In 1990, on a windswept plain in southern Peru, a scientist studying a gravesite of the ancient Chiribaya tribe discovered the mummified remains of a woman with a “hard bulbous mass” in her upper left arm.
The paleo-pathologist had stumbled upon the well-preserved evidence of a 1,000-year-old malignant bone tumor, or osteosarcoma, writes Siddhartha Mukherjee in The Emperor of All Maladies: A Biography of Cancer.
“The woman must have wondered about the insolent gnaw of pain in her bone, and the bulge slowly emerging from her arm,” he writes. “It is hard to look at the tumor and not come away with the feeling that one has encountered a powerful monster in its infancy.”
While cancer is among the oldest diseases known to humanity — the earliest cases may go back 4,000 years — it was also exceedingly rare in the ancient world, mostly because few people lived long enough to contract it.
Mukherjee, a cancer physician and researcher at Columbia University Medical Center in New York, has chronicled the history of an illness that has fascinated, bedeviled and humbled doctors, philosophers and patients alike. He looks the monster in the eye and aims to know it, moving beyond history into the realm of biography.
It’s “an attempt to enter the mind of this immortal illness, to understand its personality, to demystify its behavior,” Mukherjee writes. Ultimately, he wants to know whether this disease can be vanquished.
Elegant prose
At 470 pages, not counting the extensive notes and index, this isn’t a breezy book; and for those who are well-read in the subject, some of it may be familiar. Mukherjee’s elegant prose animates the science and captures our interest, however, as we meet patients, activists and researchers.
There’s Sidney Farber, the father of modern chemotherapy, a pathologist who toils in the basement at Children’s Hospital in Boston and, beginning in 1947, looks for a cure for childhood leukemia. And there’s socialite Mary Woodard Lasker, a Radcliffe College graduate, who joins forces with Farber to wage “war” on cancer, merging the powers of science and political lobbying.
The researchers, physicians and activists who do battle with cancer are undaunted as they try to thwart their wily enemy, which “exploits the fundamental logic of evolution unlike any other illness.” Yet Mukherjee wisely knows who the real heroes are.
We meet Mukherjee’s patient Carla Reed, a 30-year-old kindergarten teacher with acute lymphoblastic leukemia, in the book’s prologue, sitting on her hospital bed with “peculiar calm.” Mukherjee tells Reed her chance of being cured through chemotherapy is 30 percent. As Reed begins her treatments, we experience her inner turmoil: “For Carla, the physical isolation of those days became a barely concealed metaphor for a much deeper, fiercer loneliness, a psychological quarantine even more achingly painful than her actual confinement,” the author writes.
Mukherjee is quite certain Carla won’t be alive by the time he completes his tome and she will provide his story’s ending. He’s wrong; she has gone into remission.
Fewer people are dying of cancer, thanks to genetic screening, early detection and treatments that range from chemotherapy to radical prophylactic mastectomy.
If a woman living in 500 BC with Hodgkin’s disease could time-travel to the 21st century, she would gain 30 or 40 years in life expectancy, Mukherjee says. However, if that same woman had metastatic pancreatic cancer, modern medicine might buy her only a few more months.
Curing cancer may not be possible because of its unpredictability, Mukherjee concedes, and “we might as well focus on prolonging life rather than eliminating death. This War on Cancer may best be ‘won’ by redefining victory.”
Sept.16 to Sept. 22 The “anti-communist train” with then-president Chiang Kai-shek’s (蔣介石) face plastered on the engine puffed along the “sugar railway” (糖業鐵路) in May 1955, drawing enthusiastic crowds at 103 stops covering nearly 1,200km. An estimated 1.58 million spectators were treated to propaganda films, plays and received free sugar products. By this time, the state-run Taiwan Sugar Corporation (台糖, Taisugar) had managed to connect the previously separate east-west lines established by Japanese-era sugar factories, allowing the anti-communist train to travel easily from Taichung to Pingtung’s Donggang Township (東港). Last Sunday’s feature (Taiwan in Time: The sugar express) covered the inauguration of the
The corruption cases surrounding former Taipei Mayor and Taiwan People’s Party (TPP) head Ko Wen-je (柯文哲) are just one item in the endless cycle of noise and fuss obscuring Taiwan’s deep and urgent structural and social problems. Even the case itself, as James Baron observed in an excellent piece at the Diplomat last week, is only one manifestation of the greater problem of deep-rooted corruption in land development. Last week the government announced a program to permit 25,000 foreign university students, primarily from the Philippines, Indonesia and Malaysia, to work in Taiwan after graduation for 2-4 years. That number is a
This year’s Michelin Gourmand Bib sported 16 new entries in the 126-strong Taiwan directory. The fight for the best braised pork rice and the crispiest scallion pancake painstakingly continued, but what stood out in the lineup this year? Pang Taqueria (胖塔可利亞); Taiwan’s first Michelin-recommended Mexican restaurant. Chef Charles Chen (陳治宇) is a self-confessed Americophile, earning his chef whites at a fine-dining Latin-American fusion restaurant. But what makes this Xinyi (信義) spot stand head and shoulders above Taipei’s existing Mexican offerings? The authenticity. The produce. The care. AUTHENTIC EATS In my time on the island, I have caved too many times to
In a stark demonstration of how award-winning breakthroughs can come from the most unlikely directions, researchers have won an Ig Nobel prize for discovering that mammals can breathe through their anuses. After a series of tests on mice, rats and pigs, Japanese scientists found the animals absorb oxygen delivered through the rectum, work that underpins a clinical trial to see whether the procedure can treat respiratory failure. The team is among 10 recognized in this year’s Ig Nobel awards (see below for more), the irreverent accolades given for achievements that “first make people laugh, and then make them think.” They are not