Book Review: Being Mortal by Atul Gawande

Couple of recent business trips gave me some plane time to read this book. As the full title "Being Mortal - Medicine and What Matters in the End" clearly indicates, book material deals with how we should be treated when our time in this planet nears its end. Though depressing, certainly it is a book we all should read since the subject warrants a lot of social discussion and individual level understanding. Atul Gawande is a surgeon by profession who has made a name for himself in the last decade as a writer through his books such as The Checklist Manifesto, Complications, etc. Being a person of Indian descent, he starts off the book narrating at length how his grandfather (father's father) lived out his old age as a rich self-made landowner in India. There was a large extended family that supported him as age was catching up slowly disabling him. But since the family was well off and there were a large number of people available to take care of him, adjustments could be made to help him continue his life style. For example, going around all the agricultural land he owned each day was part of his routine. When he couldn't walk around the land briskly anymore, family got him a horse so that he can still go on his rounds. When his ability to even sit on the horse came into question, a servant followed him as he made his daily rounds and so on. 

Atul's father, who himself is a physician, had seen firsthand how his father lived out his last years. So, as a practicing physician in the US, he found how American society treated its own elderly totally objectionable. For a multitude of reasons, American families don't continue to function as large support network to ensure the quality of life for their family's elderly are retained come what may. It doesn’t feel practical in our current setup. Instead the elderly tend to live by themselves as long as they could. They don't feel comfortable living with their children as they feel that it is an unnecessary interference in their children's lives and a loss of independence for themselves. When they can't take care of themselves, assisted living and nursing homes start to show up in the picture. Most of these facilities are designed to make sure the elderly they care for are safe. Whether they enjoy their life is of secondary importance though given a choice most seniors will chose to prioritize their quality of life over safety. 

Since families are not closely involved in the day-to-day operations of the elderly, what kind of end of life care each one wants does not get discussed at the right time. Sons & daughters confront those questions all of a sudden when the elderly are not able to make those decisions themselves oneday. This also leads to the convention of "doing everything we can" to save the life of the elderly. But this is done  at the expense of their quality of life is not well understood, thus putting the elderly through a wringer making them suffer enormously though that is not what they would have wanted. This also has the downside of spiking the cost with no real return. 

While these problems may appear intractable and hard to solve, author points out specific towns in US that have adopted the practice of doctors talking to patients during their routine visits (like annual physicals) about DNR (Do Not Resuscitate), Living Will, what kind of care they'd like to receive when they are terminally ill. This practice has transformed those localities. Since the discussion is pervasive, it is not making people uncomfortable. As the discussions have taken place around kitchen tables and doctor offices earlier, even if there is no written documentation, relatives and physicians have a very good sense of what the patients want when they are not able to make the decisions for themselves. This provides a lot of hope for turning the system around despite all the 'death panel' scare tactics politicians and irresponsible media use for temporary gains. 

In the end it boils down to moving from "put a patient through hell temporarily for long term gains" approach used in medicine when patients are young, to "do all you can to help patient maintain quality of life and happiness" approach as they grow old. This transition has to be made routine even if it brings in some risks or can shorten their lives a little. Being comatose under a vegetative state for months may be technically prolonging one's life. But that is no way to "live".

Since the intended audience is general public, book is written like a series of stories with lot of detailed anecdotes (how the weather was, what she was eating, what clothes patient was wearing, how did he feel, etc.) that at times makes it feel like a lot of fluff. I couldn't help feeling that the content of the whole book could have been conveyed in a 15 page article. But I understand only when things are personalized this way in easy to read prose, the intended messages will get through, particularly when the audience is general public interested in light reading. 

On a related note, I have been pushing all my friends to write out their Last Will and Living Will for the past 5+ years. It doesn't matter how young you are or how uncomfortable it may make you feel to think about your own mortality, you owe it to your family to document your wishes. I hear excuses such as “My family/setup is so simple, it doesn’t require a Will” or “I don’t have a lot of property and so why do I need to write a Will?”. But trust me, if you pass away unexpectedly without a Will, you will put your family through a lot of trouble. I have offered to provide my Will as a template where you can just change name and few personal details and sign it in half an hour to hold a legally valid Will of your own. Some friends took me up on the offer but not as many as I had hoped. Since it is a closely tied topic to this book, would like to make that offer again. If you'd like to get a copy of the template I used, just send me an email. Next ten days might be a good time to complete such tasks as things slow down during the holiday season.

Happy holidays and a wonderful new year to you and yours!
-sundar.

Book Review: Sapiens: A Brief History of Humankind by Yuval Noah Harari

Few years back a friend of mine said he saw a Bollywood movie star's picture with this book in his hand and so out of curiosity he picked it up to read. :-) Thus, I had heard of this book but never bothered to purchase a copy. It eventually landed in my lap when another friend gave it to me as a present. So, finally picked it up to read.

Harari names the book Sapiens, but then in the subtitle itself limits the scope to Homosapierns alone. In its breadth of coverage, book does span pretty much the entire human history starting from paleolithic age to 2015 where bionic body parts are getting attached to human beings and man/machine meld cyborgs are on the horizon. Towards the end it worries about singularity, what entity will replace human beings and so on. Author does seem to think he is writing a major piece of work that is important and relevant as indicated by the tone of the book and the aspects of human lives he is trying to touch upon. But as I was racing through the chapters, it left me a bit unsatisfied as there is no comprehensive thesis or idea that is new. It covers material most readers of my age might have already read about from high school history to simple books on anthropology. When I read a book by Jared Diamond (whose name appears on the cover with a quote from him to promote the book), I used to notice a similar breadth of human civilization coverage that used to be impressive since it will push another new idea in parallel. For example, his Guns, Germs and Steel pushed the idea of how those three things shaped human civilization as it stands today. Similarly his Collapse argued as to how civilizations that lasted several centuries or ones intended to last a millennium, collapse precipitously when they reach a tipping point. The discussions and stories covering human history will form the scaffoldings needed to understand the overall thesis of the book. I didn't find any such overarching thesis in this book. It seems to just narrate history at great length covering a large span of time and pretty much stops at that. 

There are certainly interesting tit bits sprinkled around. In Chapter 7, when the author is discussing the evolution of writing, he nicely describes how in its initial form, Sumerian writing circa 3500 BC on clay tablets helped record property/land details for tax purposes. Basically their writing combined two elements. One is a representation of numbers. They used rudimentary versions of base 6 as well as 10. (Their base 6 usage still has its fingerprints today in the 360 degrees of a circle.) Second element is a representation of things such as merchandise, animals, land, and people. This allowed them to store lot more information than what any human being can remember and recall. Thus, first writings in human history probably belonged to an accountant rather than a poet or a prophet. The pre-Columbian Andes used a totally different system to record details that some would argue should not even be considered as writing. Instead of trying to write on clay tablets, they used knots made on colourful cords called quipus. A quipu may contain several cotton or woolen cords. By tying thousands of knots on different places in a string of hundreds of cords, they could use one quipu to store possibly an entire town's transaction details. It reminded me of the Blockchain technology currently being promoted to record land details so that they can't be easily tampered with. 

Some other sections made me wince. For example in Chapter 18, he is making valid arguments about how violence has been coming down as centuries pass. But in a subsection titled Imperial Retirement, he says that by the time India was asking for its freedom in the 1940's, British empire was too ready to give up power through a peaceful transition! To quote him verbatim, "At least some of the praise usually heaped on Mahatma Gandhi for his non-violent creed is actually owed to the British Empire". I fully understand that when colonial powers like Britain invaded and took over India centuries back, that was the world norm and in fact centuries before several other invaders have taken over Britain as well. So we can't judge that history using today's values. But when fighting occupiers violently with every means you got is the world norm, Gandhi's non-violent freedom fighting movement in India that eventually succeeded deserves all the praise you can heap on it. Though you can compare some other violent era in history and argue that the amount of violence unleashed in India is comparatively less, taking away credit from Gandhi and giving it to the British empire portraying it as a benign power that was walking away on its own is totally disingenuous and a rewriting of history. Beyond Mandela & MLK, too bad Gandhi's model didn't become the norm in the world and we still continue to throw bombs at people to resolve conflicts even in the 21st century.

Overall Harari comes across as knowledgeable, capable of covering vast periods of history. But once you finish and put down the book, you may not remember very many interesting things you learned that you didn't know before. 

I am out on vacation this week and the next. So, packing Misbehaving: The Making of Behavioral Economics

Book by Richard Thaler in the carry-on suitcase. Let me see how it turns out. 

-sundar.

Book Review: Misbehaving: The Making of Behavioral Economics by Richard Thaler

It is good to have friends who not only point you towards interesting books but actually mail order the book and get it delivered to you. This one landed in my doorstep thusly. :-) 

Book chronicles the birth and development of the field of behavioral economics via interesting stories, anecdotes, experiments and personal experiences. Richard Thaler, who is the author of the book was awarded a Nobel in Economics in 2017 for his contributions to the development of this field. It is amusing to hear the story from his perspective since he and few other economists noticed faults in the traditional economic models and proposed alternate models decades back just to prove their points. It has since evolved into this huge field now. Book's language and contents are very accessible as there is nothing too technical or complicated. 

As you may know, in the traditional school of economics, individuals are always seen as very rational entities that are not swayed even an iota by emotions, pressures, or social/environmental influences. The falsity of this notion is illustrated by a simple example. Let us say you go to a departmental store to buy a toaster that costs $20. If the store clerk says there is a sale starting tomorrow and so if you come back tomorrow and buy the same toaster, it will cost you only $10, most of us will skip the purchase that day, return the next day and pick it up for half the price thus saving $10. But if you are in the store to buy a $1000 TV, and the store clerk tells you that if you come back and buy the same TV tomorrow, it will cost you only $990, most people just shrug and buy the TV that day itself. This is because the human mind while working with a price tag of $20 finds a $10 discount a big one (50%!) that justifies going home empty handed and making the trip next day to buy it for $10 less. But while working with the $1000 price tag, same $10 discount doesn't look that important to make another trip to the store the next day. 

While this thought process may be easy to understand from a normal human behavior point of view, traditional economics uses models of human beings that will consistently make the second trip to save $10 or always ignore it and go for the purchase the same day, irrespective of the price of the item. Logically this is the correct behavior since whether a second trip to the store is worth $10 or not should not be influenced by other Supposedly Irrelevant Factors (SIFs) like the price of the item you are trying to buy. But we are all not Spock from Star Trek and so easily get influenced by SIFs. This is basically the bone of contention. Traditional economists refused to take this into considerations and kept pushing back with anyone of the following arguments:

- This observed odd behavior will all iron out when the stakes are really high.

- When all individual behaviors are added up to compute the big picture, it will even out.

- Even individuals will behave very rationally and consistently across all the activities if you look broadly on all their activities. So focusing on one behavior to find fault is not right and so on. 

People like Thaler and even Daniel Kahneman have proven this notion wrong time and again. Book is organized chronologically and so starts off with the 1970-80's related experiments in this domain. So, notions like endowment effect and mere ownership paradigm make their first appearances. Then he talks about the conceptualization of acquisition and transaction utilities. Acquisition utility is the value you derive from a purchase. Let us say you buy a bottle of cold water for $2. If you are really thirsty, you think it is worth the price. This is all the standard economic model considers. But in reality human beings also associate a transaction utility, because of which they feel great about buying that bottle of water for $2 if they got it from an expensive resort or restaurant since they expect to pay more for it. But if the same bottle (brand, temperature, quantity) of water was purchased from roadside, it feels like a rip-off since people expect to pay less than a dollar for it on the road side. While it is irrational, this is how the world works. In the following chapters we encounter sunk costs, mental accounting (where money that we rationally know is fungible is treated as not fungible), marshmallow experiments and quasi hyperbolic discounting. Each one of these terms are worth looking up as they are all good topics for party conversations. :-)

Second half of the book has several interesting real world case studies where these notions of behavioral economics are applied to improve business or people's behavior. For example, when credit cards were being introduced, gas stations wanted to charge customers using credit cards a surcharge to cover the fee they need to pay to credit card companies. Naturally CC companies hated this idea since it will make it look like their customers are being penalized for using the card and wanted the gas stations to include the fee as part of the standard gas price. After some consultation, gas stations (who did want the increase in sales CC will bring due to the ease of funds availability) decided to list the standard price with CC fee included and then give a "discount" for customers paying with cash. Mathematically & rationally there is absolutely no difference between surcharge and discount. But customers started viewing the discount as an advantage and were willing to go with "standard" price when they wanted to use the CC. Everyone was happy! There is a more elaborate example of how using such techniques Thaler helped turn a failing ski-resort business into a profitable one. There are also several negative examples like his interaction with NFL, GM and Uber that looked at his input but decided to discard them or didn't understand the importance to deploy the ideas to their own peril as per his recounting. He does list few academics by name, who fought against his ideas and lost as per his narration. I am sure those professors will remember the events differently. :-)

In the 90's the field had started getting traction with papers being published, conferences being organized and students starting to routinely working with him. In this phase there is also a large section that deals with finance and stock market that is quite interesting. There is an amusing complete chapter on how his colleagues who are all professors at the Booth School of Business in the University of Chicago went around picking offices in a new building they were moving into. Apparently it resulted in such a tense contest with emotions and competitiveness running quite high but in the end many missing important aspects of office selection (e.g. view) and focusing on aspects that turned out to be not so important (e.g. bigger office with ten more square foot space in the building plan that was hardly noticeable in the real office). Chapters on NFL player salary, TV game show analysis are all quite entertaining and help illustrate the span of domains where behavioral economics ideas will be applicable. 

Book wraps up with how these notions were applied to help improve employees save more in their retirement savings account (nudge them by making savings the default option instead of expecting employees to opt-in), and even working with Governments in other countries (U.K. for example) to promulgate these ideas to improve governance. 

Major complaints I had with the book fall into two categories. One is that in several chapters author is dropping too many names of colleagues, graduate students, professors he worked with to run experiments or write papers. It might be amusing or very nice for those individuals to see their names in the book. Thaler might be paying his dues to his collaborators in this manner as well. But when too many of these names appear in some sections, it feels like some irrelevant insider information that is too distracting. Second one is related to my own exposure to many of the studies, experiments and papers since they have been discussed in the mainstream media often over the years (e.g. how due to endowment effect, people will value a coffee mug they owned just for an hour more than what it is actually worth). So, while the prose is very light and easy to read, several sections didn't have a lot of new information for me. Still it was fun to go through the discussion again. Do give it read if you haven't already. 

-sundar.

Book Review: The Man Who Knew Infinity by Robert Kanigel

In a very interesting coincidence I got both the English and Tamil versions of this book as gift from two different friends last December just days apart! The English version came in first from a friend that gives me books each time we meet. As you may know, this book has been made into a movie couple of years back. Since I had seen the movie (and so knew the main plot points), I had kept it in the "toRead" list a little further down the line. Few days later I met another friend who is the actual translator of the book into Tamil. Apparently it has been translated into multiple Indian languages as a "National Book Trust" project in India to commemorate Ramanujan's 130th year anniversary. The crispness of the Tamil translation's title (Ananthathai Arinthavan that precisely translates to The Man Who Knew Infinity in an elegant way) bowled me over. It’s been a while since I had read a serious book in Tamil. So, took it up immediately. Since I had both English and Tamil versions with me, went back and forth between the two versions almost chapter by chapter. It was a very interesting experience since I had never read a full book in two languages simultaneously ever before. :-) 

While Ramanujan's story is a really sad one, reading the book was a delight in several ways. I don't read a lot of biographies. But whenever I had read them in the past, they tended to be about Physicists/Mathematicians from Europe in the mid 20th century or books like Agony and the Ecstasy describing the life of Michelangelo and so on. At the time I read those books, I had not seen much of Europe and so had to imagine most of what was being described. But in this case, the small Tamilnadu towns where Ramanujan grew up, the kind of houses he lived in, names of the people who were part of his life, the schools and temples he frequented were all extremely familiar to me as I grew up in the same parts of India with similarly named relatives/friends in my childhood speaking the same language and eating the same food. This sense of familiarity added to the fun. If I had read the book only in English or only in Tamil, I wouldn't have had a chance to learn a slew of Tamil words for complex Math and Science terms (for example, Tamil term for String Theory is "Izhaiyooga Iyarppiyal”). Google translation is not showing the same term in Tamil. The rhyming poetic nature of such terms indicate that they were probably coined by the Tamil translator Prof. P. Vanchinathan, as he has a long track record of such cleverness. (He has developed a Python script that can verify whether a Tamil poem written to be of certain clause (called Venba) passes all the requirements!). He has nicely translated even the occasional English poems embedded in the English version of the book.

One disappointment I had with the book is that after reading it, I am not left with a lot more new information that I will carry forward. I did learn about the Wrangler, Senior Wrangler ranking in Cambridge, will remember the timeline of Ramanujan's story better, etc. But in the end I am left with the same details of what I had known before, Ramanujan's difficult days in India, his contact with G.H.Hardy, his miserable time in England while he published a lot with Hardy and his subsequent return to India followed by his demise. These broad strokes are what you are left with in the end. Compared to the movie, the book does get into lot more mathematical details to which I am grateful. Just to make sure I remember at least something brand new that I didn't know before, I went and read about Ramanujan’s Tau Function on the web.

Book talks a lot about how India hasn't changed much to be able to recognize such hidden gems that may be lurking around. While I do sympathize with this view, I am not very clear on what is a good solution that will prevent future Ramanujans being left undiscovered. He wasn't good at taking tests and acing them. So, he didn't finish college in India and as a result couldn't proceed through normal channels to get the recognition he deserved. While he had knocked the doors of dozens of potentials patrons to get support to continue his research, he eventually succeeded when Hardy read his letter and came forward to help him. It would have been very nice if the first person he contacted quickly recognized the immensity of his talent and work and gave him all the support he needed. But hind sight is 20/20. Today how can we separate real talent coming in through unorthodox means from fakes that claim superiority? Naturally we don't want to be fooled by charlatans or waste resources on those who may truly believe they are talented but in reality are not. Do you live in a country/society that has a means to recognize future Ramanujans who don't want to go through the regular academic channels? If so, let me know how the process works.

Book's author Robert Kanigel deserves a lot of credit/respect for the amount of research he has done, traveling through every part of rural/urban South India pertinent to Ramanujan's story (his description of the houses in small town India that I am familiar with stands out so vividly compared to Western homes that are architecturally/philosophically/functionally very different) as well as parts of England that Ramanujan spent time on, gathering a lot of details from first world war time archives and so on. Details in the book reflects his sincerity in trying to bring out a book that gives the readers a very close personal vivid record of Ramanujan's life, which was so very different from Hardy's. There are a lot of discussions about how scholars of Oxbridge lived in the early parts of 20th century. They were highly respected, well connected, all men, many of whom remained bachelors, wrote papers, attended conferences across Europe, had servant maids to cook & clean and so wouldn't have known how to make a simple meal. Contrast that life style with Ramanujan's who was displaced from his familiar surroundings, being a strict Tamil Brahmin couldn't eat non-vegetarian food and so had to cook for himself, was often depressed, wasn't comfortable with his fellow colleagues/neighbors but had an amazing ability to churn out paper after paper on higher order mathematics that stunned his English colleagues!

Even though I wish I could retain a lot more of Ramanujan's math, the book has lot more details compared to the movie. So, worth a read. BTW, while the movie was decent, I was puzzled by the way the actor portraying Ramanujan (actor Dev Patel) pronounced the name like an American rather than like a South Indian (who’d pronounce it as Raa-maa-nu-jan). Since the whole plot of the movie is describing how uncomfortable Ramanujan was in England not being able to give up his TamBram habits, the actor mispronouncing the protagonist’s name was awkward!

If you can read Tamil, please order the book from this National Book Trust link:
http://www.nbtindia.gov.in/books_detail__9__national-biography__2733__a-man-who-knew-infinity.nbt
Books of this kind are hard to come by particularly in languages like Tamil. So, we owe the team that brought it out our support via ordering a copy.

Book Review: The Gene - An Intimate History by Siddhartha Mukherjee

During grad school days we used to joke that the prestige of a journal paper you publish is inversely proportional to the length & complexity of the journal's name. You can be sure that I have never published anything in journals like "Nature" or "Science". :-) 

I have developed a similar, admittedly snobbish notion about books written by non-fiction writers. There are authors who publish a lot vs. those who write just a couple of books in their lifetime. While the so called prolific writers take a small idea and quickly churn out a 300 page drivel by adding a lot of fluff (that are no doubt easy to read), there are others who write comprehensive works in their field of expertise that makes you feel glad you picked them up to read. Siddhartha Mukherjee's new book titled The Gene - An Intimate History clearly falls into the second category.

After Emperor of All Maladies that chronicled the history and current status of cancer research, he understandably felt so exhausted and thought he will never pick up the pen to write another book ever since he had written out everything he knew, narrated all the stories he had and so felt he was done once and for all. But then eventually wrote this book to talk about the normal functioning of the human genes as opposed to the EoAM book that talked about abnormal functioning of genes that had gone haywire. 

Book spans roughly 2500 years starting from Greek philosophers. He weaves personal family history that has a liberal sprinkling of mental disorders nudging him to wonder about genetic causes with research conducted by stalwarts like Mendel & Darwin all the way to CRISPR/Cas-9 in the present day. Centuries past, Pythagoras cohorts believed that the sperm traverses through the male body collecting signals from all the different body parts as to how it should grow up and then uses those instructions to grow into an entity that looks similar to the father. During Mendel's time he had figured that there is some indivisible unit entity in biological beings that is able to transmit flower color or height in pea plants from parent plant to child plant in a binary mode (i.e. characteristic quality gets either transmitted or not transmitted but doesn't get diluted half way when different parents are crossed) and can even remain hidden for multiple generations before revealing itself in a descendant further down the line. Then subsequently the DNA double helix structure, how the genes are made of just 4 alphabets (GACT), stretches of parts of the DNA forms a gene, how genes encode a recipe for making proteins that in turn creates cells that contains copies of DNA were all understood step-by-slow-and-painful-little-step. The amount of thoughts, efforts, extremely painful research and notes keeping that has brought our understanding of human genome to where it is today is simply humbling. 

Author has a knack for visual metaphors found allover the book. Many are quite useful to visualize the enormity of tasks on hand. He states that the human DNA when laid out in a straight line can stretch from US to Europe in which clusters of genes may be found like small islands found as pin pricks in the ocean! Collecting all the pin prick land masses may form something like Tokyo's metro train line equivalent. This mental picture helps you easily understand the sparseness with which genes are distributed in the DNA structure. Mapping the genome is described as climbing a rope to scale a mountain by moving your hands up the rope one palm at a time without leaving any gap. Another approach called "shot gun" used to decode human genome is described as breaking down the sequence into thousands of little pieces (as if blown by a shot gun), reading them and then trying to sequence them by noticing the overlapping letters found in adjacent segments. He also paints nice visuals as in the case of describing cell biologist Thomas Morgan's lab where he was studying fruit flies saying, "Bunches of overripe bananas hung from sticks. The smell of fermented fruit was overpowering, and a haze of escaped flies lifted off the tables like a buzzing veil every time Morgan moved". Even in my little writing attempts I have tried to paint such visuals as it tends to brings a sense of immediacy to the story. But in my case, I was describing some time/place I personally knew & had experienced. But since Morgan's lab was functioning during the first decade of the twentieth century, we can be sure that the author is not describing what he saw. :-) But with a smile, we can move on since it certainly helps the reader visualize the image well. 

I tend to wince when I read articles or books that tend to describe how one particular event or discovery transformed the entire human history. Good but simple example will be a write up of how if that apple hadn't landed on Newton's head, we wouldn't have discovered the notion of gravity and so won't have planes/GPS, etc. While such stories may sound amazing/nail biting, I tend to think sooner or later some other fruit or thing would have landed on Newton's or someone else's head and we would have understood gravity. So, I liked how the author, despite describing several monumental discoveries related to cell biology, genes and DNA, chronicles them as impressive discoveries but treats them as one in a series of steps that lead us to the present state (which still has lot more things left to discover). 

There are so many details in this domain of genetic research that are fascinating. Just to give one example, Cystic Fibrosis is a disease caused by genetic mutation and is very prevalent in European gene pool. If so, you'd wonder why evolution didn't cull it out by survival of the fittest selection process. It turns out that the mutation prevents salt and water loss in the host and so can prove to be an advantage when there are cholera epidemic that can kill people through dehydration! So, single mutation could be advantageous. But if a man and a women both with single mutation have a child, it can inherit double mutation that results in CF! 

Similarly, I had wondered as to how an entire organism like a human being is formed from a single fertilized cell. We know about cell division and the DNA in the cell serves as the recipe to make the human being. But as the cells divide, how does the process knows not to grow a thumb where your head is? If you don't have the patience to read this 600 page book, you can read this old but small article that lays out the details to a good extent. Research done on C. elegans (a small worm) to understand this phenomenon discussed in the book is fascinating. Author covers Nazi Germany and segregated US's eugenics efforts, development of companies like Genentech, inventions created to use viruses to carry bits of DNA that need to be implanted into bacteria and then animal/human cells, all the Nobel prizes harvested over the decades, latest ethical concerns in labs in China rushing to modify human genome that may propagate endlessly into future civilizations and concluding with the need for a deliberate well thought out mandate to guide this field into an appropriate future that we could be proud of. 

One thing I didn't like is the lack of drawings/pictures/images. I think the work is extremely well suited to carry a lot of illustrations. But the author states that he prefers to paint word pictures so that readers can generate their own vivid mental images. I couldn't agree with this view. I certainly would have appreciated lot more drawings close to the text describing them. (Even few photographs included are bundled into a contiguous section of few pages in the middle of the book.)

I am sure before my time is over, I am going to see at least two major revolutions that will reshape human lives phenomenally. One is going to be in the IT (Information Technology) area with the advent of ubiquitous high speed wireless networks (think 5G and beyond) combined with machine learning/AI. The other is going to be in genetic engineering. While the front seat view should be fascinating, hopefully the journey and destinations will be as safe in biotechnology as self-driving cars promise them to be!! :-)

Happy New Year!

-sundar.