Scourges that have plagued human beings since the ancients still threaten to unleash themselves; new maladies are brewing that have yet to make their appearance in the headlines; lethal germs employed as weapons of warfare and terrorism have reemerged as a worldwide menace. Regardless of their mode of attack, microbes exist to multiply, thrive, and find new hosts; they cross national boundaries and social classes, attacking without prejudice. Now medical historian and pediatrician Howard Markel, author of Quarantine! (“Engrossing . . . Meticulously documented” —Sherwin Nuland, The New Republic), tells the story of six epidemics that broke out during the two great waves of immigration to the United States—from 1880 through 1924, and from 1965 to the present—and shows how federal legislation closed the gates to newcomers for almost forty-one years out of fear that these new people would alter the social, political, economic, and even genetic face of the nation. Markel writes about tuberculosis today, the most serious public health threat facing the contemporary world. He writes about bubonic plague and how it came to this country in the early twentieth century; about trachoma in the years before World War I; about Ellis Island and how an East European rabbi was diagnosed and treated for the dreaded eye infection; about typhus fever and an epidemic on the Texas-Mexico border in the aftermath of Pancho Villa’s revolution; and about AIDS, the Haitian exodus, and the early years of the AIDS epidemic.Markel explains how immigration in the twenty-first century is characterized by porous borders, rapid travel, and scattered destinations. While more than 75 percent of all immigrants during the first great wave of immigration came through New York Harbor, transportation today allows travel to all parts of the United States from the farthest reaches of the globe, giving public health physicians little opportunity to definitively diagnose infectious diseases that can incubate silently in a traveler, making the spread of epidemics far more than a theoretical concern.Markel looks at our nation’s response to the pathogens present in our midst and examines our foolhardy attempts at isolation and our vacillation between demanding a public health system so punitive that it worsens matters rather than protects and settling for one that is too lax; how we are fascinated with all things infectious and then hardly give microbes a second thought; how the United States, a country that since its inception has prided itself on being a nation of immigrants, continues its tradition of blaming newcomers for its physical and social ills; and how globalization, social upheaval, and international travel render us all potential inhabitants of the so-called Hot Zone. Finally, Markel puts forth a plan for a globally funded public health program that could stop the spread of epidemics, help eradicate certain diseases, and protect us all.

    She focuses on a different danger in each chapter-from the looming risk of lethal influenza to in-depth information on the public health perils posed by bioterrorism. With a novelist's descriptive eye and a thriller writer's sense of tension, she warns us that the most ceaselessly creative bioterrorist is still Mother Nature, whose microbial operatives are all around us, ready to pounce when conditions are right.

    Steven Hatch first came to Liberia in November 2013, to work at a hospital in Monrovia. Six months later, several of the physicians Dr. Hatch had mentored and served with were dead or barely clinging to life, and Ebola had become a world health emergency. Hundreds of victims perished each week; whole families were destroyed in a matter of days; so many died so quickly that the culturally taboo practice of cremation had to be instituted to dispose of the bodies. With little help from the international community and a population ravaged by disease and fear, the war-torn African nation was simply unprepared to deal with the catastrophe.A physician’s memoir about the ravages of a terrible disease and the small hospital that fought to contain it, Inferno is also an explanation of the science and biology of Ebola: how it is transmitted and spreads with such ferocity. And as Dr. Hatch notes, while Ebola is temporarily under control, it will inevitably re-emerge—as will other plagues, notably the Zika virus, which the World Health Organization has declared a public health emergency. Inferno is a glimpse into the white-hot center of a crisis that will come again.

    As the pandemic unfolded, Gottlieb was in regular contact with all the key players in Congress, the Trump administration, and the drug and diagnostic industries. He provides an inside account of how level after level of American government crumbled as the COVID-19 crisis advanced.A system-wide failure across government institutions left the nation blind to the threat, and unable to mount an effective response. We’d prepared for the wrong virus. We failed to identify the contagion early enough and became overly reliant on costly and sometimes divisive tactics that couldn’t fully slow the spread. We never considered asymptomatic transmission and we assumed people would follow public health guidance. Key bureaucracies like the CDC were hidebound and outmatched. Weak political leadership aggravated these woes. We didn’t view a public health disaster as a threat to our national security.Many of the woes sprung from the CDC, which has very little real-time reporting capability to inform us of Covid’s twists and turns or assess our defenses. The agency lacked an operational capacity and mindset to mobilize the kind of national response that was needed. To guard against future pandemic risks, we must remake the CDC and properly equip it to better confront crises. We must also get our intelligence services more engaged in the global public health mission, to gather information and uncover emerging risks before they hit our shores so we can head them off. For this role, our clandestine agencies have tools and capabilities that the CDC lacks.Uncontrolled Spread argues we must fix our systems and prepare for a deadlier coronavirus variant, a flu pandemic, or whatever else nature -- or those wishing us harm -- may threaten us with. Gottlieb outlines policies and investments that are essential to prepare the United States and the world for future threats.

    If we continue with current farming practices, vast amounts of wilderness will be lost, millions of birds and billions of insects will die, and the public will lose billions of dollars as a consequence of environmental degradation. Clearly, there must be a better way to meet the need for increased food production.Written as part memoir, part instruction, and part contemplation, Tomorrow's Table argues that a judicious blend of two important strands of agriculture--genetic engineering and organic farming--is key to helping feed the world's growing population in an ecologically balanced manner. PamelaRonald, a geneticist, and her husband, Raoul Adamchak, an organic farmer, take the reader inside their lives for roughly a year, allowing us to look over their shoulders so that we can see what geneticists and organic farmers actually do. The reader sees the problems that farmers face, trying toprovide larger yields without resorting to expensive or environmentally hazardous chemicals, a problem that will loom larger and larger as the century progresses. They learn how organic farmers and geneticists address these problems.This book is for consumers, farmers, and policy decision makers who want to make food choices and policy that will support ecologically responsible farming practices. It is also for anyone who wants accurate information about organic farming, genetic engineering, and their potential impacts onhuman health and the environment.

    America faced a troubling question: What happened? How was this epidemic allowed to spread so far before it was taken seriously? In answering these questions, Shilts weaves the disparate threads into a coherent story, pinning down every evasion and contradiction at the highest levels of the medical, political, and media establishments. Shilts shows that the epidemic spread wildly because the federal government put budget ahead of the nation's welfare; health authorities placed political expediency before the public health; and scientists were often more concerned with international prestige than saving lives. Against this backdrop, Shilts tells the heroic stories of individuals in science and politics, public health and the gay community, who struggled to alert the nation to the enormity of the danger it faced. And the Band Played On is both a tribute to these heroic people and a stinging indictment of the institutions that failed the nation so badly.

    It’s not just that the grid has grown old and is now in dire need of basic repair. Today, as we invest great hope in new energy sources--solar, wind, and other alternatives--the grid is what stands most firmly in the way of a brighter energy future. If we hope to realize this future, we need to re-imagine the grid according to twenty-first-century values. It’s a project which forces visionaries to work with bureaucrats, legislators with storm-flattened communities, moneymen with hippies, and the left with the right. And though it might not yet be obvious, this revolution is already well under way.Cultural anthropologist Gretchen Bakke unveils the many facets of America's energy infrastructure, its most dynamic moments and its most stable ones, and its essential role in personal and national life. The grid, she argues, is an essentially American artifact, one which developed with us: a product of bold expansion, the occasional foolhardy vision, some genius technologies, and constant improvisation. Most of all, her focus is on how Americans are changing the grid right now, sometimes with gumption and big dreams and sometimes with legislation or the brandishing of guns.The Grid tells--entertainingly, perceptively--the story of what has been called “the largest machine in the world”: its fascinating history, its problematic present, and its potential role in a brighter, cleaner future.

    But as costs levitate, that argument becomes more difficult to make. Today, we spend twice as much as Japan on health care—yet few would argue that our health care system is twice as good.Instead, startling new evidence suggests that one out of every three of our health care dollars is squandered on unnecessary or redundant tests; unproven, sometimes unwanted procedures; and overpriced drugs and devices that, too often, are no better than the less expensive products they have replaced.How did this happen? In Money-Driven Medicine, Maggie Mahar takes the reader behind the scenes of a $2 trillion industry to witness how billions of dollars are wasted in a Hobbesian marketplace that pits the industry's players against each other. In remarkably candid interviews, doctors, hospital administrators, patients, health care economists, corporate executives, and Wall Street analysts describe a war of "all against all" that can turn physicians, hospitals, insurers, drugmakers, and device makers into blood rivals. Rather than collaborating, doctors and hospitals compete. Rather than sharing knowledge, drugmakers and device makers divide value. Rather than thinking about long-term collective goals, the imperatives of an impatient marketplace force health care providers to focus on short-term fiscal imperatives. And so investments in untested bleeding-edge medical technologies crowd out investments in information technology that might, in the long run, not only reduce errors but contain costs.In theory, free market competition should tame health care inflation. In fact, Mahar demonstrates, when it comes to medicine, the traditional laws of supply and demand do not apply. Normally, when supply expands, prices fall. But in the health care industry, as the number and variety of drugs, devices, and treatments multiplies, demand rises to absorb the excess, and prices climb. Meanwhile, the perverse incentives of a fee-for-service system reward health care providers for doing more, not less.In this superbly written book, Mahar shows why doctors must take responsibility for the future of our health care industry. Today, she observes, "physicians have been stripped of their standing as professionals: Insurers address them as vendors ('Dear Health Care Provider'), drugmakers and device makers see them as customers (someone you might take to lunch or a strip club), while . . . consumers (aka patients) are encouraged to see their doctors as overpaid retailers. . . . Before patients can reclaim their rightful place as the center—and indeed as the raison d'être—of our health care system," Mahar suggests, "we must once again empower doctors . . . to practice patient-centered medicine—based not on corporate imperatives, doctors' druthers, or even patients' demands," but on the best scientific research available.

    The same twenty-year avoidable disparity exists in the Calton and Lenzie neighborhoods of Glasgow, and in other cities around the world.In Sierra Leone, one in 21 fifteen-year-old women will die in her fertile years of a maternal-related cause; in Italy, the figure is one in 17,100; but in the United States, which spends more on healthcare than any other country in the world, it is one in 1,800. Why?Dramatic differences in health are not a simple matter of rich and poor; poverty alone doesn't drive ill health, but inequality does. Indeed, suicide, heart disease, lung disease, obesity, and diabetes, for example, are all linked to social disadvantage. In every country, people at relative social disadvantage suffer health disadvantage and shorter lives. Within countries, the higher the social status of individuals, the better their health. These health inequalities defy the usual explanations. Conventional approaches to improving health have emphasized access to technical solutions and changes in the behavior of individuals, but these methods only go so far. What really makes a difference is creating the conditions for people to have control over their lives, to have the power to live as they want. Empowerment is the key to reducing health inequality and thereby improving the health of everyone. Marmot emphasizes that the rate of illness of a society as a whole determines how well it functions; the greater the health inequity, the greater the dysfunction.Marmot underscores that we have the tools and resources materially to improve levels of health for individuals and societies around the world, and that to not do so would be a form of injustice. Citing powerful examples and startling statistics ("young men in the U.S. have less chance of surviving to sixty than young men in forty-nine other countries"), The Health Gap presents compelling evidence for a radical change in the way we think about health and indeed society, and inspires us to address the societal imbalances in power, money, and resources that work against health equity.

    Brill’s vivid narrative—filled with unexpected twists and turns—takes us from the Oval Office, where President Obama signs off on an unprecedented plan that will infuriate the teachers’ unions because it offers billions to states that win an education reform “contest”; to boisterous assemblies, where parents join the fight over their children’s schools; to a Fifth Avenue apartment, where billionaires plan a secret fund to promote school reform; to a Colorado high school, where students who seemed destined to fail are instead propelled to college; to state capitols across the country, where school reformers hoping to win Obama’s “contest” push bills that would have been unimaginable a few years ago. It’s the story of an unlikely army—fed-up public school parents, Ivy League idealists, hedge-funders, civil rights activists, conservative Republicans, insurgent Democrats—squaring off against unions that the reformers claim are protecting a system that works for the adults but victimizes the children. Class Warfare is filled with extraordinary people taking extraordinary paths: a young woman who goes into teaching almost by accident, then becomes so talented and driven that fighting burnout becomes her biggest challenge; an antitrust lawyer who almost brought down Bill Gates’s Microsoft and now forms a partnership with Bill and Melinda Gates to overhaul New York’s schools; a naïve Princeton student who launches an army of school reformers with her senior thesis; a California teachers’ union lobbyist who becomes the mayor of Los Angeles and then the union’s prime antagonist; a stubborn young teacher who, as a child growing up on Park Avenue, had been assumed to be learning disabled but ends up co-founding the nation’s most successful charter schools; and an anguished national union leader who walks a tightrope between compromising enough to save her union and giving in so much that her members will throw her out. Brill not only takes us inside their roller-coaster battles, he also concludes with a surprising prescription for what it will take from both sides to put the American dream back in America’s schools.

    Why We Get Sick compels readers to reexamine the age-old attitudes toward sickness. Line drawings.

    By 1988 she was living at home but was brain dead after a tragic cycle of misunderstanding, over-medication, and culture clash: "What the doctors viewed as clinical efficiency the Hmong viewed as frosty arrogance." The Spirit Catches You and You Fall Down is a tragedy of Shakespearean dimensions, written with the deepest of human feeling. Sherwin Nuland said of the account, "There are no villains in Fadiman's tale, just as there are no heroes. People are presented as she saw them, in their humility and their frailty—and their nobility.

    He tells of the large science-steeped family who fostered his early fascination with chemistry. There follow his years at boarding school where, though unhappy, he developed the intellectual curiosity that would shape his later life. And we hear of his return to London, an emotionally bereft ten-year-old who found solace in his passion for learning. Uncle Tungsten radiates all the delight and wonder of a boy’s adventures, and is an unforgettable portrait of an extraordinary young mind.

    His passing on March 6, 1900, would have been unremarkable if a city health officer hadn’t noticed a swollen black lymph node on his groin—a sign of bubonic plague. Empowered by racist pseudoscience, officials rushed to quarantine Chinatown while doctors examined Wong’s tissue for telltale bacteria. If the devastating disease was not contained, San Francisco would become the American epicenter of an outbreak that had already claimed ten million lives worldwide.To local press, railroad barons, and elected officials, such a possibility was inconceivable—or inconvenient. As they mounted a cover-up to obscure the threat, ending the career of one of the most brilliant scientists in the nation in the process, it fell to federal health officer Rupert Blue to save a city that refused to be rescued. Spearheading a relentless crusade for sanitation, Blue and his men patrolled the squalid streets of fast-growing San Francisco, examined gory black buboes, and dissected diseased rats that put the fate of the entire country at risk.In the tradition of Erik Larson and Steven Johnson, Randall spins a spellbinding account of Blue’s race to understand the disease and contain its spread—the only hope of saving San Francisco, and the nation, from a gruesome fate.

    As an untried medical student studying the intersection of global health and communicable disease, Donaldson soon found himself in dangerous Sierra Leone, on the border of war-struck Liberia, where he struggled to control the spread of Lassa Fever. The words, “you know Lassa can kill you, don’t you?” haunted him each day. With the country in complete upheaval and working conditions suffering, he is forced to make life-and-death decisions alone as a never-ending onslaught of contagious patients flood the hospital. Soon however, he is not only fighting for others but himself when he becomes afflicted with a life threatening disease. The Lassa Ward is more than just an adventure story about the making of a physician; it is a portrait of the Sierra Leone people and the human struggle of those risking their daily comforts and lives to aid them.