A Prayer for Ukrainian Children and Judge Ketanji Brown Jackson.

Posted on | March 23, 2022 | 3 Comments

Mike Magee

What a haunting display – the juxtaposition of low’s and high’s in human behavior. The goodness of Ukrainian children exhibiting courageous, adult behavior, struggling without complaint to survive while in full flight vs. entitled elected Senators relentlessly and with straight faces bullying and “acting out” like spoiled preschoolers in the shadow of a composed, elegant and determined Judge Ketanji Brown Jackson. You can almost hear in the spring breezes a collective sigh – “Must we? Must we?”

Humans do continue to surprise on the upside, and misbehave with utter predictability on the downside. How should we make sense of this?

That there is goodness in this world is undeniable. That there is evil, capable of taking root to branch and multiply with breathtaking speed and by surprise is equally the case. But little candles throw great beams, and light enlightens, while sins cast long shadows. We and our world are both evil and good. By our deeds you shall know us. All the learning, earning and yearning can’t replace a moment’s hesitation or justice withheld in the face of evil. Tyranny, poverty, disease – there is more than enough to battle to prove our inner worth. Though it’s useful to remind that the knowledge and power that accrues can always be turned upon ourselves. That we possess a conscience does not assure its use. But it can be stirred by the universe and the belief that we all have a right to be here among the trees and stars. Amid the noisy confusion people do somehow find peace inside, and dreams of a beautiful world, and a confidence (sometimes shaken but never withdrawn) that injustice is a two-edged sword and given time justice will prevail.

God Bless the Ukrainian children! God Bless Judge Ketanji Brown Jackson! And God heal the rest of us!

Category: Uncategorized
Tags: good vs. evil

The Free Online Lecture on “American Epidemics” is May 10th. Here’s What You’ll Learn.

Posted on | March 21, 2022 | 2 Comments

Mike Magee

On May 10^th, at noon, I’ll be delivering a FREE live online luncheon lecture titled: “The History of Epidemics in America.” What’s in it? For that, you’ll need to tune in. I’ll be providing the proper link as we get closer to the date.

It’s a once-only, slide lecture – entertaining and enjoyable, with text available after the lecture online. (So no need to take notes.) Here are 15 “learnings” we’ll cover:

Epidemics, as historians have emphasized are “social, political, philosophical, medical, and above all ecological events.”
Competing and complimentary species cycles in pursuit of nutrition and reproduction maintain, or distort, ecological balance.
Populations initially respond to epidemics with fear and flight. Scapegoating and societal turmoil are common features. Diseases disadvantage the poor, the weak, and those without immunity or prior exposure.
Epidemics often travel side by side with warfare in transmitting and carrying microbes, and exposing vulnerable populations. Historically, epidemics have repeatedly played a role in determining the ultimate outcomes of warfare and conflict.
Throughout history, scientific advances have enabled (through enhancements in travel, congregation, and the ability to enter into virgin territory) epidemics, and also provided the knowledge and tools to combat epidemics.
Domestication and sharing of animals has enhanced the introduction of microbes to populations vulnerable to epidemic disease.
Disease, associated with aggression, has been the major factor in destruction of native cultures and decimating native populations in the Americas.
Slavery was largely a response to workforce demands created by the epidemic eradication of native populations intended to serve as indentured servants on large agricultural plantations that raised and exported highly lucrative products into Old World markets.
Epidemics often result in unintended consequences. For example, Yellow Fever and the defeat of the French in Saint-Domingue led to Napoleon’s divestment of the Louisiana Territory. Struggles to control and explain the Yellow Fever outbreak in Philadelphia in 1793 helped define the emergence of two very different branches of American Medicine over the next century.
Scientists defining “germ theory” and social engineers leading the “sanitary movement” reinforced each other’s efforts to lessen urban centers vulnerability to epidemics.
Immunization has a long and controversial history. As enlightened public policy, it has saved many lives. It can, as illustrated by the Eugenics Movement, create uncomfortable legal precedents and unintended consequences.
The U.S. scientific community prematurely declared victory over communicable diseases in the 1960s.
In the wake of HIV/AIDS, some scientific leaders actively warned of ongoing population wide vulnerabilities beginning in 1992.
Genetic reverse engineering technologies empowering “gain-of-function” research led to Consensus Statements in 2014 warning of potential disastrous consequences, and epidemics that would be difficult to control.
The U.S. Health Care System in leadership, strategic operation, mitigation, and delivery of acute services failed on a large scale when confronted with the Covid-19 pandemic.

Musings From Borodino, Russia.

Posted on | March 14, 2022 | Comments Off on Musings From Borodino, Russia.

Mike Magee

Two hundred and ten years ago, on September 7, 1812, a Putinesque commander, narrowly won a battle, but lost a war and entered a downward cycle that ended his reign. The battle was the Battle of Borodino, a town on the river Moskva , 70 miles west of Moscow. The commander was Napoleon.

The facts are clear-cut: Napoleon arrived with 130,000 troops, including his 20,000 Imperial Guards, and 500 guns. Opposing him were 120,000 Russians with 600 guns. The battle engaged from 6 AM to Noon. The French took 30,000 casualties, while the Russians lost 45,000 men, but survived to fight another day.

As Leo Tolstoy describes the scene of carnage on page 818 of his epic novel, War and Peace, in 1867, “Several tens of thousands of men lay dead in various positions and uniforms in the fields and meadows where for hundreds of years peasants of the villages…had at the same time gathered crops and pastured cattle. At the dressing stations, the grass and soil were soaked with blood over the space of three acres. Crowds of wounded and unwounded men of various units, with frightened faces, trudged on…Over the whole field, once so gaily beautiful with its gleaming bayonets and puffs of smoke in the morning sun, there now hung the murk of dampness and smoke and the strangely acidic smell of saltpeter and blood. Small clouds gathered and began to sprinkle on the dead…”

But in the next paragraphs, it becomes clear that Tolstoy’s intent and focus is not to describe why and how Napoleon had won the Battle of Borodino, but rather how this was the beginning of the end of his army and the Napoleonic reign.

Tolstoy writes: “For the French, with the memory of the previous fifteen years of victories, with their confidence in Napoleon’s invincibility, with the awareness that they had taken part of the battlefield, that they had lost only a quarter of their men, and that they still had the intact twenty-thousand-man guard, it would have been easy to make the effort (to advance and annihilate the Russians)….But the French did not make that effort….It is not that Napoleon did not send in his guard because he did not want to, but that it could not be done. All the generals, officers, and soldiers of the French army knew that it could not be done, because the army’s fallen spirits did not allow it….(They were) experiencing the same feeling of terror before an enemy, which, having lost half his army, stood as formidably at the end as at the beginning of the battle. The moral strength of the attacking French was exhausted…(For the Russians, it was) a moral victory, the sort that convinces the adversary of the moral superiority of his enemy and of his own impotence, that was gained by the Russians at Borodino.”

The Russians not only retreated, but did not stop in Moscow, continuing another 80 miles beyond their beloved city. But as Tolstoy describes, “In the Russian army, as it retreats, the spirit of hostility towards the enemy flares up more and more; as it falls back, it concentrates and increases.”

As for the French, they take Moscow but stop there. Again from Tolstoy, “During the five weeks after that, there is not a single battle. The French do not move. Like a mortally wounded beast, which, losing blood, licks its wounds, they remain in Moscow for five weeks without undertaking anything, and suddenly, with no cause, flee back…without entering a single serious battle…”

Putin’s aging dreams of conquest likely are Napoleonic in scale. But as his hesitant forces observe the Borodino-like human carnage that they have unleashed on Mariupol, at the estuary of the Kalmius and Kalchik rivers, and prepare to enter Kyiv, the first eastern Slavic state which, a Millennium ago, acquired the title “Mother of Rus Cities”, their vulnerability and lack of “moral strength” is already apparent. Lacking a rational stated goal other than dominance, the young Russian conscripted soldiers and their commanders must certainly grow more concerned day by day. They too have become entrapped, and are “experiencing the same feeling of terror before an enemy, which, having lost half his army, stood as formidably at the end as at the beginning of the battle.”

As for Putin, like Napoleon, he may feel the winds of fate blowing heavily on his shoulders even now. Napoleon did make it back to Paris. But three years after the Battle of Borodino and the 5-week occupation of Moscow, he met his Waterloo on June 16, 1815, at the hands of the Duke of Wellington. He died in exile on the island of Helena on May 5, 1821. In his last will, he wrote, “I wish my ashes to rest on the banks of the Seine, in the midst of that French people which I have loved so much.”

Putin likely feels a similar love for Mother Russia but may be disappointed. Ella Wheeler Wilcox, a popular, if lightly acclaimed poet from Branford, CT, felt the same for her husband, a spiritualist. They promised each other that, whoever went first, would reach back to the other and make contact after death. When he died in 1916, and did not follow through, Ella sunk into depression. It was during this dark period, in the year of the 1917 Russian Revolution, that she wrote “The Winds of Fate.”

“One ship drives east and another drives west
Tis the set of the sails
And not the gales
Which tells us the way to go
Like the winds of the seas are the ways of fate,
As we voyage along through the life;
Tis the set of a soul
That decides its goal,
And not the calm or the strife.”

Tolstoy issued a similar warning in 1867. In the years that followed, Russia’s feudal society would be slow to reform and its Industrial Revolution slow to take hold. When it did, urbanization was mismanaged, food in short supply, and unrest visible and unsettling. WW I added insult to injury, leaving the corridor for the 1917 Russian Revolution wide open. Russian leaders today find themselves similarly vulnerable.

Category: Uncategorized

Independent Oversight of America’s Science Establishment Long Overdue.

Posted on | March 10, 2022 | 2 Comments

Mike Magee

Brevig Mission, Akaska, is a small ocean side village that was the home of several hundred Inuit Natives in 1918. It is 586 miles due northeast of Anchorage. According to a 2019 CDC article, in a 5-day period, between November 15 and 20, 1918, 72 of the 80 adult inhabitants perished.

The tragedy was part of a larger disaster, the 1918 Flu Pandemic which claimed 675,000 lives over a two year period in the U.S. and an estimated 50 million nationwide while infecting one third of the world’s population. An H1N1 virus, similar to the 2009 Bird Flu nearly a century later, it was especially lethal in young adults age 15 to 34.

In the absence of a vaccine, and without access to antibiotics to treat opportunistic bacterial infections, with a war raging, large military encampments and crowded troop ships promoting transmission, this singular event overnight dropped lifespan in America by 12 years.

Brevig Mission, its mass gravesite, preserved in permafrost, remained untouched until 1951, when Johan Hultin, a 25-year-old Swedish microbiologist and Ph.D. student at the University of Iowa, was granted permission to excavate the site in order to obtain lung tissue from one of the victims. Hultin was unsuccessful in his attempts to grow the virus once he thawed the frozen tissue, and visions of Brevig Mission receded in his mind.

Forty six years later, in 1997, two other scientists, Jeffrey Taubenberger and Anne Reid, successfully deciphered the genomic structure of the single strand of the 1918 pandemic RNA. Its donor was a 21-year old South Carolina serviceman who died of the disease on September 20, 1918.

On reading a review, Johan Hultin, now 72, contacted Taubenberger, and under the auspices of the Armed Forces Institute of Pathology, they returned together to Brevig Mission. With appropriate permissions, they were able to obtain frozen lung specimens, and definitely identified the killer microbe as the 1918 H1N1 bird flu virus.

The next highly controversial step was to attempt to reverse engineer the virus back to life. The microbiologist assigned to complete this task was the Department of Agriculture investigator, Terrence Tumphy. He successfully brought the virus back to life in 2005 working in a CDC BSL3 (the second highest security level) Lab.

A BSL3 laboratory contains primary and secondary barriers. As described by the CDC, “Investigators wear a powered air purifying respirator (PAPR), double gloves, scrubs, shoe covers and a surgical gown, and shower before exiting the laboratory. The work is conducted within a certified Class II biosafety cabinet (BSC), which prevents any airflow escape into the general circulation.”

What they learned was that the virus’s rapid multiplication created a virus load that was 50 times as great as every day respiratory viruses and specifically and almost exclusively targeted lung tissue. These deadly attributes were the result of 8 separate but contributory unique mutations of the genetic structure.

The CDC’s author in December, 2019, made a point to note that, “In 1918, the world population was 1.8 billion people. One hundred years later, the world population has grown to 7.6 billion people in 2018. As human populations have risen, so have swine and poultry populations as a means to feed them. This expanded number of hosts provides increased opportunities for novel influenza viruses from birds and pigs to spread, evolve and infect people. Global movement of people and goods also has increased, allowing the latest disease threat to be an international plane flight away.”

He went on to warn that, “If a severe pandemic, such as occurred in 1918 happened today, it would still likely overwhelm health care infrastructure, both in the United States and across the world. Hospitals and doctors’ offices would struggle to meet demand from the number of patients requiring care. Such an event would require significant increases in the manufacture, distribution and supply of medications, products and life-saving medical equipment, such as mechanical ventilators. Businesses and schools would struggle to function, and even basic services like trash pickup and waste removal could be impacted.”

That same month, Wuhan, China, (after several months delay) informed the WHO that a pandemic causing virus was on the loose. It will likely be impossible to ever prove that U.S. funded (through the Department of Defense, State Department, and NIH) “gain-of-function” research created and inadvertently released Covid-19 which has killed nearly 1 million Americans, and 6 million worldwide. But what can be stated with certainty is that we were warned.

On July 14, 2014, a group of respected working scientists, concerned with biosafety in virology laboratories worldwide, gathered as “The Cambridge Working Group” and released a consensus report. It stated in part: “Accident risks with newly created ‘potential pandemic pathogens’ raise grave new concerns. Laboratory creation of highly transmissible, novel strains of dangerous viruses…pose substantially increased risks. An accidental infection in such a setting could trigger outbreaks that would be difficult or impossible to control.”

In most countries, clear checks and balances, and independent oversight of scientists is a given. In our Medical-Industrial Complex, freed of all restraint during the Reagan years, profiteering and integrated career ladders are well established, and scientists (flowing freely in and out of government, academic medicine, science foundations, and for-profit corporations) police themselves.

An overhaul of this scientific management system is long overdue.

Category: Uncategorized
Tags: 1918 flu > anne reid > brevig mission > CDC > covid > jeffrey taubenberger > johan hultin > science oversight > terrence tumphy

A Conversation Between Leo Tolstoy and Volodymyr Zelensky.

Posted on | March 2, 2022 | 8 Comments

Mike Magee

The English translator of Leo Tolstoy’s epic Russian novel, “War and Peace”, Richard Pevear, writes in his introduction, “The book is set in the period of the Napoleonic wars (1805-1812) and tells the interweaving historical events of two very different families of the Russian nobility – the severe Bolonskys and the easygoing Rostovs – and of a singular man reminiscent of the author himself – Count Pierre Bezukhov. It embodies the national myth of ‘Russia’s glorious period’ as Tolstoy himself called it…”

On page 348, in a moment of intense introspection, the very same Pierre broodingly reflects, “What is bad? What is good? What should one love, what hate? Why live, and what am I? What is life and what is death? What power rules over everything?”

Pierre’s mind provides this very dark response, “You will die – and everything will end. You will die and learn everything – or stop asking.”

Seemingly acting as a Cable news commentator to the current epic struggle between Putin and Ukraine in response to a 40 mile Russian military caravan inching single lane toward Kiev, Tolstoy comments on page 605, “millions of men, renouncing their human feelings and their reason, had to go from west to east and kill their own kind, just as, several centuries earlier, hordes of men had gone from east to west, killing their own kind…Fatalism in history is inevitable for the explanation of senseless phenomena…”

President Zelensky’s address to the Parliament of the European Union this week seemed to suggest to Tolstoy that it is possible to transcend one’s culture. From a war bunker, the Ukrainian president said, “I don’t read from paper, the paper phase is over, we’re dealing with lives. Without you, Ukraine will be alone. We’ve proven our strength. We’re the same as you. Prove that you’ll not let us go. Then life will win over death. This is the price of freedom. We are fighting just for our land. And for our freedom, despite the fact that all of the cities of our country are now blocked…We are fighting for our rights, for our freedom, for our lives and now we are fighting for our survival, Every square today, no matter what it’s called, is going to be called Freedom Square, in every city of our country. No one is going to break us. We are strong. We are Ukrainians.”

His final words are a direct and poetic appeal, “Do prove that you will not let us go. Do prove that you indeed are Europeans. And then life will win over death and light will win over darkness. Glory be to Ukraine.”

Poets, politicians, and religious leaders have tread this path before. Rome’s 1^st century CE intellectual, Seneca, stated with confidence that “Injustice never rules forever.”

In his Inaugural Address on January 20, 1961, President John F. Kennedy, expanded on this theme and the implied obligations with these remarks, “Now the trumpet summons us again – not as a call to bear arms, though arms we need; not as a call to battle, though embattled we are; but a call to bear the burden of a long twilight struggle, year in and year out, ‘rejoicing in hope, patient in tribulation’, a struggle against the common enemies of man: tyranny, poverty, disease and war itself.”

St. Augustine understood well the interlocking nature of human justice when he wrote, “Charity is no substitute for justice withheld.” And the Talmud cautions that timing is of the essence with this passage, “Three things are good in little measure and evil in large: yeast, salt and hesitation.”

“All sins cast long shadows”, states the Irish proverb. And yet, at times in history, we can be pleasantly surprised by the cascading effect of single voices of courage like those of President Zelensky. As Shakespeare reminded, “How far that little candle throws his beams! So shines a good deed in a naughty world.”

This is not to say that Putin, and his oligarchs and KGB allies, will be easily toppled. But the range and coordinated nature of the international response is encouraging. As Thoreau noted, “There are a thousand hacking at the branches of evil to one who is striking at the roots.”

But at the end of the day, it comes down to this, do you believe in the fundamental goodness of human nature? Walt Whitman did. He wrote, “I am as bad as the worst, but, thank God, I am as good as the best.”

Of course these are words, and the Zelensky family and their fellow citizens of the Ukraine need action from all corners of the globe. As the African proverb states, “By his deeds we know a man.”

Category: Uncategorized
Tags: positive leadership > president zelensky > putin > russia > tolstoy > ukrain > war and peace

We Had Plenty Of Warning. Will Microbes Finally Force Modernization of the American Health Care System?

Posted on | February 11, 2022 | 3 Comments

Mike Magee

Science has a way of punishing humans for their arrogance.

In 1996, Dr. Michael Osterholm found himself rather lonely and isolated in medical research circles. This was the adrenaline infused decade of blockbuster pharmaceuticals focused squarely on chronic debilitating diseases of aging.

And yet, there was Osterholm, in Congressional testimony delivering this message: “I am here to bring you the sobering and unfortunate news that our ability to detect and monitor infectious disease threats to health in this country is in serious jeopardy…For 12 of the States or territories, there is no one who is responsible for food or water-borne surveillance. You could sink the Titanic in their back yard and they would not know they had water.”

Osterholm’s choice of metaphor perhaps reflected his own frustration and inability to alter the course of the medical-industrial complex despite microbial icebergs directly ahead.

For nearly a half-century, America’s scientists had been declaring victory over infectious diseases. General George Marshall got the ball rolling when he declared in 1948 that we now had the means to eradicate infectious disease. Seven years later, Rockefeller Foundation scientist Paul Russell, who along with Fred Soper had championed the use of DDT, published “Mastery of Malaria”, recommending a global spraying campaign. Eight years after that in 1963, Johns Hopkins scientist, Aidan Cockburn, published his seminal piece, “The Evolution and Eradication of Infectious Diseases”, in which he memorably declared , “With science progressing so rapidly, such an endpoint (of infectious diseases) is almost inevitable.” And finally, in 1969, Surgeon General William H. Stewart, declared with complete confidence that it was time to “close the book on infectious diseases.”

Yale historian Frank M. Snowden explained in his book, Epidemics and Society, that the two decades following the end of WW II were years of “social uplift.” This was a period that marked progress (for the fortunate) in housing, wages, diet, and education. In infrastructure as well – from roads, to sewers, to water treatment plants, and safer manufacturing equipment – there was some justification for the self-congratulatory waves in the air.

The infectious diseases themselves seemed stalled, static, relatively benign and historic. Plague had yielded to sanitary cordons, isolation, and quarantine. Water and sewer management had neutralized the threat of cholera in most locations. DDT, paired with quinine, had defanged malaria. And vaccines for just about every nasty childhood disease were now required for school entry. As Snowden describes, we “fell victim to historical amnesia.”

When HIV arrived in the early 1980s, it proved every stereotype about the manageability of infectious diseases false. Here was a brand new infection, impacting both the developed and developing world, which spread rapidly far and wide, had a devastating and tortuous kill rate, and ignited a wide range of associated opportunistic infections.

In its wake, the scientific community was forced to reverse course. In 1992, the IOM served notice with the publication of “Emerging Infections: Microbial Threats to Health in The United States.” Two years later, in 1994, the CDC declared “The public health infrastructure of this country is poorly prepared for the emerging disease problems of a rapidly changing world.”

In 1998, the Department of Defense weighed in. saying “Historians in the next millennium may find that the 20th century’s greatest fallacy was the belief that infectious diseases were nearing elimination. The resultant complacency has actually increased the threat.”

They personified the threat of these organisms as the enemy of mankind, explaining that there were “powerful evolutionary pressures on these micro-parasites.” Their analysis revealed intense mixing of microbes gene pools, highly crowded and impoverished non-immune urbanized populations, growing high speed travel (including almost 2 billion air passengers worldwide that year), populations displaced and vulnerable due to warfare, the absence of health care services in many areas, and growing environmental degradation. And in the middle of this human mess were tens of thousands of different viruses and some 300,000 different bacterial species capable of attacking humans.

In a JAMA article in 1996, Nobel Laureate Joshua Lederberg alerted the public that our fight with microbes was far from over, and that the odds were severely tipped in the microbes favor. The IOM 1992 report had noted that they outnumber us by a billion fold, and mutate a billion times more quickly than us. “Pitted against microbial genes”, Lederberg wrote, “we have mainly our wits.” He coined the term “emerging and reemerging diseases” to encompass historic infectious diseases as well as newcomers like HIV/AIDS.

Eradication of infectious diseases was now a dream of the past. We had been warned and re-warned. But as Ebola and SARS arrived in the early days of the new millennium, the scientific community in the U.S. and around the world were anything but sure-footed. Slowly policy leaders were awakening to the global nature of the threat. The George W. Bush administration in 2003 created the President’s Emergency Plan for AIDS Relief (PEPFAR) and the President’s Malaria initiative (PMI).

The WHO promoted early detection and notification obligations after China delayed notifying the world of its detection of SARS for almost four months. In 2019, they repeated the offense, but this time with a much more capable microbial foe, COVID-19. The microbe encountered weak defenses on arriving rapidly in the US. The health care system was spotty at best, unable to respond to the challenge with adequate material or manpower to manage the surge of morbidity and mortality. Trump denied, delayed, and distorted at every turn. And the disease deftly mutated, seemingly at will.

With U.S. deaths now approaching 1 million, confidence and trust in science has been grossly maligned. Our democratic institutions have been severely weakened. Our health care system remains porous and highly variable. The challenges are stark and the solutions somewhat obvious. We need universal health coverage, forward looking and coordinated national public health leadership, active participation in the global health community, policies that address income inequality, sound environmental policy, and modernization of our physical infrastructure.

The only question that remains is this – Do we, as Americans, now have the wisdom and determination to do what needs to be done?

Category: Uncategorized
Tags: CDC > covid > DOD > Ebola > Frank Snowden > george marshall > HIV > infectious disese > Joshua lederberg > michael osterholm > paul russell > SARS

Is There a “Famous Trio” in Human Science For the 21st Century?

Posted on | February 10, 2022 | 2 Comments

Mike Magee

Yale historian, Frank M. Snowden wisely notes in his 2020 book, “Epidemics and Society”, that “We must avoid the pitfall of believing the driver of scientific knowledge is ever a single genius working alone.”

To make his point, Snowden tells the story of what he terms “The Famous Trio” – three different scientists of the 19th century, who together launched and solidified ,“The Germ Theory” .

The first of the three was Louis Pasteur (1822-1895) a chemist with a sharp eye and mind. He had been hired to find a solution for wine and milk that was spoiling too fast. The tools he wielded were mostly observational, including a still primitive microscope. With it Pasteur was able to identify putrefying microbes as causal, but went two steps further. He noted that a heating process killed the microbes and halted the product putrefaction, and tied the microscopic organisms to specific human diseases. With this knowledge, he unveiled a commercial process of serial attenuation of disease causing microbes that allowed safe inoculation of humans and acquired immunity.

The second was Robert Koch (1834-1910), a physician 20 years younger than Pasteur. While studying Anthrax at the University of Gottingen, he visualized the large causative bacteria, introduced it into a lab animal, and reproduced the disease. Going one step further, he described resistant spores of the bacteria, identified them in grazing fields, and proved that eating grass laden with spores could spread Anthrax between animals. His careful investigative approach led to the uncovering of the etiology of tuberculosis and to “Koch’s Postulates”, four steps still in place today, which when followed, constitute laboratory based scientific proof of a theory. Beyond this, Koch was a technology innovator, teaming up with the Carl Zeiss optical company, whose lenses, in combination with specialized tissue stains and fixed culture mediums, allowed Koch to visualize and describe M. tuberculosis.

The third innovator was Joseph Lister (1827-1912), a professor of surgery at Edinburgh. Thanks to the development of ether and nitrous oxide in the 1840s, pain management intra-operatively was under partial control. Improving techniques and tools helped control blood loss. But post-operative infection remained a persistent and deadly threat. Viewing the work of Pasteur and Koch, Lister recognized the possibility that contamination with microbes might be the cause. In carefully designed studies employing hand scrubbing, sterilization of tools, and spraying the patient with carbolic acid, rates of post-operative sepsis declined. Other colleagues added sterile gowns, gloves and masks, merging these added measures with Lister’s support.

Arguably, the life-saving “Germ Theory” was the work product of complimentary insights and serial incremental progress. Can the same be said of the pharmaceutical industry whose outsize profitability owes much to a fascination with “me-too” drug production and direct-to-consumer marketing? It might also be reasonable to ask, of the $29 billion funded 729 digital health tech US-based startups in 2021, how many represent additive and progressive insights that might eventually lead to game-changing advances in the health of America?

Is there a “Famous Trio” in human science for the 21st century in the making? Who are they, and how do they complement each other?