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Even when I was a teen, I’m not sure I read any YA non-fiction, preferring adult non-fiction instead. Since one of my reading resolutions for this year was to read more non-fiction, I thought I should also make an effort to read more YA non-fiction. So I borrowed a couple of acclaimed YA non-fiction books, Invisible Allies and the second edition of Invisible Enemies, both by Jeanette Farrell, and An American Plague by Jim Murphy. I also borrowed two adult books, The Ghost Map by Steven Johnson and The Spirit Catches You and You Fall Down by Anne Fadiman, that I had long been meaning to read. While all five books have their merits individually, I think I got more out of each book by reading them as a group. I’m not sure if I consciously chose to borrow these books as a group because I suspected they’d work so well together or simply because they were the first non-fiction books that came to mind. In any case, the first four books all deal with the effects of culture and the movement of people around the world on medical issues, particularly those related to public health, some more explicitly than others.

~really long, so click below to read the rest~

In Invisible Enemies, Jeanette Farrell tells the stories of seven infectious diseases (smallpox, the plague, leprosy, tuberculosis, malaria, cholera, and AIDS) and their effect on people. She begins by discussing medical beliefs in historical times, then focuses on one disease per chapter, describing the microbe that causes the disease, the disease in history, attempts at treatment (basically, completely misguided prior to the acceptance of germ theory), the identification of the cause of the disease, efforts to contain or eradicate the disease, and the current state of the disease. Due to this format, Farrell does not have much space to explore each disease in depth, but she still manages to write with clarity, engaging readers while conveying a lot of information. However, what especially interested me were the differences between this book, which I read first, and those by Johnson and Murphy.

Cholera has existed in the Indian subcontinent for over 2,000 years. However, it was not until the early 19th century that a cholera epidemic hit British soldiers in India and eventually spread around the world. Farrell devotes several pages in Invisible Enemies‘ chapter on cholera to London’s cholera outbreak of 1854 and the man who traced it to a water pump on Broad Street. It’s the most epidemiological part of the entire book, and as there is something about epidemiology that I find extremely fascinating, I was glad that I had already borrowed Steven Johnson’s The Ghost Map.

The Ghost Map is ostensibly about the aforementioned cholera outbreak and the two men who discovered its root. However, the scope of the book is wide, since part of Johnson’s framework is that one must understand how the era, and the common beliefs of the time, came to be, in order to understand why John Snow and Henry Whitehead were the right men to investigate the cause of this particular outbreak of cholera.

Snow was a doctor of some acclaim for his study of and medical practice concerning the use of gases for anesthesia. But he also had an interest in other medical issues, and eventually turned his attention to cholera. Whitehead was an Anglican reverend whose intimate knowledge of the Golden Square community, the epicenter of the outbreak, enabled him to work in conjunction with Snow and to ultimately identify the first person who became ill in this particular outbreak. Unfortunately, according to Johnson, Whitehead’s role in the investigation is often minimized or simply overlooked; he is not mentioned in Farrell’s account at all. (Also, while Farrell credits the Broad Street pump with starting Snow’s investigation of the companies supplying piped water to London’s homes, as Johnson shows, Snow was convinced that cholera was spread via water and was already collecting statistics on cholera victims and the water companies that supplied their homes with water. He saw the Broad Street outbreak as another means of discrediting the miasma theory, which blamed sicknesses such as cholera on foul air, and those who considered cholera among the lower classes a sign of their inferiority.) Much of the book, the parts I found most interesting, discusses the growth of London and the epidemiological investigation. It’s when Johnson becomes a futurist and starts discussing urbanism, the possibility of pandemics, and terrorist attacks that I became bored.

The titular American plague of Jim Murphy’s book is Philadelphia’s outbreak of yellow fever in 1793. (Not to be confused with the Memphis outbreak in 1878, the subject of Molly Caldwell Crosby’s The American Plague.) Whether or not you’ve read Laurie Halse Anderson’s Fever 1793, Murphy’s book makes for fascinating reading, especially with Paraguay’s current outbreak of yellow fever hitting the news.

Philadelphia had already been hit hard by several different diseases in 1793. When people began dying in late summer, sharing the same horrific symptoms (Murphy identifies a sailor as one of the first, if not the first, persons to die of yellow fever, and later says water casks on ships were the perfect method for transporting yellow fever-carrying mosquitoes), many doctors did not believe that the culprit was yellow fever. Yellow fever was among the most feared diseases of the era, and Murphy, using numerous primary sources, writes of various “remedies” for yellow fever and how these attempts at curing were based on the beliefs of the period. He also shows the far-reaching effects of this particular outbreak on American history and government. Like The Ghost Map, implicit in Murphy’s narrative is the belief that the outbreak—why it occurred, peoples responses to it, and attempts at ending it—cannot be separated from the events and medical theory of the period. The historical context is essential to understanding the outbreak, and to look at cholera in 1854 London or yellow fever in 1793 Philadelphia without noting this context is to not fully comprehend a diseases causes or effects.

(Sidenote that may be of interest only to me: Murphy and Farrell differ in their very brief mentions of the failure of DDT in the campaigns exterminate the mosquitoes responsible for spreading yellow fever and malaria, respectively. Farrell focuses on the effect of DDT on the food chain—DDT was also ingested by roaches, which were eaten by lizards, which became sick, thereby sickening the cats who ate the lizards, etc.—and the evolution of DDT-resistant mosquitoes. Murphy discusses the lack of funding to fully eradicate the disease-bearing mosquitoes as well as the “concern about health risks and environmental problems associated with the use of DDT,” specifically mentioning Rachel Carson’s Silent Spring as well as her prediction that DDT would only worsen the problem by creating mosquitoes resistant to DDT and other pesticides.)

Reading these books, you can see how, as trade goods and people began moving rapidly around the world, so did sickness and disease. Unlike the above books, the subject of Anne Fadiman’s The Spirit Catches You and You Fall Down is not microbes or epidemics, but the treatment of young epileptic girl. Still, like the Johnson and Murphy books, understanding culture is essential to understanding how and why this particular situation arose. Plus, it could not have occurred if the world was not shrinking and people did not have the ability to move halfway around the world in a relatively short (evolutionarily speaking) amount of time.

Of course, epilepsy is the Western diagnosis. For the parents of Lia Lee, Hmong immigrants, it is obvious that the correct diagnosis is quag dab peg, “the spirit catches you and you fall down.” While Hmong know that quag dab peg can be dangerous, it could also have been seen as a blessing, since “Hmong epileptics often become shamans.” When one of Lia’s seizures scared her parents enough to send them to the emergency room of the county hospital, it led to a series of confrontations between Lia’s parents and the doctors and social service providers who all thought they were acting with Lia’s best interests at heart. The doctors prescribed medicines, the Lees thought the medicine was making Lia sick, the doctors were unable to convey the Lees why they must give Lia Western medicines, the Lees continued to try to heal Lia with traditional methods, and so on. Both sides were unable to communicate with the other due to linguistic and, most importantly, cultural barriers. Fadiman writes gracefully and sympathetically about a very difficult situation, and if you read just one of these books, make it The Spirit Catches You and You Fall Down.*

I suppose Farrell’s Invisible Allies is the odd book of the bunch, since it examines the many ways microbes benefit humans. Following the same format as Invisble Enemies, Farrell looks at just a few of the millions of microbes that are beneficial to humans. These advantageous microbes dwarf the number that are dangerous to humans, and the ones that Farrell discusses here all happen to be at least partly related to food production and consumption (cheese, bread, chocolate, and the microbes in our intestinal tracts, and the final chapter which focuses on sewage and cleaning polluted waters). It’s easy to think of the negative effects of microbes on our lives, making this book an intriguing, if sometimes slightly disgusting, look at how we benefit from them.

* Also, it so clearly and devastatingly shows how certain values and aspects of belief systems are not universal. Schools and public libraries must also deal with cultural clashes, not to the same potentially harmful effect, obviously. But as some of our libraries are increasingly patronized by immigrants, I think it’s important to keep in mind that publicly funded institutions such as public schools and libraries may (literally) be foreign concepts and that other conceptions of property and group ownership may differ from what we value as American public service providers. Okay, off my soapbox now. On another note, it does have teen appeal, especially for those considering entering a medical field. I was reminded that I wanted to read this book after noticing that one of my teens had requested it from another library.