Book recommendations from Atul Gawande

Who is your favorite novelist of all time? And your favorite novelist writing today?

First, I should confess that while I’m an avid reader of fiction, I’m an amateur. I still have swaths to catch up on. But keeping that in mind, my all-time favorite novelist is Leo Tolstoy. He had this extraordinary capacity to see all the forces coming to bear on people at any given moment — desire, family, culture, history, accident — and to somehow bring the relevance of those forces alive without beating you about the head with it.

My favorite writing today: Hilary Mantel. I have zero interest in historical fiction, let alone historical fiction about the Reign of Terror or the court of Henry VIII. But she has that same Tolstoyan ability to make the odd and faraway worlds her characters inhabit feel like they matter to us. I want my writing about our own world to connect with people at least a little bit the way these writers do — meaning both viscerally and intellectually, and with a recognition of all the forces at work.

Who is your favorite doctor character in fiction?

Dr. Watson in the Sherlock Holmes stories. I’ve been hooked on Sherlock Holmes for years — every story is a kind of diagnosis — and Watson’s is the inviting voice of the entire series. He is intelligent, observant and faithful, the way we want all doctors to be. He is also guileless and naïve, where Holmes is neither, and that is his ultimate limitation in each mystery. But his lack of cunning is why we trust him — and why Holmes does, too.

It's no surprise Atul Gawande is as well read as he is. Great writers seem, without exception, to be great readers.

Ethics of fighting Ebola

I can't think of too many people better qualified to break down the ethics of fighting Ebola than Peter Singer.

In this respect, Ebola is – or, rather, was – an example of what is sometimes referred to as the 90/10 rule: 90% of medical research is directed toward illnesses that comprise only 10% of the global burden of disease. The world has known about the deadly nature of the Ebola virus since 1976; but, because its victims were poor, pharmaceutical companies had no incentive to develop a vaccine. Indeed, pharmaceutical companies could expect to earn more from a cure for male baldness.

Government research funds in affluent countries are also disproportionately targeted toward the diseases that kill these countries’ citizens, rather than toward diseases like malaria and diarrhea that are responsible for much greater loss of life.

The most accurate way to judge the efficacy of a vaccine is through a double blind trial. One group of patients suffering from the malady are given the potential vaccine, the other set a placebo, and neither the doctors nor patients know who received what. When dealing with a shortage of vaccines and a disease as deadly as Ebola, the usual rules may not apply. That may be okay.

But, when facing a disease that kills up to 70% of those who are infected, and no accepted treatment yet exists, patients could reasonably refuse consent to a trial in which they might receive a placebo, rather than an experimental treatment that offers some hope of recovery. In such cases, it might be more ethical to monitor carefully the outcomes of different treatment centers now, before experimental treatments become available, and then compare these outcomes with those achieved by the same centers after experimental treatments are introduced. Unlike in a randomized trial, no one would receive a placebo, and it should still be possible to detect which treatments are effective.

Walking vs running a mile: the caloric output

To use the above, simply multiply your weight (in pounds) by the number shown. For example, if you weigh 188 lbs, you will burn about 107 calories (188 * .57) when you walk a mile, and about 135 calories (188 * .72) when you run a mile.

As you can see, running a mile burns roughly 26 percent more calories than walking a mile. Running a minute (or 30 minutes, or an hour, etc.) burns roughly 2.3 times more calories than the same total time spent walking.

Okay, now a few caveats. These calculations are all derived from an “average” weight of the subjects; there may be individual variations. Also, age and gender make a difference, though quite a modest one. Your weight is by far the biggest determinant of your calorie burn per mile. When you look at per-minute burn, your pace (your speed) also makes a big difference.

These calculations aren't meant to be precise. They are good approximations, and much more accurate than the old chestnut: You burn 100 calories per mile.

Walking a mile does not burn as many calories as running a mile.

Reading any tables of calories burned per minute for any activity is sobering. Running only burns 11 to 16 calories a minute. The painful truth is that modern society provides many fast and easy ways to add calories but few ways to burn them off quickly.

The age of surplus: we are drowning in both information and food.

Trick to fixing every TV show and movie

From Vulture, Here Is the Simple Mind-Trick That Makes Every Movie and TV Show Seem Better.

It's a gag, and yet, trying to figure out the logical inflection point in every TV show and movie (once you read the article you'll understand what I mean) might be a way of pinpointing when many of those programs went off the rails. Entering some character's fever dream usually marks an end to any narrative suspense.