interesting stuff...

[quotesfrommyreading]

Vibrio bacteria and copepods proliferated in warm, brackish coastal waters, where fresh and salty waters met, such as in the Sundarbans, an expansive wetlands at the mouth of the world's largest bay, the Bay of Bengal. This was a netherworld of land and sea long hostile to human penetration. Every day, the Bay of Bengal's salty tides rushed over the Sundarbans' low-lying mangrove forests and mudflats, pushing seawater as far as five hundred miles inland, creating temporary islands of high ground, called chars, that daily rose and vanished with the tides. Cyclones, poisonous snakes, crocodiles, Javan rhinoceroses, wild buffalo, and even Bengal tigers stalked the swamps. The Mughal emperors who ruled the Indian subcontinent up until the seventeenth century prudently left the Sundarbans alone. Nineteenth-century commentators called it “a sort of drowned land, covered with jungle, smitten by malaria, and infested by wild beasts,” and possessed of an “evil fertility”.

But then, in the 1760s, the East India Company took over Bengal and with it the Sundarbans. English settlers, tiger hunters, and colonists streamed into the wetlands. They recruited thousands of locals to chop down the mangroves, build embankments, and plant rice. Within fifty years, nearly eight hundred square miles of Sundarbans forests had been razed. Over the course of the 1800s, human habitations would sprawl over 90 percent of the once untouched, impenetrable, and copepod-rich Sundarbans.

Contact between human and vibrio-infested copepod had probably never been quite so intense as in these newly conquered tropical wetlands. Sundarbans farmers and fishermen lived in a world semisubmerged in the half-salty water in which vibrio bacteria thrived. It wouldn't have been particularly difficult for the vibrio to penetrate the human body. A fisherman who splashed his face with water by the side of a boat, say, or a villager drinking from a well corroded with a few ounces of floodwaters, could easily ingest a few invisible copepods. Each one might be infested with as many as seven thousand vibrios.

This intimate contact allowed Vibrio cholerae to “spill over” or “jump” into our bodies. The bacteria wouldn't have found a particularly welcome reception there, at first. Human defenses are designed to repel such intrusions, from the acid environs of our stomachs, which neutralize most bacteria, and the competitive wrath of the microbes that inhabit our gut to the constantly patrolling cells of the immune system. But in time, V. cholerae adapted to the human bodies to which it was repeatedly exposed. It acquired, for example, a long, hairlike filament at its tail that improved its ability to bond to other vibrio cells. Endowed with the filament, the vibrio could form tough microcolonies that could stick to the lining of the human gut like scum on a shower curtain.

Vibrio cholerae became what's known as a zoonosis, from the Greek zoon for “animal” and nosos for “disease”. It was an animal microbe that could infect humans. But V. cholerae wasn't a pandemic killer yet.

  —  Pandemic: Tracking Contagions, from Cholera to Ebola and Beyond (Sonia Shah)

[quotesfrommyreading]

You might have heard it referred to as a “murder” hornet. The bulky, thumb-sized hornet has the demeanour of a cartoonish supervillain, with its tiger-striped abdomen, large burnt orange-coloured face, teardrop eyes like a demonic Spider-Man and a pair of vicious mandibles. Despite a flurry of public concern to the contrary, murder hornets do not murder people; they kill honeybees. The hornets loiter outside bee hives and gruesomely decapitate emerging worker bees, dismembering the unfortunate victims and feeding the body parts to their larvae.

This carnage can go on until a hive is completely annihilated, the crime scene marked by thousands of scattered corpses. In some places, bees do fight back. Bees in the hornets’ native range have evolved a defensive tactic whereby a mob of bees will hurl themselves at a hornet that enters the hive, covering the invader in a ball-like mass and then vibrating their flight muscles to generate so much heat, up to 47C, that the hornet is roasted alive. Honeybees in Europe and North America, however, are unused to the hornet and are essentially helpless in face of the slaughter.

  —  How the speed of climate change is unbalancing the insect world

[quotesfrommyreading]

By tying career advancement to the publishing of papers, academia already creates incentives for scientists to do attention-grabbing but irreproducible work. The pandemic strengthened those incentives by prompting a rush of panicked research and promising ambitious scientists global attention.

  —  How the Pandemic Defeated America

[quotesfrommyreading]

On the way back to the main building, JC showed me the “layered security” protocols he had learned designing embassy properties: a fence, “no trespassing” signs, guard dogs, surveillance cameras … all meant to discourage violent confrontation. He paused for a minute as he stared down the drive. “Honestly, I am less concerned about gangs with guns than the woman at the end of the driveway holding a baby and asking for food.” He paused, and sighed, “I don’t want to be in that moral dilemma.”

That’s why JC’s real passion wasn’t just to build a few isolated, militarised retreat facilities for millionaires, but to prototype locally owned sustainable farms that can be modelled by others and ultimately help restore regional food security in America. The “just-in-time” delivery system preferred by agricultural conglomerates renders most of the nation vulnerable to a crisis as minor as a power outage or transportation shutdown. Meanwhile, the centralisation of the agricultural industry has left most farms utterly dependent on the same long supply chains as urban consumers. “Most egg farmers can’t even raise chickens,” JC explained as he showed me his henhouses. “They buy chicks. I’ve got roosters.”

JC is no hippy environmentalist but his business model is based in the same communitarian spirit I tried to convey to the billionaires: the way to keep the hungry hordes from storming the gates is by getting them food security now. So for $3m, investors not only get a maximum security compound in which to ride out the coming plague, solar storm, or electric grid collapse. They also get a stake in a potentially profitable network of local farm franchises that could reduce the probability of a catastrophic event in the first place. His business would do its best to ensure there are as few hungry children at the gate as possible when the time comes to lock down.

So far, JC Cole has been unable to convince anyone to invest in American Heritage Farms. That doesn’t mean no one is investing in such schemes. It’s just that the ones that attract more attention and cash don’t generally have these cooperative components. They’re more for people who want to go it alone. Most billionaire preppers don’t want to have to learn to get along with a community of farmers or, worse, spend their winnings funding a national food resilience programme. The mindset that requires safe havens is less concerned with preventing moral dilemmas than simply keeping them out of sight.

  —  The super-rich ‘preppers’ planing to save themselves from the apocalypse

[quotesfrommyreading]

Persecuted in both East and West, European communists of all stripes came to inhabit a culture of conspiracy, secrecy, and exclusivity. In their native countries they worked in cells, knew one another by pseudonyms, and communicated using passwords and dead-letter drops. In the USSR, they kept their thoughts to themselves, refrained from criticizing the party, and searched their lodgings for secret microphones. Wherever they were, they observed a “rigid etiquette,” which has been beautifully described by the writer Arthur Koestler in both his novels and his memoirs. Koestler, much of whose fiction and nonfiction describes his relationship with communism, himself was drawn to the German party in the 1930s, not least because of his attraction to secrecy, conspiracy, and intrigue: “Even a superficial contact will make the innocent outsider feel that members of the Party lead a life apart from society, steeped in mystery, danger and constant sacrifice. The thrill of being in touch with this secret world is considerable even for people with an adult and otherwise unromantic mentality. Still stronger is the flattering effect of being found worthy of a certain amount of trust, of being permitted to perform minor services for the harrassed men who live in such constant danger.”

The lure of an elitist existence, complete with access to privileges and to privileged information, remained an important part of the attraction of communism for decades. At his special Comintern school Wolfgang Leonhard read for the first time the same high-level telegrams circulated among the party bosses and realized how much more they contained than the propaganda fed to the masses: “I remember very well the feelings with which I held one of these secret information bulletins in my hands for the first time. There was a sense of gratitude for the confidence placed in me, and a sense of pride at being one of those officials who were sufficiently mature politically to be trusted with the knowledge of other points of view.”

  —  Iron Curtain: The Crushing of Eastern Europe 1944-1956 (Anne Applebaum)

[quotesfrommyreading]

In almost every country in the world this deification of institutions has been promoted by their antiquity. As nobody can remember when they were not, and as no authentic records exist of their first establishment, their genealogy can be traced direct to Heaven without danger of positive disproof.

  —  Where Will It End? (Edmund Quincy, 1857)

[quotesfrommyreading]

[In 2010], CBS Sports and Turner Broadcasting paid $771 million to the NCAA for television rights to the 2011 men’s basketball tournament alone. That’s three-quarters of a billion dollars built on the backs of amateurs—on unpaid labor. The whole edifice depends on the players’ willingness to perform what is effectively volunteer work.

  —  The Scandal of NCAA College Sports

[quotesfrommyreading]

Traditionally, you name a virus after the place where it is first identified. Needless to say, the local residents weren't very happy with calling this deadly microbe “Four Corners virus.” Not just because the bad publicity would cause vacationers to drive their RVs elsewhere, but because of the more general stigma. Already, a group of Navajo children visiting the state capital had been discriminated against because they happened to come from the Four Corners area.

So then we suggested “El Muerto virus,” after the Canyon del Muerto that was close to the site of capture of the rodent from which the virus was isolated. Unfortunately, this was near the site of a pivotal battle between the Navajo and Kit Carson's US Army. When people understood the history of what had actually happened there, we decided that maybe this wasn't such a good name either. Then there was the internal bickering among the scientists about who was the first to identify the virus, who had the right to name it, and so on. After this experience, there has been a gradual trend toward not naming diseases after places but to be descriptive about the nature of the clinical illness.

In the end, the decision was made to call it Sin Nombre, which is Spanish for “no name.” You'd never have gotten away with calling it No Name in English, but somehow the Spanish gave it a little flourish, and the name stuck. And nobody caught the irony that a virus that was killing Indians was called No Name for a people who have had no voice.

  —  The Next Pandemic: On the Front Lines Against Humankind’s Gravest Dangers (Ali S. Khan)

[quotesfrommyreading]

It is in vain to alledge, that our ancestors brought them hither, and not we. We inherit our ample patrimony with all its incumbrances; and are bound to pay the debts of our ancestors. This debt, particularly, we are bound to discharge: and, when the righteous Judge of the Universe comes to reckon with his servants, he will rigidly exact the payment at our hands. To give them liberty, and stop here, is to entail upon them a curse.

  —  Timothy Dwight IV, President of Yale College (1810)

[quotesfrommyreading]

In trying to figure out how one individual got sick, you couple the individual clinical investigation with the epidemiologic investigation. Then you align that with the entomology, or in this case the mammology, and go out and see which animals are there and which are potentially infected. Then you put these three pieces together to think about what is the right set of prevention strategies to try to keep other people from getting sick. This approach is a “One Health” approach to emerging infections. Not just to focus on humans but also the implicated animals and the environment to identify potentially novel prevention strategies. This is the pattern we follow when we prevent rabies in humans by vaccinating dogs.

  —  The Next Pandemic: On the Front Lines Against Humankind’s Gravest Dangers (Ali S. Khan)

[quotesfrommyreading]

There are seldom words or time enough to lay a conspiracy theory to rest. Each rebuttal is met with a fresh round of delusions.

  —  How Donald Trump Could Subvert the 2024 Election

[quotesfrommyreading]

Until the early nineteenth century few tools existed to detect a toxic substance in a corpse. Sometimes investigators deduced poison from the violent sickness that preceded death, or built a case by feeding animals a victim's last meal, but more often than not poisoners walked free. As a result murder by poison flourished. It became so common in eliminating perceived difficulties, such as a wealthy parent who stayed alive too long, that the French nicknamed the metallic element arsenic poudre de succession, the inheritance powder.

The chemical revolution of the 1880s changed the relative ease of such killings. Scientists learned to isolate and identify the basic elements and the chemical compounds that define life on Earth, gradually building a catalog, The Periodic Table of the Elements. In 1804, the elements palladium, cerium, iridium, osmium, and rhodium were discovered; potassium and sodium were isolated in 1807; barium, calcium, magnesium, and strontium in 1808; chlorine in 1810. Once researchers understood individual elements they went on to study them in combination, examining how elements bonded to create exotic compounds and familiar substances, such as the sodium-chlorine combination that creates basic table salt (NaCl).

The pioneering scientists who worked in elemental chemistry weren't thinking about poison in particular. But others were. In 1814, in the middle of this blaze of discovery, the Spanish chemist Mathieu Orfila published a treatise on poisons and their detection, the first book of its kind. Orfila suspected that metallic poisons like arsenic might be the easiest to detect in the body's tissues and pushed his research in that direction. By the late 1830s the first test for isolating arsenic had been developed. Within a decade more reliable tests had been devised and were being used successfully in criminal prosecutions.

But the very science that made it possible to identify the old poisons, like arsenic, also made available a lethal array of new ones. Morphine was isolated in 1804, the same year that palladium was discovered. In 1819 strychnine was extracted from the seeds of the Asian vomit button tree (Strychnos nux vomica). The lethal compound coniine was isolated from hemlock the same year. Chemists neatly extracted nicotine from tobacco leaves in 1828. Aconitine – described by one toxicologist as “in its pure state, perhaps the most potent poison known” – was found in the beautifully flowering monkshood plant in 1832.

And although researchers had learned to isolate these alkaloids – organic (carbon-based) compounds with some nitrogen mixed in – they had no idea how to find such poisons in human tissue. Orfila himself, conducting one failed attempt after another, worried that it was an impossible task. One exasperated French prosecutor, during a mid-nineteenth-century trial involving a morphine murder, exclaimed: “Henceforth let us tell would-be poisoners; do not use metallic poisons for they leave traces. Use plant poisons...Fear nothing; your crime will go unpunished. There is no corpus delecti [physical evidence] for it cannot be found.”

So began a deadly cat and mouse game – scientists and poisoners as intellectual adversaries. A gun may be fired in a flash of anger, a rock carelessly hurled, a shovel swung in sudden fury, but a homicidal poisoning requires a calculating intelligence. Unsurprisingly, then, when metallic poisons, such as arsenic, became detectable in bodies, informed killers turned away from them. A survey of poison prosecutions in Britain found that, by the mid-nineteenth century, arsenic killings were decreasing. The trickier plant alkaloids were by then more popular among murderers.

In response, scientists increased their efforts to capture alkaloids in human tissue. Finally, in 1860, a reclusive and single-minded French chemist, Jean Servais Stas, figured out how to isolate nicotine, an alkaloid of the tobacco plant, from a corpse. Other plant poisons soon became more accessible and chemists were able to offer new assistance to criminal investigations. The field of toxicology was becoming something to be reckoned with, especially in Europe.

The knowledge, and the scientific determination, spread across the Atlantic to the United States. The 1896 book Medical Jurisprudence, Forensic Medicine and Toxicology, cowritten by a New York research chemist and a law professor, documented the still-fierce competition between scientists and killers. In one remarkable case in New York, a physician had killed his wife with morphine and then put belladonna drops in her eyes to counter the telltale contractions of her pupils. He was conviced only after Columbia University chemist Rudolph Witthaus, one of the authors of the 1896 text, demonstrated the process to the jury by killing a cat in the courtroom using the same gruesome technique. There was as much showmanship as science, Witthaus admitted; toxicology remained a primitive field of research filled with “questions still unanswerable”.

  —  The Poisoner's Handbook: Murder and the Birth of Forensic Medicine in Jazz Age New York (Deborah Blum)

[quotesfrommyreading]

Performance-enhancing drug use is bound with the history of cycling, especially the Tour de France, a three-week, 2,000-plus-mile race. The event, held every July, is almost impossibly hard, and has been that way since its debut in 1903.

Riders have always found ways to make the race easier. In 1904, cyclists left their bikes and hitched rides in cars, trains or buses to cut miles off the route. Every stage winner and the first four finishers were among twenty-nine riders punished for cheating that year, ushering in the Tour's dance with dishonesty.

Through the early 1900s, riders relied on substances like ether, cocaine and strychnine to blunt the pain. Some stopped at bars to chug wine and other numbing spirits. They used cocaine-based mixtures to convince their bodies they could go on when their brains said they couldn't. Riders believed they could breathe easier if first they had taken some strychnine (so highly toxic it is used as rat poison) and/or nitroglycerine (given to heart attack patients to stimulate the heart).

The abuse of these drugs was affirmed by Henri Pélissier and his brother, Francis, French riders who abandoned the 1924 Tour and then gave a blockbuster interview to a journalist, Albert Londres, of Le Petit Parisien. The story was titled, “Les Forçats de la Route” – “The Prisoners of the Road.”

Henri Pélissier told Londres, “You have no idea what the Tour de France is like. It's like martyrdom. And even the Stations of the Cross had only fourteen stations, while we have fifteen stages. We suffer from start to finish.” Pélissier showed the journalist the contents of the bag he had carried throughout the race: cocaine for the eyes, chloroform for the gums, horse ointment for the knees. Pills he called “dynamite.”

Amphetamines became popular in the mid-1940s, and would lead to dangerous accidents. French rider Jean Malléjac collapsed with his bike at the 1955 Tour, six miles from the summit of Mont Ventoux, the famous bald mountain that towers more than 6,200 feet above the Provence retion of France, and fell onto boulders at the roadside, with one foot attached to a pedal and the other pawing frantically through the air. He remained unconscious for fifteen minutes in what the Tour doctor deemed an amphetamine-fueled breakdown.

Another French cyclist, Roger Rivière, landed in a tangle of metal at the bottom of a steep slope after crashing over a wall during the 1960 Tour. He broke his back. Doctors found painkillers in his pocket, which could have distorted his judgment and slowed his reflexes so much that he had been unable to apply his brakes. He never regained use of his lower limbs. Just two years later, fourteen Tour riders left the race because they had been sickened by morphine.

The Tour and drugs went hand in hand, despite a growing public concern. Five-time Tour winner Jacques Anquetil was famously open about his own regimen. He once said, “You can't win the Tour de France on mineral water alone...Everybody dopes.” Nothing was illegal.

By 1963, doping had grown so dangerous that a group of cyclists, doctors, lawyers, journalists and sports officials came together to push for drug testing. Two years later, France passed its first national antidoping laws and drug testing began at the Tour.

Led by Anquetil, riders balked. Before the Tour's first stage, they gathered and chanted, “No pissing in test tubes!” Their protest included walking their bikes for the first fifty meters of that stage. Félix Lévitan, the Tour director, called the riders “a band of drug addicts” bent on “discrediting the sport of cycling.”

Then came one of the blackest days in cycling's dark history. On July 13, 1967, the British rider Tom Simpson began zigzagging across the road not far from the top of Mont Ventoux. He finally toppled over, then told a British team mechanic, “Get me up, get me up. I want to go on. I want to go straight. Get me up, get me straight.” Spectators helped him back onto his bike, but just one hundred meters later, he crumpled onto the road again, still gripping his handlebars as he went into a coma.

Three hours later, he was dead. An autopsy report said he had died of heat prostration that led to a heart attack. But his jersey pockets told another story. In them were empty vials dusted with amphetamines.

  —  Cycle of Lies: The Fall of Lance Armstrong (Juliet Macur)

[quotesfrommyreading]

Every smell begins with a molecule. Whether it is a charcoal whiff of the smoke off a grill on a summer evening, the lemon dish soap in my mother's kitchen, or the acrid breeze that greets me at the garbage dump, every aroma is made up of invisible particles. A single scent can hold more than a hundred of them, combining to create the complex aroma of Chanel No. 5, of ham roasting on Christmas day, of the brined ocean shore in Maine.

 —   Season to Taste: How I Lost My Sense of Smell and Found My Way (Molly Birnbaum)

[quotesfrommyreading]

Diodorus Siculus spent much of his life describing major historical events such as the fall of Troy or the rise of Alexander the Great. But, sometime in the middle of the first century BC, the Sicilian-born Greek writer felt moved to address a contemporary issue that had captured his attention: the drinking habits of the Gauls, the Celtic people who occupied modern-day France at this time.

The Gauls were, he observed, excessively fond of wine, so much so that they usually drank it neat and often went into battle inebriated. In Siculus’s eyes, this love of the grape not only betrayed the Gauls’ lack of breeding (a civilised Roman would always dilute his wine), it also left them open to exploitation by canny Roman traders.

“Many Italian merchants, with their usual passion for money, look on the Gallic craving for wine as their treasure,” he wrote. “They transport the wine by boat on the navigable rivers and by wagon through the plains, and receive in return for it an incredibly high price.” Then, with thinly veiled incredulity, Siculus added: “For an amphora [a wheel-thrown terracotta container that typically held around 20 litres of liquid] of wine they get in return a slave – a servant in exchange for a drink!”

It will come as a shock to absolutely no one to learn that human beings were every bit as likely to succumb to the temptations of drink 2,000 years ago as they are today. What many people will find more surprising about Siculus’s words, however, is the picture they paint of relations between the Romans and their Celtic neighbours – one in which the two peoples were engaging in trade, rather than hacking each other to pieces.

In the popular imagination, the Celtic-speaking people of western Europe were constantly at war with the Romans. The truth was very different. There were battles, of course, and the relationship would eventually end in bloodshed and subjugation after Julius Caesar launched his campaigns of conquest in Gaul in 58 BC. But the violence was preceded by long periods of peace and collaboration, and that collaboration benefited both parties.

Siculus clearly thought that the Gauls were being duped by wily Roman traders. After all, in Rome a Gaulish slave would fetch five or six times the price they could command at home. But Siculus was missing the point. In Gaul, slaves were available in surplus, a result of raiding between rival tribes. Once an external market developed for slaves, raiding could be intensified to satisfy the demand. A Gaulish leader could then offload surplus slaves in return for Roman wine that, distributed to his followers, would greatly enhance his status. For the chief, then, it was a very good deal indeed.

The Roman merchants were also doing very nicely out of their trading links with the Gauls. By the late second century BC, the Roman economy was changing dramatically. Small farms were being bought up and merged into vast estates run for their aristocratic owners by managers commanding armies of slave workers. The easiest commodity to produce on the slave-manned farms was wine. But as the estates grew and became more reliant on grape monoculture, wine production began to outstrip Italian demand. For the estates in western Italy, the solution to the problem was simply to ship the surplus to the major ports of southern Gaul – Massalia (Marseilles) and Narbo (Narbonne) – where middlemen were ready to transport it to the Gauls. The slaves acquired in return were brought back to labour on the estates. It was a system that benefited everyone – except, of course, the slaves.

  —  The Celts: were they friends or foes of the Romans?

[quotesfrommyreading]

Around the world, the cost of a transplant on the black market ranges from $20,000 to $200,000 – the higher price generally reflecting better treatment and care. The “donor” typically receives a fraction of this cost. The amount that they receive varies from country to country. In the Philippines and Columbia impoverished farmhands and bonded labourers have been documented as receiving less than $2,000 for a kidney. In contrast, kidneys have been sold for between $10,000 and $20,000 in Israel and Turkey.

In Egypt a kidney can sell for anywhere between $5,000 and $20,000. Patients, or “transplant tourists”, pay between $50,000 and $100,000 for a kidney transplant, including travel and accommodation. The price generally depends on market demand. For a kidney, the price paid to the seller can be anywhere between $5,000 and $20,000. Part of the broker’s job is to find out just how wealthy the buyer is, and to establish the absolute minimum the seller is prepared to accept. An impoverished, unemployed seller with no legal status is in no position to negotiate. For this reason, illegal migrants make valuable targets.

A series of drawn-out conflicts in the region have supplied a steady flow of people whose desperation can be commodified in different ways: bodies to be smuggled, sold or harvested. Hakim said that he referred between 20 and 30 sellers a week, who are themselves referred to him by his contacts in Khartoum. “They agree the deal [organ sale] in advance, and I call my uncle to receive them. After the operation, they continue to the coast to try and make the crossing,” he said. Most, he said, don’t make it across the Mediterranean.

I asked whether he felt any remorse for the people he was exploiting. “Yes, I feel bad for them. But I always give them their money. There are other brokers who would agree with you on a price, then disappear after the surgery without paying you,” Hakim said. “This happens at least 40% of the time.”

Most people are not paid what they are promised, but because it is illegal to sell a kidney there is little they can do. Brokers and the medical professionals they work with are aware of this, using the threat of criminal prosecution to silence their victims.

I met Hiba, a young single mother from Sudan, in Cairo in March 2020. She sold her kidney to help support her young daughter. She had been promised $10,000, but was paid $4,000. After she recovered from the surgery, she went back to the hospital to get her money. But prior to the surgery, she had signed documents that stated she was donating her kidney for free. This was enough to give those involved with the surgery legal cover. And now, if Hiba chose to report them to the police, she could be arrested for the criminal offence of selling a kidney. She was powerless to get the full fee she’d been promised.

One reason that worldwide convictions for illicit organ removal are so rare is that victims are reluctant to come forward. Another is systemic corruption. Hakim suggested that doctors pay bribes to protect themselves from police investigations. But he added, a little vaguely: “The doctors are not controlling the business. The people who control this business take a commission from the doctors. You don’t know them or what they do. You just know that those people take a commission from doctors, they control the business [the organ trade] – otherwise, no doctor would be able to work [performing transplants].”

When I asked Hakim if he meant government officials, he simply replied, “They are people higher up.” The threat of arrest, Hakim claimed, acts as a form of official extortion. Corrupt medical professionals, performing illegal transplants, who pay for protection will not be investigated, while those who refuse to pay could be arrested.

  —  ‘For me, there was no other choice’: inside the global illegal organ trade

[quotesfrommyreading]

The arrival of a patient with acute leukemia still sends a shiver down the hospital's spine – all the way from the cancer wards on its upper floors to the clinical laboratories buried deep in the basement. Leukemia is cancer of the white blood cells – cancer in one of its most explosive, violent incarnations. As one nurse on the wards often liked to remind her patients, with this disease “even a paper cut is an emergency.”

For an oncologist in training, too, leukemia represents a special incarnation of cancer. Its pace, its acuity, its breathtaking, inexorable arc of growth forces rapid, often drastic decisions; it is terrifying to experience, terrifying to observe, and terrifying to treat. The body invaded by leukemia is pushed to its brittle physiological limit – every system, heart, lung, blood, working at the knife-edge of its performance. The nurses filled me in on the gaps in the story. Blood tests performed by Carla's doctor had revealed that her red cell count was critically low, less than a third of normal. Instead of normal white cells, her blood was packed with millions of large, malignant white cells – blasts, in the vocabulary of cancer. Her doctor, having finally stumbled upon the real diagnosis, had sent her to the Massachusetts General Hospital.

  —  The Emperor of All Maladies: A Biography of Cancer (Siddhartha Mukherjee)