Great non-fiction writing is like great fiction writing: It produces books that are hard to put down, that give you insight into yourself and others, and that change the way you look at the world.

The Big NecessityA young woman named Rose George has produced a great work of reporting and, for my money, has likely produced the best environmental book of 2008: The Big Necessity: The Unmentionable World of Human Waste and Why It Matters.

There is nothing more emblematic of our broken relationship with the earth than the way that we deal — or, mainly, fail to deal — with our own poop.

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In the richest countries, we spend enormous sums bringing potable water great distances, only to use it to give turds a bath. We are beginning to recognize that that civilization will end when supplies of phosphorus do, and that the end is in sight. Meanwhile, we urinate nitrogen and phosphorus rich liquid into more of that fresh, drinkable water and send it down the drain without a thought.

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And in much of the world, people have no decent sanitation facilities at all. With witty writing helping to leaven the hard, searing chapters on life in Indian slums and villages (and African slums, and Chinese villages, and …), George opens the stall door on what she correctly identifies as a very private, singular act with consequences that are very often all too “public and plural” — namely the transmission of disease, the destruction of watercourses, the corruption of public officials, and other maladies.

George repeats something I heard many years ago and believe even more having read her book: that sanitary engineers have done more to increase social health, wealth, and well-being than all the doctors, nurses, and pharmacists in the world, earning primary credit for our improved lifespans. As Nortin Hadler, M.D., a medical professor at the University of North Carolina points out in The Last Well Person: How to Stay Well Despite the Health Care System, medicine in developed countries is getting increasingly concerned with changing what kills you, but isn’t having much luck changing the total time you have.

What Hadler doesn’t say is that this is because sanitary engineers — the people who keep the poop out of the water — have done all the heavy lifting in terms of increasing longevity. We are endlessly fascinated with miraculous and wildly expensive interventions on premies and on children with exotic diseases; meanwhile, we’ve all but forgotten what cholera is, thanks to plumbers and proper wastewater treatment. Cholera is the disease that many of us only know from reading about John Snow’s famous action of removing a contaminated pump-handle from a London slum, thereby stopping a cholera outbreak cold and proving that it was a disease spread by contact with fecal-borne bacteria, not through air, as had been thought.

(A man named Stephen Johnson wrote a terrific book about Snow’s breakthrough — and about how the establishment struggled to ignore him — called The Ghost Map.)

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If only James Hansen or Al Gore could find a demonstration as simple as Snow’s pump handle.

Anyway, I digress. Now if you’ll excuse me, I’m off to research the Scandinavian, urine-separating, NoMix toilets in George’s book.