The dark history of influenza

“Influenza: The hundred-year hunt to cure the 1918 Spanish Flu pandemic” by Dr. Jeremy Brown

It was a global pandemic at a scale never seen in hundreds of years. It was believed to have been originated in North China, which predated the general outbreaks in Europe and America by few months. And the disease “was found in the spray and mucus from the throat, nose, and mouth. It could be spread through droplet infection by sneezing and coughing, and by hand-to-mouth contact.”

Despite the striking similarities, this, of course, was not Covid-19, but the 1918 influenza pandemic. It was dubbed the worst influenza pandemic in recorded history, infected around 500 million people (about one third of the total population back then) where it is estimated that between 50 and 100 million people died.

So, what happened? According to the author, Dr. Jeremy Brown, the experts have settled on 4 explanations for why so many people died in that pandemic:

  1. The virus had a protein on its surface that prevented the production of interferons, which normally functioned to signal our immune system that our body have been attacked. Then healthy lung cells that transfers oxygen into the bloodstream are hijacked by the penetrating virus which destroyed them and replaced them with dull fibrous ones that are incapable of transporting oxygen.
  2. With the patients’ bodies weakened and their lungs damaged, they caught bacterial infections such as staphylococcus or streptococcus which were deadly in this era before antibiotics. This is what the experts believed to be the main cause of the majority of deaths in the 1918, not from the flu virus itself but from these secondary infections.
  3. The flu virus triggered an overreactive immune response that turned the body against itself. Normally, a wound causes an inflammation (necessary to fight infections) and the inflammation is mediated by other kind of messenger protein called cytokines. And once the infection is healed, our cells stop producing cytokines and our immune system returns to its normal state. But in many of 1918 flu victims, the return to normal didn’t happen and instead their lungs suffer from “cytokines storm”, an overproduction of these messenger proteins, which in turn destroy healthy cells along with invading ones. When the cytokines storm strikes, the immune system spirals out of control.
  4. The rapid spread of the virus is due to living arrangements at the time, where people were living in tenements or barracks due to war, working-class families shared beds, soldiers slept side by side.

Attacking the lungs? cytokines storm? We might as well change the label to Covid-19 and the symptoms wouldn’t be out of place.

So what did they do to cure it? The immediate prevention measures tick all the contemporary boxes: wearing mask, social distancing, while businesses, schools and theatres were shut down. The book then shows the gruesome “remedies” for the flu pandemic, the trial and errors that would make us think that we’re sure glad to live in a more modern time. Remedies such as bloodletting, enemas, a shot of mercury, enormous dose of quinine, etc that are not only worthless in curing flu but also dangerous (bloodletting was the same procedure that killed George Washington).

Moreover, we often take for granted all the progresses that have happened in history, since a procedure as trivial as consuming aspirin to cure our flu symptoms can have deadly side effects during the 1918 pandemic, as back then doctors still haven’t figure out the safe dosage of aspirin that we should consume, hence people weren’t only dying from the flu but a lot died due to aspirin overdozed.

But eventually, the pandemic was over after 2 years and 3 waves, and the world proceeded to have the Roaring Twenties. So what cured it? Here’s the harsh truth, the pandemic was over because people who got infected either died or developed immunity. It became endemic. In other words, it was simply due to herd immunity that was developed over 2 years and not from a super cure that emerged to save the day. A rather anti-climactic ending, don’t you think?

This is where the book, written in 2018, then switches into a more technical elaboration that focuses on the 100 years of evolution of medicine since that 1918 pandemic and the journey to once and for all attempt to cure the disease of influenza. Now it is almost impossible to summarise every discovery in this review, but the following are the most important and relevant ones.

So, a virus is a box of chemicals that does not have the structures of a basic cell. They have no mitochondria (so they cannot make energy), they have no ribosomes (so they cannot build proteins), they lack lysosomes (which get rid of waste and toxins), they cannot metabolise, they cannot replicate on their own. So in order to reproduce, they must invade living cells. Viruses infects bacteria and plants, birds, fish, reptiles, and mammals.

While viruses do not target cells specifically to kill them, the mechanism where they hijack a cell and use it as a reproducing machine might injure, weaken, or destroy the cells as a collateral damage. In fact, if a virus is too lethal, it can destroy the host cells before they can even be used to create viral copies. This mechanism is the same for every virus, no matter how differ they are in the level of deadliness, from common flu to HIV to ebola.

According to Dr. Brown, in the discovery of the anatomy of viruses, “[w]e are especially interested in one particular family of viruses that has the clumsiest name: the orthomyxoviruses. Ortho means “straight,” in Greek, and myxa means “mucus.” The straight-mucus family of viruses includes influenza. Actually, there are three influenza viruses—they go by A, B, and C. Only the A and B strains cause significant disease in humans, and it is the A strain that is responsible for pandemic flu.”

Furthermore, if a mammalian strain and a bird strain of influenza hijack the same cell at the same time, their genes can mix to create an entirely new kind of virus that can turn deadly. This is exactly what happened in 1918 and in Hong Kong 1997, where birds contributed to parts of the influenza virus. While at first, the virus could only infect those who directly handled birds and could not be transmitted from one person to another, it would take only a small mutation for the virus to gain that ability, setting the stage for a new influenza pandemic.

And that is the key word, mutation.

But do not fret just yet, because our immune systems have evolved to prevent and contain the attacks from viruses, bacteria, and other foreign pathogens. The 1st line of defense consists of cells called phagocytes, which operates as a kind of traffic police that are always on patrol. Once they detect pathogens in our system they will envelop them and pull them inside the cell (where the pathogen will be obliterated). Dr. Brown explains, “Phagocytes do not target specific bacteria or viruses. Rather, they have been programmed in our genetic code to recognize pathogens in general. We are born with this innate immunity, and the phagocytes require no prior contact with a pathogen to search for, recognize, and destroy it.”

The 2nd line of our defense are the antigen-presenting cells, which target specific viruses or bacteria. While the 1st line is like a traffic police, this 2nd one is like detectives, they profile a suspect, they digest the pathogen and present some of its building blocks (such as a receptor or protein) to another type of immune cell called a helper T cell. These T cells then proliferate in huge numbers and use the pathogen profile to target the corresponding invader. Dr. Brown elaborates that “[e]ven years after a first encounter with a pathogen, T cells remember their old foe and spring into action. That’s why most of us get chicken pox only once. Our first encounter with the virus produces T cells that are forever on guard in the future.”

Indeed, the immune system does not care how the pathogen entered the body, as it will generate the same immune response regardless whether it came through the normal course of events or through a needle as a weakened form of vaccine. And after that the body is able to fight a similar invader more quickly and effectively the next time around, while if the antigen is new we may still produce antibodies against it but the process is slower and we become sicker for longer as our body adapts.

And that lies the core problem for influenza. The influenza virus throws a wrench into our immune system because it is a shape-shifter. It frequently changes the proteins on its surface, making it difficult for our existing antibodies to identify them. This is why we can catch the flu more than once, why the virus is almost impossible to eradicate, and this so-called “antigenic drift” is also why the flu vaccine needs to be updated every year (remember the key word, mutation).

In addition, there is a larger change that the virus can undergo, dubbed the “antigenic shift”, and this is how we get a flu pandemic. During antigenic shift viral proteins assume an entirely new structure and then the virus will become “novel.” (As in the case of novel coronavirus 2019). These novel viruses are most often arise when human and animal viruses share and swap their genes, and they emerge like entirely new criminals and not old one in disguise, which makes them more undetectable, more sneakier, more prolific, and potentially more deadly.

Antigenic shift generated the 1918 influenza virus and the swine flu outbreak of 2009, where the inflammation caused by the influenza virus can spillover to other problems, or the virus could attack the already existing disease(s) in our body, such as pneumonia, and make them worse by leading to a lung failure, kidney failure, and eventually multiple organ failures that culminated at the death of the patient.

And as Dr. Brown repeatedly mentioned in the book, it is not over yet. The battle against influenza has not been won, and another pandemic like 1918 was just around the corner because the virus itself never really go away and constantly mutating. Well, we now know what happen next in late 2019 and early 2020, with today in 2021 the “double mutation” delta variant is creating a new wave once again.

Teaching meditation in a fun way

“Meditation for Fidgety Skeptics” by Dan Harris, Jeff Warren, and Carlye Adler

If you’re a subscriber to the 10 Percent app then the title of this book, “Meditation for Fidgety Skeptics”, shouldn’t be unfamiliar for you. It is similar with that fun course in the app, “Meditation for Skeptics”, where Dan Harris and Jeff Warren drive around America on a huge bus to teach meditation to various types of people or groups of people.

And that is exactly what this book is about, the extended analysis and diary for that particular journey across the country. It has all the similar level of fun narrative, jokes, and meaningful lessons that the course provide us. It also has the transcript of all the guided meditations for that course, complete with the hilarious commentaries.

Moreover, while Dan Harris’ first book, 10% Happier, was more about his journey from TV meltdown to searching for meaning to discovery of meditation (and meeting all the wonderful teachers along the way that become the teachers in the Ten Percent app), this 2nd book is also about the technicalities of meditation, that are detailed enough to teach us everything we need to know to start meditating like the pros, but clear and concise enough that it doesn’t dwell too much on the nonsense.

You may say, the book is perfect for anyone skeptical on this whole meditation mumbo jumbo, but curious enough to want to give it a good try. Always a good fun with these guys.

Tennis from the lens of one of the legends

“A Champion’s Mind” by Pete Sampras

This book shows the technical side of tennis, and what pro players – or to be exact, Pete Sampras – are thinking about during the game and what strategies they are employing (and why). It also shows the human side of the sport and the emotional cocktail that comes with the job, especially as tennis’ no 1 ranked player in the world. The cherry on top is the 1990s tennis scene that Sampras re-lived and being nostalgic about in his writing, which brings fond memories for me too. In short, it is an insightful book about the world of tennis that is very enjoyable to read.

Dale Carnegie’s bread and butter

“Develop Self Confidence, Improve Public Speaking” by Dale Carnegie

The last book of the 5 Dale Carnegie books that I have in my possession. And I’m reading it snap bang in the middle of relaxing summer, which for me no reading soothes more than his books.

And this particular book is the stuff that Warren Buffett highly attributed as one of key factors for his success, Carnegie’s bread and butter, his wisdom on public speaking.

Along with the usual Carnegie-esque stories to make his excellent points (that are delightfully old school from his time), the book also provides famous people’s good habit, from Abraham Lincoln’s memory retention to Mark Twain’s note-less speeches to Teddy Roosevelt’s fiery passion on stage.

Here are the key points of the book:

  • Preparation is key.
  • Do your research.
  • Know your audience.
  • Keep it clear and consized.
  • Provide a clear conclusion.
  • The natural law of remembering: vivid impressions, repetition, association.
  • Stress important words, subordinate unimportant ones.
  • Vary your pitch. Talk like a human and not a monotone robot.
  • Vary your rate of speaking.
  • Pause before and after important ideas.
  • Dress meticulously, even have a winning smile if you can (everything about out appearance will be examined under the microscope).
  • Good lighting can go a long way.
  • Clear up distractions on the stage that can take away attention from you.
  • Avoid technical terms when necessary, especially when talking to outsiders.
  • Picture your points, visualised your ideas.
  • Take command over your language. Speak meticulously and with class.
  • Be well-read so that you can add multiple contexts into your speech.

There’s never a dull moment when it comes to Dale Carnegie books, and this one is no exception.

Philosophy meets history meets psychology

“How to Think Like a Roman Emperor: The Stoic philosophy of Marcus Aurelius” by Donald Robertson

This book is first and foremost a book about Stoicism, viewed through the lens of arguably its last true great philosopher, Marcus Aurelius. The book also partly an application of Cognitive Behaviour Therapy, in which the author, Donald Robertson, is an expert.

Now, if Stoicism is a practical philosophy, then Cognitive Behaviour Therapy is an applied Stoicism. And there’s probably nothing more direct than an applied Stoicism from Marcus Aurelius’ way of thinking, that were shaped through his incredible life story.

The book covers a lot of grounds, from his traumatic events, defining moments, his struggles, his triumphs, the stories of all of his teachers and his surroundings, the backstabbing, the death of some of his children, and eventually his acquired wisdom throughout the journey from a child with no ties to the aristocracy to become one of the Four Good Emperors that Roman Empire ever had.

All of that are narrated alongside the absolute gem of the book: the analysis of the many Stoic virtues that Marcus Aurelius implement for every single occurrence in his turbulent story, that are so inspiring.

The final chapter of the book in particular, about Marcus Aurelius’ reflections on his death bed, is absolutely moving. And in the audiobook version Robertson’s tone of voice is deliberately lowered down to make the chapter more solemn, which is a very nice touch.

All in all, it is often hard for us to imagine the practicality of things when only presented as theories, and find it much easier to grasps them once we witness the theories being implemented. This book is about the latter, hence it is one of the most actionable books on Stoicism that I’ve ever read. Another masterpiece from Robertson.

Start with a purpose

“Start with Why” by Simon Sinek

All habits are influenced by the environment and its triggers, according to Marshall Goldsmith. Influenced by what we are using our energy and attention for, where Greg McKeown teaches us to only focus on the essentials. They are influenced by our growth or fixed mindset, says Carol Dweck, which Susan Cain argues also influenced by our introvert-extrovert demeanor.

Moreover, any progress towards our goals depends on how we face what Steven Pressfield called the Resistance, in which Ryan Holiday suggest that they are in fact the way. It depends on how extreme we have ownership over our efforts, as illustrated by Jocko Willink, how we can screen through the cognitive biases described by Daniel Kahneman, and how we can fully utilize our brain’s capacity as trained by Jim Kwik (mind), hack our body like Dave Asprey does (body), and approach it with a monk-like attitude as taught by Jay Shetty (spirit). And in the end, change, says Robin Sharma, is hard at first, messy in the middle, and gorgeous in the end.

But underneath them all, lies the very first foundation that keeps the structure of any effort or change to remain strong throughout the journey: the underlying reason, the life’s calling, the fuel for the passion, the higher cause, the sense of purpose, or in short, the WHY. “It is the cause, not the death”, said Napoleon Bonaparte, “that makes the martyr.” And while our life’s quests and struggles are not as extreme as life and death, without the WHY none of the above matters. This is WHY this book is so important.

Much to my pleasant surprise, this book is nothing like the contents that I’ve been accustomed to with the author, Simon Sinek, in his brilliant podcast interviews. While it is still based on psychology and its applications in sociology, it is heavily tailored to business, innovation, and its marketing approach, akin to Charles Duhigg’s the Power of Habit.

And it fits. Because there’s arguably nothing that can illustrate the power of WHY better than business and innovation stories, from the “cult” of Apple and Harley Davidson, to why Honda need to create a second brand for their luxury cars, why TiVo failed to reach a tipping point, to how the Wright Brothers can invent the first aeroplane with no funding and minimum expertise while Samuel Pierpont Langley with his all star team and government funding failed to do so.

All of this are analysed with tools that can be applicable to anything in life. Tools such as the celery test, the school bus test, the golden circle, or the golden pyramid with the WHY-level at the top, HOW-level in the middle, and WHAT-level at the bottom.

Because when you want to lose weight and start living a healthy life, you need a WHY. If you want to stop smoking, you need a WHY. If you want to start up a company, volunteer to help the poor, pursue a PhD, train to win a race, enlist in a military service, organise a mass protest, or want your organisation to last for decades, everything need a strong WHY to keep the cause alive. And this book analyses it very well.

The best of Charlie Munger

“Poor Charlie’s Almanack: The wit and wisdom of Charles T. Munger” by Charlie Munger and Peter D. Kaufman

If this is a music album, this book would be Charlie Munger’s greatest hits. It comprise of his short biography, followed by testimonials from his family and closest circle, then a closer look into his intellectual framework and the mental models that have shaped his way of thinking and investment decisions, and neatly closed with 11 speeches that define his outlook on life and the market.

Here are some examples of the gems from Munger in the book:

  • When you borrow a man’s car, you always return it with a full thank of gas.
  • Concentrate on the task immediately in front of [you] and to control spending.
  • People make mistakes, the right thing to do is to admit your mistakes.
  • Do the job right the first time.
  • Take a simple idea and take it seriously.
  • We don’t claim to have perfect morals, but at least we have a huge area of things that, while legal, are beneath us.
  • Capitalism without failure is like religion without hell.
  • I’d rather make my money playing piano in a whorehouse than account for options as recommended by John Doerr (he really dislike derivatives).
  • You don’t have to be brilliant, only a little bit wiser than the other guys, on average, for a long, long time.
  • All I want to know is where I’m going to die, so I’ll never go there.
  • A lot of success in life and business comes from knowing what you want to avoid: early death, a bad marriage, etc.
  • Envy is a really stupid sin because it’s the only one you could never possibly have any fun at.
  • I have known no wise people (over a broad subject matter area) who didn’t read all the time. None, zero.
  • The importance of being a reliable person.
  • Roughly half of the army of Adolf Hitler was composed of believing Catholics. Given enough clever psychological manipulation, what human being will do is quite interesting.
  • Just in an ecosystem, people who narrowly specialise can get terribly good at occupying some little niche.
  • Anytime anybody offers you anything with a big commission and a 200 page prospectus, don’t buy it.
  • We don’t leap seven-foot fences. Instead, we look for one-foot fences with big rewards on the other side. So we’ve succeeded by making the world easy for ourselves, not by solving hard problems.
  • Why should we want to play a competitive game in a field where we have no advantage – maybe a disadvantage – instead of in a field where we have a clear advantage?
  • Each of you will have to figure out where your talents lie. And you’ll have to use your advantages. But if you try to succeed in what you’re worst at, you’re going to have a very lousy career.
  • I won’t bet $100 against house odds between now and the grave.
  • I try to get rid of people who always confidently answer questions about which they don’t have any real knowledge.
  • It’s kind of fun for it to be a little complicated. If you want it totally easy and totally laid out, maybe you should join some cult that claims to provide all the answers.
  • The best way to avoid envy is to plainly deserve the success we get.
  • I can’t stand his politics, I’m on the other side. But I love this man’s essays.
  • Spend each day trying to be a little wiser than you were when you woke up. Discharge your duties faithfully and well. Step by step you get ahead, but not necessarily in fast spurts. But you build discipline by preparing for fast spurts. Slug it out one inch at a time, day by day. At the end of the day, if you live long enough, most people get what they deserve.
  • As a securities investor, you can watch all sorts of business propositions in the form of security prices thrown at you all the time. For the most part, you don’t have to do a thing other than be amused. Once in awhile, you will find a ‘fat pitch that is slow, straight, and right in the middle of your sweet spot. Then you swing hard. This way, no matter what natural ability you start with, you will substantially increase your hitting average. One common problem for investors is that they tend to swing too often. This is true for both individuals and for professional investors operating under institutional imperatives, one version of which drove me out of the conventional long/short hedge fund operation. However, the opposite problem is equally harmful to long-term results: You discover a fat pitch’ but are unable to swing with the full weight of your capital.

In this chaotic and rapidly changing world, where lines are sometimes blurry, Charlie Munger stands out as the calm presence whose values and wisdom should be the benchmark for everyone. And as you can see, this book reveals them all.

It’s no wonder that it becomes an instant classic, simply unmissable!

Everything we need to know about our gut

“Happy Gut: The cleansing program to help you lose weight, gain energy, and eliminate pain” by Vincent Pedre

This book is like the summary for everything we need to know about our gut, and it is written with such brevity that it feels like a cheat sheet where only the most important information are presented.

The book begins with describing the ideal state: how a healthy gut looks like. Then it takes us step by step through the whole digestive process, starting from the top (our mouth), to the middle (our gut), down to the bottom (our colon). Along the way he explains the many functions of our organs, which makes it easier to understand within the context of the digestive process.

Moreover, while the first few chapters are absolute masterpieces on describing our gut and digestive system, the proceeding chapters dive straight into the practicalities: What certain types of food are made of, what to avoid and what to consume (and why), all the problems and challenges for our gut, and culminating with so many recipes for a good gut flora that takes about 1/3 of the length of the book.

And all of these gems are discussed within the frame of C.A.R.E: Cleanse (remove gut irritants, infections, food sensitivities, and toxins in food) Activate (reactivate healthy digestion by replacing essential nutrients and enzymes) Restore (reintroduce beneficial bacteria for a healthy guy flora) Enhance (repair, regenerate, and heal the intestinal lining).

Now, while there are so many great knowledge that I’ve learned from this book, there are some that stand out more than the others. These are the selected few:

  • “Between the antibiotics, eating the wrong foods that feed the bad organisms, the toxins you are exposed to in your environment, and the resulting dysbiosis, over a period of days to months you develop a leaky gut. This leakiness or “hyperpermeability” exposes your body to partially digested protein molecules from food. The immune system does not recognize these so it attacks, which results in food sensitivities. You might not even be aware of these sensitivities, which can manifest as hives, allergies, chronic sinus inflammation, and migraines and become the triggers for irritable bowel syndrome and autoimmune disease.”
  • ““Leaky gut” is not a diagnosis but a process, a description of the underlying pathology of numerous diseases that we treat yet have failed to find a cure for. It is a condition in which connections between the cells that line the inside of the intestines (known as tight junctions) become looser, allowing larger molecules (such as partially digested food particles) to pass through the gut wall. Usually, properly digested food is absorbed directly through the cell wall, but in a leaky gut, the pathway between the cells is opened up, exposing the gut-associated immune system to a wide variety of substances our immune cells would otherwise not come into contact with.”
  • “Your immune system is constantly patrolling the gut border for anything it does not recognize in order to prevent an all-out invasion. As the immune system encounters these escaped particles, it attacks. And in individuals with a genetic predisposition to autoimmune diseases, this increased load on the immune system leads to the type of dysregulation that becomes an autoimmune disease. As you are exposed to large protein molecules in a leaky gut from the incompletely digested foods you eat on a daily basis, you develop immune reactions to those foods.”
  • “Often a diet rich in the foods that you are sensitive to, in combination with a leaky or hyperpermeable gut, leads to fluid retention and inflammation and, as a result, weight gain. People who are very food sensitive often lose five to six pounds in the first week after removing these foods from their diet.”
  • “Even when you restrict yourself stringently by following one of the popular diets, including limiting calories or carbs, or monitoring carb-fat-protein ratios, your food sensitivities will make it very difficult to lose weight. When you remove the foods that are “toxic” to your body because they activate your immune response, weight loss happens naturally.”

Because if there is one thing that nearly all modern diseases have in common, it is inflammation. And it underlines the importance of this book, since many metabolic diseases, including inflammation, begin in the gut.

The art of neuroscience

“How the Mind Works” by Steven Pinker

Book number 2 out of 5, in my quest of reading one Steven Pinker book a year that are in my possession.

This one is a 673 pages-long book about how the mind works, but one which bizarrely seldom mentions about its underlying neuroscience. Granted that this book was published in 1997, which shows how far the biological field of our brain has since developed, but the many assumptions and the omittance of any scientific finding to back up the theses are still appalling.

So instead, what is it about then? To be perfectly honest, I don’t really know. There are so many gibberish in between the paragraphs and so many derailing from the main topic, with its good points (such as the computational theory of the mind, or the effect of optical illusion to our brain, or evolutionary psychology) often drowned in a sea of unnecessary gimmicks and overcompensating fancy words.

Perhaps it’s a bit unfair to judge this book after reading excellent [and newer] books on mind such as “Thinking, fast and slow” by Daniel Kahneman, or “The Chimp Paradox” by Steve Peters, any Daniel Goleman’s series, or even the fun one “You Are Not So Smart” by David McRaney that are more straight forward.

But still, the lack of scientific evidence, untidy organisation of information, the many off topics that are way too long, and no clear concluding points (if any) with just a little hint of arrogance are making it hard to like this book.

The future of banking

“Bank 3.0: Why banking is no longer somewhere you go, but something you do” by Brett King

According to the author, Brett King, there are 4 phases of behavioural disruption in banking: 1. The arrival of the internet 2. The emergence of smart device or app phone 3. Our switch to mobile payment on a broad scale (which is where we currently are) 4. Banking no longer being somewhere we go, but something we just do.

Published in 2013, this book is largely about the road to the 4th disruption. It shows an exciting glimpse of what the future may look like and how banks will play their role in it. It is a world where “someone else owns the customer, [while] banks become the manufacturers, networks and processes that support the utility of banking.”

The book ultimately takes us through the evolution of banking, which are illustrated by abundance of data and statistics to provide us with the contextual trend, where now by the time I read it in 2021 I can see how plenty of the predictions by King have already happening.

An essential read for bankers or those who are interested to learn about the banking industry.