This broadly encompassing masterful work illuminates with insight and inspiration a dark subject matter that has certainly touched us all: cancer. Truly the emperor of all maladies, cancer is a frightening diagnosis. With elegant style Dr. Mukherjee provides a thorough history of our understanding and approach towards cancer through anthropological and historical reference, catalogs of medical achievement, and advances in biochemical, genetic, and epidemiological understanding of causation and prognosis, all while inserting a myriad of personal side stories and tangential narratives that give this heavy piece of non-fiction the light and palatable feel of a novel.
Not long ago while speaking with my father about my stepmother’s breast cancer, he had voiced a curious statement that I had a hard time comprehending. He indicated that when he was growing up cancer wasn’t really talked about as it is today. Back then it was a death sentence of a disease, misunderstood and often shuttered away from the public eye. This perception is counter-intuitive with today’s social stigma of cancer that has changed from bleak condolence to common understanding and support. The news often divulges public initiatives to promote prevention and early screening. For those diagnosed with cancer it is not an immediate death sentence as there are now a myriad of options for treatment as well as support groups for patients and their families.
Now having read this book, I better understand the social background that characterized that stigma that my father witnessed while growing up and have a more robust appreciation for the stepwise improvements in cancer diagnosis, treatment, and prevention. For instance, it is amazing to know that during the 40’s and and 50’s while little was known about cancer’s cellular and genetic mechanisms, this was the time of greatest advancement with many of the cytotoxic chemotherhapies that are still currently used today. When those treatments were first implemented it was as though the treatment and therapies were developed with backwards understanding since these chemicals were poisonous to cellular development and therefore would inhibit the growth of cancer cells, yet they were boldly used by clinicians without truly understanding the biochemical mechanisms why these therapies were effective.
Without repeating the context of the book, I’ll acknowledge that Mukherjee does an excellent job of discussing very technical and scientific topics with a delicate and engaging style. However, I must admit that in my reading I often considered that although his research was extensive, Mukherjee was quite comfortable towards applying poetic license to propel his narrative. For instance the following quote about a medical conference contains such a rich description of emotion, setting, and environment that only first-hand witness would have awareness of:
“As the exhausted audience trickled out of the massive auditorium in Atlanta, it was already dark outside and the warm, muggy black of air provided no relief.” (327)
Or in the following passage Mukherjee offers a poetic foil regarding the competing views of clinical practitioners and biochemical researchers ignoring each other at a conference:
“”I don’t remember any enthusiasm among the clinicians to reach out to the cancer biologists to synthesize the two poles of knowledge about cancer,” Erikson recalled. The two halves of cancer, cause and cure, having feasted and been feted together, sped off in separate taxis into the night.” (375)
These examples are just brief indications of Mukherjee’s ability to add drama and emotional context to otherwise dry historical events. I point them out not in complaint, but with a reader’s awareness that Mukherjee has written this book specifically in order to incite excitement and interest in cancer research. His motives are successful, for this is a splendid book, worthy of being read by both scientific enthusiasts and laypeople alike.
Despite my praise, I must acknowledge that there are difficult moments buried this book. As I noted in my intro, Mukherjee inserts many personal side stories from his own clinical experience. He shares the stories of those who struggle and survive as well as those who lose their battle with cancer’s claim over the body. In my reading I often reflected upon the lives past of those dear to me who were touched by cancer’s claim. My grandmother, who I never met, lost to breast cancer in the 70’s. My former boss who was inspirational in shaping my professional career, all while wearing the mask of jovial courage as she battled her breast cancer that eventually took her in 2008. My loving and influential uncle, with whom I clearly remember speaking with in 2005 when he was initially diagnosed with prostate cancer about how he was determined to persevere with conviction, and this he did, until he was lost to metastatic lung cancer in 2009. And of my stepmother who currently faces her dilemma to chose whether she will suffer the side effects of chemotherapy once again or find comfort with her current state of cancer’s remission.
“The story of cancer isn’t the story of doctors who struggle and survive, moving from one institution to another. It is the story of patients who struggle and survive, moving from one embankment of illness to another. Resilience, inventiveness, and survivorship – qualities often ascribed to great physicians – are reflected qualities, emanating first from those who struggle with illness and only then mirrored by those who treat them. 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)