Book-Blogging: The Emperor of All Maladies, by Siddhartha Mukherjee

(For this book review, I used Grammarly’s plagiarism checker because I wanted to ensure I didn’t steal words like this guy – from Florida, naturally – stole bulldogs. Explanation/Disclaimer/Disclosure below. UPDATE: The organization asked me to remove the link; something about Google’s Webmaster Guidelines not allowing sponsored links…)

Before I go on a bit of a tangent, I don’t want to bury the lede: if you haven’t read The Emperor of All Maladies, you should – it is an excellent “biography” of cancer, a group of diseases that has been with us since there was an us to be with. The author, Siddhartha Mukherjee, does an awesome job in the definitional sense: his ability to walk the reader through the complicated, difficult history of the disease with such ease and readability should inspire awe.

For the vast majority of modern history*, humans had more reason to fear the nameless, ever-present Grim Reaper outside of them than the rarely violent, relatively quiet one waiting on the inside.

They often worried about being on the wrong end of an Act of God, as when God plagued the Philistines with a pestilence (now thought to have been the bubonic plague) as divine retribution for stealing the Ark of the Covenant from his favored people, the Children of Israel (or so the Children of Israel believed).

They feared the air, sometimes more than they feared the wrath of God; it could be full of poisonous, deadly effluvia – and there would little they could do about it (it was thought). Everyone — scientists and laypeople alike — believed that decaying matter aerosolized and infected populations with malaria (old Italian for ‘bad air,’ actually), cholera, yellow fever, typhus, and most of the other major diseases they faced.

But then a lot changed, all at once. In the 100 years between 1850 and 1950, they figured out how to beat Death in life, sometimes. Though they were wrong about Miasma Theory and its omnipresent effluvia, the fear manifested itself in relentless bouts of cleaning and sanitizing, which inadvertently protected them from the real killers.

Robert Koch, Louis Pasteur, Joseph Lister, and others convinced them – agonizingly slowly – that Death came from unseen beings, and, properly convinced, they began searching for the “magic bullets” that would rid the world of infectious disease. Paul Ehrlich (who coined the terms “magic bullet” and “chemotherapy”) discovered an arsenic-based compound, Salvarsan, that was effective against syphilis; Walter Reed wiped out yellow fever near the Panama Canal; Alexander Fleming found “Mould Juice” in a messy laboratory. The world changed, fast.

It was as if the Grim Reaper outside lost his scythe. We died less from infectious diseases, and we lived longer; the Reaper was something to fear, but not to acquiese to as quickly as before**.

But we have other things to fear, often inside us; more often, the Grim Reaper attacks calmly, silently, and with remarkable patience.

Of the things we fear inside of us – heart disease, congestive heart failure, diabetes – nothing brings the worry that a small lump on the breast or an enlarged lymph node does. It’s cancer that keeps us up at night.

Cancer, as Mukherjee points out, has always been with us; five thousand years ago, the Egyptians wrote about it in detail (“there is no treatment”). Though never in the history of mankind has it mattered more than it does now.

Mukherjee chose to style his book as a “biography” of cancer, and it works. The prose is clear, illuminating, and, at times, intimate; a practicing physician, he’s able to describe the disease through his very real patients in a moving way.

A physician-researcher-writer-teacher in the vein of Atul Gawande, Mukherjee calmly and lucidly walks lay readers through the complicated science of cancer – no simple task. He describes the history of cancer as a grisly recounting of painful, debilitating treatments: from William Halsted’s radical mastectomies to Sidney Farber’s near-death aminopterin chemotherapy to today’s “modern” drugs aimed only at our genes and not our tissues (certainly less grisly, possibly less painful).

The book is an excellent history of the politics of cancer, and the way medicine, advocacy, and politics intersect. It’s not an accident, for example, that we speak of cancer as an adversary, something to “beat” in a “war” – it was a calculated decision by Mary Lasker, an early and powerful advocate for cancer research (and therefore the funding for it). There are drawbacks to using that language – how many patients would have been better off “accepting defeat” by going the palliative route? – but it has given strength to millions of cancer patients and affected family members.

The Emperor of All Maladies is totally fascinating, and it’s a shame it took me four years to get to it. Read it.

*Loosely defined as post-hunter-gatherer

**Which is not to say that we’ve defeated infectious disease. Obviously that isn’t the case. Antibiotic-resistant bacteria are quickly leading us towards the horrifying prospect of a post-antibiotics future, for one thing. For another, knowing how to cure tuberculosis hasn’t rid the world of tuberculosis – it’s as much about the science of delivery as the science of bacteriology. And each time society breathes a sigh of relief, a new disease emerges that humbles it once again (see: Spanish flu, SARS, HIV, avian/swine flu, etc. etc.)[G7]

Grammarly Explanation/Disclaimer/Disclosure – Grammarly, a San Francisco-based company that offers grammar and plagiarism analysis software, reached out to me about trying out its software, and offered a small incentive to link to it on a future post. The organization gave me free trial access (subscription is typically $29.95/month or $139.95/year), which I used for this post, and for placing that sentence/link at the top of this blog offered me a $50 Amazon gift card – which I hope is enough to interest me in trying out their software but not enough to incent me to promote a product I don’t like.

Fortunately, that’s not an issue; I like the software – it’s simple, smart, and a useful way to catch typical grammar issues. It seems to be able to show trends over time, too, so that, theoretically, I could analyze batches of posts to discover that I often use passive voice or consistently abuse long sentences (like this one…). I think using it consistently would make me a better writer.

I haven’t yet decided if I’ll purchase an annual subscription to the software. After playing around with it for two more weeks, I’ll be in a better position to decide.


  2 comments for “Book-Blogging: The Emperor of All Maladies, by Siddhartha Mukherjee

  1. March 14, 2014 at 8:32 am

    This book by Dr Mukherjee bought a tremendous effect on my work ethics .I work for a clinical research industry and I recognize and acknowledge this book for a in depth dive for Oncology. We participate and work in many clinical trials and majority of them are Cancer trials.
    On a average cancer trials in our industry we generally check to increase the life expectancy of the patients since there are no complete cure for Cancer. There are loads of side effects on the chemothrapy and after reading this book I feel more responsible when I am heading a trial for oncology. I check all the details again and again with great care and accuracy. Try to find a logic in more depth with the relevent Adverse events n other incidents.

    This book actually drew a face for “Cancer” to me!!! I now can relate my work, knowledge and with this dreaded disease very clearly. I feel more responsible to conduct and analyze data from those trials and keep in mind the ordeal this disease has created worldwide.
    I work with some top 10 pharma company in the world in their oncology trials and I have recommended this book to many of my clients and gifted too few of them as well.
    Together we are still fighting against this disease and hopefully will be able to save the earth from his clutch!!!

    A strongly recommended book for all those who have a thrust for knowledge and ready to dive deep with the author for the facts and figures!!!!
    A gripping history of cancer and the early and current challenges the researchers and people face every day to tackle and win over the Emperor.

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