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Brian Lehrer: It's The Brian Lehrer Show on WNYC. Good morning again, everyone. Malcolm Gladwell is back with us now. The many Times best selling author and host of the podcast Revisionist History has a new book that builds on the book from 25 years ago that really put him on the map as an ideas person, including an ideas person about ideas and how they spread fashion trends, best selling books, teenage smoking rates, Sesame Street, all kinds of things. As Malcolm reminds us in this sequel, that book was The Tipping Point. The new book is Revenge of the Tipping Point: Overstories, Superspreaders, and the Rise of Social Engineering. Malcolm, always good to talk. Welcome back to WNYC.

Malcolm Gladwell: Thank you. Good morning.

Brian Lehrer: Going back to the original Tipping Point, that was 20 years before the pandemic, but you framed up a way to think about what becomes popular in our culture as through the construct of an epidemic. Can you remind us of that premise as you originally conceived of it?

Malcolm Gladwell: Yes. The core of the observation was if you look at the way that an idea spreads or a behavior spreads, it looks exactly like the way a virus spreads. It has a tipping point, which is a classic thing that you see in an epidemic, which is the epidemic. Remember back in March of 2020 when Covid went from something we'd barely heard of to something that was everywhere? March of 2020 was a tipping point. That's a very classic epidemic pattern. And I think you see that with ideas as well, that when they are contagious, we pick them up from each other. And when an idea takes off, it takes off in exactly the same way a virus does.

Brian Lehrer: You refer at the start of the new book to the idea that maybe the original tipping point caught on so much because it was a hopeful book in hopeful times. The Cold War was over. Crime was in freefall. It was the dawning of a new millennium. We live in very different times today in that respect. So would you say you've turned to a darker set of things that now go viral for this book? Looks to my eye like you have.

Malcolm Gladwell: I have, yes. I mean, I'm also older. I'm 61. I'm no longer 36 or whatever I was when I wrote the first book. We've just come off Covid, one of the biggest pandemics in almost a century. I talk about the opioid crisis, which is claiming the lives of more than 100,000 Americans a year. It's hard to be as upbeat as I was in the first book. This time around, I'm interested in the ways in which the principles of epidemics are sometimes used against us, so I've taken a little bit of a turn with this book.

Brian Lehrer: Talk about the opioid epidemic, which I know you address in the book and which you just mentioned. If March 2020 was the tipping point for Covid, was there a tipping point for opioid addiction?

Malcolm Gladwell: Yes. Well, there were several. One of the features of this particular epidemic is that it's changed shape on several occasions. The introduction of OxyContin by Purdue Pharma is obviously the first tipping point. This extremely powerful, extremely dangerous painkiller is introduced, and by around 2000, the early 2000s, Purdue was marketing it in a way that is making it widespread. That epidemic then has a second tipping point when OxyContin users start switching to heroin and fentanyl, and the epidemic sort of gets turbocharged a second time. That's when we start to see overdose rates or overdose deaths exceeding 100,000 in the United States.

The crucial thing about that, though, is I begin my chapter on opioid crisis with a simple chart that just shows overdose deaths in countries around the developed world. We're really the only country that has a truly out of control crisis. There are many countries in Europe that have no opioid problem whatsoever. Its important to understand that this is not like Covid, which was everywhere. This is something that was homegrown. I dip into the reasons why I think this was such a exclusively American, not exclusively, but heavily American phenomenon.

Brian Lehrer: What are one or two? Is it at all the nature of American capitalism compared to even western European capitalism?

Malcolm Gladwell: Well, I think it could be more specific than that. I think that there are certain states-- I mean, the opioid crisis, you can break it down a second time and say that there were certain states that had a much more serious crisis than others. New York state, for example, got off pretty easily. Whereas Massachusetts, our neighbor, had a terrible opioid crisis. Indiana had a terrible opioid crisis. Illinois, its neighbor, did not. A lot had to do with state laws, with how easy it was for doctors to prescribe powerful opioids. In the year 2000, it was a lot harder to prescribe an opioid, if you were a physician in New York state than it was in Massachusetts.

It has to do with the fact that the illegal drug trade had entrenched itself in American society a lot more firmly than it had in some countries in Europe. It had to do with the fact that Purdue Pharma, which started this all with OxyContin, was an American company that focused its marketing attention on this country in the beginning.

Brian Lehrer: Listeners, now's your chance. Anything you always wanted to ask Malcolm Gladwell, but never had him over for lunch, now's your chance. 212-433-WNYC, 212-433-9692 on any of the topics from his new book based on this conversation or things you may have read or heard elsewhere, his old books, his podcast, Revisionist History, if you're a listener or anything else related, 212-433-WNYC, 212-433-9692. Give us a call or text us a question. If you have anything for Malcolm Gladwell today, now's your chance.

In your subtitle, and I'll say the title again for people just joining us, the new book is called Revenge of the Tipping Point: Overstories, Superspreaders, and the Rise of Social Engineering. In that subtitle you have the phrase "the rise of social engineering." What does that refer to?

Malcolm Gladwell: I think that one of the things that marks the era we live in is that institutions have increasingly taken epidemic principles and applied them in a somewhat Machiavellian way to further their own ends. I mentioned Purdue Pharma very much did that, pursued a very specific, deliberate, and brilliant strategy to persuade a very small number of doctors to become superspreaders for OxyContin. That's social engineering.

I have a chapter about Harvard admissions policy at Harvard University and trying to examine the puzzle of why does Harvard play more varsity sports than any other university in the country? Why do they give such an enormous admissions preference for people who play sports like tennis, rowing, sailing, and fencing? I think that's an attempt to engage in social engineering, to make sure that the traditional culture of Harvard, which is a white, upper middle class culture, stays intact. I think that's something we need to be aware of, that people use the epidemic rules and principles to further their own ends, and that can be quite an insidious force.

Brian Lehrer: That's really interesting. You connected those two things in the subtitle, the rise of social engineering and superspreaders. How about the other one, overstories? What does that refer to?

Malcolm Gladwell: I spend a lot of time in the book trying to figure out the contribution of the kind of common narratives that communities tell themselves. The chapter where I talk about this first is a chapter about Miami, trying to explain why does Miami have-- Miami is the center, the national center of Medicare fraud. Medicare fraud would be the biggest kind of criminal fraud in the country, and it is practiced in Miami at levels that are not seen anywhere else in the country. The question is why? What's going on in Miami that makes it so conducive to that kind of criminality?

I broadened that out to talk about how I think that countries, states, cities, communities, towns develop these kinds of common narratives that play a very powerful role in shaping people's behavior, even in ways that people are unaware of. I think Miami has a distinctive overstory. I mean, there are many explanations why Miami is so strange, but the first explanation is, I think, it has a very distinctive overstory. It has told itself a narrative about what you can do if you live in Miami that is different from the narratives that you hear in Minneapolis or other cities that have extremely low levels of this kind of criminal behavior.

Brian Lehrer: Does New York have an overstory?

Malcolm Gladwell: Yes, it has many. The city that never sleeps I think is an incredibly powerful overstory. Right? It says that you should come here for the energy, for the excitement, for the drama. It's an overstory that gives New Yorkers permission to exult in the chaos of the city. It's a crucial part of who we are.

Brian Lehrer: One specific thing that's new in the world since the original Tipping Point, your first book 25 years ago, in terms of the spread of ideas, is social media itself. There was no Facebook, no Instagram, no TikTok when you were watching ideas go viral, and documenting them, and explaining them at that time. I think public attitudes have changed over time from being hopeful-- as you say, that was a more hopeful book in a more hopeful time, from being hopeful that those social media platforms would do a lot of good, democratize journalism, be a place where ideas could really be debated, and lies could be debunked. Of course, today we see it largely, at least, doing the opposite of all those things. Do you have examples in the new book where you describe how these platforms have changed the nature of the epidemiology of ideas, or specific examples?

Malcolm Gladwell: The phrase social media does not appear in my book even once. I made a very deliberate attempt to steer away from that. I feel like there are a million books out there on social media. I didn't think we needed another one. I thought there were other aspects of the epidemic model that needed to be explored. Jonathan Haidt's book on what social media is doing to the mental health of young people is-- I don't think I can match that.

Brian Lehrer: Do you think then that there are other aspects of what causes the virality of all kinds of things from actual viruses? You do have a COVID-19 section. I'll ask you about that, but there are other aspects of what make ideas or diseases or whatever go viral that aren't getting enough attention now because everybody talks about social media all the time.

Malcolm Gladwell: Yes, I would agree with you that we talk too much about social media. It's funny, I wrote a piece for The New Yorker, must be 10 years ago now, right after Arab Spring, more than 10 years ago, when we were at the height of saying-- it was all this talk about how Twitter was going to create democratic revolutions around the world and save us. I wrote a piece saying I thought that was nonsense and I was roundly denounced, and now I think everyone agrees with me. I feel I said my piece on this a long time ago in the pages of The New Yorker.

I think one of the things that's crucial to understand is that even though we have platforms like social media that are international in scope, that don't respect borders, one of the things that's striking to me when I look at epidemic outbreaks, particularly today, is how local they are. I gave the example of Miami, and I give a bunch of examples in the book. The book opens with the account of an epidemic of bank robbing in Los Angeles in the early '90s, which was a time when half of all bank robberies in the United States took place in LA. That was just LA. It didn't spread. Its one of numerous examples I point to of these contagious phenomenon that are incredibly specific.

I think that we're fooled sometimes into thinking-- when we look at social media, into thinking that everything takes place on a grand scale, and that's not true. I think epidemics, particularly even more so now than before, are things that are very, very specific to place and are generated within the boundaries of one community or another.

Brian Lehrer: That's so interesting at a time when we take everything as national. We were talking about this in our politics segment last hour. It used to be all politics is local. Now, it's all politics is national. In these congressional races in the New York suburbs, people, instead of looking so much at the individual, they're looking more than in the past at, "Oh, but do I want Trump to have a republican congress to work with?" or vice versa. You're bringing us back to an awareness, like in your Miami example, like your New York versus Massachusetts in the opioid crisis example, to remember the importance of place.

Malcolm Gladwell: Yes, I think both things can be true, that in some dimensions, like politics, we can be increasingly focused on national as opposed to state or regional things. At the same time, I think we can have these very specific regional phenomenon that are strikingly diverse.

Brian Lehrer: You know what's happening on the phones? I invited people to call in with anything they always wanted to ask Malcolm Gladwell, but never had you over for lunch, but I did that right after our stretch on your chapter on the opioid crisis. All our calls are, "Do you think this is contributing to the opioid crisis? Do you think that's contributing to the opioid crisis?" I'm not gonna hold you up as the ultimate opioid epidemic expert of the universe and make you answer all these questions, but I'll read you one, maybe interesting one that came in in a text message. Again, if you don't address this at all, then you just don't.

Listener writes, "What is Malcolm's thought on how America is one of only two developed countries that allows direct-to-consumer advertising of pharmaceuticals? Did that affect the opioid prescribing and epidemic? Probably people in America don't realize that we didn't used to have it, and a lot of the world doesn't have it, all these ads when you watch television for all these prescription drugs.

Malcolm Gladwell: Yes, I think I'm right when I say that that is something distinctive about America, but it's not germane here because the class of pharmaceuticals that opioids belong to are not allowed to be advertised directly to consumers, so it was entirely Purdue working with doctors. Pretty sure you can't market opioid painkillers directly to consumers.

Brian Lehrer: So that's not relevant in that context. You do write about the spread of the actual epidemic, COVID-19, so much has been studied and said about that since 2020. What's an example of something you bring that might be new for a lot of listeners?

Malcolm Gladwell: Well, the big thing is my whole chapter is about something that we only began to understand dimly at the end of the epidemic, which was that the epidemic, Covid, was spread overwhelmingly by a very, very, very small number of infected people. In other words, if you had 100 infected people in a room, probably only two or three were really doing any work in spreading that virus to others. It was an epidemic that was propelled by a small number of superspreaders who, for reasons we only dimly understand, for some genetic reason that is obscure, produced far more, what are called aerosols.

When you breathe, you emit little droplets of moisture, and if you're infected with Covid, the virus was found in each of those droplets. A small number of us produce 100 times more of those droplets than the rest of us, and those people played an absolutely central role in the pandemic. I think that's an incredibly important observation that will fundamentally change how we fight the next pandemic. We're not going to be dealing with all of us. We're going to be instead trying to figure out who the people are who are these superspreaders and helping them first, treating them first, identifying them, making sure that they're the ones who limit their exposure to others.

Brian Lehrer: We're almost out of time. I'll read you two more text messages that came in. The more diverse ones are on our text thread as it turns out, not on the phones, for this particular segment. One person just writes in response to my question, "Tell Malcolm I'd love to have him over for lunch sometime. We'll make something nice. Text me." Another one, because you do say you wrote the original Tipping Point 25 years ago, before you were a parent among other things. Listener writes, "What is the number one thing you got wrong about parenting before you became a father?" Dare you answer that question?

Malcolm Gladwell: Yes, so many things. I thought it was possible to give advice to parents. Turns out I think all advice is of limited value because every child is different and they never do what you want them to do anyway. I used to give advice to parents before I had kids. Now that I have kids, I realize I will never give advice again.

Brian Lehrer: He will give analysis of how ideas and other epidemics spread in our world. Malcolm Gladwell's new book is Revenge of the Tipping Point: Overstories, Superspreaders, and the Rise of Social Engineering. Thanks for coming on with us, Malcolm.

Malcolm Gladwell: Thank you, Brian.

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