Impressions of Siddhartha Mukherjee’s The Emperor of All Maladies: A Biography of Cancer

(Cancer sucks, but that’s not much of a spoiler)

For a long time I tried to think of humans as just another animal, albeit one with advanced alien technology that allows it to kill other animals en masse and domesticate the ones it thinks are yummy. This hopefully happens in my brain to cope the heinous acts humans often do since, after all, we’re just selfish animals trying to live. This is also why I sometimes make the claim to be happy for the existence of diseases- they keep our numbers in check and prevent us from overpopulating the world and annihilating it. This does not go over well at parties where most people have lost someone to disease and no one is interested in such morbid and callous ideas.

Unfortunately such callous detachment only works well if you’re capable of maintaining it. Until recently, no relatives or friends of mine had been the victims of a disease. That made it easy for me to make stupid dumb arguments that evoked horrible memories of loss and grief for many people I care about. Then my maternal grandfather was diagnosed with cancer a few years ago and although he lived beyond his diagnosed life expectancy his slow death remained difficult for my mother and sisters, and to a lesser extent, myself. And even then a major part of why his death was difficult for me was because, through my limited knowledge of cancer, I was aware that genetics plays a large role in a person’s susceptibility. Therefore my grandfather’s cancer was just a signal of my potential future cancer.

The Emperor of All Maladies by Siddhartha Mukherjee

This led to my reading of Siddhartha Mukherjee’s Biography of Cancer, thinking that if my fear was based in what I didn’t know about cancer if I learned more about the disease I could quell my fear to a large extent. Thankfully, at the close of four hundred and seventy pages, that and more transpired in me. I developed, at least for the moment, what lots of books would like to provoke- compassion for others. In the case of this book, compassion for patients of cancer and the people who work to limit its detrimental effects (my own mother included) on others. From his astoundingly moving and well-cited text, Mukherjee uses his personal experiences as a clinical oncologist as a through-line in a centuries spanning story about the frustrations, chance revolutions and defeats in the lives of medical researchers, oncological clinicians, patients, pharmaceutical scientists and disease advocates.

One decision Mukherjee makes that allows his writing to flourish is the structure of his text. Rather than a chronological tale that details innovations in each time period, most chapters are based around an oncological discovery or roadblock and the persons and groups involved. This allows the narrative to flow well and remain understandable even in those sections where Mukherjee’s chemist side overtakes the page and he provides minute chemical and biological details that may interest some, but left me waiting for his return to another section about the personalities involved in cancer research or one his patient’s cancer narratives.

Also notable is the amazing amount of research involved in this text, which lends Mukherjee’s take on the more monumental moments in cancer history believability and immersion that would otherwise be absent. Particularly, when writing about the roles of Sidney Farber and Mary Lasker played in cancer research and advocacy, Mukherjee’s use of their journals and other primary resources gave me the opportunity to experience the frustrations they often encountered throughout their “War on Cancer.”

The book does becoming confusing at times, but that’s mostly when several scientific developments are occurring closely together and not much unpacking is done. Also, the book provides a section of photos three-fourths through the text that come out of nowhere and although very interesting, the photos could have benefited by being put in context of the relevant textual sections, but I figure that’s due more so to the book’s production and editing than the author’s decision to isolate these amazing, and often graphic, images.

What I most loved about this book is how much hope it gave to me about humanity’s future. Not a future where cancer no longer threatens us (Mukherjee states near the end of the text that cancer will most likely continue its mutation as treatment options continue to progress),  but a future where progression continues. If challenges make life worth living, then cancer proves the ultimate challenge. It’s disappearance is unlikely, but if we keep pace with it and use our wits we can ensure that each generation continues to stand a chance against our distorted mirror selves.

Read this book if you’d like to test your cold dead heart for signs of life or want to gain some perspective on humanity’s struggle with one of oldest enemies- bureaucracy.

FB Status Worthy Quotes From the Texts
“If the history of medicine is told through the stories of doctors, it is because their contributions stand in place of the more substantive heroism of their patients.” (148) I spoke to my mom about palliative cancer care twice while reading this book and she still remembers her first cancer patient’s fight with cancer and recalls it as a source of strength.

“Our encounter with cancer has rounded us off; it has smoothed and polished us like river rocks.” (338) Perhaps the most romantic way to think about cancer. It keeps us in check.

“History repeats but science reverberates.” (466)

“There is another moment [besides discovery]- its antithesis- that is rarely recorded: the discovery of failure.” (146) In addition to the content of this quote, I just love the syntactical magic happening here.

Check out the Vine video below for a peek at next week’s Book Impression…book.

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