Review of The Emperor of All Maladies”

                                                                                                                                                -By Dr. Sthabir Dasgupta


Scholars and scientists are not unified in their thoughts on the issue of disease. Pioneer of cellular science Rudolph Virchow had taught us that these issues cannot be dealt in isolation. The issues have its equal share of importance in the realm of political and social arena. The disunity in thoughts of scholars has indeed paved the way for serious discussion and debate in the horizon of science and the resultant is we are more enlightened. However the official scientific institutions are more engrossed in achieving short term success and it seems only a total failure of such view can disillusion them.

Dr. Siddhartha Mukherjee a researcher and practicing oncologist of USA had coined Cancer as the “The Emperor of all Maladies” and have penned down its biography. This voluminous and historic work is worth a big round of applause. Each of his pages of his work has footprints of his tremendous effort and hard work. As a true scientist the work also depicts his heart felt sympathies for cancer patients and their families. Each section of his work keeps the reader alert and conscious of success of the cancer research (treatment) and also its associated failure, which becomes further lively by his poetic language.

Dr. Mukherjee had preferred to call his work as a “Biography of Cancer” instead of ‘history of cancer research’. In this script cancer is the leading actor and surrounding him (it) are scientists, doctors, sophisticated social workers, media, cancer patients and other workers of the cancer institutes as characters. All these characters have one goal in common – annihilation of cancer. So that is the reason on the one hand we see hard-work and dedication and on the other we see hypocrisy, ego, deception and false pride. As a reader scan through the pages, he witnesses tears, agony and despair and at the same time he also sees the smiles of relief from the pains of disease. All these is happening surrounding the Big-C, who seems to be unperturbed and is moving ahead with its universal program which it is destined to execute. It is these stories which startle the reader who realizes about the nature of the cancer cell and its un-predictable behavior.

A logical reader does not limit himself in being submerged into the literary masterpiece of such a serious work. The reader questions and raises doubt. Like cancer has been named as “Emperor of Maladies”. In the world of disease the role of King, General and subjects is in a state of continuous flux. In the background of this flux there are problems of the race (s) prevalent in a nation, the character of the existing time, responsibility of state and all these form a complex equation. Hence it will probably not be appropriate to impose the emperor of maladies of one nation as the emperor for others. The “Biography of Cancer” also appears to be a bit of over-usage of the word “Biography”. If you talk of life history of cancer, then the question of its birth is inevitable, thought subtly accepting it the author has preferred to avoid its details. Cellular science has taught us that the commencement of life has link to cancer. The reality of cells shows that, even it is undesired; cancer is a part and parcel of our lives. The author though has accepted that ‘cancer has been stitched into our genome’ but has not been able to realize its significance.

If Mr. Mukherjee was committed in presenting the facts in its entirety than he would not have started his narration of cancer history from 2500 BC, he could have spoken about Mohenjo-Daro (i.e. 4000 BC) where ample evidences on realization of mankind about cancer were there. From 2500BC he takes a great leap to 500BC and tells the story of breast cancer of Atossa, the queen of Persia. We came to know from the journal of “Medical History” way back in 1959 as written by A T Sandyson that her majesty did not have breast cancer at all. After going through the pages we learn that the term “Cancer” was derived from the word Karkinos as coined by Hippocrates around 300BC. So according to this book there was no treatment of cancer done by our famous Charaka and Sushsruta (around 600 BC) implying there was no malady known as “Karkat”, its like America did not exist before Columbus.

 It appears that more than his concern for the biography of cancer, he is more enthused about the “War on Cancer”. Causal association of virus with cancer remains a common illusion of the cancer establishments and probably unwillingly the author is also trapped in the same. Robert N Proctor’s history on War of Cancer has been published in the year 2000  (“The Nazi war on Cancer”) and it cannot be assumed that the author is unaware that the history is devoid of glory. The dedication of numerous scientists towards cancer research is an undisputable truth. However it should be borne in mind that true scientist never provoke for war on the contrary they find means for its avoidance and seek avenues for further development. The author’s unquestionable faith towards the establishment and his youthful zeal makes him appeal for war but definitely it is done in a poetic manner in this work.

Though it is accepted that cancer cannot be eradicated, a clarion call for war with ‘Magic and Targeted Bullet’ is given. However he hesitates to understand that the bullets are neither magic nor targeted. Despite knowing full well that chemotherapy does little good to cancer patients he continues to have faith on it. Our dreams and cellular realities are altogether two different aspects, remains un-articulated in the book. On the contrary he is romanticized by “Early Detection” and talks of holy-war against smoking for the prevention of cancer as evidenced in galore in the pages of this book, but not a single world is uttered against diesel. The rate of cancer of lungs in Japan has increased despite a substantial decrease in smoking is also a fact and many such truth has not been a part of the agenda discussion of the author. Hence how despite cancer life can go-along is also not presented to the readers.

While reading this book one can get an impression the author’s thought process is limited within a periphery and at times chauvinist outlook has fascinated him. Else while talking about medical scams he goes and gives examples about Lanka (read South Africa) while the genesis of such scams is in Ayodhya (read New York) is glossed over. Patch Work Mouse by Joseph Hixon written in 1976 is a case in the point. Presentation of half truths cannot make a history complete. “We will be victorious in our war against cancer, we might have to redefine the meaning of the victory”, has been the conclusion of Mr. Siddhartha Mukherjee. We can have our limitless aspiration but whether that is going to alter the life of cancer is not possible to comment. Despite all these Mr. Mukherjee will be remembered by the readers for presenting such a complex topic like cancer in such a simple and literary manner. We wish that Mr. Mukherjee continue his research casting aside his illusions and obsessions.

[Translated from Bengali by Abhijit Mukherjee]



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