

This is a book that's exactly what it purports to be. Pathogenesis is the history of western civilization as viewed through the lens of plague and disease. I'm wary when it comes to books that try to reframe history along certain lines because they tend to play up the importance of their subject, it's bound to happen. That's the case here, but I would class it as "over-magnification" and not nearly to a degree where the book is purposely misinforming you. This book is accessible and covers a broad swath of human history, it's easy to read with an excellent audiobook (read by the author!) to boot, but I wouldn't rely on this book as my sole source for historical information. I really liked taking a deeper dive into an influence on history that is often overlooked but as shown by Kennedy often produced outsized impacts.
Broken into 8 parts, we start with the primordial soup, the birth of bacteria and viruses and quickly work our way from neolithic man, through the rise of Christianity and the fall of the Roman Empire, to the development of germ theory and modern sanitation. This book will mainly be a recap for anyone who has studied history, but even if you haven't, I doubt that Neanderthals, and Alexander the Great, Rome, and Slavery are going to be fresh topics. Framed around well known events, this book shines the spotlight on the moments in history books where you read something like, "the enemy camp thus was riddled through with plague and weakened" and the tide was miraculously turned. There is plenty of information that goes beyond the basic history, so nerds need not roll their eyes in boredom.
Where this differs from a Wikipedia article is in the quality of the writing and the depth of the research. Kennedy manages to work a flowing narrative out of what is otherwise a well formulated outline, taking us through nearly 20,000 years of human history without ever killing the pace. What I really appreciated was that despite most of the book being a refresher, he includes the most up-to-date historical findings from contemporary scholars as a part of the summary. An example would be what killed the Neanderthals; it was likely endemic plagues migrating north along with migrants from early sub-Saharan population centers as the earth warmed. This isn't the first time that I've seen plague offered as the reason for the rapid extinction of the various paleolithic humanoid subspecies, but never as coherent and accessible as the theory is presented here. It's like that with most subjects, giving you a glimpse past the surface details with an eye to plague and pathogen.
Kennedy frames the history of disease through a public health lens, highlighting a critical message: despite our scientific ability to identify and solve root causes of disease, poverty and inequity continue to undermine global health. We've understood that poor people who live in bad conditions get sick since the 1850s (it's shocking but true), but medical focus has shifted away from prevention toward treatment alone. Despite the WHO's establishment in the 1970s, global health initiatives have fallen short of their potential because healthcare professionals have been encouraged to "stay in their lanes" - developing treatments rather than addressing the social determinants of health. Pathogenesis serves as a powerful reminder that true progress in public health requires confronting the socioeconomic factors that create disease vulnerability, not just treating symptoms after outbreaks occur.
However, my main gripe with the book comes out of this conclusion, because the counter example provided for our modern public health regime is that of the Great Leap Forward and the subsequent period of reform and opening up. Despite the death toll in both human and sparrow lives, the author finds time to complement the totality with which the Chinese government is able to affect their public health scheme. His conclusion paints China as the next great hope for an effective global public health campaign, proposing that COVID marks the transition from western democratic leadership of the global system. Indeed, while paying lip service to their spotty human rights record, Kennedy inexplicably takes their COVID statistical claims at face value, citing figures that paint the death rates in the US as 300 times higher than in China (something I find patently unbelievable). It's not my patriotic spirit that finds this objectionable, but rather the part of me that demands the same scholarly rigor as was applied to the rest of the book.
This is a well sourced and valuable treatment of western civ and the history of pathogens. Barring its questionable conclusion, I found it generally accurate and entertaining to read.
PS: I wasn't sure where to fit this in, but when this author visits topics that I am better versed in, such as the slave trade, I noticed that there's a tendency to oversimplify. To Kennedy, the primary reason behind the mass enslavement of black Africans was their immunity to Malaria and Yellow Fever. While this is certainly true and a major contributing factor to their desirability as noted by the book, it discounts other notable (and likely more potent) factors.
In the same chapter where the author details the difficulties white slavers had just surviving on the African continent, he manages to ignore the implications of that fact: chiefly that a significant portion of the supply of African slaves was provided by indigenous slavers operating out of economic need. He makes no mentions of the collapse of the Arab and African economies, how the supply of enslaved people grew due to the inflationary effect of American gold and silver. While plague does factor into this economic rationale, a more complete explanation would focus on the economics; it would acknowledge plague's effect on supply by decimating the population of American natives while discounting alternative sources of slaves according to cost. Kennedy tries to explain that the calculus was more economic and racial than it was motivated by concerns for the health and conditions of the slaves, but does not go on to explain the rationale as I just did. This is really a nitpick, but I wouldn't want someone to read this book and just assume that Kennedy's pathogenic focused take on history is a definitive one.
This is a book that's exactly what it purports to be. Pathogenesis is the history of western civilization as viewed through the lens of plague and disease. I'm wary when it comes to books that try to reframe history along certain lines because they tend to play up the importance of their subject, it's bound to happen. That's the case here, but I would class it as "over-magnification" and not nearly to a degree where the book is purposely misinforming you. This book is accessible and covers a broad swath of human history, it's easy to read with an excellent audiobook (read by the author!) to boot, but I wouldn't rely on this book as my sole source for historical information. I really liked taking a deeper dive into an influence on history that is often overlooked but as shown by Kennedy often produced outsized impacts.
Broken into 8 parts, we start with the primordial soup, the birth of bacteria and viruses and quickly work our way from neolithic man, through the rise of Christianity and the fall of the Roman Empire, to the development of germ theory and modern sanitation. This book will mainly be a recap for anyone who has studied history, but even if you haven't, I doubt that Neanderthals, and Alexander the Great, Rome, and Slavery are going to be fresh topics. Framed around well known events, this book shines the spotlight on the moments in history books where you read something like, "the enemy camp thus was riddled through with plague and weakened" and the tide was miraculously turned. There is plenty of information that goes beyond the basic history, so nerds need not roll their eyes in boredom.
Where this differs from a Wikipedia article is in the quality of the writing and the depth of the research. Kennedy manages to work a flowing narrative out of what is otherwise a well formulated outline, taking us through nearly 20,000 years of human history without ever killing the pace. What I really appreciated was that despite most of the book being a refresher, he includes the most up-to-date historical findings from contemporary scholars as a part of the summary. An example would be what killed the Neanderthals; it was likely endemic plagues migrating north along with migrants from early sub-Saharan population centers as the earth warmed. This isn't the first time that I've seen plague offered as the reason for the rapid extinction of the various paleolithic humanoid subspecies, but never as coherent and accessible as the theory is presented here. It's like that with most subjects, giving you a glimpse past the surface details with an eye to plague and pathogen.
Kennedy frames the history of disease through a public health lens, highlighting a critical message: despite our scientific ability to identify and solve root causes of disease, poverty and inequity continue to undermine global health. We've understood that poor people who live in bad conditions get sick since the 1850s (it's shocking but true), but medical focus has shifted away from prevention toward treatment alone. Despite the WHO's establishment in the 1970s, global health initiatives have fallen short of their potential because healthcare professionals have been encouraged to "stay in their lanes" - developing treatments rather than addressing the social determinants of health. Pathogenesis serves as a powerful reminder that true progress in public health requires confronting the socioeconomic factors that create disease vulnerability, not just treating symptoms after outbreaks occur.
However, my main gripe with the book comes out of this conclusion, because the counter example provided for our modern public health regime is that of the Great Leap Forward and the subsequent period of reform and opening up. Despite the death toll in both human and sparrow lives, the author finds time to complement the totality with which the Chinese government is able to affect their public health scheme. His conclusion paints China as the next great hope for an effective global public health campaign, proposing that COVID marks the transition from western democratic leadership of the global system. Indeed, while paying lip service to their spotty human rights record, Kennedy inexplicably takes their COVID statistical claims at face value, citing figures that paint the death rates in the US as 300 times higher than in China (something I find patently unbelievable). It's not my patriotic spirit that finds this objectionable, but rather the part of me that demands the same scholarly rigor as was applied to the rest of the book.
This is a well sourced and valuable treatment of western civ and the history of pathogens. Barring its questionable conclusion, I found it generally accurate and entertaining to read.
PS: I wasn't sure where to fit this in, but when this author visits topics that I am better versed in, such as the slave trade, I noticed that there's a tendency to oversimplify. To Kennedy, the primary reason behind the mass enslavement of black Africans was their immunity to Malaria and Yellow Fever. While this is certainly true and a major contributing factor to their desirability as noted by the book, it discounts other notable (and likely more potent) factors.
In the same chapter where the author details the difficulties white slavers had just surviving on the African continent, he manages to ignore the implications of that fact: chiefly that a significant portion of the supply of African slaves was provided by indigenous slavers operating out of economic need. He makes no mentions of the collapse of the Arab and African economies, how the supply of enslaved people grew due to the inflationary effect of American gold and silver. While plague does factor into this economic rationale, a more complete explanation would focus on the economics; it would acknowledge plague's effect on supply by decimating the population of American natives while discounting alternative sources of slaves according to cost. Kennedy tries to explain that the calculus was more economic and racial than it was motivated by concerns for the health and conditions of the slaves, but does not go on to explain the rationale as I just did. This is really a nitpick, but I wouldn't want someone to read this book and just assume that Kennedy's pathogenic focused take on history is a definitive one.