The Emperor of All Maladies
It won a Pulitzer, well written. The topic will be tough for me, but I want to learn more.
Hard, very hard to read. And truly an excellent book, very detailed, that explores the history of cancer. I feel I have learned a lot about this illness, that it is made of deranged cells that multiply and are incredibly hard to stop, let alone prevent. But many, many people have committed and are working to confront this terrible disease. Harrowing stories, but also stories of real hope and people who made it. It feels a bit less invincible. A 672-page read, but what a read.
Notes
- We start with Galen and his theory that tumors were a black fluid invading the body.
- It then evolves with the radical mastectomy, practically removing large parts of the patient’s body to eradicate the tumor. It worked only at an early stage and was brutal.
- Cancer is heterogeneous. It presents in various forms and each of them responds differently to treatments. This means there is no single medicine but different approaches.
- Brilliant chapter on the fight against smoking!
- Chemo: Cancer therapy is like hitting the dog with a stick to get the fleas off.
- Final finding: cancer is caused by mutations in certain genes. Some factors like smoking increase the probability that this happens.
- A couple of memorable quotes:
As I watched, he began to insert numbers here and there with such a light hand it was astonishing. “You may read somewhere that for your type of tumor there is a high probability of local recurrence or metastasis,” he said. “Perhaps even fifty or sixty percent.” Fitz nodded, stiffening. “Well, we know how to take care of it, when it happens.” I noticed he had said “when,” not “if.” The numbers conveyed a statistical truth; the phrasing, however, carried a nuance. “We know how to take care of it,” he said, not “we will eliminate it.” It meant caring, if it could not be cured. The conversation lasted almost an hour. In his hands, information was a living, liquid thing, ready at any moment to congeal into something hard. She had let her leg dangle that way because the tumor had invaded her spine and the other leg was almost paralyzed, and sitting any other way was not possible. Her indifference was calculated, the jokes rehearsed and rehearsed. Her illness had tried to humiliate her. It had made her anonymous, stripped her of her sense of humor; it had condemned her to die an ugly death in a cold hospital room God knew how many miles from home. She had responded with resolve, trying always to be one step ahead, trying to outwit the cancer. It was like watching someone absorbed in a game of chess. Every time Germaine’s disease made a move, imposing another obligation, she answered with an equally proud move. That last evening, tied to life by only a slender thread, when with all the strength and dignity she could muster she managed to push herself, in her wheelchair, into the private space of her own bathroom, it was as if in that act she gathered the whole essence of a war that had been going on for four thousand years.