More than any other medical phenomenon, infectious disease epidemics are embedded in history. COVID Ramblings: A Medical Historian’s Digressions—Dr. Michael Nevins’s personal post-recovery retreat into history--delivers a captivating array of images, insights, and reflections, with generous lacings of wit and an eye for absurdity.  Some of the sixteen short chapters seem “ripped from the headlines” of centuries past, while others reflect the present-day realities of sickness and healing. 

Along the way we meet Moulin Rouge cancan dancer Jane Avril and the “hysteria” guru Jean-Martin Charcot of nineteenth-century Paris, feminist writer Charlotte Perkins Gilman and the “neurasthenia” rest-cure guru S. Weir Mitchell of Philadelphia, and the self-appointed public health guru (“Dr. Trump”) currently holding forth from the Oval Office.  Noah Webster writes an exhaustive history of “epidemics and pestilential diseases” a half century before the introduction of the germ theory.  Boston’s Autocrat of the Breakfast-Table (Oliver Wendell Holmes, Sr.) and tormented Hungarian physician Ignaz Semmelweis (working in Vienna) try in vain to tell a hostile medical profession how to save women in childbirth.  Joseph Lister sprays carbolic acid around the operating room.  George Bernard Shaw’s fictional dilemma-torn doctor tangles with the dawning immune system.  

On the technical side, there are short discussions of the cardiac risks of hydroxychloroquine (that early hope for COVID-19 treatment), T-cells (those “essential workers” of the immune system), and the destructive “cytokine storm” (the second of COVID’s deadly one-two punches). 

The author’s personal experience as a member of New Jersey’s first bioethics commission is brought to bear on the nightmare scenario of insufficient ventilators and ICU beds for COVID-19 victims, as well as the omnipresent preoccupation with death and dying that characterizes pandemics.  

Nevins turns to classical Jewish texts in a reflection on social distancing.  Today’s magical separation of six feet morphs into injunctions about Biblical cubits­—both metaphors for personal space.  A chapter on that “constant nightmare” of history, the periodic visitations of the bubonic plague (the Black Death), awakens echoes that resonate deeply with COVID-19.  Like the nineteenth-century cholera epidemics that both taxed and matured fledgling public health systems, COVID-19 will redefine (and hopefully mature) aspects of twenty-first century public health.

Nevins, a prolific historian of medicine, packs a lot into this slim volume of eclectic and highly readable essays. COVID Ramblings is a fine early entry in what promises to be decades of reflection on the first global pandemic of the third millennium.