Read Why We Get Sick: The New Science of Darwinian Medicine by Randolph M. Nesse George C. Williams Online


The answers are in this groundbreaking book by two founders of the emerging science of Darwinian medicine, who deftly synthesize the latest research on disorders ranging from allergies to Alzheimer's and from cancer to Huntington's chorea. Why We Get Sick compels readers to reexamine the age-old attitudes toward sickness. Line drawings....

Title : Why We Get Sick: The New Science of Darwinian Medicine
Author :
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ISBN : 9780679746744
Format Type : Paperback
Number of Pages : 304 Pages
Status : Available For Download
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Why We Get Sick: The New Science of Darwinian Medicine Reviews

  • Kyle
    2019-02-15 05:30

    The title and physical design of this book gave me the initial impression that this book was fluff. "The New Science" made it sound, frankly, like pseudoscience. The impression of pseudoscience (perhaps I was alone in that first impression) does the book a disservice, however; the book is not pseudoscience fluff. In technical terms, it is some damn good stuff. Randolph Nesse is a biomedical doctor well-known and respected in the academic community. Williams is an evolutionary Anthropologist and biologist (or rather, he was; he died a few years ago). Anyway, that's beside the point; the point is, these two authors know their stuff and the book benefits from their holistic research backgrounds. "Why We Get Sick" is an interesting title, since the question plagues each chapter. Evolutionary medicine concerns the "why" questions of medicine and health, as opposed to the "what" or "how" questions focused on in regular medical practice. Evolutionary medicine tries to put health in an evolutionary context, and humans in relation to their evolutionary past; all wonderfully worthy goals. Yet, the problem with this approach is that there is simply too much we don't know; evolutionary medicinal research constantly tries to bring theorizing into the realm of testability, and often fails.Hence, the greatest strength of this book is actually its greatest weakness. Nesse & Williams know their shit, yet because of that, they are hesitant to actually provide firm claims to knowledge. This is a good thing! But, it also brings the title of the book into question. Why do we get sick? answer: we're still working on that, but in the meantime there has been a lot of cool and interesting research that provides clues. If you go into this book expecting hard answers, you will be disappointed; however, if you go into the book expecting interesting questions and thought-provoking clues about how medicine relates to the humans as evolutionary animals, then you will be very pleased. This book makes a wonderful introduction into the world of evolutionary medicine, and would be a great companion book to something like Evolutionary Medicine, A Planet of Viruses, or Parasite Rex (with a New Epilogue): Inside the Bizarre World of Nature's Most Dangerous Creatures. We like to study history because the past can give us clues about the future; bio-medicine is no different, and looking into the human evolutionary past can provide wonderful clues about the human future.

  • M7md Alghanmi
    2019-01-29 09:20

    كنت أتساءل لفترة طويلة عن "كيف نظرية لها فترة طويلة تحت الدراسة والتطبيق ولها قبول واسع جدا في كثير من الأوساط العلمية؛ كيف نظرية تم تطبيقها بقوة في كل المجالات العلمية تقريبا؛ كيف نظرية أثرت على مسيرة المعرفة البشرية بهذا الزخم؛ كيف نظرية بحجم نظرية دارون الى الآن لم يتم تطبيقها على الطب؟؟"…وكان هذا الكتاب جواب جميل مبدئيا على ذاك السؤال.…"لماذا نمرض؟"الكتاب يجيب على هذا السؤال حسب وجهة نظر أكثر شمولية من معظم ما ندرسه في كلية الطب."لماذا يهاجم الجسم نفسه أحيانا؟""لماذا -في عائلة تحمل نفس الجينات- يصاب فقط بعض أفرادها؟""لماذا تكون يبالغ الجسم أحيانا في ردة فعله تجاه المرض الى درجة انه قد يؤذي نفسه؟""لماذا تنتشر بعض الأمراض في مناطق جغرافية معينة؟"والإجابات دائما كانت ابعد من مجرد تبرير لإصابات فردية.…هذا الكتاب لن يغير طريقتك في ممارسة الطب، ولن يؤثر بشكل كبير على كيفية دراستك له…كل ما سيفعله هذا الكتاب هو فتح أبواب جديد للتفكير في الأمراض وأعراضها وردود فعل أجسادنا لها،هذا الكتاب سيجعل دراستك للطب أكثر متعة، وأعمق تفكيرا، وأبعد نظرة مما هي عليه.أظن انه من حقك على نفسك كطبيب أو طالب طب أن تقرأ هذا الكتاب.

  • Soumya Sayujya
    2019-02-04 12:40

    When something terrible happens(and serious disease is always terrible )people want to know why. In a pantheistic world, the explanation was simple one God had caused the problem,another could cure it. In the time since people have been trying to get along with only one God,explaining disease and evil has become more difficult. Generations of theologians have wrestledwith the problem of theodicy-how can a good God allow such bad things to happen to good people? An evolutionary approach to disease studies not the evolution of the disease but the design charac-teristics that make us susceptible to the disease. The apparent flaws in the body'sdesign, like everything else in nature, can be fully understood only with evolutionary as well as proximate explanations. Trying to determine the evolutionary origins of disease is much more than a fascinating intellectual pursuit; it is also a vital yet underused tool in our quest to understand,prevent, and treat disease.This book answers variety of questions which must be nagging every individual either consciously orsubconsciously like”Why isn't the body more reliable? Why is there disease at all? When viewedfrom Darwininan percepective the reasons are remarkably few :::First, there are genes thatmake us vulnerable to disease. Some though fewer than has been thought-are defectivescontinually arising from new mutations but kept scarce by natural selection. Other genes cannot beeliminated because they cause no disadvantages until it is too late in life for them to affect fitness. Most deleterious genetic effects, however, are actively maintained by selection because they have unappreciated benefits that outweigh their costs. Some of these are maintainedbecause of heterozygote advantage; some are selected because they increase their own frequency, despite creating a disadvantage for the individual who bears them; some are genetic quirks that have adverse effects only when they interact with a novel environmental factor.Second, disease results from exposure to novel factors that were not present in the environment in which we evolved. Given enough time, the body can adapt to almost anything,but the ten thousand years since the beginnings of civilization are not nearly enough time, and we suffer accordingly. Infectious agents evolve so fast that our defenses are always a stepbehind. Third, disease results from design compromises, such as upright posture with its associated back problems. Fourth, we are not the only species with adaptations produced andmaintained by natural selection, which works just as hard for pathogens trying to eat us and the organisms we want to eat. In conflicts with these organisms, as in baseball, you can't win'em all. Finally, disease results from unfortunate historical legacies. If the organism had beendesigned with the possibility of fresh starts and major changes, there would be better ways of preventing many diseases. If evolution proceeded by implementing sensible plans,how benificial would it be to human beings,saving us a lot of discomfort! (But REMEMBER natural selection caresonly about our fitness, not our comfort) So evolution does no sensible planning. It always proceeds by just slightly modifying what it already has. Alas, every successive generation of thehuman body must function well, with no chance to go back and start afresh. The human body turns out to be both fragile and robust. Like all products of organic evolution, it is a bundle ofcompromises, each of which offers an advantage, but often at the price of susceptibility to disease. These susceptibilities cannot be eliminated by any duration of natural selection, for it is the very power of natural selection that created them.Also, this book brings us face to face with the harsh reality that natural selection has no mandate tomake people happy, and our long-range interests are often well served by aversive experiences. Natural selection does not select for health, but only for reproductive success. Thereare genes that cause disease but may possibly increase reproductive success (at least in modern societies). If a gene increases the rate of successful reproduction-by whatever mechanism-it will spread.This book also shows us why we can't win against bacteria? Its because the bacteria evolves much faster than we do. It has a new generation every hour or so, while we take twenty years. Thank goodness we can still kill it with antibiotics, although this may be a temporary blessing. Alsoexplaining why we must act accordingly to doctor’s prescription and take as many doses as theyprescribe::” You will do yourself and the rest of the world a favor by taking your antibiotics even after you feel better, because otherwise you may be giving a lift to those variants thatcan survive short exposures to antibiotics, and those antibiotic-resistant organisms make lifedifficult for us all."Then the book goes to explain how the many of the mordern age diseases would not have beenpossble when humans last evolved(persumably in stone age)and so how we are not yet evolvedsuitably to the present novel environment:: Myopia is a classic illustration of a disease whosecause is simultaneously strongly genetic and strongly environmental. To become myopic, a person must have both the myopia genotype and exposure to early reading or other close work. Many other diseases also result from complex gene-environment interactions. For instance,some people eat all the fat they want and never get heart disease, while others eat the sameamount of fat and drop dead at age forty.Finnally, A Darwinian perspective on medicine can, however, help us to understand the evolutionary origins of disease, and this knowledge will prove profoundly useful in achievingthe legitimate goals of medicine:: Diseases do not result from random or malevolent forces, they arise ultimately from past natural selection. Paradoxically, the same capacities that make us vulnerableto disease often confer benefits. The capacity for suffering is a useful defense.Autoimmune disease is a price of our remarkable ability to attack invaders. Cancer is the price of tissues that can repair them-selves. Menopause may protect the interests of our genes inexisting children. Even senescence and death are not random, but compro-mises struck bynatural selection as it inexorably shaped out bodies to maximize the transmission of our genes.In such paradoxical bene-fits, some may find a gentle satisfaction, even a bit of meaning-atleastthe sort of meaning Dobzhansky recognized. After all, nothing in medicine makes sense exceptin the light of evolution.Have you ever asked yourself “WHY ME” after falling sick? Then read this book cause it answers allof them beautifully!

  • Justin
    2019-02-19 05:18

    Started off good and is a great concept for a book, is almost 20 years out of date, it offers way too many questions without enough answers, and it tends to overreach in some of its explanations (especially when they start talking about matters of the mind). Also the format is distracting with a new topic every turn of the page and not always the most engaging writing. Better off as an intro to the field, and one that should be skimmed, not intently read.

  • Diana Pauksta
    2019-01-28 08:18

    READ THIS BOOK! it's fascinating and it makes sense. it explains a lot about why our bodies malfunction in the ways they do and how many diseases/genetic disorders were actually trade-offs for increasing our genetic fitness (the ability of your offspring to produce viable offspring themselves). i read it for ecology + evolution of human disease, and it is the most interesting and accessible science book i've read.

  • Stephen
    2019-01-21 10:34

    Years ago I read an exceptional book on evolution by David Sloan Wilson. I say exceptional because it advocated for freeing evolution from being mere natural history: instead, Wilson argued that we should use it to understand all matters biological, including medicine. He used as his example the case of morning sickness in pregnancies, revealing research that illustrated that far from being a problem to be solved, morning sickness is an adaptive behavior which protects fetuses from foods that might be toxic to them in their highly vulnerable state. This application of evolution floored me, and so you can imagine my delight to discover an entire book on the subject, Why We Get Sick.For the most part, Why We Get Sick fulfills my anticipation, though its authors are writing mostly to introduce the concept of evolution-informed medicine to the public. Though they share the insights that research with this focus have revealed already, in any more instances they can only offer speculation, as Darwinian medicine is still quite new. The book covers general health, and explains the science of injuries, nutrition, and sickness. They establish early on that the Darwinian model can help us understand a given disease's ultimate root, and avoid prolonging it in our clumsy efforts to dispels the symptoms. Often symptoms of a disease are actually the products of our own immune system, and if we disrupt those defenses the disease itself is given free reign. Fevers, for instance, are one of our body's ways of disrupting an infection. It doesn't matter to our genes if it makes us uncomfortable: they're more concerned with killing the invaders. But the invaders have their own defenses, and they adapt a lot more quickly than we do -- another reason some diseases to be here to stay, like the flu. The existence of multiple flu strains and our constant attempts to find new ways to kill them are evolution in action, the ongoing biological arms race. Other physical ailments are hangovers of evolution, like our back problems and heel spurs; walking upright on two feet is something our bodies are still getting used to. We haven't even started adapting to novel environments, another element of disease: we have bodies accustomed to hardship now living in a world of abundant, cheap food and easy living. Little wonder we struggle with obesity and problems of physical inactivity. And then there are the genetic diseases and strangely adaptive byproducts of mental illnesses...Why We Get Sick is compact, dense, and brimming with information: the authors are writing to introduce people to the viewpoint, so there's lot of enticing speculation. If one section doesn't catch your interest, rest assured another will. I for one am quite excited about this novel approach to medicine, and if health or evolution are of any interest to you, this intersection of the two should prove fascinating.Related:American Mania: When More Isn't Enough, Peter WhybrowEvolution for Everyone, David Sloan Wilson NPR news article on the "paleo diet" and Darwinian medicine

  • Crosby
    2019-02-19 10:25

    This is a book for those who are not satisfied with answers to their questions that sound like: "just because that's the way things are...", or "what difference does it make?..." or "it's part of the plan.....". More specifically, the book puts common health maladies such as the common cold, heart attacks, obesity, cancer, morning sickness, senescence, etc under a spotlight called Darwinian medicine. This concept is based upon comparing contemporary humans to their stone age ancestors and essentially proposes that the rate of today's advances in culture, health care, travel, agriculture, technology etc have exceeded natural selection's ability to adapt the human body to current needs. As a consequence we have a human body that was best adapted by natural selection for the stone ages trying to survive in a world and environment that has dramatically changed. For example, according to Nesse and Williams, we are obese because our stone age ancestors found it difficult to find high energy sources of food such as sugar and fat so natural selection provided a "sweet tooth" to enable them to recognize such substances by taste. Today, we have access to all the sugar and fat we could possibly want yet our "sweet tooth" continues to encourage our bodies to seek out more, as though it would be gone tomorrow, to the detriment of our health. The book is loaded with fascinating examples such as this and for each one there is an equally fascinating explanation that makes sense in light of the concept of medical darwinism. One shortcoming from my perspective is that the authors do not propose enough practical examples for how this information might be used to improve health care. Nevertheless, their concept has been taken seriously enough by some of the nation's top medical schools (i.e. Johns Hopkins, Baylor College of Medicine, etc, see Science, "Darwin Applies to Medical School" April 10, 2009) as they deliberate adding an evolution component to the training of physicians.

  • Ethan
    2019-02-16 08:30

    Your body is designed to make more humans under stone age conditions - that includes your brain. Our present circumstances are far removed from the stone age, but it'll be millions of years before our anatomy catches up. In the meantime, life is going to continue to be hard, no matter how much stuff we have.

  • Sandra
    2019-02-19 12:27

    Worth a read. The authors argue for the value of an evolutionary perspective to better understand disease processes and health vulnerability, rather than just looking at the "proximate" causes (the usual medical model). They do a good job of showing how "evolution" is generally misunderstood by lay people to mean some kind of advancing perfectionism of the body, when it is more like a process of kluging stuff together in a way that guarantees genetic survival. They also do a good job of showing how we and all forms of life are engaged in a sort of war for survival with each other. They also do a very good job of explaining how evolution is not much related to longevity, that in fact many things that have survival value in youth become problematic for us as we age. Much of what is presented is just speculation but that's ok because the books purpose is to promote more research designed to answer questions about how evolution impacts health.

  • Elentarri
    2019-01-24 13:26

    This is a well written book that takes a look at why people get sick from an evolutionary perspective. This book is easy enough to understand without requiring a medical/biology degree, but not so simplified that it assumes the readers are have the attention span of a gnat and the intelligence of an amoeba. This is a meat and potatoes type of book compared to the bowl full of lettuce books that seem to be common in the popular science genre these days.I do however wish the authors would update this book to include any additional information discovered/hypothesized in the last 20 years, but what they cover is still relevant and very interesting.

  • Jeremy
    2019-02-18 11:39

    Okay, I am not finishing this book (I read about 60%) because I feel like the authors are just talking just to talk and aren't really saying anything. I will explain why:First, before I get started on the content, on the Kindle edition titles of sections continually appear on the bottom of a page while the content starts on the next page. Did anyone think about that when this was released?Secondly, I expected this book to be heavily scientific and detailed, I.e. knowledgable. It is not that. This book reads more like someone's half-hearted dissertation, a theory based on logic but with little evidence to support it. I don't disagree with the message, which is that evolution has created many ways for bacteria and viruses to invade us, and many ways for us to repel them and heal ourselves. Of course that's the general idea, but I bought the book to learn more in detail. But this isn't a science book, it's a theory book. You don't learn about medicine and how the body behaves. Instead you read things such as: inflammation and fever are ways for us to make our bodies inhospitable to bacteria. Duh, really? You think? Would you like to be more specific? Apparently not, the authors don't want to be more specific. Another example: I was very interested in the section on cancer. The first several pages of the section talk about how we have so many cells with so much history from cells of our many predecessors that there are just too many opportunities for cellular mistakes to occur. We should be lucky we don't get cancer more often, the authors imply. Oh, really? They just got through most of the book telling us how we have so many evolutionary defenses from multitudes of different microscopic invaders, and yet we shouldn't expect similarly rigorous defenses from cellular defects over our evolution? The authors also give us pearls of wisdom such as: genetics help determine our predisposition to cancer, and if we kill ourselves off by living dangerously while young we probably won't have to worry about cancer. It kind of sounds like they're either making unsupported claims, reading some news articles, regurgitating the obvious, and any other way of trying to add as much as possible to pad the book to make it longer.Stay away from this one.

  • Xander
    2019-02-16 07:23

    This is part treatise, part exposition. Nesse (a psychiatrist) teams up with Williams (an evolutionary biologist) to explain us how biology relates to medicine and why we especially doctors, should ask ourselves evolutionary questions when dealing with sickness.If you have a fever, it's common practice to deal with this by taking fever-suppressing drugs. But this might not always be the smartest thing to do: the fever might by a bodily adaptation to deal with malignant viruses or bacteria. Suppressing this survival mechanism might just as well delay and worsen your condition!This is just one example of the myriad of cases Nesse and Williams treat in this book. I have to admit, it really surprised me to learn how far medical practitioners are removed from the theory of evolution and how barren evolutionary medicine as a science is (partly due to the financial structure of science in the US; partly due to the recency of breakthroughs in evolutionary biology; partly due to human resistance and aversion to evolution in general).The reason why this book is part treatise, is that Nesse and Williams give a lot of examples of medical conditions where evolutionary thinking could light up matters, but due to the lack of research it is mostly 'best guesses'. This is not to say that this is just 250 pages of 'Just so stories' (something that evolutionary psychologists easy fall prea to): Nesse and Williams give convincing arguments for each example and offer directions for future research.It is not a book that is written in an attractive style and the hundreds of examples are sometimes hard to follow (without the necessary background knowledge). But the content Nesse and Williams offer is interesting and thought provoking. I'm curious how Darwinian medicine fares in 2017: what conclusions Nesse and Williams draw in this book have become reality? On what points were they refuted?

  • Jurij Fedorov
    2019-02-12 12:46

    A very interesting read on why we get sick and how we should think about the fact that we get sick. I learned a lot from this book and the first part of the book is great and very informative.Pro:Very knowledgeable writers that understand things that most of medical science does not know about and does not think about. None of my doctors know anything about this science - too bad. Nesse is the definition of expert. And the book has a great writing style and is easy to read. If you are a doctor or work in the medical profession then read it now.Con:Why is there no update to this book? It was written 20 years ago and evolution used practically is one of the most progressive scientific fields in the world. And Nesse is still active in this field and more popular than ever. Some of the ideas do seem a bit dated and a few areas have had new discoveries since then. Some discoveries have made the picture more clear and could be added as a small guide for what you can do to improve your own health. It's still a great book but I wonder if some of the other few books on the subject are better? They do seem to be much less popular and much more advanced so this book still has its place on your bookshelf.

  • Brooke
    2019-02-16 08:35

    I learned so much from this book! It gave me a very inclusive view of diseases (of all sorts from morning sickness, to cancer, to anxiety), how they effect us and why this may be. I am someone who has a hard time learning if I don't understand the point, the why's, the big picture. This book was perfect for me because that is exactly what it explains. It has given me a new 'pep in my step' so to speak, going to my college courses because I can now see the broad view that these detailed mechanism contribute too. You would think that with a book as informative as this one, it would start reading like a textbook, but it never did! It held me and never felt tedious. It was explaining the mechanism of cancer and I couldn't get enough. I would highly suggest this to anyone who has an inquisitive personality, or anyone in science.

  • Dan Burcea
    2019-01-20 13:36

    More of a Darwinian Medicine manifesto than a hard science book. There are lots of "this could be done" and "that should be attainable if.." and too little of "this is what we achieved". However it raises some intriguing ideas about how medicine can be revolutionized by viewing sickness through the lenses of Darwinism.

  • Nichinungas
    2019-01-28 09:24

    Fantastic ideas.

  • Andrea
    2019-02-02 12:29

    Very interesting and very well presented. Akin to the work of the late Stephen Jay Gould. Excellent and highly recommended.

  • Zelemir
    2019-02-03 13:38

    This is a fantastic book about the evolutionary reasons of Disease and how some symptoms like fever and cough are actually defense mechanisms, that are supposed to protect you. While this specific piece of information was already known to me, the well reasoned conclusion, that because a cough is a defense mechanism, it is not always wise to suppress it, if you don't know what's causing it. This book is delivering a amazing way to think about the things that make our lives uncomfortable. One major flaw of this book is the lack of experimental evidence behind many of the claims in this book, that in theory work but were never actually proven, since the whole point of the book is that the evolutionary mindset of thinking about disease is so novel and unexplored.However, this book is quite old and there may be studies about the claims made in this book by now, I haven't looked them up though.

  • Samantha Griffiths
    2019-02-19 11:33

    Not a lot of people think in evolutionary terms when it comes to their health - and this book clearly demonstrates why they should. I especially appreciate that the authors make no definitive claims where there is no definitive evidence. They are forthcoming when there is doubt, and they are careful not to steer the reader in the wrong (pseudoscientific) direction. A favourite for sure!

  • Seth
    2019-02-12 08:16

    I debated about giving this book one star. Perhaps it would have been better if it were newer, but this was almost always so basic for a former biology student it was painful. It was extremely short on details or reasoning for its argument.

  • Super Telling
    2019-02-12 13:41

    I read it in 2017, so the content is not quite fresh to me any more.

  • Nicholas
    2019-01-21 06:24

    I'm angry about this book. I was fascinated while I was reading it but afterward I was trying to explain it to my dad and I just couldn't articulate it. Then I realized that I had no idea what I had read.The book is about Darwinian medicine. Namely why we have evolved to have disease and old age and a bunch of other stuff.This book makes a lot more sense now. Cool.Quotes:"The discussion centers on the concept of adaptation by natural selection: adaptations by which we combat pathogens, adaptations of pathogens that counter our adaptations, maladaptive but necessary costs of our adaptations, maladaptive mismatches between our body's design and our current environments, and so on.""Why, in a body of such exquisite design, are there a thousand flaws and frailties that make us vulnerable to disease? If evolution by natural selection can shape sophisticated mechanisms such as the eye, heart, and brain, why hasn't it shaped ways to prevent nearsightedness, heart attacks, and Alzheimer's disease? If our immune system can recognize and attack a million foreign proteins, why do we still get pneumonia? If a coil of DNA can reliably encode plans for an adult organism with ten trillion specialized cells, each in its proper place, why can't we grow a replacement for a damaged finder? If we can live a hundred years, why not two hundred.""Our bodies were designed over the course of millions of years for lives spent in small groups hunting and gathering on the plains of Africa. Natural selection has not had time to revise our bodies for coping with fatty diets, automobiles, drugs, artificial lights, and central heating. From this mismatch between our design and our environment arises much, perhaps most, preventable modern disease. The current epidemics of heart disease and breast cancer are tragic examples.""We would like to imagine that life is naturally happy and healthy, but natural selection cares now a whit for our happiness.""The loss of ultraviolet blocking resulting from ozone depletion is more than counterbalanced in most areas by the local air pollution. What is new is not sun exposure or ozone inadequacy but our pattern of sun exposure.""Every adaptation has costs.""Before we block the expression of a symptom, we should first try to understand its origin and possible functions.""Many of the more unfortunate aspects of human psychology are not flaws but design compromises.""Our emotions are adaptations shaped by natural selection.""Emotions are Darwinian algorithms of the mind.""Mass communications, especially television and movies, effectively make us all one competitive group even as they destroy our more intimate social networks. Competition is no longer within a group of fifty or a hundred relatives and close associates, but among five billion people. You may be the best tennis player at your club, but you are probably not the best in your city and almost certainly not the best in your country or planet."

  • Joel Yap
    2019-02-10 09:36

    A wonderful book in which the author laments the state of modern medicine as treating diseases by addressing proximate causes. Much of medicine today is guided by molecular biology; this means that most illnesses are treated by understanding how the causative agents spread, replicate & cause damage to the human body (this is especially true for the study of infectious diseases). Thus, doctors today are well aware of how we fall sick, but not why.Nesse advocates an evolutionary approach to medicine as it allows us to understand why we fall sick, or why disease even exists. The symptoms of disease can be classified according to 3 categories: 1) Pathogenic adaptations 2) Bodily defenses & 3) Incidental consequence of infection. Nesse cautions against overtreating symptoms that belong to (2). He cites fever as an example. Sometimes, a symptom does not fall neatly into any category & can be both (1) & (2). An example he gives is coughing. He speculates that coughing is both (1) & (2) as it is often the means by which the pathogen spreads & at the same time allows the body to expunge phlegm. Because coughing belongs to (1), we probably cough more often & violently than we should but because it also belongs to (2), completely eliminating coughing delays recovery from the underlying illness.A fundamental understanding of evolution & natural selection is needed to fully appreciate this book. However, Nesse does sometimes explain basic concepts on a need-to basis & the book is accessible to the layman. He ends by saying that nothing in medicine makes sense except in the light of evolution. An entertaining & hugely insightful book that provides a framework in which both everyday & serious medical problems can be understood.

  • Karima Wagner
    2019-01-25 11:32

    I enjoyed every second spent reading this book! In summary, Darwinian Medicine proposes that descriptions of disease in current medical textbooks omit the importance of an evolutionary explanation for why humans are vulnerable to this disease. These explanations will have immediate practical benefits for medical practice. General physicians still don't think of fever as useful and they still give iron supplements to patients with chronic infections, perhaps letting the fever run its course without treatment is better for the patient.. Infectious disease specialists still think that pathogens have evolved to benign co-existence in our environment. Psychiatrists still believe that anxiety, sadness, and jealousy is abnormal and they try to treat the problem rather than research the selective advantages of genes that predispose to schizophrenia and bipolar disorder. Rheumatologists don't know that the high uric acid levels of gout may have been selected to slow aging and they prescribe anti-inflammatory agents that may hasten hip degeneration. Obstetricians have not considered the possibility that nausea of pregnancy may be a defense against toxins. The research on weather evolutionary standpoint to better understand genes and disease will be profoundly grateful when dealing with the prevalence in disease.

  • 711Isabel B
    2019-02-07 09:28

    So far, I am really enjoying Why We Get Sick, even though it's way to hard for me. I am slowly plodding through it, and learning a lot. I keep putting it down and going "Ohhhhhhh........That's REALLY interesting!"I was suddenly sparked into an interest in Darwinian medicine when I first picked up the book. That was because it sparked my curiosity, made me question the human body.Was there a reason that we got fevers.......Was there perhaps a reason, to burn infection out of the body (warning: if a fever gets too high, 103 - 104 degrees, can cause tissue damage), or reason that we are susceptible to heart diease? Why do we exist? Will antibiotics stop working in future because pathagens will become resistant to them?This book answered a lot of questions that they had also sparked (talk about brain washing).This book was extremely challenging, and when I ended it, I still didn't fully understand everything that it mentioned That said, I think that it would still be interesting to read it again in a couple of years (or even sooner). I think that it was very inspiring, but not a light read.

  • james
    2019-02-13 08:36

    My only qualm with the book is that it starts off acknowledging that evolution is only a paradigm and not the ultimate truth, but ends stating that biology only makes sense with an evolutionary perspective.But how well the authors explain so much! They continuously call for more research on this or that, and offer a fair amount of speculation. But it's always quite clear when they are explaining fact, theory, or speculation. Make up your own mind - their explanations are awfully coherent and scientific. No science background needed - dig in and learn.And in case you don't read it, know this: meat manufacturers habitually pump antibodies into their animals in order to keep them healthy. Unfortunately, when we consume them, it gives bacteria and viruses a head start on making counters to these antibodies, so when we do get sick, and go to the doctor, the antibodies we get won't do us no good. Of course, this falls somewhere between fact and speculation.

  • Andres
    2019-01-22 10:31

    Read this for a medical anthropology class. Darwinian medicine is a very interesting look at not only how our body deals with sickness but more importantly why it reacts to disease (or becomes diseased) in the first place, exploring what exactly in the evolution of our bodies causes these types of reactions or pathologies.Since I read this book chunks at a time over a few months I don't know how it all works together, but it is a bit of a slog at times to get through. What irked me the most, though, were long explanations for certain questions that ended in some variation of "but that's only a guess". I understand that this is a new way to approach the subject and conjecture is routine, but with so many instances of complicated explanations ending with shrugged shoulders, it gets a little wearisome.Interesting but not riveting, this 16 year old book could certainly make due with an update!

  • Joe Iacovino
    2019-02-09 09:28

    The style of the book was spot-on. There are many essay-style parts which make up the chapters. The book itself served as a medium for asking questions and often posed many of its own. An overall nice take of the evolutionary perspective especially when it comes to how we tend to view symptoms (defenses) as well as some nice tie-ins to psychology. I feel that although some of this is becoming dated as the thinking being suggested is now finding its way into curriculum, epigenetics now offering some supportive insight, etc, this remains a great book for the first year college student who is approaching any of the sciences (hard or soft). I truly liked this book and believe it provides a useful perspective. In addition,this book will serve up some solid critical thinking discussions in a classroom.

  • Joseph Masters
    2019-02-02 13:28

    I enjoyed this book and am thoroughly convinced of the importance of 'evolutionary medicine'. This book has truly changed the way I think and I now quite often find myself thinking in evolutionary terms about medicine.However, I found the authors' writting styles just a little difficult to get on wtih, they could have been a bit more to the point. The book also became a little predictable/repetative towards the end and I felt like I had to force myself through the last few chapters. I also felt many of the theories produced were a little speculative (not that there is anything wrong with speculation); I would have liked to have seen a bit more evidence integrated into the text.It is for these reasons that I have given three stars, even though I feel the overall message of this book is a very interesting and important one.

  • GlobeRunner
    2019-01-29 13:33

    A really enjoyable book presenting research findings, theories and suggestions for future research in the field of Darwinian medicine. Most of the time, the authors clearly state which category the material falls into and they generally steer clear of making assumptions. Unfortunately, this doesn't apply when they discuss dietary fat: "the single thing most people can do to most improve their health is to cut the fat contents of their diets." As is so often the case with physicians, their lack of knowledge in human nutrition and exercise science shines through. (If it hadn't been for this flaw, I would have given the book 5 stars). Surprisingly, this was also the only idea that felt outdated - even though the book is 20 years old!