Good news, everyone!

The hospital is called Aravind. It was started in 1976 by a man named Govindappa Venkataswamy, known as Dr. V. He was 58, had just been forced to retire, and his hands were crippled by arthritis so bad he could barely hold a pen. He had scalpels custom-made for his twisted fingers and still performed over 100,000 eye surgeries in his life.

Two years before he retired, Dr. V walked into a McDonald’s for the first time. He looked at the menu, looked at the assembly line in the back, and came out with an odd idea. He would sell cataract surgeries the way McDonald’s sold burgers.

So he mortgaged his house. His brothers and sisters pooled their life savings. He opened an 11-bed clinic in Madurai. Then he flew to Chicago and enrolled in Hamburger University, the actual McDonald’s training program, to learn how the assembly line worked.

At Aravind, cataract surgery is broken into small steps. Nurses prep one patient while the surgeon operates on another. Each surgeon switches between two tables. The operation itself takes about six minutes.

So far Aravind has seen 55 million patients and done 6.8 million surgeries. More than half of those patients paid nothing. Not a rupee. The ones who can pay subsidize the ones who cannot.

A surgery at Aravind costs between $40 and $125 depending on the lens. In the US, Medicare pays about $1,766 for the same operation. Aravind also has better results. Their complication rate is 1.5%, and serious eye infections happen in about 2 out of every 10,000 surgeries. Most American hospitals are not that good.

They built their own lens factory too, called Aurolab. Imported lenses were costing hundreds of dollars each, so Aurolab makes them for around ten. Today Aurolab produces roughly 10% of the world’s eye lenses and ships to 160 countries.

Every year, Aravind sends doctors and nurses out to rural villages for 2,500 eye camps. They screen people who have been blind for years, bus them to the hospital, operate on them, and bus them back home seeing.

Dr. V died in 2006. His family still runs Aravind. Harvard Business School has been teaching the story as a case study since 1993. I still do not see it in my feed.

In 1985, three British scientists stared at their data and realized a hole had opened up in the sky above Antarctica. Over the next 20 years, it grew to be larger than all of North America. If we had done nothing, two-thirds of the ozone layer would have been destroyed by 2065. Millions would have died of skin cancer. Global food production would have been cut in half.

So every country on Earth signed a treaty. All 197 UN member states. It is the only treaty in history every single country has signed. It is called the Montreal Protocol, it banned a class of chemicals called CFCs, and it went into effect in 1987. CFCs were in refrigerators, air conditioners, aerosol cans, and hairspray. They were tearing the ozone layer apart.

Two scientists had tried to warn us 11 years earlier. Mario Molina was Mexican. Sherwood Rowland was American. In 1974, they published a paper in Nature saying CFCs were going to destroy the ozone layer. The chemical industry called them cranks. It took a decade and an actual hole in the sky before people believed them. Both scientists later won the Nobel Prize.

The treaty worked. Since 2000, ozone-depleting chemicals in the stratosphere have dropped by about a third. 99% of the world’s ozone-depleting chemicals have been phased out. The 2025 Antarctic ozone hole was the fifth smallest since 1992 and closed earlier in the season than any year since 2019.

Full recovery is projected by 2040 for most of the world, 2045 over the Arctic, and 2066 over Antarctica. A lot of people reading this will live to see it.

US government scientists estimate that 443 million cases of skin cancer and 2.3 million skin cancer deaths in the United States alone will have been avoided because of this treaty. Globally, the number is much higher. A lot of us are walking around right now without the skin cancer we would have had.

When I was a kid, adults talked about the hole in the ozone layer the way people now talk about climate change. That was the villain. Everyone was sure it was going to kill us all.

In 1990, 2.3 billion people were living on less than $3 a day. Today that number is 808 million. A billion and a half humans moved from not enough food to eat, to enough food to eat. The bulk of that lift came from China and India just getting richer. China alone pulled 800 million people out of poverty. That is more than the population of the United States, Canada, and Western Europe combined.

And it is not just money. A baby born in 1900 was expected to live 32 years. A baby born today is expected to live 71. We more than doubled human life expectancy in four generations. In 1820, 9 out of 10 adults on the planet could not read. Today 87% can. More than 5 billion people can now read a book, a recipe, a text from their kid. Two hundred years ago, that number was under 100 million.

Child deaths are the one that hits me the hardest. In 1990, 1 in every 11 children died before their fifth birthday. Today it is 1 in 27. In 2022, for the first time in recorded history, the number of children who died under age 5 dropped below 5 million in a single year. That is still too many. But 30 years ago the number was over 12 million. Nobody threw a parade.

Not everything is better. The news is right about that part. Climate is getting worse. Wars are getting worse in some places. Hunger went back up in Africa. Progress has slowed since COVID. But if you zoom out and look at where humans were 35, 100, 200 years ago, it is not even close. Most people alive today have more food, more medicine, more schooling, more years of life, and more freedom than any generation before them.

The reason you never see this on your feed is that “118,000 humans escaped extreme poverty yesterday” does not make you click. A plane crash does. So you see the plane crashes and you miss the quiet miracle that has been running in the background of your whole life.

The first one is a Dutch guy named Gert-Jan Oskam. In 2011, he crashed his motorcycle in China and broke his neck. He was paralyzed from the hips down for 12 years. In 2023, a team in Switzerland put electrodes in his skull and in his spinal cord, then connected them through a small computer he wears in a backpack. When he thinks about walking, the brain electrode picks up the signal. A computer in the backpack decodes it. The spine electrode zaps his leg muscles in the right order. He walks.

He can go up stairs. He can stand at a bar and order a drink. Last year he painted a wall in his own house because nobody was around to help. That story is from a direct quote in Nature. The craziest part is that after enough training, he can take a few steps even when the device is switched off. The team thinks his nerves are actually starting to heal.

Then in January 2025, a team at Fudan University in China did it with fewer wires. They put two electrodes the size of a grain of rice inside a man’s motor cortex and a small stimulator in his spine. His name is Lin. He fell down a four meter staircase two years earlier and had lost the ability to move his legs completely. By day three after surgery, he was moving both legs with his mind. By day 15, he walked more than 5 meters with a walking frame. In his own words, “I used to cry every day. Now I can walk again.” Two other paralyzed people had the same surgery a few weeks later. Both regained leg movement within hours.

And then in the US, Neuralink has its own version. An American named Noland Arbaugh broke his neck in a swimming accident in 2016. In January 2024, he got the first Neuralink brain chip. He cannot walk yet, but he plays online chess and video games with his thoughts. He controls his computer and phone without moving a muscle. In April 2025, a fifth American patient got one at the University of Miami.

There are about 20 million people on this planet living with spinal cord injuries. Most have been told their whole life that nothing can be done. In the last 36 months, three different teams in three different countries have now shown that something can be done.

I had no idea the recovery was this big until I started reading the numbers. A humpback is the size of a school bus. It can weigh 40 tons. It sings songs that travel hundreds of miles underwater and migrates further than any mammal alive, swimming up to 5,000 miles each way between the tropics and the poles. By the 1950s we had killed roughly 95% of every population on Earth.

In 1986, after years of pressure, every member of the International Whaling Commission agreed to ban commercial whaling. Forty years ago this year. That is the entire story of what happened next. We stopped killing them, and they did the rest themselves.

The South Atlantic numbers are the ones that broke me. In the 1830s there were about 27,000 humpbacks swimming between South America and Antarctica. After 12 years of intense hunting in the early 1900s, the population was down to 450 animals. Four hundred and fifty whales left in a stretch of ocean the size of three Atlantic Oceans. A 2019 paper from the University of Washington and NOAA put the current count at about 25,000. Roughly 93% of where they were before we showed up with harpoons.

Off the west coast of Australia, a similar story. The population is about 90% recovered, growing 9% a year, and Murdoch University researchers are now arguing the species should come off the threatened list entirely.

Globally there are about 84,000 humpback whales swimming the planet right now. The IUCN, which tracks the conservation status of every species in the world, downgraded humpbacks from “Endangered” to “Least Concern.” If you have ever seen a whale breach in real life or in a documentary, the only reason you got to see that is because of what happened in 1986. Your grandparents lived in a world that was running out of whales, and you do not.

Whales also turn out to be quiet climate machines, which I did not know until this week. A single great whale stores about 33 tons of carbon dioxide in its body over its lifetime. When it dies, the body sinks to the deep ocean floor and that carbon stays locked there for centuries. A mature oak tree captures about 12 tons over a 500 year maximum lifespan. So one whale, in 70 years, locks up almost three oaks worth of carbon for longer than the trees would have lived. There are caveats here, and some scientists think the climate effect is smaller than the headline number suggests, but the direction is clear. More whales, more carbon out of the air.

The story is not finished. 7 of the 14 great whale species are still endangered or vulnerable. Ships keep hitting whales. Fishing nets kill an estimated 300,000 whales, dolphins, and porpoises every year. The North Atlantic right whale is in real trouble, with only a few hundred animals left.

In 1951, James was 14. He got a bad chest infection and the doctors had to take out one of his lungs. The surgery used 13 units of blood from people he never met. He was in the hospital for days afterward, alive only because strangers had given him their blood. While he was lying there, he made a private deal with himself. The day he turned 18 and was old enough to donate, he would start giving blood back. Every two weeks. For as long as they would let him. He kept that deal for 64 years.

He started in 1954. After his first few donations, doctors found something odd in his blood. He had unusually strong antibodies against something called the Rh D antigen. What that means is his body was producing a rare protein that could be turned into a medicine called anti-D. Anti-D is given to pregnant women whose blood would otherwise attack their own babies in the womb. Before 1967, this condition was killing thousands of Australian babies a year and nobody knew why. Mothers were losing pregnancy after pregnancy, and the babies who did make it were sometimes born with brain damage. Then doctors worked out the cause, and they worked out that James had the antibody that could stop it. So he kept showing up to the donation center. Every two weeks. For the next 50 years.

He made his last donation in May 2018, at age 81, because that is the legal cutoff in Australia. By then he had given blood and plasma 1,173 times. 1,163 of those came from his right arm. He once told a reporter he had been scared of needles his whole life and had never watched a single one go in. He said, “I look at the ceiling. I look at the nurses. I look at the other people in their beds.”

His daughter Tracey received the anti-D injection while pregnant with her son Scott. Scott exists because of his grandfather’s blood. His granddaughter-in-law Rebecca got it during her pregnancies too. James’s grandson Jarrod once put it like this. “It’s pretty cool that part of him went into mum and got me a brother, then protected my kids and his great-grandkids.”

Over 3 million doses of the medicine made from his blood have been given to Australian mothers since 1967. The Red Cross estimates 2.4 million babies are alive today because James Harrison kept showing up. He was paid nothing. Australian law does not allow blood donors to be paid. He was given the Medal of the Order of Australia in 1999 and his daughter said he found the whole thing embarrassing.

He died in his sleep on February 17, 2025, in a nursing home in New South Wales. About a year ago. When he made his last donation in 2018, six mothers came to the donation center and stood next to his recliner with babies in their arms, babies who were alive because of him. He hated that they were making him stop. “I would keep on going if they let me,” he said.

I keep thinking about the 14-year-old in the hospital bed in 1951. He had no idea his blood was special. He just knew that he was alive because of people he would never meet, and he decided he was going to do the same thing for someone else. Then he did it 1,173 times in a row, hating every single appointment, looking at the ceiling.