The Edge of Life: Controversies and Challenges in Human Health
BWB Texts, $15.00,
BWB Texts is publishing a series of “Short books on big topics by great New Zealand writers” each month. They are edited by Geoff Walker and Denis Welch and so far have covered topics from politics and memoir to climate change and inequality. The difficulty facing any author of a little book on a huge subject lies in deciding the principles used to select topics for exploration and explanation. Mike Berridge, who is a research scientist at the Malaghan Institute, takes as his brief the challenges for the average reader in distinguishing between science and pseudoscience, the difficulties of integrating new knowledge and the balance between public and private good.
He has selected from the many current “controversies in human health” a small group of topics: the dissemination of scientific knowledge, recent findings in microbiology (particularly those concerning the microbiome), the sugar industry, fluoridation and its politics, cancer biology and treatment, and the future of gene therapy, stem cell transplant and pharmacogenetics.
Fluoridation is again in the news after the transfer of decision-making about local water treatment from councils to hospital boards. This does not meet Berridge’s logical conclusion that central government should respond to the clear scientific evidence of fluoride’s benefit and absence of harms. If District Health Board members read nothing else on fluoridation, they will benefit from reading this chapter which provides a brisk summary of the evidence to date.
Germs aren’t necessarily bad for us, and early exposure to micro-organisms is likely to be beneficial to infants early in life and has far reaching effects in their adulthood. Our gut microbes, which used to be regarded as relatively passive passengers, have now been shown to “underpin not only the development and maintenance of our immune defence system but also the regulation of body metabolism and the development and functioning of the brain”. Berridge also describes the effects of diet on the life of our microbe populations and is highly critical of the sugar industry. These issues are current in the popular press, and Berridge again provides a crisp summary.
It is the chapter on “Cancer: Complexity, Controversy and New Dimensions” which is the longest, and would warrant expansion into a short book of its own. Even more than any of the other topics explored in this volume, cancer biology and medicine are now hitting the headlines. For the public to be able to understand the issues, they need information about cell biology, cancer genetics, epigenetics, and an understanding of the complexities of immunology, as well as the concepts of personalised medicine. Berridge provides a brief overview of these topics which may whet the appetite of the lay reader, but which needs much more space. In addition, a dispassionate examination of the processes of drug development, funding and marketing as well as resource allocation would be of great interest.
This little book goes some way to address the author’s concerns that in health issues, science so frequently takes a back seat to prejudice and ill-founded, firmly held opinion.
Rae Varcoe is a poet, book reviewer and former physician who lives in Nelson.