin down. We can test for potency these days, but that wasn’t the case back then. Different citrus fruits have differing amounts of ascorbic acid - as do other fresh fruits and vegetables. And this differs too based on freshness, preparation, and source. So there were a ton of variables which were difficult to account for. Likewise, in the human subjects, there were variables such as whether they had been at sea recently (and thus already pre-scorbutic), whether there were other health issues, how good nutrition was at home, and so on. These all tended to make it difficult to pin down the cause and the cure.

But perhaps the greatest obstacle was philosophic. The medicine of the day was in thrall to an erroneous belief: the “humour” theory of disease. There were four “humours”: blood, black bile, yellow bile, and phlegm - and all disease was an imbalance of these fluids. This was, to put a fine point on it, utter baloney. But that wouldn’t be known for many years.

The reason that this was a problem was that it required, as the author puts it, “great philosophical backflips and other mental acrobatics in a vain attempt to reconcile common sense with their theoretical constructs.” And, on a related note, it meant that practical experimental evidence was disregarded if it couldn’t be made to fit the theory.

Yes, that is a problem. It was a problem then, and it is a problem now. (Regular readers will know that this is one of my biggest beefs with American Evangelicalism’s approach to, well, everything. The theory always trumps reality or experience. Thus, there is no way to learn anything - everything is already known.) This was a big reason that the navies didn’t listen to the mere merchants. After all, their success in preventing scurvy was merely experimental, not based on intellectual theory. It took irrefutable evidence to topple the theory, and in the meantime, millions died.

In a weird moment, I ran across another bizarre theory in this book - one that was all too familiar. It was this idea of acid and alkaline balance. Because scurvy was (in this theory) either acid or alkaline, depending on the symptom, treatments varied. While one particular acid could have cured it, not all acids are equal. Thus, advocating for vinegar, sour wine, or - I am not making this up - “oil of vitriol” - that is, sulfuric acid - as a cure wouldn’t be effective, even though lemon juice would be. I mention this because as part of my childhood, we cycled through some scientifically ludicrous “alternative medicine” approaches to nutrition. Most were pretty harmless, although annoying. But this idea of classifying foods as acid or alkaline (often in ways that were contrary to the actual facts) and using that to treat disease was neither some ancient “wisdom” nor science. It was a faddish 18th Century piece of malarkey.

One thing that really struck me in this connection was the reason that the ancient Greek and Roman writings were considered authoritative in medicine. These days, we tend to (usually correctly) assume that more recent - and better controlled and designed - studies tend to be more accurate, and that the more modern, the more likely something is to be correct. In the past, the opposite was often true. In this case, the Greeks and Romans were revered on the theory that mankind has been degenerating since the Fall, and thus the older minds were less clouded and more brilliant. Sad to say, this ridiculous idea (which flies in the face of the evidence - and that includes morality too) remains current in certain religious circles. I have literally heard stuff like “imagine what the ancients could have done with their brilliant minds and our technology” and “we should trust the superior wisdom of the past and [fill in morally abhorrent thing here.]” There is nothing magic about the past, or the people of the past. Sometimes they were right. Often not.

By the way, it wasn’t just the “science” of the day that was problematic. Then, as now, there was a tendency to blame the victims of disease. Many dismissed sailors as morally degenerate, and scurvy merely as divine disfavor displayed against them. And of course, no sense in trying to cure a disease caused by divine disfavor - particularly if it afflicts people who you consider inferior. Hmm, I can think of another disease that got this treatment.

Eventually, three persons managed to get the treatment right - and it took the efforts of all three to do so.

The first was the surgeon, James Lind. He did the first truly controlled experiment in this area, discovering that lemon juice was effective in treating and preventing scurvy. Unfortunately, Lind never did shake the “humours” explanation, and so failed to make a coherent case for why it worked. Lind’s writings, however, would eventually influence others.

Captain James Cook was the next important figure. Working off of Lind’s recommendations, he brought citrus along on his voyages, and made sure to take on fresh vegetables whenever possible. He thus kept scurvy to a minimum during his famous voyages. Alas for Cook, he became mentally erratic on his last voyage, and managed to get himself into a deadly conflict in the Hawaiian Islands, and was killed. Thus, his effective technique never had an effective advocate.

The last was the aristocrat Gilbert Blane. He took the foundation laid by Lind’s experiments and Cook’s experiences, and used his influence to make the use of citrus the official policy of the British Navy, thus saving millions of additional lives, and contributing significantly to world history. (More on this below.)

Blane was successful, in part, because he drew a seemingly obvious connection that the British bureaucrats running the navy didn’t seem to grasp:

Scurvy wasn’t just costing “expendable” lives. It was causing the loss of expensive ships, and endangering national security.

Yeah, that sounds pretty callous. And it is. Because Naval policy was darn calloused. Ships would be stuffed with twice the number of necessary men, because it was assumed that half would be lost to scurvy over the course of the voyage. That’s pretty appalling. And horribly inefficient, as Blane pointed out. The loss of skilled sailors was leading to the sinking of ships and bad results all around. Furthermore, Britain would struggle to defend her vulnerable homeland if she couldn’t keep ships in the necessary places to prevent an invasion. It was by this calculation that Blane was able to convince the Navy bosses that it was worth the expense of keeping citrus (and concentrated citrus juice) in ready supply on board their ships.

Unsurprisingly, this change paid off. Suddenly, Britain had an immediate advantage over her foes: she could stay afloat longer, and could field more experienced and skilled sailors and gunners.

The author contrasts two wars with different results as an illustration of the difference. In the American Revolution, scurvy was a significant reason why England struggled to supply its troops - and prevent the Spanish and French from lending aid and sending troops. We have this American myth that the Revolution was a bunch of farmers with pitchforks throwing off the yoke of the most powerful nation on earth. That’s not really true. We were led by our own aristocratic class, and significantly aided by other superpowers who had a vested interest in keeping England occupied.

The contrast, however, is in the wars against Napoleon a few decades later, when England’s newfound ability to avoid scurvy led to its successful blockade of French and Spanish ports. This kept those sailors unable to practice at sea. But it also kept Napoleon from being able to launch an invasion of the British Isles - which probably would have been successful if he had put his superior army on the ground. (By Waterloo, England had been able to increase and train its army - because of the delay France suffered in invading. Not unlike the Battle of Britain in World War II…)

One final quote from Gilbert Blane regarding the cure of scurvy is apropos.

“There is not probably to be found in the whole range of human affairs a finer illustration of the practical benefits of progressive knowledge in promoting the great interests of mankind: so that science, while it lends an aid, also sheds a grace and dignity over the useful arts: nor can there be a more striking proof of the maxim, that humanity, like every other virtue, is the best policy.”

Two things stand out here. First is the love for science and progressive knowledge as used to benefit mankind. The second is that “humanity,” in the sense of “being humane,” isn’t just morally good - it is good public policy too. If saving impoverished sailors from death for moral reasons wasn’t enough, one could do it because of the good it brought to the nation as a whole.

If you want to understand the frustration that many of us who think and read and learn have with the current state of the Right in America, this is a good place to start. Some of us still believe that science isn’t a vast conspiracy - but it often is and should be a benefit to mankind. We also believe that humane public policy is ultimately beneficial. We all benefit from a healthy, educated, employed population. And we all suffer when we refuse (usually with fiscal objections) to invest in education, health care - and humane policies in general.

***

I couldn’t find a place to put it in the main review, but I did have to mention that The War of Jenkins’ Ear gets a mention in this book. War usually sucks - and this one is no exception. But that is the coolest name for a war that I can think of.