I came to this book, fresh from losing a loved one to cancer. I expected to be 
depressed by it, as I had been by Alexander Solzhenitsyn's Cancer Ward, which I had read in my teen years, and had reacted to with an intensity that only one at that stage of life can muster!
I was wrong...
It is a big book - 571 pages in the paperback version I read. But don't let the size put you off. Since it is connected by stories within stories, you can put it down and take it up whenever the mood strikes you, without losing too much by way of the thread of the story.
I was hooked right from page 15, where Mukherjee differentiates between 'hyperplasia' and 'hypertrophy'! "In hypertrophy, the number of cells did not change; instead, each individual cell merely grew in size....Hyperplasia, in contrast, was growth by virtue of cells increasing in number" , he explains. The book abounds in such explanations - false positives and false negatives is another example; there is also plenty of information about the manner in which studies are devised. Only a man of science, of medicine, could have made it so simple and easy to understand for the lay person...And I am glad that Mukherjee found the time to write it.
I like the book for the insight it offers into the way the world of science and its denizens work. The pulls and counter pulls, the depth of interest that binds a scientist to his/her profession are as difficult to understand; the scientific temperament like the more-written about artistic/creative temperament is clearly a thing apart!
I liked the book for the many stories of scientists that it presents. However, Roentgen's accidental discovery of the x-ray, when he whisks his wife Anna into the lab and gets the world's first x-ray pales in comparison with the efforts of Marie Curie who distilled pitchblende into a millionth part in her hunt for purer radium; in the process, the skin of her hand began to peel off in blackened layers, 'as if the tissue had been burnt from the inside'. Such love for one's work is a rare thing, but more common in that world it seems....She later died of leukemia in 1934.
I was also enthralled by the story of George Papanicolaou, a Greek cytologist who arrived penniless in New York in 1913, worked selling carpets initially before finding a research position at Cornell. He studied normal smears for a DECADE, before turning his attention to cancer cells and worked on these smears from 1928 to 1950; he gave us the 'Pap smear', which detects pre-malignant cells in cervical cancer.Perhaps there are others, slaving away, unhonored and unsung...maybe they have made a remarkable contribution to science, but we know them not!
Then, there is 'Yella' or Yellapragada Subbarao, who too had arrived penniless in Boston in 1923. I love the presence of this man from 'Madras' in the narrative. Only because, it is often hard to find Indians mentioned and acknowledged, unless they have won the Nobel Prize! Yella performed biochemical 'autopsies' on cells and later at Lederle, where he went to work, made synthetic versions of the natural chemicals that he found within cells. Along with another chemist, Harriet Kiltie, he created variants of folate antagonists which were later tried on patients by Sidney Farber, an oncologist.
The fight against cancer does not take a linear path - one discovery does not lead to another. Achievements in one area are not necessarily known in another. Sometimes the answer is right there in front of their eyes but the scientists do not make the connection! So there is the account of a postdoc scientist from Bombay, Lakshmi Charon Padhy who reported the isolation of an oncogene - a gene that in certain circumstances transforms into a tumour cell - from a rat tumour called a neuroblastoma in 1982 and named it neu. His discovery was published in a high profile scientific journal.. He created an antibody to the neu protein. If the neu antibody had been added to the neuroblastoma cells, the result would have been an anti-cancer drug right there - that went unnoticed as more were felled by the disease.
There are other instances of lack of communication. No attempt was made the clinicians and cancer biologists to come together and synthesize the knowledge that each had - So, Ray Erikson won an award for identifying the function of a critical oncogene. At the same function, Tom Frei was was honoured for his advancement of the cure for leukemia. But there was still no coming together.... "The two halves of cancer, cause and cure, having feasted and been feted together, sped off in separate taxis into the night," observes Mukherjee.
"Normal cells are identically normal; malignant cells become unhappily malignant in unique ways," notes Mukherjee, a quote that is reminiscent of Tolstoy in Anna Karenina about happy families and unhappy ones! So every cancer patient is unique as every cancer genome is unique.
So too are the stories of the victims and the survivors. The story of Carla and her battle with leukemia connects the beginning and the end of the book. It is supposed to provide the human element, the 'now' factor. Had this been a smaller book, Carla's story may have been one of the main threads. Here, the mention is not substantial. More about an individual case is hardly possible in a book with such a large canvas.
Mukherjee's foray into the rural reaches of America to meet the survivor of extensive treatment with a cocktail of drugs, his revelation that the boy "Jimmy" used in "The Jimmy Fund," Sidney Farber's effort to garner monetary support for cancer research had actually survived comes as a surprise.
I do not like to think of this as a 'biography' of science. I think some clever editor must have thought that to promote it as a biography would increase sales. I do not see cancer appear like an almost human being....malevolent though it is! It does not acquire a persona, with an initial, middle and late stage of development...the disease has remained the same as it always has. Only our understanding of it has changed, based on research over the ages...as have treatment regimens.
On a personal note, I must add that I have been to Framingham, but never knew that it is the "American epidemiologist's English village," where a cohort of some 5000 men and women have been studied since 1948, throwing up data for hundreds of epidemiological studies!
Finally, I would like to conclude that this is a book that you should read. You can carry it around, read it between other books. It took me about two months to read. And an equal amount of time to write this review!!!It has been my most ambitious attempt at reviewing to date!
I too would like to quote Thomas Wolfe as does Mukherjee, "I've made a long voyage and been to a strange country, and I've seen the dark man very close". Says Mukherjee, "...it was the most sublime moment of my clinical life to have watched that voyage in reverse, to encounter men and women returning from that strange country - to see them so very close, clambering back." Surely, it is good to know what this is all about.
depressed by it, as I had been by Alexander Solzhenitsyn's Cancer Ward, which I had read in my teen years, and had reacted to with an intensity that only one at that stage of life can muster!I was wrong...
It is a big book - 571 pages in the paperback version I read. But don't let the size put you off. Since it is connected by stories within stories, you can put it down and take it up whenever the mood strikes you, without losing too much by way of the thread of the story.
I was hooked right from page 15, where Mukherjee differentiates between 'hyperplasia' and 'hypertrophy'! "In hypertrophy, the number of cells did not change; instead, each individual cell merely grew in size....Hyperplasia, in contrast, was growth by virtue of cells increasing in number" , he explains. The book abounds in such explanations - false positives and false negatives is another example; there is also plenty of information about the manner in which studies are devised. Only a man of science, of medicine, could have made it so simple and easy to understand for the lay person...And I am glad that Mukherjee found the time to write it.
I like the book for the insight it offers into the way the world of science and its denizens work. The pulls and counter pulls, the depth of interest that binds a scientist to his/her profession are as difficult to understand; the scientific temperament like the more-written about artistic/creative temperament is clearly a thing apart!
I liked the book for the many stories of scientists that it presents. However, Roentgen's accidental discovery of the x-ray, when he whisks his wife Anna into the lab and gets the world's first x-ray pales in comparison with the efforts of Marie Curie who distilled pitchblende into a millionth part in her hunt for purer radium; in the process, the skin of her hand began to peel off in blackened layers, 'as if the tissue had been burnt from the inside'. Such love for one's work is a rare thing, but more common in that world it seems....She later died of leukemia in 1934.
I was also enthralled by the story of George Papanicolaou, a Greek cytologist who arrived penniless in New York in 1913, worked selling carpets initially before finding a research position at Cornell. He studied normal smears for a DECADE, before turning his attention to cancer cells and worked on these smears from 1928 to 1950; he gave us the 'Pap smear', which detects pre-malignant cells in cervical cancer.Perhaps there are others, slaving away, unhonored and unsung...maybe they have made a remarkable contribution to science, but we know them not!
Then, there is 'Yella' or Yellapragada Subbarao, who too had arrived penniless in Boston in 1923. I love the presence of this man from 'Madras' in the narrative. Only because, it is often hard to find Indians mentioned and acknowledged, unless they have won the Nobel Prize! Yella performed biochemical 'autopsies' on cells and later at Lederle, where he went to work, made synthetic versions of the natural chemicals that he found within cells. Along with another chemist, Harriet Kiltie, he created variants of folate antagonists which were later tried on patients by Sidney Farber, an oncologist.
The fight against cancer does not take a linear path - one discovery does not lead to another. Achievements in one area are not necessarily known in another. Sometimes the answer is right there in front of their eyes but the scientists do not make the connection! So there is the account of a postdoc scientist from Bombay, Lakshmi Charon Padhy who reported the isolation of an oncogene - a gene that in certain circumstances transforms into a tumour cell - from a rat tumour called a neuroblastoma in 1982 and named it neu. His discovery was published in a high profile scientific journal.. He created an antibody to the neu protein. If the neu antibody had been added to the neuroblastoma cells, the result would have been an anti-cancer drug right there - that went unnoticed as more were felled by the disease.
There are other instances of lack of communication. No attempt was made the clinicians and cancer biologists to come together and synthesize the knowledge that each had - So, Ray Erikson won an award for identifying the function of a critical oncogene. At the same function, Tom Frei was was honoured for his advancement of the cure for leukemia. But there was still no coming together.... "The two halves of cancer, cause and cure, having feasted and been feted together, sped off in separate taxis into the night," observes Mukherjee.
"Normal cells are identically normal; malignant cells become unhappily malignant in unique ways," notes Mukherjee, a quote that is reminiscent of Tolstoy in Anna Karenina about happy families and unhappy ones! So every cancer patient is unique as every cancer genome is unique.
So too are the stories of the victims and the survivors. The story of Carla and her battle with leukemia connects the beginning and the end of the book. It is supposed to provide the human element, the 'now' factor. Had this been a smaller book, Carla's story may have been one of the main threads. Here, the mention is not substantial. More about an individual case is hardly possible in a book with such a large canvas.
Mukherjee's foray into the rural reaches of America to meet the survivor of extensive treatment with a cocktail of drugs, his revelation that the boy "Jimmy" used in "The Jimmy Fund," Sidney Farber's effort to garner monetary support for cancer research had actually survived comes as a surprise.
I do not like to think of this as a 'biography' of science. I think some clever editor must have thought that to promote it as a biography would increase sales. I do not see cancer appear like an almost human being....malevolent though it is! It does not acquire a persona, with an initial, middle and late stage of development...the disease has remained the same as it always has. Only our understanding of it has changed, based on research over the ages...as have treatment regimens.
On a personal note, I must add that I have been to Framingham, but never knew that it is the "American epidemiologist's English village," where a cohort of some 5000 men and women have been studied since 1948, throwing up data for hundreds of epidemiological studies!
Finally, I would like to conclude that this is a book that you should read. You can carry it around, read it between other books. It took me about two months to read. And an equal amount of time to write this review!!!It has been my most ambitious attempt at reviewing to date!
I too would like to quote Thomas Wolfe as does Mukherjee, "I've made a long voyage and been to a strange country, and I've seen the dark man very close". Says Mukherjee, "...it was the most sublime moment of my clinical life to have watched that voyage in reverse, to encounter men and women returning from that strange country - to see them so very close, clambering back." Surely, it is good to know what this is all about.
