Extra Life. The Astonishing Story of How We Doubled Our Lifespan by Steven Johnson

"The average person born in the United States a century ago could expect to live a little more than forty years. Today that number is just below eighty years. And Americans are four times more likely to live into their hundreds than they were a few decades ago." 

In Extra Life, science author Steven Johnson explores the many reasons why this is so beginning with the discovery of a way to vaccinate against the speckled monster, as smallpox was sometimes called. In Chapter 1, Johnson delves into the earliest history of how mankind worked to defeat the scourge of smallpox. 

In Chapter Two, solving the mystery of cholera, a disease common in the crowded cities of the nineteenth century, which killed millions.  In this chapter, Johnson focuses on the 1854 Broad Street cholera outbreak. 

Chapter 3 explores the efforts of W.E.B. Du Bois, a civil rights activist and author to improve the lives of Black Americans. Du Bois mapped data in an area of Philadelphia called the Seventh Ward, that was the city's largest Black community. His research demonstrated that African Americans were "dying at a rate about 5 percent higher than their white neighbors." Du Bois showed that this shortened life expectancy was due to poor living conditions, a consequence of the way American society was organized.

The pasteurization of milk is discussed in Chapter 4. In the United States, drinking a glass of milk in the 19th century could kill you, especially if you were a child. As cities grew larger, providing safe milk became a serious problem without refrigeration. Johnson goes into detail on how many cities had large herds of cows, and the practices to produce large quantities of milk that ended up killing children. Louis Pasteur's discovery that heating liquids killed off germs was only the beginning. It would be a half century later before pasteurization was a standard practice. But it's implementation lowered the death rate in children.

In Chapter 5, Beyond-The-Placebo-Effect, the regulation and testing of new drugs is examined. Many new drugs were never tested and only pulled off shelves when there were deaths. It would be well into the 20th century before RCTs and other practices were implemented to ensure drug testing and efficacy.

In Chapter 6, the discovery and impact of antibiotics is detailed while Chapter 7 delves into the development of safety features in cars, as automobiles became the predominant mode of transportation. Chapter 8, Feed the World explores the decline of famine due to our ability to produce ammonium nitrate (a compound in artificial fertilizer) and to mass-produce meat protein. In Chapter 9, Johnson reviews all of the amazing innovations that have increased human life expectancy as well as suggesting that we need to continue working and discovering new ways to improve health and quality of life.

Discussion

Extra Life offers younger readers a shorter version of Johnson's book of the same name. In this version of Extra Life, Johnson provides summaries of the same major innovations that improved quality of life, health care and safety, that he explored in his book for adult readers. In considering these innovations, Johnson delves deeper into the backstory, either identifying unsung heroes or exploring how such innovations became a matter of public policy.

One such unsung hero was Frances Oldham Kelsey who refused to approve the use of thalidomide as a sleeping pill in the United States, thus saving tens of thousands of babies from being born with malformed limbs. Another little known hero was Nathan Straus, a German immigrant to America, who was deeply concerned about child mortality and who was determined to provide a supply of safe milk to young children. He not only funded pasteurization plants but fought to have unpasteurized milk outlawed. 

An example of how Johnson delves deeper into the backstory is the story of the development of the smallpox vaccination. In Extra Life, readers will learn about Lady Mary Montagu, who contracted smallpox at the age of twenty-five and survived to travel with her husband to the Ottoman Empire in 1716. There she learned about a custom of exposing children to smallpox - a procedure now known as variolation. It was this technique, brought to England by Montagu that allowed Edward Jenner to develop his first vaccination for smallpox. As Johnson writes, "On the one hand, we have the satisfying narrative of brilliant Edward Jenner, inventing vaccination on one day in 1796/ On the other, we have a much more complicated story, where part of an idea emerges halfway around the world and migrates from culture to culture through word of mouth, until a perceptive and influential young woman takes note of it and imports it to her home country, where it slowly begins to take root, ultimately allowing a country doctor to make a key improvement on the technique after decades of using on his own patients."

One of the main points Johnson makes about the innovations that contributed to increasing our lifespan, is that these are often not just the work of one "genius" or brilliant scientist, but often a collaborative effort. A perfect example of this is the discovery of penicillin, which is attributed to Robert Fleming. However, the story is much more complicated than that and as Johnson writes, "The triumph of penicillin is actually one of the great stories of international multidisciplinary collaboration. It is a story of a network, not an eccentric genius. Fleming was a member of that network, but only one of many. He seemed to have not entirely grasped the true potential of what he had stumbled upon."

It's clear from Johnson's book, that the innovations he highlights have made significant strides in lengthening lives around the globe. And he encourages his readers to be the next generation in this constant goal, of improving lives. Extra Life is engaging, informative and filled with many interesting but little-known stories that make it a wonderful read. 

Johnson includes a section on Recommended Reading, Notes for each of the chapters, and a Bibliography. This well-written, short book is highly recommended for young readers who are interested in medical history, and public health. 

Book Details:

Extra Life. The Astonishing Story of How We Doubled Our Lifespan by Steven Johnson
New York: Viking Life      2023
121 pp.