The Survival For The Sickest – A Different Perspective to The Origin, Spread and Extinction of Any Disease

The Survival of the Sickest 

A Medical Maverick Discovers Why We Need Disease

(Rechristened as The Surprising Connections Between Disease and Longevity in the later editions)


Dr. Sharon Moalem with Jonathan Prince

Publisher — Harper Collins, New York, NY 10022
© 2007 Sharon Moalem

The first reading of the title would make it reread it, for we think our eyes have erred in falsely reading The Survival of The Fittest as The Survival of The Sickest. Even though the book is indeed a work of non-fiction, it is written in the style that is even racier than a thriller fiction. So the authors want to ensure that your attention remains riveted to the contents of the book, from cover to cover.

The book is as much about medicine as it is about myth. Dr. Sharon Moalem, the author, posits the book that wonders why, by simultaneously asking why not. The book is presented as ‘magical medical mystery tour’ that seeks to explore how we got here, where we are heading to and can we do anything about it.

Dr. Sharon Moalem challenges to fundamentally change the way we think about our bodies, our health, and our relationship to just about every other living thing on earth. In a fresh and engaging examination of our evolutionary history, spread over around 208  pages, through the three section of the book – Introduction, Eight Chapters and The Conclusion, Dr. Moalem reveals how many of the conditions that are diseases today, have actually given our ancestors a chance in the survival sweepstakes. But the book also seeks to demonstrate just how little modern medicine really understands about human health. Through The Introduction, forcefully offers us a new way of thinking that can help all of us live longer, healthier lives.

The eight chapters, each dealing with a separate disease or a hereditary disorder, examine in detail the basic proposition of the book – ‘Evolution likes genetic traits that help us survive and reproduce -it doesn’t like traits that weaken us or threaten our health. That preference for genes that gives us a survival or reproductive advantage is called natural selection’. In other words, ‘if a gene produces a trait that makes an organism less likely to survive and reproduce, that gene won’t get passed on, at least not for very long.

However, this detailed tour comes with a few covenants that requires us to discard a few preconceptions –

  1. We are not alone. We are always in the constant company of thousands of bacteria, insects, fungi and what not.
  2. Evolution does not occur in its own. Every single living organism is heard-wired to survive and reproduce. Evolution occurs when the organisms try to improve the odds to survive and to reproduce. Some times evolution in one organism may mean death to other organism – like the spread of COVID at the expense of it carrier human beings. This can unleash a chain of cascading wave of evolution in hundreds or thousands of other species.
  • An organism’s interaction with another organism is not the only influence on their evolution; their interaction with the planet also plays equally important role.

A briefest review of the contents of the eight chapters in a book review by a layman, for the laymen, would be not only be incongruous but also will be inadequate. So here is a list of  each of the chapter titles and the topics covered in the chapter –

  • Chapter 1: Ironing it out – Hemochromatosis, bloodletting, and human iron consumption
  • Chapter 2: A spoonful of sugar helps the temperature go down – Diabetes, climate change, and brown fat
  • Chapter 3: The cholesterol also rises – Sunlight, vitamin D, cholesterol, and the physiological makeup of race
  • Chapter 4: Hey, Bud, can you do ma a Fava – Vegetables, fava beans, and the spread of malaria
  • Chapter 5: Of microbes and man – The virulence of bacteria, Guinea worms, and parasitic diseases
  • Chapter 6: Jump into the gene pool – Mutating DNA and “jumping” genes
  • Chapter 7: Methyl madness : road to the final phenotype -Genetic suppression and childhood obesity
  • Chapter 8: That’s life: Why you and your iPod must die  – Cancer cells and childbirth

While Concluding, the authors expect that we shall have appreciated three things –

  1. The life is in a constant state of creation. Evolution never stops, it keeps changing with passage of time.
  2. Nothing in this world exists in isolation. All types of living organisms on the planet keep evolving together.
  3. Our relationship with the disease is far more complex than we have ever realized.

Life of every organism is a miraculous whole, so much greater than the sum of its parts. Also, the nature is so inherently bent towards creating a disorder that seeing a small figment of our life in order should treated as a miracle. That miracle id the miracle of evolution. Under such circumstances rather than taking our health for granted, it is time that we appreciate it with reverence that it deserves. It needs to be appreciated that diseases do not exist in isolation. The origin, spread and extinction of any disease is a function of interconnectedness of life, in any and all forms, on the earth.

May be such an appreciation may lead us to search for ways to direct the evolution of infectious agents away from virulence, towards harmlessness – instead of waging an antibiotic war that we may never be able to win.

The bottom line is that while evolution is amazing, it is, inherently, not perfect, and every adaptation comes with a compromise. The riveting reading of ‘The Survival for The Sickest’ should help you to change your perspective on disease and the role genetics plays in our lives.

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Other books by Dr. Sharon Moalem:

  1. How Sex Works: Why We Look, Smell, Taste, Feel, and Act the Way We Do (published: April 2008)
  2. Inheritance: How Our Genes Change Our Lives—And Our Lives Change Our Genes (Published: April 2014)
  3. The Better Half: On the Genetic Superiority of Women (Published: April, 2020)

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Acknowledgement: Dr. Dileep Andhare sends a monthly knowledge enhancing e-mail broadcast to his all the DNVGL Business Assurance India, Sri Lanka and Bangladesh Region professional colleagues. The subject of each e-mail is his current experience relating to the field of occupational health and safety. His April 2020 e-mail MHG broadcast had referred to this book ‘The Survival for the Sickest’ as he was addressing the lessons that OHS professional should take home in these times of pandemic. I am grateful for the motivation that e-mail provided me to immediately reach for this book and read it.  Dr. Dileep Andhare is a practicing occupational and environmental health specialist.