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Why We Get Sick: the New Science of Darwinian Medicine Hardcover – 1 Oct 1995
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"By bringing the evolutionary vision systematically into one of the last unconquered provinces, Nesse and Williams have devised not only means for the improvement of medicine but fundamental new insights into the human condition."--Edward O. Wilson, Harvard University
"In moving the focus from 'how' to 'why' questions, Nesse and Williams introduce readers to a new way of thinking about illness, one that promises to be of increasing interest as...our culture turns toward evolutionary explanations for human predicaments."--Peter D. Kramer, author of Listening to Prozac --This text refers to the Paperback edition.
About the Author
Randolph M Nesse, M.D., is a practicing physcian and professor and associate chair for education and academic affairs in the Department of Psychiatry at the University of Michigan Medical School.
George C. Williams, Ph.D., is a professor emeritus of ecology and evolution at the State University at Stony Brook and editor of The Quarterly Review of Biology. --This text refers to the Paperback edition.
Top customer reviews
There's not really much more I can say if Richard Dawkins wants to give a copy to our Doctors.
This is a very interesting book and may help us understand why we get sick and lists 6 different issues:
3. Novel environments
5. Design compromises
6. Evolutionary legacies
If this interests you then I suggest read some of the other more in depth reviews or even buy the book...
What I enjoyed about this book is the common sense approach - even when being very scientific the authors have a lovely way of telling a story.
"A caveat is necessary. Doctors and patients, like all other people, are prone to extend theories too far..."
It has great chapters on lots of different subjects and reads like a story like I mentioned earlier and this for me is why the book is so good - its readable unlike for example many research papers on the same subject...
Like all the books I recommend, don't take it too seriously, learn from it and move on. It is one perspective on a multi- faceted terminal condition we call human life...
At first glance, this quote from WHY WE GET SICK wouldn't seem to be relevant to the topic. But since the hypothesis of the book is that evolution and natural selection govern the senescence of aging and the physiological responses to diseases and mortally competitive environments, the fact that the gaudier frog has evolved with potent internal poisons that (should) signal "danger" to any potential predator makes the connection vis-a-vis both the amphibian's toxin and the starving hiker whose internal defense mechanisms may at least cause vomiting and diarrhea if frog's legs make it onto the dinner menu.
As authors Randolph Nesse and George Williams summarize:
"First, there are genes that make us vulnerable to disease ... Most deleterious genetic effects ... are actively maintained by selection because they have unappreciated benefits that outweigh their costs ... Second, disease results from exposure to novel factors that were not present in the environment in which we evolved ... Third, disease results from design compromises, such as upright posture with its associated back problems ... Fourth, ... natural selection ... works just as hard for pathogens trying to eat us and the organisms we want to eat. In conflicts with these organisms, as in baseball, you can't win 'em all. Finally, disease results from unfortunate historical legacies ... the human body must function well, with no chance to go back and start afresh ... Susceptibility to disease ... cannot be eliminated by any duration of natural selection, for it is the very power of natural selection that created them."
Under the umbrella of natural selection, the authors include everything from the obvious and non-arguable, such as fever as a mechanism to kill invading pathogens with heat, to the less obvious and perhaps debatable, such as the instinctive desire of small children to remained unweaned from mother's breast, which serves to prolong lactation and ensures that Mom won't become pregnant with a potential rival. Other examples fall into the category, Gee, Why Didn't I Think of That, including the morning sickness of pregnancy, which serves to prevent Mom from ingesting toxins during that vulnerable period when the unborn child is experiencing peak organ formation, and the causative agent of gout, uric acid, the build-up of which also protects the body from the aging effects of oxidative damage. Then there's cancer, which wouldn't be a problem had we not tissue cells that grow and regenerate. And did you know that premature ejaculation in the male is ostensibly selective, in an evolutionary sense, for those men that can get the gene transfer job done, so to speak, and then flee before the female's alpha male partner shows up to brain the interloper with a knotty pine cudgel?
Nesse and Williams lucidly present an unconventional paradigm of medicine, a different perspective from which to view disease and aging, that's only accasionally preachy. They rue the fact that it's not part of the mainstream, and argue for its inclusion in the curriculum of the country's medical schools. They fail to mention what I think is the more practical route to widespread acceptance, i.e. when it can make the medical industry lots of money.
Hey honey! How about some frog legs for dinner? I see a bright green one with yellow and red speckles perched in the carrotwood out back!
In this book the authors describe why (and not how) we
suffer from various diseases. Looking at diseases from an
evolutionary viewpoint gives us tremendous insight and
offers innovative ideas for treatment and prevention.
Though I tend to treat radical new ideas with skepticism, I
found most of the arguments in this book very convincing.
Apart from being ingenious, this book is also very
entertaining and easy to read.
In my opinion this is the science 'Book of the decade'
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