Hello. This is Eric Topol for Medscape. It's my incredible privilege today to speak one-on-one with Michael Lewis, the storyteller of our era, about his new book, The Premonition: A Pandemic Story. Find more on Medscape: wb.md/34TO9LV
As a still-licensed RN who was retired from the bedside 19 years ago, I have been shocked and dismayed by our society's response to Covid19. I remember before the polio vaccines, hearing that public playgrounds were closed and my father building a swing-set for us. Of course from then on, all the kids on the block played in OUR yard. I remember lining up at the Drs office with my 4 sibs for our Salk vaccine. On cSpan I recently saw a public information film depicting small towns competing with each other by ad hoc immunization clinics at community centers, schools, libraries and other public places. I learned that during the 1919 flu pandemic that people were quarintined by having their doors nailed shut by public health officers. I also learned that when you had a communicable disease, two people showed up at your door; one a health worker and the other a policeman who, if you refused treatment, would transport you to the public hospital. These two vignettes illustrate the fact that the US once had a public health system. Until I saw the Lewis story on 60 Minutes, I thought the politicization of disease was something new. This interview disabused me of this notion.
In Michael Lewis' podcast (Against The Rules: 6 Levels Down), they go into detail about a company trying to make sense on how medical billing works. I wish them (and Turquoise Health) lots of luck!
The contrast between the Fifth Risk and A Premonition is explained in A Premonition. These institutions were once important and did great work. The Fifth Risk calls out the incoming Trump administration for failing to respect the value of government, yet that really started with Reagan. A Premonition shows Reagan knee-capping and politicizing the CDC and we should presume also the FDA. Hence the two books are not contradictory, they just have skewed timelines. (Addresses comments at roughly 32 minutes into the video.)
Excellent interview with Michael Lewis I look forward to reading his book. Michael is modest he is a incredible sleuth investigator and writer I'm glad he is so curious about things. I saw the videos coming across from China too and thought the same things as Charity Dean things were surreal; at first I saw these pictures of big dirt movers in an area where they wanted to build a temporary hospital, then people being locked in, hysterically crying nurses in China a Doctor that China didn't want to talk. At the time I thought this was big virus and coming here too all from some information I remember in 5 or 6th grade social studies (I wasn't a A student either)pandemics. Michael's books should be required reading in High School, he gets to the root of things, fascinating writer hope he does a biography of himself one day. Michael is a American un sung hero. I'm looking forward to reading his latest two books, haven't yet.
Most Americans drive to work from increasingly wider radiuses. So, the biggest social network for transmission is the gas stations and convenience stores.
Third thought. FEMA and Katrina. How does federalism hinder the formation of an actually competent and potent CDC? “Form follows function.” If the CDC lacks ability to actually do what we want it to do, how can we expect it to have grown in the way we wanted it to be? Remember, FEMA couldn’t act in Louisiana until Louisiana asked for help. This created a gap in the event Louisiana lost the ability to ask for help. Beau of the Fifth Column recently highlighted that these United States became the United States (plural became singular) after the Civil War. Yet we haven’t fully become one. Often the federal can’t do what needs to be done in a timely manner required by crisis because of our law. So what should we really expect from the CDC?
New thought: CDC came about shortly after WWII. Problems arose with the politicization during the Reagan years. The CDC, and we’ll presume FDA, can’t function quickly as required in a fog of war. Is there also contribution from the lack of true warriors? The WWII generation phased out in that same time window. Warriors were comfortable working with risk and uncertainty. Now those who had never faced true difficulties rose to power. Add to this, at the same time, computers and big data came along. Not only do you now have those inexperienced working in a fog of war, you now have them used to having data and living in an illusion of being all knowing. This is why Chess isn’t strategic and games like Settlers of Catan, Risk 2210 AD, Root, Everdell, Horrified, Pandemic, Sid Meier’s Civilization, and yes D&D or other “matrix” games are better for teaching thought patterns.
