Over the weekend, Flannista finally finished The Emperor of All Maladies: A Biography of Cancer by Siddhartha Mukherjee. It took five months. Normally it doesn't take me so long to complete a book, but it is a detailed, complicated and ultimately eloquent story of a disease that humans have lived with -- and died from -- for more than five thousand years. Although the first sentence of the book is: "This book is a history of cancer," the author writes in the same paragraph, that it is a biography of cancer in:
. . . an attempt to enter the mind of this immortal illness, to understand its personality, to demystify its behavior. But my ultimate aim is to raise a question beyond biography: Is cancer's end conceivable in the future. Is it possible to eradicate this disease from our bodies and societies forever?
Apparently not. That is the book's stunning and sobering conclusion. Here is the last sentence: "The question then will not be if we will encounter this immortal illness in our lives, but when."
There are many reasons for this, of course. First, we are living longer and mutations in cancer genes accumulate with aging. Two, many of us are lazy (or in denial or afraid of doctors) and do not have annual physicals, mammograms, pap smears or a colonoscopy beginning at age 50, etc. Screenings such as these are key to catching cancer when it is most treatable. Third, many of us do not eat properly and/or exercise regularly which keeps cancer at bay more than I realized. Last, many of us are unaware of the harmful chemicals that humans continue to produce that can cause cancer, and/or we completely ignore the harm of smoking products which are unquestionably the number one cause of many cancers. (I write "smoking" rather than "tobacco" because thanks to the more sophisticated chemicals now lacing marijuana, its "smoke may be as harmful, or perhaps even more toxic, than tobacco smoke. Smoking two marijuana cigarettes causes as much airway damage as smoking 10 cigarettes.") Needless to say, I won't be lighting up my annual birthday cigar this year.
Most striking about the book is the compassion Dr. Mukherjee has for his cancer patients and their fight to survive:
Cancer is not a concentration camp, but it shares the quality of annihilation: it negates the possibility of life outside itself and beyond itself; it subsumes all living. The daily life of a patient becomes so intensely preoccupied with his or her illness that the world fades away. Every last morsel of energy is spent tending the disease . . . . The poet Jason Shinder wrote, "Cancer is a tremendous opportunity to have your face pressed right up against the glass of your mortality." But what patients see through the glass is not a world outside cancer, but a world taken over by it -- cancer reflected endlessly around them like a hall of mirrors.
Winner of the Pulitzer Prize for General Nonfiction, The Emperor of All Maladies is a riveting and urgent book. It did indeed help to demystify cancer for me, but it also reinforced that cancer seems inexorable, and once it catches someone, she or he will dodge "one blow only to be caught by another."
Will this emperor ever be disrobed?
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