Summary:

Since the first surgeon general was sworn into office in the 19th century, the Office of the Surgeon General has positioned itself as the leading voice on public health matters in the United States. In recent history, the office has had its highest profile campaigns rallying against issues such as tobacco use, obesity, and HIV/AIDS. Considering the combination of prevalence, morbidity, and mortality associated with these health issues, there is no doubt that any effort to stem the tide was a worthwhile endeavor.

When Dr. Vivek Murthy became the surgeon general in 2014, his office continued the historical campaigns against these health issues. At the same time, Dr. Murthy began investigating a looming epidemic within our borders: loneliness and social isolation.

It may be hard to convince the average person that loneliness is a problem of similar scale as tobacco use, obesity, or AIDS. There is no question that loneliness is unpleasant, even if it only lasts for a few moments. But the notion that one’s state of mind can predispose to disease or premature death somehow feels like a stretch. Addressing this skepticism, Dr. Murthy writes in his book about Dr. Julianne Holt-Lunstad, a psychologist at Brigham Young University who also faced a great deal of cynicism surrounding her research into the effect of social relationships on “everything from our behavior to our cellular function.” She had a breakthrough in 2010 when she published a massive study analyzing the health outcomes of over 300,000 participants, categorized by their degree of social connectedness. She found that social isolation was significantly linked to premature death, representing a risk nearly as serious as pack-per-day smoking, and more serious than obesity, alcohol use, and lack of exercise. Dr. Holt-Lunstad’s research spurred further studies which linked loneliness to heart disease, stroke, and depression, amongst other diseases.

These findings are hard to ignore, especially in light of the ongoing opioid addiction crisis and rises in teenage depression and suicide, all of which have been linked to loneliness and social isolation. In Together, Dr. Murthy weaves together scientific research, personal anecdotes, and current events to create a manifesto for tackling the next great public health crisis.

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For much of the western world, the Ebola crisis came and went without much fanfare. Perhaps we were jolted by the initial news stories, taken aback by the images from affected areas, and slightly unnerved by the travel advisories as we entered security lines at the airport. But for the most part, the Ebola outbreak was an abstract crisis affecting people on the other side of the world, multiple continents away. The closest that most Americans came to Ebola was to hear in the news about the four diagnosed cases in Texas and New York City. It is safe to say that most of the world remains unaware of the depths of this crisis in the West African hotspot countries of Liberia, Sierra Leone, New Guinea, and Nigeria.  

Arthur Pratt is a Sierra Leonian pastor and filmmaker, and he witnessed firsthand the invisible enemy that threatened to destroy his country, the communities, and the families that lived there. Despite the human cost that this disease extracted from the West African people, Pratt was inspired by how the people in Sierra Leone rose up to defend their country from a viral invasion that was attacking “the fabric of what it means to be African.” He felt it necessary to tell the world the story of Sierra Leone’s unsung heroes, and so he created a documentary titled Survivors, which focused on the work done by the ambulance drivers and nurses, interwoven with personal stories of children, mothers, fathers, and communities touched by the disease. Survivors gets up close and personal to the 21-month battle against Ebola in West Africa, and shows how the common people of Sierra Leone risked everything to come together and fight back against an existential threat.

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The world is a big place – 7.4 billion people and counting. As much as we all enjoy the game of finding our doppelganger in a crowd, there probably isn’t anyone in the world who is exactly like us. With a genetic code of over 3 billion base pairs, of which there are innumerable permutations, we would be hard pressed to find a clone of ourselves even if the world had 7 trillion people. The exception is if you were born with an identical sibling. But then again, you would know if you had a twin. Wouldn’t you?

The documentary Three Identical Strangers tells the unbelievable story of Bobby Shafran, Eddy Galland, and David Kellman – three identical triplets who were separated at birth and serendipitously reunited at the age of 19. The film takes us through the circumstances of their reunion, highlighting the brothers’ instant rapport over their similarities and the ensuing fame resulting from the public fascination with their extraordinary story. It began as a euphoria-filled saga complete with talk show interviews, movie cameos, and even a successful restaurant which they called “Triplets”.

The honeymoon phase ended in horrific fashion once the parents of the respective siblings began asking questions as to why the brothers were separated in the first place. A journalist who had been investigating the triplets’ adoption agency, Louise Wise Services, helped to uncover the details of an elaborate study performed by a child psychiatrist named Dr. Peter Neubauer. In this study, each brother was placed into a home which had another adoptive sister, and specifically assigned to a family of lower, middle, and upper-class backgrounds. While the exact details of the study objective remain unknown, it appears that the study was trying to determine whether psychiatric illness was correlated more strongly with genetics or with developmental environment; this is referred to colloquially as a “nature vs. nurture” experiment.

The implications were earth-shattering. The brothers struggled to cope with the realization that they had been marionettes in some sort of sick experiment, with Dr. Neubauer pulling the strings the whole time. Even worse was the fact that there were possibly several more identical siblings with the same story who were deprived of their biological soul mate, all at the behest of Neubauer and his associates. In fact, other sets of identical siblings were eventually made aware of the experiment, and did have the chance to meet, albeit many years after their birth.

The triplets also learned that their biological mother had serious psychiatric problems – hence their inclusion in the study. All three brothers had behavioral difficulties as adolescents, and it was distressing to consider whether their issues may have been exacerbated by the separation anxiety they experienced upon being separated at birth. In particular, Eddy suffered from worsening episodes of bipolar disorder throughout his life. In 1995, at the age of 33, he committed suicide. He is notably absent for the duration of the documentary, with Bobby and David narrating much of the film. Today, they are still trying to uncover the particulars of Dr. Neubauer’s study, but the research records remain under seal at Yale University until 2066. They may never know the full extent of what was done to them and why.

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What is an atlas? To most people, an atlas is a collection of maps constructed by cartographers who meticulously plot the surface of the earth, inch by inch. In the medical field, we use the word atlas to refer to textbooks of human anatomy, but the endeavor is much the same, and no less painstaking – the human body is quite complex, after all. Though some anatomy atlases are famous for their beautiful depictions of anatomical structures, it is more important that they are accurate. What good would a map be otherwise?  

Yet this quest for accuracy is founded on an inherent dishonesty. Anatomy atlases are supposed to be our guides to the human body, but in reality, they depict the anatomical structures of only a human body. Every person is different, and that goes for their underlying anatomy as well. That being said, these minor variations are fairly unimportant for learners at the novice level. At the same time, one can’t help but feel like these books have been stripped of the key element that defines what it means to be human.  

It is fitting that an artist would be the one to bring light to this issue. Laura Ferguson, Artist-In-Residence in the Master Scholars Program in Humanistic Medicine (MSPHM) at the NYU School of Medicine, has lived nearly her whole life with scoliosis. She saw in her own story the tendency of clinicians to boil a person down to a diagnosis – normal or abnormal. For doctors, this categorization is often necessary. But the artist recognizes that a person is more than just the sum of their parts. Laura saw past the medicalization of her anatomy and cherished the beauty of her curved spine.  

Laura’s arrival at the medical school ushered in a renewed focus on the humanism of medicine, starting with the Art & Anatomy seminar she began in 2009, open to students, doctors, researchers, and all other staff members at NYU Langone Health. In the seminar, students spend 90 minutes a week undertaking illustrations of various anatomical specimens: bones, organs, and even cadavers in the anatomy lab.  

Now almost a decade into this project, Laura has showcased her students’ work in her recent book Art & Anatomy: Drawings, co-edited by Katie Grogan, Associate Director of the MSPHM. Unlike with other anatomy books, the goal for her students was never to be “accurate”; such a word has limited meaning in the world of art. Instead, Laura taught students to observe things that they had never taken the time to see before. Then, she encouraged them to draw what they saw, as they saw it. The result is the compilation of drawings into a different kind of atlas – an atlas of the mind, of creative spirit, and of humanistic expression.

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Most students of biology are well aware of our humble beginnings as puny, single-celled lifeforms. The mechanism of our remarkable transformation was famously described by Charles Darwin in his groundbreaking text On the Origin of Species, published in 1859. In many respects, Darwin’s magnum opus was just the opening chapter of a much broader discussion of how we humans have taken our current form. Darwin elucidated only a general process of adaptation and evolution in the face of environmental pressures. He left his successors with the more onerous task of applying this rule to the tortuous history of human evolution.

Rising to the occasion nearly a full century later was Homer Smith, a prominent kidney physiologist who spent much of his life and career as the Director of Physiological Laboratories at the NYU School of Medicine. Dr. Smith shares his account of our evolutionary history in his 1953 book From Fish to Philosopher. In the book, he posits that organisms must have a system for maintaining a distinct “internal environment” in order to have any sense of freedom from the perennially dynamic external environment. He guides the reader through the various biological filtration devices that have come and gone over the eras, culminating with the fist-sized organs dangling next to our spines.

The book is often billed as a detailed treatise on how modern-day mammalian kidneys have arisen from their more primordial forms – a fair assessment, especially given the author’s background. But this book offers readers something much more ambitious in scope than a rehashing of his work in renal physiology. For example, the first chapter of the book, “Earth”, highlights geological milestones that molded the early environment of the first known lifeforms. In Dr. Smith’s words,

“the history of living organisms has been shaped at every turn by earth’s vicissitudes, because every geologic upheaval, by causing profound changes in the distribution of land and sea, has had profound effects on the climates of both, and hence of the patterns of life in both” (pp. 9).

By the final chapter, “Consciousness”, he has begun to ponder questions of metacognition and learning. He marvels at how our complex nervous system has allowed classical pianists to balance the rigidity required for technical prowess, and the fluidity required for creativity. This is not a textbook about our kidneys. From Fish to Philosopher is a story of mankind’s genesis, told through the existential musings of a physiologist who left no stone unturned.

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Leonardo da Vinci – the name alone evokes images of an artistic virtuoso, the Renaissance man, the mind behind the Mona Lisa. Though known best as an artist, his work extended beyond paintings into a myriad of disciplines, with notebook entries documenting his studies of optics, bird flight, comparative anatomy, hydraulics, and countless others. And yet what has been obscured by the shadow cast by his prolific career are the details of how a young man from a town called Vinci became Leonardo da Vinci. What did he do every day? What did he eat? Who were his friends? Did he even have any? We tend to immortalize Leonardo as a god, and yet he was human after all, not unlike the rest of us. This realization should encourage us to study one of history’s most celebrated humans, and see if we ourselves might be able unlock our own inner genius.

Walter Isaacson aids us in this study with his thoroughly researched biography of Leonardo da Vinci. He adds this to his growing portfolio of biographies of history’s great minds, including Benjamin Franklin, Albert Einstein, and Steve Jobs. In this most recent biography, Isaacson takes us through the life and times of Leonardo, highlighting milestones of his career, while also underscoring some of the seemingly trivial habits that were signatures of Leonardo’s personality and worldview.

Born of illegitimacy and openly gay, Leonardo was no stranger to defying convention. In fact, many of his grandest discoveries were a result of his willingness to challenge commonly accepted wisdom. Yet his greatest asset was his relentless curiosity and unquenchable thirst for knowledge, a recurring theme of Isaacson’s biography and of Leonardo’s life. Intertwined with this curiosity was his tendency to draw connections across disciplines, blurring the lines between art and science. Everything that Leonardo produced – whether his sketches of war machines, his treatises on anatomy, or his timeless portraits – was a manifestation of his desire for unifying knowledge.

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