Mar 20

Book Review: The Emperor of All Maladies

The Emperor of All MaladiesThe Emperor of All Maladies by Siddhartha Mukherjee

My friend recommended this book, and I so value the strength of her recommendation that I bought it as an audiobook despite the daunting 20 hour length. It did occur to me that a book about cancer is perhaps not the best book for a hypochondriac to read, but I got through all of it without any imaginary tumors, so that turned out okay.

This book is a little like GUNS GERMS AND STEEL, where it may not be the easiest read, but if you get all the way through it, you will be a better informed and wiser person. The subtitle of this novel is “a biography of cancer,” which is accurate in that it covers cancer from the earliest known recorded instance (an Egyptian queen who had her Greek slave remove her tumor-laced breast) to a case concurrent with the writing of the novel, a woman named Carla who came down with leukemia. The author, a doctor new to the oncology ward, talks about his patients and his interactions with them, but the bulk of the book deals with the history of how the medical profession has dealt with this ancient malady over the centuries.

There are parts of this book that squicked me out, notably the visceral descriptions of how radical masectomies of the late nineteenth and early twentieth centuries hacked apart women’s torsos, yet failed to spare them from death by breast tumor (unless the surgeries killed them first). Descriptions of bone marrow transplants also induced cringing. The history of cancer is the history of millions of deaths, each one a poignant and unfair tragedy. Mukherjee could have milked this and made this book completely maudlin, but I am glad he didn’t. Cancer is tragic enough without embellishment. He does include many interesting quotes and epitaphs from doctors and scientists and patients, ranging from the spiritual to the dryly pedantic.

There are many heroes in this book. Mukherjee sings the praises of the tireless activists who raised money for cancer research, and to various researchers, such as the man who persisted in researching pap smears, even though he didn’t know they would ever prove useful. He talked about the molecular chemists who snuck behind the backs of their own drug companies to go ahead with research that turned out to provide a near-univeral cure for a once-fatal form of cancer. He discussed the history of the original “Jimmy” of the “Jimmy fund” which raised money for a children’s cancer hospital. He tracked down one of the original patients in the first children’s cancer hospital and recorded her memories of her time there.

As with many books about science, there were sections where I felt I didn’t have the necessary background in organic chemistry or molecular biology to really get a good understanding of what was going on. I know what a protein is, but when there are eight or nine different proteins, and they all have short, two letter names my eyes started to glaze over.  People with a heftier background in science may get more out of it.

The main flaw of this book, and its strength, is that it’s comprehensive. That is to say, it’s more comprehensive than most people will ever need to know about cancer, unless they are unfortunate enough to have cancer touch their lives. This is a flaw in that, as I said, 20 hours is a long time to listen to mountains of research about a disease I don’t have. It’s good information to have, however. As we get older and older, our individual chances of getting some form of cancer in our lifetimes gets close to 1 in 3, so I was glad that I was able to get a general overview of this disease, because it frequently impacts everyone’s life either directly or indirectly.

I recommend this book for people who like to read about diseases and medical history. I recommend it for cancer patients or loved ones who are already reading obsessively about a particular type of cancer, because it will round out your bibliography. I recommend it for medically-inclined nerds, and voracious science buffs. I also recommend it for people who have an interest in the AIDS crisis, because it seems that there’s a lot of overlap. I don’t recommend it for hypochondriacs, or for people who want a fast-paced, easy read.

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