Nicholas's Reviews > Survival of the Sickest: A Medical Maverick Discovers the Surprising Connections Between Disease and Longevity

Survival of the Sickest by Sharon Moalem
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Jul 27, 2011

really liked it
Read from July 26 to 27, 2011

This book reminds me very strongly of Freakonomics. I don't know about Dr. Moalem being a "maverick," but he does take the unconventional approach to dealing with common health problems by looking at how our most common and serious ailments (heart disease, obesity, skin cancer and vitamin d deficiencies for example) are a consequence of our evolutionary lineage. Moalem does a great job at walking the fine line between the nature vs. nurture debate.

Where this book succeeds is in getting us to look at our health problems as an admixture of the decisions we make and who we are and where we come from. It makes absolute sense to start looking at disease and treating diseases on a custom level with cures and preventative care designed around and tailored to the genetic predispositions of certain individuals. Does that mean we treat people of different races differently? Oooooooh. In the post-Civil Rights era that seems like a huge political no-no, but on a genetic level it makes sense. What is race anyway? Current science has shed a huge spotlight on the glaring problems of treating people as different expressions of humanity simply based on superficial characteristics like skin color, but the genetic heritage of people from different environments all around the globe do have some variation that makes them predisposed to certain types of health problems. The main issue is this: our ancestors evolved some trait that would help them survive some environmental pressures in the distant past. Those pressures, like starvation and ice age temperatures, are not necessarily manifest in the industrial West any more, so those adaptations now present liabilities to us. In some cases. It's an interesting way to look at disease. In my opinion it should be THE way we look at and focus on preventative care for disease. It's the equivalent of taking the long look versus the short look and I think our medical science needs to evolve in that direction.

This book could have been organized better. The beginning sets a template for looking at different cases of evolutionary history through the lens of specific diseases. What follows seems more like anecdotes and Snapple facts about evolution and natural selection and general genetic biology than an organized work driven by a thesis. Maybe that's not the point. Moalem sums up things in his very brief conclusion by stating that this is a book of questions designed to get people thinking about our health in a radically different way. He succeeds. Along the way there's a lot of interesting trivia from physiology to natural history that makes the work pretty engaging. Moalem has a quirky writing style that sometimes works, but it felt like sometimes his humor fell pretty flat. He ends several sections and chapters with proverbial jokes or cheesy lines that are so bad you can almost hear the crickets, but it's fun, unpretentious and not stuffily academic. There is real science in here as well and the book is well-researched. The theme reminded me of Gladwell's Outliers in the sense that Moalem feels like an investigator trying to pry up loose floorboards for secret influences on our current health. Unlike Outliers, I didn't get the sense that the author was cherry-picking his facts to suit his argument. The truth is, there is a lot buried in our genes that hold the keys to our health, longevity and our understanding of life in general. The earlier organization based on specific diseases with well-thought out evolutionary descents gives way around mid-book to chapters based on ideas or principles, which is a kind of confusing adjustment. Felt like it made me lose my rhythm a bit.

Overall the book is enjoyable, informative and insightful. There's nothing groundbreakingly or astonishingly different, but it's probably the only compilation of these facts and ideas in a digestible format for the public. Check it out if you're interested in your own health, public policy regarding health or just have an interest in evolutionary biology. You won't be disappointed.
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07/26/2011 page 100
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