Medics can write!

Over time there have been many doctors who have written and published successfully in the non-medical field. Some very successful writers have been doctors. In the 18th century there was Erasmus Darwin (poet and grandfather of Charles), Oliver Goldsmith (Vicar of Wakefield) and the poet John Keats and in the 19th century the great Russian writer Anton Chekov, and the all time favorite with so many, Sir Arthur Conan Doyle of Sherlock Holmes fame. Closer to our times, Richard Gordon wrote a series of humor filled ‘doctor’ novels which gently mocked at the medical profession. These were also made into movies in the 50’s with the handsome Dirk Borgade as the dashing Dr Simon Sparrow.   AJ Cronin wrote some lovely tales, all of which i read  avidly as a youngster. And in retrospect, his novel “The Citadel’ had some influence on my choice of medicine as a career.  Closer to the ‘best seller’ list are Robin Cook and Michael Crighton and from India there is Kaveri Nambisan, who is a practicing surgeon.  Another successful doctor-writer is Abraham Verghese, whose  earlier books, My own Country and Tennis Partner, were based on his own personal story as a physician. His novel of 2009, Cutting for Stone, topped the  NYT book chart for many weeks. All  three of these i would recommend  to all. Today, i am writing about another doctor author, who has stayed within his expertise domain but drawn on his personal experiences to give us a wonderful book.

The central character of the book  is neither man, woman, beast or object, but the universally dreaded “Cancer”.  The “Emperor of All Maladies”  by  Siddhartha Mukherjee  recounts the history and scientific developments in cancer, going back to the earliest mention of the disease. The author is a trained oncologist, who was inspired by the courage of those who he treated and transformed by the  triumphs and failures of the efforts to treat them.  He has delved into lives of the charismatic characters – doctors, scientists and lay crusaders – who have driven the research and led the campaign to place this disease onto the centre stage of our attention.

The paradigm till the end of the 19th century was that  ‘cancer is incurable’ and hence did not deserve attention of doctors. Although the American Association for Cancer Research was established in 1910 and there were efforts to set up a national laboratory, nothing really happened. It continued to be called  “The Great Darkness”  till the pre-was years. The National Cancer Institute (NCI) was passed in 1937 by President Roosevelt. The dedication of the pioneers like Sydney Farber who was the first use ant anti-cancer drug, anti-folate compound to treat childhood cancer, of Peyton Rous who described viral oncogenesis, of  Papanicolou who painstakingly scanned thousands of vaginal smears to describe the cellular changes of a pre-cancer state and many others led to changes in the understanding of the disease and approaches to its treatment. The subsequent few decades  saw the development of many anti-cancer drugs and multi-drug treatment regimes, the development of the controlled trial as a modality for  establishing efficacy of these regimes, and the realization that it was not going to be easy to make cancer “curable”.  These aand subsequent landmark events such as the establishment of screening programs, preventive oncology, the contributions of the era of molecular biology   are all dealt with with warmth and understanding.

He has also traced the parallel story of the ‘politics’ of cancer – for, what works without its own set of politics!! The increasing deaths due to cancer was, in the meanwhile pushing the demand for a “war on cancer”. The role of Mary Lasky in fighting the public battle and persuading the political class to assign the funds for this war make an equally interesting story. All these are interspersed with true life events and personal biographies.

The style is clear and the language is simple. The text is extremely readable and all the scientific aspects have been described in really simple fashion.   I don’t think a non-scientist should have any problems understanding any of it! Of course, i would like to have some feed back on this!

I have a personal point of contact with the events described in the book. Between 1978-80, I was a post-doctoral fellow in the iconic NIH campus at Bethesda. There were large number of other post-docs from India and my closest friend during that period had done her PhD at the Adyar Cancer Institute and moved to NIH to work at that “Mecca” for cancer research, the  NCI. The ups and downs of NCI fortunes are well brought out in the narrative of this book. The late 70’s was a down phase and my friend’s supervisor, a pioneer of the immunotherapy era of cancer,  had been a big shot in the NCI hierarchy. She spent many early months at NCI, injecting large batches of mice with various protocols containing BCG (what we give children for protection against tuberculosis). Then she injected them with tumor cells and measured the growth of the tumors by painstakingly using a vernier caliper on each mouse tumor. Since the batches were in hundreds, and space was at a premium on campus, all such work was out sourced.  So, she made these 6am to 7pm trips to a facility outside Philadelphia, i think, to make her measurements. But, soon thereafter, the boss was demoted, his lab reduced is size and strength and my friend had to change her supervisor. In the years that followed, this once ‘hot shot’ NCI scientist committed suicide – it happened a few years after i left NIH and i cannot say if his unfortunate end was in any directly linked to his NCI career!

So, for those of you who read non-fiction, this is a good book. Do let me now how you like it.

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One thought on “Medics can write!

  1. Sita, I enjoyed thi blog of yours. I have read a review of this book “The emperor of maladies”, perhaps, in the Rime magazine. You’re right. That reviewer had also said that a lay reader wouldn’t find it much difficult to fathom the medical technicalities.
    Let’s see when I am able to get hold of a copy

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