Philippa Kaur

By Layal Liverpool

Systemic inequalities mean Black people often face worse health outcomesER Productions Limited/Getty Images
Inflamed: Deep medicine and the anatomy of injustice
Rupa Marya and Raj Patel
Allen LaneAdvertisement

THE covid-19 pandemic exposed stark inequalities globally, with socially and economically disadvantaged groups facing higher than average risks of becoming seriously ill and dying.
“Not all patients were equal,” write Rupa Marya and Raj Patel in their new book, Inflamed. The authors, both academics and activists, write: “[In the US,] Black, Indigenous, and people of colour (BIPOC) were over-represented, their bodies subject to inflammation of all kinds, long before the SARS-CoV-2 virus ever settled into their lungs. Not only lack of access to health care, but systemic social and economic disenfranchisement rendered their bodies most susceptible to Covid when it hit.”
Inflammation is the body’s response to infection or damage. Immune cells spring into action and a flurry of chemicals are released to promote repair and recovery – for instance, by destroying invading microbes or healing a wound. Once healing is complete and balance restored, inflammation should subside.
But sometimes it persists, transforming the body’s healing mechanism into what the authors describe as “a smoldering fire that creates ongoing harm”. For doctors to truly identify and treat the underlying causes of ill health, the two argue, they must begin by understanding how systemic racism and inequality contribute to this type of persistent, harmful inflammation in people’s bodies.
Inflamed delves into a growing body of research examining how inequality drives health disparities. For instance, Black people in the US are more likely to earn less and have more debt compared with white people, contributing to chronic stress. They are also more likely to be exposed to environmental health hazards, such as lead in drinking water, and to live in areas with limited access to affordable, healthy food options, making it difficult to maintain a healthy diet.
“High mortality rates in Black infants are halved when they are cared for by Black physicians”
All these factors, driven by systemic racism, combine “to create a potent pro-inflammatory threat”, write Marya and Patel. They add that the unequal distribution of these triggers of inflammation may explain why Black people have the highest rates of cardiovascular disease in the US.
Daily discrimination damages people’s health too, argue Marya and Patel. For instance, a 2018 US study found that Black men who reported directly experiencing unfair treatment by police, or hearing stories about it, had on average shorter telomeres – caps of DNA that protect the ends of chromosomes, and that shorten each time a cell divides – compared with Black and white men who didn’t report experiencing this trauma. “Racism is a cognitive load that is experienced throughout the body,” write the authors.
Doctors also contribute, they argue. In the US, Black newborn babies die at more than twice the rate of white newborns. Research suggests this mortality rate is halved when Black infants are cared for by Black physicians. Meanwhile, race-based medical practices, such as the use of an adjustment for Black race in equations used in many countries to estimate people’s kidney function, also contribute to health disparities.
Doctors need to be more aware of how someone’s environment and life experiences contribute to disease, say the authors. Even something as simple as air quality differs significantly depending on the environment, they say, with disparities within countries and between them. Most deaths linked to air pollution occur in low and middle-income countries.
Inflamed takes the reader on a journey deep inside the human body, travelling through the immune, circulatory, digestive, respiratory, reproductive, endocrine and nervous systems. In doing so, it reveals how external inequalities affect these systems and cause serious harm.

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By Annalee Newitz

noEnde/Shutterstock
PICK up a pack of cigarettes and you will probably see a terrifying picture of cancer lesions with a stern warning about how smoking can kill. For decades in the US, this was called the surgeon general’s warning, and it was a reminder that cigarettes are so bad that the government’s top doctor was against them. Now, the current surgeon general, Vivek Murthy, has recommended that we apply similar warnings to social media misinformation.
Speaking in mid-July to CNN, Murthy said that social media networks played a “major role” in circulating misinformation about covid-19. He said that this “harms … More

By Clare Wilson

In How to Mars, the Red Planet is so boring that TV ratings have tankedgorodenkoff/Getty Images
How to Mars
David Ebenbach
Tachyon PublicationsAdvertisement

IN 2012, a Dutch group announced a novel plan for financing the literally astronomical costs of setting up a base on Mars: the firm would sell the TV rights for the selection and training of the would-be astronauts and the colonisation process too.
While there was massive public interest and more than 4000 people worldwide applied to be part of what was admitted to be a one-way mission, the company involved, Mars One Ventures, seemed out of its depth and went bankrupt in 2019. Now the idea lives on in fiction, in the form of How to Mars, the debut sci-fi novel from David Ebenbach.
The book explores with both humour and pathos the consequences of humanity leaving the challenging task of extraterrestrial colonisation to a TV company focused on ratings and sponsorship opportunities. The pitfalls are obvious from the start. During the selection process, the firm, Destination Mars!, seems less interested in finding people with the “right stuff” than in creating a telegenic melting pot.
Scandinavian Stefan, who speaks almost accentless English, is secretly told to “sound more Danish”, leaving him suspicious of the accents of his competitors. During the training programme in an Australian desert, another applicant is ejected for making the mistake of “breaking the fourth wall”, or speaking to the camera.
“The Mars settlers are in a vulnerable position: their survival depends on the goodwill of a TV company”
As the book opens, the six scientists at the colony are two years into their mission and all is not well. The crew members have become bored – of each other, the monotonous food and the never-changing scenery.
Perhaps unsurprisingly, viewers are bored too, which means the team suffers the indignity of the show being cancelled for poor ratings. The TV company has no incentive to move to Stage Two: sending out the next batch of colonists and terraforming Mars. The crew’s handlers on Earth have been suspiciously quiet about that side of things for a while.
The settlers are in a vulnerable position: their survival depends on the goodwill of a company on which they are now just a financial drain. When they disagree about something with a handler, she sets them straight: “Do you realize that you don’t even get to eat unless we send you food?”
Fortunately for the story, the colonists’ lives soon take a more interesting turn, bringing fresh challenges as well as the return of TV viewers.
The humour has shades of Douglas Adams, whose The Hitchhiker’s Guide to the Galaxy series excelled at satirising the frustrations of ordinary people battling faceless bureaucracy. In Ebenbach’s novel, Destination Mars! saddles the colonists with towels that aren’t absorbent because they bear enormous company logos.
But on the whole, How to Mars is a more serious read than Hitchhiker’s, exploring themes such as bereavement and mental illness. One crew member’s turmoil in particular is portrayed with convincing realism.
Indeed, a genuine fear for Earth’s real-life space agencies is that future missions to Mars may be jeopardised by the astronauts coming to hate each other. This has been investigated in mock missions, where crews are isolated for months in sealed habitats.
So far, no space agencies have turned any such projects into reality TV. If How to Mars is any guide, let’s hope they never do.

Clare also recommends…
Book series
Red Dwarf
Grant Naylor
If funny sci-fi is your thing, try the Red Dwarf series by “Grant Naylor” – actually jointly written by Rob Grant and Doug Naylor, the two scriptwriters of the TV series of the same name.
Film
Galaxy Quest
Dean Parisot
This Star Trek spoof didn’t make a big splash on its release, but now has a cult following.

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By Michael Marshall

The Plimpton 322 tabletAndrew Kelly/Rare Books and Manuscripts Library, Columbia University
The ancient Babylonians understood key concepts in geometry, including how to make precise right-angled triangles. They used this mathematical know-how to divide up farmland – more than 1000 years before the Greek philosopher Pythagoras, with whom these ideas are associated.
“They’re using a theoretical understanding of objects to do practical things,” says Daniel Mansfield at the University of New South Wales in Sydney, Australia. “It’s very strange to see these objects almost 4000 years ago.”
Babylonia was one of several overlapping ancient societies in Mesopotamia, a region of southwest Asia that was situated between the Tigris and Euphrates rivers. Babylonia existed in the period between 2500 and 500 BC, and the First Babylonian Empire controlled a large area between about 1900 and 1600 BC.Advertisement
Mansfield has been studying a broken clay tablet from this period, known as Plimpton 322. It is covered with cuneiform markings that make up a mathematical table listing “Pythagorean triples”. Each triple is the lengths of the three sides of a right-angled triangle, where each side is a whole number. The simplest example is (3, 4, 5); others include (5, 12, 13) and (8, 15, 17).
The triangles’ sides are these lengths because they obey Pythagoras’s theorem: the square of the longest side is equal to the sum of the squares of the other two sides. This classic bit of mathematics is named for the Greek philosopher Pythagoras, who lived between about 570 and 495 BC – long after the Plimpton 322 tablet was made.
“They [the early Babylonians] knew Pythagoras’ theorem,” says Mansfield. “The question is why?”

Mansfield thinks he has found the answer. The key clue was a second clay tablet, dubbed Si.427, excavated in Iraq in 1894. Mansfield tracked it down to the Istanbul Archaeology Museums.
Si.427 was a surveyor’s tablet, used to make the calculations necessary to fairly share out a plot of land by dividing it into rectangles. “The rectangles are always a bit wonky because they’re just approximate,” says Mansfield. But Si.427 is different. “The rectangles are perfect,” he says. The surveyor achieved this by using Pythagorean triples.
“Even the shapes of these tablets tell a story,” says Mansfield. “Si.427 is a hand tablet… Someone’s picked up a piece of clay, stuck it in their hand and wrote on it while surveying a field.” In contrast, Plimpton 322 seems to be more of an academic text: a systematic investigation of Pythagorean triples, perhaps inspired by the difficulties surveyors had. “Someone’s got a huge slab of clay… [and] squashed it flat” while sitting at a desk, he says.
Journal reference: Foundations of Science, DOI: 10.1007/s10699-021-09806-0
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By Francesca Steele

Guy (Gael García Bernal) and Prisca (Vicky Krieps) in OldUniversal Pictures
Time is definitely not a healer in Old, the latest film from writer, director and producer M. Night Shyamalan, where the bodies of stranded tourists hurtle towards old age at an accelerated rate due to a local geological quirk.
This fascinating (and, typically for Shyamalan, high-concept) premise raises all sorts of thorny questions. What is important to us when time is short? What can time teach us –  and what can it steal from us? Can ageing prosthetics ever be applied convincingly?
Shyamalan, the film-maker behind supernatural thrillers including The Sixth Sense and The Village, has become as famous for the disappointing execution of excellent premises as he is for dreaming them up in the first place.Advertisement
Old, based loosely on the graphic novel Sandcastle by Pierre Oscar Lévy and Frederik Peeters, starts out as one of Shyamalan’s best efforts in years. It begins with such creepy camera angles and creepy casting that the slow pacing for which he is sometimes lambasted works perfectly.
Dread rises from the outset. Guy (Gael García Bernal) and Prisca (Vicky Krieps) have brought their children, 6-year-old Trent (Nolan River) and 11-year-old Maddox (Alexa Swinton), to an idyllic resort that Prisca pointedly reminds us she found randomly on the internet.

The dialogue is a little excessive. “You’re always thinking about the future. It makes me feel not seen!” yells Prisca. “You’re always thinking about the past. You work in a goddamn museum,” retorts Guy.
But if the script feels clunky, the production doesn’t. The family swan around their lush hotel room, as the camera spies them menacingly from outside like a predator. Trent has a habit of asking random hotel guests what they do for a living, but the way the camera pans across his subjects’ faces makes the exchange feel unsettling rather than adorable, as if we’re being introduced to an ensemble soon to be picked off.
A special day at an idyllic, private beach is arranged by the over-eager hotel manager. At the cove, hemmed in by rocks and swiftly abandoned by their shifty driver (Shyamalan himself, in the kind of cameo role beloved of Alfred Hitchcock), they find themselves stranded with a cast of characters worthy of an Agatha Christie murder mystery.
There is a doctor (Rufus Sewell, on fabulously sinister form), his trophy wife (Abbey Lee), their young daughter (Mikaya Fisher) and his mother (Kathleen Chalfant). Then there is psychologist Patricia (Nikki Amuka-Bird), who has epilepsy, her nurse-husband (Ken Leung) and a rapper (Aaron Pierre) whose partner washes up dead (and naked) the moment they arrive, heralding an onset of strange and increasingly grotesque symptoms.

Swimsuits become too tight. Patricia’s seizures disappear. A tumour balloons in minutes and must be cut out right there on the beach. A pregnancy is delivered moments after it begins.
There is no doubting Shyamalan’s talent for suspense. In the film’s first half, he labours lovingly over one shot where characters age years as the camera pans across the beach. In other scenes, it perches just behind children’s heads so we can observe their parents’ alarmed expressions without knowing precisely what is so shocking. Like a Stephen King novel, the horror here is not in the revelation but the build-up.
Sadly, Old is a stylistic triumph but a narrative dud. The second half of the film is severely hampered by too many undercooked ideas and a plot too intent on explaining itself. All those questions about what value we put on time – or ought to – are skirted over too fast. Philosophical enquiry makes way for a signature Shyamalan plot twist, which, in the end, feels perfunctory and unsurprising.
The film quickly loses its grip when it asks us to emotionally invest in characters even as it dispatches them one by one, collapsing in the process from a sinister body horror into a confused (sand)castle in the air.
Old is in UK and US cinemas now

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