Category: Science

Everybody Lies

Cover image for Everybody Lies by Seth Stephens-Davidowitzby Seth Stephens-Davidowitz

ISBN 9780062390875

“There was a darkness and hatred that was hidden from the traditional sources but was quite apparent in the searches people made.”

Big data has been much hyped as the next big thing in science, but Everybody Lies sets out to show what can be done with big data that wasn’t possible before, while also acknowledging its shortcomings, and the ways it can be complemented by traditional small data collection techniques. Seth Stephens-Davidowitz makes the argument that the Google dataset he has been working with is particularly valuable, because unlike even anonymous surveys, users have an incentive to be honest, and little or no sense of wanting to impress anyone. To get the information they want from Google, they must query honestly about even the most taboo subjects, from sex to race to medical problems. Facebook, for example, is not nearly as useful, because people are consciously presenting a certain version of themselves to their friends. But if you want Google to bring you back the “best racist jokes,” you have to tell it so. You can’t hide, and still get what you want. The result is a partial but unprecedented glimpse into the human mind.

I picked up this book to get the interesting facts that Stephens-Davidowitz learned from his analyses of this revealing dataset. That said, there is also plenty of basic introduction to data collection and research methodology, which might be a bit tedious for anyone who is already familiar with this material. However, I appreciated the attention to basics when it came to statistical analysis, an area where I don’t have the same background knowledge or experience. The author also spends a good bit of time trying to convince skeptics on one side that big data is useful, and on the other side, warning evangelists of the limitations. A big dataset can actually be an encumbrance if you don’t know what questions to ask of it. However, I sometimes took issue with the way the author tried to present information in an accessible way. Comparing a large dataset to your Grandma’s lifetime of collected wisdom is more harmful than helpful because only one of those things is based on verifiable numbers rather than impressions.

One subject that doesn’t get much attention in Everybody Lies is privacy. Stephens-Davidowitz notes that the Google datasets are anonymized, and that multiple sessions by the same user are not connected. He does reference an old Yahoo dataset that released the search histories of anonymized users, which enabled a different level of pattern detection between searches made by the same individual. Later in the book, he delves into the ethics of using pattern detection from large dataset in particular situations. For example, a study has been done that examines which words in a loan application—God, promise, will pay, thank you, hospital—are most indicative of a potential default on the loan’s repayment. This study used the loan application itself, but what if in the future your suitability for a job was calculated based on analyzing patterns in the language of anything and everything you’ve ever written publicly on the internet? This really only brushes the surface of potential privacy problems.

So what did Stephens Davidowitz find that was interesting? A methodology of approximating the percentage of American men that are gay that accounts for those who are in the closet more accurately than any previous estimate. A behind the scenes look at where and when racist searches are highest that might explain discrepancies between polling numbers and Obama’s actual election results. The one telling Google search that also best predicted the current president’s success in any given electoral district, regardless of public polling numbers. These are the fascinating glimpses into the human psyche that I came for, but I had to read through a lot of other information of questionable interest to get at them.

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Evicted

Cover image for Evicted by Matthew Desmondby Matthew Desmond

ISBN 9780553447446

“There are two freedoms at odds with each other: the freedom to profit from rents and the freedom to live in a safe and affordable home.”

Between 2007 and 2009, the American housing market was shaken by the subprime mortgage crisis, in which banks foreclosed on millions of homeowners who could not keep up with their rapidly inflating mortgage payments. But another group of people is deeply affected by the trauma of displacement on a more regular basis: the renting poor. Many of these families are spending between fifty and seventy percent of their monthly income on housing, and even a small crisis can easily cause them to fall behind on the rent, making them subject to eviction.  Sociologist Matthew Desmond takes the reader into two of Milwaukee’s poorest neighbourhoods, one predominantly white, the other mostly black, and spends eighteen months examining what happens when landlords evict those who have fallen behind on the rent.

Desmond begins on Milwaukee’s black North side, with the properties own and managed by a black couple named Sherrena and Quentin. Sherrena’s motto was “the hood is good,” and they regularly bought and rented out marginal properties that required more work that they could honestly keep up with to really be fit for habitation. They could regularly expect to collect $20 000 in rents on the first of every month. On the South side, Desmond examines a run-down trailer park owned by a man called Tobin, who attracted press attention because the park was so dilapidated that the city considered it an “environmental biohazard.” Despite this state of affairs, Tobin earned nearly half a million dollars a year from his property. Landlords can ask tenants to move out with only twenty-eight days’ notice, but when they are behind on the rent, an eviction notice may provide only one to five days’ warning before the sheriff’s deputies and a crew of movers show up to clear the home. The contents of the home are then deposited on the curb, or taken to storage and held for payment, driving the family further into debt.

A significant factor that emerges in both of the neighbourhoods Desmond examines is the presence of children. As a single mother with two sons, Arleen struggled terribly to find a new place to rent that would accept her children. When Pam and Ned were evicted from Tobin’s trailer park, they faced an even bigger dilemma. Pam had two daughters from a previous relationship, her daughters with Ned, and another baby on the way. No landlord wanted that many children causing additional wear and tear on the property. When an eviction comes, children often lose many or most of their possessions, miss or have to change schools, and are sometimes separated from their immediate families as they are shunted off to different relatives who can provide shelter while the parents look for a new home.

Desmond draws particular attention to the plight of black women, who face a disproportionate rate of eviction. Desmond points out that “If incarceration had come to define the lives of men from impoverished black neighborhoods, eviction was shaping the lives of women. Poor black men were locked up. Poor black women were locked out.” The problem is compounded by the fact that with so many men in jail, the women are frequently raising children alone. Black women with children are by far the most likely to face eviction. Unable to miss work or obtain childcare, they are often unable to attend housing court to contest their eviction. An eviction record then further decreases their likelihood of being able to secure housing in the future. If they choose to miss work to attend court, they may find themselves both homeless, and out of a job.

One very interesting aspect of the book comes not in the body of the work, but in the author’s note, where Desmond describes the process of researching and writing Evicted. He not only went into these neighbourhoods to conduct interviews, but actually lived in them, renting a trailer in Tobin’s mobile home park, and later moving in with an acquaintance on Milwaukee’s black North side. Most interestingly, the landlords were fully aware of what he was working on, and it actually seems as if they trusted him more readily than many of the tenants, some of whom believed that Desmond was probably an undercover cop, or maybe working for the landlord.

Evicted is a book that is largely about documenting the problem, and putting a human face on it. However, Desmond does offer some policy suggestions at the end of the book, such as expanding the housing voucher program, and providing a right to legal representation in housing court.  I was surprised by his support of housing vouchers, because earlier in the book he discussed how landlords overcharge by an average of $55 a month when they know that a tenant has a housing voucher. This means that the tenant pays up to 30% of their monthly income towards the rent, and the rest is paid for by tax dollars through the housing voucher. But Desmond does point out that this program is much more scalable than trying to build more public housing. The idea of representation in housing court made a lot of sense; Desmond describes how seventy percent of tenants do not even go to court, which means a default eviction, and ninety percent of those who do show up do not have a lawyer. This means that housing court, as it currently stands, essentially functions as an eviction assembly line. No doubt another entire book could be written about the possible policy solutions to the eviction problem.

Evicted offers a series of portraits of instability, of chronic poverty in a life with no centre or grounding. It chronicles the rise of eviction rates, and paints an empathetic portrait of the impact this constant uncertainty has on poor families. It also upends the notion that homelessness is caused solely by poverty, and examines the ways in which eviction can contribute to impoverishment. Desmond makes the case that housing is an overlooked issue in our efforts to address poverty, and asks the reader to consider what it means about our values if we refuse to confront this problem.

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Rest

Cover image for Rest by Alex Soojung-Kim Pang by Alex Soojung-Kim Pang

ISBN 978-0-465-7487-7

“Rest is not something that the world gives us. It’s never been a gift. It’s never been something you do when you’ve finished everything else. If you want rest, you have to take it. You have to resist the lure of busyness, make time for rest, take it seriously, and protect it from a world that is intent on stealing it.”

If someone told you that you could feel better while working less and getting more done, you would probably think they were selling snake oil, or at least methamphetamines. But in Rest, Alex Soojung-Kim Pang is making exactly that contention, while bringing the science to back it up. Pang’s core thesis is that rest and work are interdependent rather than opposing forces in our lives, and that this idea is backed up by psychology, neuroscience, and sports medicine. Pang cites a variety of scientific studies from around the world, on subjects such as sleeping, napping, exercise, and creativity in order to show how these activities—which occur outside of work—come together to profoundly influence productivity and creative thinking on the job. He also looks into the lives of figures like Charles Darwin, Winston Churchill, and Dwight Eisenhower, to show how they incorporated restful practices into their daily routines while also producing great work, or operating under extremely stressful circumstances.

Pang’s contention is not unique, and he isn’t the first person to call out the destructive nature of our sleep-deprived, always-on business culture. However, I did like the way he approached rest holistically. Sleep is an important part of the book, but Pang also examines routines, exercise, and hobbies, as well as vacations and sabbaticals to see how these others forms of taking a break from work affect our performance. He also demonstrates that it is not just doing these activities that is important, but also being mentally disconnected from work in the process. It is not that our society does not enjoy ample leisure time, necessarily, but rather than we make poor use of it. Pang extensively explored the digital aspect of that distraction in his previous book, so he does not touch on it much in Rest.

One section I found particularly interesting was the study of napping—as opposed to night-time sleep. While I was generally on board with Pang’s message that we need to rest more, and rest smarter, I have long been pretty anti-nap, because I always seem to wake up groggy and nauseous from mid-day sleep. But Pang includes a section on what studies show about optimizing napping (see page 121) to your circumstances, whether you want to feel more rested, process new learning, or be more creative when you wake. Apparently both the length and the timing of the nap are key, and the ideal time is between five and seven hours after waking up in the morning, which is a low point in the Circadian rhythm of the human body. Using that information, I took two successful naps after reading this book!

One of the most famous studies cited in Rest is K. Anders Ericsson’s famous study of Berlin violin students, the best of whom had accumulated about 10, 000 hours of deliberate practice at the time they were assessed. This study became famous after Malcolm Gladwell wrote about in Outliers. Gladwell has been frequently critiqued for his oversimplification and selective use of Ericsson’s study. Here Pang highlights another part of Ericsson’s work Gladwell ignored, namely that the best students tended to sleep more, and often took afternoon naps. Deliberate practice took a lot of mental effort, and sleep helped them to consolidate the learning and benefits of that practice. The students also recognized that there was a limit to the amount of deliberate practice they could do in a day, and that continuing beyond that point was not useful.

Though Pang cites a variety of studies by a diverse group of researchers, I did notice that his examples always tended to be white men, usually scientists and executives. Pang has enough insight to note that women can particularly benefit from vacation, for example, because it can relieve them of household and childcare responsibilities, in addition to their work duties, but beyond such passing references, he seems to have little interest in exploring how this research could be relevant to, or exemplified in, the lives of women. This is not to say that there are no women examples, but they tend to be passing, as opposed to the more in-depth profiles of Darwin and Eisenhower.

Although Pang’s thesis is not unique, he provides a good overview of studies in a variety of interconnected realms that contribute to a well-rounded approach to rest and its relationship to productivity. I see in this book the outlines of the best parts of my daily routine, largely discovered through trial and error. But the keys are here for the taking, if you haven’t already discovered them elsewhere.

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Being Mortal

Cover image for Being Mortal by Atul Gawandeby Atul Gawande

ISBN 978-0-8050-9515-9

“Death, of course, is not a failure. Death is normal. Death may be the enemy, but it is also the natural order of things.”

In 1945, most Americans died at home. By the 1980s that number was down to 17%. Today it is trending back upwards as more people pursue options that allow them to live out their final days in the comfort of their own homes. Doctor and writer Atul Gawande explores how dying became medicalized in the intervening years, as science offered new innovations for beating back disease in the 20th century. Encompassing both the elderly and the terminally ill, Gawande examines how end of life care falls short of providing patients with the best possible quality of life in their final days, instead focusing on what else can be tried to fix the unfixable, and beat back the inevitable. From nursing homes to cancer wards to assisted living facilities to hospice care, Gawande reveals the shortcomings of the institutions we have created for the dying, and asks how we can be better prepared to face the question of mortality with clear eyes and compassion.

Atul Gawande’s previous books Better and The Checklist Manifesto both make it amply clear that he takes continuous professional improvement extremely seriously. In Being Mortal, he examines how society and the medical system can improve the treatment and care of elderly and terminally ill patients. Using the case of his wife’s grandmother, he shows how North American nursing homes commonly fall short, by focusing on safety rather than quality of life. Turning to his own grandfather in India, he shows some of the comparative advantages of multi-generational in-home care, but also highlights the inter-generational conflicts and tensions that can arise from this living situation. In the end, he concludes that both models fall short of providing the elderly with the level of control they need to have over their lives in order to be happy.

Gawande is wary of over-idealizing care provided by children in their homes for their elderly parents. In addition to his own grandfather, he uses the case of Shelley and her father Lou to show the stresses and tensions that this can result in. However, many people feel that this model is the ideal, and it is commonly argued that the decline of children caring for their parents indicates a lack of respect for elders in North American culture that comes from the veneration of youth. But Gawande has a slightly different take. He argues that what is being venerated is not youth, but the independent self, and both nursing homes and living with one’s children degrade that independence which is so central to the North American identity. But this way of thinking offers up a question that has been insufficiently answered: “if independence is what we live for, what do we do when it can no longer be sustained?”

Gawande talks about patients, both his own and those he meets in the course of his research, talking with geratiatricians and hospice care workers. He also draws on examples from his own life. Early in the book, he discusses the situation of his wife’s grandmother, Alice Hobson, who lived independently for many years, but eventually began having falls that made it too dangerous for her to continue living alone. She ultimately ending up in a nursing home she despised. Later, after he has explored the nuances of geriatric and hospice care, Gawande approaches the case of his own father, who was discovered to have a slow-growing tumour in his spine when he was in his seventies. His father’s case shows Gawande putting his new skills to use, but equally demonstrates that life is complicated and unpredictable, and that even with this knowledge, the end of life will not necessarily be ideal. Gawande is offering hope and help, not a magical solution that will make every difficult situation easy.

Being Mortal is a book that is important for young and old alike. For those facing choices about where and how they will live in their last years, Gawande offers food for thought about the different options available. Younger readers will be better prepared to navigate these conversations with their parents. And of course, anyone of any age can find themselves faced with an unexpected illness that catapults them into facing their own mortality sooner than they might have wished or planned. Readers will emerge with a better understanding of the warning signs of decline that can severely limit independence, the factors that most affect satisfaction with elder and hospice care for the patients, and questions to use in discussions with doctors and loved ones.

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Lab Girl

Cover image for Lab Girl by Hope Jahrenby Hope Jahren

ISBN 9781101890202

“Science has taught me that everything is more complicated than we first assume, and that being able to derive happiness from discovery is a recipe for a beautiful life.” 

The daughter of a community college science professor, Hope Jahren always felt at home in the laboratory, playing there while her father worked. After obtaining her PhD from UC Berkeley, she would go on to become a geobiologist, founding multiple laboratories, and winning honours from the Fulbright to the Young Investigator Medal. Part memoir, and part science, Lab Girl shares Jahren’s experiences from graduate school to tenured professor, and all the bumps along the way, including funding cuts, bipolar disorder, and changing institutions.

Lab Girl began its life as a text book, but Jahren found herself unable to separate what she had learned from how she learned it. So it became a memoir, and Jahren’s chapters alternate between describing her life and work, and waxing poetic about trees, plants, and nature more generally. When she reveals, late in the book, that she also writes poetry, it comes as no surprise. With her descriptions, she is able to make processes like photosynthesis and flowering both beautiful and interesting. Through her words you can fully appreciate the stunning feat that is a plant’s ability to make sugar out of light, or that fact that a tree that is one of the few living things—flora or fauna—that can stand motionless through a cold winter, and not die. Using the metaphor of the struggle a seed undergoes to become a plant, Jahren chronicles her own struggle to grow into a scientist, in a profession where money is short, and women are not always welcome, and others don’t always see the significance of what you are doing.

Jahren’s relationship with her parents is distant and cool, even as she describes her father as the inspiration for her interest in science. After the chapters on her childhood, they are rarely mentioned again. She does eventually marry, but she meets her husband late in life, and even then he features little in the text. The primary relationship in Lab Girl, and one of the most interesting parts of the story, is the decades long friendship with her lab assistant Bill. The two met when Jahren was a PhD student and teaching assistant, and Bill was an undergraduate. He is an odd but compelling character, and a constant in Jahren’s life as she moves from Georgia Tech to Johns Hopkins to the University of Hawaii. After they completed their degrees at the same time, Bill followed her to Atlanta to work in her first lab, and has remained her right hand ever since.

Another clear theme that emerges in Lab Girl is the ongoing difficulty of funding scientific research, particularly research that does not have any immediately identifiable practical application. A huge part of Jahren’s job is not doing the science or teaching she was hired for, but writing grant applications to ensure the continued operation of her lab, and the salaries of Bill and their ever-changing cast of student assistants. Without money, there is no science, and though Jahren secured a salary for herself, universities do not generally pay for labs, beyond some start-up funding for new professors. Jahren even slips a line into the book apologetically soliciting patrons, adding that she would be “absolutely crazy” not to include it.

I listened to Lab Girl as an audiobook, which Jahren performs herself, reading in a soft voice with a few pleasant traces of her Minnesota childhood. Her voice is quiet and unassuming, until she comes to the more difficult parts of the text, such as describing her struggles with mental illness. Then her voice overflows with emotion, giving the audiobook a personal touch that would not have been possible if it was performed by a voice actor. It perfectly embodies the way Jahren blends the personal and the scientific.

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Black Man in a White Coat

Cover image for Black Man in a White Coat by Damon Tweedyby Damon Tweedy

ISBN 978-1-250-10504-2

“When I started medical school and learned about the adverse health outcomes that afflicted black people, I had assumed these disparities were chiefly due to genetics. To be sure, there are diseases like sickle-cell anemia, lupus, and sarcoidosis, which appear to preferentially target black patients at a biological level. But what had become abundantly clear to me during my years in medical school and as a doctor, however, were the many ways that social and economic factors influence health, and, more than anything else, account for the sickness and suffering that I have seen.”

The son of a working class African-American family from Maryland, in 1996 Damon Tweedy accepted a scholarship to Duke University Medical School. As he began learning about various diseases and conditions, he was soon bombarded by a familiar refrain: “more common in blacks than in whites.” Tweedy initially assumed these problems were genetic vulnerabilities, but his experiences soon led him to realize that social and economic factors were, in most cases, much more significant, and in turn these factors play out “along racial lines.” Initially intent on avoiding drawing any attention to his race, Tweedy instead becomes interested in reducing these disparities.

Tweedy divides his books into three parts, proceeding chronologically, first from his medical training at Duke, onto his internship, and then into his practice as a psychiatrist. Each stage presents new challenges. As a student, one of his professors mistakes him for a maintenance worker come to change the lights in the lecture hall, then tries to pretend that the error never occurred. In medical school, Tweedy must balance the well-being of his black patients against the problems that might be caused if he confronts his superiors. He is relieved, in one case, when the supervising doctor is the one to challenge a white nurse who asserts that a nineteen-year-old black woman who suffered a placental abruption after smoking crack cocaine should be sterilized. Later, in his own practice, he confronts new challenges, such as treating a biracial woman who is afraid of black men because of how her black father treated her white mother.

As a scholarship student, Tweedy starts out with an inferiority complex, afraid that people will think he does not deserve to be in medical school. He fears anything that will draw attention to his race, and cringes at every mention of racial medical statistics. This initial fear tempers somewhat, but it leads to his very cautious and measured approach in this book. Tweedy largely skirts around more controversial topics such as the war on drugs and discriminatory policing, both factors which contribute to the shortening of black lives.

Through a more personal lens, Tweedy also examines his own health problems. He discovered his high blood pressure when he and a classmate were practicing taking vital signs in their first year of medical school. A follow-up visit to the doctor also revealed early signs of kidney failure, prompting Tweedy to rethink his diet and exercise routines. This helps him relate very personally to the difficulty patients have making lifestyle changes for the sake of their health. But while he realizes that his own blood pressure and blood sugar are more important health metrics than his weight, since he remains naturally thin throughout, he doesn’t seem to extend this insight to patients, often remarking on their weight. He also fails to stand up for a black patient who wants to try lifestyle changes before going on blood pressure medication, afraid that he will be considered a racial agitator if he challenges the other doctors.

This book felt particularly relevant at the time of reading, as news went viral of a Delta flight attendant refusing to believe that Tamika Cross, a Texas obstetrician and gynecologist, was a doctor. Tweedy’s experience makes it abundantly clear that there are disparities for black doctors and patients alike, and that they play out in subtle ways throughout the medical system, but add up to a large gap in care. What is less clear is the path forward. The Affordable Care Act is acknowledged as something that may help some patients, but not enough. Nor does Tweedy feel that every black patient needs a black doctor; he more than once trips over his own assumptions about black patients, and encounters skepticism of his credentials among both black and white patients. But his stories provide a window for issues that deserve broader consideration.

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Hidden Figures

Cover image for Hidden Figures by Margot Lee Shetterlyby Margot Lee Shetterly

ISBN 978-0-06-236359-6

“Unless an engineer was given a compelling reason to evaluate a woman as a peer, she remained in his blind spot, her usefulness measured against the limited task at hand, any additional talents undiscovered.”

The quick marketing description of Hidden Figures touts this book as the story of the black women mathematicians of NASA, who helped put men on the moon. But Margot Lee Shetterly’s narrative begins long before that. During World War II, women were entering the workforce in unprecedented numbers, pulled into the vacuum left by men departing to serve in the military. Many of the black women who would go on to play significant roles in the space race began their careers in the segregated West Computing department of the National Advisory Committee for Aeronautics (NACA) on the Virginia Peninsula. In those days, computers were people, not machines, and the insatiable demand for bright mathematical minds cracked the door for black women to enter the agency that would one day become the National Aeronautics and Space Administration (NASA).

Author Margot Lee Shetterly grew up on the Virginia Peninsula, her father one of the many African Americans who worked for NASA’s Langley Research Center. This was so common in the area that during her childhood, Shetterly took it for granted that “the face of science was brown like mine.” But on a return trip home to visit her parents during adulthood, she began to realize how remarkable her community really was. She peppered her father with questions about his early days at Langley, and began interviewing women from their church who had worked as computers in the early days. By the time she finished Hidden Figures, Shetterly could “put names to almost fifty black women who worked as computers, mathematicians, engineers, or scientists at the Langley Memorial Aeronautical Laboratory from 1943 through 1980.”

Shetterly focuses on three main figures, including Dorothy Vaughn, Mary Jackson, and Katherine G. Johnson. For most people, the last name is the only one that might be familiar, particularly after she was awarded the Presidential Medal of Freedom in 2015. Shetterly touches briefly on many other women who worked for NACA and NASA, and in the later part of the book, brings in Dr. Christine Darden, representing the next generation of black women who were able to take advantage of the advances made by their predecessors. She follows Dorothy Vaughn from being a member of the West Computing pool, to head of that department, to overseeing its dissolution when the creation of NASA finally desegregated the computers. After beginning her career as a teacher, Katherine Johnson joined the computers in 1953, before going on to calculate launch windows and trajectories for several of America’s first space flights.

Meanwhile, Mary Jackson’s story in Hidden Figures always seemed to be building but never quite as centered as it could be. This made a great deal more sense when I arrived at the epilogue, and learned that Shetterly had to cut the section she had intended to include about Jackson’s later career. After notably achieving the title of engineer, in 1981 Jackson took a pay cut to move across to human resources, where she focused on ensuring equal employment opportunities for women and minorities at the agency. Shetterly recounts some of this in the epilogue, but I very much wished to read the complete chapter on the subject that was cut from the manuscript.

Throughout the narrative, Shetterly balances the math and science with the personal stories of the women. But she is also adept at counterpointing the developments at Langley and the career trajectories of the women with events in the United States at large, particularly as it pertains to the Civil Rights movement. In the space race against the USSR, the continued segregation and inequality of African Americans was on international display, undermining America’s stated ideals. While activists were being dragged off buses and beaten at lunch counters, the black computers were quietly fighting against segregated cafeterias, colored bathrooms, and the difficulty of achieving titles and paygrades commensurate with their education, acknowledgements that were automatically granted to their white or male peers. Shetterly deftly places all of this in context with the larger movements of history.

Shetterly has a writing style that leans more towards the academic than to narrative non-fiction. The documentation includes hundreds of notes, and ten pages of bibliography. Hidden Figures is as much science as anthropology. For that reason, I also look forward to the release of the film that will help bring these amazing women to life for those who might not be as interested in reading the in-depth details of math and engineering, but who still need to hear this story.

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The Man Who Wasn’t There

Cover image for The Man Who Wasn't Thereby Anil Ananthaswamy

ISBN 978-1-101-98432-1

“But in the devastation are clues to what makes us who we are. These maladies are to the study of the self what brain lesions are to the study of the brain: They are cracks in the façade of the self that let us examine an otherwise almost impenetrable, ongoing, unceasing neural process.”

What is the self? This is an old and difficult question at the intersection of religion, philosophy, psychology, and neuroscience. By investigating Alzheimer’s disease, autism, body integrity identity disorder, Cotard’s syndrome, and schizophrenia in turn, Anil Ananthaswamy is able to show how the disruptions these conditions cause can illuminate the illusive concept of self, which can be so difficult to examine when it is functioning seamlessly. Through interviews with patients as well as their caregivers, Ananthaswamy offers insight into the phenomenology of these conditions, interspersed with lucid explanations of the most current scientific thinking.

The Man Who Wasn’t There explores neuroscience of the most fascinating and mind-bending sort. Ananthaswamy does begin with the most dramatic of the conditions he is exploring, Cotard’s syndrome, in which the patient believes herself to be dead. But in general this is a very sober and analytic investigation. Ananthaswamy is delving deep, and his explanations are detailed; he is willing to dig into nuance rather than oversimplifying matters. He has a tendency to interleave explanations and examples, which can make for some circular reading, since the science is often best understood once the example is in hand.

The crucial thing about this book may be that it doesn’t assume we have all the answers about what the self is and how it works. Instead, it is about questioning our assumptions. Again and again, it asks, what does this condition tell us about what we currently believe to be true? How does this affirm or challenge our current thinking or our intuitions about the self? For example, why is it that people with schizophrenia can tickle themselves? On the surface, this would seem to be an unusual but not particularly noteworthy phenomenon. But The Man Who Wasn’t There digs into such little quirks, and shows how they might connect to a larger impairment of the sense of agency, which can lead patients to feel that they are not the source of their self-generated thoughts or sensations.

One of the things I appreciated about this book was the focus on phenomenology, or the lived experience of the people who experienced the conditions Ananthaswamy is investigating. There are, of course, limits to this approach. He is necessarily speaking with people who have recovered—or never entirely lost—their ability to articulate their experiences. He also speaks with doctors, researchers, and caregivers, but does not rely on them exclusively when he can talk to the patients themselves. And in the new afterword to the paperback edition, Ananthaswamy speaks powerfully against the stigma we tend to attach to “illnesses that seem to be of the mind more than the body.” The Man Who Wasn’t There is integrative, fundamentally challenging this common sense of duality by showing how deeply the mind and body are connected.