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DO HARM: The Book That Began with a Word I Did Not Know

I am not a physician. I have never cultured a specimen, read a chest film, or signed a death certificate. I trained as a dramatist at Columbia, in the Oscar Hammerstein II Center, which qualifies me to tell you how a scene builds and not much else about a hospital. So let me get the obvious objection out of the way early, because it is the first thing a serious reader should ask. What business does a playwright have writing a book about hospital-acquired infection? The answer is the whole book, and it starts in a shut room in Newark in 2002.

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Enthymemes: The Argument You Finish Yourself

“Because you’re worth it.” Four words, running in L’Oréal advertising since 1971, and by the time you reached the period you had already done the heavy lifting. No one told you that personal worth justifies the purchase, that expensive cosmetics are how worth gets expressed, that you in particular qualify for the category. You supplied every one of those claims yourself, silently, in the half second the slogan allowed. The advertiser handed over a conclusion and trusted you to build the staircase leading up to it.

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The Goldfish Never Said That

A fabricated statistic taught a generation to believe their minds had broken. The truth about attention is stranger, and it names a culprit nobody wants to indict. Picture the goldfish. You have met it a thousand times, in conference keynotes and morning television and the opening line of ten thousand blog posts. It swims in its little bowl of received wisdom and carries one damning number on its back: nine seconds of attention, a full second longer than the modern human animal. We hold nuclear codes and write string quartets, and we supposedly lose the thread after eight seconds while the fish swims on, victorious. The crown of creation, outconcentrated by a snack with fins.

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One Eighth of an Inch: Julian Jaynes, the Bicameral Mind, and the Bandwidth of God

Start with a measurement, because the measurement is where the famous theory hides its best secret. In The Origin of Consciousness in the Breakdown of the Bicameral Mind, published in 1976, the Princeton psychologist Julian Jaynes had to explain how one half of the brain could hand a finished thought to the other half. He reached for anatomy and found a strip of nerve fiber connecting the two temporal lobes, the anterior commissure, which he measured at slightly more than one eighth of an inch in diameter. That tiny bridge, he proposed, carried the voices of the gods. The width of the channel is the whole argument, and almost everyone who summarizes Jaynes leaves it out.

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One Thirty Over Eighty: How America Lowered the Hypertension Line While Europe Held Steady

A single edit to a single table turned tens of millions of healthy Americans into patients overnight. The question is whether the line was drawn for them or for the people who bill them. In November of 2017, the American College of Cardiology and the American Heart Association released a clinical guideline that ran to roughly four hundred and eighty pages, and somewhere in the front matter they moved a single number. The threshold for diagnosing high blood pressure fell from 140/90 to 130/80. Nobody’s artery changed that day. No chest tightened, no vessel narrowed, no symptom appeared. And yet, by the arithmetic of that one revision, about thirty-one million Americans who had been healthy the previous evening were now classified as having a chronic cardiovascular disease. National prevalence of hypertension climbed from near thirty-two percent of adults to near forty-six percent between one edition of a document and the next, and among adults under forty-five the rate more than doubled. Nothing about the population’s arteries had changed; only the boundary of the word had moved.

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The Vacuum Where the Evidence Should Be

Zach Bush, a physician in good standing, sits across from an interviewer and describes the soul, calm and fluent, generous with wonder. He says that every millionth of a second the atoms of your body dissolve and return, that a single fertilized cell organizes itself into a child by reading a map no biologist can locate, and that the map lives in the vacuum, in the electromagnetic field that fills the empty space inside every atom. He calls this the anatomy of the soul. In a 2021 essay on his own website he writes that the body projects itself as a hologram, and that its apparent solidity is an impression made by light. The performance is seductive because the vocabulary is real. Differentiation, migration, electromagnetic field, vacuum: each of those words has a home in a textbook. The trouble begins the moment you check whether they are being used the way the textbooks use them, or whether they have been borrowed to dress an idea that biology and physics both reject.

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Still Eating Your Patients

Seventeen years ago I asked whether every veterinarian should be required to be a vegetarian. The question has sharpened since then. The right word now is vegan, because the line between dairy cow and veal calf is no longer plausibly deniable, and because the climate science on animal agriculture has overrun the old fence between eggs and the slaughterhouse. The provocation in 2009 was short, almost a snapshot of a paradox. A profession that swears to relieve animal suffering, going home from the clinic and ordering bacon. The post received twelve comments, a few sympathetic, a few cautious, and then it slept on the page while the world kept slaughtering animals at industrial scale. The question never left me.

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