Extra Life summary

It’s hard to imagine a less threatening substance than milk. We associate it with babies, childhood, and bedtime snacks – hardly concepts that suggest intense danger.

And yet, for quite a while, milk was dangerous. In New York in the 1840s, more than 50 percent of all deaths occurred in infants and young children. Although cholera was partly to blame, the main culprit seems to have been contaminated milk.

Nowadays, those of us who are familiar with the FDA, or the US Food and Drug Administration, know it as a titanic organization – one with vast powers and huge responsibilities. The FDA regulates the production and sale of foodstuffs and medicines in the United States. But things weren’t always this way; until the 1960s, the FDA was a much weaker beast.

So what changed? To answer that question, let’s look at the career of Frances Oldham Kelsey, who began working with the FDA in 1960. When she joined, things were pretty different. The entire organization only had three medics on its staff. Kelsey was one of them – and, like her colleagues, she was tasked with vetting new drugs for safety. Her professional decisions changed the future of the pharmaceutical industry for good.

As long as we humans have existed, we’ve been locked in a battle with harmful bacteria. Take an illness like tuberculosis, or TB, for short. Even 6,000-year-old Egyptian skeletons display spinal deformities caused by this bacterial disease. In fact, for a large part of the relatively recent nineteenth century, TB was responsible for a quarter of all deaths.

So how did we begin to gain the upper hand in the fight against bacterial diseases? What marked the turning point? The answer is simple: penicillin and other antibiotics.

Learning to drive can be stressful, and for good reason. After all, you’re transporting your frail human body around in a speeding hunk of metal and glass, and you’re doing so on busy roads, among other unpredictable drivers. It’s a situation that might make anyone anxious. 

But if driving can prove stressful now, imagine what it was like only a few decades ago – when all the safety features we currently take for granted hadn’t yet been invented. Seat belts, airbags, even recessed steering wheels – all these technologies are surprisingly recent. 

Just a hundred years ago, the world was ravaged by a series of devastating famines. The 1920s saw about 50 million people lose their lives to one famine or another. Some were caused by the weather, others by the aftermath of World War I – or, in the Soviet Union, by disastrous central planning. 

By historical standards, none of this was particularly unusual. In the mid-nineteenth century, one in eight people in Ireland perished during the Irish Potato Famine. One in four had to emigrate. And, even more shockingly, in the 1300s famine wiped out a third of northern Europe’s entire population.