The Imaginations of Unreasonable Men

by Bill Shore

  I recognized something in one of the women in the photos. She is attractive, perhaps in her late twenties, with jet black hair and high cheek bones shining in the sun. She is wearing a colorful, flowered blouse and carrying her feverish son, with a green towel draped around his shoulders. They are outside, with one of the lush green hillsides of Cambodia behind them, just slightly blurred.

  From the way her body is angled it looks as though she may be balancing in the back of a truck. Her son’s chin is tucked between her left arm and breast, and her strong left hand presses against his back to steady him as they race toward their destination. His lower jaw is pulled slightly to the left, as if his teeth are chattering from severe chills. His eyelids are heavy, almost closed. But not her eyes. In fact, her eyes burn fiercely, not with fever but with frightened determination.

  I’ve never met this woman, but I recognize her because I can see from her urgency and selflessness that she is every mother I’ve ever known. Her name is Pheap Sung. She told the photographer that, “He was sick for three days, had a very high fever. I would have sought help at a private clinic, but I did not have the money. The free clinic is a long way, but I decided I had to take him. I thought he might have malaria.”14

  I doubt it would have made any difference if the clinic had been five times as far. There is no such thing as unreasonable when it comes to a mother doing what is necessary for her child. There is no such thing as too far, too much, too expensive, or too complicated. The look on her face was a plea, a look that could go right through the camera’s lens all the way across the globe to Steve Hoffman or Rip Ballou or Jay Keasling or Victoria Hale, a plea to not stop at the conventional response, to not be deterred by the unreasonable, to not accept that good is good enough, to not succumb to a failure of imagination.

  The 3,000 African kids who die every day from malaria die quietly and invisibly. That’s because they die routinely, year in and year out, in numbers too large to fathom. They die in the pages of medical journals, not in our living rooms on high-definition TV. Unlike a child buried in the rubble after Haiti’s earthquake, they don’t reach the threshold for Anderson Cooper or the 82nd Airborne, or for benefit rock concerts on MTV.

  This tension between the immediate and the long-term, between the personal and the abstract, is always with us. It exists in every effort to create meaningful change. The drama of tragedy always prevails over the numbing of statistics. Saving 8 million lives over ten years might get a headline—on a slow news day. The improbable rescue of one child a day from a collapsed building in Port au Prince can lead the news for weeks.

  The consequence, while understandable, is a spectacular failure of imagination. When we focus on the one rather than the many, on the symptom rather than the cause, on what we can accomplish on our own rather than on what needs to be accomplished by the broader community, we neglect our greatest opportunities to do the greatest good. It is equivalent to suffering a massive stroke that leaves one seeing only what is in our direct line of sight, with no peripheral vision or sense of relationship to the larger, surrounding world.

  There is no recourse to such failure of imagination but to recognize it, confront it, and struggle to overcome it as one might a crippling stutter.

  It would be nice if there were a more concrete and guaranteed prescription, perhaps a handy checklist to tick through. But overcoming failures of imagination has less to do with following procedure or tapping external resources than it has to do with looking deeply and expansively within. It requires each of us to intentionally challenge our own imagination, questioning whether we have engaged it to the fullest, and especially pushing to contemplate, and react to, not only what we see but also to what we do not see.

  A few years ago, the commencement speaker at a college graduation made exactly this point. The speaker, Ophelia Dahl, cofounder of Partners in Health (PIH) and daughter of the children’s book author Roald Dahl, quoted Adam Hochschild, who wrote about the importance of “drawing connections between the near and the distant.” Dahl, speaking to the women in the class of 2006 at Wellesley College, went on to explain one of the ingredients most essential to fighting for whatever might be their cause:Linking our own lives and fates with those we can’t see will, I believe, be the key to a decent and shared future. . . .

  Imagination will allow you to make the link between the near of your lives with the distant others and will lead us to realize the plethora of connections between us and the rest of the world, between our lives and that of a Haitian peasant, between us and that of a homeless drug addict, between us and those living without access to clean water or vaccinations or education, and this will surely lead to ways in which you can influence others and perhaps improve the world along the way.15

  Dahl said that being the daughter of writer Roald Dahl meant learning a lot about imagination at an early age. She implied that it had served her well in helping to envision and create Partners in Health. After all, PIH had succeeded where so many others had failed precisely because of a leap of imagination. The leap was not that highly educated doctors in Boston would volunteer to provide health care to Haitians in Haiti—though it would be fair to call that a stretch in its own right—but rather that with the support of partners from Boston, Haitians could create and deliver their own health care. That is where imagination really triumphed.

  The photos at the UN exhibition satisfied Ophelia Dahl’s challenge to draw connections and link “our own lives and fates with those we can’t see.” I recognized Pheap Sung because it was in her face that I also finally met and recognized the mother of Alima, the young Ethiopian schoolgirl I’d befriended, whose photo still graces my bookshelf, who died of cerebral malaria before reaching the age of fourteen, and who should not have. The terror, love, and determination in the eyes of Alima’s mother could not have been much different from what I saw in the eyes of Pheap Sung.

  We can’t all go to Ethiopia, Uganda, or Haiti, or perhaps even to a malaria vaccine lab in a strip mall across town, to witness suffering or to fully understand the need, opportunity, and possibility. But if we are purposeful about using our moral imagination, we shouldn’t have to.

  In today’s world more than at any time in human history, we have access to all of the information we need to bridge the chasm between distant and near. The question is what we will do with it: whether we will not only analyze and categorize and think about it, but also let ourselves feel something about it and act on those feelings.

  Compassion is both blessing and balm. But unless it is hitched to the power of imagination, it can leave us one step behind the next tragedy, and the next, always a day late and a dollar short. We’ll likely end up doing good, but not nearly good enough.

  Moral imagination is supposed to be what differentiates us from other species. But our boast is bigger than our bite. We remain only partially evolved, a work in progress to be admired and resisted both at once. We find ourselves, as Bruce Springsteen sings, “halfway to heaven and just a mile outta hell.”

  If we hope to truly change the world rather than just the bits and pieces of it that drift in front of us, we must reach for more than the traditional tools stored in those drawers we glibly label “social entrepreneur,” “business leader,” or “politician.” Indeed, we must reach inside, not out; we must shape our own evolution, with faith that the greatest value we can deliver may lie not in what we know but in what we seek to know.

  ACKNOWLEDGMENTS

  THIS BOOK WAS MADE BETTER by many heads and hands—especially by PublicAffairs editor Clive Priddle, who created order out of chaos. He never lost sight of the story I wanted to tell, even when I kept it pretty well hidden. Thanks also to my initial editor, Morgan Van Vorst, and to Susan Weinberg, publisher, and Peter Osnos, founder and editor-at-large of PublicAffairs, for taking a gamble on this book and for their faithful commitment to giving voice to those who might otherwise be voiceless. Katherine Streckfus’s copyedit improved every page and I deeply appreciate her extr
aordinary diligence, as well as the formidable production skills of Melissa Raymond. I am also grateful to my longtime friend and agent, Flip Brophy, for helping to make such a perfect match, as she has done many times before.

  There were many experts in the global health field who generously guided me through their own stories as well as the history and science of malaria and vaccine development. I have the utmost respect for their expertise and dedication. They include Ruth Nussenzweig, Pedro Alonso, Peter Hotez, David Lanar, Jay Keasling, Kinkead Reiling, Jack Newman, Paul Roepe, Dan Carucci, Marcelo Jacobs-Lorena, Judith Epstein, Victoria Hale, Ray Chambers, and Brian Greenwood, and also Regina Rabinovich, Joe Cerell, and their colleagues on the staff of the Bill and Melinda Gates Foundation.

  My greatest debt of gratitude goes to Steve Hoffman and his wife, Kim Lee Sim, who repeatedly and patiently opened up their lab and lives so that I could get a glimpse of the human trials and tribulations behind the science. Their work, assisted by their three sons, has genuinely been a family affair, and if the way Alexander, Ben, and Seth have turned out is any indication of how Sanaria’s vaccine to eradicate malaria will fare, the world has reason for hope.

  At critical junctures along the way, I was sustained by creative and caring friends, including, first and foremost, Jeff Swartz, as well as Joel Fleishman, Harris Wofford, Chris and Diana Chapman-Walsh, Leah and Bill Steinberg, Rick Russo, David and Katherine Bradley, Sue and Bernie Pucker, and my sister-in-law and babysitter extraordinaire, Patti Jordano.

  The staffs of Share Our Strength and Community Wealth Ventures generously took up the slack, as they always have when my attentions were focused elsewhere. Their unrelenting determination to end childhood hunger, and the sacrifices they’ve made in pursuit of that goal, speak volumes about who they are, the choices they’ve made, and their shared commitment to those who are the most vulnerable and voiceless among us. Special thanks to my executive team colleagues Pat Nicklin, Chuck Scofield, Eric Schweickert, and Josh Wachs, and also to Amy Celep from Community Wealth Ventures. My sister Debbie, cofounder of Share Our Strength, always an indispensable leader, has once again been a selfless champion of my attempt to put words to the lessons we’ve learned. Thanks to Alice Pennington for her enthusiasm in keeping me and the manuscript organized, and for always being such a thoughtful colleague and caring friend, and also to Sarah Sandsted for so capably fielding all manner of assignments large and small.

  In this and all I do I’ve been inspired by the strength and resilience of my older son Zach, the determination of my daughter Mollie, and the curiosity and joyfulness of my young niece Sofie Shore.

  My wife, Rosemary, has been a partner in this project in every way, with characteristically unfailing instincts upon which I’ve greatly depended. She and our son, Nate, a fount of imagination in his own right, bore the brunt of my conflicting desires to write and keep my day job. But their love, energy, and spirit made the long hours and absences bearable, and finishing the book especially rewarding. In the course of my research I frequently realized just how many things I don’t know, but I do know how lucky I am to have them at the center of my life.

  NOTES

  CHAPTER 1

  1 The Little Prince, by Antoine de Saint Exupéry and translated by Katherine Woods, is available online at http://www.angelfire.com/hi/littleprince/frames.html. The quotation is from Chapter 21.

  2 See Brother Thomas Bezanson’s obituary at http://www.icgerie.com/homes/dusckas/obit/2007/08/bezanson.html. See also the page on Brother Thomas at the Pucker Gallery website, http://www.puckergallery.com/bt.html.

  3 Rosemary Williams, ed., and Bill Aron, photographer, Creation Out of Clay: The Ceramic Art and Writings of Brother Thomas (Grand Rapids, MI: William B. Eerdman’s, 1999), 90.

  4 Victoria G. Hale, “Our Story: How OneWorld Health Was Founded,” http://www.oneworldhealth.org/story.

  5 See “Our Impact,” Teach for America, http://www.teachforamerica.org/mission/our_impact/our_impact.htm.

  6 See Harlem Children’s Zone, “The HCZ Project: 100 Blocks, One Bright Future,” http://www.hcz.org/about-us/the-hcz-project.

  7 Sun Tzu, The Art of War (Mineola, NY: Dover Publications, 2002).

  CHAPTER 2

  1 For biographical material on Steve Hoffman, see the Sanaria website, http://www.sanaria.com/index.php?s=44.php, and Thomas C. Luke and Stephen L. Hoffman, “Rationale and Plans for Developing a Non-Replicating, Metabolically Active, Radiation-Attenuated Plasmodium Falciparum Sporozoite Vaccine,” Journal of Experimental Biology 206 (2003): 3803-3808; first published online September 23, 2003, at http://jeb.biologists.org/cgi/reprint/206/21/3803.

  2 Quotes from scientists and others that are not otherwise attributed are from interviews I conducted with them in person or by phone. Often we met more than once, in some cases numerous times over a period of several years. Steve Hoffman and I met regularly over a period of nearly five years at his office or over meals, and we talked frequently by phone and e-mail.

  CHAPTER 3

  1 Paul R. Russell, “Introduction,” in Preventive Medicine in World War II, vol. 6, Communicable Diseases: Malaria, Col. John Boyd Coates, Jr., ed. (Washington, DC: Medical Department, U.S. Army), available at http://history.amedd.army.mil/booksdocs/wwii/Malaria/chapterI.htm.

  2 Committee on U.S. Military Malaria Vaccine Research, Battling Malaria: Strengthening the U.S. Military Malaria Vaccine Program (Washington, DC: National Academies Press, 2006), 14. See also Malaria Vaccine Initiative, “Fact Sheet: Malaria and the Military,” 2004, http://www.malariavaccine.org/files/FS_Malaria-Military_9-15-04.pdf.

  3 “What Is Malaria?” Malaria Site: All About Malaria, April 14, 2006, http://www.malariasite.com/malaria/WhatIsMalaria.htm.

  4 Ethiopian North American Health Professionals, “Facts and Statistics,” http://www.enahpa.org/.

  5 Dr. Denise Doolan, Patent Application, http://www.faqs.org/patents/app/20080248060; Mark Zottola, “Computational Chemistry, Anti Malaria Drug Research,” U.S. Army Research Laboratory, June 3, 2009, http://www.arl.hpc.mil/Publications/eLink_Spring03/malaria.html.

  6 Craig Smith and Arthur Hooper, “The Mosquito Can Be More Dangerous Than the Mortar Round: The Obligations of Command,” Naval War College Review (Winter 2005), http://www.thefreelibrary.com/The+mosquito+can+be+more+dangerous+than+the+mortar+round%3A+the+-a0129363033.

  7 Ibid.

  8 Ibid.

  9 Ibid.

  10 Ruth Nussenzweig, conversation with the author in her lab at New York University, March 18, 2009; Douglas Birch, “The Struggle to Vanquish an Ancient Foe,” Baltimore Sun, June 18, 2000.

  11 Robert Langreth, “Booster Shot,” Forbes.com, November 12, 2007, http://www.forbes.com/free_forbes/2007/1112/078.html?partner=yahoomag.

  12 David Biello, “Self-Experimenters: Malaria Vaccine Maven Baits Irradiated Mosquitoes with His Own Arm,” Scientific American, March 12, 2008, http://www.scientificamerican.com/article.cfm?id=malaria-vaccine-researcher-lets-misquitos-bite-him ; Michael Myser, “The Malaria Fighter,” Business 2.0, January/February 2006.

  13 William Deresiewicz, “Solitude and Leadership,” AmericanScholar.org, Spring 2010, http://www.theamericanscholar.org/solitude-and-leadership/.

  CHAPTER 4

  1 The company website is at http://www.sanaria.com/. For a photo of the new headquarters, see http://www.sanaria.com/index.php?s=48.php.

  2 Jason Fagone, “The Scientist Ending Malaria with His Army of Mosquitoes,” Esquire, December 8, 2008, http://www.esquire.com/features/best-and-brightest-2008/malaria-prevention-1208.

  3 E. Nardin, F. Zavala, V. Nussenzweig, and R. S. Nussenzweig, “Pre-Erythrocytic Malaria Vaccine: Mechanisms of Protective Immunity and Human Vaccine Trials,” Parassitologia 41, nos. 1-3 (1999): 397-402.

  4 John F. Kennedy, address at Rice University, Houston, Texas, September 12, 1962. See text of speech online at http://www.jfklibrary.org/Historical+Resources/Archives/Reference+Desk/Speeches/JFK/003POF03SpaceEffort09121962.htm.

 
CHAPTER 5

  1 Donald Burke, American Society of Tropical Medicine and Hygiene Centenniel Address, Philadelphia, December 3, 2003, http://www.astmh.org/AM/Template.cfm?Section=Meeting_Archives&Template=/CM/ContentDisplay.cfm&ContentID=1500.

  2 P. Trouiller, P. Olliaro, E. Torreele, J. Orbinski, R. Laing, and N. Ford, “Drug Development for Neglected Diseases: A Deficient Market and a Public-Health Policy Failure,” The Lancet 359, no. 9324 (2002): 2188-2194.

  3 Hélène Delisle, Janet Hatcher Roberts, Michelle Munro, Lori Jones, and Theresa W. Gyorkos, “Review: The Role of NGOs in Global Health Research for Development,” Health Research Policy and Systems 3, no. 3 (2005), http://www.health-policy-systems.com/content/pdf/1478-4505-3-3.pdf.

  4 Michelle Barry, Presidential Address, 51st annual meeting of the American Society of Tropical Medicine and Hygiene, Denver, Colorado, November 12, 2002, http://www.astmh.org/AM/Template.cfm?Section=History_of_ASTMH&Template=/CM/ContentDisplay.cfm&ContentID =1323 .

  5 Gary Taubes, Science Watch Newsletter, http://esi-topics.com/malaria/interviews/StephenHoffman.html, May 2006.

  6 B. H. Kean, with Tracy Dahlby, MD: One Doctor’s Adventures Among the Famous and Infamous from the Jungles of Panama to a Park Avenue Practice (New York: Ballantine Books, 1990).

  7 Guy Charmot, “Lavaran and the Discovery of the Malaria Parasite,” Centers for Disease Control and Prevention, February 8, 2010, http://www.cdc.gov/malaria/about/history/laveran.html.

  8 Dr. Ronald Ross, speech at the Nobel Banquet in Stockholm, December 10, 1902, reprinted in Nobel Lectures: Physiology or Medicine (1901- 1902) (Singapore: Published for the Nobel Foundation by World Scientific Publishing Co., 1999).