Page 2 of 33

Posted on

Six Hundred Million Breaths

The first inhale, the last exhale, and the enormous unexamined middle. A human being spends nine months underwater and then, in a single violent second, becomes an air-breathing animal. We tend to picture that first breath as a natural unfolding, the lungs simply beginning what they were built to do. The reality is closer to a demolition. Before birth the lungs are not empty. They are filled with fluid secreted by the lung tissue itself, and that fluid has to go somewhere before air can enter. Labor begins clearing it. The surge of adrenaline and noradrenaline that accompanies delivery flips the epithelial cells lining the airways from secreting fluid to absorbing it, and sodium channels in those cells begin pulling the liquid back into the tissue and the bloodstream. The mechanical compression of the chest during a vaginal delivery squeezes out more. Even so, at the moment of birth the newborn faces a set of collapsed, wet sacs whose internal surfaces are stuck together by the surface tension of water, and it must pull them open with nothing but the muscles of its own chest and diaphragm.

Continue reading → Six Hundred Million Breaths

Posted on

The Plume and the Alibi

An answer to Caroline Fraser, whose book Murderland argues that lead and arsenic from the smelters of the Pacific Northwest helped produce the serial killers of the 1970s and 1980s. A reader sent me a fragment of an interview with you. You are asking why the Pacific Northwest produced so many serial killers, and you have arrived at smelters, at lead, and at a pair of graphs that lie on top of each other. You won a Pulitzer for Prairie Fires and you do not deserve a lazy reply, so here is the long one. One half of what you are saying is sound. The other half is rotten, and the rot is spreading into the half that deserves to survive.

Continue reading → The Plume and the Alibi

Posted on

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.

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

Posted on

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.

Continue reading → Enthymemes: The Argument You Finish Yourself

Posted on

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.

Continue reading → The Goldfish Never Said That

Posted on

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.

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

Posted on

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.

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