Survival of the Sickest: A Medical Maverick Discovers Why We Need Disease (Hardcover)

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Key Phrases: host manipulation, jumping genes, agouti gene, Younger Dryas, African Americans, Aran Gordon (more...)

Editorial Reviews

Amazon.com Review

Dan Ariely on Survival of the Sickest
MIT professor Dan Ariely has become one of the leaders in the growing field of behavioral economics, and his bestselling book debut, Predictably Irrational, has brought his ideas--and his ingenious experiments and charming sense of humor--to a much wider audience. With the simplest of tests (often an auction or a quiz given under a few conditions) he shows again and again not only that we are wired to make irrational decisions in many situations, but that we do so in remarkably predictable ways.

I have always been puzzled by the way in which genetic diseases have managed to survive throughout the ages. How could it be that these diseases were able to withstand the evolutionary process, where only the most fit survive, and continue to be transferred from one generation to the next? Survival of the Sickest provides a thought provoking yet entertaining explanation to this puzzle.

In this insightful book Dr. Sharon Moalem demonstrates how conditions that are considered unhealthy (such as hemochromatosis, diabetes, and high cholesterol), or even deadly in extreme cases, might actually put their carriers at an advantage in combating other life-threatening illnesses. For example, he explains that hemochromatosis, a disease that, if left untreated, will kill you, may have actually been a defense against the deadliest pandemic in history--the bubonic plague during the 14th century. It turns out that this genetic mutation, which continues to be passed down through generations, actually helped spare many lives at one point.

Throughout the book, Dr. Moalem draws many connections between seemingly disparate subjects, such as the accidental invention of ice wine and cold diuresis, in order to illustrate the basic mechanisms of genetics and medicine in charming and intuitive ways. He skillfully interweaves his knowledge of history, genetics, and medicine not only as they relate to specific medical conditions but also in a way that addresses important challenges of modern society and our future evolution.

In the most general terms, Dr. Moalem's description of the human body and its complexity left me in awe of how far we have come in our understanding of biology and medicine, while also being reminded that the road to understanding ourselves is still wide open with much more to learn in the decades, and even centuries, to come. It is a fantastic journey on which he leads us and Dr. Moalem is a kind, knowledgeable, humorous, and helpful guide.

From Publishers Weekly

Moalem, a medical student with a Ph.D. in neurogenetics, asks a number of provocative questions, such as why debilitating hereditary diseases persist in humans and why we suffer from the consequences of aging. His approach to these questions is solidly rooted in evolutionary theory, and he capably demonstrates that each disease confers a selective advantage to individuals who carry either one or two alleles for inherited diseases. But very little is new; the principles, if not every particular, that Moalem addresses have been covered in Randolph Nesse and George Williams's Why We Get Sick, among others. Whether he is discussing hemochromatosis (a disorder that causes massive amounts of iron to accumulate in individuals), diabetes or sickle cell anemia, his conclusion is always the same: each condition offers enough positive evolutionary advantages to offset the negative consequences, and this message is repeated over and over. Additionally, Moalem's endless puns and simple jokes wear thin, but his light style makes for easy reading for readers new to this subject. (Feb.)
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Product Details

• Hardcover: 288 pages
• Publisher: William Morrow; 1 edition (February 6, 2007)
• Language: English
• ISBN-10: 0060889659
• ISBN-13: 978-0060889654
• Product Dimensions: 9.1 x 6.1 x 1.3 inches
• Shipping Weight: 15.2 ounces (View shipping rates and policies)
• Average Customer Review: 4.6 out of 5 stars  See all reviews (78 customer reviews)
• Amazon.com Sales Rank: #86,781 in Books (See Bestsellers in Books)

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Customer Reviews

Most Helpful Customer Reviews

49 of 51 people found the following review helpful:

5.0 out of 5 stars Captivating and provocative, February 6, 2007

By	Avid Reader (London) - See all my reviews

If you're a fan of books like The Tipping Point and Freakonomics, I highly recommend Survival of the Sickest. It's full of the same kinds of fascinating insights that make for great cocktail party conversation. As a parent, I was particularly fascinated by the chapter on how what you eat during pregnancy can influence the way your children (and even their children) metabolize their food. And as a health conscious person, you'll get practical, actionable ideas on how to think about personalizing your diet based on your background.

36 of 38 people found the following review helpful:

5.0 out of 5 stars Captivating, April 21, 2007

By	B. McEwan "yellokat" (Brooklyn, NY USA) - See all my reviews (TOP 1000 REVIEWER)    (REAL NAME)

This book about genetics, evolution and disease is a genuine page turner, that's how deeply interesting it is, and how well it is written. The basic premise runs like this: The environment puts pressure on all living things, including humans, to evolve characteristics that help us survive long enough to reproduce and pass on our genes. Over the millenia, various conditions such as drought, ice ages and other climate changes have sparked genetic mutations that enhance our abilities to survive. These include some biological conditions that are advantageous in the short term, but sometimes detrimental in the long term.

For example, today we consider diabetes mellitus a serious disease because it raises human blood sugars to dangerous levels that can result in loss of limbs and sight, among other problems. However, in an ice age, when temperatures were significantly lower than they are now, having extra sugar in the blood may have enabled our ancestors to survive the cold because sugar lowers the temperature at which we freeze to death. Similarly, Sickle Cell Anemia may have evolved to help people resist malaria.

What's especially interesting is that this theory would explain why ethnic groups that are prone to diabetes -- Scandinavians and people from the British Isles, for instance -- originally came from northern areas that were at one time covered by glaciers. And the ancestors of those groups that tend to carry the genes for Sickle Cell generally originated from climates in which malaria was prevalent.

Another intriguing idea is that some "sicknesses" only become serious problems when an individual is older and past his or her prime reproductive years. So if one of our ancestors had, for instance, a chronic disease like diabetes, it probably wouldn't kill him/her until after the person had children.

There are many such fascinating observations and facts in this relatively short book and I highly recommend it to anyone who wonders how things and people got to be the way they, and we, are today.

23 of 23 people found the following review helpful:

5.0 out of 5 stars Eye Opening, February 22, 2007

By	haley - See all my reviews

You don't need a degree in evolutionary biology to understand Survival of the Sickest. This book gives you a peak into how evolution can actually select for disease, and makes a compelling case for why and how understanding this can shape the way disease is treated in the future. It also explains some fascinating facts - like how some Americans are immune to HIV because they have a mutation and how a person can rust to death but be saved by giving blood. It'll leave you thinking completely differently about your body, and - in some cases - like when it advises that you should take your sunglasses off for a few minutes when you get into the sun so that your eyes can "tell" your skin to be on guard against it, it'll actually affect the way you act.