College Quarterly
Fall 1996 - Volume 4 Number 1
Reviews The Coming Plague: Newly Emerging Diseases in A World Out of Balance
Laurie Garrett
New York: Farrar, Straus & Giroux, 1994

Reviewed by Michael R. Whealen

In his iconoclastic and little-known book The Story of Stupidity: A History of Western Idiocy From the Days of Greece to the Moment You Saw This Book, James F. Welles chides Western civilization for what he calls its "neurotic paradox" - "a self-destructive learning process which occurs when an act is reinforced with an immediate short-term reward although its long-term consequences will be maladaptive." If we but add to Welles' description the observation that individuals and peoples often commit the neurotic paradox with the best of intentions, then we have a classic example of the neurotic paradox as the subject of the book under review.

Laurie Garrett (whose credentials are impeccable - she did her research as a fellow at the Harvard School of Public Health) is basically arguing that, in the long run, Western medicine's attempts to fight the advance of deadly or severely debilitating microparasites (bacteria, viruses or multicelled organisms) among human populations are doomed to failure. For instance, an increasing number of strains of bacteria are becoming resistant to formerly efficacious antibiotics faster than the drug companies can manufacture new ones, strains of malaria have appeared that are resistant to all drug therapy, and some viruses have evolved ingenious internal mechanisms that literally pump out drugs designed to invade and destroy them. More alarmingly, lethal new plagues are appearing (Ebola, AIDS, Legionnaires' Disease) that are highly resistant to treatment and carry a high rate of mortality. And many of them are spreading - and evolving - exponentially.

It is of course no coincidence that the majority of the victims of these plagues live in the so-called "developing" nations. Throughout her book, Garrett does an excellent job of showing the correlations between disease on the one hand, and environmental degradation, demographic surges, socioeconomic deprivation and political unrest on the other. Epidemiology - if it is well done and engagingly written - makes for fascinating reading even for the lay public. The identification of disease vectors (the paths by which microparasites move from non-human to human hosts) is like detective work, and Garrett presents a multitude of highly readable and often suspenseful "hunts for the perpetrators" in her book.

Twenty years ago, William H. McNeill reminded us in his exemplary book, Plagues and Peoples that "humankind has been in a position to upset older balances of nature in quite the same fashion that disease upsets the natural order within a host's body. Looked at from the point of view of other organisms," he continued, "humankind therefore represents an acute epidemic disease."

Laurie Garrett might well agree. Her message is not the inevitability of impending devastation but it is a stern warning. "While the human race battles itself, fighting for scarcer and scarcer resources," she declares, "the advantage moves to the microbes court. They are the predators and they will be victorious if we, Homo sapiens, do not learn how to live in a rational global village that affords the microbes few opportunities." Or, to quote Pogo, "we have met the enemy, and they is us."

Michael Whealen is a Toronto-based writer with an enduring interest in pathological processes. At the time of writing, he taught in the Law Enforcement program at Seneca College in King City, Ontario.


• The views expressed by the authors are those of the authors and do not necessarily reflect those of The College Quarterly or of Seneca College.
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1996 - The College Quarterly, Seneca College of Applied Arts and Technology