THE EMPEROR OF ALL MALADIES

Linda at five

Earlier I whined about my inability to sleep in the middle of the night.  My usual practice seems to be to fall asleep at about 8:00 pm and sleep like the dead until midnight.  Then, failing to go back to sleep, I take a “sleep-ease” kind of pill, get back in bed – and lay awake cursing my brain, which persists in dashing from topic to (unrelated) topic like a berserk housefly.  After an hour or two of this I get up, sit on the couch, and read.  I try to read something heavy, on the assumption that such stuff will wear me out quickly.  In an hour or so I find that my eyes won’t focus and the book persists in falling into my lap, so I stagger back to bed – where I lay, cursing my brain again, for a few dozen minutes.  And then I wake up, and it is morning.  I get 8 hours of sleep every night, and it only takes 11 hours to do it.  Young people: try not to grow up to be like me. 

It is not my exciting lifestyle that affects my sleep: much of each day I spend removing sand grains from mammoth bones.  Useful, perhaps, but not very exciting.

The book I have been reading is The Emperor of All Maladies, by Siddhartha Mukherjee.  I just finished it, for the second time.  I liked it before; I plan to rave about it now. 

First, Mukherjee:  He is a professor and cancer researcher with Columbia University.  One would have to concede that he is well educated: Stanford, then Oxford University as a Rhodes Scholar, and finally an M.D. from Harvard.  The book shows that he has had significant hands-on experience (“clinical practice”) with cancer patients.  From citations scattered throughout the book it is obvious that he has read many important books that I always thought I would read – but haven’t, yet.  He seems at home with many of the classical studies that I always meant to assimilate, sometime.  And he is a young guy, with little children!

Yeah, but has he ever climbed Mt. Baker, or run an ultra-marathon?

Okay, the book.  Its subtitle is The Biography of Cancer.  The long first section is history: what did our forebears know about cancer, and what did they do about it? Oddly enough, this is the part of the book that will – in places – make you wish you were doing something else.  Some of the ancient “remedies” described will merely strike you as pathetic; what can you expect from people before iPads?  However, “heroic” efforts involving surgery and chemotherapy performed fairly recently will make you cringe.  In my view, the best advice concerning cancer given before the mid-20^th century came from Imhotep.  Imhotep was the architect who built the step pyramid for King Djoser of Egypt’s 3^rd Dynasty.  That was about 4500 years ago.  Imhotep also was a physician, and was later worshipped as a god.   Concerning cancer, Imhotep said in effect: leave it alone.

But then the book gradually changes pace, dealing with recent developments.  The realization that cancers are the result of something gone haywire within a cell is fairly recent.  The impact of genomics on cancer is discussed.  Your old friends, oncogenes and tumor-suppressor genes, are skillfully and clearly described.  The why of mutation, and what we can do to decrease its prevalence, come into play.  There is a fascinating (well, at least to me) treatment of cascading chains of molecular interaction – and what we might be able to do to muck up the bad ones.  And there are lots of other plums of wisdom waiting for you to extract from Mukherjee’s beautifully crafted  pudding – but this has gone on for 619 words already, and you probably are eager to get back to the political news.  (Take heart: only nine months to go.)

In the end this masterful book gets a little too metaphysical for my tastes, but it also is pervaded by an aura of cautious optimism.  You close it with a smile on your face, and then go back to bed.  No, wait, that’s me, not you.

So, buy the damned thing, and read it.  You can get it from Amazon for $14.32 (hardcover), $11.25 (paperback), or $13.99 (Kindle).  Or you can beat Sidd out of his paltry royalty and buy it second hand through Abebooks for <$7.50, including shipping.