Why Zebras Don't Get Ulcers

I have so much to say about this book but I'll try to summarize it into a few points:

1. A lot of the concepts in this book was illustrated with the dichotomy of “westernized” and “non-westernized” people as a shorthand for developed and non-developed societies, which I found dated (despite me reading the latest revised edition published in 2004) and bordering on offensive. Based on this alone, I might've given the book 1 or 2 stars.

2. The science in this one was well summarized and generally engaging. A lot of it was not new to me and which I had learnt in Physiology classes back in university, but I appreciated some concepts on a deeper level given the way Sapolsky explains it. Sometimes the technical jargon can get a bit heavy and my eyes would glaze over if I was reading the ebook, and in times like these I much preferred the audiobook. I would've given this aspect 4 stars.

3. A special shout-out to the last chapter about managing stress, which I found exceptionally well done compared to the rest of the book.

I find that there's been not enough said about Point 1 in particular in the reviews for this book so I'll devote a bit of my review to calling that out.

A huge part of this book is concerned about how far human society has evolved compared to wild animals but a lot of our physiological stress responses hasn't quite caught up with that. There's even a motif through this book about a zebra escaping from a lion on the savannah, which lends to the title of the book and is a way Sapolsky uses to illustrate what we have evolved to do (short-burst fight or flight physiological responses) compared to what we actually do in this time and age (utilizing what is meant to be short-burst responses but dragging that out into prolonged stress responses to human society things like mortgages, job security, anxiety over our long-term health, our children, etc.).

All of that is well and good, but what I raise issue with is how Sapolsky basically divides humanity into two halves: you're either “westernized” or “non-westernized”. If you're “westernized”, you live in the most advanced frontier of humanity and your society has developed far along enough that you're dealing with high-end jobs and therefore high-end stressors. This book is written about and for you. If you're a “non-westernized” person, then you're literally not far from that zebra being chased by the lion on the savannah. Here are some quotes to back that up (from the 3rd revised edition published in 2004):

”If you're a human, having enough food and water for this meal, but not being sure where the next meal is coming from is a major stressor as well, one of the defining experiences of life outside the westernized world.” (Ch 5)

”Stress-induced glucocorticoid secretion works roughly the same in all the mammals, birds, and fish..and it has only been in the last half-century or so that westernized versions of just one of those species had much of a chance of surviving something like a stroke.” (Ch 10)

So yes, if you're from a “non-westernized” part of the world, you're definitely going to be so poor and living in the wild that your “defining experience of life” will be not being sure where your next meal is going to come from. You also would have not much of a chance surviving a stroke because of course the healthcare in your society is likely to be non-existent, given how backward your society even is. Do you even have a society or are you just troops of animals living in the wild?

Another example of this casual racism is found in Ch 9, where Sapolsky talks about stress and pain. He zooms in on how acupuncture, a traditionally East Asian medical technique dating back thousands of years, has been found to release opioids to help patients deal with pain. He notes that “Western scientist” had heard of it and “[dumped] it into a bucket of anthropological oddities—inscrutable Chinese herbalists sticking needles into people, Haitian shamans killing with voodoo curses, Jewish mothers curing any and all disease with their secret-recipe chicken soup.” OK, already eyebrow-raising but at least he acknowledged that they were dumping it into a bucket, although I would raise issue with how these are written off as “anthropological oddities”. “Western science” hasn't yet figured out how they worked or bothered spending money researching into them but that doesn't mean that they're entirely nonsense just because they originated from a non-Western/non-white society.

But I haven't come to my point about this chapter. The concern here is about how to tell if these techniques really were objectively efficacious or if they were some kind of cultural placebo, where the people within these societies have been raised to believe in the efficacy of it and therefore derived those benefits from them, even if they were objectively useless. Sapolsky then talks about a “prominent Western journalist” (see the continued emphasis on ‘Western') being administered acupuncture in China for pain relief after an appendicitis surgery: ”He survived just fine. Hey, this stuff must be legit—it even works on white guys.” I quote this verbatim and Sapolsky doesn't even seem to be writing this in any kind of satire. Non-Western techniques are only legitimized when they work on “white guys”. No matter how many countries and people have benefited from them in the past thousands of years, it's obviously all bogus until “white guys” or “Western science” says they aren't. This language and concept is just so extremely problematic in this time and age.

So... I won't go into the actual science of the book beyond what I summarized in my points above, because there're plenty of reviews already that talk about it here. I just wanted this review to focus primarily on the points that probably a lot of people even today would glaze over but which I really think shouldn't be ignored. The book's science is solid and engaging, but my enjoyment of the book overall was dampened significantly by the casual racism peppered through the book.