Meskel

The Book of the Week is “Meskel” by Mellina and Lukas Fanouris, originally published in 1995.

This is the story of two families, two of whose members– the authors– married and lived in Addis Ababa, Ethiopia (formerly Abyssinia) through the 1970’s. Their forebears had originally come from Greece to live in Abyssinia in 1926. Upon settling in their new country, wife and husband of one family– Evangelia and Manoli Fanouris, started a Greek restaurant, and newspaper and magazine distribution business/bookstore. Then they began having children; Lukas was one of the younger ones.

In late 1934, there was border fighting between Abyssinia and Italian Somaliland. The Italians used poison gas against the Somalis. Although Evangelia’s brother Logotheti had designed the Royal Palace and had friends in high places, Emperor Haile Selassie still threatened Manoli with death because he sold foreign publications that were critical of the regime. Other untoward events occurred through the years, due to the Italian invasion and later, WWII. Nevertheless, the Fanouris did not leave the country, as their business provided them with a good life.

Mellina married Lukas Fanouris when he aggressively courted her. The families had known each other for years from the Greek community in Addis Ababa. She worked for the United Nations. In late 1973, Ethiopia was facing “… union unrest, drought in the north, and rumors of famine, allegations of corruption in the government and rising food prices.” Army soldiers were fed up with their living conditions and turned against the Emperor. Lukas’ parents lived richly, what with a five-bedroom, five-bath mansion, flower garden, balcony and verandas. But there came a time when they finally needed to flee anti-government strikes, protests and violence.

In September 1974, a documentary on Ethiopians’ starvation due to drought was finally released, after the military had taken control of the media. In December, the nation changed from a kingdom to a socialist state, limiting the imported reading material of the populace to Marx, Lenin and Engels. Businesses were nationalized and martial law was imposed. The new leader, Lieutenant Colonel Mengistu Haile Mariam, copied other dictators in recent memory– Stalin (U.S.S.R.), Mao Tse Tung (China), Peron (Argentina), Pinochet (Chile) and Pol Pot (Cambodia), by ordering citizens to do hard manual labor on farms, telling them to take pride in feeding the country; and by imposing the usual witchhunts, torture, arrests, show-trials and imprisonment for political dissidents and members of the old regime. Not to mention the trampling on what industrialized, democtratic nations would consider due process.

Read the book to learn the details of how the authors survived the attack on their freedoms through the 1970’s, and the suspenseful survival saga of Lukas and his brother Pavlos.

The Antidote

The Book of the Week is “The Antidote” by Barry Werth, published in 2014. This suspenseful saga is about the public drug company, Vertex.

Vertex has created the core substances in drugs that treat niche diseases, such as hepatitis C and cystic fibrosis. It has partnered with various other drug companies to use their resources.

Unconventionally, in the 1990’s, Vertex’s employees were organized into teams working on protein targets rather than those working on different diseases. The company’s teams were demoralized when they failed month after month to come up with a successful molecule.

The cost of American drugs is so high not just because the drugmakers are greedy, but because their employees feel entitled to a large reward for creating an effective product that does minimal harm to patients. They take tremendous risks– acquire pricey, extensive educations in organic chemistry and such, working long daily hours, suffer loads of stress from dealing with grant applications, patent disputes, licensing issues, doctor-insurer issues, undergoing the rigorous process of seeking FDA approval after laboring months or years on a drug substance– possibly applying for approval at the same time as another company with a competing product, and face the possibility of being laid off anytime. This is why life-saving, life-prolonging medicines are astronomically expensive. However, the drugs would not exist, but for the necessary evil of a greed machine that raises the funds to pay for the price of creating them.

Vertex posted a “profit” of more than $2 million in the fourth quarter of 1993, even though it had yet to sell even one pill. Its financial arrangements with its partners allowed it to claim that its income exceeded its expenses. By the end of the 1990’s, however, there were still no actual drugs produced, and the company was likely many years and hundreds of millions of dollars from the market. It was thus a likely takeover target. Some of Vertex’s scientists and lawyers became avid day-traders of the company’s stock in the autumn of 2000, after a deal with Novartis.

Trading rumors fly all the time, and one influential analyst at a big-name investment bank might downgrade a drug company’s stock, causing a selloff. In the early 2000’s, there was an SEC accusation of insider trading against Vertex’s house counsel. Ironically, it is common practice for panel members of the FDA to receive financial support in research-funding from many pharmaceutical companies.

Those companies that are public must answer to Wall Street. Unsurprisingly, at numerous medical conferences, their executives spout cliches such as “…We believe it’s a matter of time before we break this disease wide open and make a really big difference for a lot of people.”

Read the book to learn about actions Vertex took in research, development and finance in order to stay in business twenty years while accumulating losses of more than $1.5 billion; the causes of its high turnover of executives; how it became more geared toward finding commercial applications with its research results, and how it had fared product-wise and financially by autumn 2013.

Trouble Man

The Book of the Week is “Trouble Man” by Steve Turner, published in 1998. This is a biography of Marvin Gaye. His father, a Pentecostal preacher for the House of God church, and violent drunk, was the third oldest of thirteen surviving siblings, born in October 1914.

Gaye was born in April 1939. His full name was Marvin Pentz Gaye II. “His Motown image was still that of a polite, handsome black man who believed in fidelity, success and family life… like his father, Marvin was misogynistic. The function of women, he believed, was to serve and obey men.”

Unfortunately, his life spiraled downward into drug addiction and promiscuity, not unlike another famous and popular peforming artist of a later generation– Richard Pryor. Read the book to learn the details.

Dean & Me

The Book of the Week is “Dean & Me” by Jerry Lewis and James Kaplan, published in 2005. This is a career memoir of one half of the super-successful comedy team, “Martin and Lewis.”

Starting in the mid-1940’s, Dean Martin and Jerry Lewis did live shows of banter, singing and slapstick, and performed in movies, on recordings and on TV and radio. They hobnobbed with “The Rat Pack”– other night-club and casino comedians and singers who included Frank Sinatra, Joey Bishop and Sammy Davis, Jr., in the late 1950’s.

Read the book to learn about Lewis’ complex, love-hate relationship with Martin, Lewis’ later solo career, and the nature of American comedic entertainment in the mid-twentieth century.

UPClose: John Steinbeck

The Book of the Week is “UPClose: John Steinbeck” by Milton Meltzer, published in 2008. This is a brief account of Steinbeck’s life, in the context– superficially described– of the historical backdrop of his generation, including labor unrest, migrant farmworkers, political elections, The Great Depression, wars of various nations, and the then-literary taste of the United States. The author fails to mention stock market speculation as a cause of The Great Depression.

Steinbeck was born in 1902. At different times in his life, he was a journalist, novelist and short-story writer. He covered wars, wrote neutrally about unionization in America, and sympathetically about migrant farmworkers and their deplorable living conditions. When his novel “Of Mice and Men” was released, his publisher “… insisted John submit to the usual publicity projects for launching a new book: press conferences, interviews, book signings, cocktail parties.”

Read the book to get an overview of Steinbeck’s life and his times.

Genius on the Edge – Bonus Post

This blogger skimmed “Genius on the Edge” by Gerald Imber, MD, published in  2010. This long book describes the career of Dr. William Halsted.

Halsted was born in 1852 in New York City. There was still much ignorance about medicine in his generation. Fatal diseases, such as malaria, yellow fever and tuberculosis were rampant. He developed a passion for medicine at Yale University. The most prominent doctors of his age included Pasteur, Lister, Morse, Hunter, Wells, Koch, Morton, Young and Warren. They spurred progress in sanitation, anaesthesia, and the collection of new information and techniques for treating patients.

In the 1870’s, Columbia College, Physicians and Surgeons didn’t require undergraduate degrees for entry because it was seeking revenue from student tuition. The three-year program was all lectures– no labs, no interaction with patients. In the 1870’s, during Halsted’s internship at Bellevue Hospital, many personnel didn’t wash their hands before operating, and smoked.

In late 1884, Halsted started using cocaine as a local anaesthetic in dentistry. He displayed, “…hyperactivity, rambling speech, inattention, and suspended decision-making ability.” Medical students and their teachers started using cocaine as a pick-me-up. They became addicted. “The drug was readily available in Europe, through Merck, and there was no stigma associated with its purchase.” In late 1886, Halsted went to work at Johns Hopkins Pathological– the “Bell Labs” of medicine. He went to Baltimore because his addiction had wrecked his career in New York. He substituted morphine for cocaine.

It is unclear how much better Halsted could have performed were it not for his addiction. He did have a brilliant career, but there were bouts of irresponsibility, socially and teaching-wise. He missed classes, started surgery at 10am instead of 8 after a while, failed to show up for meetings, and retreated to his country home for almost half the year. One positive side effect of his addiction was that Halsted delegated complete patient care to residents when he had morphine withdrawal symptoms. So the residents got a golden opportunity they would not have had otherwise, to learn their craft.

Side Note (There’s nothing new under the sun.): “As a group, they [nurses] felt themselves underpaid and overworked.” The Training School taught them to cook and clean. They were required to wear brown Oxford shoes.

Halsted experimented on dogs on and off for a couple of years, between months-long stints in drug rehab. He began seeing human patients for surgery in early 1889. He pioneered the medical-school residency program. He instituted the training of surgeons to train other surgeons. Three other doctors at Johns Hopkins who wrought major change in medicine in the U.S. were William Osler, William Welch, and Howard Kelly. Halsted specialized in surgery for breast cancer and inguinal hernia.

Johns Hopkins wanted to remain on the cutting edge of medicine by opening a medical school but it needed money to do so. Female heirs of prominent, wealthy families raised the money and placed conditions on the school’s opening, requiring gender equality. After much controversy, it opened in the fall of 1893.

Read the book to learn how medicine in America changed through the years of the late 19th into the 20th century, and how, according to this book, Johns Hopkins led the way.