Patrick Radden Keefe (2021)

If there was ever a story that demonstrated one rule for the rich and another for the poor, this is it.

The Sackler dynasty has had a huge social prominence, with its name adorning university medical research institutes and wings of art galleries. The wealth all came from selling oxycontin, one of the most potent painkillers available and a boon to many with chronic pain. Their innovation was to own the company that developed a slow-release mechanism to allow a morphine derivative to be delivered orally. All this is a great service to humanity.

But… In Keefe’s telling, the way oxycontin was sold made no attempt to ensure that it wasn’t being over-prescribed or abused, and indeed targeted doctor and pharmacists who were clearly off-loading more pills that their communities could possibly need. And it’s hard to believe that the company didn’t know this, given that they’d also been early investors in medical information collection and analysis that could spot such patterns. The rest of the story degenerates into legal wranglings designed to keep the Sackler name out of any court decisions and away from personal blame.

It’s a troubling history that taints what should have been a clear and welcome medical breakthrough by the search for enormous profits by any means.

5/5. Finished Tuesday 6 September, 2022.

(Originally published on Goodreads.)

Carlo Levi (1945)

An autobiographical tale set in a minimally-disguised corner of southern Italy, in which an anti-Fascist activist is sentenced to internal exile. And it really is an exile for a cultivated and urbane man who finds himself in a peasant community that’s radically different to his experience: almost a different country.

In many ways this is a study of how two different cultures can co-exist almost side-by-side and yet touch only in the most minimal and superficial ways. The peasantry have a fatalistic view of their lot, assuming they’ll be mis-treated and used by the rich; the richer members of the villages see themselves as far above the norm; while the visitor from outside remains long enough to uncover the petty jealousies and insecurities of people desperately trying to achieve and maintain their position within a strictly limited environment. The only real way to rise is to leave, to go to America and then either send home money or return and become – hopefully – someone of distinction.

There are some comic insights into how little Fascism actually penetrated into the heartlands of Italy, and how many were willing to unofficially look the other way as Levi practices as a doctor (despite being forbidden to do so) while demanding that he respects the other, most trivial, aspects of his exile. The village already has two doctors, who charge more than the peasants can afford for their services (and so remain poor themselves) but who are both determined to protect their positions – one is tempted to say to the disadvantage of their fellow villagers, but of course they don’t see the peasants as “fellows” at all. A perception of social position locks everyone into place, unable to co-operate to improve things or to influence the outside world to bring help.

4/5. Finished Monday 5 September, 2022.

(Originally published on Goodreads.)

Ananyo Bhattacharya (2021)

Not so much a biography of the man (although there’s plenty of that), but of his work and the major activities going on in maths and computing to which he contributed.

It’s almost impossible to comprehend how influential Von Neumann was to mid-twentieth-century science. He seemed to be able to see where the next set of major problems were going to appear, and then lay the groundwork for them – only to have shifted on to some new problem by the time others caught up. He was “first” into game theory and cellular automata, and early (though definitely not first) into computing. He made enormous mathematical contributions to the Manhattan Project. He also seems to have been quite at home at Princeton’s Institute for Advanced Study, which many others have described very negatively in terms of the new work accomplished there. Perhaps that was a feature of being an exile: he had to be self-contained and able to take his work anywhere with him.

4/5. Finished Thursday 1 September, 2022.

(Originally published on Goodreads.)

John Carreyrou (2018)

A history of the Theranos blood-testing scandal.

Theranos was once the hottest Silicon Valley property. There seem to have been several reasons for this, one of which was not its technology, which was largely undemonstrated and unproven – and which turned out to be entirely fictitious (or “vapourware”, in software terms). But it had a charismatic CEO who self-consciously fashioned herself on Steve Jobs, and an origin story phrased in terms of “disrupting” an existing industry that was worth billions. That, it seems, was enough.

This is really a story of how a weird corporate culture managed to silence its critics within and without. Those within often knew something was wrong, especially those with experience in other start-ups. Those without were either threatened or bought off. But it’s shocking to what extent many senior people seemed quite content to represent, advise, and profit from a company while being contentedly ignorant of what its product actually was.

The executives in charge have faced the courts, and their defence seemed largely to be that “fake it ‘till you make it” was a valid new-economy strategy. I have some sympathy with the idea, and they certainly weren’t the first group to try it. Where they were perhaps more innovative was in trying this with a healthcare device, probably the most regulated business niche and not a place to attempt a fraud. Perhaps their enthusiasm ran away with them, but there’s plenty in this book that illuminates shady practices and ruthlessness that don’t make them look at all sypathetic.

4/5. Finished Tuesday 30 August, 2022.

(Originally published on Goodreads.)

Jeremy Farrar (2021)

I wonder if this book was too early: were we sufficiently out of the coronavirus pandemic to assess it and our healthcare systems’ abilities to deal with it? Perhaps. But this is a good look at the early days from the perspective of the Wellcome Trust, one of the world’s biggest medical charities.

4/5. Finished Sunday 28 August, 2022.

(Originally published on Goodreads.)