Extra Life | Steven Johnson

Summary of: Extra Life: A Short History of Living Longer
By: Steven Johnson


Delve into the fascinating world of ‘Extra Life: A Short History of Living Longer’ by Steven Johnson, which unravels the foundations behind humanity’s fight against death and disease. This book summary uncovers the amazing discoveries, tireless innovators, and key turning points in extending human lives. Explore the unique breakthroughs within vaccination, food safety, pharmaceutical regulation, anti-bacterial medication, and vehicular safety. Join us as we shed light on the complex interactions, strategies, and efforts that have contributed to humanity’s momentous successes in living longer.

Beyond Eureka: Vaccination’s Origins

Contrary to the simple narrative often portrayed, the practice of vaccination wasn’t born from a sudden stroke of genius. Its concept was built upon earlier techniques and practices, such as inoculation and variolation, that had been in use in Asia for a long time. Edward Jenner’s discovery of vaccination expanded upon these principles, and it was eventually popularized in Britain after Lady Mary Wortley Montagu encountered the practice in Istanbul. Over time, vaccination evolved into the life-saving technique we know today.

We may often hear stories of eureka moments behind world-changing inventions and discoveries. However, the truth tends to be more complicated and nuanced. The development and evolution of vaccination illustrate this perfectly.

While the widely-known tale of Edward Jenner discovering vaccination revolves around his observation that milkmaids had lower rates of smallpox, the story goes much deeper. He hypothesized that their immunity was linked to a previous exposure to a milder, similar illness: cowpox. But even before Jenner’s experimentation, the concept of using diseases to build immunity wasn’t new.

A procedure called “inoculation” had been practiced in Asia for a long time, possibly even millennia. Specifically regarding smallpox (or variola major), the process was referred to as “variolation”. Inoculation and vaccination differ in their approach to inducing immunity – the former uses live strains of the actual virus, while vaccination employs a less harmful yet similar pathogen. By modern standards, some ancient practices of inoculation might seem bizarre, like the Chinese technique of administering powdered smallpox scabs through nasal insufflation. However, the underlying principles held merit and served as the foundation for future developments.

The idea of variolation made its way to Britain through Lady Mary Wortley Montagu, an aristocrat who had encountered the practice in Constantinople (present-day Istanbul). Her eagerness to share this technique played a significant role in catalyzing its adoption in Europe. Without her advocacy, Jenner’s groundbreaking idea might not have emerged, and vaccination as we know it might not have come to be.

Over the following centuries, vaccination continued to advance and eventually established itself as a global life-saving measure. By the 1980s, the success of vaccination programs reached a milestone with the eradication of smallpox worldwide. This achievement not only symbolized the triumph of Jenner’s discovery but also recognized the vital contributions of preceding ideas and practices that laid the foundation for modern vaccination.

Making Milk Safe

Though milk seems innocent, it was once perilous, causing many infant and child deaths in the 1800s due to contamination. Cows were kept in cramped, unsanitary conditions and fed swill, which led to diseases that spread to their milk. Pioneering journalist Frank Leslie initiated a campaign against this unchecked hazard, eventually prompting reforms in the dairy industry. However, despite knowing that pasteurization could eliminate disease-causing microbes, the method was only widely adopted in the early 1900s after political agitation and government regulations made it mandatory. This illustrates the critical role of dedicated proponents in advancing life-enhancing ideas.

Impact of Strict Regulations

The US Food and Drug Administration (FDA) stands tall today as a powerful authority responsible for regulating food and drug production and sales. Its transformation from a weak organization to an influential authority can be traced to the 1960s, during the career of Frances Oldham Kelsey. Kelsey played a pivotal role in exposing the dangers of thalidomide, a drug responsible for serious birth defects in infants. Her vigilant actions and the resulting public outcry led to the strengthening of the FDA, making medicine progressively safer and effective.

The present-day FDA is a mighty regulatory body with extensive powers to control the production and sale of food and drugs in the United States. However, the organization had less authority and was relatively weaker until the 1960s. A significant turning point was the impact of Frances Oldham Kelsey’s work at the FDA, starting in 1960. As one of the three medics within the organization, Kelsey was responsible for assessing new drugs for safety, an endeavor that would significantly alter the pharmaceutical industry’s future.

During Kelsey’s time, strict regulations were established, making medicine safer and more effective. In 1960, the FDA reviewed drug safety profiles within 60 days, after which manufacturers could freely sell their product. More importantly, demonstrating a drug’s effectiveness was not required – if the drug caused no harm, it could enter the market.

Frances Oldham Kelsey faced a critical test when she began reviewing Contergan, a drug containing thalidomide for treating anxiety, morning sickness, and insomnia. Kelsey found the drug’s safety information inadequate and requested further investigation. In the following months, while Kelsey and the FDA faced pressure from the manufacturer, distressing reports surfaced linking thalidomide to nerve damage and severe birth defects in babies.

Thalidomide caused over ten thousand children worldwide to be born with malformed limbs while many others died in utero or as newborns. Kelsey’s cautious approach averted a tragedy in the United States, where the drug remained unlicensed.

This disaster prompted the public and lawmakers to demand evidence-based medicine, discarding the carelessness and fraudulence of preceding times. Congress bolstered the FDA, mandating drug companies to provide proof of a drug’s effectiveness in addition to its safety. The transformation initiated by Frances Oldham Kelsey has led to the formidable FDA we know today – an organization committed to upholding the highest standards of safety and efficacy in food and medicine.

Penicillin: A Cooperative Triumph

For centuries, humans have struggled against bacterial diseases like tuberculosis, which caused a quarter of all deaths in the nineteenth century. The discovery of penicillin and antibiotics marked a turning point in this battle, but contrary to popular belief, it was not just the work of Alexander Fleming. Instead, it was a collaborative effort among Fleming, Ernst Boris Chain, Howard Florey, and Mary Hunt. Their individual discoveries and contributions allowed penicillin to become the life-saving medicine it is today.

Bacteria have been a persistent threat to human health, leading to diseases such as tuberculosis that claimed countless lives throughout history. The tides began to shift with the discovery of penicillin and other antibiotics. Contrary to a simplified tale of chance, the story of penicillin is one of collaboration and persistence.

While it’s true that in 1928, Scottish scientist Alexander Fleming accidentally discovered the antibiotic properties of penicillin mold, his findings were only the starting point. He observed that a mysterious mold had stopped the bacterial growth on his sample, hinting at the potential of this substance to battle infections that had plagued humanity for eons.

Taking Fleming’s discovery further, two Oxford scientists, German-Jewish refugee Ernst Boris Chain and Australian Howard Florey, recognized penicillin’s potential. They conducted animal and human trials and eventually brought the project to the US during World War II. Its life-saving capabilities garnered massive interest from authorities.

Another unsung hero in this collective effort is bacteriologist Mary Hunt, known as “Moldy Mary.” She understood the challenge of producing penicillin at scale and searched extensively for mold samples that could reproduce more efficiently. Her determination ultimately led her to find the perfect strain in a decaying supermarket cantaloupe.

Almost every strain of penicillin in use today can be traced back to that very cantaloupe. This remarkable story highlights not just the initial discovery by Alexander Fleming but the invaluable contributions and cooperation among scientists that unleashed the full potential of penicillin, saving countless lives worldwide.

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